Sleep problems in Chinese elderly in Hong Kong

Background: To examine the sleep habits and one-year prevalence of sleep di sturbance (difficulty in falling asleep, broken sleep and early morning wak ening) as well as insomnia (subjectively inadequate or poor sleep) in an el derly Chinese population in Hong Kong. Method: In Phase 1, a representative sample of elderly aged 70 years or abo ve were interviewed with a sleep questionnaire, and Cantonese versions of t he Mini-Mental State Examination (CMMSE) and Geriatric Depression Scale(CGD S). In Phase 2, those with scores suggestive of cognitive impairment on CMM SE or depression on CGDS were interviewed by psychiatrists for making clini cal diagnoses according to DSM IV. Results: 1,034 elderly were interviewed in Phase 1. Occasional or persisten t sleep disturbance were reported by 75% and insomnia in 38.2% of elderly. Slightly less than half of elderly with sleep disturbance complained of ins omnia. Advancing age was associated with a higher rate of sleep disturbance while females had a higher rate of insomnia. Factors associated with sleep disturbance and insomnia included poor perceived health, past history of s moking, current depressive disorders, more chronic physical illness, more l ife events and more somatic complaints. Only 2.8% of the sample had taken s leeping pills within a one -year period. Conclusions: Sleep disturbance and insomnia are two separate but overlappin g constructs and should be differentiated. Sleep disturbance is very common in the elderly and may be due to physiological changes with ageing. In con trast, those with a concommitant complaint of insomnia have impaired physic al and mental health and may merit more medical attention.