Galea, Melissa (2008) Subjective sleep quality in the elderly: relationship to anxiety, depressed mood, sleep beliefs, quality of life, and hypnotic use. Other Degree thesis, Victoria University.

Abstract

The complaint of insomnia in older adults is associated with the use of hypnotics. This study was aimed at exploring possible differences between self-categorised good sleepers and poor sleepers on a range of variables, and the factors associated with the use of hypnotic medication amongst the elderly. Participants in the current study were aged 60 to 98 years old. A total of 74 (28 males, 46 females) older adult hostel residents participated in the current study. Twenty-two participants were self-reported good sleepers, and 52 participants were self reported poor sleepers, with 21 using benzodiazepine hypnotic medication regularly and 31 not using hypnotics. The measures used included the Pittsburgh Sleep Quality Index (PSQI), Geriatric Depression Scale (GDS), The Beck Anxiety Inventory (BAI), Sleep Beliefs Questionnaire (SBQ), and World Health Organisation Quality of Life-Brief (WHOQoL). The findings demonstrated that self-categorised good sleepers had significantly better sleep quality and habitual sleep efficiency, and significantly shorter sleep latency, regardless of hypnotic use. It was also found that good sleepers and poor sleepers taking benzodiazepines had significantly longer sleep duration than poor sleepers not taking benzodiazepine hypnotics. The prediction that self-classified good sleepers would have lower depressed mood than their self-classified poor sleeping counterparts, whether they were taking benzodiazepine hypnotics or not, was supported. The findings suggested that while self-classified good sleepers had lower anxiety levels than poor sleepers using hypnotic agents, these poor sleepers had significantly lower anxiety levels when compared to their counterparts not using benzodiazepines. Further variables of difference between good and poor sleepers included the psychological and social relationships domains of quality of life. Interestingly, the results indicated that the main role benzodiazepine hypnotic agents have for poor sleepers appears to be longer sleep duration. Benzodiazepine use did not have a significant ameliorative effect on any of the other sleep variables measured in the current sample of hostel dwelling, older adults. The findings indicated that sleep duration and habitual sleep efficiency demonstrated good predictive validity for whether subjective poor sleepers take benzodiazepine hypnotics. It was concluded that an alternative to managing poor sleep needs to be education programs, such as education delivered by nurses or evidence based self-help programs (eg. Morawetz, 2003)

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