Extended Abstract
1. Objectives
Aging causes different physical and mental health problems and diseases in the elderly [1]. One of these problems is sleep disorder [2] such that about 50% of older people complain about the difficulty in initiating or maintaining sleep [3]. Accordingly, based on studies, sleep disorders in nursing homes is more than 75% [4, 5]. Hence, there is a need to recognize the various aspects of sleep disorders in the elderly and enrich our knowledge about its affecting factors to better evaluate the problems associated with sleep disorders and to take the necessary measures to reduce it. Since few studies have been conducted to assess the predictors of sleep disorders in the elderly, especially those living in nursing homes, this study aimed to investigate the prevalence of sleep disorders and its predictors among elderly residents of nursing homes in Ahvaz City, Iran.
2. Methods & Materials
This is a cross-sectional study conducted in 2017. The statistical population consisted of all elderlies (n=205) living in 4 nursing homes located in Ahvaz City, Iran. Using convenience sampling method and based on inclusion and exclusion criteria, 130 elderlies were selected as study samples. The inclusion criteria were ability to speak, willingness to participate in the study, aged older than 60 years, no cognitive disorders (i.e. memory impairment, dementia, Alzheimer) according to the medical records, and no participation in other studies at the same time. Those unwilling to participate were excluded from the study. Before data collection, written informed consent was obtained from each participant.
The study was also approved by the Research Ethics Committee of Ahvaz University of Medical Sciences (code: IR.AJUMS.REC1394.142). For collecting data, the Pittsburgh sleep quality index (PSQI), 12-item general health questionnaire (GHQ-12), VAUX social support questionnaire, Western Ontario and McMaster universities arthritis index (WOMAC), and a demographic form were used. After collecting data, they were analyzed in SPSS v.22. To present the variables, descriptive statistics such as mean and standard deviation were used, and for examining the concurrent effect of each predictor on elderly sleep disorder, stepwise linear regression analysis was carried out. The significance level was set at 0.05 (P<0.05).
3. Results
Of 130 participants, 86 (66.2%) were men and 44 (33.8%) women with a Mean±SD age of 68±7.8 years. Regarding WOMAC score of the participants, their Mean±SD knee pain was 18.13±10.11, while the Mean±SD joint stiffness was 4.13±2.18 and Mean±SD physical function was 33.33±15.19. Moreover, their Mean±SD perceived social support and general health were 25.24±7.72 and 9.26±1.7, respectively.
Regarding the evaluation of sleep quality of the participants, 18 (13.8%) reported mild sleep disorders, 106 (81.5%) moderate, and 6 (4.6%) severe sleep disorders. The stepwise linear regression analysis results (Table 1) showed that “concurrent disease” (β=0.2), “joint stiffness” (β=0.259), and “knee pain” (β=0.244) had a significant positive correlation with sleep disorder in subjects, while “perceived social support” was negatively correlated with having sleep disorders (β=-0.266). According to the coefficient of determination (R2), 18.9% of changes in sleep disorders is predicted by the four above mentioned variables. The regression model has a good fit (F=7.24, P<0.001).
4. Conclusion
According to the results, 86.1% of elders had sleep disorders. The perceived social support, concurrent disease, joint stiffness, and knee pain were predictors of sleep disorders in the elderly. They could predict 18.9% of sleep disorders. Further studies should be conducted to identify other factors affecting sleep disorders in older people. Furthermore, it is necessary to study these factors in more details, and some interventions should be conducted to reduce the impact of these factors.
Ethical Considerations
Compliance with ethical guidelines
This study has been approved by Research Ethics Committee of Ahvaz Jundishapur University of Medical Sciences (Code: IR.AJUI.REC.1394.142).
Funding
This study has been approved by Research Deputy of Ahvaz Jundishapur University of Medical Sciences (code: 77s93).
Authors' contributions
Conceptualization, methodology and validation: Shahab Papi, Zeynab Karimi, Parvin Shahri; Investigation and formal analysis, resources, and draft preparation: Gholamreza Ghaed Amini Harooni, Shahab Papi, Parvin Shahri; Editing: Zeynab Karimi, Azadeh Nazarpour; and Supervision and project administration: Parvin Shahri.
Conflict of interest
The authors declared no conflict of interest.
Acknowledgments
The authors would like to thank authorities of Ahvaz Jundishapur University of Medical Sciences and Retired Organization of Ahvaz City and all elders that contributed in this article.