Daytime sleeping, sleep disturbance, and circadian rhythms in the nursing home.
Daytime sleeping, sleep disturbance, and circadian rhythms in the nursing home.
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DOI：
10.1097/01.jgp.0000192483.35555.a3
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发表时间：
2006-02
期刊：
影响因子：
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通讯作者：
Jennifer L Martin;Adam P. Webber;Tarannum Alam;J. Harker;K. Josephson;C. Alessi
中科院分区：
文献类型：
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作者：
Jennifer L Martin;Adam P. Webber;Tarannum Alam;J. Harker;K. Josephson;C. Alessi
目的本研究报告了疗养院居民日间睡眠异常的频率，并确定了与日间睡眠、夜间睡眠障碍和昼夜节律异常相关的因素。方法：作者对非药物睡眠干预试验中在常规护理条件下收集的数据进行了二次分析。对来自四个洛杉矶疗养院的所有居民进行了日间睡眠筛查（睡眠>或=15%的观察，9：00 am-5：00 pm）。白天睡眠的非住院患者进行两个晚上的腕动记录以评估夜间睡眠障碍（睡眠<80%，10：00 pm-6：00 am）。夜间睡眠障碍的居民完成了额外的72小时腕关节活动记录，以评估昼夜活动节律和光照。结果492名被调查者中，69%的人白天睡眠正常，其中60%的人夜间睡眠受到干扰。睡眠障碍和白天睡眠很少记录在医疗记录中。居民们一天中有三分之一的时间呆在房间里，通常是在床上，很少在户外或暴露在明亮的光线下。更多的时间在床上和较少的社会活动是白天嗜睡的重要预测因素。接受评估的居民中有97%的人昼夜节律异常。白天睡眠较多和夜间睡眠较少与较弱的昼夜活动节律有关。晚些时候的昼夜节律峰期（峰值）与更明亮的光线暴露有关。结论日间嗜睡、夜间睡眠障碍和昼夜节律异常是养老院居民普遍存在的问题。可修改的因素（例如，在床上的时间）与睡眠/觉醒异常有关。心理健康专家应该考虑导致养老院居民睡眠问题的因素的复杂性。
OBJECTIVE This study reports the frequency of abnormal daytime sleeping and identifies factors related to daytime sleeping, nighttime sleep disturbance, and circadian rhythm abnormalities among nursing home residents. METHODS The authors conducted secondary analysis of data collected under usual care conditions within a nonpharmacologic sleep intervention trial. All residents from four Los Angeles nursing homes were screened for daytime sleeping (asleep>or=15% of observations, 9:00 am-5:00 pm). Consenting residents with daytime sleeping had two nights of wrist actigraphy to assess nighttime sleep disturbance (asleep<80%, 10:00 pm-6:00 am). Residents with nighttime sleep disturbance completed an additional 72-hour wrist actigraphy recording to assess circadian activity rhythms and light exposure. RESULTS Sixty-nine percent of 492 observed residents had daytime sleeping, of whom 60% also had disturbed nighttime sleep. Sleep disturbance and daytime sleeping were rarely documented in medical records. Residents spent one-third of the day in their rooms, typically in bed, and were seldom outdoors or exposed to bright light. More time in bed and less social activity were significant predictors of daytime sleepiness. Ninety-seven percent of residents assessed had abnormal circadian rhythms. More daytime sleeping and less nighttime sleep were associated with weaker circadian activity rhythms. Later circadian rhythm acrophase (peak) was associated with more bright light exposure. CONCLUSION Daytime sleepiness, nighttime sleep disturbance, and abnormal circadian rhythms were common in nursing home residents. Modifiable factors (e.g., time in bed) are associated with sleep/wake abnormalities. Mental health specialists should consider the complexity of factors causing sleep problems in nursing home residents.