Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.
Department of Scientific Research Management, Shanghai Health Development Research Center, Shanghai, China.
PLoS One. 2020 May 15;15(5):e0232834. doi: 10.1371/journal.pone.0232834. eCollection 2020.
Sleep problems have become the most common complaints among the elderly. There are a few studies that explored the prevalence of poor sleep quality and its associated factors among the elderly in nursing homes. Therefore, this study aimed to examine the prevalence of poor sleep quality and its associated factors among the Chinese elderly in nursing homes.
A total of 817 elderly residents, from 24 nursing homes, were included in this cross-sectional study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and poor sleep quality was defined as PSQI >5. Multiple binary logistic regression was used to estimate the strength of the association between risk factors and poor sleep quality in terms of adjusted odds ratios (AORs) and their 95% confidence intervals (CIs), and interactions of risk factors for poor sleep quality were also examined.
The prevalence of poor sleep quality was 67.3% (95% CI: 64.0, 70.5%) among the Chinese elderly in nursing homes. Multiple binary logistic regression results showed that participants with the following characteristics had an increased risk of poor sleep quality after adjustments for other confounders: being 70-79 years old (AOR: 1.78, 95% CI: 1.08, 2.92) or 80 years old and above (AOR: 2.67, 95% CI: 1.68, 4.24); having one to two kinds of chronic diseases (AOR: 2.05, 95% CI: 1.39, 3.01) or three or more kinds of chronic diseases (AOR: 2.35, 95% CI: 1.39, 4.00); depression symptoms (AOR: 1.08, 95% CI: 1.04, 1.11), anxiety symptoms (AOR: 1.11, 95% CI: 1.05, 1.18), and social support(AOR: 0.97, 95% CI: 0.95, 0.99). Additive interactions were detected between age and anxiety symptoms (AOR: 8.34, 95% CI: 4.43, 15.69); between chronic disease and anxiety symptoms (AOR: 8.61, 95% CI; 4.28, 17.31); and between social support and anxiety symptoms (AOR: 6.43, 95% CI: 3.22, 12.86).
The prevalence of poor sleep quality among the elderly in nursing homes is relatively high. Besides, anxiety symptoms has additive interactions with age, chronic disease and social support for poor sleep quality. These findings have significant implications for interventions that aim to improve sleep quality among elderly residents in nursing homes.
睡眠问题已成为老年人最常见的抱怨之一。有一些研究探讨了养老院老年人中睡眠质量差的流行情况及其相关因素。因此，本研究旨在调查养老院中中国老年人睡眠质量差的流行情况及其相关因素。
本横断面研究共纳入了 817 名来自 24 家养老院的老年人。使用匹兹堡睡眠质量指数（PSQI）评估睡眠质量，将 PSQI>5 定义为睡眠质量差。采用多变量二项逻辑回归估计危险因素与睡眠质量差之间的关联强度，以调整后的优势比（AOR）及其 95%置信区间（CI）表示，并检验危险因素对睡眠质量差的交互作用。
养老院中老年人睡眠质量差的患病率为 67.3%（95%CI：64.0，70.5%）。多变量二项逻辑回归结果显示，在调整其他混杂因素后，具有以下特征的参与者睡眠质量差的风险增加：年龄为 70-79 岁（AOR：1.78，95%CI：1.08，2.92）或 80 岁及以上（AOR：2.67，95%CI：1.68，4.24）；患有 1-2 种慢性疾病（AOR：2.05，95%CI：1.39，3.01）或 3 种及以上慢性疾病（AOR：2.35，95%CI：1.39，4.00）；存在抑郁症状（AOR：1.08，95%CI：1.04，1.11）、焦虑症状（AOR：1.11，95%CI：1.05，1.18）和社会支持（AOR：0.97，95%CI：0.95，0.99）。还检测到年龄与焦虑症状（AOR：8.34，95%CI：4.43，15.69）；慢性疾病与焦虑症状（AOR：8.61，95%CI；4.28，17.31）；以及社会支持与焦虑症状（AOR：6.43，95%CI：3.22，12.86）之间存在相加交互作用。
养老院老年人睡眠质量差的患病率相对较高。此外，焦虑症状与年龄、慢性疾病和社会支持对睡眠质量差具有相加交互作用。这些发现对旨在改善养老院老年居民睡眠质量的干预措施具有重要意义。
