Sleep Quality among Homeless-Experienced Older Adults: Exploratory Results from the HOPE HOME Study
Background Sleep is essential to health and affected by environmental and clinical factors. There is limited longitudinal research examining sleep quality in homeless older adults. Objective To examine the factors associated with poor sleep quality in a cohort of older adults in Oakland, California...
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| Veröffentlicht in: | Journal of general internal medicine : JGIM 2024-02, Vol.39 (3), p.460-469 |
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| creator | Garcia, Cheyenne M. Schrier, Elizabeth F. Carey, Caitlin Valle, Karen A. Evans, Jennifer L. Kushel, Margot |
| description | Background
Sleep is essential to health and affected by environmental and clinical factors. There is limited longitudinal research examining sleep quality in homeless older adults.
Objective
To examine the factors associated with poor sleep quality in a cohort of older adults in Oakland, California recruited while homeless using venue-based sampling and followed regardless of housing status.
Design
Longitudinal cohort study.
Participants
244 homeless-experienced adults aged ≥ 50 from the Health Outcomes in People Experiencing Homelessness in Older Middle Age (HOPE HOME) cohort.
Main Measures
We assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI). We captured variables via biannual questionnaires and clinical assessments.
Key Results
Our sample was predominantly men (71.3%), Black (82.8%), and had a median age of 58.0 years old (IQR 54.0, 61.0). Two-thirds of participants (67.2%) reported poor sleep during one or more study visits; sleep duration was the worst rated subdomain. In a multivariable model, having moderate-to-severe depressive symptoms (AOR 2.03, 95% CI 1.40–2.95), trouble remembering (AOR 1.56, 95% CI 1.11–2.19), fair or poor physical health (AOR 1.49, 95% CI 1.07–2.08), two or more chronic health conditions (AOR 1.76, 95% CI 1.18–2.62), any ADL impairment (AOR 1.85, 95% CI 1.36–2.52), and being lonely (AOR 1.55, 95% CI 1.13–2.12) were associated with increased odds of poor sleep quality. Having at least one confidant was associated with decreased odds of poor sleep (AOR 0.56, 95% CI 0.37–0.85). Current housing status was not significantly associated with poor sleep quality.
Conclusions
Homeless-experienced older adults have a high prevalence of poor sleep. We found that participants’ physical and mental health was related to poor sleep quality. Poor sleep continued when participants re-entered housing. Access to physical and mental healthcare, caregiving support, and programs that promote community may improve homeless-experienced older adults sleep quality, and therefore, their overall health. |
| doi_str_mv | 10.1007/s11606-023-08429-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2872180090</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2872180090</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-affbdaa42896d18321f2b42c1aabc3eb805f932c31713ca4da3808b24a9dc37b3</originalsourceid><addsrcrecordid>eNp9kcFuFDEMhiMEotvCC3BAkbj0Epo42UmGW1UtXaRW21I4R5nEU7bKTJZkRmLfnpQtIHHgYkv259-Wf0LeCP5ecK7PihANbxgHybhR0DL1jCzEEpZMqFY_JwtujGJGS3VEjkt54FxIAPOSHEmtjWyNWBB_FxF39HZ2cTvtqRvSeE_XacCIpbDVjx3mLY4eA93EgJmehzlO5QOtnZiym1Le089YHou0z2mg0zek683NqobrFb2b5rB_RV70LhZ8_ZRPyNePqy8Xa3a1ufx0cX7FvIRmYq7vu-CcAtM2QRgJoodOgRfOdV5iZ_iybyV4KbSQ3qngpOGmA-Xa4KXu5Ak5Pejucvo-Y5nssC0eY3QjprlYMBqE4bzlFX33D_qQ5jzW6yy0UphGc9CVggPlcyolY293eTu4vLeC20cL7MECWy2wvyywqg69fZKeuwHDn5HfP6-APACltsZ7zH93_0f2J-vSkOk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2931867027</pqid></control><display><type>article</type><title>Sleep Quality among Homeless-Experienced Older Adults: Exploratory Results from the HOPE HOME Study</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Garcia, Cheyenne M. ; Schrier, Elizabeth F. ; Carey, Caitlin ; Valle, Karen A. ; Evans, Jennifer L. ; Kushel, Margot</creator><creatorcontrib>Garcia, Cheyenne M. ; Schrier, Elizabeth F. ; Carey, Caitlin ; Valle, Karen A. ; Evans, Jennifer L. ; Kushel, Margot</creatorcontrib><description>Background
Sleep is essential to health and affected by environmental and clinical factors. There is limited longitudinal research examining sleep quality in homeless older adults.
Objective
To examine the factors associated with poor sleep quality in a cohort of older adults in Oakland, California recruited while homeless using venue-based sampling and followed regardless of housing status.
Design
Longitudinal cohort study.
Participants
244 homeless-experienced adults aged ≥ 50 from the Health Outcomes in People Experiencing Homelessness in Older Middle Age (HOPE HOME) cohort.
Main Measures
We assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI). We captured variables via biannual questionnaires and clinical assessments.
Key Results
Our sample was predominantly men (71.3%), Black (82.8%), and had a median age of 58.0 years old (IQR 54.0, 61.0). Two-thirds of participants (67.2%) reported poor sleep during one or more study visits; sleep duration was the worst rated subdomain. In a multivariable model, having moderate-to-severe depressive symptoms (AOR 2.03, 95% CI 1.40–2.95), trouble remembering (AOR 1.56, 95% CI 1.11–2.19), fair or poor physical health (AOR 1.49, 95% CI 1.07–2.08), two or more chronic health conditions (AOR 1.76, 95% CI 1.18–2.62), any ADL impairment (AOR 1.85, 95% CI 1.36–2.52), and being lonely (AOR 1.55, 95% CI 1.13–2.12) were associated with increased odds of poor sleep quality. Having at least one confidant was associated with decreased odds of poor sleep (AOR 0.56, 95% CI 0.37–0.85). Current housing status was not significantly associated with poor sleep quality.
Conclusions
Homeless-experienced older adults have a high prevalence of poor sleep. We found that participants’ physical and mental health was related to poor sleep quality. Poor sleep continued when participants re-entered housing. Access to physical and mental healthcare, caregiving support, and programs that promote community may improve homeless-experienced older adults sleep quality, and therefore, their overall health.</description><identifier>ISSN: 0884-8734</identifier><identifier>EISSN: 1525-1497</identifier><identifier>DOI: 10.1007/s11606-023-08429-4</identifier><identifier>PMID: 37783981</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adults ; Aged ; Chronic Disease ; Chronic illnesses ; Cohort Studies ; Female ; Homeless people ; Homelessness ; Housing ; Humans ; Ill-Housed Persons ; Internal Medicine ; Longitudinal Studies ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Older people ; Original Research ; Quality assessment ; Sleep ; Sleep Quality</subject><ispartof>Journal of general internal medicine : JGIM, 2024-02, Vol.39 (3), p.460-469</ispartof><rights>The Author(s), under exclusive licence to Society of General Internal Medicine 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Society of General Internal Medicine.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-affbdaa42896d18321f2b42c1aabc3eb805f932c31713ca4da3808b24a9dc37b3</cites><orcidid>0000-0002-1361-6889</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11606-023-08429-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11606-023-08429-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37783981$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Garcia, Cheyenne M.</creatorcontrib><creatorcontrib>Schrier, Elizabeth F.</creatorcontrib><creatorcontrib>Carey, Caitlin</creatorcontrib><creatorcontrib>Valle, Karen A.</creatorcontrib><creatorcontrib>Evans, Jennifer L.</creatorcontrib><creatorcontrib>Kushel, Margot</creatorcontrib><title>Sleep Quality among Homeless-Experienced Older Adults: Exploratory Results from the HOPE HOME Study</title><title>Journal of general internal medicine : JGIM</title><addtitle>J GEN INTERN MED</addtitle><addtitle>J Gen Intern Med</addtitle><description>Background
Sleep is essential to health and affected by environmental and clinical factors. There is limited longitudinal research examining sleep quality in homeless older adults.
Objective
To examine the factors associated with poor sleep quality in a cohort of older adults in Oakland, California recruited while homeless using venue-based sampling and followed regardless of housing status.
Design
Longitudinal cohort study.
Participants
244 homeless-experienced adults aged ≥ 50 from the Health Outcomes in People Experiencing Homelessness in Older Middle Age (HOPE HOME) cohort.
Main Measures
We assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI). We captured variables via biannual questionnaires and clinical assessments.
Key Results
Our sample was predominantly men (71.3%), Black (82.8%), and had a median age of 58.0 years old (IQR 54.0, 61.0). Two-thirds of participants (67.2%) reported poor sleep during one or more study visits; sleep duration was the worst rated subdomain. In a multivariable model, having moderate-to-severe depressive symptoms (AOR 2.03, 95% CI 1.40–2.95), trouble remembering (AOR 1.56, 95% CI 1.11–2.19), fair or poor physical health (AOR 1.49, 95% CI 1.07–2.08), two or more chronic health conditions (AOR 1.76, 95% CI 1.18–2.62), any ADL impairment (AOR 1.85, 95% CI 1.36–2.52), and being lonely (AOR 1.55, 95% CI 1.13–2.12) were associated with increased odds of poor sleep quality. Having at least one confidant was associated with decreased odds of poor sleep (AOR 0.56, 95% CI 0.37–0.85). Current housing status was not significantly associated with poor sleep quality.
Conclusions
Homeless-experienced older adults have a high prevalence of poor sleep. We found that participants’ physical and mental health was related to poor sleep quality. Poor sleep continued when participants re-entered housing. Access to physical and mental healthcare, caregiving support, and programs that promote community may improve homeless-experienced older adults sleep quality, and therefore, their overall health.</description><subject>Adults</subject><subject>Aged</subject><subject>Chronic Disease</subject><subject>Chronic illnesses</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Homeless people</subject><subject>Homelessness</subject><subject>Housing</subject><subject>Humans</subject><subject>Ill-Housed Persons</subject><subject>Internal Medicine</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Older people</subject><subject>Original Research</subject><subject>Quality assessment</subject><subject>Sleep</subject><subject>Sleep Quality</subject><issn>0884-8734</issn><issn>1525-1497</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFuFDEMhiMEotvCC3BAkbj0Epo42UmGW1UtXaRW21I4R5nEU7bKTJZkRmLfnpQtIHHgYkv259-Wf0LeCP5ecK7PihANbxgHybhR0DL1jCzEEpZMqFY_JwtujGJGS3VEjkt54FxIAPOSHEmtjWyNWBB_FxF39HZ2cTvtqRvSeE_XacCIpbDVjx3mLY4eA93EgJmehzlO5QOtnZiym1Le089YHou0z2mg0zek683NqobrFb2b5rB_RV70LhZ8_ZRPyNePqy8Xa3a1ufx0cX7FvIRmYq7vu-CcAtM2QRgJoodOgRfOdV5iZ_iybyV4KbSQ3qngpOGmA-Xa4KXu5Ak5Pejucvo-Y5nssC0eY3QjprlYMBqE4bzlFX33D_qQ5jzW6yy0UphGc9CVggPlcyolY293eTu4vLeC20cL7MECWy2wvyywqg69fZKeuwHDn5HfP6-APACltsZ7zH93_0f2J-vSkOk</recordid><startdate>20240201</startdate><enddate>20240201</enddate><creator>Garcia, Cheyenne M.</creator><creator>Schrier, Elizabeth F.</creator><creator>Carey, Caitlin</creator><creator>Valle, Karen A.</creator><creator>Evans, Jennifer L.</creator><creator>Kushel, Margot</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1361-6889</orcidid></search><sort><creationdate>20240201</creationdate><title>Sleep Quality among Homeless-Experienced Older Adults: Exploratory Results from the HOPE HOME Study</title><author>Garcia, Cheyenne M. ; Schrier, Elizabeth F. ; Carey, Caitlin ; Valle, Karen A. ; Evans, Jennifer L. ; Kushel, Margot</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-affbdaa42896d18321f2b42c1aabc3eb805f932c31713ca4da3808b24a9dc37b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adults</topic><topic>Aged</topic><topic>Chronic Disease</topic><topic>Chronic illnesses</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Homeless people</topic><topic>Homelessness</topic><topic>Housing</topic><topic>Humans</topic><topic>Ill-Housed Persons</topic><topic>Internal Medicine</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Older people</topic><topic>Original Research</topic><topic>Quality assessment</topic><topic>Sleep</topic><topic>Sleep Quality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Garcia, Cheyenne M.</creatorcontrib><creatorcontrib>Schrier, Elizabeth F.</creatorcontrib><creatorcontrib>Carey, Caitlin</creatorcontrib><creatorcontrib>Valle, Karen A.</creatorcontrib><creatorcontrib>Evans, Jennifer L.</creatorcontrib><creatorcontrib>Kushel, Margot</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of general internal medicine : JGIM</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Garcia, Cheyenne M.</au><au>Schrier, Elizabeth F.</au><au>Carey, Caitlin</au><au>Valle, Karen A.</au><au>Evans, Jennifer L.</au><au>Kushel, Margot</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sleep Quality among Homeless-Experienced Older Adults: Exploratory Results from the HOPE HOME Study</atitle><jtitle>Journal of general internal medicine : JGIM</jtitle><stitle>J GEN INTERN MED</stitle><addtitle>J Gen Intern Med</addtitle><date>2024-02-01</date><risdate>2024</risdate><volume>39</volume><issue>3</issue><spage>460</spage><epage>469</epage><pages>460-469</pages><issn>0884-8734</issn><eissn>1525-1497</eissn><abstract>Background
Sleep is essential to health and affected by environmental and clinical factors. There is limited longitudinal research examining sleep quality in homeless older adults.
Objective
To examine the factors associated with poor sleep quality in a cohort of older adults in Oakland, California recruited while homeless using venue-based sampling and followed regardless of housing status.
Design
Longitudinal cohort study.
Participants
244 homeless-experienced adults aged ≥ 50 from the Health Outcomes in People Experiencing Homelessness in Older Middle Age (HOPE HOME) cohort.
Main Measures
We assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI). We captured variables via biannual questionnaires and clinical assessments.
Key Results
Our sample was predominantly men (71.3%), Black (82.8%), and had a median age of 58.0 years old (IQR 54.0, 61.0). Two-thirds of participants (67.2%) reported poor sleep during one or more study visits; sleep duration was the worst rated subdomain. In a multivariable model, having moderate-to-severe depressive symptoms (AOR 2.03, 95% CI 1.40–2.95), trouble remembering (AOR 1.56, 95% CI 1.11–2.19), fair or poor physical health (AOR 1.49, 95% CI 1.07–2.08), two or more chronic health conditions (AOR 1.76, 95% CI 1.18–2.62), any ADL impairment (AOR 1.85, 95% CI 1.36–2.52), and being lonely (AOR 1.55, 95% CI 1.13–2.12) were associated with increased odds of poor sleep quality. Having at least one confidant was associated with decreased odds of poor sleep (AOR 0.56, 95% CI 0.37–0.85). Current housing status was not significantly associated with poor sleep quality.
Conclusions
Homeless-experienced older adults have a high prevalence of poor sleep. We found that participants’ physical and mental health was related to poor sleep quality. Poor sleep continued when participants re-entered housing. Access to physical and mental healthcare, caregiving support, and programs that promote community may improve homeless-experienced older adults sleep quality, and therefore, their overall health.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>37783981</pmid><doi>10.1007/s11606-023-08429-4</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-1361-6889</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of general internal medicine : JGIM, 2024-02, Vol.39 (3), p.460-469 |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Adults Aged Chronic Disease Chronic illnesses Cohort Studies Female Homeless people Homelessness Housing Humans Ill-Housed Persons Internal Medicine Longitudinal Studies Male Medicine Medicine & Public Health Middle Aged Older people Original Research Quality assessment Sleep Sleep Quality |
| title | Sleep Quality among Homeless-Experienced Older Adults: Exploratory Results from the HOPE HOME Study |
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