A new study dispels the age old belief that sleep doesn’t get more difficult with age. The study shows that sleep quality tends to improve the older people got, with adults in their 80s getting better sleep than any other age group surveyed. The new study was published in the journal Sleep.
More than a person’s biological age, the study suggests, it’s factors like stress and underlying depression or illness that tend to affect quality of rest. The researchers note that when these external influences are taken out of the equation, elderly adults aren’t any more likely to report sleep problems than younger adults in their 20s and 30s.
The researchers from University of Pennsylvania’s Center for Sleep and Circadian Neurobiology and Division of Sleep Medicine had begun the study to show that sleep problems are associated with aging. “This flies in the face of popular belief,” said lead author, Michael Grandner, a research associate at the Center for Sleep and Circadian Neurobiology at the Perelman School of Medicine at the University of Pennsylvania, in a statement. “These results force us to rethink what we know about sleep in older people - men and women.”
The researchers included data from 155,877 adults who took part in a 2006 phone survey about sleep quality by the Centers for Disease Control and Prevention. To gauge rates of sleep disturbance and daytime tiredness, researchers asked questions such as “Over the last two weeks, how many days have you had trouble falling asleep or staying asleep or sleeping too much?” and “Over the last two weeks, how many days have you felt tired or had little energy?” The participants were also asked about race, income, education, depressed mood, general health and time of last medical checkup.
Results showed that on an average, elderly adults reported sleeping better than younger adults. When they did complain about sleep issues, it was usually a sign of other health problems at play. “Once you factor out things like illness and depression, older people should be reporting better sleep. If they’re not, they need to talk to their doctor. They shouldn’t just ignore it,” Grandner said in a statement.
In general, health problems and depression were associated with worse sleep across age groups, and women reported more sleep issues than men. The researchers added that there was brief spike in complaints among middle-aged adults between 40 to 59 years old. Among women in this age group, Grander ascribed sleep difficulties to menopause as well as the stress of work and raising children. For men, workplace stress and increases in rates of heart disease and high blood pressure could be the culprits, he said. After this mid-life spike, sleep complaints continue to decrease.
“We believe the reason is that as people age, perhaps their perception of how important sleep is may be different than in other age groups,” said Dr. Nirav Patel, a co-author of the study. Furthermore, older people who have reached retirement have much different daily structures than those of working professionals or students, he said.
“Even if sleep is actually worse in the elderly than young people, their perceptions of it might be different,” says Grandner. “As you get older, you may have other things going on, other health problems, and you may not consider a little sleep disruption to be something that really bothers you.”
Professor Derk-Jan Dijk, Professor of Sleep and Physiology and Director of the Surrey Sleep Research Centre, said the study was “interesting”. He said, “We have got to get away from all these myths about ageing - many people are very content with their sleep.” However, he said that asking people for their subjective opinion about sleep patterns could produce answers that were dependent on their mood at the time. “If you are angry because your boss didn't give you a pay rise, your perception of sleep quality may be very different from someone who is feeling generally content.”
A singular study cannot change the delivery of health care, Patel said. But given the magnitude of the study - the sample size was so large - it is difficult to discount the study. “The question that was posed was so broad that it captures the gamut of sleep disorders,” he said.
“The basic message is that when you control for quality of health and mood, older people do not necessarily have more sleep disturbance,” said Dr. Ramadevi Gourineni, a professor of neurology and director of the insomnia program at Northwestern University. Many doctors feel uncomfortable talking about sleep with patients because they lack medical training in this area, Gourineni said. “Rather than trying to understand the problem and figuring out how to deal with it, they have dismissed it as a normal problem that occurs with age,” she said.
The results of the study should cause doctors to look at a patient’s underlying medical conditions, including psychiatric problems or sleep disorders such as sleep apnea, as the cause for sleep complaints, Gourineni said.
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