Optimising quality of sleep among older people in the community and care homes: An integrated approach

Arber, Sara and Armstrong, David and Eyers, Ingrid and Morgan, Kevin and Orpwood, Roger and Skene, Debra (2017). Optimising quality of sleep among older people in the community and care homes: An integrated approach. [Data Collection]. Colchester, Essex: UK Data Archive. 10.5255/UKDA-SN-851802

Good sleep in later life reduces risk of falls and depression, is essential for maintaining activity and performance levels, and reduces challenging behaviour encountered in dementia sufferers. This multi-disciplinary research project addresses practice and policy relevant issues arising from the nature, impact and management of the sleep-wake balance in later life. It will extend and 'join up' strategically targeted areas of sleep research relevant to understanding and improving autonomy, active ageing, and quality of later life.
Academic partners from six disciplines and four institutions, together with five non-academic partners, will achieve these objectives through research within eight inter-linked work packages. Multiple methods will be used to improve understanding of disrupted sleep and associated medication use in later life, using secondary analysis of existing large databases, and in-depth research with older people in the community and care homes. Interventions will be conducted to evaluate the effects of ‘blue-enriched’ light on quality of sleep in the community and care homes, evaluate a supported self-management programme for insomnia among older patients in general practice, and evaluate newly-developed sensor-devices to improve sleep. A user-friendly information and advice website on sleep will be developed, and a sleep education module prepared for the DIPEx website.

Data description (abstract)

The project sought to produce new knowledge, processes and products with major implications for improving sleep and hence quality of life for older individuals in both the community and care homes. This was done through a series of 8 work packages (WP) that each collected a range of data:

WP1: looked at the epidemiology of disrupted sleep through secondary analysis of several large-scale datasets.
WP2: looked at poor sleep among older people in the community with 2 phases. Phase 1 used a self-completion, postal questionnaire administered to 1158 people over the age of 65 forming one data file with 54 variables (age, sex, marital status, last occupation, number of health conditions, the Pittsburgh Sleep Quality Index, PSQI. The PSQI asks questions about sleep in the previous month, such as how long did it take you to fall asleep, number of awakenings in the night and use of sleeping medication). Phase 2 comprised of 62 qualitative interviews with poor sleepers identified through phase 1; plus 59 daily audio-sleep diaries over two weeks. 60 daily sleep and activities diaries were also recorded for 14 days equaling one data file of 60 cases, coded in 30 minute periods, 13 variables coded per 30 min block (i.e. 48 blocks x 13 variables per day, plus additional 12 variables per person), totaling 650 variables per person within the file (food and drink intake, social contact, main and secondary activities). Actigraphy was also used.
WP3: looked at the determinants of poor quality sleep in care homes through a 2 week collection period in 10 care homes. Sleep and activity diaries were completed by researchers daily for 14 days - one data file for 125 residents, 68 variables coded for each day comprising 72 variables in total. Profiles of residents were also recorded with 66 variables for 145 residents in total.
WP4: explored supported self-management for insomnia among chronically ill patients through a randomised control trial over 6 months.
WP5: evaluated light therapy among older people in the community with a randomised cross-over 11 week trial of 2 different light intensities with 33 older people.
WP6: was similar to WP5 in that it evaluated light therapy but this time in care home residents. A cross -over 12 week trial of 2 different light intensities in 7 care homes involving 80 residents was carried out.
WP7: looked at the development and evaluation of sensor-based devices to improve sleep of older people through engineering developments and trials of a range of novel devices.
WP8: focused on the development of a website.

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