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An actigraphic study comparing community dwelling poor sleepers with non-demented care home residents

An actigraphic study comparing community dwelling poor sleepers with non-demented care home residents
An actigraphic study comparing community dwelling poor sleepers with non-demented care home residents
Sleep disturbances are a common problem among institutionalized older people. Studies have shown that this population experiences prolonged sleep latency, increased fragmentation and wake after sleep onset, more disturbed circadian rhythms, and night-day reversal. However, studies have not examined the extent to which this is because of individual factors known to influence sleep (such as age) or because of the institutional environment. This article compares actigraphic data collected for 14 days from 122 non-demented institutional care residents (across ten care facilities) with 52 community dwelling poor sleepers >65 yrs of age. Four dependent variables were analyzed: (i) “interdaily stability” (IS); (ii) “intradaily variability” (IV); (iii) relative amplitude (RA) of the activity rhythm; and (iv) mean 24?h activity level. Data were analyzed using a fixed-effect, single-level model (using MLwiN). This model enables comparisons between community and institutional care groups to be made while conditioning out possible “individual” effects of “age,” “sex,” “level of dependency,” “level of incontinence care,” and “number of regular daily/prescribed medications.” After controlling for the effects of a range of individual level factors, and after controlling for unequal variance across groups (heteroscedascity), there was little difference between community dwelling older adults and institutional care residents in IS score, suggesting that the stability of day-to-day patterns (such as bed get-up, lunch times, etc.) is similar within these two resident groups. However, institutional care residents experienced more fragmented rest/wake patterns (having significantly higher IV scores and significantly lower mean activity values). Our findings strongly suggest that the institutional care environment itself has a negative association with older people's rest/wake patterns; although, longitudinal studies are required to fully understand any causal relationships.
0742-0528
842-854
Meadows, Robert
c83b704f-082d-41d7-83ba-de86d409c349
Luff, Rebekah
b12da7ec-5b6b-4928-9993-c0228cf140b5
Eyers, Ingrid
e3f44ca2-5e0c-480d-a708-64ac0eb8366e
Venn, Susan
567b041d-efe8-478d-b90f-d24183585a4c
Cope, Emma
e7a0838b-9fe8-4fc6-8020-f43c2b93f7e9
Arber, Sara
b7f63a77-ae92-4970-9cf5-98d7118c41d1
Meadows, Robert
c83b704f-082d-41d7-83ba-de86d409c349
Luff, Rebekah
b12da7ec-5b6b-4928-9993-c0228cf140b5
Eyers, Ingrid
e3f44ca2-5e0c-480d-a708-64ac0eb8366e
Venn, Susan
567b041d-efe8-478d-b90f-d24183585a4c
Cope, Emma
e7a0838b-9fe8-4fc6-8020-f43c2b93f7e9
Arber, Sara
b7f63a77-ae92-4970-9cf5-98d7118c41d1

Meadows, Robert, Luff, Rebekah, Eyers, Ingrid, Venn, Susan, Cope, Emma and Arber, Sara (2010) An actigraphic study comparing community dwelling poor sleepers with non-demented care home residents. Chronobiology International, 27 (4), 842-854. (doi:10.3109/07420521003797732).

Record type: Article

Abstract

Sleep disturbances are a common problem among institutionalized older people. Studies have shown that this population experiences prolonged sleep latency, increased fragmentation and wake after sleep onset, more disturbed circadian rhythms, and night-day reversal. However, studies have not examined the extent to which this is because of individual factors known to influence sleep (such as age) or because of the institutional environment. This article compares actigraphic data collected for 14 days from 122 non-demented institutional care residents (across ten care facilities) with 52 community dwelling poor sleepers >65 yrs of age. Four dependent variables were analyzed: (i) “interdaily stability” (IS); (ii) “intradaily variability” (IV); (iii) relative amplitude (RA) of the activity rhythm; and (iv) mean 24?h activity level. Data were analyzed using a fixed-effect, single-level model (using MLwiN). This model enables comparisons between community and institutional care groups to be made while conditioning out possible “individual” effects of “age,” “sex,” “level of dependency,” “level of incontinence care,” and “number of regular daily/prescribed medications.” After controlling for the effects of a range of individual level factors, and after controlling for unequal variance across groups (heteroscedascity), there was little difference between community dwelling older adults and institutional care residents in IS score, suggesting that the stability of day-to-day patterns (such as bed get-up, lunch times, etc.) is similar within these two resident groups. However, institutional care residents experienced more fragmented rest/wake patterns (having significantly higher IV scores and significantly lower mean activity values). Our findings strongly suggest that the institutional care environment itself has a negative association with older people's rest/wake patterns; although, longitudinal studies are required to fully understand any causal relationships.

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More information

Published date: June 2010

Identifiers

Local EPrints ID: 185727
URI: http://eprints.soton.ac.uk/id/eprint/185727
ISSN: 0742-0528
PURE UUID: 92172c2b-0f4d-4183-a8c1-c78fb89107dd
ORCID for Rebekah Luff: ORCID iD orcid.org/0000-0001-7871-0246

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Date deposited: 11 May 2011 07:40
Last modified: 14 Mar 2024 03:15

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Contributors

Author: Robert Meadows
Author: Rebekah Luff ORCID iD
Author: Ingrid Eyers
Author: Susan Venn
Author: Emma Cope
Author: Sara Arber

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