Association of Sleep Disturbance and Physical Functioning Following Acute Hospitalisation in Older Adults

Three out of 10 older adults are admitted in US hospitals where they are at risk for a decline in physical function. Identifying factors related to sleep and recovery of physical function is key to facilitating independence after discharge. This study examined the association between sleep and functional recovery following an acute hospitalisation in community-dwelling older adults. Participants aged 65+ years (n = 52) were recruited during hospitalisation at the UTMB hospital in Galveston, Texas. Prior to discharge (baseline) and at 4-weeks post-discharge (follow-up), participants completed sleep questionnaires, including PROMIS Sleep-Related Impairment and Sleep Disturbance, as well as physical function testing and questionnaires, Short Physical Performance Battery (SPPB) and PROMIS Physical Function. A subset of participants (n = 24) wore an actigraphy device for 4 weeks post-discharge to record sleep continuity. Separate multivariate regression models were conducted to determine whether baseline sleep predicted physical functioning at follow-up as well as if pre-post hospital changes in sleep predicted pre-post changes in physical functioning. Baseline PROMIS Sleep-Related Impairment was inversely associated with SPPB Balance (p = 0.023), SPPB Chair Stand (p = 0.0406), SPPB Total (p = 0.01), and PROMIS Physical Function (p = 0.008). Change in PROMIS Sleep-Related Impairment between baseline and follow-up was inversely associated with change in SPPB Total (p = 0.03), SPPB Balance (p = 0.0102), and PROMIS Physical Function (p = 0.012). Additionally, change in PROMIS Sleep Disturbance was inversely correlated with change in PROMIS Physical Function (p = 0.04). These results showed that self-reported sleep disturbances and daytime sleep-related impairments during and after hospitalisation predicted physical functioning at 4-weeks post-discharge. Trail Registration: clinicaltrials.gov as NCT02990533.