Comparing Sleep Quality, Duration, and Efficiency Among Low-Income Community-Dwelling Older Adults With and Without Physical Disabilities.

The study is cross-sectional, so it cannot show that disability causes shorter sleep or that short sleep causes disability. Of 121 recruited, 87 completed all required assessments, so the analysed sample was smaller than the recruited sample. The disability group had 24 participants, and the non-disability group had 63 participants. Physical disability was defined only by self-reported use or advised use of a cane or walker, so other disabilities and function levels were not captured. Sleep aid use was self-reported and did not include frequency, dosage, or drug class, and medications for other conditions were not assessed. Preexisting medical or mental health conditions and home living arrangements were not assessed, so they may have influenced sleep. The PSQI covers the previous month, while actigraphy measured 7 days, so the two measures do not directly compare sleep quality. The sample had few men and limited racial and ethnic diversity, and results were not stratified by sex or race/ethnicity. It is not clear whether the sleep duration difference was clinically important.

The study was supported by NIH Grant #R01MD018025, with protocols pre-registered on ClinicalTrials.gov (NCT05778604). The authors disclosed no potential conflicts of interest.

Do not conclude that physical disability causes poor sleep quality or that sleep medicines do not differ in effect. The study was cross-sectional, so it cannot show cause; it found a significant difference only in sleep duration, while sleep quality, efficiency, and sleep aid use were not significantly different, and many health and medication factors were not measured.