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Sleeping Well, Aging Well: A Descriptive and Cross-Sectional Study of Sleep in "Successful Agers" 75 and Older

From the Sleep and Chronobiology Program, Department of Psychiatry, University of Pittsburgh School of Medicine (HCD, LS, SP, JM, SB, PRH, EAN, BB, RDN, MDM, CFR), the University of Pittsburgh School of Public Health (SM, CFR), the Advanced Center for Interventions and Services Research in Late-Life Mood Disorders (HCD, LS, SP, SB, PRH, MDM, CFR), and the John A. Hartford Center of Excellence in Geriatric Psychiatry (CFR), Pittsburgh, Pennsylvania.

Objectives: To examine diary-based, laboratory-based, and actigraphic measures of sleep in a group of healthy older women and men (75 years of age) without sleep/wake complaints and to describe sleep characteristics which may be correlates of health-related quality of life in old age.

Design: Cross-sectional, descriptive study.

Setting: University-based sleep and chronobiology program.

Intervention: None.

Participants: Sixty-four older adults (30 women, 34 men; mean age 79).

Measurements: We used diary-, actigraphic-, and laboratory-based measures of sleep, health-related quality of life, mental health, social support, and coping strategies. We used two-group t-tests to compare baseline demographic and clinical measures between men and women, followed by ANOVA on selected EEG measures to examine first-night effects as evidence of physiological adaptability. Finally, we examined correlations between measure of sleep and health-related quality of life.

Results: We observed that healthy men and women aged 75 and older can experience satisfactory nocturnal sleep quality and daytime alertness, especially as reflected in self-report and diary-based measures. Polysomnography (psg) suggested the presence of a first-night effect, especially in men, consistent with continued normal adaptability in this cohort of healthy older adults. Continuity and depth of sleep in older women were superior to that of men. Diary-based measures of sleep quality (but not psg measures) correlated positively (small to moderate effect sizes) with physical and mental health-related quality of life.

Conclusions: Sleep quality and daytime alertness in late life may be more important aspects of successful aging than previously appreciated. Good sleep may be a marker of good functioning across a variety of domains in old age. Our observations suggest the need to study interventions which protect sleep quality in older adults to determine if doing so fosters continued successful aging.

Key Words: sleep • successful aging • aging • health-related quality of life