Journal
SLEEP
Volume 34, Issue 12, Pages 1715-1721Publisher
OXFORD UNIV PRESS INC
DOI: 10.5665/sleep.1444
Keywords
Aging; rehabilitation; mortality
Categories
Funding
- NIA [K23 AG028452]
- VA HSRD [IIR-01-053-1, IIR 04-321-2, AIA-03-047]
- NIMH [T32 MH 019925-11, T32 MH019934]
- VA Greater Los Angeles Healthcare System Geriatric Research, Education and Clinical Center (GRECC)
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Study Objective: To evaluate the association between self-reported sleep quality among older adults during inpatient post-acute rehabilitation and one-year survival. Design: Prospective, observational cohort study. Setting: Two inpatient post-acute rehabilitation sites (one community and one Veterans Administration). Participants: Older patients (aged >= 65 years, n = 245) admitted for inpatient post-acute rehabilitation. Interventions: None. Measurements and Results: Within one year of post-acute rehabilitation, 57 participants (23%) were deceased. Cox proportional hazards models showed that worse Pittsburgh Sleep Quality Index (PSQI) total scores during the post-acute care stay were associated with increased mortality risk when controlling for amount of rehabilitation therapy received, comorbidities, and cognitive functioning (Hazard ratio [95% CI] = 1.11 [1.02-1.20]). Actigraphically estimated sleep was unrelated to mortality risk. Conclusions: Poorer self-reported sleep quality, but not objectively estimated sleep parameters, during post-acute rehabilitation was associated with shorter survival among older adults. This suggests self-reported poor sleep may be an important and potentially modifiable risk factor for negative outcomes in these vulnerable older adults. Studies of interventions to improve sleep quality during inpatient rehabilitation should therefore be undertaken, and the long-term health benefits of improved sleep should be explored.
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