الفهرس 
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Abstract
Elderly are frequently complaining of sleep disturbances as they take longer time to fall asleep and may awaken more frequently at night. They are generally considered a light sleep persons (Morgan, 1992; Haponik, 1994; Kane et al., 1994). But they can improve their quality of sleep by performing sleep hygiene measures, so we should give an attention to these measures to manage sleep complaints and decrease its effect on their life. Sleep disturbance, a common complaint among older people, may impact their quality of life negatively by causing fatigue, difficulty in concentrating, poor muscle coordination and reducing physical activity and by the potential adverse effects of psychoactive medications taken to alleviate the sleep problems. In general, insomnia can also leave the sufferer feeling tired and unable to perform daily activities. An inability to perform daily functions can adversely affect family life, relationships, jobs, or anything else that involves human interaction (Maggi et al., 1998; Keane, 1997).The purpose of this study was to determine the effects of sleep disturbances on QOL of elderly people. This study was carried out at Menouf city and El-hamol village at Menoufyia governorate. The data collection phase was through the year 2001-2002 The tool which was utilized for data collection includes the following: - 1-constructed questionnaire, which includes:-A-Sociodemographic data.Clinical data including complaints, past and present medical histories.Sleep assessment
questionnaire:-It has questions about time of going to sleep, habits done before sleep as taking shower, reading and watching television, does he/she eats immediately before bedtime, type of food preferred, number of meals eaten along the day and number of bellows used.2- Sickness impact profile scale (SIP):QOL was operationalized by measure indicating sickness aspect of quality of life. SIP is a generic behavioral based multidimensional instrument (Hulebos et al., 1991). It consists of 136 items grouped into 12 categories. Each category represents a different aspect of daily functioning. Each item describes changes in behavior that are attributable to health status Bruin et al., 1992).The SIP could be scored according to the number and type of items endorsed. Scoring can be done at the level of categories and dimensions as well as at the total SIP levels (Visser et al., 1994). bResults:- As regard health related characteristics of elderly studied group, there was a statistically significant difference between males and females in relation to BMI, smoking and tea drinking (0.05), and no significant difference in relation to disability, coffee, use of medications, presence of chronic health problems and use of sleep medicationsThe results reveals that of the total sample were complaining of sleep disturbances and more than half who suffering from sleep disturbances were aged less than 65 years., and of them were women, widowed , illiterate, not working and had moderate income As regard causes of sleep disturbances, the result shows statistically significant relation between sleep disturbances and physical activities, and tea drinking (p0.05). Also pain was the most common cause , followed by the need to go to toilet, noise and lastly mosquito, light and weather respectively.The finding shows that, there is a statistically significant difference between males and females in relation to trouble falling a sleep, awaken too early, and parasomnia. As regard QOL, the result reveals that, only of elderly have good QOL, were females, married, have moderate income and rural residents . On the other hand of elderly have poor QOL. Also there was a statistically significant difference between QOL levels of elderly and their ages, income, physical activities and use of sleep medications .Lastly the result shows that, more than tow thirds of studied group who suffered from sleep disturbances had poor QOL with a statistically significant relation between sleep complaints and ambulation, mobility, body care and movement, social interaction, emotional behavior, alertness behavior, recreation and pastimes and total scores of QOL dimensions .Conclusionfrom the results of this study we concluded thatsleep is a major health issue, and disturbed sleep or inadequate sleep is one of the most common complaints encountered by elderly. About two thirds of the total sample was complaining of sleep disturbances and more than half of them were aged less than sixty six years. Also most of the studied sample who suffer from sleep disturbances were women, widowed, illiterate, not working and had moderate income.The causes of sleep complaints of the studied group were tea drinking, pain, low physical activities, and feeling of loneliness of widowed elderly persons.As regard QOL, the result reveals that, elderly who have good QOL were aged more than seventy years, were females, married, have moderate income and rural residents. On the other hand, elderly who have poor QOL were not working.Studied group who were suffered from sleep disturbances had poor QOL with a statistically significant relation between sleep complaints and ambulation, mobility, body care and movement, social interaction, emotional behavior, alertness behavior, recreation and pastimes, and total scores of QOL dimensions.RecommendationsBased up on the findings of this study the following recommendations are made1- Health education by community health nurse toa- Educate families about elderly needs, and causes of sleep <b disturbances. Elderly should be advised to - Still active as possible and participate in social activities. - Limit intake of tea especially at night - Avoid over intake of fluids afternoon - Go to toilet before bed time -Understand the importance of recreation for elderly health. c- Advice doctors about limiting of medications prescribed to elderly persons as possible- Improving tools to differentiate between each type of sleep disorders and its possible effect on each dimension of QOL3- Further studies on a large scale using a larger sample size of elderly persons from different geographical areas.