Prevalence and Risk Factors of Sleep Quality among Older Adults in Varamin, Iran
-
Hasan Ahmadi Gharaei
,
Fatemeh Ghorbani
,
Sara Naderpoor
,
Vida Alizad
,
Soodabeh Ghasemi
,
Zahra Hasanalizadeh
,
Foozieh Noori
,
Elham Momen Baghsiyahi
Abstract
Background and Objective: The global aging population is increasing. Aging is associated with a gradual decrease in physiological activities and an increased risk of chronic diseases and sleep disorders. This study aimed to determine the prevalence and risk factors of sleep quality among elderly people.
Materials and Methods: This cross-sectional study was conducted on 894 elderly individuals aged 60 years or older, selected using a multistage sampling method in Varamin City, Tehran Province, Iran. Data were collected using the Pittsburgh Sleep Quality Index (PSQI). Mean and frequency were used for descriptive analysis, and multivariable logistic regression was used to identify risk factors for poor sleep quality. P-value < 0.05 was considered statistically significant, and Stata software was used for data analysis.
Results: Of the participants, 509 (56.5%) were women, and the mean age was 69.1 ± 7.5 years. The overall prevalence of poor sleep quality was 39.8%. Multivariable logistic regression analysis showed that poor sleep quality was signifi-cantly associated with female sex [male odds ratio (OR)=0.5, 95% confidence interval (CI): 0.4-0.7], coronary heart disease (CHD) (OR=1.9, 95% CI: 1.5-3.0), gastrointestinal (GI) disease (OR=1.8, 95% CI: 1.5-3.0), and depression (OR=3.6, 95% CI: 2.1-6.2). There was no relationship between age, marital status, occupation, education, financial sta-tus, and other diseases with sleep quality (P > 0.05).
Conclusion: Poor sleep quality among elderly individuals was relatively common and more prevalent among women. Moreover, comorbidities such as depression, CHD, and GI diseases were identified as factors affecting the quality of sleep in elderly people.
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6. Marengoni A, Angleman S, Melis R, et al. Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev 2011; 10: 430-9.
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8. Sagayadevan V, Abdin E, Binte Shafie S, et al. Prevalence and correlates of sleep problems among elderly Singaporeans. Psychogeriatrics 2017; 17: 43-51.
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14. Li J, Yao YS, Dong Q, et al. Characterization and factors associated with sleep quality among rural elderly in China. Arch Gerontol Geriatr 2013; 56: 237-43.
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16. Aunjitsakul W, Pitanupong J, Werachattawan N, et al. Sleep quality among elderly people within the outpatient department of Songklanagarind Hospital, Thailand: a cross-sectional study. J Health Sci Med Res 2017; 35: 195-204.
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18. Borji M, Jahani S, Shiri P, et al. Assessing sleep quality among the elderly people in Ilam city in 2015. J Geriatr Nurs 2016; 2: 44-53. [In Persian].
19. Sheikhy L, Karami-Mattin B, Chupani J, et al. Evaluation the status of sleep quality in elderly people in Kermanshah city. J Rehab Med 2015; 3: 81-8. [In Persian].
20. Mirzaei M, Gholamrezaei E, Bidaki R, et al. Quality of sleep and methods of management of sleep disorders in elderly of Yazd city in 2016. J Shahid Sadoughi Univ Med Sci 2017; 25: 467-75. [In Persian].
21. Mohammad Gholi Mezerji N, Naseri P, Omraninezhad Z, et al. The Reliability and Validity of the Persian Version of Pittsburgh Sleep Quality Index in Iranian People. Avicenna J Neuro Psycho Physiology 2017; 4: 95-102.
22. Wang P. Self-Reported Sleep Quality, Duration And Health-Related Quality Of Life In Older Chinese. Value Health 2016; 19: A905.
23. Safa A, Adib-Hajbaghery M, Fazel-Darbandi A. The relationship between sleep quality and quality of life in older adults. Iran J Psychiatr Nurs 2015; 3: 53-62. [In Persian].
24. Gulia KK, Kumar VM. Sleep disorders in the elderly: a growing challenge. Psychogeriatrics 2018; 18: 155-65.
25. Zhang Y, Ren R, Lei F, et al. Worldwide and regional prevalence rates of co-occurrence of insomnia and insomnia symptoms with obstructive sleep apnea: A systematic review and meta-analysis. Sleep Med Rev 2019; 45: 1-17.
26. Abbasi A, Bahrami H, Beygi B, et al. Risk Factors of Sleep Disorders in Elderly: A Population-Based Case-Control Study. Iran J Epidemiol 2019; 15: 172-8. [In Persian].
27. Krishnan V, Collop NA. Gender differences in sleep disorders. Curr Opin Pulm Med 2006; 12: 383-9.
28. Izadi Avanji FS, Adib Hajbaghery M, Afazel MR. Quality of sleep and it's related factors in the hospitalized elderly patients of Kashan hospitals in 2007. Feyz Med Sci J 2009; 12: 52-60. [In Persian].
29. Haseli-Mashhadi N, Dadd T, Pan A, et al. Sleep quality in middle-aged and elderly Chinese: distribution, associated factors and associations with cardio-metabolic risk factors. BMC Public Health 2009; 9: 130.
30. Turkmen K, Erdur FM, Guney I, et al. Sleep quality, depression, and quality of life in elderly hemodialysis patients. Int J Nephrol Renovasc Dis 2012; 5: 135-42.
31. Chien MY, Chen HC. Poor sleep quality is independently associated with physical disability in older adults. J Clin Sleep Med 2015; 11: 225-32.
32. Smagula SF, Stone KL, Fabio A, et al. Risk factors for sleep disturbances in older adults: Evidence from prospective studies. Sleep Med Rev 2016; 25: 21-30.
33. Kishimoto Y, Okamoto N, Saeki K, et al. Bodily pain, social support, depression symptoms and stroke history are independently associated with sleep disturbance among the elderly: a cross-sectional analysis of the Fujiwara-kyo study. Environ Health Prev Med 2016; 21: 295-303.
34. Tel H. Sleep quality and quality of life among the elderly people. Neurol Psychiatry Brain Res 2013; 19: 48-52.
35. Hayashino Y, Yamazaki S, Takegami M, et al. Association between number of comorbid conditions, depression, and sleep quality using the Pittsburgh Sleep Quality Index: results from a population-based survey. Sleep Med 2010; 11: 366-71.
36. Spiegel K, Leproult R, L'Hermite-Balériaux M, et al. Leptin levels are dependent on sleep duration: relationships with sympathovagal balance, carbohydrate regulation, cortisol, and thyrotropin. J Clin Endocrinol Metab 2004; 89: 5762-71.
37. Taheri S, Lin L, Austin D, et al. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med 2004; 1: e62.
38. Schultes B, Schmid S, Peters A, et al. Sleep loss and the development of diabetes: a review of current evidence. Exp Clin Endocrinol Diabetes 2005; 113: 563-7.
39. Whitworth JA, Williamson PM, Mangos G, et al. Cardiovascular consequences of cortisol excess. Vasc Health Risk Manag 2005; 1: 291-9.
40. Isgaard J. Cardiovascular disease and risk factors: the role of growth hormone. Horm Res 2004; 62: 31-8.
41. Poynter B, Shuman M, Diaz-Granados N, et al. Sex differences in the prevalence of post-stroke depression: a systematic review. Psychosomatics 2009; 50: 563-9.
42. Ghaemmohamadi MS, Behzadifar M, Ghashghaee A, et al. Prevalence of depression in cardiovascular patients in Iran: A systematic review and meta-analysis from 2000 to 2017. J Affect Disord 2018; 227: 149-55.
43. Soenen S, Rayner CK, Jones KL, et al. The ageing gastrointestinal tract. Curr Opin Clin Nutr Metab Care 2016; 19: 12-8.
44. Merchant HA, Liu F, Orlu Gul M, et al. Age-mediated changes in the gastrointestinal tract. Int J Pharm 2016; 512: 382-95.
45. Goldacre MJ. Demography of aging and the epidemiology of gastrointestinal disorders in the elderly. Best Pract Res Clin Gastroenterol 2009; 23: 793-804.
46. Bilski J, Mazur-Bialy A, Magierowski M, et al. Exploiting Significance of Physical Exercise in Prevention of Gastrointestinal Disorders. Curr Pharm Des 2018; 24: 1916-25.
47. Dickman R, Green C, Fass SS, et al. Relationships between sleep quality and pH monitoring findings in persons with gastroesophageal reflux disease. J Clin Sleep Med 2007; 3: 505-13.
48. Zhao W, Jin H, Xu M, et al. Sleep Quality of Functional Gastrointestinal Disorder Patients in Class-Three Hospitals: A Cross-Sectional Study in Tianjin, China. Biomed Res Int 2018; 2018: 3619748.
49. Habibi F, Mahdavi SB, Khaniabadi BM, et al. Sleep quality and associated factors in Iranian inflammatory bowel disease patients. J Res Med Sci 2019; 24: 59.
50. Khanijow V, Prakash P, Emsellem HA, et al. Sleep Dysfunction and Gastrointestinal Diseases. Gastroenterol Hepatol (N Y) 2015; 11: 817-25.
2. World Health Organization. Aging and Health [Online]. [cited 1 Oct 2025]. Geneva, Switzerland: World Health Organization; Available from: URL: https://www.who.int/en/news-room/fact-sheets/detail/ageing-and-health.
3. Heidari Z, Feizi A. The Isfahan Comprehensive Elderly Study: Objectives, research design, methodology, and preliminary results. J Res Med Sci 2017; 22: 85.
4. Statistical Center of Iran. Selected Findings of the 2016 National Population and Housing Census [Online].Tehran: Iran: Statistical Centre of Iran; 2016. Available from: URL: https://irandataportal.syr.edu/wp-content/uploads/Iran_Census_2016_Selected_Results.pdf.
5. Khodamoradi A, Hassanipour S, Khotbesara RD, et al. The trend of population aging and planning of health services for the elderly: A review study. J Torbat Heydariyeh Univ Med Sci 2018; 6: 81-95. [In Persian].
6. Marengoni A, Angleman S, Melis R, et al. Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev 2011; 10: 430-9.
7. Steves CJ, Spector TD, Jackson SH. Ageing, genes, environment and epigenetics: what twin studies tell us now, and in the future. Age Ageing 2012; 41: 581-6.
8. Sagayadevan V, Abdin E, Binte Shafie S, et al. Prevalence and correlates of sleep problems among elderly Singaporeans. Psychogeriatrics 2017; 17: 43-51.
9. Roepke SK, Ancoli-Israel S. Sleep disorders in the elderly. Indian J Med Res 2010; 131: 302-10.
10. Ancoli-Israel S, Cooke JR. Prevalence and comorbidity of insomnia and effect on functioning in elderly populations. J Am Geriatr Soc 2005; 53: S264-71.
11. Beck SL, Schwartz AL, Towsley G, et al. Psychometric evaluation of the Pittsburgh Sleep Quality Index in cancer patients. J Pain Symptom Manage 2004; 27: 140-8.
12. Luo J, Zhu G, Zhao Q, et al. Prevalence and risk factors of poor sleep quality among Chinese elderly in an urban community: results from the Shanghai aging study. PLoS One 2013; 8: e81261.
13. Duclos C, Beauregard MP, Bottari C, et al. The impact of poor sleep on cognition and activities of daily living after traumatic brain injury: a review. Aust Occup Ther J 2015; 62: 2-12.
14. Li J, Yao YS, Dong Q, et al. Characterization and factors associated with sleep quality among rural elderly in China. Arch Gerontol Geriatr 2013; 56: 237-43.
15. Park JH, Yoo MS, Bae SH. Prevalence and predictors of poor sleep quality in Korean older adults. Int J Nurs Pract 2013; 19: 116-23.
16. Aunjitsakul W, Pitanupong J, Werachattawan N, et al. Sleep quality among elderly people within the outpatient department of Songklanagarind Hospital, Thailand: a cross-sectional study. J Health Sci Med Res 2017; 35: 195-204.
17. Torabi S, Shahriari L, Zahedi R, et al. A survey the prevalence of sleep disorders and their management in the elderly in Jahrom City, 2008. J Jahrom Univ Med Sci 2013; 10: 35-41.
18. Borji M, Jahani S, Shiri P, et al. Assessing sleep quality among the elderly people in Ilam city in 2015. J Geriatr Nurs 2016; 2: 44-53. [In Persian].
19. Sheikhy L, Karami-Mattin B, Chupani J, et al. Evaluation the status of sleep quality in elderly people in Kermanshah city. J Rehab Med 2015; 3: 81-8. [In Persian].
20. Mirzaei M, Gholamrezaei E, Bidaki R, et al. Quality of sleep and methods of management of sleep disorders in elderly of Yazd city in 2016. J Shahid Sadoughi Univ Med Sci 2017; 25: 467-75. [In Persian].
21. Mohammad Gholi Mezerji N, Naseri P, Omraninezhad Z, et al. The Reliability and Validity of the Persian Version of Pittsburgh Sleep Quality Index in Iranian People. Avicenna J Neuro Psycho Physiology 2017; 4: 95-102.
22. Wang P. Self-Reported Sleep Quality, Duration And Health-Related Quality Of Life In Older Chinese. Value Health 2016; 19: A905.
23. Safa A, Adib-Hajbaghery M, Fazel-Darbandi A. The relationship between sleep quality and quality of life in older adults. Iran J Psychiatr Nurs 2015; 3: 53-62. [In Persian].
24. Gulia KK, Kumar VM. Sleep disorders in the elderly: a growing challenge. Psychogeriatrics 2018; 18: 155-65.
25. Zhang Y, Ren R, Lei F, et al. Worldwide and regional prevalence rates of co-occurrence of insomnia and insomnia symptoms with obstructive sleep apnea: A systematic review and meta-analysis. Sleep Med Rev 2019; 45: 1-17.
26. Abbasi A, Bahrami H, Beygi B, et al. Risk Factors of Sleep Disorders in Elderly: A Population-Based Case-Control Study. Iran J Epidemiol 2019; 15: 172-8. [In Persian].
27. Krishnan V, Collop NA. Gender differences in sleep disorders. Curr Opin Pulm Med 2006; 12: 383-9.
28. Izadi Avanji FS, Adib Hajbaghery M, Afazel MR. Quality of sleep and it's related factors in the hospitalized elderly patients of Kashan hospitals in 2007. Feyz Med Sci J 2009; 12: 52-60. [In Persian].
29. Haseli-Mashhadi N, Dadd T, Pan A, et al. Sleep quality in middle-aged and elderly Chinese: distribution, associated factors and associations with cardio-metabolic risk factors. BMC Public Health 2009; 9: 130.
30. Turkmen K, Erdur FM, Guney I, et al. Sleep quality, depression, and quality of life in elderly hemodialysis patients. Int J Nephrol Renovasc Dis 2012; 5: 135-42.
31. Chien MY, Chen HC. Poor sleep quality is independently associated with physical disability in older adults. J Clin Sleep Med 2015; 11: 225-32.
32. Smagula SF, Stone KL, Fabio A, et al. Risk factors for sleep disturbances in older adults: Evidence from prospective studies. Sleep Med Rev 2016; 25: 21-30.
33. Kishimoto Y, Okamoto N, Saeki K, et al. Bodily pain, social support, depression symptoms and stroke history are independently associated with sleep disturbance among the elderly: a cross-sectional analysis of the Fujiwara-kyo study. Environ Health Prev Med 2016; 21: 295-303.
34. Tel H. Sleep quality and quality of life among the elderly people. Neurol Psychiatry Brain Res 2013; 19: 48-52.
35. Hayashino Y, Yamazaki S, Takegami M, et al. Association between number of comorbid conditions, depression, and sleep quality using the Pittsburgh Sleep Quality Index: results from a population-based survey. Sleep Med 2010; 11: 366-71.
36. Spiegel K, Leproult R, L'Hermite-Balériaux M, et al. Leptin levels are dependent on sleep duration: relationships with sympathovagal balance, carbohydrate regulation, cortisol, and thyrotropin. J Clin Endocrinol Metab 2004; 89: 5762-71.
37. Taheri S, Lin L, Austin D, et al. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med 2004; 1: e62.
38. Schultes B, Schmid S, Peters A, et al. Sleep loss and the development of diabetes: a review of current evidence. Exp Clin Endocrinol Diabetes 2005; 113: 563-7.
39. Whitworth JA, Williamson PM, Mangos G, et al. Cardiovascular consequences of cortisol excess. Vasc Health Risk Manag 2005; 1: 291-9.
40. Isgaard J. Cardiovascular disease and risk factors: the role of growth hormone. Horm Res 2004; 62: 31-8.
41. Poynter B, Shuman M, Diaz-Granados N, et al. Sex differences in the prevalence of post-stroke depression: a systematic review. Psychosomatics 2009; 50: 563-9.
42. Ghaemmohamadi MS, Behzadifar M, Ghashghaee A, et al. Prevalence of depression in cardiovascular patients in Iran: A systematic review and meta-analysis from 2000 to 2017. J Affect Disord 2018; 227: 149-55.
43. Soenen S, Rayner CK, Jones KL, et al. The ageing gastrointestinal tract. Curr Opin Clin Nutr Metab Care 2016; 19: 12-8.
44. Merchant HA, Liu F, Orlu Gul M, et al. Age-mediated changes in the gastrointestinal tract. Int J Pharm 2016; 512: 382-95.
45. Goldacre MJ. Demography of aging and the epidemiology of gastrointestinal disorders in the elderly. Best Pract Res Clin Gastroenterol 2009; 23: 793-804.
46. Bilski J, Mazur-Bialy A, Magierowski M, et al. Exploiting Significance of Physical Exercise in Prevention of Gastrointestinal Disorders. Curr Pharm Des 2018; 24: 1916-25.
47. Dickman R, Green C, Fass SS, et al. Relationships between sleep quality and pH monitoring findings in persons with gastroesophageal reflux disease. J Clin Sleep Med 2007; 3: 505-13.
48. Zhao W, Jin H, Xu M, et al. Sleep Quality of Functional Gastrointestinal Disorder Patients in Class-Three Hospitals: A Cross-Sectional Study in Tianjin, China. Biomed Res Int 2018; 2018: 3619748.
49. Habibi F, Mahdavi SB, Khaniabadi BM, et al. Sleep quality and associated factors in Iranian inflammatory bowel disease patients. J Res Med Sci 2019; 24: 59.
50. Khanijow V, Prakash P, Emsellem HA, et al. Sleep Dysfunction and Gastrointestinal Diseases. Gastroenterol Hepatol (N Y) 2015; 11: 817-25.
| Files | ||
| Issue | Vol 8 No 3-4 (2023): Summer-Autumn | |
| Section | Original Article(s) | |
| Keywords | ||
| Sleep quality; Elderly; Depression; Aging; Coronary heart disease | ||
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How to Cite
1.
Ahmadi Gharaei H, Ghorbani F, Naderpoor S, Alizad V, Ghasemi S, Hasanalizadeh Z, Noori F, Momen Baghsiyahi E. Prevalence and Risk Factors of Sleep Quality among Older Adults in Varamin, Iran. J Sleep Sci. 2026;8(3-4):82-89.
