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Ekström H, Svensson M, Elmståhl S, Wranker LS. The association between loneliness, social isolation, and sleep disturbances in older adults: A follow-up study from the Swedish good aging in Skåne project. SAGE Open Med 2024; 12:20503121231222823. [PMID: 38249948 PMCID: PMC10798090 DOI: 10.1177/20503121231222823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 12/02/2023] [Indexed: 01/23/2024] Open
Abstract
Objectives The aim of this follow-up study was to investigate whether loneliness and social isolation in a sample of older adults, mean age of 67.4 years at baseline examination, were associated with sleep disturbances at re-examination at a mean age of 76.4 years. Methods The study sample consisted of 2897 participants. Data on loneliness, social isolation, and sleep disturbances were collected through questionnaires and medical examinations. Logistic regression models were constructed to identify associations between levels of loneliness and social isolation at baseline and sleep disturbances at follow-up. Sociodemographic and health-related confounding factors were controlled for in the models. Results Sleep disturbances were reported by 25.6% (95% CI: 24.0%-27.2%) at baseline and 23.7% (95% CI: 22.1%-25.3%) at re-examination. Odds ratios for sleep disturbances at re-examination in relation to not being lonely or socially isolated were as follows: single occasions of loneliness (OR: 1.37, 95% CI: 1.05-1.78), recurring periods/constant loneliness (OR: 1.92, 95% CI: 1.01-1.99), less severe social isolation (OR: 1.18, 95% CI: 0.78-1.79), and severe social isolation (OR: 1.88, 95% CI: 1.01-3.49). Discussion Sleep disturbances are common among older adults and are associated with loneliness and social isolation. Healthcare professionals should be aware of the potential effects of loneliness and social isolation when investigating sleep disturbances in older adults.
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Affiliation(s)
- Henrik Ekström
- The Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Markus Svensson
- The Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Sölve Elmståhl
- The Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Lena Sandin Wranker
- The Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
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Yang H, Gao X, Lian Y, Wu T, Yang Z, Wu Q. Associations of Leisure Activities and Sleep Duration with Cognitive Function: A Nationwide Prospective Cohort Study of Chinese Old Adults. J Alzheimers Dis 2023; 94:303-311. [PMID: 37248901 DOI: 10.3233/jad-230112] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Leisure activities and sleep duration are correlated and have been linked to cognitive function, but most studies have examined only one of these factors. OBJECTIVE To investigate the independent and joint associations of leisure activities and sleep duration with cognitive function among older adults. METHODS We included 7,796 participants aged≥65 years from the Chinese Longitudinal Healthy Longevity Survey during 2008-2018 (waves 5-8). Self-reported leisure activities and sleep duration were assessed at baseline, and cognitive function was measured repeatedly using the Chinese version of the Mini-Mental State Examination (MMSE) at baseline and during follow-up. We used linear mixed models to estimate regression coefficients (β) and 95% confidence intervals (CI). RESULTS The median follow-up duration was 5.77 years. After adjusting for each other and potential confounders, both lower leisure activity score (each 1-point decrease β= -0.33, 95% CI: -0.36 to -0.30) and longer sleep duration (each 1-hour increase β= -0.17, 95% CI: -0.22 to -0.11) were independently associated with lower MMSE score. Furthermore, we observed an additive interaction between leisure activities and sleep duration (pinteraction < 0.001). A combination of low leisure activity score and long sleep duration was strongly associated with decreased MMSE score (β= -2.51, 95% CI: -2.85 to -2.16) compared with the group with combined high leisure activity score and normal sleep duration. CONCLUSION Both leisure activities and sleep duration were independently associated with cognitive function. Moreover, the combination of leisure inactivity and prolonged sleep duration predicted worse cognitive function (a preclinical hallmark of Alzheimer's disease) in an additive manner.
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Affiliation(s)
- Haimei Yang
- Department of Prevention and Health Care, Daping Hospital, Army Medical University, Chongqing, China
| | - Xia Gao
- Department of Health Management, Daping Hospital, Army Medical University, Chongqing, China
| | - Yan Lian
- Department of Prevention and Health Care, Daping Hospital, Army Medical University, Chongqing, China
| | - Tingting Wu
- Department of Prevention and Health Care, Daping Hospital, Army Medical University, Chongqing, China
| | - Zongming Yang
- Department of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou, China
| | - Qianrong Wu
- Department of Prevention and Health Care, Daping Hospital, Army Medical University, Chongqing, China
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Amiri A, Kalantari M, Gharebashloo F. Association between leisure activities and sleep disturbances among children with and without cerebral palsy. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2022. [DOI: 10.12968/ijtr.2021.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background/Aims Sleep disturbances are common among children with cerebral palsy, resulting in adverse consequences. Investigating the association between leisure activities and sleep disturbances could help to develop ways to promote their sleep quality. This study primarily aimed to investigate the association between leisure activities and sleep disturbances among children with and without cerebral palsy. The secondary aim was to study the prevalence of sleep disturbances and some of its associated factors. Methods A total of 75 children with cerebral palsy (study group) (mean age 10.0 ± 2.5 years) and 75 typically developing children (control group) (mean age 10.5 ± 2.9 years) were randomly selected to completed the Children's Assessment of Participation and Enjoyment. Sleep disturbances were assessed using the Sleep Disturbance Scale for Children. Factors associated with sleep disturbances (age, gender, school attendance, bedroom sharing, type of cerebral palsy, motor functions, eating and drinking ability and communication functions) were statistically analysed and the prevalence of sleep disturbances was calculated. Results Overall frequency of leisure participation was strongly correlated with overall sleep disturbances (P<0.001) among both groups. The prevalence of overall sleep disturbances was 17.1% and 10.6% among the study and the control groups respectively. Eating and drinking ability and spastic quadriplegia emerged as the strongest predictors of overall negative scores on the Sleep Disturbance Scale for Children. Conclusions Greater participation in leisure activities is associated with better sleep. Occupational therapists are encouraged to consider this association when planning for occupation-based interventions aimed at enhancing occupational performance.
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Affiliation(s)
- Alireza Amiri
- Physiotherapy Research Centre, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Minoo Kalantari
- Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Gharebashloo
- Physiotherapy Research Centre, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Balikji J, Hoogbergen MM, Garssen J, Roth T, Verster JC. Insomnia Complaints and Perceived Immune Fitness in Young Adults with and without Self-Reported Impaired Wound Healing. Medicina (B Aires) 2022; 58:medicina58081049. [PMID: 36013516 PMCID: PMC9412748 DOI: 10.3390/medicina58081049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/31/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: Adequate sleep and an effective immune system are both essential to maintain a good health status. The current study aimed to determine the nature of insomnia complaints and perceived immune fitness among Dutch young adults with and without self-reported impaired wound healing. Materials and Methods: A total of (n = 2033) Dutch students (83.8% women) completed an online survey. Perceived immune fitness was assessed with a single-item scale and insomnia complaints with the SLEEP-50 insomnia subscale. The sample comprised a control group without self-reported impaired wound healing (n = 1622), a wound infection (WI) group (n = 69), a slow healing wounds (SHW) group (n = 250), and a COMBI group that experienced both WI and SHW (n = 92). Results: Comparisons with the control group revealed that individuals of the SHW and COMBI groups reported significantly poorer perceived immune functioning, increased insomnia complaints and daytime fatigue, and poorer sleep quality. Conclusions: Individuals with self-reported impaired wound healing have a poorer perceived immune functioning, increased insomnia complaints, daytime fatigue, and poorer sleep quality.
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Affiliation(s)
- Jessica Balikji
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands
| | - Maarten M. Hoogbergen
- Division of Plastic Surgery, Catharina Ziekenhuis, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands
| | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands
- Global Centre of Excellence Immunology, Nutricia Danone Research, 3584 CT Utrecht, The Netherlands
| | - Thomas Roth
- Sleep Disorders & Research Centre, Henry Ford Hospital, Detroit, MI 48202, USA
| | - Joris C. Verster
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia
- Correspondence: ; Tel.: +31-30-253-6909
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Kim DE, Kim E. Types of social activities associated with fewer insomnia symptoms and the mediating role of loneliness in older adults. Psychogeriatrics 2022; 22:299-307. [PMID: 35128761 DOI: 10.1111/psyg.12813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/24/2021] [Accepted: 01/17/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND A positive association has been known to exist between social activity engagements and fewer insomnia symptoms in later life. However, little is known about which social activities are associated with insomnia symptoms. Investigating mediating factors in this relationship may contribute to developing effective strategies for the reduction of sleep complaints in older adults. This study aimed to examine the mediating role of loneliness on the relationship between engagement in different social activities and insomnia symptoms. METHODS We used secondary data from the 2018 Health and Retirement Study. The study sample included 3236 older adults who responded to a survey on social activity engagement, insomnia symptoms, and loneliness. After adjusting for covariates, simple mediation analyses were performed with bootstrapping to identify the mediating role. RESULTS Among the several types of social activities, higher levels of engagement in educational courses and community arts group had a significant and direct relationship with fewer insomnia symptoms in older adults. Mediation analyses confirmed the mediating role of loneliness in the relationship between these specific social activity engagements and insomnia symptoms. CONCLUSION These findings provide new evidence for associations among social activity, loneliness, and insomnia symptoms in older adults.
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Affiliation(s)
- Da Eun Kim
- College of Nursing and Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea
| | - Eunjoo Kim
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) four project, College of Nursing, Seoul National University, Seoul, South Korea
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Filipczyk K, Smolarczyk-Kosowska J, Kunert Ł, Filipczyk P, Dębski P, Piegza M, Pudlo R. Physical, Cognitive and Social Rehabilitation in Relation to Sleep Quality and Cognitive Functions in the Elderly. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105148. [PMID: 34067939 PMCID: PMC8152037 DOI: 10.3390/ijerph18105148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/04/2021] [Accepted: 05/09/2021] [Indexed: 11/16/2022]
Abstract
The aim of the study was to assess cognitive functions and sleep quality after a 3-month holistic intervention including physical, social and cognitive rehabilitation in patients 65+. Twenty-nine people participated in the study. The study was divided into two stages. In the first stage, a self-administered questionnaire consisting of sociodemographic questions was used, and cognitive functions were assessed using the Rey-Osterrieth complex figure test, Addenbrooke's Cognitive Examination III (ACE III) test, Montreal Cognitive Function Assessment Scale (MoCA) and digit repetition test. All patients were also assessed for sleep quality using the Athens Insomnia Scale (AIS). After three months, the patients were assessed for cognitive functions and sleep quality, which was the second stage of the study. Analysis of the results obtained by patients in the study showed a statistically significant improvement in sleep quality and cognitive function. Rehabilitation activities, including physical training, cognitive exercises and occupational therapy, reduce the severity of mild cognitive disorders and reduce insomnia.
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Affiliation(s)
- Karolina Filipczyk
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 42-612 Katowice, Poland; (J.S.-K.); (Ł.K.); (P.D.); (M.P.); (R.P.)
- Correspondence: ; Tel.: +48-32-285-43-58
| | - Joanna Smolarczyk-Kosowska
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 42-612 Katowice, Poland; (J.S.-K.); (Ł.K.); (P.D.); (M.P.); (R.P.)
| | - Łukasz Kunert
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 42-612 Katowice, Poland; (J.S.-K.); (Ł.K.); (P.D.); (M.P.); (R.P.)
| | - Przemysław Filipczyk
- Faculty of Health Sciences, Jan Długosz University in Czestochowa, 42-200 Czestochowa, Poland;
| | - Paweł Dębski
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 42-612 Katowice, Poland; (J.S.-K.); (Ł.K.); (P.D.); (M.P.); (R.P.)
| | - Magdalena Piegza
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 42-612 Katowice, Poland; (J.S.-K.); (Ł.K.); (P.D.); (M.P.); (R.P.)
| | - Robert Pudlo
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 42-612 Katowice, Poland; (J.S.-K.); (Ł.K.); (P.D.); (M.P.); (R.P.)
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Kim DE, Roberts TJ, Moon C. Relationships among types of activity engagement and insomnia symptoms among older adults. BMC Geriatr 2021; 21:87. [PMID: 33516192 PMCID: PMC7847011 DOI: 10.1186/s12877-021-02042-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 01/20/2021] [Indexed: 01/18/2023] Open
Abstract
Background An increasing awareness exists that lack of activity engagement is associated with insomnia symptoms. However, the majority of studies have focused on the association between a single type of activity engagement and insomnia symptoms. Methods This is a cross-sectional study using secondary data from the Health and Retirement Study examining the relationships among different types of activity engagement and insomnia symptoms among older adults. The sample for this study included 3321 older adults who responded to survey modules on activity engagement and insomnia symptoms in 2016. Activity engagement was measured using items for three types of activities (i.e., social, cognitive, and physical) validated in this study. Insomnia symptoms were measured using four items (i.e., difficulty of falling asleep, waking up during the night, waking up too early, and feeling rested). Independent t-tests were conducted to identify the differences in insomnia symptoms according to activity engagement level. Regressions were conducted to examine the associations among three types of activity engagement and insomnia symptoms after adjusting for covariates such as demographics, chronic disease, activities of daily living difficulty, cognitive function, sleep disorder, loneliness, and caregiving. Results The respondents in the high-level social, cognitive, and physical activity engagement groups were found to show fewer insomnia symptoms. Furthermore, higher social (β = − 0.04, p = 0.040) and cognitive (β = − 0.06, p = 0.007) activity engagements were associated with fewer insomnia symptoms even after adjusting for other types of activity engagement and all covariates. Conclusions This study suggests that older adults with higher social and cognitive activity engagements may be likely to have fewer insomnia symptoms. Based on these results, future research is needed to develop multi-component intervention programs that can encourage older adults to engage in these activities. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02042-y.
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Affiliation(s)
- Da Eun Kim
- College of Nursing and Research Institute of Nursing Science, Kyungpook National University, Daegu, Republic of Korea.
| | - Tonya J Roberts
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Chooza Moon
- College of Nursing, University of Iowa, Iowa City, IA, USA
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Jalali R, Mohammadi M, Vaisi-Raygani A, Salari N. The prevalence of sleep disorders among Iranian older adults: A systematic review and meta-analysis. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-020-01252-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cybulski M, Cybulski L, Krajewska-Kulak E, Orzechowska M, Cwalina U, Kowalczuk K. Sleep disorders among educationally active elderly people in Bialystok, Poland: a cross-sectional study. BMC Geriatr 2019; 19:225. [PMID: 31426755 PMCID: PMC6701151 DOI: 10.1186/s12877-019-1248-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 08/13/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Sleep disorders in an ageing society constitute a significant public health problem. It is estimated that approximately 50% of people aged 55 years and older have trouble sleeping, including initiating and maintaining sleep. The aim of this study was to determine the prevalence of sleep disorders in a group of educationally active elderly people living in Bialystok, Poland. METHODS The study included a total of 182 people - residents of Bialystok - aged 60 or older; 146 women (80.22%) and 36 men (19.78%). The study used three standardized psychometric scales: The Athens Insomnia Scale (AIS), The Epworth Sleepiness Scale (ESS) and The Insomnia Severity Index (ISI). RESULTS More than half of the respondents scored 6 or more points on the AIS, which is considered a value that indicates a high probability of insomnia symptom occurrence. A similar percentage of respondents obtained a point value on the ISI indicating the presence of insomnia. The vast majority of respondents scored below 11 points on the ESS, which means no symptoms of excessive sleepiness. There was a significant correlation between the results of the above scales in the examined group in total and also by sex. CONCLUSIONS Sleep disorders, particularly insomnia, constitute a significant social and health problem in the group of educationally active elderly people living in Bialystok. In light of the obtained study results, it is recommended to conduct and improve existing health education programs aimed at the elderly regarding sleep disorders to improve the quality of their sleep, and thus quality of life, and raise the awareness of the elderly about the importance of sleep in everyday life. There is a need for further research in the field of sleep disorders in the elderly to determine the prevalence of these disorders on a national scale.
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Affiliation(s)
- Mateusz Cybulski
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, 7a M. Sklodowskiej-Curie str., 15-096, Bialystok, Poland.
| | - Lukasz Cybulski
- National security student, Faculty of Social Sciences, University of Warmia and Mazury in Olsztyn, 14 Zolnierska str., 10-561, Olsztyn, Poland
| | - Elzbieta Krajewska-Kulak
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, 7a M. Sklodowskiej-Curie str., 15-096, Bialystok, Poland
| | - Magda Orzechowska
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, 7a M. Sklodowskiej-Curie str., 15-096, Bialystok, Poland
| | - Urszula Cwalina
- Department of Statistics and Medical Informatics, Faculty of Health Sciences, Medical University of Bialystok, 37 Szpitalna str., 15-295, Bialystok, Poland
| | - Krystyna Kowalczuk
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, 7a M. Sklodowskiej-Curie str., 15-096, Bialystok, Poland
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Correlates of sleep quality and sleep duration in a sample of urban-dwelling elderly Nigerian women. Sleep Health 2017; 3:257-262. [PMID: 28709512 DOI: 10.1016/j.sleh.2017.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 05/14/2017] [Accepted: 05/17/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Aging, female sex, and urbanization increase the risk of sleep impairment. Sleep in urban-dwelling elderly African women has been sparsely studied. We studied the characteristics and correlates of sleep quality and habitual sleep duration in a primary care population of urban-living Nigerian women. METHODS Sleep quality and sleep duration over the previous 1 month were estimated using the Pittsburgh Sleep Quality Index (PSQI). Excessive daytime sleepiness, risk of obstructive sleep apnea (OSA), and depressive symptoms were also assessed. RESULTS Of the 428 subjects included, 117 (27.3%) were poor sleepers endorsing PSQI scores >5, whereas 126 (29.4%) slept <7 hours. The poor sleepers were more likely to be obese (P = .022), to have a high risk for OSA (P = .013), and to have clinically significant depressive symptoms (P = .001) compared with the good sleepers. Habitual sleep duration of <7 hours was associated with past oral contraceptive use (P = .025) and a trend toward a higher likelihood of high risk for OSA (P = .05) and coffee consumption (P = .05). On regression, the odds of high risk for OSA were higher with poor sleep quality and sleep duration <7 hours, respectively, whereas the odds of coffee consumption were higher with sleep duration <7 hours. CONCLUSIONS Poor sleep quality and inadequate sleep are common in our population of elderly women. High risk for OSA independently predicts poor sleep quality and, along with report of coffee consumption, independently predicts habitual sleep duration of <7 hours.
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Hellström A, Nilsson C, Nilsson A, Fagerström C. Leg ulcers in older people: a national study addressing variation in diagnosis, pain and sleep disturbance. BMC Geriatr 2016; 16:25. [PMID: 26797291 PMCID: PMC4722676 DOI: 10.1186/s12877-016-0198-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 01/12/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Leg ulcers commonly emerge as a symptom of other comorbidities, often in older people. As a consequence of the ulcer, pain and sleep disturbances might occur. Due to the complex illness, the responsibility of treatment is unclear between health caregivers. The interaction between ulcer type, sleep and pain has not previously been investigated. This study aimed to explore pain in older men and women (65 years and older) with different diagnoses of leg ulcers and to investigate the associations of sleep disturbances and pain in people with leg ulcer diagnosis. METHODS The study used a cross-sectional design and data from the Swedish Registry of Ulcer Treatment, collected between May 2009 and December 2013. One thousand and eight hundred and twenty four people were included, and 62.9% were women. The mean age was 83.4 years (SD 8.8). For the analyses, the chi-square test, Mann-Whitney U-test, t-test, one-way ANOVA and logistic regression was performed. Pain was measured by the Numeric Rating Scale (NRS), and sleep disturbances was assessed dichotomously. RESULTS We found the prevalence of pain intensity ≥ 5 on the NRS to be 34.8% in those reporting pain. Additionally, the pain intensity was associated with the number of ulcers (p = 0.003). Sleep disturbances were associated with pain (p < 0.001) and were found in 34.8% of the total sample. Although more women than men reported pain and scored higher on the NRS, no significant gender difference in sleep disturbances was found (p = 0.606). The mean NRS scores did not differ significantly between the ulcer types; however, arterial and venous-arterial ulcers increased the risk of sleep disturbances, as did higher pain scores. CONCLUSIONS The majority of the participants were of advanced age (>80 years) and frequently suffered from pain and sleep disturbances. Further research is needed regarding pain, sleep and wound healing in the oldest old with leg ulcers. Ulcer pain sometimes appears to receive less attention in ulcer management, as do sleep disturbances, implying that individual needs might not be satisfactorily met. National guidelines in managing leg ulcers, which also consider consequences such as sleep disturbances, pain and discomfort, are needed.
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Affiliation(s)
- Amanda Hellström
- Department of Health and Care Sciences, Linnaeus University, Stagneliusg. 14, SE-392 34, Kalmar, Sweden.
| | | | | | - Cecilia Fagerström
- Blekinge Institute of Technology, Blekinge Centre of Competence, Karlskrona, Sweden.
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