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Poor sleep among residents of assisted living facilities is common, and can lead to a worsening quality of life, and subsequent placement in a nursing home, according to the results of a new study.

Researchers at the University of California, Los Angeles, looked at the sleeping habits of 121 seniors in assisted living facilities in the L.A. area. After an initial visit to determine sleep quality, researchers conducted follow-up visits at three and six months. Roughly 65% of participants had “significant sleep disturbance” as measured by the Pittsburgh Sleep Quality Index, according to the report. Common sleep complaints included waking up in the middle of the night or early morning (60.3%) and the inability to fall asleep within 30 minutes (59.5%).

Poor sleep was associated with increased need for assistance with activities of daily living (ADL) and greater instances of depression. At the three- and six-month follow-up visits, these symptoms among the problem sleepers were worse, according to the report. Researchers suggest further studies should be conducted to see if improving quality of sleep could slow functional decline. The report appears in the Journal of the American Geriatrics Society.