Study on sleep quality and associated psychosocial factors among elderly in a rural population of Kerala, India

Abstract

Background: Sleep is an important physiological process with many restorative functions. Insomnia defined as difficulty in falling or staying asleep which is frequent in older people. Reduced sleep quality can result in impaired daytime function which can lead to severe consequences. This study was conducted to examine sleep quality of elderly and to determine its relationship with psychosocial factors, in a rural population of Kerala. Methods: A community based cross sectional study was done by interviewing 170 people who were 60 years or above, selected by simple random sampling, after getting consent. The study tools used were Pittsburgh sleep quality index (PSQI), General anxiety disorder 7 item (GAD-7) scale, geriatric depression score (GDS 5 items) and a self designed general sociodemographic questionnaire. Data was tabulated using MS Excel and analyzed using SPSS V-20. Results: The sleep quality according to global PSQI was good for 27.6%, while it was poor for 72.4% of respondents. The mean GPSQI of the study was 8.04±4.59. Absence of toilet inside home (p=0.036), current health problems (p=0.003), multiple (>3) health problems (p=0.006), regular use of current medications (p=0.033) had a significant association with poor sleep quality. Association between general anxiety disorder and GPSQI was significant with poor sleep quality among those with severe anxiety (p=0.017). Association between GDS-5 score and GPSQI showed a significant association between symptoms suggestive of depression and poor sleep quality (p=0.014). Conclusions: Questions on sleep quality should be routinely asked by clinicians as part of general health assessment of an elderly.