Poor nighttime sleep associated with daytime napping in older adults

May 1 2008

Deficiencies in nighttime sleep are associated with daytime napping in older adults, according to a study published in the May 1 issue of the journal SLEEP.

Suzanne E. Goldman, PhD, of Vanderbilt University Medical Center in Nashville, Tenn., and colleagues measured the nighttime and daytime sleep of 235 individuals (average age: 80.1 years) with wrist actigraphy, or a method of monitoring human rest/activity cycles and is useful for determining sleep patterns and circadian rhythms, and sleep diaries for an average of 6.8 nights.

According to the results, naps of at least five minutes were recorded in sleep diaries by 75.7 percent of the participants. The odds for napping were higher for individuals with higher levels of nighttime fragmentation, respiratory symptoms, diabetes, and pain. Self-reported diabetes was associated with a 43 percent longer nap duration, while self-report of any pain was associated with 27.5 percent shorter nap duration. This study also suggested that each hour of previous night's sleep time was associated with a 4.1 percent longer sleep time the next night (nap night), and each hour of napping (the next day) was associated with 10.2 percent less sleep on the night of the nap.

"Our study is important both clinically and for future research. It points out the need for health care providers to discuss nighttime sleep and daytime napping with older individuals. It also points out the need to identify the causes of disturbed nighttime sleep in order to determine appropriate treatment. Our study suggests that that older adults nap because of health problems and disrupted sleep at night. Thus the napping may reflect needed sleep," said Dr. Goldman.

Not sleeping well can lead to a number of problems. Older adults who have poor nighttime sleep are more likely to have a depressed mood, attention and memory problems, excessive daytime sleepiness, more nighttime falls and use more over-the-counter or prescription sleep aids. In addition, recent studies associate lack of sleep with serious health problems such as an increased risk of obesity, cardiovascular disease and diabetes.

While most people require seven to eight hours of sleep a night to perform optimally the next day, older adults might find this harder to obtain. Older adults must be more aware of their sleep and maintain good sleep hygiene by following these tips:

• Establishing a routine sleep schedule.
• Avoiding utilizing bed for activities other than sleep or intimacy.
• Avoiding substances that disturb your sleep, like alcohol or caffeine.
• Not napping during the day. If you must snooze, limit the time to less than one hour and no later than 3 p.m.
• Stick to rituals that help you relax each night before bed. This can include such things as a warm bath, a light snack or a few minutes of reading.
• Don't take your worries to bed. Bedtime is a time to relax, not to hash out the stresses of the day.
• If you can't fall asleep, leave your bedroom and engage in a quiet activity. Return to bed only when you are tired.
• Keep your bedroom dark, quiet and a little cool.

Although sleep patterns change as people age, disturbed sleep and waking up tired every day are not part of normal aging. Those who have trouble sleeping are advised to see a sleep specialist at a facility accredited by the American Academy of Sleep Medicine (AASM).

http://www.aasmnet.org/