Sleep and Cognition in Older Adults

Dzierzewski, Joseph M.; Dautovich, Natalie D.; Ravyts, Scott G.

doi:10.1016/j.jsmc.2017.09.009

Cited by 194 publications

(137 citation statements)

References 83 publications

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“…In fact, older adults have a high prevalence of insomnia, with estimates as high as 65% (Ohayon, 2002). The high prevalence of insomnia in late-life is clinically relevant because insomnia, and insomnia-related symptomology, are associated with a myriad of adverse consequences (Dzierzewski, Dautovich, & Ravyts, 2018;Foley, Ancoli-Israel, Britz, & Walsh, 2004;Jaussent et al, 2011;Kay & Dzierzewski, 2015;Spira et al, 2014), ranging from individual (e.g. decreased quality-of-life) to societal (e.g.…”

Section: Introductionmentioning

confidence: 99%

CBT for late‐life insomnia and the accuracy of sleep and wake perceptions: Results from a randomized‐controlled trial

Dzierzewski

Martin

Fung

et al. 2019

Journal of Sleep Research

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Subjective and objective estimates of sleep are often discordant among individuals with insomnia who typically under‐report sleep time and over‐report wake time at night. This study examined the impact and durability of cognitive‐behavioural therapy for insomnia on improving the accuracy of sleep and wake perceptions in older adults, and tested whether changes in sleep quality were related to changes in the accuracy of sleep/wake perceptions. One‐hundred and fifty‐nine older veterans (97% male, mean age 72.2 years) who met diagnostic criteria for insomnia disorder were randomized to: (1) cognitive‐behavioural therapy for insomnia (n = 106); or (2) attention control (n = 53). Assessments were conducted at baseline, post‐treatment, 6‐months and 12‐months follow‐up. Sleep measures included objective (via wrist actigraphy) and subjective (via self‐report diary) total sleep time and total wake time, along with Pittsburgh Sleep Quality Index score. Discrepancy was computed as the difference between objective and subjective estimates of wake and sleep. Minutes of discrepancy were compared between groups across time, as were the relationships between Pittsburgh Sleep Quality Index scores and subsequent changes in discrepancy. Compared with controls, participants randomized to cognitive‐behavioural therapy for insomnia became more accurate (i.e. minutes discrepancy was reduced) in their perceptions of sleep/wake at post‐treatment, 6‐months and 12‐months follow‐up (p < .05). Improved Pittsburgh Sleep Quality Index scores at each study assessment preceded and predicted reduced discrepancy at the next study assessment (p < .05). Cognitive‐behavioural therapy for insomnia reduces sleep/wake discrepancy among older adults with insomnia. The reductions may be driven by improvements in sleep quality. Improving sleep quality appears to be a viable path to improving sleep perception and may contribute to the underlying effectiveness of cognitive‐behavioural therapy for insomnia.

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Section: Introductionmentioning

confidence: 99%

CBT for late‐life insomnia and the accuracy of sleep and wake perceptions: Results from a randomized‐controlled trial

Dzierzewski

Martin

Fung

et al. 2019

Journal of Sleep Research

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“…Nevertheless, we were able to show the increased frequency of sleep problems in the inflammatory group. Our results become even more interesting and robust when we consider the decline in normative sleep functioning with age while our findings showed more sleep complaints in younger inflammatory group patients. Increased rate of fatigue is another important finding of our study that needs further evaluation in patients with chronic inflammatory skin disorders.…”

Section: Discussionmentioning

confidence: 81%

Insomnia and other sleep complaints in inflammatory versus noninflammatory skin disorders: An observational case‐control study

Mostaghimi¹,

Hetzel

2019

Int J Dermatology

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Background Sleep problems are common in patients with dermatologic disorders.However, it is unknown whether inflammatory skin disorders are associated with more sleep problems than noninflammatory skin disorders.Purpose To determine whether sleep problems occur more frequently in people with inflammatory skin disorders compared to noninflammatory skin disorders.Study design Observational case-control study.Methods Patients with inflammatory skin disorders (psoriasis [n = 17] and chronic eczema [n = 30]) and noninflammatory skin disorders (nonmelanoma skin cancers [NMSC] [n = 31]) were enrolled. Data collection occurred during a single visit. Statistical analysis of questionnaire results between groups utilized inverse propensity score weighted (IPSW) ANOVA and logistic regression models.Results Groups differed in mean (SD) age (P < 0.001) and itch severity (P < 0.001).Based on IPSW ANOVA models, the inflammatory group had significantly higher fatigue scores (mean [95% CI]; 32.0 [28.4-35.5]) than the noninflammatory group (25.5 [21.6-29.3]; P = 0.017). The inflammatory group odds of insomnia were significantly greater based on two definitions of insomnia, ISI ≥ 15 and PSSQ-I, with odds ratios (95% CI) of 14.4 (2.16-525) and 4.82 (1.45-20.7), respectively. These results were consistent in comparisons between the three groups, with no difference between psoriasis and chronic eczema, but with chronic eczema, significantly more were affected than NMSC.Conclusions Patients with inflammatory skin disorders report significantly more fatigue and have higher odds of insomnia compared to patients with noninflammatory skin cancers.

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“…Sleep disorder is closely related to cognition (50) and patients with primary insomnia have been reported to suffer from subjective memory impairment in virtual water mazes (51). Sleep duration is negatively correlated with age in older adults (52) and chronic insomnia in the elderly is likely to exacerbate cognitive impairment (53). In the current study, D-gal-induced ageing rats, PCPA-induced the insomnia rats and D-gal-and PCPA-induced ageing insomnia rats demonstrated cognitive decline in the Morris water maze.…”

Section: Primermentioning

confidence: 99%

Establishment of a rat model with ageing insomnia induced by D‑galactosef and para‑chlorophenylalanine

et al. 2020

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The current study aimed to establish a rat model of ageing insomnia induced by D-galactose and/or para-chlorophenylalanine. Following establishment of the model, body weights were measured, and Morris water maze and pentobarbital-induced sleep tests were performed. The serum levels of inflammatory mediators and the neural levels of neurotransmitters were detected. The results demonstrated that the body weights of PCPA+D-gal-induced ageing insomnia rats decreased significantly. Ageing insomnia rats exhibited longer latencies to the platform in the Morris water maze tests and fewer target crossings. The sleep latency of the model rats was longer and sleep time was shorter by contrast. The relative expression of hippocampal IL-6, TNF-α, NF-κB and mGluR2 mRNA of the PCPA+D-gal-induced ageing insomnia group was higher, while the relative expression of 5-HT 1A R and GABA A R a1 mRNA were lower. The serum levels of IL-1β, IL-6, TNF-α and brain level of glutamate increased in the PCPA+D-gal-induced ageing insomnia group, while the levels of 5-HT and GABA decreased. In conclusion, memory function, sleep time, expression of inflammatory factors and neurotransmitters are altered in ageing insomnia rats induced by D-galactose and para-chlorophenylalanine, indicating the successful establishment of a murine model of ageing insomnia.

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Sleep and Cognition in Older Adults

Cited by 194 publications

References 83 publications

CBT for late‐life insomnia and the accuracy of sleep and wake perceptions: Results from a randomized‐controlled trial

CBT for late‐life insomnia and the accuracy of sleep and wake perceptions: Results from a randomized‐controlled trial

Insomnia and other sleep complaints in inflammatory versus noninflammatory skin disorders: An observational case‐control study

Establishment of a rat model with ageing insomnia induced by D‑galactosef and para‑chlorophenylalanine

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