Sleep disturbances in the institutionalized aged.

One hundred eighty nursing home residents, not psychotic or demented, average age 82 years, were administered a 30-minute structured interview to identify and characterize their sleeping patterns, health status, medications, psychosocial environment, and living conditions. In addition, both the residents and the night nurses rated quality of sleep on a five-point scale. Residents and nurses on all shifts also rated appetite and exercise on five-point scales. Residents were classified as having a sleep disturbance if they met at least one of the following criteria and reported poor sleep quality: onset of sleep latency greater than 30 minutes, three or more nighttime awakenings, and less than six hours sleep per night. Forty-five per cent of the residents met at least one clinical research criterion. Residents with sleep disturbance rated their sleep quality significantly lower than their peers not meeting research criteria. However, the nurses' ratings did not discriminate problem sleepers, and they correlated poorly with the residents' ratings. These subjective patient evaluations are discussed in relation to nursing evaluations, prescription of hypnotic medications, and other variables.