Previous studies report that 40-50% of the elderly report difficulty with sleep and that there is a significant relationship between sleep disturbance and both physical and mental health. It has been suggested that many of these sleep problems are often the result of declining health. Therefore, it is important to understand the implications of sleep disturbances on the physical and mental functional status in the elderly
Methods: 1503 participants were obtained from 10 primary care sites in Illinois primarily serving elderly patients (6 Chicago, 4 outside Chicago metropolitan area). The mean age of participants was 75.5(±6.8, range 62-100) years, 62% female and a diverse ethnic background. Subjects were interviewed and completed questionnaires including 5 sleep related questions and the SF12 questionnaire. In addition a systematic chart review was carried out. Based on weighted formula, a Physical Component Summary (PCS12) and Mental Component Summary (MCS12) score were calculated. To maintain consistency with sleep items and scales, PCS12 and MCS12 scales were converted to z-scores based on normative mean and standard deviation
Results: Approximately 70% of the participants responded positively to at least one of the sleep questions and 40% to two or more. Participants most commonly reported a positive response (45%) to a question about the "difficulty falling asleep, staying asleep, or being able to sleep". The number and type of sleep problems reported predicted both physical and mental health status. Even if a respondent answered yes to only one sleep problem they were more likely to have a higher PCS12 and MCS12 score. In order to determine what question sequence most efficiently predicted physical and mental health status a forward entry regression model was used. The question "Do you feel excessively sleepy during the day?" best predicted both PCS12 (R2=0.46, F=72.16, p<0.001) and MCS12 (R2=0.35, F=54.8, p<0.001). Even when a patient responded positively to all 5-sleep questions, a sleep complaint was only reported in the chart 19.2% of the time
Conclusion: The result of this study indicates that when elicited, sleep complaints are an excellent predictor of general physical and mental health status. Yet, sleep problems are often not recognized by primary care physicians. Therefore questions about sleep should be an integral part of a medical history.
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