Negative Factors Affecting the Sleep Quality of the Elderly in Iran: A Systematic Review

Abstract

Objective: As age increases, different physical and mental problems, including sleep disorders, occur in the elderly. The Person-Environment-Occupation (PEO) model is one of the most common practical models in occupational therapy. The current study aims to review negative factors affecting the sleeping quality of the elderly in Iran based on the PEO model. Materials & Methods: According to PRISMA (the preferred reporting items for systematic reviews and meta-analyses) guidelines and in this systematic review study, we searched Google Scholar, Scopus, PubMed, Magiran, IranMedex, and SID databases using the keywords of “Elderly”, “aging”, “geriatric”, “older adult”, “Iran”, and “sleep” in English and Persian articles published from 2010 to 2019. Studies on the sleep problems of other age groups, letters to the editor, duplicate studies, studies on non-Iranian seniors, studies published in languages other than Persian and English, and those with unavailable full-texts were excluded. In the next stage, the titles and abstracts of the retrieved articles were independently reviewed by two researchers to identify the studies that meet the inclusion criteria. The dispute was resolved through discussion and reaching an agreement. Then, the full text of eligible articles was retrieved. Articles approved based on at least 20 out of 22 items of the STROBE (strengthening the reporting of observational studies in epidemiology) checklist were included in the study. Finally, 24 articles that were in line with the research objectives were selected for an in-depth review. Results: Out of 24 studies, 11 reported quantitative sleep problems, 9 of which claimed that more than 70% of the elderly had sleep problems. The negative factors affecting the sleep quality of Iranian older adults were presented and categorized based on personal, environmental, and occupational factors. Eighteen articles addressed personal factors, where the most common factor was related to personal health issues. Eleven articles reported environmental factors, where the most common factor was related to the physical environment. In three articles, the factors that had a negative effect on sleeping are occupational and included the change of sleeping place and not talking to others before going to bed. Conclusion: Personal factors (e.g. aging, female gender, disease), environmental factors (e.g. lack of communication with relatives and friends, inappropriate physical environment, and living in a nursing home), and occupational factors (e.g. change of sleeping place, hospitalization, and not talking to others before going to sleep) are negative factors affecting the sleep quality of the elderly in Iran.

A bibliometric analysis of sleep in older adults

“…Increasing the daily consumption of fruits, meat, and eggs can increase the duration of sleep (41). Physiological factors such as snoring, apnea, and abnormal sleep behavior and duration can also interfere with sleep (42). Studies have found that improving physical activity levels has a positive impact on sleep in older adults (43).…”

The impact of social support, physical and psychological performance on sleep outcomes in Iranian older adults: a case-control study

“…Ramezanifar et al (2021) reported that factors affecting sleep problems were job stress, and shift work, which can impair sleep quality. Therefore, therapists are required to attend to occupational factors in intervention and counseling [ 58 ].…”

Living in urban or rural environments affect the sleep quality of the elderly in Bushehr (Southern Iran): emphasizing the active and inactive of the elderly

“…In the review article of Mortazavi et al (2021), environmental factors such as economic level, staying in a nursing home, living in an environment with extreme cold or heat, unsuitable physical environments and living in certain areas were reported as effective factors in the sleep disorder of the elderly [21]. Ashghab et al (2022) reported that manipulating environmental factors such as reducing the amount of noise, dimming the ambient light, and using blindfolds and earmuffs can significantly improve sleep quality in nurses [22].…”