Browse > Article
http://dx.doi.org/10.7586/jkbns.2021.23.2.151

Relationship among Cognition, Sleep Patterns, Salivary Melatonin Level and Sleep Disorder Inventory of Older Adults in Nursing Homes  

Shim, Haeun (College of Nursing, The Catholic University of Korea)
Sohng, Kyeong-Yae (College of Nursing, The Catholic University of Korea)
Publication Information
Journal of Korean Biological Nursing Science / v.23, no.2, 2021 , pp. 151-158 More about this Journal
Abstract
Purpose: The purpose of this study was to investigate sleep quality in older adults in nursing home with objective data collection. Methods: Participants included 74 older adults in nursing homes in Korea aged 65 years or above. Data were collected using a wearable device (Fitbit), salivary melatonin level and Sleep Disorder Inventory (SDI). The Pearson correlation coefficient was calculated to examine whether there was any correlation between sleep-related variables such as Total Sleep Time (TST), Rapid Eye Movement (REM) sleep, shallow sleep, deep sleep, salivary melatonin level and SDI. Results: There were distortion of sleep structure, as TST comprised short REM sleep (15.93±5.47%), long shallow sleep (74.18±8.08%) and short deep sleep (9.89±5.03%). Also, salivary melatonin levels were low (15.06±7.77 pg/mL). Moreover, we found than melatonin was significantly associated with TST (r = .251, p= .044), REM sleep (r= .294, p= .020) and deep sleep (r= .391, p= .002). But there was no correlation between SDI and other sleeprelated variables. Conclusion: These findings highlight that insufficient sleep structure is associated with the salivary melatonin level among older adults in nursing home. We suggest developing programs to promote sleep quality of older adults in nursing homes.
Keywords
Aged; Nursing homes; Sleep; Melatonin;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Karami Z, Golmohammadi R, Heidaripahlavian A, Poorolajal J, Heidarimoghadam R. Effect of daylight on melatonin and subjective general health factors in elderly people. Iran Journal of Public Health. 2016;45(5):636-643.
2 Kim HJ, Lee YL, Sohng KY. The effects of footbath on sleep among the older adults in nursing home: a quasi-experimental study. Complementary Therapies in Medicine. 2016;26:40-46. https://doi.org/10.1016/j.ctim.2016.02.005   DOI
3 Zhou G, Liu S, Yu X, Zhao X, Ma L, Shan P. High prevalence of sleep disorders and behavioral and psychological symptoms of dementia in late-onset alzheimer disease: a study in Eastern China. Medicine (Baltimore). 2019;98(50):e18405. https://doi.org/10.1097/MD.0000000000018405   DOI
4 Lee YJ, Park MJ, Kim EJ, Kim SM. The effect of lavender fragrance on sleep of institutionalized elderly. Journal of the Korean Gerontological Society. 2002;22(3):159-172.
5 Kim AR. The influence of physical activity and depression on sleep quality in community-dwelling older adults: a comparison between young-old and oldold. Journal of Korean Biological Nursing Science. 2015;17(4):287-296. https://doi.org/10.7586/jkbns.2015.17.4.287   DOI
6 Tractenberg R, Singer C, Cummings J, Thal L. The sleep disorders inventory: an instrument for studies of sleep disturbance in persons with Alzheimer's disease. Journal of Sleep Research. 2003;12(4):331-337. https://doi.org/10.1046/j.0962-1105.2003.00374.x   DOI
7 Hjetland GJ, Nordhus IH, Pallesen S, Cummings J, Tractenberg RE, Thun E, et al. An actigraphy-based validation study of the sleep disorder inventory in the nursing home. Frontiers in Psychiatry. 2020;11(173). https://doi.org/10.3389/fpsyt.2020.00173   DOI
8 Littner M, Kushida CA, Anderson WM, Bailey D, Berry RB, Davila DG, et al. Practice parameters for the role of actigraphy in the study of sleep and circadian rhythms: an Update for 2002. Sleep. 2003;26(3):337-341. https://doi.org/10.1093/sleep/26.3.337   DOI
9 Gooneratne N, Metlay JP, Guo W, Pack F, Kapoor S, Pack AI. The validity and feasibility of saliva melatonin assessment in the elderly. Journal of Pineal Research. 2003;34(2):88-94. https://doi.org/10.1034/j.1600-079x.2003.02945.x   DOI
10 Scholtens R, van Munster BC, van Kempen MF, de Rooij S. Physiological melatonin levels in healthy older people: a systematic review. Journal of Psychosomatic Research. 2016;86:20-27. https://doi.org/10.1016/j.jpsychores.2016.05.005   DOI
11 Sohng KY, Seung KJ, Yang JH, Choi DW, Kim SS, et al. Fundamental nursing ll revised ed. Seoul: Soomoonsa; 2021. p.443-444.
12 Altendahl M, Cotter DL, Staffaroni AM, Wolf A, Mumford P, Cobigo Y, et al. REM sleep is associated with white matter integrity in cognitively healthy, older adults. Journal of Public Library of Science ONE. 2020;15(7):e0235395. https://doi.org/10.1371/journal.pone.0235395   DOI
13 Eduardo F, Ahmad Q, Michael H. Meta-analysis: melatonin for the treatment of primary sleep disorders. FOCUS. 2018;16(1):113-118. https://doi.org/10.1176/appi.focus.16101   DOI
14 Ferman TJ, Smith GE, Dickson DW, Graff-Radford NR, Lin SC, Wszolek Z, et al. Abnormal daytime sleepiness in dementia with Lewy bodies compared to Alzheimer's disease using the multiple sleep latency test. Alzheimer's Research & Therapy. 2014;6(9):76. https://doi.org/10.1186/s13195-014-0076-z   DOI
15 Suzuki K, Miyamoto M, Hirata K. Sleep disorders in the elderly: diagnosis and management. Journal of General and Family Medicine. 2017;18(2):61-71. https://doi.org/10.1002/jgf2.27   DOI
16 Stefan L, Vrgoc G, Rupcic T, Sporis G, Sekulic D. Sleep duration and sleep quality are associated with physical activity in elderly people living in nursing homes. International Journal of Environental Resident Public Health. 2018;15(11):2512. https://doi.org/10.3390/ijerph15112512   DOI
17 Wilfling D, Dichter MN, Trutschel D, Kopke S. Prevalence of sleep disturbances in german nursing home residents with dementia: a multicenter cross-sectional study. Journal of Alzheimers Disease. 2019;69(1):227-236. https://doi.org/10.3233/JAD-180784   DOI
18 Rowe M, McCrae C, Campbell J, Horne C, Tiegs T, Lehman B, et al. Actigraphy in older adults: comparison of means and variability of three different aggregates of measurement. Behavioral Sleep Medicine. 2008;6(2):127-145. https://doi.org/10.1080/15402000801952872   DOI
19 Haghayegh S, Khoshnevis S, Smolensky MH, Diller KR, Castriotta RJ. Accuracy of wristband fitbit models in assessing sleep: systematic review and metaanalysis. Journal of International Medical Research. 2019;21(11):e16273. https://doi.org/10.2196/16273   DOI
20 Sletten TL, Magee M, Murray JM, Gordon CJ, Lovato N, Kennaway DJ, et al. Efficacy of melatonin with behavioural sleep-wake scheduling for delayed sleepwake phase disorder: a double-blind, randomised clinical trial. PLoS Medicine. 2018;15(6):e1002587. https://doi.org/10.1371/journal.pmed.1002587   DOI
21 Cajochen C, Altanay-Ekici S, Munch M, Frey S, Knoblauch V, Wirz-Justice A. Evidence that the lunar cycle influences human sleep. Current Biology. 2013; 23(15):1485-1488. https://doi.org/10.1016/j.cub.2013.06.029   DOI
22 Fetveit A, Bjorvatn B. Sleep disturbances among nursing home residents. International Journal of Geriatric Psychiatry. 2002;17(7):604-9. https://doi.org/10.1002/gps.639   DOI
23 Li J, Vitiello M, Gooneratne N. Sleep in normal aging. Sleep Medicine Clinics. 2018;13(1):1-11. https://doi.org/10.1016/j.jsmc.2017.09.001   DOI
24 Martin J, Alam T, Harker J, Josephson K, Alessi C. Sleep in assisted living facility residents versus home-dwelling older adults. The Journals of Gerontology. 2008;63(12):1407-1409. https://doi.org/10.1093/gerona/63.12.1407   DOI
25 Fortes M, Owen J, Raymond-Barker P, Bishop C, Elghenzai S, Oliver S, et al. Is this elderly patient dehydrated? diagnostic accuracy of hydration assessment using physical signs, urine, and saliva markers. Journal of the American Medical Directors Association. 2015;16(3):221-228. https://doi.org/10.1016/j.jamda.2014.09.012   DOI
26 Geerdink M, Walbeek T, Beersma DGM, Hommes V, Gordijn MCM. Short blue light pulses (30 Min) in the morning support a sleep-advancing protocol in a home setting. Journal of Biological Rhythms. 2016;31(5):483-497. https://doi.org/10.1177/0748730416657462   DOI
27 Fabio M, Sheikh S, Fernando M, Antonio G, Thomas P. A review of approaches for sleep quality analysis. Institute of Electrical and Electronics Engineers. 2019;7:24527-245246. https://doi.org/10.1109/ACCESS.2019.2900345   DOI
28 Suresh KS, Shiv KM, Kalpana T, Rakhi G. How to calculate sample size for observational and experimental nursing research studies? National Journal of Physiology, Pharmacy and Pharmacology. 2020;10(1):1-8. https://doi.org/10.5455/njppp.2020.10.0930717102019   DOI
29 Kwon Y, Park J. Standardization study of the Korean mini-mental state examination (MMSE-K) for the elderly. Journal of Korean Neuropsychiatric Association. 1989;28(1):125-135.
30 Yang CJ, Aibel K, Meyerhoff R, Wang F, Harpole D, Abernethy AP, et al. Actigraphy assessment of sleep quality among patients with acute myeloid leukaemia during induction chemotherapy. BMJ Support Palliative Care. 2018;8(3):274-277. https://doi.org/10.1136/bmjspcare-2018-001509   DOI
31 Schneider J, Schroth M, Ottenbacher J, Stork W. A novel wearable sensor device for continuous monitoring of cardiac activity during sleep. Institute of Electrical and Electronics Engineers; 2018:1-6. https://doi.org/10.1109/SAS.2018.8336725
32 Neikrug AB, Ancoli-Israel S. Sleep disturbances in nursing homes. The Journal of Nutrition, Health & Aging. 2010;14(3):207-211. https://doi.org/10.1007/s12603-010-0051-8   DOI
33 Heo B, Kim J. Sleep disorders of elders with dementia in long-term care hospitals Journal of Korean Gerontological Nursing. 2009;11(2):139-151.
34 Ministry of Health and Welfare. 2020 Status of welfare facilities for the elderly [Internet]. Wonju [cited 2021 March 30]. Available from: http://www.mohw.go.kr/react/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=032901&CONT_SEQ=355052&page=1
35 Boga SM, Saltan A. Identifying the relationship among sleep, mental status, daily living activities, depression and pain in older adults: a comparative study in Yalova, turkey. Journal of Pakistan Medical Association. 2020;70(2):236-242. https://doi.org/10.5455/jpma.301384   DOI
36 Eser I, Khorshid L, Cinar S. Sleep quality of older adults in nursing homes in Turkey: enhancing the quality of sleep improves quality of life. Journal of Gerontological Nursing. 2007;33(10):42-49. https://doi.org/10.3928/00989134-20071001-07   DOI
37 Marino M, Li Y, Rueschman MN, Winkelman JW, Ellenbogen JM, Solet JM, et al. Measuring sleep: accuracy, sensitivity, and specificity of wrist actigraphy compared to polysomnography. Sleep. 2013;36(11):1747-1755. https://doi.org/10.5665/sleep.3142   DOI
38 Crowley K. Sleep and sleep disorders in older adults. Neuropsychology Review. 2011;21(1):41-53. https://doi.org/10.1007/s11065-010-9154-6   DOI
39 Hwang E. Sleep patterns of older residents in long-term-care facilities: a comparison with older adults in home-care services and community-dwelling older adults. Journal of Korean Gerontological Nursing. 2021;23(1):75-84. https://doi.org/10.17079/jkgn.2021.23.1.75   DOI
40 Jeon B, Choi-Kwon S. Factors influencing sleep disturbances among older adults living within a community. Jornal of Korean Adult Nursing. 2017;29(3)235-245. https://doi.org/10.7475/kjan.2017.29.3.235   DOI