Sleep Quality in Hospitalized Elderly- Literature Review (original) (raw)
Related papers
2017
Sleep is essential to everyone's health and wellbeing. Between 30-40% of people experience impaired sleep and is most common in older adults. Older adults also experience a higher number of hospitalisations in comparison to any other age group. This thesis aimed to investigate the causes and consequences of impaired sleep quality for older adults during and following hospital admission. Over 80% of older adults with self-reported poor sleep do not discuss it with any health professionals. This thesis has demonstrated that there is need for future research to justify effective and successful interventions to improve sleep quality for older adults.
Sleep disturbance in older ICU patients
Clinical Interventions in Aging, 2014
Maintaining a stable and adequate sleeping pattern is associated with good health and disease prevention. As a restorative process, sleep is important for supporting immune function and aiding the body in healing and recovery. Aging is associated with characteristic changes to sleep quantity and quality, which make it more difficult to adjust sleep-wake rhythms to changing environmental conditions. Sleep disturbance and abnormal sleep-wake cycles are commonly reported in seriously ill older patients in the intensive care unit (ICU). A combination of intrinsic and extrinsic factors appears to contribute to these disruptions. Little is known regarding the effect that sleep disturbance has on health status in the oldest of old (80 ), a group, who with diminishing physiological reserve and increasing prevalence of frailty, is at a greater risk of adverse health outcomes, such as cognitive decline and mortality. Here we review how sleep is altered in the ICU, with particular attention to older patients, especially those aged 80 years. Further work is required to understand what impact sleep disturbance has on frailty levels and poor outcomes in older critically ill patients.
Sleep Quality in the Admitted Elderly: A Prospective Observational Study in Eastern India
Bengal Physician Journal
Background: With declining age, elderly admissions are encountered with sleep disturbances during the hospital stay. Poor sleep health can adversely affect many organ functions causing a weakened immune system, increased adverse cardiovascular events, impaired cognitive function, and increased fall risk and frailty in the elderly. The present study tried to address the issue of sleep quality in admitted elderly patients in a hospital setup. Materials and methods: A prospective observational study was conducted among the elderly inpatients of a few tertiary care setups in Eastern India. Patients were personally interviewed to evaluate the history of sleep quality at home, sleep quality after the first and the third days of admission, and potential associated factors. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality in the subjects. Patient-reported factors contributing to poor sleep health were noted. Data were statistically analyzed. Results: Sleep efficiency is significantly affected by hospital stay. The global PSQI score conferred poor sleep quality in 51.05% elderly in baseline, 58.64% after the first night of hospitalization, and 62.86% after the third night of hospitalization. Sleep quality was assessed using PSQI questionnaire. Prolonged sleep latency and decreased total sleep duration were noted among study participants at the third time point in comparison with the first. Factors like doctor-nurse interruption, pain, light, and noise as some of the most frequently reported factors contributed to poorer sleep. Higher age, infrequent physical activity, previous history of hospitalization, anxiety, and depressive state were significantly associated with higher odds of poor sleep quality. Conclusion: The study demonstrated that overall sleep quality was significantly affected during hospital stay in older adults. Patient-reported factors contributing toward poorer sleep health must be intervened in order to achieve better treatment outcomes in the elderly.
Effectiveness of strategies to manage sleep in residents of aged care facilities
JBI Reports 2(4) :115-83., 2004
Background The promotion of sleep in older adults is a significant issue in high-level residential aged care facilities, with as many as 67% of residents experiencing disruptions to their sleep patterns. Not only do health concerns such as cognitive impairment, pain and incontinence impact upon this population's sleep quality and quantity, but environmental factors including noise, light and night-time nursing care also affect sleep of those residing in institutions. In order to address the issue of sleep disruption, assessment and diagnosis of sleep problems and implementation of interventions that are effective in promoting sleep are essential.Objectives The objective of this review was to determine the most effective tools for the assessment and diagnosis of sleep in older adults in high-level aged care. The review also sought to determine the most effective strategies for the promotion of sleep in this population. Outcome measures for this review were: indicators of improved sleep quality and quantity, including an improvement in daytime functioning and improved night-time sleep; reduction in use of hypnotics and sedatives; and increased satisfaction with sleep.Search strategy A literature search was performed using the following databases for the years 1993–2003: AgeLine, APAIS Health, CINAHL, Cochrane Library, Current Contents, Dissertation Abstracts International, Embase, Medline, Proquest, PsycInfo, Science Citations Index. A second search stage was conducted through review of reference lists of studies retrieved during the first search stage. The search was limited to published and unpublished material in English language.Selection criteria The review was limited to papers addressing sleep diagnosis, assessment and/or management in adults aged 65 or over who were residing in high-level aged care. The review included randomised controlled trials (RCTs) and, due to the limited number of RCTs available, non-RCTs, cohort and case control studies and qualitative research were also considered for inclusion. Research was included if it addressed the assessment, diagnosis or management of sleep using outcome measure of improved night-time sleep or daytime function, improvements in resident satisfaction with sleep or reduction in medication use associated with sleep. The types of interventions considered by this review were alternative therapies including massage, aromatherapy and medicinal herbs; behavioural or cognitive interventions; biochemical interventions; environmental interventions; pharmacological interventions and related nocturnal interventions such as continence care. Instruments and strategies to diagnose and assess the sleep of older high-level care residents, including objective and subjective assessment tools, were considered by this review.Data collection and analysis All retrieved papers were critically appraised for eligibility for inclusion and methodological quality independently by two reviewers, and the same reviewers collected details of eligible research. Papers were grouped according to the type of intervention or type of assessment tool used and findings were presented in a narrative summary.Findings Wrist actigraphy was found to be the most accurate objective sleep assessment tool for use in the population of interest, and issues surrounding its use are presented. Although no subjective sleep assessment tools were identified in this review, the evidence suggested that subjective reports of sleep quality are an important consideration in sleep assessment. Evidence suggested that behavioural observations may be an effective assessment strategy when conducted on a frequent basis. The review found no evidence on the effectiveness of any assessment tools for the diagnosis of specific sleep problems in older adults. The use of multidisciplinary strategies including reduction of environmental noise, reduction of night-time nursing care that disrupts sleep and daytime activity is likely to be the most effective strategy for the promotion of sleep in older high-level care residents. The use of sedating medications did not appear to have a substantial effect in promoting sleep, and health practitioners in high-level aged care should consider their use cautiously.
Client – centered Nursing Care Journal, 2025
Background: One of the aspects affecting the quality of life (QoL) of the older adults is sleep quality. Hospitalized older adults may experience a poor quality of sleep due to one or more diseases and their related disabilities. This study determines the predictive role of disability and comorbidities in the sleep quality of hospitalized elderly patients. Methods: This cross-sectional, correlational study was conducted on 300 hospitalized older adults admitted to the teaching hospitals affiliated with Qazvin University of Medical Sciences, Iran, in 2023. The subjects were recruited via convenience sampling. The data were collected using the demographic characteristics form, the Pittsburgh sleep quality index, the World Health Organization (WHO) disability assessment schedule 2.0 and the Charlson comorbidity index. They were analyzed using the chi-square test or the Fisher exact test, independent t-test, and binary logistic regression in the SPSS software, version 26. In addition, the statistical significance was set at P<0.05. Results: The Mean±SD sleep quality, disability and comorbidity scores were 6.12±2.99, 23.36±9.20 and 1.15±0.37, respectively. Half of the older adults (50%) had poor sleep quality. There was a significant relationship between the sleep quality scores and all domains of disability (P<0.05) except for participation and life activities (P≥0.05). The results of the logistic regression model showed that disability (odd ratio=1.044, P<0.004) and comorbidities (odd ratio=2.078, P<0.044) were predictors of sleep quality in hospitalized older adults. No significant relationship was observed between sleep quality and gender, education, smoking, and non-opioid analgesics in multivariate regression analysis. Conclusion: Disability and comorbidities are important predictors of sleep quality in hospitalized older adults; therefore, it is necessary to consider effective interventions to minimize hospitalization-associated disability and to help improve the sleep quality of older adults.
Frontiers in Aging Neuroscience, 2016
Objective/Background: We examined the rates, predictors, and outcomes [mortality risk (MR), length of stay (LOS), and total charges (TC)] of sleep disturbances in older hospitalized patients. Patients/Methods: Using the U.S. Nationwide Inpatient Sample database (2002-2012), older patients (≥60 years) were selected and rates of insomnia, obstructive sleep apnea (OSA) and other sleep disturbances (OSD) were estimated using ICD-9CM. TC, adjusted for inflation, was of primary interest, while MR and LOS were secondary outcomes. Multivariable regression analyses were conducted.
Sleep in hospitalized medical patients, Part 1: Factors affecting sleep
Journal of Hospital Medicine, 2008
BACKGROUND: Multiple factors lead to sleep disturbances in hospitalized medical patients. Inadequate sleep can lead to both psychological and physiological consequences. METHODS: A PubMed search was conducted using the terms: (''sleep deprivation,'' ''sleep,'' or ''insomnia'') and (''hospitalized,'' ''inpatient,'' ''critical illness,'' or ''acute illness'') to review the published data on the topic of sleep in hospitalized medical patients. The search was limited to English-language articles published between 1997 and 2008. Subsequent PubMed searches were performed to clarify the data described in the initial search, including the terms ''hospital noise,'' ''hospital environment,'' ''obstructive sleep apnea,'' and ''heart failure.'' RESULTS: Few articles specifically addressed the topic of sleep in hospitalized medical patients. Data were limited to observational studies that included outcomes such as sleep complaints and staff logs of wakefulness and sleep. In Part 1, we review normal sleep architecture, and discuss how major medical disorders, the hospital environment, and medications can disrupt sleep during hospitalization. In Part 2, we will propose an evaluation and treatment algorithm to optimize sleep in hospitalized medical patients. CONCLUSIONS: Hospitalization may severely disrupt sleep, which can worsen pain, cardiorespiratory status, and the psychiatric health of acutely ill patients. Like vital signs, the patient sleep quality reveals much about patients' overall well-being, and should be a routine part of medical evaluation.
Risk of Sleep Apnea in Hospitalized Older Patients
Journal of Clinical Sleep Medicine, 2014
Background/Objectives: To assess the prevalence of undiagnosed obstructive sleep apnea (OSA) amongst general medical inpatients and to investigate whether OSA risk is associated with in-hospital sleep quantity and quality. Design: Prospective cohort study. Setting: General medicine ward in academic medical center Participants: 424 hospitalized adult patients ≥ 50 years old without a sleep disorder diagnosis (mean age 65 years, 57% female, 72% African American). Main Measures: The Berlin questionnaire, a validated screen for determining risk of OSA, was administered to hospitalized medical patients. Sleep duration and efficiency were measured via wrist actigraphy. Self-reported sleep quality was evaluated using Karolinksa Sleep Quality Index (KSQI). Key Results: Two out of every five inpatients ≥ 50 years old39.5%, n=168) were found to be high risk for OSA. Mean in-hospital sleep duration was ~ 5 h and mean sleep efficiency was 70%. Using random effects linear regression models, we found that patients who screened at high risk for OSA obtained ~ 40 minutes less sleep per night (-39.6 min [-66.5,-12.8], p=0.004). These findings remained significant after controlling for African American race, sex, and age quartiles. In similar models, those patients who screened at high risk had ~ 5.5% less sleep efficiency per night (-5.50[-9.96,-1.05], p=0.015). In multivariate analysis, patients at high risk for OSA also had lower self-reported sleep quality on KSQI (-.101[-.164,-.037], p=0.002). Conclusion: Two out of every five inpatients older than 50 years screened at high risk for OSA. Those screening at high risk have worse in-hospital sleep quantity and quality.