Prevalence and Risk Factors of Insomnia in Community-Dwelling Chinese Elderly: A Taiwanese Urban Area Survey

Aug 25, 2004The Australian and New Zealand journal of psychiatry

How common insomnia is and its risk factors among older adults living in a Taiwanese city

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Abstract

The prevalence of one-month insomnia among older individuals is 6%, with higher rates in women (8%) compared to men (4.5%).

Frequent use of sleep medications was reported by 8.4% of participants.
Poor sleep quality was the most common sleep complaint, followed by difficulty falling asleep and early morning awakenings.
Nocturnal urination was strongly associated with insomnia, with an odds ratio of 20.6.
Regular use of sleep medications had an odds ratio of 3.2 for insomnia risk.
For men, factors such as pulmonary disease, being unmarried, excessive daytime sleepiness, and mental illness were linked to increased insomnia risk.
Women with insomnia were associated with factors like lack of education, body pain, and depression.

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OBJECTIVE: To determine the prevalence of and risk factors for self-reported sleep complaints in the elderly.

METHOD: A cross-sectional interview study was conducted in a total of 2045 non-institutionalized older individuals aged 65 years or above of an urban community of Taiwan.

RESULTS: The prevalence of one-month insomnia was 6% overall with a higher rate in elderly women (8%) than men (4.5%). Frequent use of hypnotics over the past month was 8.4%. Among specific sleep complaints, poor sleep quality was the most commonly reported symptom, followed by difficulty falling asleep and difficulty maintaining sleep or early morning awakenings. Increasing age did not correlate with an increased rate of insomnia and female gender was not an independent risk factor. Factors associated with insomnia for both genders were nocturnal micturation (OR = 20.6) and regular use of hypnotics (OR = 3.2). Pulmonary disease (OR = 2.7), not married (OR = 2.3), excessive daytime sleepiness (OR = 2.4), and mental illness (OR = 8.6) were risk factors for men while lack of education (OR = 1.8) and body pain (OR = 2.6) were risk factors for women. Depression (OR = 2.2) was strongly associated with insomnia in the elderly women as well.

CONCLUSIONS: There was a low insomnia prevalence rate in the urban elderly community. Identified insomniacs required treatment of physical and mental problems, particularly in gender-specific risk factors. For those who complained of putative poor sleep quality symptom, early intervention may halt their progress of sleep disturbance and avoid unnecessary benzodiazepine use. Future longitudinal studies to investigate causes of insomnia, as well as its detrimental effects on mood and health, are warranted.

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Prevalence and Risk Factors of Insomnia in Community-Dwelling Chinese Elderly: A Taiwanese Urban Area Survey

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