title: Insomnia among community dwelling elderly in Alexandria, Egypt.
abstract: BACKGROUND
  Insomnia is a common problem in the elderly population. Poor sleep quality is associated with decreased memory and concentration, increased risk of falls, cognitive decline, and higher rate of mortality. Inadequate sleep hygiene such as irregular sleep schedules, use of stimulants, and daytime naps may predispose to insomnia.
  
  
  OBJECTIVE
  The aim of this study was to determine the prevalence of insomnia among community dwelling elderly in Alexandria and to assess some of the risk factors and comorbid conditions related to insomnia.
  
  
  METHODS
  This is a cross-sectional study conducted among 380 elderly people taken from different clubs in Alexandria using a predesigned structured interview questionnaire. Data on sociodemographic characteristics, medical history, and personal and sleeping habits were collected. The Insomnia Severity Index was used to assess insomnia and the Depression Anxiety Stress Scale was used to measure depression, anxiety, and stress.
  
  
  RESULTS
  One-third (33.4%) of the elderly suffered from insomnia. On logistic regression, the most independent factors that were significantly associated with insomnia were number of chronic diseases [odds ratio (OR)=7.25 for having ≥5 diseases], being female (OR=2.37), anxiety (OR=1.91), watching television in bed before sleeping (OR=1.90), depression (OR=1.74), nocturia (OR=1.13), and daily sunlight exposure (OR=0.57).
  
  
  CONCLUSIONS
  Insomnia is a common problem among the elderly in Alexandria. Female sex, chronic diseases, mental health problems, and bad sleep hygiene practice increase the risk for insomnia. Improving knowledge among the elderly about the prevalence and risk factors of insomnia could help the development of effective public health prevention and intervention programs for better sleep quality.
authors.affiliation: aGeriatric Health Specialty bMental Health Specialty, Family Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
authors.forename: Abla I
authors.initials: AI
authors.lastname: Ayoub
authors.forename: Medhat
authors.initials: M
authors.lastname: Attia
authors.forename: Heba M
authors.initials: HM
authors.lastname: El Kady
authors.forename: Ayat
authors.initials: A
authors.lastname: Ashour
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D018434:Sickness Impact Profile; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology* / Q000523:psychology*; D012959:Socioeconomic Factors