Abstract
Objectives
To review the literature on sleep disturbances in nursing home settings. Although 50% of older adults complain of sleep difficulties, increased reports of sleep disturbances are generally associated with poor health. After controlling for comorbidities that often contribute to poor sleep, studies have shown that primary sleep disturbances in healthy older adults are, in fact, rare. Although common in older adults, sleep complaints are even more prevalent in elders living in nursing homes and the sleep disturbances experienced by institutionalized older adults are more severe. Factors contributing to sleep impairment in nursing home residents include age-related changes in sleep architecture and circadian rhythms, sleep disorders, dementia, depression, other medical illness, polypharmacy, and institutional and environmental factors. It is important that nursing home residents suffering from sleep problems be evaluated and treated.
Conclusion
Implementing some environmental and culture changes could result in significant improvement in the sleep of nursing home residents.
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References
Foley DJ, Monjan AA, Brown SL, et al. Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep 1995;18(6):425–432.
Vitiello MV, Moe KE, Prinz PN. Sleep complaints cosegregate with illness in older adults: clinical research informed by and informing epidemiological studies of sleep. J Psychosom Res 2002;53(1):555–559.
Vitiello MV, Prinz PN, Williams DE, et al. Sleep disturbances in patients with mild-stage Alzheimer’s disease. J Gerontol 1990;45(4):M131–M138.
Jacobs D, Ancoli-Israel S, Parker L, et al. Twenty-four hour sleep-wake patterns in a nursing home population. Psychol and Aging 1989;4(3):352–356.
Ancoli-Israel S, Jones DW, Hanger MA, et al. Sleep in the nursing home. In: Kuna ST, Suratt PM, Remmers JE, eds. Sleep and Respiration in Aging Adults. New York: Elsevier Press, 1991, pp 77–84.
Pat-Horenczyk R, Klauber MR, Shochat T, et al. Hourly profiles of sleep and wakefulness in severely versus mild-moderately demented nursing home patients. Aging Clin Exp Res 1998;10:308–315.
Ancoli-Israel S, Parker L, Sinaee R, et al. Sleep fragmentation in patients from a nursing home. J Gerontol 1989;44(1):M18–M21.
Schnelle JF, Cruise PA, Alessi CA, et al. Sleep hygiene in physically dependent nursing home residents. Sleep 1998;21(5):515–523.
Martin JL, Webber AP, Alam T, et al. Daytime sleeping, sleep disturbance, and circadian rhythms in the nursing home. Am J Geriatr Psychiatry 2006 Feb;14(2):121–129.
Schnelle JF, Ouslander JG, Simmons SF, et al. Night-time sleep and bed mobility among incontinent nursing home residents. J Am Geriatr Soc 1993;41(9):903–909.
Ohayon MM, Carskadon MA, Guilleminault C, et al. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: Developing normative sleep values across the human lifespan. Sleep 2004 Nov 1;27(7):1255–1273.
Neikrug AB, Ancoli-Israel S. Sleep disorders in the older adult. Gerontologist 2009;Sep 9. [Epub ahead of print].
Myers BL, Badia P. Changes in circadian rhythms and sleep quality with aging — mechanisms and interventions. Neurosci Biobehav Rev 1995;19(4):553–571.
Campbell SS, Dawson D, Anderson MW. Alleviation of sleep maintenance insomnia with timed exposure to bright light. J Am Geriatr Soc 1993;41:829–836.
Ancoli-Israel S, Martin J, Shochat T, et al. Morning light delays activity acrophase in demented elderly. Soc.Light Treatment Bio Rhythms 12, 15. 2000. Ref Type: Abstract
Shochat T, Martin J, Marler M, et al. Illumination levels in nursing home patients: Effects on sleep and activity rhythms. J Sleep Res 2000;9(4):373–380.
Ancoli-Israel S, Klauber MR, Jones DW, et al. Variations in circadian rhythms of activity, sleep and light exposure related to dementia in nursing home patients. Sleep 1997;20(1):18–23.
Satlin A, Volicer L, Ross V, et al. Bright light treatment of behavioral and sleep disturbances in patients with Alzheimer’s Disease. Am J Psychiatry 1992;149:1028–1032.
Koyama E, Matsubara H, Nakano T. Bright light threatment for sleep-wake distrubances in aged individuals with dementia. Psychiatry and Clinical Neurosciences 1999;53(2):227–229.
Burns A, Allen H, Tomenson B, et al. Bright light therapy for agitation in dementia: a randomized controlled trial. Int Psychoger 2009;21(04):711–721.
Riemersma-van der Lek R, Swaab DF, Twisk J, et al. Effect of bright light and melatonin on cognitive and noncognitive function in elderly residents of group care facilities: a randomized controlled trial. JAMA 2008;299(22):2642.
Kripke DF, Mullaney DJ, Wyborney VG, et al. There’s no basic rest activity cycle. In: Stott FD, Raftery EB, Sleight P, et al., eds. Proc. 2nd International Symposium on Ambulatory Monitoring. London: Academic Press, 1978, pp 105–113.
Ancoli-Israel S, Kripke DF, Klauber MR, et al. Periodic limb movements in sleep in community-dwelling elderly. Sleep 1991;14(6):496–500.
Ancoli-Israel S. Epidemiology of sleep disorders. In: Roth T, Roehrs TA, eds. Clinics in Geriatric Medicine. Philadelphia: W.B. Saunders Company, 1989, pp 347–362.
Young T, Palta M, Dempsey J, et al. The occurrence of sleep disordered breathing among middle-aged adults. N Engl J Med 1993;328:1230–1235.
Ancoli-Israel S, Kripke DF, Klauber MR, et al. Sleep disordered breathing in community-dwelling elderly. Sleep 1991;14(6):486–495.
Ancoli-Israel S, Klauber MR, Butters N, et al. Dementia in institutionalized elderly: Relation to sleep apnea. J Am Geriatr Soc 1991;39(3):258–263.
Gehrman PR, Martin JL, Shochat T, et al. Sleep disordered breathing and agitation in institutionalized adults with Alzheimer’s disease. American Journal of Geriatric Psychiatry 2003;11(4):426–433.
Martin JL, Mory AK, Alessi CA. Nighttime oxygen desaturation and symptoms of sleep-disordered breathing in long-stay nursing home residents. The journals of gerontology 2005;60(1):104–108.
Resnick HE, Phillips B. Documentation of Sleep Apnea in Nursing Homes: United States 2004. Journal of the American Medical Directors Association 2008;9(4):260–264.
Ancoli-Israel S, Klauber MR, Kripke DF, et al. Sleep apnea in female patients in a nursing home: Increased risk of mortality. Chest 1989;96(5):1054–1058.
Nieto FJ, Young T, Lind B, et al. Association of Sleep-Disordered Breathing, Sleep Apnea, and Hypertension in a Large Community-Based Study. JAMA 2000;283(14):1829–1836.
Newman AB, Nieto FJ, Guidry U, et al. Relation of sleep-disordered breathing to SL cardiovascular disease risk factors: the Sleep Heart Health Study. Am J Epidemiol 2001 Jul 1;154(1):50–59.
Aloia MS, Ilniczky N, Di Dio P, et al. Neuropsychological changes and treatment compliance in older adults with sleep apnea. J Psychosom Res 2003;54:71–76.
Ayalon L, Ancoli-Israel S, Stepnowsky C, et al. Adherence to continuous positive airway pressure treatment in patients with Alzheimer’s disease and obstructive sleep apnea. American Journal of Geriatric Psychiatry 2006;14(2):176–180.
Coleman RM, Bliwise DL, Sajben N, et al. Epidemiology of Periodic Movements During Sleep. In: Guilleminault C, Lugaresi E, eds. Sleep/Wake Disorders: Natural History, Epidemiology, and Long-Term Evolution. New York: Raven Press, 1983, pp 217–229.
Richards KC, Roberson PK, Simpson K, et al. Periodic leg movements predict total sleep time in persons with cognitive impairment and sleep disturbance. Sleep 2008 Feb 1;31(2):224–230.
Earley CJ, Allen RP. Pergolide and carbidopa/levodopa treatment of the restless legs syndrome and periodic leg movements in sleep in a consecutive series of patients. Sleep 1996;19(10):801–810.
Hornyak M, Trenkwalder C. Restless legs syndrome and periodic limb movement disorder in the elderly. J Psychosom Res 2004 May;56(5):543–548.
Martin J, Marler MR, Shochat T, et al. Circadian rhythms of agitation in institutionalized patients with Alzheimer’s Disease. Chronobiol Intl 2000;17(3):405–418.
Bliwise DL. Sleep in normal aging and dementia. Sleep 1993 Jan;16(1):40–81.
Bliwise DL. Sleep and circadian rhythm disorders in aging and dementia. In: Turek FW, Zee PC, eds. Regulation of sleep and circadian rhythms. New York: Marcel Dekker, Inc., 1999, pp 487–526.
Vitiello MV, Bliwise DL, Prinz PN. Sleep in Alzheimer’s disease and the sundown syndrome. Neurology 1992;42(7 suppl 6):83–93.
Donaldson C, Tarrier N, Burns A. Determinants of carer stress in Alzheimer’s disease. Int J Ger Psych 1998 Apr;13(4):248–256.
Gaugler JE, Edwards AB, Femia EE, et al. Predictors of institutionalization of cognitively impaired elders: Family help and the timing of placement. Journals of Gerontology Series B-Psychological Sciences and Social Sciences 2000 Jul;55(4):247–255.
Vitiello MV, Borson S. Sleep disturbances in patients with Alzheimer’s Disease. CNS Drugs 2001;15(10):777–796.
Nihtila EK, Martikainen PT, Koskinen SVP, et al. Chronic conditions and the risk of long-term institutionalization among older people. The European Journal of Public Health 2008;18(1):77.
Benca RM, Obermeyer WH, Thisted RA, et al. Sleep and psychiatric disorders: A meta-analysis. Arch Gen Psychiat 1992;49:651–668.
Schnelle JF, Alessi CA, Al-Samarrai NR, et al. The nursing home at night: effects of an intervention on noise, light and sleep. J Am Geriatr Soc 1999;47:430–438.
Schnelle JF, Ouslander JG, Simmons SF, et al. The nighttime environment, incontinence care, and sleep disruption in nursing homes. J Am Geriatr Soc 1993;41(9):910–914.
Martin JL, Ancoli-Israel S. The critical assessment and treatment of sleep disorders in the long-term care environment. Long Term Care Interface 2001;2(1):48–52.
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Neikrug, A.B., Ancoli-Israel, S. Sleep disturbances in nursing homes. J Nutr Health Aging 14, 207–211 (2010). https://doi.org/10.1007/s12603-010-0051-8
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DOI: https://doi.org/10.1007/s12603-010-0051-8