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Insomnia symptoms among old people in nursing homes

Published online by Cambridge University Press:  20 September 2017

Andreas Skottheim ,
Hugo Lövheim ,
Ulf Isaksson ,
Per-Olof Sandman  and
Maria Gustafsson
Andreas Skottheim
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
Hugo Lövheim
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
Ulf Isaksson
Affiliation:
Department of Nursing, Umeå University, Umeå, Sweden Arctic Research Centre, Umeå University, Umeå, Sweden
Per-Olof Sandman
Affiliation:
Department of Nursing, Umeå University, Umeå, Sweden Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden Department of Health Sciences, University of Technology, Luleå, Sweden
Maria Gustafsson*
Affiliation:
Department of Pharmacology and Clinical Neuroscience, Division of Clinical Pharmacology, Umeå University, Umeå, Sweden
*
Correspondence should be addressed to: Maria Gustafsson, Department of Pharmacology and Clinical Neuroscience, Umeå University, SE-901 87 Umeå, Sweden. Phone: +46 90 785 35 62; Fax: +46 90 12 04 30. Email: [email protected].
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Abstract

Background:

Insomnia symptoms are common among old people, and hypnotics and sedative drugs are often prescribed in spite of small benefits. The aim of this study was to estimate the prevalence of insomnia symptoms and to analyze the association between insomnia symptoms, cognitive level, and prescription of hypnotics and sedatives among old people living in nursing homes.

Methods:

The study comprised 2,135 people living in nursing homes in the county of Västerbotten, Sweden. Data concerning hypnotic and sedative drugs, cognitive function, and prevalence of insomnia symptoms were collected, using the Multi-Dimensional Dementia Assessment Scale (MDDAS).

Results:

The three most common insomnia symptoms were “sleeps for long periods during the day,” “interrupted night-time sleep,” and “wakes up early in the morning” with 57.8%, 56.4%, and 48.0%, respectively, of the residents exhibiting the symptoms at least once a week. Different insomnia symptoms showed different association patterns with sex and age. Most insomnia symptoms were more common among people with cognitive impairment compared to those with no cognitive impairment and seemed to reach their peak prevalence in people with moderate to severe cognitive impairment, subsequently decreasing with further cognitive decline. Of the study population, 24.0% were prescribed hypnotics and sedatives. Prescriptions were more common among those without cognitive impairment, and among those exhibiting the symptom “difficulty initiating sleep.”

Conclusions:

Insomnia symptoms and prescription of hypnotics and sedatives are common among old people living in nursing homes. Considering the risk of adverse effects, it is important to regularly re-evaluate the need for these drugs.

Keywords

insomnia symptomshypnotics and sedativesdementiacognitive impairmentnursing homes
Type
Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 1 , January 2018 , pp. 77 - 85
Copyright
Copyright © International Psychogeriatric Association 2017 

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