Poor Self-Reported Sleep Quality Predicts Mortality within One Year of Inpatient Post-Acute Rehabilitation among Older Adults

Martin, Jennifer L.; Fiorentino, Lavinia; Jouldjian, Stella; Mitchell, Michael N.; Josephson, Karen R.; Alessi, Cathy A.

doi:10.5665/sleep.1444

Cited by 55 publications

(62 citation statements)

References 24 publications

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“…A total of 74 studies met the inclusion criteria; the process of study selection is shown in Figure 1 8, 9, 11, 12, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89,...…”

Section: Resultsmentioning

confidence: 99%

Self‐Reported Sleep Duration and Quality and Cardiovascular Disease and Mortality: A Dose‐Response Meta‐Analysis

Kwok

Kontopantelis

Kuligowski

et al. 2018

JAHA

319

227

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BackgroundThere is growing evidence that sleep duration and quality may be associated with cardiovascular harm and mortality.Methods and ResultsWe conducted a systematic review, meta‐analysis, and spline analysis of prospective cohort studies that evaluate the association between sleep duration and quality and cardiovascular outcomes. We searched MEDLINE and EMBASE for these studies and extracted data from identified studies. We utilized linear and nonlinear dose‐response meta‐analysis models and used DerSimonian–Laird random‐effects meta‐analysis models of risk ratios, with inverse variance weighting, and the I2 statistic to quantify heterogeneity. Seventy‐four studies including 3 340 684 participants with 242 240 deaths among 2 564 029 participants who reported death events were reviewed. Findings were broadly similar across both linear and nonlinear dose‐response models in 30 studies with >1 000 000 participants, and we report results from the linear model. Self‐reported duration of sleep >8 hours was associated with a moderate increased risk of all‐cause mortality, with risk ratio, 1.14 (1.05–1.25) for 9 hours, risk ratio, 1.30 (1.19–1.42) for 10 hours, and risk ratio, 1.47 (1.33–1.64) for 11 hours. No significant difference was identified for periods of self‐reported sleep <7 hours, whereas similar patterns were observed for stroke and cardiovascular disease mortality. Subjective poor sleep quality was associated with coronary heart disease (risk ratio, 1.44; 95% confidence interval, 1.09–1.90), but no difference in mortality and other outcomes.ConclusionsDivergence from the recommended 7 to 8 hours of sleep is associated with a higher risk of mortality and cardiovascular events. Longer duration of sleep may be more associated with adverse outcomes compared with shorter sleep durations.

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Section: Resultsmentioning

confidence: 99%

Self‐Reported Sleep Duration and Quality and Cardiovascular Disease and Mortality: A Dose‐Response Meta‐Analysis

Kwok

Kontopantelis

Kuligowski

et al. 2018

JAHA

319

227

View full text Add to dashboard Cite

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“…Sleep problems in various general populations with and without chronic diseases have been associated with poorer self-rated health 5 and with increased mortality. 6,7 Without appropriate treatment, sleep problems can become persistent, as reported by Morin et al, 8 who found that 49% of patients with insomnia symptoms at baseline had insomnia symptoms at the 1-year follow-up as well. Elderly people with chronic conditions are at risk of developing persistent sleep disturbances, 9 and sleep disturbances have been associated with increased costs for healthcare utilization in samples with and without chronic disease.…”

mentioning

confidence: 76%

The Course of Sleep Problems in Patients With Heart Failure and Associations to Rehospitalizations

Johansson

Broström

Sanderman

et al. 2015

Journal of Cardiovascular Nursing

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“…In our prior work, we found that sleep disruption in the post-acute care setting was associated with less improvement in functioning and shorter survival over the year following discharge from post-acute rehabilitation. 11;12 …”

Section: Objectivementioning

confidence: 99%

A Longitudinal Study of Poor Sleep After Inpatient Post–Acute Rehabilitation: The Role of Depression and Pre-Illness Sleep Quality

Martin

Jouldjian

Mitchell

et al. 2012

The American Journal of Geriatric Psychiatry

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Objectives To explore the unique impact of poor sleep and symptoms of depression on sleep quality for up to one year after inpatient post-acute rehabilitation among older adults. Design Prospective longitudinal cohort study. Setting Two in-patient post-acute rehabilitation facilities Participants 245 individuals over age 65 years (mean age=80 years, 38% female) Interventions None. Measurements Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) during the post-acute care stay twice to evaluate pre-illness sleep quality and sleep quality during the post-acute care stay, and again at 3, 6, 9 and 12-months follow-up. Demographics, symptoms of depression, cognitive functioning, and comorbidities were also assessed. Results Across time points, sleep was significantly disturbed for many individuals. Nested regression models predicting PSQI total score at 3, 6, 9 and 12 months showed that variables entered in Block 1 (age, gender, cognitive functioning and comorbidities) were significant predictors of poor sleep at 6-months, but not at 3, 9 or 12 months follow-up. Depression (Block 2) and pre-illness PSQI total score (Block 3) were significant predictors of PSQI total score at all follow-up time points. PSQI total score during post-acute care (Block 4) explained a significant proportion of variance only at the 3-month follow-up. Conclusions This study confirms that chronic poor sleep is common among older adults during post-acute rehabilitation, and resolution of sleep disturbance after acute health events may be a lengthy process. Our findings expand understanding of the role of depressive symptoms and pre-existing sleep complaints in predicting poor sleep over time among these vulnerable older adults.

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Poor Self-Reported Sleep Quality Predicts Mortality within One Year of Inpatient Post-Acute Rehabilitation among Older Adults

Cited by 55 publications

References 24 publications

Self‐Reported Sleep Duration and Quality and Cardiovascular Disease and Mortality: A Dose‐Response Meta‐Analysis

Self‐Reported Sleep Duration and Quality and Cardiovascular Disease and Mortality: A Dose‐Response Meta‐Analysis

The Course of Sleep Problems in Patients With Heart Failure and Associations to Rehospitalizations

A Longitudinal Study of Poor Sleep After Inpatient Post–Acute Rehabilitation: The Role of Depression and Pre-Illness Sleep Quality

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