Gender Differences are Noted in Factors Associated with Insomnia in Older Adult Outpatients: A Cross-Sectional Study

Abstract

\n Background: Insomnia is a common sleep disturbance in older adults and is associated with many poor health outcomes. This study aimed to investigate the relevance of insomnia in older adult outpatients and to analyze differences between genders in factors associated with insomnia.Methods: This cross-sectional study was conducted in the outpatient clinics of a tertiary hospital in Southern Taiwan from July to September 2018. A total of 400 consecutive subjects aged 60 years or older were recruited. Insomnia was defined as a score of > 6 points on the Athens Insomnia Scale (AIS). Socio-demographics, health behaviors and clinical data were collected by face-to-face interview. Multivariable logistic regression was adopted for statistical analysis of the entire sample and stratified by gender.Results: Participants’ mean age was 74.74 ± 8.54 years, and the majority (93%) had more than one chronic disease. The prevalence of insomnia accounted for 30% (120/400) of all subjects, with males 22.9% (46/201) and females 37.2% (74/199). Gender, appetite, exercise, depressive symptoms, and sleep-related conditions such as short sleep duration, sleeping pills usage, medium-high risk of obstructive sleep apnea(OSA) and restless leg syndrome(RLS) were factors associated with insomnia in older adults. Exercise, sleeping pills usage, and RLS had an independent association with insomnia only in men, while appetite was associated with insomnia in women only.Conclusions: Insomnia is highly prevalent among older adults, predominantly females. Significant differences are found between genders in factors associated with insomnia. Understanding gender differences may help clinicians to modify associated factors when managing older adults with insomnia.