Date of Award


Document Type

Thesis - Pacific Access Restricted

Degree Name

Master of Science (M.S.)



First Advisor

William A. Kehoe

First Committee Member

Rajul A. Patel

Second Committee Member

Linda L. Norton

Third Committee Member

Timothy J. Smith


As people age they are more likely to develop chronic conditions and will tend to be on multiple medications for long periods of time to manage those conditions. Some of these medications have side effects that are anticholinergic in nature. These side effects can impact different parts of the body including the central nervous system. As people enter their later years the permeability of the blood brain barrier increases, increasing their risk of these kinds of side effects.

Sleep related disorders occur at a higher frequency in the older adults than in younger adults. This is a concern for older adults because poor sleep quality has been linked to chronic health conditions as well as declining function and quality of life. Although some medications are known to cause insomnia there has not been any work done to look at how an accumulative influence of anticholinergic burden may be influencing sleep despite their known influence on the central nervous system.

The purpose of this research is to see if the anticholinergic burden of the medications is related to self-reported sleep quality. Fourteen outreach events targeting Medicare beneficiaries were conducted during the 2014 Medicare open enrollment window in northern/central California. Medication therapy management (MTM) services were provded by trained student pharmacists under the supervision of licensed pharmacists where demographic and medication information were collected.

Beneficiaries who reported having trouble sleeping had higher anticholinergic burden than those who did not. Beneficiaries who only reported difficulty falling asleep had higher anticholinergic burden than those who did not. Correlations between anticholinergic burden and the number of nights with trouble sleeping was positive but this association only reached statistical significance with definite anticholinergic burden. Linear regression did not suggest that anticholinergic burden was a predictor of the number of nights with difficulty sleeping.



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