Abstract
Objectives
Older people who are admitted to inpatient rehabilitation settings often experience
sleep disturbance or disorders. Both intrinsic and environmental factors may contribute
to reduced sleep quality. Poor sleep quality has been reported to be associated with
poorer rehabilitation outcomes. The aim of this review was (1) to describe the prevalence
of sleep disturbance or disorder among older people participating in inpatient rehabilitation,
and (2) to describe interventions that have been trialed to increase sleep quality
and/or quantity in older people in rehabilitation settings and report on their efficacy.
Design
Systematic review involving search of 3 electronic databases and gray literature.
Two authors independently reviewed citations and reviewed full text and agreed on
included studies. Data were extracted and synthesized and risk of bias was assessed.
Setting and Participants
Studies were included if they provided quantitative data about the prevalence of sleep
disturbance or disorder in older people in a rehabilitation setting or if they reported
the results of a randomized trial evaluating an intervention to improve sleep quality
in older people in a rehabilitation setting.
Measures
Studies were included if they reported data from monitoring (such as polysomnography
or actigraphy), clinical assessments, or questionnaires.
Results
16 studies reporting prevalence data and 3 studies reporting evaluations of interventions
were included in this review. Studies reported data from stroke and mixed population
rehabilitation settings. The prevalence of obstructive sleep apnea was high and ranged
from 12% to 92% in stroke rehabilitation settings. Other types of sleep disturbance,
such as difficulty initiating sleep, were also common.
Conclusions and Implications
Many older people participating in inpatient rehabilitation have sleep disturbance
or sleep disorders. Poor sleep quality is associated with poorer health status and
recovery; therefore, it is important that rehabilitation settings take steps to enhance
sleep quality for inpatients drawing on the principles of good sleep hygiene.
Keywords
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Article info
Publication history
Published online: April 17, 2020
Footnotes
K.E.L. is supported by a NHMRC-ARC Research Development Fellowship.
The authors declare no conflicts of interest.
Identification
Copyright
© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
