Poor Sleep Linked to Future Nursing Home Admission

According to the Centers for Disease Control and Prevention, insufficient sleep is associated with a number of chronic diseases and conditions—such as diabetes, cardiovascular disease, obesity and depression. In addition, insufficient sleep is associated with the onset of many diseases and is responsible for motor vehicle and machinery-related crashes. Previous studies have also linked disturbed sleep with disability in older adults and impairment in activities of daily living and mobility. Kristine Yaffe, from the University of California/San Francisco (UCSF; California, USA), and colleagues report that fragmented or interrupted sleep could predict future placement in a nursing home or assisted living facility. The team measured the sleep of 1,664 women, mean age of 83 years, enrolled in the Study of Osteoporotic Fractures. Participants were asked to wear actigraphs on their non-dominant wrists for at least three days. These devices record movement, and the resulting data can be used to characterize patterns of sleep and wake. Demographic information as well as place of residence at initial interview and at 5-year follow-up was also provided. The researchers found that greater sleep fragmentation associated with greater risk of placement in a nursing home or personal care home 5 years later.  Further, compared to women with the least fragmented sleep, those who spent the most time awake after first falling asleep had about 3 times the odds of placement in a nursing home. Individuals with the lowest sleep efficiency—those who spent the smallest proportion of their time in bed actually sleeping—also had about 3 times the odds of nursing home placement.  The study authors conclude that: “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.”