Types and Risk Factors for Insomnia among Older Adults in an Outpatient Care Setting
Panita Limpawattan MD1, Worawit Euawiriyanukool MD2, Kittisak Sawanyawisuth MD3
Affiliation : 1 Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 2 Medicine Center,Bangkok Chanthaburi Hospital, Chanthaburi, Thailand 3 Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Objective : Insomnia symptoms [IS] are characterized by difficulty with initiating sleep [DIS], difficulty with maintaining
sleep [DMS] and early morning awakening [EMA]. More IS are likely to be associated with poorer sleep outcomes. Studies
regarding types of IS and their predictors in the elderly patients are limited. The objectives of this study were to add data on
types of IS and risk factors of having more than one IS in Thai older adults.
Materials and Methods : This was a cross-sectional study. Subjects who were aged >60 years and who attended the internal
medicine outpatient clinic of Srinagarind Hospital, Thailand were randomly interviewed from March 2012 to August 2013.
Information on baseline characteristics and sleep variables were collected.
Results : There were 100 participants with insomnia (median age = 71.5; 74% female) recruited from the outpatient medical
clinic. Difficulty with maintaining sleep [DMS] was the most frequent IS (70%) and most subjects had at least 2 IS (62%).
Being female (adjusted odds ratio [AOR] 5.9), less duration of sleep (AOR 0.6), movement/sound of partner (AOR 10.7) and
feeling thirsty (AOR 9.6) were independent factors of having >2 IS or more compared to 1 IS.
Conclusion : DMS was the most common. Other than gender, the modifiable factors showed a greater association with
having >2 IS compared to 1 IS.
Keywords : Age factors, Insomnia, Sleep initiation and maintenance disorders, Outpatient clinic, Tertiary hospital
