Sleep and Circadian Rhythms in Spousally Bereaved Seniors

Abstract

A laboratory study of sleep and circadian rhythms was undertaken in 28 spousally bereaved seniors (≥60 yrs) at least four months after the loss event. Measures taken included two nights of polysomnography (second night used), ∼36 h of continuous core body temperature monitoring, and four assessments of mood and alertness throughout a day. Preceding the laboratory study, two-week diaries were completed, allowing the assessment of lifestyle regularity using the 17-item Social Rhythm Metric (SRM) and the timing of sleep using the Pittsburgh Sleep Diary (PghSD). Also completed were questionnaires assessing level of grief (Texas Revised Inventory of Grief [TRIG] and Index of Complicated Grief [ICG]), subjective sleep quality (Pittsburgh Sleep Quality Index [PSQI]), morningness-eveningness (Composite Scale of Morningness [CSM]), and clinical interview yielding a Hamilton Depression Rating Scale (HDRS) score. Grief was still present, as indicated by an average TRIG score of about 60. On average, the bereaved seniors habitually slept between ∼23:00 and ∼06:40 h, achieving ∼6 h of sleep with a sleep efficiency of ∼80%. They took about 30 min to fall asleep, and had their first REM episode after 75 min. About 20% of their sleep was in Stage REM, and about 3% in Stages 3 or 4 (slow wave sleep). Their mean PSQI score was 6.4. Their circadian temperature rhythms showed the usual classic shape with a trough at ∼01:00 h, a fairly steep rise through the morning hours, and a more gradual rise to mid-evening, with an amplitude of ∼0.8°C. In terms of lifestyle regularity, the mean regularity (SRM) score was 3.65 (slightly lower than that usually seen in seniors). Mood and alertness showed time-of-day variation with peak alertness in the late morning and peak mood in the afternoon. Correlations between outcome sleep/ circadian variables and level of grief (TRIG score) were calculated; there was a slight trend for higher grief to be associated with less time spent asleep (p = 0.07) and reduced alertness at 20:00 h (p = 0.05). Depression score was not correlated with TRIG score (p > 0.20). When subjects were divided into groups by the nature of their late spouse's death (expected/after a long-term chronic illness [n = 18] versus unexpected [n = 10]), no differences emerged in any of the variables. In conclusion, when studied at least four months after the loss event, there appears to be some sleep disruption in spousally bereaved seniors. However, this disruption does not appear to be due to bereavement-related disruptions in the circadian system.

Dream Content in Complicated Grief: A Window into Loss-Related Cognitive Schemas

“…CG, like MDD and PTSD, is also associated with sleep disturbances (Germain, Caroff, Buysse & Shear, 2005; Hardison, Neimeyer, & Lichstein, 2005; Monk et al, 2008), several psychometric studies have now shown symptoms of these three conditions constitute distinct clusters (e.g., Boelen & van den Bout, 2005; Golden & Dalgleish, 2010; Prigerson et al, 1996; Prigerson, Frank et al, 1995), and that CG represents a distinct syndrome (Boelen, van den Bout, & de Keijser, 2003; Langner & Maercker, 2005). …”

Can the circadian phase be estimated from self-reported sleep timing in patients with Delayed Sleep Wake Phase Disorder to guide timing of chronobiologic treatment?

“…An average temperature value was then calculated for each 1-hour bin across the 24-hour period. Several studies have established the validity of monitoring cBT using this method (Byrne & Lim, 2007;McKenzie & Osgood, 2004;Monk et al, 2008;Roach et al, 2010).…”

Effects of a Two‐Hour Change in Bedtime on the Sleep of Healthy Seniors

“…It changes not only in its length, depth, and fragility (Bliwise, 1993; Prinz, 2004), but also in its timing. It is likely that at least some of the sleep disruption experienced by healthy older adults (seniors) is the result of circadian timing issues (Monk, 2005) that are orchestrated principally by the master brain clock, the suprachiasmatic nuclei (Dardente & Cermakian, 2007), although sleep may also be affected by various life events, such as illness or the death of a spouse (Monk et al, 2008). Even in healthy seniors, there are significant age-related circadian phase differences (Czeisler et al, 1992; Monk, 2005).…”