Too little sleep and too much sleep among older adults: Associations with self‐reported sleep medication use, sleep quality and healthcare utilization

Choi, Namkee G.; DiNitto, Diana M.; Marti, C. Nathan; Choi, Bryan Y.

doi:10.1111/ggi.12749

Cited by 15 publications

(14 citation statements)

References 28 publications

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“…7 Both shorter and longer sleep durations relative to these recommendations have been associated with increased incidence of cardiovascular disease, diabetes mellitus, stroke, and allcause mortality. [8][9][10][11][12] Because sleep plays an important role in the regulation of inflammatory responses, adverse health outcomes from poor quality or short sleep are believed to be associated with increased systemic inflammation. 13 The nature of the association between long sleep duration and increased mortality risk remains poorly understood, and it is unknown whether these associations are causal or modifiable.…”

Section: Introductionmentioning

confidence: 99%

“…14 Restorative sleep is now recognized as essential for physical, cognitive, and psychological well-being across the life span. 4,9,13,[15][16][17] Sleep itself is an important behavioral risk factor for worsening pain, depression, anxiety, and chronic conditions, perpetuating both sleep problems and poor health outcomes. Thus, unresolved sleep problems have far-reaching consequences on physical and mental health among older adults.…”

Section: Introductionmentioning

confidence: 99%

“…19 Despite these well-recognized risks, older adults are twice as likely as younger adults to be prescribed sleep-inducing medications such as benzodiazepines, nonbenzodiazepine receptor agonists, and antipsychotics. 9,19,20 Not only are these medications associated with considerable adverse effects, but benefits are modest at best. 9 Recent research into positive psychosocial resources suggests possible non-pharmacologic intervention strategies that build on these positive resources.…”

Section: Introductionmentioning

confidence: 99%

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Psychosocial Factors Associated with Sleep Quality and Duration Among Older Adults with Chronic Pain

Zaidel

Karl

Kraemer³

et al. 2021

Population Health Management

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Sleep complaints are common among older adults with chronic pain. Because of the risk of significant side effects, sleep medications are not recommended as first-line treatments. Little is known about the association between positive psychosocial factors and sleep, but further awareness could support non-drug strategies to minimize poor sleep. The purpose of this study was to (1) determine the prevalence of self-reported poor sleep quality and short/long sleep duration in a population of older adults with chronic pain, and (2) examine the associations of negative risk factors, sleep-inducing medications, and positive psychosocial characteristics on sleep outcomes in this population. This study analyzed survey responses from 4201 adults ages ‡65 years with diagnosed back pain, osteoarthritis, and/or rheumatoid arthritis, and at least 1 year of continuous medical and drug plan enrollment. The most commonly reported sleep outcome was short sleep duration (39%), followed by poor sleep quality (22%), and long sleep duration (9%). Based on pharmaceutical claims, prescriptions for opioids (59%) or benzodiazepines (22%) were common. Perceived stress, depression, and pain or sleep prescription medications were independently associated with poor sleep quality and short or long sleep durations. The positive psychosocial factors of higher resilience and more diverse social networks were independently associated with good sleep quality and optimal sleep duration. These results underscore the importance of social and coping factors to sleep, which may provide new opportunities to improve sleep and well-being in older adults with chronic pain.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Psychosocial Factors Associated with Sleep Quality and Duration Among Older Adults with Chronic Pain

Zaidel

Karl

Kraemer³

et al. 2021

Population Health Management

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“…Studies have shown that ICU patients experience poor sleep quality (Shiung et al, ; Pisani et al , ), possibly because of frequent treatment, continuous light exposure, noise from equipment and ambient noise in an emergency, mechanical ventilation, medication side effects and their disease conditions (Boyko et al , ). Insufficient sleep among critically ill patients can have adverse catabolic effects and negatively impact recovery, thus extending hospitalization durations and increasing medical costs (Xu et al , ; Choi et al, ). Poor sleep quality has been shown to be associated with a higher likelihood of health care use (Choi et al, ).…”

Section: Introductionmentioning

confidence: 99%

“…Insufficient sleep among critically ill patients can have adverse catabolic effects and negatively impact recovery, thus extending hospitalization durations and increasing medical costs (Xu et al , ; Choi et al, ). Poor sleep quality has been shown to be associated with a higher likelihood of health care use (Choi et al, ). Moreover, the impact of poor sleep quality on health appears to remain after discharge from the ICU (Altman et al, ).…”

Section: Introductionmentioning

confidence: 99%

Back massage intervention for improving health and sleep quality among intensive care unit patients

Hsu

Guo

Chang

2019

Nursing in Critical Care

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Background A massage may relax muscles, improve blood circulation and reduce pain and anxiety while also improving sleep quality by increasing comfort. However, there is little research on whether a back massage improves sleep quality in intensive care unit (ICU) patients. Aims and objectives This study examined the effects of a back massage on improving vital signs, sleep quality, anxiety and depression among ICU patients. Design Adopting a quasi‐experimental design, convenience sampling was used to recruit ICU patients from a medical centre in Southern Taiwan. The experimental group received back massages for three consecutive days (n = 30), while controls received usual care (n = 30). Methods The Verran and Snyder‐Halpern Scale and the Hospital Anxiety and Depression Scale were used, and subjective and objective sleep time (wrist actigraphy and sleep duration from nurse observations) was recorded. The effect of the intervention was examined using a generalized estimating equation model with a robust standard error and an exchangeable working correlation matrix adjusting for time. Results The results show that subjective sleep quality scores in ICU patients were low. Mean observed sleep time (measured by nurses) was 3·9 h, but mean sleep time measured using wrist actigraphy was 5·9 h. Back massages improved breathing in patients, increased sleep quality reflected by both subjective and objective data and were associated with a significant change in anxiety. Conclusions These findings suggest that a 10‐min back massage can improve sleep quality, sleep duration, breathing and anxiety in ICU patients. Relevance to clinical practice The implementation of a back massage shows positive improvements in the sleep quality of ICU patients. The training and theory of massage interventions should be further applied when developing courses in critical care nursing.

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Correlates of Sleep Health among Older-Age People with and without HIV in Uganda

Yoo-Jeong,

Ratnayake,

Tong

et al. 2024

AIDS Behav

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There is a growing population of older people with HIV (PWH) in Uganda. Sleep problems disproportionately affect older people and PWH. This study aimed to estimate correlates of sleep health among older Ugandans (aged ≥ 50 years) with and without HIV, using data from the Quality of Life and Aging with HIV in Rural Uganda Study. We used the Pittsburgh Sleep Quality Index to assess sleep quality, duration, and efficiency. We fitted multivariable linear and logistic regression models to estimate the associations between sleep outcomes and variables selected based on the Senescent Sleep Model: age, HIV serostatus, loneliness, urbanicity, symptoms of depression and anxiety, and perceived stress. Of 556 participants, 271 were PWH and 285 were people without HIV (PWoH). There were no statistically significant differences in sleep outcomes by HIV serostatus. Of the total sample, most reported very good (32.79%) or fairly good sleep quality (49.37%). The mean sleep duration was 6.46 h (SD = 1.74). The mean sleep efficiency was 73.98% (SD = 19.52%) with 36.69% having optimal (≥ 85%) sleep efficiency. A positive depression screen was associated with worse sleep quality (adjusted odds ratio [aOR] = 0.21; 95% CI [0.12, 0.36]), shorter sleep duration (b=-0.44; 95% CI [-0.60, -0.28]), and worse sleep efficiency (aOR = 0.51; 95% CI[0.31, 0.83]). Interventions targeting depression may improve sleep among older Ugandans, independent of HIV serostatus. Longitudinal studies are needed to determine the potential bidirectionality of this relationship and elucidate pathways to support sleep health among older Ugandans.

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Too little sleep and too much sleep among older adults: Associations with self‐reported sleep medication use, sleep quality and healthcare utilization

Cited by 15 publications

References 28 publications

Psychosocial Factors Associated with Sleep Quality and Duration Among Older Adults with Chronic Pain

Psychosocial Factors Associated with Sleep Quality and Duration Among Older Adults with Chronic Pain

Back massage intervention for improving health and sleep quality among intensive care unit patients

Correlates of Sleep Health among Older-Age People with and without HIV in Uganda

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