Sleep quality of benzodiazepine users in nursing homes: a ...



Sleep quality of benzodiazepine users in nursing homes: a comparative study with non-users.

Authors:

Jolyce Bourgeois PharmD1 , Monique M. Elseviers MSc PhD1,2, Luc Van Bortel MD PhD1, Mirko Petrovic MD PhD 1,3, Robert H. Vander Stichele MD PhD1

1 Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium

2 Department of Nursing Science, University of Antwerp, Antwerp, Belgium

3 Department of Geriatrics, Ghent University Hospital, Ghent, Belgium

Correspondence:

Jolyce Bourgeois

Ghent University - Heymans Institute of Pharmacology

De Pintelaan 185 (1 block B)

9000 Ghent

Key words:

Benzodiazepines, Sleep medication, sleep quality, older adults, nursing homes, comparative study

Word count abstract: 251

Word count main text: 3571

ABSTRACT:

Objectives:

To describe subjective sleep quality among chronic users of benzodiazepines (BZDs) in Belgian nursing homes, to compare it to non-users, and to investigate determinants of bad sleep quality.

Methods:

All mentally competent residents from 10 nursing homes were screened and compiled in a group of chronic BZDs users or in a group of non-users, based on the medication chart. We collected demographic, functional and medication characteristics, and global and specific sleep parameters, using the Pittsburgh Sleep Quality Index (PSQI). Linear regression was used to investigate which parameters were associated with sleep quality.

Results:

Of the 300 residents, 178 (59%) were chronic BZD users and 122 non-users. The two groups did not differ in demographic and functional characteristics (mean age= 85.5 years; range 57-100, 75% women). The users reported significantly more difficulties with falling asleep, more midnight awakenings, were less rested in the morning and had a worse self-perceived sleep quality compared to non-users. Sleep duration and time to fall asleep did not differ.

The self-perceived sleep quality was mainly determined by problems during initiation of sleep.

After controlling for demographic, medication and functional characteristics, BZD use remained strongly associated with bad sleep (r=0.173, p=0.003), and a study centre effect (differences among nursing homes) was observed (r=0.229, p ................
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