Skip to main content
SpringerLink
Log in

Sleep disturbances in nursing homes

  • JNHA: Clinical Neurosciences
  • Published:
The journal of nutrition, health & aging

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. 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.

    CAS  PubMed  Google Scholar 

  2. 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.

    Article  PubMed  Google Scholar 

  3. 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.

    CAS  PubMed  Google Scholar 

  4. 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.

    Article  CAS  Google Scholar 

  5. 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.

    Google Scholar 

  6. 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.

    CAS  Google Scholar 

  7. Ancoli-Israel S, Parker L, Sinaee R, et al. Sleep fragmentation in patients from a nursing home. J Gerontol 1989;44(1):M18–M21.

    CAS  PubMed  Google Scholar 

  8. Schnelle JF, Cruise PA, Alessi CA, et al. Sleep hygiene in physically dependent nursing home residents. Sleep 1998;21(5):515–523.

    CAS  PubMed  Google Scholar 

  9. 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.

    Article  PubMed  Google Scholar 

  10. 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.

    CAS  PubMed  Google Scholar 

  11. 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.

    PubMed  Google Scholar 

  12. Neikrug AB, Ancoli-Israel S. Sleep disorders in the older adult. Gerontologist 2009;Sep 9. [Epub ahead of print].

  13. Myers BL, Badia P. Changes in circadian rhythms and sleep quality with aging — mechanisms and interventions. Neurosci Biobehav Rev 1995;19(4):553–571.

    Article  CAS  PubMed  Google Scholar 

  14. 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.

    CAS  PubMed  Google Scholar 

  15. 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

    Google Scholar 

  16. 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.

    Article  CAS  PubMed  Google Scholar 

  17. 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.

    CAS  PubMed  Google Scholar 

  18. 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.

    CAS  PubMed  Google Scholar 

  19. 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.

    Article  CAS  PubMed  Google Scholar 

  20. 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.

    Article  Google Scholar 

  21. 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.

    Article  CAS  PubMed  Google Scholar 

  22. 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.

    Google Scholar 

  23. Ancoli-Israel S, Kripke DF, Klauber MR, et al. Periodic limb movements in sleep in community-dwelling elderly. Sleep 1991;14(6):496–500.

    CAS  PubMed  Google Scholar 

  24. 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.

    Google Scholar 

  25. 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.

    Article  CAS  PubMed  Google Scholar 

  26. Ancoli-Israel S, Kripke DF, Klauber MR, et al. Sleep disordered breathing in community-dwelling elderly. Sleep 1991;14(6):486–495.

    CAS  PubMed  Google Scholar 

  27. 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.

    CAS  PubMed  Google Scholar 

  28. 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.

    PubMed  Google Scholar 

  29. 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.

    PubMed  Google Scholar 

  30. 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.

    Article  PubMed  Google Scholar 

  31. 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.

    Article  CAS  PubMed  Google Scholar 

  32. 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.

    Article  CAS  PubMed  Google Scholar 

  33. 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.

    Article  CAS  PubMed  Google Scholar 

  34. 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.

    Article  PubMed  Google Scholar 

  35. 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.

    Article  PubMed  Google Scholar 

  36. 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.

    Google Scholar 

  37. 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.

    PubMed  Google Scholar 

  38. 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.

    CAS  PubMed  Google Scholar 

  39. Hornyak M, Trenkwalder C. Restless legs syndrome and periodic limb movement disorder in the elderly. J Psychosom Res 2004 May;56(5):543–548.

    Article  PubMed  Google Scholar 

  40. 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.

    Article  CAS  Google Scholar 

  41. Bliwise DL. Sleep in normal aging and dementia. Sleep 1993 Jan;16(1):40–81.

    CAS  PubMed  Google Scholar 

  42. 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.

    Google Scholar 

  43. Vitiello MV, Bliwise DL, Prinz PN. Sleep in Alzheimer’s disease and the sundown syndrome. Neurology 1992;42(7 suppl 6):83–93.

    CAS  PubMed  Google Scholar 

  44. Donaldson C, Tarrier N, Burns A. Determinants of carer stress in Alzheimer’s disease. Int J Ger Psych 1998 Apr;13(4):248–256.

    Article  CAS  Google Scholar 

  45. 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.

    Google Scholar 

  46. Vitiello MV, Borson S. Sleep disturbances in patients with Alzheimer’s Disease. CNS Drugs 2001;15(10):777–796.

    Article  CAS  PubMed  Google Scholar 

  47. 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.

    Article  Google Scholar 

  48. Benca RM, Obermeyer WH, Thisted RA, et al. Sleep and psychiatric disorders: A meta-analysis. Arch Gen Psychiat 1992;49:651–668.

    CAS  PubMed  Google Scholar 

  49. 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.

    CAS  PubMed  Google Scholar 

  50. 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.

    CAS  PubMed  Google Scholar 

  51. 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.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, University of California, San Diego, SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, USA

    A. B. Neikrug & Sonia Ancoli-Israel

  2. Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, #0733, La Jolla, Ca, 92093-0733, USA

    Sonia Ancoli-Israel

Authors
  1. A. B. Neikrug
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sonia Ancoli-Israel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sonia Ancoli-Israel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-010-0051-8

Key words

Search

Navigation