Contribution of Routine to Sleep Quality in Community Elderly

Abstract

Among the common problems related to aging is sleep quality; over half of older adults suffer from symptoms of insomnia. Age-related changes in circadian sleep/wake regulation constitute a major underlying factor. Constant and organized lifestyle may moderate the effects of circadian rhythm changes on sleep. Preliminary findings have linked daily regularity to sleep quality among healthy adults and in patients with Parkinson disease. The current study investigated the relationships between daily routines and sleep quality among community dwelling elderly. Ninety-six Israeli Russian-speaking elderly living in a retirement community (mean age 75 +/- 13.88, 72% women, 82% living alone) participated. Routines were assessed with the Scale of Older Adults Routine (SOAR) by a trained interviewer at 3 time points 2 weeks apart. A subsample (n = 33) completed the Social Rhythm Metric (SRM) 2-week diary. Sleep quality was evaluated using the Pittsburg Sleep Quality Index (PSQI). Daily Functional status was assessed with the Lawton Instrumental Activities of Daily Living (IADL). Mean sleep efficiency was 78%, functional status was fairly good (mean IADL 45 of 50 [SD = 6.12]). Regression analyses indicated that increased stability in daily routine, as measured by the SOAR for the entire sample, predicted shorter sleep latency, higher sleep efficiency and improved sleep quality, beyond functional status, comorbidities, and age. Similar associations were found for the subsample using the SRM. Maintenance of daily routines is associated with a reduced rate of insomnia in the elderly. Further studies should examine these relations in broader populations with regard to health, functional status, and cultural background.