Sleep quality and associated factors of patients with mild cognitive impairment at King Chulalongkorn Memorial Hospital

Abstract

Background: Thailand has shifted into aging society. Sleep disturbance is a common problem in the elderly
which affects emotion and cognitive level. Awareness of sleep problems can help implementing in the elderly
care and preventing dementia in the future.

Objective: To study sleep quality and determine factors associated with sleep quality among patients with mild
cognitive impairment (MCI).

Methods: The cross-sectional descriptive study was conducted in MCI patients, aged 50 years and above, from
psychiatric outpatient clinic and cognitive fitness center. The data were collected by questionnaires including
demographic data and sleep environment questionnaires; Pittsburgh Sleep Quality Index (PSQI); Sleep Hygiene
Index (SHI); STOP-Bang questionnaire; Thai Mental State Examination (TMSE); Montreal Cognitive Assessment
(MoCA); Thai Geriatric Depression Scale (TGDS) and Neuropsychiatric Inventory Questionnaire (NPI-Q).
The sleep quality was presented by frequency and percentage. The associated factors were analyzed by
Chi-square test, Fisher’s exact test, and Pearson’s correlation coefficient. The predictors of poor sleep quality were
analyzed by multiple logistic regression analysis.

Results: Of the 100 subjects, 65 were female with the mean age of 71.3 7.5 years old: 64% of them had poor
sleep quality. The associated factors of sleep quality were having history of psychiatric disorders, use of
sedating psychotropic drugs, low to moderate sleep hygiene and anxiety domain of neuropsychiatric symptoms.
TGDS and STOP-Bang score were correlated with PSQI score (r = 0.215 and 0.230 respectively). The predictors
of poor sleep quality were the use of sedating psychotropic drugs (P < 0.01), low to moderate sleep hygiene
(P < 0.05) and anxiety domain of neuropsychiatric symptoms (P < 0.05).

Conclusion: The prevalence of poor sleep quality in MCI patient was 64%. The associated factors and predicted
factors of poor sleep quality were the use of sedating psychotropic drugs, low to moderate sleep hygiene and
anxiety domain of neuropsychiatric symptoms. Therefore, sleep quality should be screened in patients with MCI
due to the high prevalence.