Older adults objective self-recording of sleep in the home

Abstract

A convenient, objective source of sleep data in the natural environment can play an important role in evaluating older persons' sleep complaints. The present study tested the utility of such an instrument. Self-report (SR) sleep estimates were contrasted against sleep records derived from tape-recorded verbal responses to fixed interval tones presented throughout the night (sleep assessment device, SAD) with three groups of older women: 18 noninsomniacs, 18 insomniacs using sleep medication, and 20 nonmedicated insomniacs. Subjects collected 2 weeks on SR data and, in addition, the SAD was employed for 1 of those weeks. Sleep deterioration occurred upon introduction of the SAD, though this first night effect quickly dissipated. No differences were found between the 2 weeks of the SR data, one of which included the SAD, and subjects rated the SAD as not disturbing, both indications of unobtrusiveness. Though these subjects required more instruction time than younger subjects, they were able to effectively operate the SAD. As is often the case, SR estimates revealed greater sleep disturbance than did the objective measure, SAD, but both methods also found sleep equivalence between groups on some measures. Insomniacs were distinguished from noninsomniacs more by sleep dissatisfaction than by sleep pattern. Overall, the SAD proved to be a useful source of objective sleep data in the home for older people. Theoretical and clinical implications of these data, as well as limitations on conclusions, are discussed.