Sleep disturbances in the elderly residing in assisted living: findings from the Maryland Assisted Living Study
Sleep disturbances in the elderly residing in assisted living: findings from the Maryland Assisted Living Study
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DOI：
10.1002/gps.1380
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发表时间：
2005-10-01
影响因子：
4
通讯作者：
Lyketsos, CG
中科院分区：
文献类型：
--
作者：
Rao, V;Spiro, JR;Lyketsos, CG
大多数老年人都患有某种睡眠障碍。常见的睡眠障碍是失眠和白天过度嗜睡。目前还没有发表的关于辅助生活（AL）环境中睡眠障碍患病率的研究。目的通过简易精神状态测试（MMSE）和老年心理依赖评定量表（PGDRS）评估老年居民睡眠障碍的发生率、类型和相关性，探讨睡眠障碍对认知和身体功能的影响。研究对象为198名随机抽取的马里兰州22家机构的辅助生活居民。参与者在一份关于失眠和白天嗜睡的11项睡眠问卷中被打分。结果69%的居民存在睡眠障碍，42%的居民存在失眠，34.6%的居民存在白天嗜睡。IN和DS评分无显著相关（r = 0.10, p = 0.19）。使用催眠药、镇静抗抑郁药和抑郁与失眠有关。抑郁和整体健康状况不佳与白天嗜睡有关。在认知任务（迷你精神状态检查）中，只有失眠的参与者表现优于没有睡眠障碍和白天嗜睡的参与者；在一项身体功能测量（老年心理依赖评定量表-身体领域）中，失眠的参与者比白天嗜睡的参与者和既失眠又嗜睡的参与者表现得更好。与那些没有睡眠障碍的人、那些只有失眠的人、那些同时有失眠和白天嗜睡的人相比，患有退行性睡眠障碍的参与者在这两项指标上的表现都更差。结论AL患者的睡眠障碍发生率与养老院相似。白天嗜睡与较差的认知和日常功能有关，而失眠与较好的结果有关。对退行性椎体滑移的有效管理可能导致AL居民功能的改善。版权所有(c) 2005 John Wiley & Sons, Ltd。
Introduction A majority of the elderly suffer from some sort of sleep disturbance. Common sleep disturbances are insomnia and excessive daytime sleepiness. There are no published studies on the prevalence of sleep disturbance in the assisted living (AL) setting.Objective To estimate the prevalence, types, and associations of sleep disturbance in a stratified random sample of AL residents, and to explore the effect of sleep disturbance on cognitive and physical functioning, as assessed by the Mini-Mental State Exam (MMSE) and the Psychogeriatric Dependency Rating Scale (PGDRS).Methods Participants were 198 randomly selected assisted living residents in 22 Maryland facilities. Participants were rated on an 11-item sleep questionnaire regarding insomnia and daytime sleepiness.Results Sleep disturbance was present in 69% of residents, insomnia (IN) in 42% and excessive daytime sleepiness (DS) in 34.6%. IN and DS scores were not significantly correlated(r = 0.10, p = 0.19). Use of hypnotics, sedating antidepressants, and depression were associated with insomnia. Depression and poor general medical health were associated with daytime sleepiness. On a cognitive task (Mini Mental State Examination) participants with insomnia only out-performed participants with no sleep disturbance and daytime sleepiness; on a measure of physical function (PsychoGeriatric Dependency Rating Scale-physical domain), participants with insomnia fared better than those with daytime sleepiness only and those with both insomnia and daytime sleepiness. Participants with DS only performed worse on both measures compared to those with no sleep disturbance, those with insomnia only, and those with both insomnia and daytime sleepiness.Conclusion The prevalence of sleep disturbance in AL is similar to that reported in nursing homes. Daytime sleepiness is associated with poorer cognitive and day-to-day functioning, while insomnia is associated with better outcomes. Effective management of DS may lead to improved functioning in the AL residents. Copyright (c) 2005 John Wiley & Sons, Ltd.