How Social and Medical Factors Influence Sleep Quality in Older Adults: A Systematic Review of Cross-Sectional Studies

Indah Permata Sari; Tita Hariyanti; Retno Lestari; Respati Suryanto Dradjat

doi:10.14710/nmjn.v14i3.72365

DOI: https://doi.org/10.14710/nmjn.v14i3.72365

How Social and Medical Factors Influence Sleep Quality in Older Adults: A Systematic Review of Cross-Sectional Studies

*Indah Permata Sari

- Doctoral Program in Medical Science, Faculty of Medicine, Universitas Brawijaya , Indonesia

Tita Hariyanti - Department of Public Health, Faculty of Medicine, Universitas Brawijaya, Indonesia

Retno Lestari - Department of Nursing, Faculty of Health Sciences, Universitas Brawijaya, Indonesia

Respati Suryanto Dradjat - Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Brawijaya-Saiful Anwar General Hospital, Indonesia

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

BibTex Citation Data :

@article{NMJN72365,
    author = {Indah Sari and Tita Hariyanti and Retno Lestari and Respati Dradjat},
    title = {How Social and Medical Factors Influence Sleep Quality in Older Adults: A Systematic Review of Cross-Sectional Studies},
    journal = {Nurse Media Journal of Nursing},
  volume = {15},
    number = {3},
    year = {2025},
    keywords = {Older adults; sleep quality; systematic review; social factor.},
    abstract = {  Background:  Sleep quality is essential for overall health and well-being, particularly in older adults who are at increased risk of sleep disturbances such as insomnia and sleep apnea. Poor sleep is associated with physical, cognitive, and emotional decline in aging populations; however, existing reviews often examine medical, social, or environmental determinants in isolation, leaving limited understanding of how these factors jointly influence sleep quality in older adults.   Purpose:  This systematic review aims to synthesize cross-sectional evidence on the physiological, psychological, medical, social, and environmental factors influencing sleep quality in older adults.   Methods:  A computer-based search was conducted in PubMed, ScienceDirect, and BioMed Central (BMC) using the terms (“sleep quality” OR “sleep disturbances”) AND (“older adults” OR “elderly”) AND (“factors” OR “determinants”) AND (“cross-sectional”). Articles published between January 2020 and April 2025 were included. The review followed PRISMA 2020 guidelines and used the Joanna Briggs Institute (JBI) checklist to appraise study quality.   Results:  Twenty cross-sectional studies were included. Sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI), varied widely (6%–79%). Thematic synthesis identified five key domains: physiological decline (n = 5), psychological factors (n = 6), medical comorbidities (n = 5), social-environmental conditions (n = 3), and lifestyle factors (n = 1). Common factors associated with poor sleep included female gender, frailty, depression, anxiety, multimorbidity, and low social support. Considerable heterogeneity was noted in study populations and assessment tools.   Conclusion:  Associations observed in cross-sectional studies indicate that several interacting factors are related to sleep quality in older adults; however, causality cannot be inferred. Longitudinal research is needed to clarify these relationships and inform integrated care approaches. },
   issn = {2406-8799},  doi = {10.14710/nmjn.v14i3.72365},
    url = {https://ejournal.undip.ac.id/index.php/medianers/article/view/72365}
}

Citation Format:

Abstract

Background: Sleep quality is essential for overall health and well-being, particularly in older adults who are at increased risk of sleep disturbances such as insomnia and sleep apnea. Poor sleep is associated with physical, cognitive, and emotional decline in aging populations; however, existing reviews often examine medical, social, or environmental determinants in isolation, leaving limited understanding of how these factors jointly influence sleep quality in older adults.

Purpose: This systematic review aims to synthesize cross-sectional evidence on the physiological, psychological, medical, social, and environmental factors influencing sleep quality in older adults.

Methods: A computer-based search was conducted in PubMed, ScienceDirect, and BioMed Central (BMC) using the terms (“sleep quality” OR “sleep disturbances”) AND (“older adults” OR “elderly”) AND (“factors” OR “determinants”) AND (“cross-sectional”). Articles published between January 2020 and April 2025 were included. The review followed PRISMA 2020 guidelines and used the Joanna Briggs Institute (JBI) checklist to appraise study quality.

Results: Twenty cross-sectional studies were included. Sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI), varied widely (6%–79%). Thematic synthesis identified five key domains: physiological decline (n = 5), psychological factors (n = 6), medical comorbidities (n = 5), social-environmental conditions (n = 3), and lifestyle factors (n = 1). Common factors associated with poor sleep included female gender, frailty, depression, anxiety, multimorbidity, and low social support. Considerable heterogeneity was noted in study populations and assessment tools.

Conclusion: Associations observed in cross-sectional studies indicate that several interacting factors are related to sleep quality in older adults; however, causality cannot be inferred. Longitudinal research is needed to clarify these relationships and inform integrated care approaches.

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Keywords: Older adults; sleep quality; systematic review; social factor.

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In Vol 15, No 3 (2025): (December 2025) (In Progress)

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Alfian, S. D., Thurfah, J. N., Griselda, M., & Puspitasari, I. M. (2024). Sleep Disturbances and Depression Levels among General Indonesian Population: A National Survey. Clinical Practice & Epidemiology in Mental Health, 20(1), BMS-CPEMH-2024-18. https://doi.org/10.2174/0117450179326359240903045716
Alsulami, G., Rice, A. M., & Kidd, L. (2019). Prospective repeated assessment of self-reported sleep quality and sleep disruptive factors in the intensive care unit: Acceptability of daily assessment of sleep quality. BMJ Open, 9(6), e029957. https://doi.org/10.1136/bmjopen-2019-029957
August, K. J. (2022). Marital Status, Marital Transitions, and Sleep Quality in Mid to Late Life. Research on Aging, 44(3–4), 301–311. https://doi.org/10.1177/01640275211027281
Bella, B., Pangaribuan, S. M., & Widiastuti, S. H. (2023). Stress and Sleep Quality among the Elderly During The COVID-19 Pandemic: A cross-sectional study. Jurnal Berita Ilmu Keperawatan, 16(1), 11–21. https://doi.org/10.23917/bik.v16i1.1260
Borentain, S., Williamson, D., Turkoz, I., Popova, V., McCall, W. V., Mathews, M., & Wiegand, F. (2021). Effect of Sleep Disturbance on Efficacy of Esketamine in Treatment-Resistant Depression: Findings from Randomized Controlled Trials. Neuropsychiatric Disease and Treatment, Volume 17, 3459–3470. https://doi.org/10.2147/NDT.S339090
Budiman, M. E. A., Nuris Yuhbaba, Z., Wirasakti, G., & Rosalini, W. (2021). The Effect of Brainstorming on Loneliness Level among Elderly. Nursing and Health Sciences Journal (NHSJ), 1(3), 209–213. https://doi.org/10.53713/nhs.v1i3.75
Carpenter, J. S., Zmicerevska, N., Crouse, J. J., Nichles, A., Garland, A., Song, Y. J. C., Wilson, C., Rohleder, C., McHugh, C., Leweke, F. M., Koethe, D., Scott, E. M., & Hickie, I. B. (2022). Effects of adjunctive brexpiprazole on sleep-wake and circadian parameters in youth with depressive disorders: Study protocol for a clinical trial. BMJ Open, 12(9), e056298. https://doi.org/10.1136/bmjopen-2021-056298
Chen, J., Chen, X., Mao, R., Fu, Y., Chen, Q., Zhang, C., & Zheng, K. (2023). Hypertension, sleep quality, depression, and cognitive function in elderly: A cross-sectional study. Frontiers in Aging Neuroscience, 15, 1051298. https://doi.org/10.3389/fnagi.2023.1051298
Chin, E. C., Yu, A. P., Leung, C. K., Bernal, J. D., Au, W. W., Fong, D. Y., Cheng, C. P., & Siu, P. M. (2022). Effects of Exercise Frequency and Intensity on Reducing Depressive Symptoms in Older Adults With Insomnia: A Pilot Randomized Controlled Trial. Frontiers in Physiology, 13, 863457. https://doi.org/10.3389/fphys.2022.863457
Delaney, L. J., Currie, M. J., Huang, H.-C. C., Lopez, V., & Van Haren, F. (2018). “They can rest at home”: An observational study of patients’ quality of sleep in an Australian hospital. BMC Health Services Research, 18(1), 524. https://doi.org/10.1186/s12913-018-3201-z
Delbari, A., Ahmadi, F., Zar, A., Zandvakili, A., Sadeghipour, H. R., & Sims, J. (2024). Living in urban or rural environments affect the sleep quality of the elderly in Bushehr (Southern Iran): Emphasizing the active and inactive of the elderly. BMC Public Health, 24(1), 1340. https://doi.org/10.1186/s12889-024-18747-9
Di Nicola, M., Pepe, M., Panaccione, I., Moccia, L., Janiri, L., & Sani, G. (2023). Update on Pharmacological Treatment for Comorbid Major Depressiveand Alcohol Use Disorders: The Role of Extended-release Trazodone. Current Neuropharmacology, 21(11), 2195–2205. https://doi.org/10.2174/1570159X21666230403080624
Diniari, N. K. S. (2022). Mental disorders elderly in rural areas during COVID-19 pandemic in Bali Indonesia: A cross sectional study. Linguistics and Culture Review, 6, 139–147. https://doi.org/10.21744/lingcure.v6nS4.2105
George, P., DeCastro Molina, J., & Heng, B. (2014). The methodological quality of systematic reviews comparing intravitreal bevacizumab and alternates for neovascular age related macular degeneration: A systematic review of reviews. Indian Journal of Ophthalmology, 62(7), 761. https://doi.org/10.4103/0301-4738.138615
Gothe, N. P., Ehlers, D. K., Salerno, E. A., Fanning, J., Kramer, A. F., & McAuley, E. (2020). Physical Activity, Sleep and Quality of Life in Older Adults: Influence of Physical, Mental and Social Well-being. Behavioral Sleep Medicine, 18(6), 797–808. https://doi.org/10.1080/15402002.2019.1690493
Grey, I., Arora, T., Thomas, J., Saneh, A., Tohme, P., & Abi-Habib, R. (2020). The role of perceived social support on depression and sleep during the COVID-19 pandemic. Psychiatry Research, 293, 113452. https://doi.org/10.1016/j.psychres.2020.113452
Griffin, S. C., Williams, A. B., Mladen, S. N., Perrin, P. B., Dzierzewski, J. M., & Rybarczyk, B. D. (2020). Reciprocal Effects Between Loneliness and Sleep Disturbance in Older Americans. Journal of Aging and Health, 32(9), 1156–1164. https://doi.org/10.1177/0898264319894486
Hama, Y., Yamada, S., Nishimura, R., Yoshida, M., Tsuga, K., Morita, E., Tamada, Y., Kato, Y., Kubo, Y., Okada, R., Nagayoshi, M., Tamura, T., Hishida, A., Wakai, K., & Naito, M. (2024). Association between dysphagia risk and sleep quality in community-dwelling older adults: A cross-sectional study. Heliyon, 10(11), e32028. https://doi.org/10.1016/j.heliyon.2024.e32028
Hu, W., Chu, J., Chen, X., Liu, S., Sun, N., Han, Q., Li, T., Feng, Z., He, Q., & Shen, Y. (2022). The role of depression and physical activity in the association of between sleep quality, and duration with and health-related quality of life among the elderly: A UK Biobank cross-sectional study. BMC Geriatrics, 22(1), 338. https://doi.org/10.1186/s12877-022-03047-x
Hwang, H., Kim, K. M., Yun, C.-H., Yang, K. I., Chu, M. K., & Kim, W.-J. (2022). Sleep state of the elderly population in Korea: Nationwide cross-sectional population-based study. Frontiers in Neurology, 13, 1095404. https://doi.org/10.3389/fneur.2022.1095404
Idalino, S. C. C., Canever, J. B., Cândido, L. M., Wagner, K. J. P., De Souza Moreira, B., Danielewicz, A. L., & De Avelar, N. C. P. (2023). Association between sleep problems and multimorbidity patterns in older adults. BMC Public Health, 23(1), 978. https://doi.org/10.1186/s12889-023-15965-5
Jia, G., & Yuan, P. (2020). The association between sleep quality and loneliness in rural older individuals: A cross-sectional study in Shandong Province, China. BMC Geriatrics, 20(1), 180. https://doi.org/10.1186/s12877-020-01554-3
Kafková, M. P. (2023). Sources of Loneliness for Older Adults in the Czech Republic and Strategies for Coping With Loneliness. Social Inclusion, 11(1). https://doi.org/10.17645/si.v11i1.6185
Kamali Zarch, M., & Sorbi, M. H. (2020). Structural Relationships Between Depression, Perceived Stress, Sleep Quality, and Quality of Life: Evidence from Iranian Elderly. Thrita, 8(2). https://doi.org/10.5812/thrita.101115
Karim, M., Husein, A., Qamruddin, I., Liszen, T., & Alam, M. K. (2023). To evaluate the effects of Low-level laser therapy (LLLT) on wound healing of extraction socket: A systematic review. Bangladesh Journal of Medical Science, 22(3), 585–597. https://doi.org/10.3329/bjms.v22i3.65328
Kilic, D., Aslan, G., Ata, G., & Bakan, A. B. S. (2023). Relationship between the fear of COVID‐19 and social isolation and depression in elderly individuals. Psychogeriatrics, 23(2), 222–229. https://doi.org/10.1111/psyg.12924
Kohanmoo, A., Kazemi, A., Zare, M., & Akhlaghi, M. (2024). Gender-specific link between sleep quality and body composition components: A cross-sectional study on the elderly. Scientific Reports, 14(1), 8113. https://doi.org/10.1038/s41598-024-58801-5
Kwaśny, A., Włodarczyk, A., Ogonowski, D., & Cubała, W. J. (2023). Effect of Ketamine on Sleep in Treatment-Resistant Depression: A Systematic Review. Pharmaceuticals, 16(4), 568. https://doi.org/10.3390/ph16040568
Lan, L., Xia, L., Tang, J., Zhang, X., Lin, Y., & Wang, Z. (2019). Elevated airflow can maintain sleep quality and thermal comfort of the elderly in a hot environment. Indoor Air, 29(6), 1040–1049. https://doi.org/10.1111/ina.12599
Lin, J., Yao, H., Li, J., Tian, S., Li, X., & Hou, Q. (2023). Associations of sleep quality and exercise frequency and the risk of coronary heart disease in Chinese urban elderly: A secondary analysis of cross-sectional data. BMC Public Health, 23(1), 2199. https://doi.org/10.1186/s12889-023-17077-6
Lorber, M., Kmetec, S., Davey, A., Mlinar Reljić, N., Fekonja, Z., & Kegl, B. (2023). Associations between Sleep Quality, Frailty, and Quality of Life among Older Adults in Community and Nursing Home Settings. International Journal of Environmental Research and Public Health, 20(6), 4937. https://doi.org/10.3390/ijerph20064937
Mahyuvi, T., Perbawani, D. R., & Suwardianto, H. (2021). The Effect Of Breathing Relaxation And Lavender Aromatherapy On Insomnia In The Elderly. Interest : Jurnal Ilmu Kesehatan, 39–46. https://doi.org/10.37341/interest.v0i0.292
Matsuda, H., Mayers, T., Maki, N., Araki, A., & Eto, S. (2023). Frailty and Diminished Human Relationships Are Associated with Poor Sleep Quality in Japanese Older Adults: A Cross-Sectional Study. Geriatrics, 8(5), 91. https://doi.org/10.3390/geriatrics8050091
Munn, Z., Barker, T. H., Moola, S., Tufanaru, C., Stern, C., McArthur, A., Stephenson, M., & Aromataris, E. (2019). Methodological quality of case series studies: An introduction to the JBI critical appraisal tool. JBI Database of Systematic Reviews and Implementation Reports, Publish Ahead of Print. https://doi.org/10.11124/JBISRIR-D-19-00099
Najjar, R. P., Prayag, A. S., & Gronfier, C. (2023). Melatonin suppression by light involves different retinal photoreceptors in young and older adults. Neuroscience. https://doi.org/10.1101/2023.06.02.543372
Noguchi, T., Nojima, I., Inoue-Hirakawa, T., & Sugiura, H. (2021). Association between Social Frailty and Sleep Quality among Community-dwelling Older Adults: A Cross-sectional Study. Physical Therapy Research, 24(2), 153–162. https://doi.org/10.1298/ptr.E10085
Nous, A., Engelborghs, S., & Smolders, I. (2021). Melatonin levels in the Alzheimer’s disease continuum: A systematic review. Alzheimer’s Research & Therapy, 13(1), 52. https://doi.org/10.1186/s13195-021-00788-6
Nuermaimaiti, Q., Heizhati, M., Luo, Q., Li, N., Gan, L., Yao, L., Yang, W., Li, M., Li, X., Aierken, X., Hong, J., Wang, H., Liu, M., Maitituersun, A., Nusufujiang, A., & Cai, L. (2024). The Cross-Sectional Association Between Multimorbidity and Sleep Quality and Duration Among the Elderly Community Dwellers in Northwest China. Nature and Science of Sleep, 16, 2217–2230. https://doi.org/10.2147/NSS.S497036
Okuda, M., Noda, A., Iwamoto, K., Nakashima, H., Takeda, K., Miyata, S., Yasuma, F., Ozaki, N., & Shimouchi, A. (2021). Effects of long sleep time and irregular sleep–wake rhythm on cognitive function in older people. Scientific Reports, 11(1), 7039. https://doi.org/10.1038/s41598-021-85817-y
Pacheco, S. R., Miranda, A. M., Coelho, R., Monteiro, A. C., Bragança, G., & Loureiro, H. C. (2017). Overweight in youth and sleep quality: Is there a link? Archives of Endocrinology and Metabolism, 61(4), 367–373. https://doi.org/10.1590/2359-3997000000265
Papadopoulou, S. K., Mantzorou, M., Voulgaridou, G., Pavlidou, E., Vadikolias, K., Antasouras, G., Vorvolakos, T., Psara, E., Vasios, G. K., Serdari, A., Poulios, E., & Giaginis, C. (2023). Nutritional Status Is Associated with Health-Related Quality of Life, Physical Activity, and Sleep Quality: A Cross-Sectional Study in an Elderly Greek Population. Nutrients, 15(2), 443. https://doi.org/10.3390/nu15020443
Popay, J., Roberts, H., Sowden, A., Petticrew, M., Arai, L., Rodgers, M., Britten, N., Roen, K., & Duffy, S. (2006). Guidance on the conduct of narrative synthesis in systematic reviews: A product from the ESRC Methods Programme. Lancaster University. https://doi.org/10.13140/2.1.1018.4643
Prayag, A. S., Najjar, R. P., & Gronfier, C. (2019). Melatonin suppression is exquisitely sensitive to light and primarily driven by melanopsin in humans. Journal of Pineal Research, 66(4), e12562. https://doi.org/10.1111/jpi.12562
Reiter, R. J., Sharma, R., Romero, A., Manucha, W., Tan, D.-X., Zuccari, D. A. P. D. C., & Chuffa, L. G. D. A. (2023). Aging-Related Ovarian Failure and Infertility: Melatonin to the Rescue. Antioxidants, 12(3), 695. https://doi.org/10.3390/antiox12030695
Salis, F., Belfiori, M., Figorilli, M., Mulas, M., Puligheddu, M., & Mandas, A. (2024). Sex Differences in Elderly People’s Sleep: A Cross-Sectional Study. Medicina, 60(10), 1654. https://doi.org/10.3390/medicina60101654
Santos-Orlandi, A. A. D., Ottaviani, A. C., Alves, E. D. S., Brito, T. R. P. D., & Inouye, K. (2024). Sleep quality of vulnerable elderly people: Associated factors. Revista Brasileira de Enfermagem, 77(suppl 3), e20230283. https://doi.org/10.1590/0034-7167-2023-0283
Seo, S., & Mattos, M. K. (2024). The relationship between social support and sleep quality in older adults: A review of the evidence. Archives of Gerontology and Geriatrics, 117, 105179. https://doi.org/10.1016/j.archger.2023.105179
Seol, J., Fujii, Y., Inoue, T., Kitano, N., Tsunoda, K., & Okura, T. (2021). Effects of Morning Versus Evening Home-Based Exercise on Subjective and Objective Sleep Parameters in Older Adults: A Randomized Controlled Trial. Journal of Geriatric Psychiatry and Neurology, 34(3), 232–242. https://doi.org/10.1177/0891988720924709
Serra, L. S. M., Araújo, J. G. de, Vieira, A. L. S., Silva, E. M. da, Andrade, R. R. de, Kückelhaus, S. A. S., & Sampaio, A. L. L. (2020). Role of melatonin in prevention of age-related hearing loss. PloS One, 15(2), e0228943. https://doi.org/10.1371/journal.pone.0228943
Setia, M. (2016). Methodology series module 3: Cross-sectional studies. Indian Journal of Dermatology, 61(3), 261. https://doi.org/10.4103/0019-5154.182410
Sharifi, A., Department of Psychology, Faculty of Humanities, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran., Naderi, F., Department of Psychology, Faculty of Humanities, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran., Askari, P., & Department of Psychology, Faculty of Humanities, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran. (2022). Testing and Comparing the Causal Relationship Between Spiritual and Social Capital and Depression With the Mediating Role of Death Anxiety in the Elderly With and Without Spouse. Salmand, 17(1), 108–123. https://doi.org/10.32598/sija.2021.3174.1
Shen, Z., Chen, H., Cai, Y., Zhou, B., Chen, H., & Xie, N. (2021). Study on the Correlation among Sleep Quality, Cognitive Function, and Self-Management Ability in Hospitalized Elderly Patients with Coronary Heart Disease. Journal of Nanomaterials, 2021, 1–7. https://doi.org/10.1155/2021/4580949
Shih, A.-C., Chen, L.-H., Tsai, C.-C., & Chen, J.-Y. (2020). Correlation between Sleep Quality and Frailty Status among Middle-Aged and Older Taiwanese People: A Community-Based, Cross-Sectional Study. International Journal of Environmental Research and Public Health, 17(24), 9457. https://doi.org/10.3390/ijerph17249457
Sindi, S., Pérez, L. M., Vetrano, D. L., Triolo, F., Kåreholt, I., Sjöberg, L., Darin-Mattsson, A., Kivipelto, M., Inzitari, M., & Calderón-Larrañaga, A. (2020). Sleep disturbances and the speed of multimorbidity development in old age: Results from a longitudinal population-based study. BMC Medicine, 18(1), 382. https://doi.org/10.1186/s12916-020-01846-w
Solis-Navarro, L., Masot, O., Torres-Castro, R., Otto-Yáñez, M., Fernández-Jané, C., Solà-Madurell, M., Coda, A., Cyrus-Barker, E., Sitjà-Rabert, M., & Pérez, L. M. (2023). Effects on Sleep Quality of Physical Exercise Programs in Older Adults: A Systematic Review and Meta-Analysis. Clocks & Sleep, 5(2), 152–166. https://doi.org/10.3390/clockssleep5020014
Sterne, J. A., Hernán, M. A., Reeves, B. C., Savović, J., Berkman, N. D., Viswanathan, M., Henry, D., Altman, D. G., Ansari, M. T., Boutron, I., Carpenter, J. R., Chan, A.-W., Churchill, R., Deeks, J. J., Hróbjartsson, A., Kirkham, J., Jüni, P., Loke, Y. K., Pigott, T. D., … Higgins, J. P. (2016). ROBINS-I: A tool for assessing risk of bias in non-randomised studies of interventions. BMJ, i4919. https://doi.org/10.1136/bmj.i4919
Sun, J., Yang, M., Liu, S., Zhang, X., Xu, W., Peng, J., Song, Y., Wang, L., & Fang, G. (2025). Impact of living environment on sleep quality in older adults and the mediating role of depression: A cross-sectional study. Sleep and Biological Rhythms. https://doi.org/10.1007/s41105-024-00564-7
Sya’diyah, H., Nursalam, N., Mahmudah, M., & Wicaksono, W. P. (2020). Relationship between Caring Nurses and Elderly Loneliness. Journal of Public Health Research, 9(2), jphr.2020.1829. https://doi.org/10.4081/jphr.2020.1829
Tan, D.-X., & Hardeland, R. (2021). The Reserve/Maximum Capacity of Melatonin’s Synthetic Function for the Potential Dimorphism of Melatonin Production and Its Biological Significance in Mammals. Molecules, 26(23), 7302. https://doi.org/10.3390/molecules26237302
Thichumpa, W., Howteerakul, N., Suwannapong, N., & Tantrakul, V. (2018). Sleep quality and associated factors among the elderly living in rural Chiang Rai, northern Thailand. Epidemiology and Health, 40, e2018018. https://doi.org/10.4178/epih.e2018018
Tseng, T.-H., Chen, H.-C., Wang, L.-Y., & Chien, M.-Y. (2020). Effects of exercise training on sleep quality and heart rate variability in middle-aged and older adults with poor sleep quality: A randomized controlled trial. Journal of Clinical Sleep Medicine, 16(9), 1483–1492. https://doi.org/10.5664/jcsm.8560
Vanderlinden, J., Boen, F., & Van Uffelen, J. G. Z. (2020). Effects of physical activity programs on sleep outcomes in older adults: A systematic review. International Journal of Behavioral Nutrition and Physical Activity, 17(1), 11. https://doi.org/10.1186/s12966-020-0913-3
Vizeshfar, F., & Ghelbash, Z. (2021). Effect of a self‐care training program using smartphones on general health, nutrition status, and sleep quality in the elderly. Psychogeriatrics, 21(6), 910–919. https://doi.org/10.1111/psyg.12766
Wang, X., & Cheng, Z. (2020). Cross-Sectional Studies. Chest, 158(1), S65–S71. https://doi.org/10.1016/j.chest.2020.03.012
Watanabe, M., Shobugawa, Y., Tashiro, A., Ota, A., Suzuki, T., Tsubokawa, T., Kondo, K., & Saito, R. (2020). Association between Neighborhood Environment and Quality of Sleep in Older Adult Residents Living in Japan: The JAGES 2010 Cross-Sectional Study. International Journal of Environmental Research and Public Health, 17(4), 1398. https://doi.org/10.3390/ijerph17041398
Wen, B., Li, Y., Zhang, M., & Xu, H. (2024). Association of dysphagia and loneliness and their interaction with sleep quality among older adults in nursing homes: A cross-sectional study. PloS One, 19(9), e0311024. https://doi.org/10.1371/journal.pone.0311024
Xie, Y., Liu, S., Chen, X.-J., Yu, H.-H., Yang, Y., & Wang, W. (2021). Effects of Exercise on Sleep Quality and Insomnia in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Frontiers in Psychiatry, 12, 664499. https://doi.org/10.3389/fpsyt.2021.664499
Xie, Z., Chen, F., Li, W. A., Geng, X., Li, C., Meng, X., Feng, Y., Liu, W., & Yu, F. (2017). A review of sleep disorders and melatonin. Neurological Research, 39(6), 559–565. https://doi.org/10.1080/01616412.2017.1315864
Xu, W., Fang, J., Chen, L., Wang, D., Huang, C., Huang, T., & Guo, C. (2023). Unraveling the Nexus: Exploring the Relationship between Exercise Habits and Sleep Quality in Older Adults. Healthcare, 11(20), 2759. https://doi.org/10.3390/healthcare11202759
Xu, X., Zhou, X., Liu, W., Ma, Q., Deng, X., & Fang, R. (2022). Evaluation of the correlation between frailty and sleep quality among elderly patients with osteoporosis: A cross-sectional study. BMC Geriatrics, 22(1), 599. https://doi.org/10.1186/s12877-022-03285-z
Yang, E., Ismail, A., Kim, Y., Erdogmus, E., Boron, J., Goldstein, F., DuBose, J., & Zimring, C. (2022). Multidimensional Environmental Factors and Sleep Health for Aging Adults: A Focused Narrative Review. International Journal of Environmental Research and Public Health, 19(23), 15481. https://doi.org/10.3390/ijerph192315481
Yue, Z., Zhang, Y., Cheng, X., & Zhang, J. (2022). Sleep Quality among the Elderly in 21st Century Shandong Province, China: A Ten-Year Comparative Study. International Journal of Environmental Research and Public Health, 19(21), 14296. https://doi.org/10.3390/ijerph192114296
Zhang, Y., Yu, G., Bai, W., Wu, S., Geng, X., Zhang, W., Liu, Y., Meng, Y., Gao, J., Li, W., & Kou, C. (2024). Association of depression and sleep quality with frailty: A cross-sectional study in China. Frontiers in Public Health, 12, 1361745. https://doi.org/10.3389/fpubh.2024.1361745

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How Social and Medical Factors Influence Sleep Quality in Older Adults: A Systematic Review of Cross-Sectional Studies

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