Sleep behaviour among elderly in Hong Kong

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Sleep behaviour among elderly in Hong Kong


Author: Chan, Yee-kwan
Title: Sleep behaviour among elderly in Hong Kong
Degree: M.Sc.
Year: 2004
Subject: Hong Kong Polytechnic University -- Dissertations
Older people -- China -- Hong Kong -- Physiology
Sleep disorders -- China -- Hong Kong
Department: School of Nursing
Pages: xiv, 130 leaves : col. ill. ; 30 cm
Language: English
InnoPac Record:
Abstract: Sleep disturbances are particularly common problems in the elderly worldwide. The purpose of this study is to examine and compare the sleep behaviours between the non-institutionalized and institutionalized elderly in Hong Kong. A cross-sectional descriptive survey and quota sampling were adopted. Total 1000 elderly were participated in this study. Within which, there were 500 non-institutionalized elderly and 500 institutionalized elderly. For the non-institutionalized participants, they were come from day care centre (n=78, 7.8%), elderly centre (n=372, 37.2%) and home setting without attending any centre (n=50, 5%). Whereas the institutionalized participants, they were come from infirmary (n=50, 5%), care-and-attention home (n=150, 15%) and hostels for the elderly (n=300, 30%). As regard to the Pittsburgh Sleep Quality Index (PSQI), there had significant differences between non-institutionalized and institutionalized settings There were 33% (n=163) of the participants were poor sleepers in non-institutionalized setting. Versus, 63% (n=315) of participants in institutionalized setting was observed. About 87% of institutionalized participants had one or more than one complaint of difficulty in initiating sleep (DIS), difficulty in maintaining sleep (DMS), early morning awakening (EMA) or insomnia. The usual bedtime of institutionalized participants was much earlier than that of non-institutionalized participants. The total sleep time was longer, sleep efficiency was higher, usage of sleeping pills was lower in non-institutionalized participants than that of institutionalized participants. Significant differences (X2=73.45, p<0.001) in the Geriatric Depression Scale (GDS) were noted between non-institutionalized and institutionalized participants. About 9% (n=45) of the non-institutionalized participants and 30.6% (n=153) of institutionalized participants were depressed. Most of the institutionalized participants were unsatisfied with their life, felt unhappy, helpless, hopeless and not wonderful to be alive. Several possible contributory factors, including physiological, psychological, environmental and lifestyle factors, contributed sleep changes of elderly people. In this study, gender showed no significant difference in affecting sleep behaviour of the elderly people. However, the number of poor sleepers increases with advancing age, with perceiving poor health, with experiencing physical illness and somatic complaints. These physiological factors lead to subjective sleep dissatisfaction and hence sleep disturbance or insomnia. Psychological factors such as life events in the previous years, and obtained higher GDS score, were found to have association with poorer sleepers. Non-institutionalized participants did not experience environmental factors that affecting their nocturnal sleep. On the contrary, the institutionalized participants' sleep was affected by environmental noise, light and human disruption causing frequent awakenings and thus had lighter and shorter sleep. Amongst non-institutionalized elderly people, there is no significant difference in sleep behaviour between the elderly attending day care centres, elderly centres and those not attending any centre. However, amongst the institutionalized elderly, there is a significant difference between those who reside in infirmaries, those in C&A homes and those in hostels for the elderly. The total sleep time, sleep efficiency, PSQI score and GDS score are poorer in residents of C&A homes than in residents of hostels for the elderly and are worst amongst in infirmary residents.

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