A Clinical Research On The Insomnia Quo And Related Factors In The Elderly

Objective The purpose of this study was to figure out the incidence of insomnia in the elderly,associated factors and consequences of insomnia by investigating the current situation of insomnia he elderly.Methods The cross-sectional study was used.A convenience sample of the elderly people(aged 60 years old and over)were recruited from the outpatients,ward treatment and normal people of department geriatrics medical in the Shanghai Sixth People's Hospital during August 2015 to January 2016.According to the number of insomnia symptoms(sleep initiation disorder,sleep maintenance disorder,waking up early and sleep quality decline.),the subjects were divided into group A(with no or only one symptom of insomnia in the elderly)and group B(with two or more symptoms of insomnia in the elderly).The investigators took the form of face-to-face questionnaire interviews.The questionnaires mainly included the elderly general information(such as gender,age,chronic diseases,etc.),the Pittsburgh Sleep Quality Index(PSQI),Epworth Sleepiness Scale(ESS),Montreal Cognitive Assessment(MoCA),Hamilton Depression Scale(HAMD).Excel was used to summary the data.The SPSS 19.0 software was used for statistical analysis of the data.Result There were 125 elderly people.The maximum age was 94 years old,the minimum age was 60 years old and the average age was(81.71±7.635)years old.There were 66 elderly men and their average age was(81.71±7.635)years old.And there were 59 elderly women,their average age was(80.15±7.906)years old.The prevalence of insomnia was 36%in the elderly,and there was no statistically difference between males and females.The old people often had a lot of sleep problems at the same time,such as waking up early,sleep initiation disorder,sleep maintenance disorder,etc.The elderly with two sleep problems accounted for 26.4%and the elderly with three or more sleep problems accounted for 33.6%.Insomnia symptoms mainly contained waking up early(56.80%),maintenance disorders(54.4%)and sleep initiation(40.80%).25.8%of the elderly had daytime functional impairment.In group B 50.8%of the older people had daytime functional impairment,and 25.8%of the older people had daytime functional impairment(?~2=8.248,P<0.05).Daytime functional impairment was mainly based on daytime sleepiness(26.4%).The average score of PSQI was(11.5±3.38).Group B got statistically higher PSQI score than group A(12.59±3.373 vs 10.39±3.973,t=-3.34,P<0.05).In univariate analysis age was associated with each of the subgroup of insomnia symptoms,whereas after adjustment for potential factors,age no longer showed a significant association with two or more insomnia symptoms(P>0.05).Comparison of the incidence of group B among 60-69 age group,70-79 age group and 80-89 age group,showed that the incidence of group B increased with age group increased(P<0.05),but the incidence rate of group B in 90-99 years old was less than 80-89 years old group(P>0.05).There were 63.6%of old men and 44.1%of old women with sleep maintenance disorder,and the difference was statistically significant(?~2=4.809,P<0.05).The elderly with chronic diseases got statistically higher PSQI score than the elderly without disease(11.85±3.953vs 10.08±2.957,t=-2.095,P<0.05).The prevalence of cerebral infarction of group B was 36.5%,as well as the prevalence was 12.9%in group A,with a statistically difference between the two groups(?~2=9.336,P<0.05).Sleep quality was related with coronary heart disease(r=1.400,P<0.05).Logistic stepwise regression equations showed that asthma,chronic pain and depression were associated with insomnia symptom(P<0.05).The elderly of group B got higher scores than the elderly of group A in ESS score(4.00±2.22)and HAMD score(5.95±2.12),but lower score in MoCA score(20.73±5.15),and all the differences were statistically significant(P<0.05).Conclusion The prevalence of insomnia was 36%in the elderly.Cerebral infarction,coronary heart disease,asthma,chronic pain and depression were important factors to sleep.The elderly with two or more insomnia symptoms appeared to be poorer cognitive function,more likely to be daytime sleepiness and depression.