Skip to main content
Top
Published in: Sleep and Breathing 4/2012

01-12-2012 | Original Article

Cognitive behavioral therapy for institutionalized elders complaining of sleep disturbance in Alexandria, Egypt

Authors: Heba M. El Kady, Hala K. Ibrahim, Sherine G. Mohamed

Published in: Sleep and Breathing | Issue 4/2012

Login to get access

Abstract

Background

Behavioral interventions such as cognitive behavioral therapy (CBT) are among the most widely used nonpharmacologic alternatives for the treatment of insomnia.

Purpose

The aim of this study was to determine the prevalence of insomnia, factors affecting it, and the impact of a cognitive behavioral therapy for institutionalized elders complaining of sleep disturbance in Alexandria, Egypt.

Methods

This study was done through two phases. A cross-sectional design was used in the first phase to detect the prevalence of sleep problems and their correlates among the elderly, then pretest–posttest design was used to apply an intervention program to the elders who suffered from insomnia. A pre-designed structured interview questionnaire was presented to the participants. The main outcome measure was sleep quality, as measured by the Pittsburgh Sleep Quality Index.

Results

The study included a total of 210 elders (97 males and 113 females), with a mean age of 72.2 ± 5.3 years, about two thirds of them were poor sleepers (63.3%). The results show that after carrying out the behavioral therapy for the elders, the percentage of poor sleepers decreased from 63.3% to 46.2%. Two variables (educational level and female sex) proved to be statistically significantly related to the improvement in sleep quality.

Conclusions

A goal of this intervention program was considerably achieved. Importantly, the intervention appears to improve sleep quality among the elders. Data from this study re-enforce the continuing need for more sleep educational programs that are intended to attract the attention of elders especially those institutionalized.
Literature
1.
go back to reference Ohayon MM (2002) Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 6:97–111PubMedCrossRef Ohayon MM (2002) Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 6:97–111PubMedCrossRef
2.
go back to reference Mc Crae Ch (2009) Late-life comorbid insomnia: diagnosis and treatment. Am J Manag Care 15:14–23 Mc Crae Ch (2009) Late-life comorbid insomnia: diagnosis and treatment. Am J Manag Care 15:14–23
3.
go back to reference Montgomery P, Dennis J (2004) A systematic review of non-pharmacological therapies for sleep problems in later life. Sleep Medicine Reviews 8:47–62PubMedCrossRef Montgomery P, Dennis J (2004) A systematic review of non-pharmacological therapies for sleep problems in later life. Sleep Medicine Reviews 8:47–62PubMedCrossRef
4.
go back to reference Voyer P, Verreault R, Nkogho P, Mengue MC (2006) Prevalence of insomnia and its associated factors in elderly long-term care residents. Arch Gerontol Geriatr 42:1–20PubMedCrossRef Voyer P, Verreault R, Nkogho P, Mengue MC (2006) Prevalence of insomnia and its associated factors in elderly long-term care residents. Arch Gerontol Geriatr 42:1–20PubMedCrossRef
5.
go back to reference Mellinger GD, Balter MB, Uhlenhuth EH (1995) Insomnia and its treatment. Arch Gen Psychiatry 42:225–232CrossRef Mellinger GD, Balter MB, Uhlenhuth EH (1995) Insomnia and its treatment. Arch Gen Psychiatry 42:225–232CrossRef
6.
go back to reference Volpe S, Cuellar N, Rogers A, Hisghman V (2007) Assessment and treatment of sleep disorders in the older adult. Geriatr Nurs 28(4):254–264PubMedCrossRef Volpe S, Cuellar N, Rogers A, Hisghman V (2007) Assessment and treatment of sleep disorders in the older adult. Geriatr Nurs 28(4):254–264PubMedCrossRef
7.
go back to reference Mullan E, Katona C, Belew M (1994) Patterns of sleep disorders and sedative hypnotic use in seniors. Drugs Aging 5:49–58PubMedCrossRef Mullan E, Katona C, Belew M (1994) Patterns of sleep disorders and sedative hypnotic use in seniors. Drugs Aging 5:49–58PubMedCrossRef
8.
go back to reference Makhlouf M, Ayoub A, Abdel-Fattah M (2007) Insomnia symptoms and their correlates among the elderly in geriatric homes in Alexandria, Egypt. Sleep Breath 11:187–194PubMedCrossRef Makhlouf M, Ayoub A, Abdel-Fattah M (2007) Insomnia symptoms and their correlates among the elderly in geriatric homes in Alexandria, Egypt. Sleep Breath 11:187–194PubMedCrossRef
9.
go back to reference Alessi CA, Schnelle JF (2000) Approach to sleep disorders in the nursing home setting. Sleep Med Rev 4:45–56PubMedCrossRef Alessi CA, Schnelle JF (2000) Approach to sleep disorders in the nursing home setting. Sleep Med Rev 4:45–56PubMedCrossRef
10.
go back to reference Monane M, Glynn RJ, Avorn J (1996) The impact of sedative-hypnotic use on symptoms in elderly nursing home residents. Clin Pharmacol Therap 59:83–92CrossRef Monane M, Glynn RJ, Avorn J (1996) The impact of sedative-hypnotic use on symptoms in elderly nursing home residents. Clin Pharmacol Therap 59:83–92CrossRef
11.
go back to reference Kirkwood CK, Sood RK (1997) Sleep disorders. In: Dipiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM (eds) Pharmacotherapy: a pathophysiologic approach. Appleton and Lange, Stamford, pp 1477–1488 Kirkwood CK, Sood RK (1997) Sleep disorders. In: Dipiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM (eds) Pharmacotherapy: a pathophysiologic approach. Appleton and Lange, Stamford, pp 1477–1488
12.
go back to reference Irwin M, Olmstead R, Motivala SJ (2008) Improving sleep quality in older adults with moderate sleep complaints: a randomized controlled trial of tai chi chih. Sleep 31(7):1001–1008PubMed Irwin M, Olmstead R, Motivala SJ (2008) Improving sleep quality in older adults with moderate sleep complaints: a randomized controlled trial of tai chi chih. Sleep 31(7):1001–1008PubMed
13.
go back to reference Chesson AL (1999) Practice parameters for the use of light therapy in the treatment of sleep disorders. Sleep 22(5):641–660PubMed Chesson AL (1999) Practice parameters for the use of light therapy in the treatment of sleep disorders. Sleep 22(5):641–660PubMed
14.
go back to reference Buysse DJ, Reynolds CF III, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatr Res 28:193–213CrossRef Buysse DJ, Reynolds CF III, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatr Res 28:193–213CrossRef
15.
16.
go back to reference Morin CM (2004) Cognitive-behavioral approaches to the treatment of insomnia. J Clin Psychiatr 65(Suppl 16):33–40 Morin CM (2004) Cognitive-behavioral approaches to the treatment of insomnia. J Clin Psychiatr 65(Suppl 16):33–40
17.
go back to reference Morin CM, Bootzin RR, Buysse DJ, Edinger JD, Espie CA (2006) Psychological and behavioral treatment of insomnia: update of the recent evidence (1998–2004). Sleep 29:1398–1413PubMed Morin CM, Bootzin RR, Buysse DJ, Edinger JD, Espie CA (2006) Psychological and behavioral treatment of insomnia: update of the recent evidence (1998–2004). Sleep 29:1398–1413PubMed
18.
go back to reference Backhaus J, Junghanns K, Broocks A, Riemann D, Hohagen F (2002) Test- retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia. J Psychosom Res 53:737–740PubMedCrossRef Backhaus J, Junghanns K, Broocks A, Riemann D, Hohagen F (2002) Test- retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia. J Psychosom Res 53:737–740PubMedCrossRef
19.
go back to reference Gentili A, Weiner DK, Kuchibhatla M, Edinger JD (1995) Test–retest reliability of the Pittsburgh sleep quality index in nursing home residents. J Am Geriatr Soc 43(11):1317–1318PubMed Gentili A, Weiner DK, Kuchibhatla M, Edinger JD (1995) Test–retest reliability of the Pittsburgh sleep quality index in nursing home residents. J Am Geriatr Soc 43(11):1317–1318PubMed
20.
21.
go back to reference Foley D, Ancoli-Israel S, Britz P, Walsh J (2004) Sleep disturbances and chronic disease in older adults: results of the 2003 national sleep foundation sleep in America survey. J Psychosom Res 56(5):497–502PubMedCrossRef Foley D, Ancoli-Israel S, Britz P, Walsh J (2004) Sleep disturbances and chronic disease in older adults: results of the 2003 national sleep foundation sleep in America survey. J Psychosom Res 56(5):497–502PubMedCrossRef
22.
go back to reference Foley DJ, Monjan A, Simonsick EM, Wallace RB, Blazer DG (1999) Incidence and remission of insomnia among elderly adults: an epidemiologic study of 6,800 persons over three years. Sleep 22(suppl 2):S366–S372PubMed Foley DJ, Monjan A, Simonsick EM, Wallace RB, Blazer DG (1999) Incidence and remission of insomnia among elderly adults: an epidemiologic study of 6,800 persons over three years. Sleep 22(suppl 2):S366–S372PubMed
23.
go back to reference Vitiello MV, Moe KE, Prinz PN (2002) Sleep complaints cosegregate with illness in older adults: clinical research informed by and informing epidemiological studies of sleep. J Psychosom Res 53(1):555–559PubMedCrossRef Vitiello MV, Moe KE, Prinz PN (2002) Sleep complaints cosegregate with illness in older adults: clinical research informed by and informing epidemiological studies of sleep. J Psychosom Res 53(1):555–559PubMedCrossRef
24.
go back to reference Ito Y, Tamakoshi A, Yamaki K, Wakai K, Kawamura T, KenzoTakagi K et al (2000) Sleep disturbance and its correlates among elderly Japanese. Arch Gerontol Geriatr 30:85–100PubMedCrossRef Ito Y, Tamakoshi A, Yamaki K, Wakai K, Kawamura T, KenzoTakagi K et al (2000) Sleep disturbance and its correlates among elderly Japanese. Arch Gerontol Geriatr 30:85–100PubMedCrossRef
25.
go back to reference Habte-Gabr E, Wallace RB, Colsher PL, Hulbert JR, White LR, Smith IM (1991) Sleep patterns in rural elders: demographic, health, and psychobehavioral correlates. J Clin Epidemiol 44:5–13PubMedCrossRef Habte-Gabr E, Wallace RB, Colsher PL, Hulbert JR, White LR, Smith IM (1991) Sleep patterns in rural elders: demographic, health, and psychobehavioral correlates. J Clin Epidemiol 44:5–13PubMedCrossRef
26.
go back to reference Su TP, Huang SR, Chou P (2004) Prevalence and risk factors of insomnia in community—dwelling Chinese elderly: a Taiwanese urban area study. Aust N Z J Psychiatr 38(9):706–713CrossRef Su TP, Huang SR, Chou P (2004) Prevalence and risk factors of insomnia in community—dwelling Chinese elderly: a Taiwanese urban area study. Aust N Z J Psychiatr 38(9):706–713CrossRef
27.
go back to reference Reid KJ, Martinovich Z, Finkel S (2006) Sleep: a marker of physical and mental health in the elderly. Am J Geriatr Psychiatr 14(10):860–866CrossRef Reid KJ, Martinovich Z, Finkel S (2006) Sleep: a marker of physical and mental health in the elderly. Am J Geriatr Psychiatr 14(10):860–866CrossRef
29.
go back to reference Morin C, Hauri P, Espie CA, Spielman AJ, Buysse D, Bootzin R (1999) Nonpharmacological treatment of chronic insomnia. Sleep 22(8):1134–1156PubMed Morin C, Hauri P, Espie CA, Spielman AJ, Buysse D, Bootzin R (1999) Nonpharmacological treatment of chronic insomnia. Sleep 22(8):1134–1156PubMed
30.
go back to reference Espie CA, Inglis S, Harvey L (2001) Predicting clinically significant response to cognitive behavior therapy (CBT) for chronic insomnia in general practice: analyses of outcome data at 12 months post-treatment. J Consult Clin Psychol 69:58–66PubMedCrossRef Espie CA, Inglis S, Harvey L (2001) Predicting clinically significant response to cognitive behavior therapy (CBT) for chronic insomnia in general practice: analyses of outcome data at 12 months post-treatment. J Consult Clin Psychol 69:58–66PubMedCrossRef
31.
go back to reference Gagne A, Morin CM (2001) Predicting treatment response in older adults with insomnia. J Clin Geropsychol 7:131–143CrossRef Gagne A, Morin CM (2001) Predicting treatment response in older adults with insomnia. J Clin Geropsychol 7:131–143CrossRef
Metadata
Title
Cognitive behavioral therapy for institutionalized elders complaining of sleep disturbance in Alexandria, Egypt
Authors
Heba M. El Kady
Hala K. Ibrahim
Sherine G. Mohamed
Publication date
01-12-2012
Publisher
Springer-Verlag
Published in
Sleep and Breathing / Issue 4/2012
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-011-0629-3

Other articles of this Issue 4/2012

Sleep and Breathing 4/2012 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.