Date Presented 04/22/2023
The high prevalence of sleep disturbances in older adults warrants further research exploring their negative impacts on occupational engagement. Sensory loss and sensory impairment are common occurrences during normal aging and may result in difficulties in engaging in occupations such as sleep (Correia et al., 2016). This study examined the relationship between emotional states, including depression, anxiety, and stress, and sleep in older adults.
Primary Author and Speaker: Megan C. Chang
Additional Authors and Speakers: Madeline Bennet, Bailey Coe, Angela Santana, Katherine Schultz, Erin Serrano
Introduction: Sleep is a vital occupation to maintain health and quality of life for all age groups. Approximately 50% of older adults exhibit insomnia symptoms (López-Torres et al., 2012; Patel et al., 2018). Sleep disturbances have been associated with adverse physical and mental health outcomes (Heffner et al., 2012; Reid et al., 2006). The high prevalence of sleep disturbances in older adults warrants further research exploring their negative impacts on occupational engagement. Sensory loss and sensory impairment are common occurrences during normal aging and may result in difficulty engaging in sleep (Correia et al., 2016). The purpose of the study was to examine the relationship between sleep, sensory processing, and emotional states in older adults.
METHOD: An online, anonymous survey via Qualtrics collected demographic information and results from three standardized assessments: the Pittsburgh Sleep Quality Index (PSQI; Buysse et al., 1989), Adult Sensory Profile Scale (ASPS; Blanche et al., 2014), and Depression, Anxiety, Stress Scale-21 (DASS-21; Lovibond & Lovibond, 1995). Convenience and snowball sampling methods were used to recruit eligible participants. The data was exported from Qualtrics onto an Excel spreadsheet for data cleaning and analyzed using Statistical Analysis Software (SAS) and IBM Statistical Package for the Social Sciences (SPSS) version 27.
RESULTS: Among 67 older adults completed the survey, 36 were female (53.7 %). The average age was 69.3 ± 6.48 years. There were no significant differences in age between genders. T-tests showed that compared to males, females have more depression symptoms (p = 0.047), greater difficulties with sleep disturbances (p = 0.003), and they report taking more sleep medications (p = 0.017). Yet males experience more sleep disturbances than females (p = 0.012). T-tests found significant differences between males and females on sensory processing patterns. Females are more over-responsive to vestibular input (p = 0.003), vestibular movement (p = 0.015), auditory input (p = 0.010), visual input (p = 0.048), and under-responsive to vestibular-proprioceptive motor/postural stimuli (p = 0.001) than males. On the other hand, males tend to seek more proprioceptive input (p = 0.026) and be more under-responsive to auditory input (p = 0.012) than females. In examining the sensory processing patterns, over-responsiveness to tactile stimulation was significantly correlated to increased daytime dysfunction (r = 0.282, p = 0.021). Global scores of the PSQI were significantly correlated with total DASS scores (r = 0.559; p < 0.001). Specifically in sleep duration (r = 0.431; p < 0.001), subjective sleep quality (r = 0.536; p < 0.001), sleep disturbances (r = 0.389; p < 0.001), and daytime dysfunction (r = 0.473; p < 0.001). Sensory processing patterns were significantly correlated with increased depression (r = 0.349; p = 0.004), anxiety (r = 0.248; p = 0.043), and stress (r = 0.328; p = 0.007). Lastly, under-responsiveness to vestibular-proprioceptive input was related to higher rates of depression (r = 0.264, p = 0.031) and anxiety (r = 0.253; p = 0.039).
DISCUSSION: These findings suggest that there are several relationships between sleep, sensory processing, and emotional states among community-dwelling older adults. Moreover, older adults with poor sleep quality and/or mental health challenges should have their sensory processing patterns assessed and addressed in occupational therapy treatment.
Patel, D., Steinberg, J., & Patel, P. (2018). Insomnia in the elderly: A review. Journal of Clinical Sleep Medicine, 14(6), 1017-1024. https://dx.doi.org/10.5664%2Fjcsm.7172
Heffner, K. L., Ng, H. M., Suhr, J. A., France, C. R., Marshall, G. D., Pigeon, W. R., & Moynihan, J. A. (2012). Sleep disturbance and older adults’ inflammatory responses to acute stress. The American Journal of Geriatric Psychiatry, 20(9), 744-752. https://doi.org/10.1097/JGP.0b013e31824361de
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193-213. https://doi.org/10.1016/0165-1781(89)90047-4