Abstract
This study aimed to identify the factors associated with subjective sleep quality in community-dwelling older adults receiving community rehabilitation services. The Athens Insomnia Scale (AIS) was used to categorize the participants into good sleepers (AIS ≤ 3) and poor sleepers (AIS ≥ 4), suggesting insomnia. Locomotive activities, mental health using the mental component summary (MCS), activities of daily-living using the functional independence measure (FIM), and depression using the geriatric depression scale (GDS) were evaluated, and sleep-related participant characteristics were collected using a questionnaire. Relevant variables were selected using Lasso regression and were further analyzed using logistic regression. Poor sleepers accounted for 66.7% of the participants. The LASSO regression analysis identified age, daily-living physical activity, MCS, and pain scores as the predictive variables. A logistic regression analysis revealed that higher levels of daily-living activities (OR = 0.08, p = 0.006) and MCS (OR = 0.23, p = 0.030) were significantly associated with a reduced risk of poor sleep, whereas older age (OR = 3.87, p = 0.051) and higher pain scores (OR = 3.75, p = 0.080) were associated with an increased risk. These findings suggest that subjective sleep quality in older adults requiring long-term care may be strongly influenced by daily-living physical activity, mental well-being, and pain. Therefore, in addition to psychological support and pain management, interventions that emphasize the promotion of daily-living physical activity may be effective in maintaining good sleep quality.
