title: Sleep disturbance among older adults in assisted living facilities.
abstract: OBJECTIVE
  To evaluate whether objectively and subjectively measured sleep disturbances persist among older adults in assisted living facilities (ALFs) and to identify predictors of sleep disturbance in this setting.
  
  
  METHODS
  Prospective, observational cohort study.
  
  
  METHODS
  A total of 121 residents, age ≥ 65 years, in 18 ALFs in the Los Angeles area.
  
  
  METHODS
  Objective (actigraphy) and subjective (Pittsburgh Sleep Quality Index) sleep measures were collected at baseline and 3- and 6-month follow-up. Predictors of baseline sleep disturbance tested in bivariate analyses and multiple regression models included demographics, Mini-Mental State Examination score, number of comorbidities, nighttime sedating medication use, functional status (activities of daily living; instrumental activities of daily living), restless legs syndrome, and sleep apnea risk.
  
  
  RESULTS
  Objective and subjective sleep measures were similar at baseline and 3- and 6-month follow-up (objective nighttime total sleep [hours] 6.3, 6.5, and 6.4; objective nighttime percent sleep 77.2, 77.7, and 78.3; and Pittsburgh Sleep Quality Index total score 8.0, 7.8, and 7.7, respectively). The mean baseline nighttime percent sleep decreased by 2% for each additional unit increase in baseline comorbid conditions (measured as the number of conditions), and increased by 4.5% for each additional unit increase in baseline activities of daily living (measured as the number of activities of daily living), in a multiple regression model.
  
  
  CONCLUSIONS
  In this study, we found that objectively and subjectively measured sleep disturbances are persistent among ALF residents and are related to a greater number of comorbidities and poorer functional status at baseline. Interventions are needed to improve sleep in this setting.
authors.affiliation: Geriatric Research, Education and Clinical Center, Veterans Administration Greater Los Angeles Healthcare System, North Hills, CA 91343, USA. Connie.Fung@va.gov
authors.forename: Constance H
authors.initials: CH
authors.lastname: Fung
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Martin
authors.forename: Carol
authors.initials: C
authors.lastname: Chung
authors.forename: Lavinia
authors.initials: L
authors.lastname: Fiorentino
authors.forename: Michael
authors.initials: M
authors.lastname: Mitchell
authors.forename: Karen R
authors.initials: KR
authors.lastname: Josephson
authors.forename: Stella
authors.initials: S
authors.lastname: Jouldjian
authors.forename: Cathy
authors.initials: C
authors.lastname: Alessi
mesh_terms: D056044:Actigraphy; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D040561:Assisted Living Facilities / Q000706:statistics & numerical data*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires