Learning Objective #1: Poorer sleep was associated with disease, depression, anxiety , less leisure activities , more insomnia stress response , environmental sounds and ambient noise.

Learning Objective #2: Disease, psychological status, and environmental noise are factors to affect sleep in community dwelling elders.

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Sleep is an important function which reflects an individual¡¯s physical and psychological state. However, the prevalence of sleep problem in elders is high. The purpose of this study was to explore sleep quality in community dwelling elderly. A cross-sectional correlation design was used. Five hundred and two elders (¡Ý 65 years) were recruited from three villages in north Taiwan and 259 elders completed this study. A face-to-face interview was conducted by using the Pittsburgh Sleep Quality Index (PSQI), the Hospital Anxiety and Depression Scale (HADS), the Ford Insomnia Stress Response Test (FIRST), and the Barthal Activity of Daily Living Index. The mean age of elders were 76.0¡À6.4 years. Most of them were male (59.5%), lived with spouse and offspring (68.0%), had at least one kind of chronic disease but in stable condition (92.3%), and can perform ADL independently (88.4%). The leading leisure activities were walking (60.2%) and watching TV (52.5%). Only 28.6% of them had regular exercise. Results showed that the mean sleep efficiency (85.93¡À17.4%) and awaken numbers during sleep (1.5¡À1.2 times) were acceptable, but the sleep latency (64.2¡À84.6 min) was prolonged. Variation of perceived sleep quality among individuals was high. The mean global PSQI score was 7.4¡À4.3, and 58.3% of subjects were identified as poor sleepers (PSQI>5). Poorer sleep was associated with disease (r =0.37, p=0.000) , depression (r =0.44, p=0.000), anxiety (r=0.54, p=0.000), less leisure activities (r =-.25, p=0.000), more insomnia stress response (r=0.42, p=0.000) , environmental sounds (r =0.25, p=0.000) and ambient noise (r =0.25, p=0.000). Disease, psychological status, and environmental noise are factors to affect sleep in community dwelling elders.