Thesis

Sleep problems are more common in elderly people with intellectual disabilities

Elderly people with intellectual disabilities have more frequent and more severe sleep problems than their healthy peers. Their homes do not have enough daylight for a healthy sleep-wake rhythm. This is evident from the thesis written by Mylène Böhmer from Erasmus MC, which she will defend on 1 June.

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Sleep problems are common in elderly people with intellectual disabilities who live in a care institution. 67% of them sleep too little or have difficulty sleeping through the night. Among their healthy peers from the ERGO study, this number is 38%. The sleep problems are also more severe. Elderly people with intellectual disabilities lie awake for about half an hour longer, up to 2.5 hours per night, and sleep 15 minutes less. Researchers can see a relationship between these sleep problems and health problems, in particular mood and behavioral problems.

Mood lighting

Researcher Mylène Böhmer noticed that elderly people with intellectual disabilities are exposed to mood lighting for most of the day. This does not meet the recommended amount of light required for a healthy sleep-wake rhythm or a good mood. For her research, more than 80 elderly people with intellectual disabilities wore a light sensor. ‘For only slightly more than 30 minutes a day, the light intensity among residents was similar to that of daylight’, says Böhmer. This gave her the idea to investigate whether better lighting would affect the sleep rhythm and mood of the residents.

Effect

Dynamic artificial lighting was installed in six care homes run by care organization Middin. This lighting follows the daylight cycle of the sun and provides sufficient daylight during the day and mood lighting in the evening. Böhmer was surprised by the results. ‘In particular, the mood of the 54 residents improved within 14 weeks of the installation of this lighting. We saw a decrease in depressive symptoms and hyperactivity, as well as in apathy and irritability. Unfortunately, one year after the first measurement, there was no longer a positive effect, not even on their sleep problems.’

Mylène Böhmer in one of the care homes for elderly people with intellectual disabilities. Photographer: Levien Willemse.

Despite the hopeful finding in the short term, Böhmer believes that additional lighting is not the only solution. Although this was not central to the research, the doctoral candidate feels there is still much to be gained in the area of sleep habits. ‘Examples include getting sufficient exercise during the day, as well as attention to personal sleeping needs. Since the care is often arranged according to a tight schedule, this is not easy. In order to improve sleep quality in this target group, care providers should be given more time and financial resources to meet individual sleeping needs,’ concludes Böhmer.

This thesis is a collaboration between the care organization Middin and the chair of Medicine for the Intellectually Disabled at Erasmus MC. For her research, Böhmer also used data from the ERGO study, a long-term study among people aged 45 and over in the Ommoord district of Rotterdam.

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