Indian Journal of Sleep Medicine

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VOLUME 18 , ISSUE 2 ( April-June, 2023 ) > List of Articles

Original Article

Seniors and Sleep Health: An Eye-opener Study from the North of India

Subramani Jagadeesan, Muthathal Subramanian, Pranav Patel, Namita Kamra

Keywords : Elderly, Epidemiology, Sleep quality

Citation Information : Jagadeesan S, Subramanian M, Patel P, Kamra N. Seniors and Sleep Health: An Eye-opener Study from the North of India. Indian Sleep Med 2023; 18 (2):19-24.

DOI: 10.5005/jp-journals-10069-0114

License: CC BY-NC 4.0

Published Online: 06-10-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Introduction: Sleep is a basic human need and is imperative for good health, good quality of life (QoL), and performing well during the day. Along with the physiological changes that happen with aging, changes in sleep pattern is inexorable. Considering the implications of sleep quality and its relevance amid the elderly and the paucity of data from the region, a study is being undertaken to assess the sleep quality of aging adults and its importance, to analyze the results across socio-demographic and other factors in an urban setting. Methodology: A community-based analytical study was done in an urban resettlement colony with 459 elders. Study tools include the Pittsburgh Sleep Quality Index (PSQI), Geriatric Depression Scale (GDS), and a pre-tested semi-structured questionnaire followed by a basic physical examination. Data were tabulated and analyzed with appropriate statistical measures. Results: The point prevalence of insomnia among the participants was 82% with a mean PSQI score of 7.8. Most of them reported themselves to be not active physically and preferred drinking tea before slumber. Being a female [adjusted odds ratio (AOR) 0.48], having a television in the room (AOR 2.64), having no sleeping partner (AOR 10.2), having dyspepsia or reflux (AOR 68.7), racing thoughts or stressful (AOR 5.7), habitual daytime nap (AOR 0.14), being overweight or obese (AOR 2.5), and mild depression (AOR 2.5) had a significant role with poor sleep in the elders (p-value < 0.05). Conclusion: With this study, it could be easy to infer that elderly dwelling in urban settlements abstain from habitual physical activity (PA) and tend to suffer from alarming levels of disturbed sleep. With advancing life expectancy and hence medical comorbidities, physicians may be required to include sleep health as much as any other assessment to heighten their QoL.

  1. Ezenwanne E. Current concepts in the neurophysiologic basis of sleep; A review. Ann Med Health Sci Res 2011;1(2):173–179. PMID: 23209972.
  2. Stepnowsky CJ, Ancoli-Israel S. Sleep and its disorders in seniors. Sleep Med Clin 2008;3(2):281–293. DOI: 10.1016/j.jsmc.2008.01.011.
  3. Gulia KK, Kumar VM. Sleep disorders in the elderly: A growing challenge. Psychogeriatrics 2018;18(3):155–165. DOI: 10.1111/psyg.12319.
  4. Roepke SK, Ancoli-Israel S. Sleep disorders in the elderly. Indian J Med Res 2010;131:302–310. PMID: 20308755.
  5. Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: A preliminary report. J Psychiatr Res 1982–1983;17(1):37–49. DOI: 10.1016/0022-3956(82)90033-4.
  6. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12(3):189–198. DOI: 10.1016/0022-3956(75) 90026-6.
  7. Buysse DJ, Reynolds CF III, Monk TH, et al. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Res 1989;28(2):193–213. DOI: 10.1016/0165-1781(89)90047-4.
  8. Muhammad T, Gharge S, Meher T. The associations of BMI, chronic conditions and lifestyle factors with insomnia symptoms among older adults in India. PLoS One 2022;17(9):e0274684. DOI: 10.1371/journal.pone.0274684.
  9. Rao D, Hegde S, Joseph A, et al. Prevalence of insomnia among elderly residents in a rural area in Bangalore, Karnataka. Indian J Sleep Med 2012;7(1):14–18. DOI: 10.5958/j.0973-340X.7.1.004.
  10. George S, Paul G, Paul N. Study on sleep quality and associated psychosocial factors among elderly in a rural population of Kerala, India. Int J Community Med Public Health 2018;5:526–531. DOI: 10.18203/2394-6040.ijcmph20180114.
  11. Iyer L, Yesodharan R, Nayak AK. Prevalence of insomnia, and sleep hygiene techniques practiced among elderly residing in selected old age homes of Udupi and Dakshina Kannada District, Karnataka. Indian J Public Health Res Dev 2019;10(9):462–467. DOI: 10.5958/0976-5506.2019.02471.9.
  12. Sakamoto R, Okumiya K, Norboo T, et al. Sleep quality among elderly high-altitude dwellers in Ladakh. Psychiatry Res 2017;249:51–57. DOI: 10.1016/j.psychres.2016.12.043. Epub 2016 Dec 29.
  13. Dahale AB, Jaisoorya TS, Manoj L, et al. Insomnia among elderly primary care patients in India. Prim Care Companion CNS Disord 2020;22(3):19m02581. DOI: 10.4088/PCC.19m02581.
  14. Liu S, Chow IHI, Lu L, et al. Comparison of sleep disturbances between older nursing home residents in high- and low-altitude areas. J Geriatr Psychiatry Neurol 2020;33(6):370–376. DOI: 10.1177/0891988719892335. Epub 2019 Dec 16. Erratum in: J Geriatr Psychiatry Neurol 2020 Jul 1:891988720936429.
  15. Ogunbode AM, Adebusoye LA, Olowookere OO, et al. Factors associated with insomnia among Elderly Patients Attending a Geriatric Centre in Nigeria. Curr Gerontol Geriatr Res 2014;2014:780535. DOI: 10.1155/2014/780535. Epub 2014 Dec 22.
  16. Timalsina R. Factors associated with insomnia among elderly of a selected community of Lalitpur. J Gerontol Geriatr Res 2017;6:410. DOI: 10.4172/2167-7182.1000410.
  17. El-Gilany AH, Saleh N, Mohamed H, et al. Prevalence of insomnia and its associated factors among rural elderly: A community based study. Int J Adv Nurs Stud 2017;6(1):56. DOI: 10.14419/ijans.v6i1.7415.
  18. Thichumpa W, Howteerakul N, Suwannapong N, et al. Sleep quality and associated factors among the elderly living in rural Chiang Rai, Northern Thailand. Epidemiol Health 2018;40:e2018018. DOI: 10.4178/epih.e2018018.
  19. Zhang YS, Jin Y, Rao WW, et al. Prevalence and socio-demographic correlates of poor sleep quality among older adults in Hebei province, China. Sci Rep 2020;10(1):12266. DOI: 10.1038/s41598-020-68997-x.
  20. Su TP, Huang SR, Chou P. Prevalence and risk factors of insomnia in community-dwelling Chinese elderly: A Taiwanese urban area survey. Aust N Z J Psychiatry 2004;38(9):706–713. DOI: 10.1080/j.1440-1614.2004.01444.x.
  21. 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. DOI: 10.1093/sleep/18.6.425.
  22. La YK, Choi YH, Chu MK, et al. Gender differences influence over insomnia in Korean population: A cross-sectional study. PLoS One 2020;15(1):e0227190. DOI: 10.1371/journal.pone.0227190.
  23. Tsou MT. Gender-specific correlations of insomnia and attitudes toward treatment among community-dwelling elderly in Northern Taiwan. Int J Gerontol 2018;12(3):200–204. DOI: 10.1016/j.ijge.2017.07.002.
  24. Hellström A, Hellström P, Willman A, et al. Association between sleep disturbances and leisure activities in the elderly: A comparison between men and women. Sleep Disord 2014;2014:595208. DOI: 10.1155/2014/595208. Epub 2014 Jan 19.
  25. Zeng LN, Zong QQ, Yang Y, et al. Gender difference in the prevalence of insomnia: A meta-analysis of observational studies. Front Psychiatry 2020;11:577429. DOI: 10.3389/fpsyt.2020.577429.
  26. Alimoradi Z, Gozal D, Tsang HWH, et al. Gender-specific estimates of sleep problems during the COVID-19 pandemic: Systematic review and meta-analysis. J Sleep Res 2022;31(1):e13432. DOI: 10.1111/jsr.13432. Epub 2021 Jul 9.
  27. Serrano S, Lee JW, Dehom S, et al. Association of TV watching with sleep problems in a church-going population. Fam Community Health 2014;37(4):279–287. DOI: 10.1097/FCH.0000000000000038.
  28. Shaker R, Castell DO, Schoenfeld PS, et al. Nighttime heartburn is an under-appreciated clinical problem that impacts sleep and daytime function: The results of a Gallup survey conducted on behalf of the American Gastroenterological Association. Am J Gastroenterol 2003;98(7):1487–1493. DOI: 10.1111/j.1572-0241.2003.07531.x.
  29. Lindam A, Ness-Jensen E, Jansson C, et al. Gastroesophageal reflux and sleep disturbances: A bidirectional association in a population-based cohort study, The HUNT Study. Sleep 2016;39(7):1421–1427. DOI: 10.5665/sleep.5976.
  30. Quan SA, Li YC, Li WJ, et al. Gender differences in sleep disturbance among elderly Koreans: Hallym Aging Study. J Korean Med Sci 2016;31(11):1689–1695. DOI: 10.3346/jkms.2016.31.11.1689.
  31. Patel SR, Blackwell T, Redline S, et al. The association between sleep duration and obesity in older adults. Int J Obes (Lond) 2008;32(12):1825–1834. DOI: 10.1038/ijo.2008.198. Epub 2008 Oct 21.
  32. Cooper CB, Neufeld EV, Dolezal BA, et al. Sleep deprivation and obesity in adults: A brief narrative review. BMJ Open Sport Exerc Med 2018;4(1):e000392. DOI: 10.1136/bmjsem-2018-000392.
  33. Yang JJ, Cai H, Xia L, et al. The prevalence of depressive and insomnia symptoms, and their association with quality of life among older adults in rural areas in China. Front Psychiatry 2021;12:727939. DOI: 10.3389/fpsyt.2021.727939.
  34. Perlis ML, Smith LJ, Lyness JM, et al. Insomnia as a risk factor for onset of depression in the elderly. Behav Sleep Med 2006;4(2):104–113. DOI: 10.1207/s15402010bsm0402_3.
  35. Gambhir IS, Chakrabarti SS, Sharma AR, et al. Insomnia in the elderly: A hospital-based study from North India. J Clin Gerontol Geriatr 2014;5(4):117–121. DOI: 10.1016/j.jcgg.2014.05.005.
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