Objectively Measured Sleep Quality and Nursing Home Placement in Older Women
Article first published online: 15 JUN 2012
© 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 60, Issue 7, pages 1237–1243, July 2012
How to Cite
Spira, A. P., Covinsky, K., Rebok, G. W., Stone, K. L., Redline, S. and Yaffe, K. (2012), Objectively Measured Sleep Quality and Nursing Home Placement in Older Women. Journal of the American Geriatrics Society, 60: 1237–1243. doi: 10.1111/j.1532-5415.2012.04044.x
- Issue published online: 12 JUL 2012
- Article first published online: 15 JUN 2012
- National Institutes of Health (NIH). Grant Numbers: R01 AG005407, IIRG-08–88872, K01AG033195, K24AG031155, R01 AR35582, R01 AR35583, R01 AR35584, R01 AG026720, R01 AG005407, R01 AG027574, R01 AG027576, R01 AG005394
- Department of Defense
- Department of Veterans Affairs
- Alzheimer's Association. Grant Numbers: IIRG-08–88872, K01AG033195, K24AG031155
- Alzheimer's Association Award. Grant Number: IIRG-08–88872
- Mentored Research Scientist Development Award. Grant Number: K01AG033195
- Midcareer Investigator Award in Patient-Oriented Research. Grant Number: K24AG031155
- National Heart, Lung, and Blood Institute
- California Pacific Medical Center
- ResMed Foundation
- National Institute of Mental Health
- National Institute of Diabetes and Digestive and Kidney Diseases
- nursing home;
To determine the association between objectively measured sleep and subsequent placement in a nursing home or a personal care home.
Participants' homes and sites of the Study of Osteoporotic Fractures.
One thousand six hundred sixty-four community-dwelling women with a mean age of 83 ± 4.
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.
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.
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.