Current status of coping with insomnia among community-dwelling older adults with mild cognitive impairment and insomnia: a qualitative study

TL;DR

This study explores how older adults with mild cognitive impairment cope with insomnia and suggests non-drug treatments to improve sleep.

Contribution

The study identifies specific coping themes and subthemes among older adults with MCI and insomnia, offering insights for targeted interventions.

Findings

Three main coping themes were identified: coping attitudes, styles, and needs.

Non-pharmacological interventions are recommended for insomnia in older adults with MCI.

Community health centers should focus on sleep behavior interventions and correct sleep cognition.

Abstract

The prevalence of insomnia is relatively high among community-dwelling older adults with mild cognitive impairment (MCI), and inappropriate coping strategies for insomnia are the primary cause of its persistence. This study aims to comprehensively understand the current status of insomnia coping strategies among older adults with MCI and insomnia in the community to provide a reference basis for the subsequent formulation of targeted insomnia treatment strategies.

A descriptive qualitative study was conducted in the health education room of a community health service center using purposive sampling to select older adults for one-on-one semi-structured interviews. The inclusion criteria were: (1) age ≥ 60 years; (2) residing in the community for ≥ 6 months; (3) meeting the diagnostic criteria for MCI as outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the diagnostic criteria for insomnia as outlined in the International Classification of Sleep Disorders, Third Edition (ICSD-3); and (4) basic communication and comprehension abilities. Traditional content analysis was used to organize and analyze the data.

A total of 17 participants were ultimately included, and data saturation was achieved. The current coping status of insomnia among older adults with MCI and insomnia in the community was categorized into three themes and ten subthemes: (1) coping attitudes (including negative coping, positive coping, and ambivalent coping); (2) coping styles (including insomnia symptom coping, active intervention coping, and cognitive impairment coping); and (3) coping needs (including treatment, knowledge, cognitive, and support needs).

It is essential to implement non-pharmacological insomnia intervention methods in older adults with MCI and insomnia. It is recommended that primary healthcare institutions, such as community health service centers, pay attention to the insomnia issues of older adults with MCI, help them establish correct sleep cognition, and explore targeted, cognition-friendly, non-pharmacological insomnia intervention strategies, with a focus on providing sleep behavior intervention.