Objectively measured sleep quality and nursing home placement in older women

J Am Geriatr Soc. 2012 Jul;60(7):1237-43. doi: 10.1111/j.1532-5415.2012.04044.x. Epub 2012 Jun 15.


Objectives: To determine the association between objectively measured sleep and subsequent placement in a nursing home or a personal care home.

Design: Prospective cohort.

Setting: Participants' homes and sites of the Study of Osteoporotic Fractures.

Participants: One thousand six hundred sixty-four community-dwelling women with a mean age of 83 ± 4.

Measurements: At baseline, participants completed an average of 4 nights of wrist actigraphy; they provided data on place of residence at baseline and at follow-up, 5 years later.

Results: At baseline, participants had a mean total sleep time of 408 ± 72 minutes, mean wake after sleep onset of 71 ± 43 minutes, and mean sleep efficiency of 79 ± 11%. At follow-up, 71 (4%) were residing in a nursing home, and 127 (8%) were in a personal care home. Women with the most wake after sleep onset (by quartile) had more than twice the odds as those with the least of placement in a nursing home (adjusted odds ratio (AOR) = 2.94, 95% confidence interval (CI) = 1.34-6.44) or a personal care home (AOR = 2.33, 95% CI = 1.26-4.30). Similarly, women with the lowest sleep efficiency had more than three times the odds as those with the highest of nursing home placement (AOR = 3.25, 95% CI = 1.35, 7.82) and more than twice the odds of placement in a personal care home (AOR = 2.38, 95% CI = 1.33, 4.24). There was no association between sleep duration and placement.

Conclusion: In very old community-dwelling women, greater wake after sleep onset and lower sleep efficiency are risk factors for placement in a nursing home or personal care home. Sleep duration alone does not appear to increase the risk of placement in these long-term care settings.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Chi-Square Distribution
  • Female
  • Geriatric Assessment / methods*
  • Humans
  • Logistic Models
  • Monitoring, Ambulatory / instrumentation
  • Nursing Homes*
  • Prospective Studies
  • Risk Factors
  • Sleep / physiology*
  • Sleep Wake Disorders / diagnosis*
  • Sleep Wake Disorders / physiopathology*
  • Statistics, Nonparametric
  • United States