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Open AccessArticle

Factors that Influence Sleep among Residents in Long-Term Care Facilities

by Da Eun Kim 1 and Ju Young Yoon 2,*
School of Nursing, University of Wisconsin-Madison, Madison, WI 53705, USA
Research Institute of Nursing Science and College of Nursing, Seoul National University, Seoul 03080, Korea
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(6), 1889;
Received: 10 February 2020 / Revised: 8 March 2020 / Accepted: 10 March 2020 / Published: 14 March 2020
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Long-term care residents often experience sleep disturbances as they are vulnerable to a variety of physical, psychosocial, and environmental factors that contribute to sleep disturbances. However, few studies have examined the combined impact of multiple factors on sleep among long-term care residents. This study aimed to identify the factors that influence sleep efficiency and sleep quality based on a modified senescent sleep model. A total of 125 residents were recruited from seven long-term care facilities in South Korea. Sleep patterns and sleep quality were collected using 3-day sleep logs and the Minimal Insomnia Screening Scale for Korean adults (KMISS), respectively. The mean sleep efficiency was 84.6% and the mean score on sleep quality was 15.25. A multiple linear regression analysis showed that greater dependence in activities of daily living (ADL), higher pain, and light at night were related to lower sleep efficiency. Higher pain and fatigue, less activity time, noise and light at night, and lower nighttime staffing levels were related to poorer sleep quality. This study highlights that psychosocial and environmental factors as well as physical factors could influence sleep for long-term care residents. Our findings could be foundational evidence for multi-faceted sleep intervention program development in long-term care settings. View Full-Text
Keywords: sleep; long-term care; aged; environment sleep; long-term care; aged; environment
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Kim, D.E.; Yoon, J.Y. Factors that Influence Sleep among Residents in Long-Term Care Facilities. Int. J. Environ. Res. Public Health 2020, 17, 1889.

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