Psychoactive Medications and Actigraphically Scored Sleep Quality in Frail Nursing Home Patients

The objective of this study was to examine the association between psychoactive medications and sleep quality in a sample of nursing home patients. We studied a baseline data collection for a clinical trial of a nonpharmacologic sleep intervention program. This study was conducted at six community nursing homes. We studied 168 nursing home patients. Sleep was recorded by wrist actigraphy for three to five nights under usual care conditions. Demographic and clinical data were collected by medical record reviews and patient assessments. One or more routine psychoactive medications were being taken by 109 (65%) of the patients. Number of minutes of sleep, percent of time in bed asleep, and number of awakenings did not differ between those receiving and not receiving a psychoactive medication. Neither the use of antidepressants nor the use of only psychoactive medications reported to cause sedation was associated with significantly better sleep quality. Psychoactive medications as a general class of drugs were not associated with better or worse sleep quality in this very frail nursing home population. The effect of individual classes of psychoactive drugs on sleep quality in this patient population requires further study.