Sleep quality and associated factors of patients with mild cognitive impairment at King Chulalongkorn Memorial Hospital
Keywords:
Sleep quality, neuropsychiatric symptoms, mild cognitive impairmentAbstract
Background: Thailand has shifted to an aging society. Sleep disturbance is a common problem in the elderly which affects emotion and cognitive levels. Awareness of sleep problems can help implementing elderly care and preventing dementia in the future.
Objective: To study sleep quality and determine factors associated with sleep quality among patients with mild cognitive impairment (MCI).
Methods: The cross-sectional descriptive study was conducted in MCI patients, aged 50 years and above, from a psychiatric outpatient clinic and cognitive fitness center. The data were collected by questionnaires including demographic data and sleep environment questionnaires; Pittsburgh Sleep Quality Index (PSQI); Sleep Hygiene Index (SHI); STOP-Bang questionnaire; Thai Mental State Examination (TMSE); Montreal Cognitive Assessment (MoCA); Thai Geriatric Depression Scale (TGDS), and Neuropsychiatric Inventory Questionnaire (NPI-Q). The sleep quality was presented as frequency and percentage. The associated factors were analyzed by Chi-square test, Fisher’s exact test, and Pearson’s correlation coefficient. The predictors of poor sleep quality were analyzed by multiple logistic regression analysis.
Results: Of the 100 subjects, 65 were female with a mean age of 71.3 7.5 years old: 64% of them had poor sleep quality. The associated factors of sleep quality were having a history of psychiatric disorders, use of sedating psychotropic drugs, low to moderate sleep hygiene, and anxiety domain of neuropsychiatric symptoms. TGDS and STOP-Bang scores were correlated with PSQI scores (r = 0.215 and 0.230, respectively). The predictors of poor sleep quality were the use of sedating psychotropic drugs (P < 0.01), low to moderate sleep hygiene (P < 0.05), and anxiety domain of neuropsychiatric symptoms (P < 0.05).
Conclusion: The prevalence of poor sleep quality in MCI patients was 64%. The associated factors and predicted factors of poor sleep quality were the use of sedating psychotropic drugs, low to moderate sleep hygiene, and anxiety domain of neuropsychiatric symptoms. Therefore, sleep quality should be screened in patients with MCI due to the high prevalence.
Downloads
References
Department of Older Persons. The Ministry of Social Development and Human Security. Number and proportion of Thai elderly in overall [Internet]. 2014 [cited 2017 Jan 31]. Available from: http://www.dop.go.th/th/know/1/45.
Vapattanawong P, Prasartkul P. Thai population in the future [Internet] Institute for Population and Social Research, Mahidol University; n.d. [cited 2017 Jan 31]. A vailable from: http://www.ipsr.mahidol.ac.th/ipsr/ annualconference/conferenceii/article/article02.htm.
Gauthier S, Reisberg B, Zaudig M, Petersen RC,Ritchie K, Broich K, et al. Mild cognitive impairment. Lancet 2006;367:1262-70. https://doi.org/10.1016/S0140-6736(06)68542-5
Tierney MC, Szalai JP, Snow WG, Fisher RH, Nores A, Nadon G, et al. Prediction of probable Alzheimer's disease in memory-impaired patients: A prospective longitudinal study. Neurology 1996;46:661-5.
https://doi.org/10.1212/WNL.46.3.661
M FM, Molano A, Castro J, Zarranz JJ. Prevalence of neuropsychiatric symptoms in mild cognitive impairment and Alzheimer's disease, and its relationship with cognitive impairment. Curr Alzheimer Res 2010;7:517-26. https://doi.org/10.2174/156720510792231748
Monastero R, Mangialasche F, Camarda C, Ercolani S, Camarda R. A systematic review of neuropsychiatric symptoms in mild cognitive impairment. J Alzheimers Dis 2009;18:11-30.
https://doi.org/10.3233/JAD-2009-1120
Hayes TL, Riley T, Mattek N, Pavel M, Kaye JA. Sleep habits in mild cognitive impairment. Alzheimer Dis Assoc Disord 2014;28:145-50. https://doi.org/10.1097/WAD.0000000000000010
McKinnon A, Terpening Z, Hickie IB, Batchelor J, Grunstein R, Lewis SJ, et al. Prevalence and predictors of poor sleep quality in mild cognitive impairment. J Geriatr Psychiatry Neurol 2014;27:204-11.
https://doi.org/10.1177/0891988714527516
Beaulieu-Bonneau S, Hudon C. Sleep disturbances in older adults with mild cognitive impairment. Int Psychogeriatr 2009;21:654-66. https://doi.org/10.1017/S1041610209009120
Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep 2004;27:1255-73. https://doi.org/10.1093/sleep/27.7.1255
Naismith SL, Hickie IB, Terpening Z, Rajaratnam SM, Hodges JR, Bolitho S, et al. Circadian misalignment and sleep disruption in mild cognitive impairment. J Alzheimers Dis 2014;38:857-66.
https://doi.org/10.3233/JAD-131217
Naismith SL, Rogers NL, Hickie IB, Mackenzie J, Norrie LM, Lewis SJ. Sleep well, think well: sleepwake disturbance in mild cognitive impairment. J Geriatr Psychiatry Neurol 2010;23:123-30.
https://doi.org/10.1177/0891988710363710
Paterniti S, Verdier-Taillefer MH, Dufouil C, Alperovitch A. Depressive symptoms and cognitive decline in elderly people. Longitudinal study. Br J Psychiatry 2002;181:406-10.
https://doi.org/10.1192/bjp.181.5.406
Sadock BJ, Sadock VA. Kaplan and Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry. 11th ed. Philadelphia: Lippincott Williams & Wilkins;2015.
Assantachai P, Aekplakorn W, Pattara-Archachai J, Porapakkham Y. Factors associated with insomnia in older people with a mild to moderate degree of poor cognitive ability in Thailand. Geriatr Gerontol Int 2011; 11:16-23. https://doi.org/10.1111/j.1447-0594.2010.00627.x
Sasat S, Maneethanue O. Selected factors related to sleep quality in older persons with alzheimer's disease. J Nurs Sci Chulalongkorn University 2010;22:146-61.
Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wahlund LO, et al. Mild cognitive impairment- beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. J Intern Med 2004;256:240-6. https://doi.org/10.1111/j.1365-2796.2004.01380.x
Sitasuwan T, Bussaratid S, Ruttanaumpawan P, Chotinaiwattarakul W. Reliability and validity of the Thai version of the Pittsburgh Sleep Quality Index. J Med Assoc Thai 2014;97 Suppl 3:S57-67.
Keawphang P. Relationships between selected factors and insomnia in adult cancer patients [thesis]. Bangkok: Chulalongkorn University. 2004.
Banhiran W, Durongphan A, Saleesing C, Chongkolwatana C. Diagnostic properties of the STOP-Bang and its modified version in screening for obstructive sleep apnea in Thai patients. J Med Assoc Thai 2014;97:644-54.
Institute of Geriatric Medicine. Mini-Mental State Examination-Thai Version (MMSE-Thai 2002). Nonthaburi: Institute of Geriatric Medicine Department of Medical Services Ministry of Public Health; 1999.
Tangwongchai S, Phanasathit M, Charernboon T, Akkayagorn L, Hemrungrojn S, Phanthumchinda K, et al. The validity of thai version of the montreal cognitive assessment (MoCA-T) [abstract]. Dement Neuropsychol 2009;3:172.
Poungvarin N, Thongtang O, Assantachai P. Thai geriatric depression scale-TGDS. Siriraj Med J 1994; 46:1-9.
Kaufer DI, Cummings JL, Ketchel P, Smith V, MacMillan A, Shelley T, et al. Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory. J Neuropsychiatry Clin Neurosci 2000;12:233-9.
https://doi.org/10.1176/jnp.12.2.233
Spira AP, Stone K, Beaudreau SA, Ancoli-Israel S, Yaffe K. Anxiety symptoms and objectively measured sleep quality in older women. Am J Geriatr Psychiatry 2009;17:136-43.
https://doi.org/10.1097/JGP.0b013e3181871345
Staner L. Sleep and anxiety disorders. Dialogues Clin Neurosci 2003;5:249-58.
https://doi.org/10.31887/DCNS.2003.5.3/lstaner
Winokur A. The relationship between sleep disturbances and psychiatric disorders: introduction and overview. Psychiatr Clin North Am 2015;38: 603-14. https://doi.org/10.1016/j.psc.2015.07.001
Sirirattanapan J, Boonwan A, Phromchairak J. Excessive daytime sleepiness in obstructive sleep apnea In Bhumibol Adulyadej Hospital. Royal Thai Airforce Medical Gazette 2008;54;1.
Frighetto L, Marra C, Bandali S, Wilbur K, Naumann T, Jewesson P. An assessment of quality of sleep and the use of drugs with sedating properties in hospitalized adult patients. Health Qual Life Outcomes 2004;2:17. https://doi.org/10.1186/1477-7525-2-17
Podewils LJ, Lyketsos CG. Tricyclic antidepressants and cognitive decline. Psychosomatics 2002;43:31-5.https://doi.org/10.1176/appi.psy.43.1.31
Sharma K, Srivastava S. The effectiveness of sleep hygiene program on sleep quality and stress level in elderly population. J Ment Health Aging 2018;2:29-32.
https://doi.org/10.35841/mental-health-aging.2.1.29-32
Park SY, Oh MK, Lee BS, Kim HG, Lee WJ, Lee JH, et al. The effects of alcohol on quality of sleep. Korean J Fam Med 2015;36:294-9. https://doi.org/10.4082/kjfm.2015.36.6.294
Stein MD, Friedmann PD. Disturbed sleep and its relationship to alcohol use. Subst Abus 2005;26:1-13. https://doi.org/10.1300/J465v26n01_01
Watson EJ, Coates AM, Kohler M, Banks S. Caffeine consumption and sleep quality in australian adults. Nutrients 2016;8. pii: E479. https://doi.org/10.3390/nu8080479
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Chulalongkorn Medical Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
