ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Spain.
Department of Nursing, Faculty of Health Sciences, PASOS Research Group, UMA REDIAS Network of Law and Artificial Intelligence Applied to Health and Biotechnology, University of Malaga, Spain.
Sleep Med. 2024 Sep;121:196-202. doi: 10.1016/j.sleep.2024.07.011. Epub 2024 Jul 10.
The prevalence of sleep-related issues among older adults is a significant concern, with half of the older population reporting these problems. Consequently, strategies to improve sleep are needed for this population. This study aims to assess the effects of a health educational program on sleep behaviour among pre-frail or frail older adults residing in the community and to explore possible associations with frailty.
This randomised controlled trial (NCT05610605) included a total of 197 community-dwelling older adults with frailty/pre-frailty, divided into control (n = 88) and educational (n = 109) groups, were assessed at baseline, after the 6-month educational program (6 months), and 6 months after the intervention (12 months). The intervention comprised four group sessions and six follow-up phone calls, focusing on frailty, physical activity, dietary habits, and cognitive training. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) and wrist-worn accelerometry.
At 6 months, a significant time-by-group interaction was found for self-reported [β = -0.449, 95%CI (-0.844, -0.053), p = 0.026] and accelerometer-measured [β = 0.505, 95%CI (0.085, 0.926), p = 0.019] sleep efficiency, showing improved sleep efficiency in the intervention group vs. controls. A significant time-by-group interaction at 6 months was noted for sleep awakenings [β = -0.402, 95%CI (-0.825, -0.020), p = 0.047]. The educational program led to a significant decrease in awakenings, while the control group experienced an increase. The change in the number of awakenings (Rs = 0.183, p = 0.020) at 6 months was significantly associated with changes in frailty. Moreover, a significant time-by-group interaction was reported at the 12-month assessment [β = -0.449, 95%CI (-0.844, -0.053), p = 0.026] for self-reported sleep quality, indicating better results in the intervention group compared to controls.
The educational program improved sleep quality and sleep efficiency while reducing the number of awakenings per night among community-dwelling frail older adults, offering a practical approach to addressing sleep-related challenges in this demographic.
老年人睡眠相关问题的发生率较高，有一半的老年人群报告存在这些问题。因此，需要为这一人群制定改善睡眠的策略。本研究旨在评估针对社区居住的衰弱前期或衰弱老年人的健康教育计划对睡眠行为的影响，并探讨与衰弱的可能关联。
这是一项随机对照试验（NCT05610605），共纳入 197 名衰弱前期或衰弱的社区居住老年人，分为对照组（n=88）和教育组（n=109），在基线、6 个月的健康教育计划后（6 个月）和干预后 6 个月（12 个月）进行评估。干预包括四次小组会议和六次随访电话，重点关注衰弱、身体活动、饮食习惯和认知训练。使用匹兹堡睡眠质量指数（PSQI）和腕戴式加速度计评估睡眠质量。
在 6 个月时，自我报告的睡眠效率[β=-0.449，95%置信区间（-0.844，-0.053），p=0.026]和加速度计测量的睡眠效率[β=0.505，95%置信区间（0.085，0.926），p=0.019]存在显著的时间-组间交互作用，表明干预组的睡眠效率较对照组有所改善。在 6 个月时，睡眠觉醒次数[β=-0.402，95%置信区间（-0.825，-0.020），p=0.047]也存在显著的时间-组间交互作用。教育计划导致觉醒次数显著减少，而对照组则增加。6 个月时觉醒次数的变化（Rs=0.183，p=0.020）与衰弱的变化显著相关。此外，在 12 个月的评估中，自我报告的睡眠质量存在显著的时间-组间交互作用[β=-0.449，95%置信区间（-0.844，-0.053），p=0.026]，表明干预组的结果优于对照组。
健康教育计划改善了社区居住的衰弱老年人的睡眠质量和睡眠效率，同时减少了夜间觉醒次数，为解决这一人群的睡眠相关挑战提供了一种实用方法。
