Sleeping pills in the treatment of insomnia in older adults with depression: the role of sleep hygiene
Öz
Aim: This study aimed to determine sleeping pills used for insomnia and investigate the impact of sleep hygiene on insomnia severity in older adults with depression.
Methods: In this study, 120 older adults with depression taking sleeping pills for insomnia were included. We evaluated sleep hygiene, sleep quality, insomnia severity, depression, and anxiety using the Sleep Hygiene Index, Insomnia Severity Index, Pittsburgh Sleep Quality Index, Beck Depression Inventory, and Beck Anxiety Inventory and determined the sleeping pills used for insomnia.
Results: Quetiapine, mirtazapine, and trazodone were the most commonly used sleeping pills. Sleep hygiene was correlated with insomnia overall and was elevated in the group with higher clinical levels of insomnia. In multiple linear regression analyzes, insomnia was predicted by subjective sleep quality (20%) and sleep hygiene (9%) and sleep hygiene (4%) when depression and anxiety were adjusted.
Conclusion: Although the sleeping pills used are similar, the differentiation of insomnia severity in terms of sleep hygiene shows the importance of the latter in the treatment process. Longitudinal studies investigating the effect of simple environmental and behavioral influences on insomnia symptoms are needed.
Anahtar Kelimeler
Kaynakça
- World Health Organisation. World report on Ageing And Health. Geneva: WHO Press; 2015.
- Bostan H, Sertkaya Doğan Ö. Türkiye’nin demografik dönüşümü ve nüfus projeksiyonlarına göre fırsatlar. Doğu Coğrafya Derg. 2019;24(41):61–90.
- Gulia KK, Kumar VM. Sleep disorders in the elderly: a growing challenge. Psychogeriatrics. 2018;18(3):155–65.
- Simoes Maria M, Büla C, Santos-Eggimann B, Krief H, Heinzer R, Seematter-Bagnoud L. Sleep characteristics and self-rated health in older persons. Eur Geriatr Med. 2020;11(1):131–8.
- Patel D, Steinberg J, Patel P. Insomnia in the elderly: A Review. J Clin Sleep Med. 2018;14(06):1017–24.
- Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: Developing normative sleep values across the human lifespan. Sleep. 2004;27(7):1255–73.
- Perlis ML, Smith LJ, Lyness JM, et al. Insomnia as a risk factor for onset of depression in the elderly. Behav Sleep Med. 2006;4(2):104–13.
- Paudel ML, Taylor BC, Diem SJ, et al. Association between depressive symptoms and sleep disturbances in community-dwelling older men. J Am Geriatr Soc. 2008;56(7):1228–35.
- Lustberg L, Reynolds CF. Depression and insomnia: questions of cause and effect. Sleep Med Rev. 2000;4(3):253–62.
- Üzer A, Yücens B. The effect of circadian preferences on insomnia severity and depressive symptoms via sleep hygiene in older adults with depression and healthy controls. Psychogeriatrics. 2020;20(6):871–9.
- Corsonello A, Pedone C, Incalzi R. Age-related pharmacokinetic and pharmacodynamic changes and related risk of adverse drug reactions. Curr Med Chem. 2010;17(6):571–84.
- Scaglione F, Vampini C, Parrino L, Zanetti O. Managing insomnia in the elderly patient: From pharmacology to subthreshold depression. Riv Psichiatr. 2018;53(1):5–17.
- Abad VC, Guilleminault C. Insomnia in elderly patients: recommendations for pharmacological management. Drugs Aging. 2018;35(9):791–817.
- Kwon C-Y, Lee B, Cheong MJ, et al. Non-pharmacological Treatment for Elderly Individuals with Insomnia: A Systematic Review and Network Meta-Analysis. Front Psychiatry. 2021;11:608896.
- Stepanski EJ, Wyatt JK. Use of sleep hygiene in the treatment of insomnia. Sleep Med Rev. 2003;7(3):215–25.
- Hauri PJ. Sleep Hygiene, Relaxation Therapy, and Cognitive Interventions. In: Case Studies in Insomnia. Boston, MA: Springer US; 1991. p. 65–84.
- Suzuki K, Miyamoto M, Hirata K. Sleep disorders in the elderly: diagnosis and management. J Gen Fam Med. 2017;18(2):61–71.
- Tufan A, Ilhan B, Bahat G, Karan MA. An under-diagnosed geriatric syndrome: sleep disorders among older adults. Afr Health Sci. 2017;17(2):436.
- Thorpy M. International Classification of Sleep Disorders. In: Sleep Disorders Medicine. Third Edit. New York, NY: Springer New York; 2017. p. 475–84.
- Ozdemir PG, Boysan M, Selvi Y, Yildirim A, Yilmaz E. Psychometric properties of the Turkish version of the Sleep Hygiene Index in clinical and non-clinical samples. Compr Psychiatry. 2015;59:135–40.
- Agargun MY, Kara H, Anlar Ö. The validity and reliability of the Pittsburgh Sleep Quality Index. Turkish J psychiatry. 1996;7(2):107–15.
- Ozcelik HS, Ozdel K, Bulut SD, Orsel S. The reliability and validity of the Turkish version of the Beck Scale for suicide ideation (Turkish BSSI). Bull Clin Psychopharmacol. 2015;25(2):141–50.
- Ulusoy M, Sahin N, Erkmen H. Turkish version of the Beck Anxiety Inventory: Psychometric Properties. J Cogn Psychother. 1998;12(2):163,172.
- Boysan M, Güleç M, Beşiroğlu L, Kalafat T. Psychometric properties of the insomnia severity index in Turkish sample. Anadolu Psikiyatr Derg. 2010;11(3):248–52.
- Roenneberg T, Wirz-Justice A, Merrow M. Life between clocks: daily temporal patterns of human chronotypes. J Biol Rhythms. 2003;18(1):80–90.
- Selvi Y, Kandeger A, Boysan M, et al. The effects of individual biological rhythm differences on sleep quality, daytime sleepiness, and dissociative experiences. Psychiatry Res. 2017;256:243–8.
- Parekh PK, McClung CA. Circadian mechanisms underlying reward-related neurophysiology and synaptic plasticity. Front Psychiatry. 2016;6(1):1–11.
- Bedrosian TA, Nelson RJ. Timing of light exposure affects mood and brain circuits. Transl Psychiatry. 2017;7(1):e1017–e1017.
- Roenneberg T, Daan S, Merrow M. The art of entrainment. J Biol Rhythms. 2003;18(3):183–94.
- Antypa N, Verkuil B, Molendijk M, Schoevers R, Penninx BWJH, Van Der Does W. Associations between chronotypes and psychological vulnerability factors of depression. Chronobiol Int. 2017;34(8):1125–35. 35.
Öz
Amaç: Bu araştırma, Yaşlı Depresyon Hastaları’nda (YDH) uykusuzluk tedavisinde kullanılan uyku haplarını belirlemeyi ve uyku hijyeninin uykusuzluk şiddeti üzerindeki rolünü araştırmayı amaçlamıştır.
Yöntemler: Bu çalışmaya uykusuzluk için uyku ilacı kullanmakta olan 120 YDH dahil edildi. Katılımcıların uykusuzluk için kullandıkları uyku hapları belirlendi. Uyku Hijyeni İndeksi (UHİ), Uykusuzluk Şiddeti İndeksi (UŞİ), Pittsburgh Uyku Kalitesi İndeksi (PUKİ), Beck Depresyon Ölçeği (BDÖ) ve Beck Anksiyete Ölçeği (BAÖ) kullanılarak hastaların uyku hijyeni, uyku kalitesi, uykusuzluk şiddeti, depresyon ve anksiyete seviyeleri değerlendirildi.
Bulgular: YDH’da ketiapin, mirtazapin ve trazodon en sık kullanılan uyku haplarıydı. Uyku hijyeni genel olarak uykusuzluk şiddeti ile korelasyon göstermekteydi ve klinik uykusuzluk seviyesi daha yüksek olan grupta daha yüksek seviyelerdeydi. Çoklu doğrusal regresyon analizleri sonuçları uykusuzluk şiddetinin; öznel uyku kalitesi (%20) ve uyku hijyeni (%9) ile depresyon ve anksiyete’den bağımsız olarak tahmin edildiğini gösterdi.
Sonuç: Kullanılan uyku hapları benzer olmasına rağmen uyku hijyeni açısından uykusuzluk şiddetinin farklılaşması tedavi sürecinde uyku hijyeninin önemini göstermektedir. Basit çevresel ve davranışsal etkilerin uykusuzluk semptomları üzerindeki etkisini araştıran boylamsal çalışmalara ihtiyaç vardır.
Anahtar Kelimeler
Kaynakça
- World Health Organisation. World report on Ageing And Health. Geneva: WHO Press; 2015.
- Bostan H, Sertkaya Doğan Ö. Türkiye’nin demografik dönüşümü ve nüfus projeksiyonlarına göre fırsatlar. Doğu Coğrafya Derg. 2019;24(41):61–90.
- Gulia KK, Kumar VM. Sleep disorders in the elderly: a growing challenge. Psychogeriatrics. 2018;18(3):155–65.
- Simoes Maria M, Büla C, Santos-Eggimann B, Krief H, Heinzer R, Seematter-Bagnoud L. Sleep characteristics and self-rated health in older persons. Eur Geriatr Med. 2020;11(1):131–8.
- Patel D, Steinberg J, Patel P. Insomnia in the elderly: A Review. J Clin Sleep Med. 2018;14(06):1017–24.
- Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: Developing normative sleep values across the human lifespan. Sleep. 2004;27(7):1255–73.
- Perlis ML, Smith LJ, Lyness JM, et al. Insomnia as a risk factor for onset of depression in the elderly. Behav Sleep Med. 2006;4(2):104–13.
- Paudel ML, Taylor BC, Diem SJ, et al. Association between depressive symptoms and sleep disturbances in community-dwelling older men. J Am Geriatr Soc. 2008;56(7):1228–35.
- Lustberg L, Reynolds CF. Depression and insomnia: questions of cause and effect. Sleep Med Rev. 2000;4(3):253–62.
- Üzer A, Yücens B. The effect of circadian preferences on insomnia severity and depressive symptoms via sleep hygiene in older adults with depression and healthy controls. Psychogeriatrics. 2020;20(6):871–9.
- Corsonello A, Pedone C, Incalzi R. Age-related pharmacokinetic and pharmacodynamic changes and related risk of adverse drug reactions. Curr Med Chem. 2010;17(6):571–84.
- Scaglione F, Vampini C, Parrino L, Zanetti O. Managing insomnia in the elderly patient: From pharmacology to subthreshold depression. Riv Psichiatr. 2018;53(1):5–17.
- Abad VC, Guilleminault C. Insomnia in elderly patients: recommendations for pharmacological management. Drugs Aging. 2018;35(9):791–817.
- Kwon C-Y, Lee B, Cheong MJ, et al. Non-pharmacological Treatment for Elderly Individuals with Insomnia: A Systematic Review and Network Meta-Analysis. Front Psychiatry. 2021;11:608896.
- Stepanski EJ, Wyatt JK. Use of sleep hygiene in the treatment of insomnia. Sleep Med Rev. 2003;7(3):215–25.
- Hauri PJ. Sleep Hygiene, Relaxation Therapy, and Cognitive Interventions. In: Case Studies in Insomnia. Boston, MA: Springer US; 1991. p. 65–84.
- Suzuki K, Miyamoto M, Hirata K. Sleep disorders in the elderly: diagnosis and management. J Gen Fam Med. 2017;18(2):61–71.
- Tufan A, Ilhan B, Bahat G, Karan MA. An under-diagnosed geriatric syndrome: sleep disorders among older adults. Afr Health Sci. 2017;17(2):436.
- Thorpy M. International Classification of Sleep Disorders. In: Sleep Disorders Medicine. Third Edit. New York, NY: Springer New York; 2017. p. 475–84.
- Ozdemir PG, Boysan M, Selvi Y, Yildirim A, Yilmaz E. Psychometric properties of the Turkish version of the Sleep Hygiene Index in clinical and non-clinical samples. Compr Psychiatry. 2015;59:135–40.
- Agargun MY, Kara H, Anlar Ö. The validity and reliability of the Pittsburgh Sleep Quality Index. Turkish J psychiatry. 1996;7(2):107–15.
- Ozcelik HS, Ozdel K, Bulut SD, Orsel S. The reliability and validity of the Turkish version of the Beck Scale for suicide ideation (Turkish BSSI). Bull Clin Psychopharmacol. 2015;25(2):141–50.
- Ulusoy M, Sahin N, Erkmen H. Turkish version of the Beck Anxiety Inventory: Psychometric Properties. J Cogn Psychother. 1998;12(2):163,172.
- Boysan M, Güleç M, Beşiroğlu L, Kalafat T. Psychometric properties of the insomnia severity index in Turkish sample. Anadolu Psikiyatr Derg. 2010;11(3):248–52.
- Roenneberg T, Wirz-Justice A, Merrow M. Life between clocks: daily temporal patterns of human chronotypes. J Biol Rhythms. 2003;18(1):80–90.
- Selvi Y, Kandeger A, Boysan M, et al. The effects of individual biological rhythm differences on sleep quality, daytime sleepiness, and dissociative experiences. Psychiatry Res. 2017;256:243–8.
- Parekh PK, McClung CA. Circadian mechanisms underlying reward-related neurophysiology and synaptic plasticity. Front Psychiatry. 2016;6(1):1–11.
- Bedrosian TA, Nelson RJ. Timing of light exposure affects mood and brain circuits. Transl Psychiatry. 2017;7(1):e1017–e1017.
- Roenneberg T, Daan S, Merrow M. The art of entrainment. J Biol Rhythms. 2003;18(3):183–94.
- Antypa N, Verkuil B, Molendijk M, Schoevers R, Penninx BWJH, Van Der Does W. Associations between chronotypes and psychological vulnerability factors of depression. Chronobiol Int. 2017;34(8):1125–35. 35.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | ORJİNAL MAKALE |
| Yazarlar | |
| Yayımlanma Tarihi | 27 Eylül 2022 |
| Kabul Tarihi | 7 Ağustos 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 27 Sayı: 3 |
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