Objectively Measured Sleep Quality and Nursing Home Placement in Older Women

• Autores: Adam P. Spira, Kenneth E. Covinsky, George W. Rebok, Katie L. Stone, Susan Redline, Kristine Yaffe
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 60, Nº. 7, 2012, págs. 1237-1243
• Idioma: inglés
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• Resumen

  • Objectives: To determine the association between objectively measured sleep and subsequent placement in a nursing home or a personal care home.

    Design: Prospective cohort.

    Setting: Participants' homes and sites of the Study of Osteoporotic Fractures.

    Participants: One thousand six hundred sixty-four community-dwelling women with a mean age of 83 ± 4.

    Measurements: At baseline, participants completed an average of 4 nights of wrist actigraphy; they provided data on place of residence at baseline and at follow-up, 5 years later.

    Results: At baseline, participants had a mean total sleep time of 408 ± 72 minutes, mean wake after sleep onset of 71 ± 43 minutes, and mean sleep efficiency of 79 ± 11%. At follow-up, 71 (4%) were residing in a nursing home, and 127 (8%) were in a personal care home. Women with the most wake after sleep onset (by quartile) had more than twice the odds as those with the least of placement in a nursing home (adjusted odds ratio (AOR) = 2.94, 95% confidence interval (CI) = 1.34�6.44) or a personal care home (AOR = 2.33, 95% CI = 1.26�4.30). Similarly, women with the lowest sleep efficiency had more than three times the odds as those with the highest of nursing home placement (AOR = 3.25, 95% CI = 1.35, 7.82) and more than twice the odds of placement in a personal care home (AOR = 2.38, 95% CI = 1.33, 4.24). There was no association between sleep duration and placement.

    Conclusion: In very old community-dwelling women, greater wake after sleep onset and lower sleep efficiency are risk factors for placement in a nursing home or personal care home. Sleep duration alone does not appear to increase the risk of placement in these long-term care settings.