Overview: Sleep problems are a common challenge in long-term care
Sleep disturbances affect more than one in five residents in long-term care facilities, according to a comprehensive international study led by researchers from the University of Waterloo. The investigation analyzed health records of over 21,000 residents aged 65 and older across 228 long-term care homes in New Brunswick and Saskatchewan from 2016 to 2021, using data gathered through the standardized interRAI assessment system.
The study tracked the emergence and resolution of sleep disturbances over time, revealing that at baseline, nearly 22% of residents reported some trouble sleeping. Facility-specific rates varied dramatically, ranging from as low as 3% to as high as 56%. Within a year, about 10% of residents who initially slept well developed new sleep issues, while roughly half of those with preexisting problems saw improvements.
Key predictors of sleep problems in older adults
The researchers identified several factors that increase the likelihood of developing new sleep disturbances or maintaining them over time. Notable predictors include:
- Pain and chronic health conditions, such as heart or lung disease
- Moderate cognitive impairment
- Daytime napping
- Use of sedative or antipsychotic medications
These findings underscore how intertwined sleep quality is with physical and cognitive health in seniors living in care facilities.
Health consequences of poor sleep in seniors
Poor sleep is not just a nighttime nuisance. The study and related literature point to several adverse health outcomes linked to sleep disturbances in older adults. Notably, poor sleep has associations with an increased risk of cardiovascular disease, cognitive decline, and depression. Moreover, inadequate sleep can drive higher use of medications, which itself may elevate the risk of falls, delirium, and other complications common in long-term care settings.
A path forward: opportunities to improve resident well-being
Dr. John Hirdes, a professor in Waterloo’s School of Public Health Sciences and the study’s senior author, emphasizes that many identified risk factors are modifiable. He suggests that improving pain management, reviewing medications, and fostering healthier sleep routines could yield meaningful benefits for residents.
Practical steps for care facilities may include:
- Comprehensive pain assessment and effective analgesia plans
- Regular medication reviews, especially for sedatives and antipsychotics, with consideration of de-prescribing where appropriate
- Structured sleep routines and environmental adjustments to promote comfort and minimize nighttime disturbances
- Non-pharmacological interventions such as daytime activity, light exposure, and sleep hygiene education for staff and residents
The study’s authors stress that these interventions are not only about improving sleep but also about reducing broader health risks that affect the longevity and quality of life of seniors in care settings.
Why this research matters for policy and practice
With aging populations and the increasing prevalence of long-term care facilities, understanding sleep disturbances as a modifiable risk factor is crucial. The findings offer a data-driven foundation for developing targeted care plans that prioritize sleep health as a core component of resident well-being. As facilities seek to enhance safety and outcomes, integrating sleep-focused strategies could become a standard part of geriatric care.
Conclusion: Sleep health as a pillar of senior care
The international study from University of Waterloo highlights a clear link between poor sleep and adverse health outcomes among older adults in long-term care. By addressing pain, medication use, and daily routines, care providers can help reduce sleep disturbances and their ripple effects on cardiovascular health, cognition, mood, and overall safety. The path forward is practical and within reach for facilities committed to elevating the quality of life for their residents.
