Monday, 14 August 2017

Prevalence and Contributing Factors of Insomnia among Elderly of Pashupati Old Aged Home (Briddhashram)

Insomnia is one of the major and unsolved problems in older people. The prevalence of insomnia increases steadily with age and is often a persistent problem, particularly in older adults and are often mistaken as a normal part of ageing. Studies investigating insomnia among elderly people living in geriatric homes, especially in Nepal, are rare. The objective of this study was to determine the prevalence and contributing factors of insomnia among elderly people of Social Welfare Centre Briddhashram (Old aged home), Pashupati, Kathmandu. A descriptive cross-sectional study design was conducted among 148 elderly people of 60-94 years of age, following simple random sampling technique. The tools used were semi-structured questionnaire, Athens Insomnia Scale (AIS) and Geriatric Depression Scale (GDS). The data was collected by using semistructured interview schedule and was analyzed by using SPSS version 17.0. This study highlights that around three-fifth (61.5%) of the respondents had insomnia associated with different factors such as age, suffering from increased number of physical symptoms, irregular sleep, etc. Three-fourth (75%) of the respondents complained of pain; followed by weakness of extremities (65.5%). Depression, perceived poor health status as compared to one year ago and use of drugs for long term illness were also found to be contributing factors of insomnia. Insomnia is common among elderly population.

Ageing is a natural phenomenon and an inevitable process. Every living being born, develops, grows old and dies. With the increase in age, people lose their creativity level, problem solving ability and learning skills as well as short-term memory. All the people of the world - be they rich or poor and learned or uneducated - have to pass through this cyclical process in their lives, irrespective of their present state of strength or merit or weakness. Sleep is a vital physiological process with important restorative functions. Sleep disorders and sleeping difficulties are among the most pervasive and poorly addresses problems of aging. Getting enough sleep can have a significant impact on daily function, alertness and overall quality of life. Insomnia or sleeplessness, is a sleep disorder in which there is an inability to fall asleep or to stay asleep as long as desired. This sleep disorder is often practically defined as a positive response to either of two questions: “Do you experience difficulty sleeping?” or “Do you have difficulty falling or staying asleep?”.

With age, several changes occur that can place one at risk for sleep disturbances including increased prevalence of medical condition, increased medications use, age related changes in various circadian rhythms, and environmental and life style changes. Insomnia is generally classified as primary or secondary to some underlying cause. Primary insomnia is usually not associated with a medical or psychiatric condition. Secondary insomnia occurs most frequently in the older adult with medical or psychiatric disorders. The causes of insomnia in the elderly are divided into four groups:  physical diseases or symptoms, such as long-term pain, bladder or prostate problems, joint diseases such as arthritis or bursitis, and gastroesophageal reflux;  environmental/behavioral factors; use of drugs, such as caffeine, alcohol, or prescription medications for chronic diseases; and mental diseases or symptoms, such as anxiety, depression, loss of personal identity, or perceived poor health status 

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