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, healthrelated 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. Sleep quality is an important parameter of health-related quality of life in older adults, and it is possibly a correlate of continuing adaptability in later life. 1,2 However, sleep disturbances are common in later life, particularly beyond 75 years, with loss of nocturnal sleep continuity and depth. [1][2][3] Diminution in sleep quality may presage a decline in overall health status. Thus, as Shakespeare's Macbeth observed of "sleep that knits the raveled sleeve of care," (Macbeth, Act II, Scene II), learning how to protect sleep in later life may be important to continued healthy aging.According to Rowe and Kahn, 4 "successful aging" can be characterized by avoidance of disease, maintenance of high cognitive and physical function, and continued engagement with life. Given the evidence that behavioral factors like diet, smoking, and exercise affect one's ability to age successfully, 5 studying the effect of sleep on adaptability and overall well-being observed in healthy aging may also be informative. As the discussion of how to define "healthy aging" continues, 6 this ...
Objectives-To determine in healthy people aged ≥75 years 1) if restricting time in bed and education in health sleep practices are superior to an attention-only control condition (i.e., education in healthy dietary practices) for maintaining or enhancing sleep continuity and depth over 2.5 years; and 2) if maintenance or enhancement of sleep continuity and depth promotes the maintenance or enhancement of health-related quality of life.Methods-Single-blind, randomized, clinical trial in a university-based sleep center, enrolling 64 adults (n = 30 women, 34 men; mean age = 79 years) without sleep/wake complaints (e.g., insomnia or daytime sleepiness), followed by randomized assignment to either: 1) restriction of time in bed by delaying bedtime 30 minutes nightly for 18 months, together with education in healthy sleep practices (SLEEP); or 2) attention-only control condition with education in health dietary practices (NUTRITION).Results-SLEEP did not enhance sleep continuity or depth; however, compared with NUTRITION, SLEEP was associated with decreased time spent asleep (about 30 minutes nightly over 18 months). Contrary to hypothesis, participants in SLEEP reported a decrement in physical health-related quality of life and an increase in medical burden (cardiovascular illness), relative to NUTRITION. Neither markers of inflammation, body mass index, or exercise explained treatment-related changes in medical burden.Conclusions-Although we cannot exclude a positive effect of education in healthy nutrition, for healthy elderly >75 years of age without sleep complaints, reducing sleep time may be detrimental, whereas allowing more time to sleep (about 7.5 hours nightly) is associated with better maintenance of physical health-related quality of life and stability of medical illness burden over 30 months.
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