Ham. Middelkoop et al., SLEEP AND AGING - THE EFFECT OF INSTITUTIONALIZATION ON SUBJECTIVE AND OBJECTIVE CHARACTERISTICS OF SLEEP, Age and ageing, 23(5), 1994, pp. 411-417
To assess the impact of institutionalization on sleep/wake characteris
tics of elderly people, we compared subjective (study I: n = 160) and
objective (study II: n = 30) sleep/wake measures of non-demented insti
tutionalized subjects and age-matched non-institutionalized controls.
We also evaluated the prevalence and causes of various sleep disturban
ces. The three living conditions, i.e. independently living (IL), serv
ice home (SH) and nursing home (NH) were respectively assumed to have
minimal, moderate and maximal effects upon the timing, the amount and
the quality of the sleep/wake behaviour of the persons involved.Study
I showed that a higher level of institutionalization was significantly
(p < 0.05) associated with phase-advanced sleep/wake patterns, increa
sed amounts of time spent in bed during the 24-hour period and increas
ed usage of prescribed sedative-hypnotic drugs. Poor sleep quality and
disturbed sleep onset occurred significantly mostly in the SH group.
No differences between groups were demonstrated with respect to the pr
evalence of disturbed sleep maintenance, parasomnias and difficulty wi
th awakening and their possible causes, except for environmental noise
which was exclusively reported by institutionalized subjects. No diff
erences between groups for any of the objective measures were found (s
tudy II). Overall, our findings are in line with previous findings on
this topic, although the observed high rate of poor sleep quality and
sleep disturbances and their associated causes as observed in institut
ionalized subjects also occurs in an age-matched non-institutionalized
population.