Prevalence of insomnia and its associated factors among rural elderly: a community based study

 
 
 
  • Abstract
  • Keywords
  • References
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  • Abstract


    Background: Insomnia is a common problem among older adults and can lead to several complications affecting the quality of life of elderly people.

    Aim: To estimate the prevalence of insomnia and its associated factors among community-dwelling elderly.

    Study design: This is a cross-sectional descriptive study carried out on 1059 elderly living in three villages affiliated to Mansoura District, Egypt. Data collected during an interview included: socio-demographic and clinical features, habits before sleeping, environmental factors that could affect sleeping, the geriatric depression scale and Athens insomnia scale. Logistic regression analysis was done to find out the independent predictors of insomnia.

    Results: The prevalence of insomnia was 62.1%. The logistic regression revealed that insomnia is less likely among elderly of 75 and more (AOR=0.3) compared to those aged 60-75 years. The risk of insomnia is high among those with depression (AOR=6.4 and 14.6 for mild and moderate/severe depression; respectively), fear of death (AOR=14.7), life stressors (AOR=7.1), presence of musculoskeletal disorders (AOR=5.6), respiratory disorders (AOR=4.5), worry about children (AOR=4.5) and cold bedroom (AOR=2.7).

    Conclusion: Slightly less than two-thirds of the studied subjects have insomnia, and most of the associated factors are preventable and/or controllable.

    Recommendations: According to the results of the present study, the following recommendations are suggested: Design educational program for elders to enhance sleep through emphasizing on the importance of sleep hygiene practice, behavioral and non-pharmacological interventions, and healthy lifestyle.


  • Keywords


    Insomnia; Elderly; Risk Factors; Prevalence; Rural.

  • References


      [1] Adetola M O, Lawrence A A, Olufemi O O, Mayowa O & Adesola O (2014) Factors Associated with Insomnia among Elderly Patients Attending a Geriatric Centre in Nigeria Current Gerontology and Geriatrics. Article ID 780535, 10 pages https://doi.org/10.1155/2014/780535.

      [2] Akerstedt T (2006) psychosocial stress and impaired sleep, Scandinavian Journal of Work, Environment & Health. 32 (6): 493-501. https://doi.org/10.5271/sjweh.1054.

      [3] Altena E, Vrenken H, VanDerWerf YD, vandenHeuvel OA & Van-Someren JW (2010) Reduced Orbitofrontal and Parietal Gray Matter in Chronic Insomnia: A Voxel-Based Morphometric Study. Biology Psychiatry. 67: 182-185. https://doi.org/10.1016/j.biopsych.2009.08.003.

      [4] Anderson G (2006) The Growing Burden of Chronic Disease in American. Public Health Reports 119-123.

      [5] Bakr I M, AbdElaziz K M, Abou El Ezz N F & Fahim H I (2012) Insomnia in institutionalized older people in Cairo, Egypt: Prevalence and risk factors associated. European Geriatric Medicine 3(2): 92-96. https://doi.org/10.1016/j.eurger.2012.02.002.

      [6] Bloom BJ, Owens JA, & McGuinn M (2002) Sleep and its relation to pain, dysfunction, and disease activity in juvenile rheumatoid arthritis. Journal of Rheumatology; 29(1):169–73.

      [7] Botts EM (2009) The Independent Influence of Anxiety on Insom-nia and Sleepiness in Older Adults. University of the Rockies, USA.

      [8] Buysse DJ, Germain A, Moul DE, Franzen PL, Brar LK & Fletcher ME (2011) Efficacy of Brief Behavioral Treatment for Chronic Insomnia in Older Adults. Arch Intern Med 171(10): 887-895. https://doi.org/10.1001/archinternmed.2010.535.

      [9] Cacioppo J T, Hawkley L C, Berntson G G, Ernst J M, Gibbs A C, Stickgold R & Hobson J A (2002) Does lonely days invade the nights. Psychological Science 13: 384- 387. https://doi.org/10.1111/j.0956-7976.2002.00469.x.

      [10] Chen YS (2012) Association between chronic insomnia and depression in elderly adults. J Chin Med Assoc 75:195-206. https://doi.org/10.1016/j.jcma.2012.04.001.

      [11] El Kady HM, Ibrahim HK & Mohamed SG (2012) Cognitive behavioral therapy for institutionalized elders complaining of sleep disturbance in Alexandria, Egypt. Sleep Breath 16(4): 1173-1180. https://doi.org/10.1007/s11325-011-0629-3.

      [12] Elhusseini S (2013) Effect of self-care intervention on quality of life of older adults with heart failure. Unpublished Doctorate Thesis. Alexandria University, Faculty of Nursing.

      [13] Enomoto M, Tsutsui T & Higashino Sl (2010) Sleep-related problems and use of hypnotics in inpatients of acute hospital wards. General Hospital Psychiatry 32(3): 276-283. https://doi.org/10.1016/j.genhosppsych.2010.01.015.

      [14] Fernandez-Fernandez FJ (2002) Treatment of chronic obstructive pulmonary disease. Revista Clinica Espanola 202(9):520.

      [15] Fitzsimons D, Mullan D & Wilson J (2007) the challenge of patients' unmet palliative care needs in the final stages of chronic illness. Palliat Med 4:313–22. https://doi.org/10.1177/0269216307077711.

      [16] Furihata R, Uchiyama M & Takahashi S (2011) Self-help behav-iors for sleep and depression: a Japanese nationwide general population survey. J Affect Disord 130:75–82. https://doi.org/10.1016/j.jad.2010.09.019.

      [17] González A, Ignácio Z, Jornada L, Réus G, Abelaira H & Santos M (2016) Depressive disorders and comorbidities among the elderly: a population-based study. Rio de Janeiro 19(1):95-103 https://doi.org/10.1590/1809-9823.2016.14210.

      [18] Hirst S, Lane A & Miller C (2015) Miller's nursing for wellness in older adults. 7th ed. Philadelphia: Lippincott Williams &Wilkins pp 502-26.

      [19] Hosseini H, Esfirizi MF, Marandi SM & Rezaei A (2011) The effect of Ti Chi exercise on the sleep quality of the elderly residents in Isfahan, Sadeghieh elderly home. IJNMR 16(1):55.

      [20] Jaussent I, Dauvilliers Y & Ancelin ML (2011) Insomnia symp-toms in older adults: associated factors and gender differences. Am J Geriatr Psychiatry 19(1):88-97 https://doi.org/10.1097/JGP.0b013e3181e049b6.

      [21] Kamel NS & Gammack JK (2006) Insomnia in the elderly: cause, approach, and treatment. Am J Med 19(6):463-469. https://doi.org/10.1016/j.amjmed.2005.10.051.

      [22] Khater MS, Abou El Ezz NF (2008) Association between cognitive function and chronic insomnia among older adults living in geriatric homes in Cairo, Egypt. Ain Shams Medical Journal 59(7-9): 963-976.

      [23] Leblanc M, Desjardins S & Desgagné A (2015) the relationship between sleep habits, anxiety, and depression in the elderly. National Institute of Health J 7:33–42.

      [24] Leger D & Bayon V (2010) Societal costs of insomnia. Sleep Medicine Reviews 14: 379-389. https://doi.org/10.1016/j.smrv.2010.01.003.

      [25] Lehto H & Stein KF (2009) Death anxiety: an analysis of an evolving concept. Res Theory Nurs Pract 23(1):23-41 https://doi.org/10.1891/1541-6577.23.1.23.

      [26] Liu X & Liu L (2005) Sleep habits and insomnia in a sample of elderly persons in China 28(12):1579-1587

      [27] Makhlouf MM, Ayoub, AI & Abdel-Fattah MM (2007) Insomnia symptoms and their correlates among the elderly in geriatric homes in Alexandria, Egypt. Sleep Breath 11:187-194. https://doi.org/10.1007/s11325-006-0097-3.

      [28] Morin CM & Benca R (2012) chronic insomnia. Lancet 379(9821):1129-1141 https://doi.org/10.1016/S0140-6736(11)60750-2.

      [29] Morphy H, Dunn K, Lewis M, Boardman H & Croft P (2007) Epidemiology of Insomnia: a Longitudinal Study in a UK Population. Musculoskeletal Research Centre 30(3):274-280.

      [30] Ohayon MM (2002) Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 6:97–111. https://doi.org/10.1053/smrv.2002.0186.

      [31] Passos GS, Poyares D & Santana MG (2011) Effects of moderate aerobic exercise training on chronic primary insomnia. Sleep Med 12(10):1018–27. https://doi.org/10.1016/j.sleep.2011.02.007.

      [32] Reid KJ, Zoran M, & Sanford F Sleep (2006) A Marker of Physi-cal and Mental Health in the Elderly. Am J Geriatr Psychiat 14(10):860-866. https://doi.org/10.1097/01.JGP.0000206164.56404.ba.

      [33] Reid KJ, Baron KG, Lu B, Naylor E, Wolfe L & Zee PC (2010) Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia. Sleep Med 11(9):934-940. https://doi.org/10.1016/j.sleep.2010.04.014.

      [34] Robaina J R. Lopes C S, Rotenberg L, Faerstein E, Fischer F M, Moreno C R, Werneck G L. & Chor D (2009) Stressful life events and insomnia complaints among nursing assistants from a university hospital in Rio de Janeiro: The Pro- Saude Study, Revista Brasileira de Epidemiologia 12 (3): 501-509. https://doi.org/10.1590/S1415-790X2009000300018.

      [35] Roepke S, & Israel S (2010) Sleep disorders in the elderly. Indian j med res 131: 302-10.

      [36] Rongve A, Boeve BF &, Aarsland D (2010) correlates of care-giver-reported sleep disturbances in a sample of persons with early dementia. J Am Geriatr Soc 58:480-86. https://doi.org/10.1111/j.1532-5415.2010.02733.x.

      [37] Rwin MR, Olmstead R & Motivala SJ (2008) Improving sleep quality in older adults with moderate sleep complaints: A randomized controlled trial of Tai Chi Chih. Sleep 31(7): 1001-8.

      [38] Saber AD (2013) Insomnia among elderly in Alexandria. Master thesis, High Institute of Public Health, Alexandria University, Egypt.

      [39] Sabry AA, AboZenah H & Wafa E (2010) Sleep disorders in hemodialysis patients. Saudi J Kidney Dis Transpl 21(2): 300-305.

      [40] Sheikh JI & Yesavage JA. Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontology: A Guide to Assessment and Intervention 1986; 165-73. Available at: http//www.stanford.edu/ yesavage/GDS.html Retrieved on April 17, 2016.

      [41] Shives LR (2004) Basic Concepts of Psychiatric-Mental Health Nursing. 6th ed. Philadelphia: Lippincott Williams &Wilkins, pp 85-99.

      [42] Shokry E, Abdel-Aziz H & Abo El-Seoud A (2014) Insomnia: Prevalence, risk factors, and its effect on quality of life among elderly in Zagazig City, Egypt. J Nursing Educ Practice 4 (8):52-64.

      [43] Soldatos CR, Dikeos DG & Paparrigopoulos TJ (2000) Athens Insomnia Scale: validation of an instrument based on ICD-10 criteria. Journal of Psychosomatic Research 48(6): 555-560. https://doi.org/10.1016/S0022-3999(00)00095-7.

      [44] Stromberg A & Jaarsma T (2008) Thoughts about death and per-ceived health status in elderly patients with heart failure. European Journal of Heart Failure 10: 608–613. https://doi.org/10.1016/j.ejheart.2008.04.011.

      [45] Su TP, Huang SR & Chou P (2004) Prevalence and risk factors of insomnia in community-dwelling Chinese elderly: a Taiwanese urban area study. Aust N Z J Psychiatry 38(9): 706-713. https://doi.org/10.1080/j.1440-1614.2004.01444.x.

      [46] Suguna A, Ramakrishna G, Deepthi S, Geethu M, Mathew J, Steve P, Pooja L & Johnson P (2015) Sleep Disturbances and Death Anxiety among the Elderly in a Rural Area of Southern Karnataka. IJHSR 5(9): 24-29

      [47] Sukying C, Bhokakul V& Udomsubpayakul U (2003) An epidemiological study on insomnia in an elderly Thai population. J Med Assoc Thai 86:316-24.

      [48] Tablosky PA (2006) Gerontological Nursing. Newjersy: Pearson Prentice Hall Publication 90-102.

      [49] Tanaka H, Taira K & Arakawa M 2002. Short naps and exercise improve sleep quality and mental health in the elderly. Psychiatry Clin Neurosci 56(3):233-4. https://doi.org/10.1046/j.1440-1819.2002.00995.x.

      [50] Taylor DJ, Mallory LJ, Lichstein KL, Riedel BW & Bush AJ (2007) Comorbidity of chronic insomnia with medical problems. Sleep 30 (2): 213-8.

      [51] Tsou MT (2013) Prevalence and risk factors for insomnia in community-dwelling elderly in northern Taiwan, J Clinical Gerontol Geriatrics 4: 75-79 https://doi.org/10.1016/j.jcgg.2013.02.002.

      [52] Weronika WF, Iwona E P & Bożena M (2016) Coexistence of insomnia and chronic diseases in over 60 year’s olds. Family Medicine & Primary Care Review 18(3): 364–367.

      [53] Wong W &, Fielding R (2011) Prevalence of insomnia among Chi-nese adults in Hong Kong: a population-based study. J Sleep Res 20(1):117-12. https://doi.org/10.1111/j.1365-2869.2010.00822.x.


 

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Article ID: 7415
 
DOI: 10.14419/ijans.v6i1.7415




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