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

  • Henry C. Driscoll
    Affiliations
    Sleep and Chronobiology Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

    Advanced Center for Interventions and Services Research in Late-Life Mood Disorders, Pittsburgh, Pennsylvania
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  • Linda Serody
    Affiliations
    Sleep and Chronobiology Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

    Advanced Center for Interventions and Services Research in Late-Life Mood Disorders, Pittsburgh, Pennsylvania
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  • Susan Patrick
    Affiliations
    Sleep and Chronobiology Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

    Advanced Center for Interventions and Services Research in Late-Life Mood Disorders, Pittsburgh, Pennsylvania
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  • Jennifer Maurer
    Affiliations
    Sleep and Chronobiology Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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  • Salem Bensasi
    Affiliations
    Sleep and Chronobiology Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

    Advanced Center for Interventions and Services Research in Late-Life Mood Disorders, Pittsburgh, Pennsylvania
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  • Patricia R. Houck
    Affiliations
    Sleep and Chronobiology Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

    Advanced Center for Interventions and Services Research in Late-Life Mood Disorders, Pittsburgh, Pennsylvania
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  • Sati Mazumdar
    Affiliations
    University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania
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  • Eric A. Nofzinger
    Affiliations
    Sleep and Chronobiology Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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  • Bethany Bell
    Affiliations
    Sleep and Chronobiology Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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  • Robert D. Nebes
    Affiliations
    Sleep and Chronobiology Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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  • Mark D. Miller
    Affiliations
    Sleep and Chronobiology Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

    Advanced Center for Interventions and Services Research in Late-Life Mood Disorders, Pittsburgh, Pennsylvania
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  • Charles F. Reynolds III
    Correspondence
    Send correspondence and reprint requests to Charles F. Reynolds III, M.D., Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213
    Affiliations
    Sleep and Chronobiology Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

    University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania

    Advanced Center for Interventions and Services Research in Late-Life Mood Disorders, Pittsburgh, Pennsylvania

    John A. Hartford Center of Excellence in Geriatric Psychiatry, Pittsburgh, Pennsylvania, Pittsburgh, Pennsylvania
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      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

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      References

        • Dew MA
        • Reynolds CF
        • Monk TH
        • et al.
        Psychosocial correlates and sequelae of electroencephalographic sleep in healthy elders.
        J Gerontol. 1994; 49: P8-P18
        • Dew MA
        • Hoch CC
        • Buysse DJ
        • et al.
        Healthy older adults’ sleep predicts all-cause mortality at 4 to 19 years of follow-up.
        Psychosom Med. 2003; 65: 63-73
        • Ohayon MM
        • Carskadon MA
        • Guilleminault C
        • et al.
        Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan.
        Sleep. 2004; 27: 1255-1273
        • Rowe JW
        • Kahn RL
        Successful Aging. Pantheon Books, New York1998
        • Peel NM
        • McClure RJ
        • Bartlett HP
        Behavioral determinants of healthy aging.
        Am J Prev Med. 2005; 28: 298-304
        • Depp CA
        • Jeste DV
        Definitions and predictors of successful aging: a comprehensive review of larger quantitative studies.
        Am J Geriatr Psychiatry. 2006; 14: 6-20
        • Blazer DG
        Successful aging.
        Am J Geriatr Psychiatry. 2006; 14: 2-5
        • Hoch CC
        • Dew MA
        • Reynolds CF
        • et al.
        A longitudinal study of laboratory- and diary-based sleep measures in healthy “old old” and “young old” volunteers.
        Sleep. 1994; 17: 489-496
        • Jeste DV
        Feeling fine at a hundred and three: secrets of successful aging.
        Am J Prev Med. 2005; 28: 323-324
        • Monk TH
        • Flaherty JF
        • Frank E
        • et al.
        The Social Rhythm Metric: an instrument to quantify the daily rhythms of life.
        J Nerv Ment Dis. 1990; 178: 120-126
        • Monk TH
        • Reynolds CF
        • Kupfer DJ
        • et al.
        The Pittsburgh Sleep Diary.
        J Sleep Res. 1994; 3: 111-120
        • Buysse DJ
        • Reynolds CF
        • Monk TH
        • et al.
        The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research.
        Psychiatry Res. 1989; 28: 193-213
        • Stewart AL
        • Hays RD
        • Ware JE
        The MOS short-form general health survey. Reliability and validity in a patient population.
        Med Care. 1988; 26: 724-735
        • Miller MD
        • Paradis CF
        • Houck PR
        • et al.
        Rating chronic medical illness burden in geropsychiatric practice and research: application of the Cumulative Illness Rating Scale.
        Psychiatry Res. 1992; 41: 237-248
        • Hamilton M
        A rating scale for depression.
        J Neurol Neurosurg Psychiatry. 1960; 23: 56-62
        • Hamilton M
        The assessment of anxiety states by rating.
        Br J Med Psychol. 1959; 32: 50-55
        • Wechsler D
        Wechsler Memory Scale-Revised. The Psychological Corporation, San Antonio, TX1987
        • Wechsler D
        Wechsler Adult Intelligence Scale-III. The Psychological Corporation, San Antonio, TX1997
        • Brown L
        • Sherbenou PJ
        • Johnsen SK
        Test of Nonverbal Intelligence. Pro-Ed Inc., Austin, TX1998
        • Folstein MF
        • Folstein SW
        • McHugh PR
        Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician.
        J Psychiatr Res. 1975; 12: 189-198
        • Monk TH
        • Kupfer DJ
        Which aspects of morningness-eveningness change with age?.
        J Biol Rhythms. 2007; 22: 278-280
        • Johns MW
        A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale.
        Sleep. 1991; 14: 540-545
        • Russo J
        • Vitaliano PP
        Life events as correlates of burden in spouse caregivers of persons with Alzheimer's disease.
        Exp Aging Res. 1995; 21: 273-294
        • Cohen S
        • Kamarck T
        • Mermelstein R
        A global measure of perceived stress.
        J Health Soc Behav. 1983; 24: 385-396
        • Carver CS
        You want to measure coping but your protocol's too long: consider the Brief COPE.
        Int J Behav Med. 1997; 4: 92-100
        • Williamson G
        • Schulz R
        Physical illness and symptoms of depression among elderly outpatients.
        Psychol Aging. 1992; 7: 343-351
        • Vitiello M
        • Prinz P
        Sleep and sleep disorders in normal aging.
        in: Thorpy MJ Handbook of Sleep Disorders. Marcel Dekker, New York1990: 139-152
        • Foley DJ
        • Monjan AA
        • Brown SL
        • et al.
        Sleep complaints among elderly persons: an epidemiologic study of three communities.
        Sleep. 1995; 18: 425-432