{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T17:13:37Z","timestamp":1788110017801,"version":"build-2803163510"},"reference-count":30,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Aging"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>Insomnia is common among older adults receiving palliative care, yet the role of sleep hygiene in insomnia severity remains unclear. We conducted a cross-sectional study of 76 older veterans receiving outpatient palliative care (mean age, 75 years; 85.5% male). Participants completed the Sleep Hygiene Index, Insomnia Severity Index, Epworth Sleepiness Scale, and Geriatric Depression Scale. Nighttime pain was assessed using a 0\u201310 numeric rating scale. Multivariable linear regression examined the association between sleep hygiene and insomnia severity after adjusting for age, depressive symptoms, and nighttime pain. Poorer sleep hygiene was independently associated with greater insomnia severity (B = 0.382, 95% CI, 0.198\u20130.566; p &lt; 0.001). Higher depressive symptoms (B = 1.063, 95% CI, 0.684\u20131.442; p &lt; 0.001) and nighttime pain (B = 0.725, 95% CI, 0.331\u20131.119; p &lt; 0.001) were also independently associated with greater insomnia severity. These findings support the potential value of addressing sleep hygiene alongside depressive symptoms and nighttime pain in palliative care. Prospective and interventional studies are needed to determine whether such approaches improve sleep outcomes.<\/jats:p>","DOI":"10.1177\/30495334261485624","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T14:56:28Z","timestamp":1787928988000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Toward Better Nights: Sleep Hygiene, Depression, Pain, and Insomnia in Geriatric Palliative Veterans"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0731-2536","authenticated-orcid":false,"given":"Maria","family":"Tanielian","sequence":"first","affiliation":[{"name":"South Texas Veteran\u2019s Health Care System"},{"name":"University of Texas Health Science Center San Antonio (UTHSCSA)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjuli","family":"Vasquez","sequence":"additional","affiliation":[{"name":"South Texas Veteran\u2019s Health Care System"},{"name":"University of Texas Health Science Center San Antonio (UTHSCSA)"},{"name":"South Texas Veterans Health Care System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Texas Institute for Graduate Medical Education and Research (TIGMER)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Hochstein","sequence":"additional","affiliation":[{"name":"Texas Institute for Graduate Medical Education and Research (TIGMER)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Morkos","sequence":"additional","affiliation":[{"name":"Texas Institute for Graduate Medical Education and Research (TIGMER)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georges","family":"Assaf","sequence":"additional","affiliation":[{"name":"American University of Beirut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maritza","family":"Garza","sequence":"additional","affiliation":[{"name":"South Texas Veteran\u2019s Health Care System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0341-0641","authenticated-orcid":false,"given":"Michael J.","family":"Mader","sequence":"additional","affiliation":[{"name":"South Texas Veteran\u2019s Health Care System"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"e_1_3_5_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/rep0000027"},{"key":"e_1_3_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.53304.x"},{"key":"e_1_3_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1389-9457(00)00065-4"},{"issue":"6","key":"e_1_3_5_5_1","first-page":"1267","article-title":"Prevalence, risk correlates, and health comorbidities of insomnia in US military veterans: Results from the 2019-2020 National Health and Resilience in Veterans Study","volume":"17","author":"Byrne S. P.","year":"2021","unstructured":"Byrne S. P., McCarthy E., DeViva J. C., Southwick S. M., Pietrzak R. H. (2021). Prevalence, risk correlates, and health comorbidities of insomnia in US military veterans: Results from the 2019-2020 National Health and Resilience in Veterans Study. Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine, 17(6), 1267\u20131277. https:\/\/doi.org\/10.5664\/jcsm.9182","journal-title":"Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine"},{"key":"e_1_3_5_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmx122"},{"key":"e_1_3_5_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/HNP.0000000000000542"},{"issue":"8","key":"e_1_3_5_8_1","first-page":"S214","article-title":"The epidemiology and diagnosis of insomnia","volume":"12","author":"Doghramji K.","year":"2006","unstructured":"Doghramji K. (2006). The epidemiology and diagnosis of insomnia. The American Journal of Managed Care, 12(8 Suppl), S214\u2013S220.","journal-title":"The American Journal of Managed Care"},{"key":"e_1_3_5_9_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/480859"},{"issue":"2","key":"e_1_3_5_10_1","first-page":"S366","article-title":"Incidence and remission of insomnia among elderly adults: An epidemiologic study of 6,800 persons over three years","volume":"22","author":"Foley D. J.","year":"1999","unstructured":"Foley D. J., Monjan A., Simonsick E. M., Wallace R. B., Blazer D. G. (1999). Incidence and remission of insomnia among elderly adults: An epidemiologic study of 6,800 persons over three years. Sleep, 22(Suppl 2), S366\u2013S372.","journal-title":"Sleep"},{"key":"e_1_3_5_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/18.6.425"},{"key":"e_1_3_5_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20043101"},{"key":"e_1_3_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2022.101673"},{"key":"e_1_3_5_14_1","doi-asserted-by":"publisher","DOI":"10.7812\/TPP\/22.114"},{"key":"e_1_3_5_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/15.4.376"},{"key":"e_1_3_5_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2019.104002"},{"key":"e_1_3_5_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-006-9047-6"},{"key":"e_1_3_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2018.09.004"},{"issue":"4","key":"e_1_3_5_19_1","first-page":"484","article-title":"Effect of a Sleep Hygiene Education Program Using Telephone Follow-up Method on the Sleep Quality of the Elderly","volume":"15","author":"Moradi M.","year":"2021","unstructured":"Moradi M., Mohammadzadeh H., Noori R., Basiri Moghadam K., Sadeghmoghadam L. (2021). Effect of a Sleep Hygiene Education Program Using Telephone Follow-up Method on the Sleep Quality of the Elderly. Yektaweb_Journals, 15(4), 484\u2013495. https:\/\/doi.org\/10.32598\/sija.15.4.2895.1","journal-title":"Yektaweb_Journals"},{"key":"e_1_3_5_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/34.5.601"},{"key":"e_1_3_5_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-023-01455-3"},{"key":"e_1_3_5_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049909120907021"},{"key":"e_1_3_5_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.14063"},{"key":"e_1_3_5_24_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.7710"},{"key":"e_1_3_5_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/wvn.12367"},{"key":"e_1_3_5_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glr172"},{"key":"e_1_3_5_27_1","doi-asserted-by":"publisher","DOI":"10.1053\/smrv.2001.0246"},{"issue":"5","key":"e_1_3_5_28_1","first-page":"675","article-title":"Deciphering the temporal link between pain and sleep in a heterogeneous chronic pain patient sample: A multilevel daily process study","volume":"35","author":"Tang N. K. Y.","year":"2012","unstructured":"Tang N. K. Y., Goodchild C. E., Sanborn A. N., Howard J., Salkovskis P. M. (2012). Deciphering the temporal link between pain and sleep in a heterogeneous chronic pain patient sample: A multilevel daily process study. Sleep, 35(5), 675\u2013687A. https:\/\/doi.org\/10.5665\/sleep.1830","journal-title":"Sleep"},{"key":"e_1_3_5_29_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.5158"},{"key":"e_1_3_5_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2015.10.018"},{"key":"e_1_3_5_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(82)90033-4"}],"container-title":["Sage Open Aging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/30495334261485624","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/30495334261485624","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/30495334261485624","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T16:16:50Z","timestamp":1788106610000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/30495334261485624"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":30,"alternative-id":["10.1177\/30495334261485624"],"URL":"https:\/\/doi.org\/10.1177\/30495334261485624","relation":{},"ISSN":["3049-5334","3049-5334"],"issn-type":[{"value":"3049-5334","type":"print"},{"value":"3049-5334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"article-number":"30495334261485624"}}