Sleep Quality and Its Associated Factors in Older Adults: A Systematic Review of Cross-Sectional Studies

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

doi:10.14710/nmjn.v15i3.72365

DOI: https://doi.org/10.14710/nmjn.v15i3.72365

Sleep Quality and Its Associated Factors 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 = {Sleep Quality and Its Associated Factors in Older Adults: A Systematic Review of Cross-Sectional Studies},
    journal = {Nurse Media Journal of Nursing},
  volume = {15},
    number = {3},
    year = {2025},
    keywords = {Multidimensional factors; older adults; sleep quality; systematic review},
    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 declines in physical, cognitive, and emotional functioning in aging populations. However, existing reviews often focus on single domains, limiting understanding of how multiple factors are jointly associated with sleep quality in older adults.   Purpose:  This systematic review aimed to synthesize cross-sectional evidence on factors associated with sleep quality in older adults.   Methods:  A systematic search was conducted in PubMed, ScienceDirect, and BioMed Central (BMC) using combinations of the following 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 study quality was appraised using the Joanna Briggs Institute (JBI) checklist. Data were synthesized narratively by grouping findings into key domains influencing sleep quality.     Results:  Nineteen cross-sectional studies were included. Sleep quality, most commonly measured using the Pittsburgh Sleep Quality Index (PSQI), varied widely across studies (6%–79% poor sleep). The synthesis identified six domains of factors associated with sleep quality: gender-related differences, physiological factors, psychological factors, medical comorbidities, social-environmental conditions, and lifestyle factors. Frequently reported factors associated with poor sleep included female gender, frailty, depression, anxiety, multimorbidity, and low social support. Considerable heterogeneity was observed in study populations and measurement approaches.   Conclusion:  Evidence from cross-sectional studies indicates multiple interacting factors are associated with sleep quality in older adults; however, causal relationships cannot be established. Longitudinal research is needed to clarify these associations and support the development of integrated care strategies.   },
   issn = {2406-8799},   pages = {406--422}  doi = {10.14710/nmjn.v15i3.72365},
    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 declines in physical, cognitive, and emotional functioning in aging populations. However, existing reviews often focus on single domains, limiting understanding of how multiple factors are jointly associated with sleep quality in older adults.

Purpose: This systematic review aimed to synthesize cross-sectional evidence on factors associated with sleep quality in older adults.

Methods: A systematic search was conducted in PubMed, ScienceDirect, and BioMed Central (BMC) using combinations of the following 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 study quality was appraised using the Joanna Briggs Institute (JBI) checklist. Data were synthesized narratively by grouping findings into key domains influencing sleep quality.

Results: Nineteen cross-sectional studies were included. Sleep quality, most commonly measured using the Pittsburgh Sleep Quality Index (PSQI), varied widely across studies (6%–79% poor sleep). The synthesis identified six domains of factors associated with sleep quality: gender-related differences, physiological factors, psychological factors, medical comorbidities, social-environmental conditions, and lifestyle factors. Frequently reported factors associated with poor sleep included female gender, frailty, depression, anxiety, multimorbidity, and low social support. Considerable heterogeneity was observed in study populations and measurement approaches.

Conclusion: Evidence from cross-sectional studies indicates multiple interacting factors are associated with sleep quality in older adults; however, causal relationships cannot be established. Longitudinal research is needed to clarify these associations and support the development of integrated care strategies.

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Keywords: Multidimensional factors; older adults; sleep quality; systematic review

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

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(This policy statements has been updated at 24th January 2024)

Sleep Quality and Its Associated Factors in Older Adults: A Systematic Review of Cross-Sectional Studies

Journal Author(s) Rights

Copyright Transfer Agreement for Publishing (Publishing Right)

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