The Concomitant Pattern of Association Between Subjective Global Sleep Quality and Daytime Dysfunction in Hypnotic-Treated Older Adults: The Yilan Study, Taiwan

Abstract

Objective

The relationship between improvements in subjective sleep quality and restoration of daytime function remains unclear. This study aimed to examine the concomitant pattern between subjective sleep quality and daytime dysfunction in hypnotic-treated older adults.

Methods

This was a community-based, cross-sectional study. Participants comprised community-dwelling adults aged ≥ 65 years. Individual items from the Pittsburgh Sleep Quality Index (PSQI) were adopted to evaluate subjective global sleep quality and daytime dysfunction. Daytime dysfunction included composite scores of daytime dysfunction in the PSQI and its two sub-components: “staying awake” and “maintaining enthusiasm.” Based on hypnotic use and status in subjective sleep quality, participants were categorized into four groups: “healthy control,” “treated with good sleep quality (T+GSQ),” “treated with poor sleep quality (T+PSQ),” and “not treated with poor sleep quality (NT+PSQ)”. The associations between these four groups and daytime dysfunction were analyzed using logistic regression.

Results

In total, 2622 individuals participated in the study. After controlling for covariates, the T+PSQ group was more likely to have daytime dysfunction, including “composite daytime dysfunction” (OR: 6.41; 95% CI: 3.90–10.55), “poor at staying awake” (OR: 3.04; 95% CI: 1.45–6.37), and “poor at maintaining enthusiasm” (OR: 7.42; 95% CI: 4.33–12.70) compared to the T+GSQ group. However, the healthy control group was less likely than the T+GSQ group to present with daytime dysfunction, including “composite daytime dysfunction” (OR: 0.43; 95% CI: 0.26–0.72) and “poor at maintaining enthusiasm” (OR: 0.39; 95% CI: 0.22–0.68).

Conclusion

Subjective sleep quality attributed to hypnotic use did not necessarily indicate restoration of daytime dysfunction.

Keywords:

• daytime dysfunction
• sleep
• public health
• quality of care
• drug related

Abbreviations

CI, confidence interval; ESS, the epworth sleepiness scale; HADS, the hospital anxiety and depression scale; NT+PSQ, not treated with poor sleep quality; OR, odds ratios; PSQI, pittsburgh sleep quality index; T+GSQ, treated with good sleep quality; T+PSQ, treated with poor sleep quality.

Acknowledgments

The authors would also like to thank Yang-Ming Crusaders, Mr. Da-Wei Lin, Ms Yu-Hui Lin, Mr. Chia-Hsiang Lin, and Ms Tzu-Chun Lo for their help with data collection.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest for this work.

Additional information

Funding

This work was supported by the Ministry of Science and Technology, Taiwan [MOST-107-2314-B-010 −049] and partially supported by the Ministry of Science and Technology, Taiwan [MOST-107-2314-B-002 −219, MOST-108-2314-B-002 −110 -MY2, and MOST-110-2314-B-002 −096 -MY3].