Background Poor sleep is associated with morbidity and mortality, and research indicates that poor sleep quality is common in older people. The aim of this investigation was to determine the prevalence and risk factors of poor sleep in a community-dwelling older population.
Methods The target population was 591 men and women aged 71-80 years from the Hertfordshire Cohort Study. 443 (75.0%) agreed to participate. Sleep was assessed using the validated Pittsburgh Sleep Quality Index (PSQI) in a self-administered questionnaire. The response rate was 91.7% (n = 406). The PSQI assesses a variety of factors related to sleep quality, including estimates of duration and latency and the frequency of specific sleep disturbances. A PSQI score of >5 indicates poor sleep quality.
Results 153 (41%) participants had a PSQI score of > 5. The majority (97.3%) reported at least one symptom of disturbed sleep occurring at least once in the past month. The most commonly reported reason for disturbed sleep was getting up to use the bathroom, with 240 (60.3%) participants reporting that this woke them at least 3 times a week. 52 (13.1%) participants reported having taken medication to help them sleep at least once in the past month.
Smoking was associated with sleep duration in men but not women, with men who had ever smoked sleeping 35 minutes less compared to those who had never smoked (95% CI 16, 54, p < 0.001). Self-rated general health was also associated with sleep duration in men but not women, with men who rated their general health as fair/bad/very bad sleeping 46 minutes less than those who rated their health as good/very good (95% CI 21, 71, p < 0.001). Women, but not men, with great or some difficulty making ends meet financially were more likely to have a PSQI score >5 compared to those who easily made ends meet (OR 4.0, 95% CI 1.5, 11.0, p = 0.007). In both men and women, worse self-rated general health was significantly associated with a PSQI score of >5 [OR (95% CI) for fair/bad/very bad health compared to good/very good health: 5.0 (2.3, 11.0), p < 0.001 for men, 2.8 (1.4, 5.8), p = 0.005 for women]. Age, BMI, weight and height were not associated with either sleep duration or poor sleep (PSQI > 5).
Conclusion There was a high prevalence of poor sleep in this population. These findings reinforce the need for sleep assessment to be included in routine medical examinations of older people, especially in those with poorer general health.
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