Sleep Problems in Aging (Ageing) Adults: A Narrative Review

Abstract

The recent literature on sleep problems in aging (ageing) adults has primarily focused on negative effects as well as risk factors, buffers, and interventions. The sleep problems have typically been self-reported or measured by actigraphy. The prevalence rates for sleep problems starting at age 60 have been variable, ranging from a low of 18% in the UK to a high of 50% in China, a variability that may relate to the type of sleep data and/or cross-cultural variation. Psychological effects have included dissatisfaction with life, unhealthy aging and affective/depressive mood states. Physical effects have included elevated blood pressure, impaired functionality, frailty, comorbidity and immune dysfunction. Cognitive impairment has also resulted from sleep problems, and aging brain biomarkers have included shorter telomere length, reduced gray matter volume and earlier mortality. Psychological risk factors have included meta-cognitive beliefs, worrying, loneliness, poor relationships and depression. Physical risk factors have included inactivity, napping and comorbidity. Buffers/protective factors have included retirement, light exercise, consumption of vegetables and melatonin as a sleep medication. Only a couple interventions could be found in this recent literature on sleep in aging adults including Cognitive Behavior Therapy and exercise. A few potential underlying mechanisms for disturbed sleep in aging adults include decreased vagal activity, increased connectivity in the brain making disconnecting for sleep difficult, inflammation and orexins. Although the data highlight the severity of sleep problems in the aging, they have been primarily based on self-report surveys that have yielded mixed results across samples. Sleep Problems in Aging (Ageing) Adults: A Narrative ReviewThis narrative review involved entering the terms sleep and aging (ageing) into PubMed and PsycINFO. The search yielded 735 papers for the last five years. However, following exclusion criteria including case studies and non-English language papers, this review is a summary of the research reported in 67 papers. The recent literature is predominantly focused on negative effects of sleep problems along with studies on risk factors, buffers and interventions. This narrative review is accordingly divided into sections on prevalence of sleep problems in the aging, negative effects, risk factors, buffers and interventions. These are followed by sections on potential underlying mechanisms for sleep problems in the aging and methodological limitations of the research.