Quality of Sleep and Related Factors on Elderly Residents of the Nursing Homes

Abstract

Objective: Our study aims to determine the rate of sleep disorders in elderly people aged 65 and older, living in nursing homes in Samsun, and also to investigate the factors affecting sleep quality through a comprehensive geriatric assessment. Methods: Our study was performed in the two largest nursing homes in Samsun province between March 1st and April 30th 2018. The sleep quality of the participating individuals was assessed by the Richard’s Campbell Sleep Questionnaire (RCSQ) and the Epworth Sleepiness Scale (ESS). These individuals in our study were assessed using Geriatric Depression Scale (GDS), Mini-Mental State Examination (MMSE), Short Form 36 Health Survey (SF-36), Charlson Comorbidity Index (CCI). The obtained data were analyzed with SPSS 23.0 and p<0.05 was considered as significant. Results: A total of 84 people were included in the study and the mean age was 77.06±7.97 years. It was determined that 23.8% of the individuals had poor sleep quality at night according to RCSQ and 42.9% of the individuals had increased daytime sleepiness according to ESS. A significant statistical difference was found between the GDS scores with the RCSQ and ESS scores (p<0.001, p=0.001, respectively). The presence of depressive symptoms was associated with sleep quality at night and daytime sleepiness. A statistically significant difference was found between the MMSE and RCSQ scores (p=0.014). The presence of dementia was associated with sleep quality at night. Conclusions: The presence of depressive symptoms was found to cause poor sleep quality at night and increased daytime sleepiness. People with dementia had low sleep quality at night. The low life quality was found to associate poor sleep quality at night and increased daytime sleepiness.

Keywords

• Aged
• Sleep
• Depression

Huzurevinde Yaşayan Yaşlı Bireylerin Uyku Kalitesi ve Etkileyen Faktörler

Abstract

Amaç: Çalışmamızın amacı, Samsun ilinde huzurevlerinde yaşayan 65 yaş ve üzeri yaşlı bireylerde uyku bozukluğu oranını belirlemek ve kapsamlı geriatrik değerlendirme ile uyku kalitesini etkileyen faktörleri incelemektir. Gereç ve Yöntem: Çalışmamız 01 Mart-30 Nisan 2018 tarihleri arasında Samsun ilinin en büyük iki huzurevinde yapıldı. Katılımcı bireylerin uyku kalitesi Richard's Campbell Uyku Ölçeği (RCSQ) ve Epworth Uykululuk Ölçeği (ESS) ile değerlendirildi. Çalışmamızdaki bu bireyler Geriatrik Depresyon Ölçeği (GDS), Mini Mental Durum Testi (MMSE), Kısa Form 36 Yaşam Kalitesi Ölçeği (SF-36), Charlson Komorbidite İndeksi (CCI) kullanılarak değerlendirildi. Elde edilen veriler SPSS 23.0 ile analiz edildi ve p <0.05 anlamlı kabul edildi. Bulgular: Çalışmaya toplam 84 kişi dahil edildi ve ortalama yaş 77,06 ± 7,97 yıldı. Çalışmaya katılan bireylerin %23,8'i RCSQ değerlendirmesine göre geceleri kötü uyku kalitesine ve %42,9'u ESS’ye göre artmış gündüz uykululuk durumuna sahipti. GDS skorları ile RCSQ ve ESS skorları arasında istatistiksel olarak anlamlı fark vardı (sırasıyla; p<0,001, p=0,001). Depresif semptomların varlığı gece uyku kalitesi ve gündüz uykululuk durumu ile ilişkiliydi. MMSE ve RCSQ skorları arasında istatistiksel olarak anlamlı bir fark bulundu (p=0,014). Demans varlığı, gece uyku kalitesiyle ilişkiliydi. Sonuç: Depresif semptomların varlığının gece kötü uyku kalitesine ve gündüz uykululuğunun artmasına neden olduğu saptanmıştır. Demansı olan kişiler, geceleri kötü uyku kalitesine sahipti. Yaşam kalitesinin düşük olmasının gece kötü uyku kalitesi ve gündüz uykululuğunun artması ile ilişkili olduğu tespit edilmiştir.

Keywords

• Yaşlı
• Uyku
• Depresyon

References

1. 1. World Health Organization. Ageing and health (2018) http://www.who.int/ageing/en/ Accessed 08.02.2018. [Online]
2. 2. Siddiqui N, Farooq R, Saadat S, Siddiqui M, Javed Z, Shah A, et al. Poor sleep quality: A wake-up call for the elderly at a tertiary care center in Islamabad, Pakistan. J Pakistan Med Asssoc. 2020:1-14.
3. 3. Ohayon M. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev. 2002;6(2):97-111.
4. 4. Fetveit A, Bjorvatn B. Sleep disturbances among nursing home residents. Int J Geriatr Psychiatry. 2002;17(7):604-9.
5. 5. Foley D, Monjan A, Brown S, Simonsick E, Wallace R, Blazer D. Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep. 1995;18(6):425-32.
6. 6. Leblanc MF, Desjardins S, Desgagne A. Sleep cognitions associated with anxiety and depression in the elderly. Clin Interv Aging. 2015;10:575-82.
7. 7. Meier-Ewert HK, Ridker PM, Rifai N, Regan MM, Price NJ, Dinges DF, et al. Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk. J Am Coll Cardiol. 2004;43(4):678-83.
8. 8. Ong AD, Kim S, Young S, Steptoe A. Positive affect and sleep: A systematic review. Sleep Med Rev. 2017;35:21-32.

9. 9. Roepke SK, Ancoli-Israel S. Sleep disorders in the elderly. Indian J Med Res. 2010;131(2):302-10.
10. 10. Stoica C. Sleep, a predictor of subjective well-being. Procedia-Social and Behavioral Sciences. 2015;187:443-7.
11. 11. Crowley K. Sleep and sleep disorders in older adults. Neuropsychol Rev. 2011;21(1):41-53.
12. 12. Martins da Silva R, Afonso P, Fonseca M, Teodoro T. Comparing sleep quality in institutionalized and non-institutionalized elderly individuals. Aging Ment Health. 2020;24(9):1452-8.
13. 13. Roenneberg T, Kuehnle T, Juda M, Kantermann T, Allebrandt K, Gordijn M, et al. Epidemiology of the human circadian clock. Sleep Med Rev. 2007;11(6):429-38.
14. 14. Campbell SS, Murphy PJ. The nature of spontaneous sleep across adulthood. J Sleep Res. 2007;16(1):24-32.
15. 15. Chokroverty S. Sleep Deprivation and Excessive Daytime Sleepiness. Sleep Disorder Med: Springer; 2017. p. 29-39.
16. 16. Richards K. Techniques for measurement of sleep in critical care. Focus Crit Care. 1987;14(4):34-40.
17. 17. Ozlu Z, Ozer N. Richard-Campbell sleep questionnaire validity and reliability study. J Turk Sleep Med. 2015;2(2):29-32.
18. 18. Izci B, Ardic S, Firat H, Sahin A, Altinors M, Karacan I. Reliability and validity studies of the Turkish version of the Epworth Sleepiness Scale. Sleep Breath. 2008;12(2):161-8.
19. 19. Piani A, Brotini S, Dolso P, Budai R, Gigli GL. Sleep disturbances in elderly: a subjective evaluation over 65. Arch Gerontol Geriatr Suppl. 2004(9):325-31.
20. 20. Eser I, Khorshid L, Cinar S. Sleep quality of older adults in nursing homes in Turkey: enhancing the quality of sleep improves quality of life. J Gerontol Nurs. 2007;33(10):42-9.
21. 21. Tatineny P, Shafi F, Gohar A, Bhat A. Sleep in the Elderly. Mo Med. 2020;117(5):490-5.
22. 22. Rocha FL, Guerra HL, Lima-Costa MF. Prevalence of insomnia and associated socio-demographic factors in a Brazilian community: the Bambui study. Sleep Med. 2002;3(2):121-6.
23. 23. Fabbrini M, Aric AI, Tramonti F, Condurso R, Carnicelli L, De Rosa A, et al. Sleep disorders in menopause: results from an Italian Multicentric Study. Arch Ital Biol. 2015;153(2-3):204-13.
24. 24. Salo P, Vahtera J, Ferrie JE, Akbaraly T, Goldberg M, Zins M, et al. Trajectories of sleep complaints from early midlife to old age: longitudinal modeling study. Sleep. 2012;35(11):1559-68.
25. 25. Neubauer D. Sleep problems in the elderly. Am Fam Phys. 1999;59(9):2551.
26. 26. Lutsey PL, McClelland RL, Duprez D, Shea S, Shahar E, Nagayoshi M, et al. Objectively measured sleep characteristics and prevalence of coronary artery calcification: the Multi-Ethnic Study of Atherosclerosis Sleep study. Thorax. 2015;70(9):880-7.
27. 27. Cuellar NG, Strumpf NE, Ratcliffe SJ. Symptoms of restless legs syndrome in older adults: outcomes on sleep quality, sleepiness, fatigue, depression, and quality of life. J Am Geriatr Soc. 2007;55(9):1387-92.
28. 28. Goktas E, Ozer H, Celik F, Cıray N. The Determination of the Quality of Sleep of the Obese Individual. Dokuz Eylul Univ J Nurs Fac. 2015;8(3):156-61.
29. 29. Schwartz AR, Patil SP, Laffan AM, Polotsky V, Schneider H, Smith PL. Obesity and obstructive sleep apnea: pathogenic mechanisms and therapeutic approaches. Proc Am Thorac Soc. 2008;5(2):185-92.
30. 30. Bixler EO, Vgontzas AN, Lin HM, Calhoun SL, Vela-Bueno A, Kales A. Excessive daytime sleepiness in a general population sample: the role of sleep apnea, age, obesity, diabetes, and depression. J Clin Endocrinol Metab. 2005;90(8):4510-5.
31. 31. Jaussent I, Bouyer J, Ancelin ML, Akbaraly T, Peres K, Ritchie K, et al. Insomnia and daytime sleepiness are risk factors for depressive symptoms in the elderly. Sleep. 2011;34(8):1103-10.
32. 32. Gindin J, Shochat T, Chetrit A, Epstein S, Ben Israel Y, Levi S, et al. Insomnia in long-term care facilities: a comparison of seven European countries and Israel: the Services and Health for Elderly in Long TERm care study. J Am Geriatr Soc. 2014;62(11):2033-9.
33. 33. Azri M, Dahlan A, Masuri M, Isa K. Sleep quality among older persons in institutions. Procedia-social and behavioral sciences. 2016;234:74-82.
34. 34. Cricco M, Simonsick EM, Foley DJ. The impact of insomnia on cognitive functioning in older adults. J Am Geriatr Soc. 2001;49(9):1185-9.
35. 35. Sariyildiz M, Batmaz I, Bozkurt M, Bez Y, Cetincakmak M, Yazmalar L, et al. Sleep quality in rheumatoid arthritis: relationship between the disease severity, depression, functional status and the quality of life. J Clin Med Res. 2014;6(1):44-52.
36. 36. Schubert CR, Cruickshanks KJ, Dalton DS, Klein BE, Klein R, Nondahl DM. Prevalence of sleep problems and quality of life in an older population. Sleep. 2002;25(8):889-93.
37. 37. Hayashino Y, Yamazaki S, Takegami M, Nakayama T, Sokejima S, Fukuhara S. Association between number of comorbid conditions, depression, and sleep quality using the Pittsburgh Sleep Quality Index: results from a population-based survey. Sleep Med. 2010;11(4):366-71.
38. 38. Galimi R. Insomnia in the elderly: an update and future challenges. G Gerontol. 2010;58:231-47.
39. 39. İlhan N, Arpacı S, Havaoğlu D, Kalyoncuoğlu H, Sarı P. Quality of life and factors affecting the quality of life of elderly nursing home residents. Clinical and Experimental Health Sciences. 2016;6(2):56-65.