Prevalence and risk factors of insomnia in community-dwelling Chinese elderly: a Taiwanese urban area survey.
OBJECTIVE
To determine the prevalence of and risk factors for self-reported sleep complaints in the elderly.


METHODS
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.
Department of Psychiatry, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan. tpsu@vghtpe.gov.tw
Tung-Ping
TP
Su
Shuang-Ruang
SR
Huang
Pesus
P
Chou
D000368:Aged; D002681:China / Q000208:ethnology; D003072:Cognition Disorders / Q000175:diagnosis / Q000208:ethnology; D003430:Cross-Sectional Studies; D003710:Demography; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007326:Institutionalization / Q000706:statistics & numerical data; D008297:Male; D009483:Neuropsychological Tests; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*
D006993:Hypnotics and Sedatives