Exploring the relationship between early cognitive ability and age-60 sleep quality: The Newcastle Thousand Families Study birth cohort

OBJECTIVES

Poor sleep quality has been linked to adverse health outcomes. It is important to understand factors contributing to sleep quality. Previous research has suggested increased cognition and education duration have a protective effect on sleep quality in old age. This study aimed to assess the hypothesis that age-11 intelligence quotient and highest achieved education level are associated with subjective sleep quality at age 60.

METHODS

Participants are members of the Newcastle Thousand Families Study birth cohort, all born in 1947. Data included a calculated intelligence quotient score based on participant's 11-plus exam results, highest achieved education level, social class at ages 25 and 50 and global Pittsburgh Sleep Quality Index (PSQI) at age 60. Multivariable regression analysis was used to investigate effect sizes of variables on global PSQI, which formed the basis of a path analysis model.

RESULTS

After excluding participants with incomplete data, and those who had been diagnosed with sleep apnea, 251 participants were included in the path analysis model. Education level was associated with global PSQI (R=-0.653; 95% CI -1.161, -0.145; P = .012) but age-11 intelligence quotient was not. While a similar association was seen for women in the stratified analysis, no such associations were seen for men.

CONCLUSIONS

The results of this study show an inverse relationship between education level, but not childhood intelligence quotient, and sleep quality in later life, in women only. Future research is needed to examine the mechanism underlying this relationship.

Predicting Sleep Quality through Biofeedback: A Machine Learning Approach Using Heart Rate Variability and Skin Temperature

Sleep quality (SQ) is a crucial aspect of overall health. Poor sleep quality may cause cognitive impairment, mood disturbances, and an increased risk of chronic diseases. Therefore, assessing sleep quality helps identify individuals at risk and develop effective interventions. SQ has been demonstrated to affect heart rate variability (HRV) and skin temperature even during wakefulness. In this perspective, using wearables and contactless technologies to continuously monitor HR and skin temperature is highly suited for assessing objective SQ. However, studies modeling the relationship linking HRV and skin temperature metrics evaluated during wakefulness to predict SQ are lacking. This study aims to develop machine learning models based on HRV and skin temperature that estimate SQ as assessed by the Pittsburgh Sleep Quality Index (PSQI). HRV was measured with a wearable sensor, and facial skin temperature was measured by infrared thermal imaging. Classification models based on unimodal and multimodal HRV and skin temperature were developed. A Support Vector Machine applied to multimodal HRV and skin temperature delivered the best classification accuracy, 83.4%. This study can pave the way for the employment of wearable and contactless technologies to monitor SQ for ergonomic applications. The proposed method significantly advances the field by achieving a higher classification accuracy than existing state-of-the-art methods. Our multimodal approach leverages the synergistic effects of HRV and skin temperature metrics, thus providing a more comprehensive assessment of SQ. Quantitative performance indicators, such as the 83.4% classification accuracy, underscore the robustness and potential of our method in accurately predicting sleep quality using non-intrusive measurements taken during wakefulness.

The sleep patterns and their associations with mental health among nursing home residents: a latent profile approach

BACKGROUND

Nursing home residents commonly experience poor sleep conditions. However, few studies have explored the potential sleep patterns among nursing home residents. This study aimed to identify the sleep patterns in nursing home residents, compare residents' characteristics across sleep patterns, and examine the relationships between sleep patterns and residents' mental health (i.e., depressive and anxiety symptoms).

METHODS

This cross-sectional study was conducted in 27 nursing homes in Jinan, China, from March to June 2018. In total, 353 participants were recruited via convenience sampling, and of which, 326 completed the survey. A latent profile analysis was performed to identify sleep patterns based on the seven dimensions of the Pittsburgh Sleep Quality Index. Bivariate analyses were conducted to compare residents' characteristics among the sleep patterns. Mixed-effects logistic regression analyses were adopted to investigate the relationships between sleep patterns and residents' mental health.

RESULTS

Three sleep patterns were identified, including 'good sleepers', 'poor sleepers without hypnotic use', and 'poor sleepers with hypnotic use'. Residents' gender, education, pain, instrumental activities of daily living, and number of chronic conditions were significantly differentiated across the sleep patterns. Compared with 'good sleepers', 'poor sleepers without hypnotic use' were significantly associated with more depressive symptoms (OR = 3.73, 95% CI = 2.09, 6.65, p < 0.001), but not with anxiety symptoms (OR = 2.04, 95% CI = 0.97, 4.29, p = 0.062); whereas 'poor sleepers with hypnotic use' had significantly more depressive (OR = 5.24, 95% CI = 2.54, 10.79, p < 0.001) and anxiety symptoms (OR = 5.02, 95% CI = 2.13, 11.83, p < 0.001).

CONCLUSIONS

This study reveals three distinct sleep patterns in nursing home residents and their significant associations with residents' mental health. These findings can inform future research to develop appropriate and tailored intervention strategies for improving sleep and promoting mental health for nursing home residents.

Perceived quality of sleep across the menopausal transition: A retrospective cohort study

Background and Aims

To compare sleep quality among naturally and surgically post-menopausal women, and to identify lifestyle factors that predict sleep quality in pre, peri, and postmenopausal women.

Methods

This is a retrospective cohort study of data collected from 429 women who participated in Fels Longitudinal Study data. Sleep quality, based on the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale, demographics, medical history, depression, quality of life, and physical activity levels were included in the analysis.

Results

The four study groups did not differ on overall sleep quality with either scale (p = 0.61). Both Post-M groups were more likely to have a major sleep problem than the Peri-M and Pre-M groups (p < 0.001), and to have a history of restless leg syndrome (p = 0.016), but the two Post-M groups did not differ on these problems. Predictors of sleep quality included depression, bodily pain, vitality, and surgical menopause (p<0.001).

Conclusion

Menopause is associated with sleep disrupting conditions. This study did not find any significant differences in sleep quality among the three reproductive stages or for natural versus surgical menopause. Women may benefit from addressing other lifestyle factors associated with poor sleep quality including mental health factors.

Sleep quality and the evolution of the COVID-19 pandemic in five European countries

The COVID-19 pandemic has led to lifestyle changes across Europe with a likely impact on sleep quality. This investigation considers sleep quality in relation to the evolution of the COVID-19 pandemic in five European countries. Using panel regressions and keeping policy responses to COVID-19 constant, we show that an increase in the four-week average daily COVID-19 deaths/100,000 inhabitants (our proxy for the evolution of the pandemic) significantly reduced sleep quality in France, Germany, Italy, Spain, and Sweden between April 2020 and June 2021. Our results are robust to a battery of sensitivity tests and are larger for women, parents and young adults. Additionally, we show that about half of the reduction in sleep quality caused by the evolution of the pandemic can be attributed to changes in lifestyles, worsened mental health and negative attitudes toward COVID-19 and its management (lower degree of confidence in government, greater fear of being infected). In contrast, changes in one's own infection-status from the SARS-CoV-2 virus or sleep duration are not significant mediators of the relationship between COVID-19-related deaths and sleep quality.

Older Workers With Unpredictable Schedules: Implications for Well-Being and Job Retention

BACKGROUND AND OBJECTIVES

A substantial portion of the service sector workforce is middle-aged or older, but little is known about the scheduling conditions of these older workers. This study describes the quality of work schedules in the service sector by age and tests associations of unpredictable schedules with well-being and job retention among workers ages 50-80.

RESEARCH DESIGN AND METHODS

The Shift Project collected survey data on detailed working conditions and health from 121,408 service sector workers, recruited in 2017-2020 using social media advertisements. Survey weights aligned sample demographics with the American Community Survey, and multiple imputation addressed missingness. Ordinary least squares regression models were used to examine associations between age and schedule stability, and ordinary least squares, ordinal logit, and logit regression models tested associations between schedule stability and well-being and job retention outcomes for older workers.

RESULTS

Scheduling conditions were more stable and predictable for older compared to younger workers; however, more than 80% of workers ages 50-80 experienced one or more types of routine schedule instability. Among workers ages 50-80, unpredictable schedules were associated with psychological distress, poor-quality sleep, work-family conflict, economic insecurity, job dissatisfaction, and intentions to look for a new job. Canceled and back-to-back closing and opening ("clopening") shifts were most strongly associated with negative outcomes.

DISCUSSION AND IMPLICATIONS

Policies aimed at improving scheduling conditions hold promise to benefit older service workers' well-being. As the population ages, improving work schedules in the years approaching retirement may be important to longer working lives.

Changes and predictors of sleep quality with a 2-year follow-up in older adults according to living arrangements

OBJECTIVES

This study aimed to explore changes and predictors of sleep quality with a 2-year follow-up in Chinese elderly individuals and to further present them according to living arrangements.

METHODS

A total of 3005 individuals were effectively surveyed at baseline and at the 2-year follow-up. Generalized estimating equation (GEE) was performed to explore associations between sleep quality and predictor variables.

RESULTS

The rate of poor sleep quality was 32.6% at baseline and 27.4% at follow-up. According to living arrangements, sleep quality improved among empty nesters living as a couple (P < 0.001). After adjusting for sex, age, and other influencing factors, empty nesters living alone had poorer sleep quality (OR = 1.399, 95% CI = 1.022-1.917) than nonempty nesters. Sex, age, education, self-reported health, depression, and social support were predictors of poor sleep quality for all participants. In the subgroup analyses, self-reported physical health and body mass index (BMI) were predictors of sleep quality in the nonempty-nester group, but depression was not a predictor. Depression was a predictor of sleep quality in the empty-nester group.

CONCLUSIONS

Sleep quality was improved in this 2-year follow-up survey. However, sleep quality problems in the elderly cannot be ignored, especially empty nesters living alone. Therefore, according to living arrangements, different intervention methods should be selected to prevent and control poor sleep quality.

How Elderly People's Quality of Life Relates to Their Sleep Quality and Sleep-Related Beliefs

OBJECTIVE/BACKGROUND

Quality of life (QoL) is a broad multidimensional construct, which can be influenced by several factors across the lifespan, including sleep quality. The aim of this study was to examine the association between QoL (and its specific domains), objective and self-reported sleep quality, and subjective sleep-related factors (i.e., dysfunctional beliefs and attitudes about sleep, and metacognitive beliefs about sleeping difficulties) in healthy elderly people.

PARTICIPANTS

Fifty healthy older adults (mean age = 70.40 years, SD = 7.43) participated in the study.

METHODS

QoL was assessed using the World Health Organization's Quality of Life Assessment, BREF version (WHOQOL-BREF). Self-reported sleep quality and efficiency were measured with the Pittsburgh Sleep Quality Index (PSQI) and sleep diary. Dysfunctional beliefs and attitudes about sleep (DBAS), and metacognitive beliefs about sleeping difficulties (MCQ-I) (subjective sleep-related factors) were assessed with self-report questionnaires. Objective sleep quality and efficiency were measured using actigraphy over 7 days.

RESULTS

Regression analyses showed that self-reported sleep efficiency and dysfunctional beliefs and attitudes about sleep explained 24% of the variance in global QoL. Dysfunctional beliefs and attitudes about sleep were the only significant predictor of QoL in the environmental domain.

CONCLUSIONS

Taken together, these findings underscore the influence of sleep-related factors, and particularly dysfunctional beliefs and attitudes about sleep, along with sleep efficiency, on the perception of QoL in healthy older adults. These factors need to be considered in efforts to sustain QoL, in late adulthood at least.

Cardiovascular Endurance Modifies the Link between Subjective Sleep Quality and Entorhinal Cortex Thickness in Younger Adults

INTRODUCTION

Poor sleep is linked to impaired cognitive function, cortical brain atrophy, and lower cortical thickness. Independently, higher cardiovascular endurance has neuroprotective effects. It remains in question, however, whether cardiovascular endurance moderates the relationship between sleep and brain health. The aims of this study included the following: 1) the association between subjective sleep quality and cognitive performance, hippocampus volume, and entorhinal cortex (EC) thickness, and 2) the moderating effects of cardiovascular endurance on the associations of sleep quality with cognitive and magnetic resonance imaging measures in healthy younger adults.

METHODS

A total of 1095 younger adults (28.8 ± 3.6 yr) from the Human Connectome Project were included in the analyses. The 2-min walk test was used as a proxy of cardiovascular endurance. Self-reported sleep quality was measured using the Pittsburgh Sleep Quality Index. Composite cognitive tests were used to assess global cognition, and T1-weighted structural magnetic resonance imaging data (obtained using Siemens 3T scanner) was used to assess hippocampus volume and EC thickness. Linear regression was used to examine the moderating effects of fitness on the relationships between sleep and each of these neurocognitive outcomes after controlling for age, sex, and education year.

RESULTS

Poorer sleep quality was associated with both a lower crystalized intelligence score (B = -0.198, P = 0.034) and lower EC thickness (B = -0.013, P = 0.003). With greater 2-min walk test score, the association between greater Pittsburgh Sleep Quality Index score and lower EC thickness was attenuated (B = 0.0008, P = 0.028).

CONCLUSIONS

Higher cardiovascular endurance may mitigate the relationship between poorer subjective sleep quality and lower EC thickness. Future longitudinal studies should examine the interactive effects of sleep and fitness on brain health among older and more vulnerable populations.

The development of life goals over the adult lifespan

OBJECTIVES

Life goals are important organizing units for individual agency in development. On a societal level, they align with age-normative developmental tasks; on the individual level, they guide people's attempts at shaping their own development. This study investigates the development of life goals across the adult lifespan with a focus on differences regarding gender, parental status, education, and region.

METHOD

Using longitudinal data from the German Socio-Economic Panel study (SOEP, N=52,052; age range: 18-84 years), we estimated the developmental trajectories of importance ratings for nine life goals across the adult lifespan using multiple-group latent growth curve modelling.

RESULTS

Having a happy relationship or marriage, having children, and being there for others are the life goals rated as most important across almost the entire adult lifespan. Having a happy relationship or marriage differed strongly by gender. Up to middle adulthood it was more important for women but more important for men in late adulthood. Parental status amplified gender differences in the work and family domain. Low education was associated with a higher perceived importance of being there for others. The largest regional differences (East vs. West) were found for home ownership.

DISCUSSION

Although the importance of some life goal trajectories reflects typical age-grading in developmental tasks, other life goals (e.g., having children) remain important even after goal attainment or after developmental deadlines have passed.

Self-reported daily sleep quality modulates the impact of the framing effect on outcome evaluation in decision-making under uncertainty: An ERP study

A growing body of research has largely confirmed and supported the idea that experimental sleep loss, such as sleep deprivation or sleep restriction, could affect individuals' risk-taking behavior and brain activity. However, whether self-reported sleep quality resulting from daily life modulates how feedback is evaluated during decision-making is still unclear. In this study, we used event-related potentials (ERPs) with a Balloon Analogue Risk Task (BART) to investigate how self-reported daily sleep quality modulates the brain's response to feedback from decision-making in the gain and loss frames. Behavioral data showed an increased aversion to uncertainty in the gain frame relative to the loss frame for individuals with higher sleep quality. However, this was not true for individuals with lower voluntary sleep quality. Similarly, the ERP data demonstrated that individuals with lower self-reported daily sleep quality displayed no changes in feedback-related negativity (FRN) in response to outcomes from decision-making in the gain and loss frames; however, individuals with higher self-reported daily sleep quality showed a greater FRN in response to decision-making in the gain frame than that in the loss frame. A Pearson correlation analysis showed that self-reported daily sleep quality was positively related to the variance of the FRN amplitude in response to the gain and loss frames. These findings suggest that framing effects on decision-making under uncertainty may depend on self-reported daily sleep quality and that the effects disappear when the sleep quality declines.

Sleep Quality and Daytime Functioning in Older European Adults

Abstract. The aim of this article was to review research studies related to the issues of sleep in older adults, examining the relationship between sleep quality and a set of psychological variables of daytime functioning in healthy older adults: quality of life, subjective health, functional ability, cognitive function, and emotional state, in Europe. Combined scoping review search strategies resulted in a total of 84 articles selected for review. We conclude there is a considerable amount of European research on sleep quality and its correlates in older adults’ population. Studying these relationships may be the basis for the targeted planning of psychological interventions aiming at raising the quality of life in older adults. The selected domains of older adults’ everyday functioning were all well represented in the retrieved research studies.

Long-term effects of pregnancy and childbirth on sleep satisfaction and duration of first-time and experienced mothers and fathers

STUDY OBJECTIVES

To examine the changes in mothers' and fathers' sleep satisfaction and sleep duration across prepregnancy, pregnancy, and the postpartum period of up to 6 years after birth; it also sought to determine potential protective and risk factors for sleep during that time.

METHODS

Participants in a large population-representative panel study from Germany reported sleep satisfaction and sleep duration in yearly interviews. During the observation period (2008-2015), 2541 women and 2118 men reported the birth of their first, second, or third child and provided longitudinal data for analysis. Fixed-effects regression models were used to analyze changes in sleep associated with childbirth.

RESULTS

Sleep satisfaction and duration sharply declined with childbirth and reached a nadir during the first 3 months postpartum, with women more strongly affected (sleep satisfaction reduction compared with prepregnancy: women, 1.81 points on a 0 to 10 scale, d = 0.79 vs. men, 0.37 points, d = 0.16; sleep duration reduction compared with prepregnancy: women, 62 min, d = 0.90 vs. men, 13 min, d = 0.19). In both women and men, sleep satisfaction and duration did not fully recover for up to 6 years after the birth of their first child. Breastfeeding was associated with a slight decrease in maternal sleep satisfaction (0.72 points, d = 0.32) and duration (14 min, d = 0.21). Parental age, household income, and dual vs. single parenting were unrelated, or only very weakly related, to improved sleep.

CONCLUSIONS

Following the sharp decline in sleep satisfaction and duration in the first months postpartum, neither mothers' nor fathers' sleep fully recovers to prepregnancy levels up to 6 years after the birth of their first child.

Sleep disturbance, associated symptoms, and quality of life in adults living with HIV in Jakarta, Indonesia

Adverse symptom experiences, including sleep disturbances, are important negative predictors of quality of life (QoL), but few studies conducted in low-income countries have examined the impact of poor sleep and its associated symptoms on QoL among people living with HIV (PLWH). To this end, 200 PLWH who were receiving treatment with antiretroviral therapy (ART) were recruited through a community nongovernment organization in Jakarta, Indonesia. Validated instruments measured QoL, sleep disturbance, fatigue, pain, ART adherence, substance use, drug use severity, and methadone treatment. Descriptive statistics, bivariate correlations, and multivariate linear regression were conducted to identify independent correlates of QoL. Overall, participants perceived their QoL as being good to very good (mean = 105.70, standard deviation = 14.7) and higher among women than men (p < 0.05). After adjusting for sex, education, drug-use severity, and ART adherence, QoL was negatively associated with fatigue, insomnia, and pharmacological treatment with methadone. Along with other known symptoms of HIV, sleep problems and their complications are important to clinically address and research more fully to assure satisfying QoL among PLWH.

Sex-specific associations between sleep and mental health in university students: a large cross-sectional study

Objective: To examine the associations between sleep problems and mental health dimensions in university students, and the effect of sex on these associations. Participants: Self-reported survey data from 3,483 students aged 18-30 years was drawn from a larger web-based study (i-Share) conducted in France in the years 2013-2017. Methods: We performed logistic regression analyses stratified by sex using insufficient sleep duration, poor sleep quality, difficulty initiating sleep and excessive daytime sleepiness, in relation with stress, self-esteem, depression and anxiety. Results: All sleep problems were strongly associated with all mental health dimensions, particularly anxiety, in female students. Sleep and mental health problems were also associated in male students, with the exception of low self-esteem, but odds ratios were lower than for female students. Conclusions: Present findings warrant attention to propose early interventions targeting sleep and mental health in the university setting taking sex into account.

Effect of Subjective and Objective Sleep Quality on Subsequent Peptic Ulcer Recurrence in Older Adults

OBJECTIVE

To examine the effect of subjective and objective sleep quality on subsequent recurrence of peptic ulcer disease (PUD) among older patients after Helicobacter pylori eradication.

SETTING

Eight grade A hospitals in China.

PARTICIPANTS

Of 1689 older Chinese with H. pylori-infected PUD recruited between January 2011 and October 2014, H. pylori were eradicated and PUD was cleared in 1538 patients by the end of 2014; 1420 of these patients were followed up for up to 36 months.

MEASUREMENTS

Using multiple measures at 6-month intervals, PUD recurrence was determined with esophagogastroduodenoscopy. Subjective sleep quality was measured using the Pittsburgh Sleep Quality Index. Objective sleep quality domains were measured using an accelerometer, including sleep onset latency, sleep efficiency, total sleep time, and number of awakenings.

RESULTS

This study documented a 36-month cumulative PUD recurrence of 8.3% (annual rate = 2.8%). Multivariate analyses showed that participants who reported poorer sleep quality were more likely to experience PUD recurrence during the 36-month follow-up period (hazard ratio [HR] = 1.895; 95% confidence interval [CI] = 1.008-3.327). Regarding objective sleep quality domains, longer sleep onset latency (HR = 1.558; 95% CI = 1.156-2.278) and more nighttime awakenings (HR = 1.697; 95% CI = 1.168-2.665) increased the risk of PUD recurrence. However, a longer total sleeping time protected against PUD recurrence (HR = 0.768; 95% CI = 0.699-0.885).

CONCLUSIONS

Poor sleep quality predicts a greater risk of PUD recurrence. Accurate diagnosis and effective treatments should, therefore, be provided for older adults afflicted with poor sleep, particularly for those who previously had PUD. It is equally important to include sleep assessment as an integral part while dealing with these patients.

Das Sozio-Oekonomische Panel als Datenbasis für die Arbeits- und Organisationspsychologie

Zusammenfassung. Der Beitrag zeigt die Analysepotentiale der repräsentativen Mikrodaten des Sozio-oekonomischen Panels (SOEP) für die Arbeits- und Organisationspsychologie (A/O-Psychologie) auf. Dabei werden allgemeine Charakteristika von Stichprobe und Erhebung des SOEP vorgestellt, sowie Konstrukte mit besonderer Relevanz für die Psychologie eingeführt. Zudem diskutieren wir Analysemethoden für Paneldaten, mit denen sich die Potentiale des SOEP realisieren lassen. Neben den Möglichkeiten des SOEP für Stabilitäts- und Verlaufsanalysen stellen wir die Potentiale längsschnittlicher Daten für kausale Analysen heraus. Dabei erläutern wir insbesondere die Analyselogik längsschnittlicher Fixed Effects Modellierungen und vergleichen diese mit weiteren längsschnittlichen Analyseverfahren. Wir argumentieren, dass bei Anwendung akkurater Methoden Teilaspekte der experimentellen Analyselogik auf Grundlage längsschnittlicher Surveydaten angenähert werden können. Folglich stellen die Daten des SOEP immer dann eine wertvolle Ressource für die A/O-Psychologie dar, wenn a) unabhängige Merkmale aus ethischen oder praktischen Gründen nicht systematisch manipuliert werden können, b) die Kernbefunde experimenteller Primärstudien auf Grundlage eines repräsentativen Samples repliziert werden sollen oder c) Interesse am langfristigen Verlauf eines Indikators besteht.

Associations of Perceived Stress, Resilience and Social Support with Sleep Disturbance Among Community-dwelling Adults

Sleep disturbance is often described as sleeping poorly, difficulty falling asleep and maintaining sleep, and waking early. Currently, most studies examining sleep disturbance have focused on negative psychological variables; however, few studies have combined both negative and positive psychosocial factors to assess sleep. The aim of this study was to investigate the prevalence of sleep disturbance and psychosocial correlates in Chinese community-dwelling adults. A total of 1471 adults, between 18 and 60 years old, from eight selected community settings in Jinan, China, were surveyed using the Pittsburgh Sleep Quality Index, Perceived Stress Scale, 10-item Connor-Davidson Resilience Scale and Multidimensional Scale of Perceived Social Support and provided sociodemographic information. We found that the prevalence of sleep disturbance was 33.9%. After adjusting for age, employment status and physical co-morbidity, perceived stress was significantly associated with sleep disturbance [odds ratio (OR) = 1.14, p < 0.001], while resilience and social support were associated with a low likelihood of sleep disturbance (OR = 0.90, p < 0.001; OR = 0.97, p < 0.001). Furthermore, regression analysis showed that the interaction between perceived stress and resilience was significant (p < 0.05). Resilience buffered the negative impact of perceived stress on sleep disturbance. Given the close relationship between sleep disturbance and psychosocial correlates, the development of effective intervention programmes to improve sleep quality in this population should be considered. Copyright © 2015 John Wiley & Sons, Ltd.

Risk factors for sleep disturbances in older adults: Evidence from prospective studies

No systematic review of epidemiological evidence has examined risk factors for sleep disturbances among older adults. We searched the PubMed database combining search terms targeting the following domains 1) prospective, 2) sleep, and 3) aging, and identified 21 relevant population-based studies with prospective sleep outcome data. Only two studies utilized objective measures of sleep disturbance, while six used the Pittsburgh sleep quality index (PSQI) and thirteen used insomnia symptoms or other sleep complaints as the outcome measure. Female gender, depressed mood, and physical illness were most consistently identified as risks for future sleep disturbances. Less robust evidence implicated the following as potentially relevant predictors: lower physical activity levels, African-American race, lower economic status, previous manual occupation, widowhood, marital quality, loneliness and perceived stress, preclinical dementia, long-term benzodiazepine and sedative use, low testosterone levels, and inflammatory markers. Chronological age was not identified as a consistent, independent predictor of future sleep disturbances. In conclusion, prospective studies have identified female gender, depressed mood, and physical illness as general risk factors for future sleep disturbances in later life, although specific physiological pathways have not yet been established. Research is needed to determine the precise mechanisms through which these factors influence sleep over time.

Cellular aging and restorative processes: subjective sleep quality and duration moderate the association between age and telomere length in a sample of middle-aged and older adults

STUDY OBJECTIVES

To examine whether subjective sleep quality and sleep duration moderate the association between age and telomere length (TL).

DESIGN

Participants completed a demographic and sleep quality questionnaire, followed by a blood draw.

SETTING

Social Neuroscience Laboratory.

PARTICIPANTS

One hundred fifty-four middle-aged to older adults (age 45-77 y) participated. Participants were excluded if they were on immunosuppressive treatment and/or had a disease with a clear immunologic (e.g., cancer) component.

INTERVENTIONS

N/A.

MEASUREMENTS AND RESULTS

Subjective sleep quality and sleep duration were assessed using the Pittsburgh Sleep Quality Index (PSQI) and TL was determined using peripheral blood mononuclear cells (PBMCs). There was a significant first-order negative association between age and TL. Age was also negatively associated with the self-reported sleep quality item and sleep duration component of the PSQI. A significant age × self-reported sleep quality interaction revealed that age was more strongly related to TL among poor sleepers, and that good sleep quality attenuated the association between age and TL. Moreover, adequate subjective sleep duration among older adults (i.e. greater than 7 h per night) was associated with TL comparable to that in middle-aged adults, whereas sleep duration was unrelated to TL for the middle-aged adults in our study.

CONCLUSIONS

The current study provides evidence for an association between sleep quality, sleep duration, and cellular aging. Among older adults, better subjective sleep quality was associated with the extent of cellular aging, suggesting that sleep duration and sleep quality may be added to a growing list of modifiable behaviors associated with the adverse effects of aging.

Sleep, Aggression, and Psychosocial Adjustment in Male Prisoners

In this study, we investigate sleep quantity and quality and their association with anger-related reactions, symptoms of ADHD, depressive symptoms, physical health complaints, and life satisfaction in male prison inmates. Furthermore, we examine whether good sleep hygiene in the prison context (physical exercise during the day, switching the television off at night, limiting caffeine and cigarette consumption) is related to sleep quantity and quality. Forty-nine prison inmates (mean age = 39.37; SD = 13.95) completed questionnaires assessing sleep quality and quantity, sleep hygiene, and psychosocial and physical functioning. Short sleep duration (6 h or less) and poor sleep quality were related to higher levels of aggressiveness in aggression-provoking social situations and more physical health complaints. In addition, poor sleep quality was related to higher levels of rumination and more symptoms of ADHD. Daily caffeine consumption, a sleep hygiene variable, was related to shorter sleep duration. The results suggest that, among a sample of male prison inmates, adequate sleep duration and good sleep quality were associated with better psychosocial adjustment.

Sleep discrepancy, sleep complaint, and poor sleep among older adults

OBJECTIVES

Discrepancy between self-report- and actigraphy-measured sleep, often considered an artifact of measurement error, has been well documented among insomnia patients. Sleep problems are common among older adults, and this discrepancy may represent meaningful sleep-related phenomenon, which could have clinical and research significance.

METHOD

Sleep discrepancy was examined in 4 groups of older adults (N = 152, mean age = 71.93 years) based on sleep complaint versus no complaint and presence versus absence of insomnia symptoms. Participants completed the Beck Depression Inventory-second edition (BDI-II) and 14 nights of sleep diaries and actigraphy.

RESULTS

Controlling for covariates, group differences were found in the duration and frequency of discrepancy in sleep onset latency (SOLd) and wake after sleep onset (WASOd). Those with insomnia symptoms and complaints reported greater duration and frequency of WASOd than the other 3 groups. Quantities of SOLd and WASOd were related to BDI-II score and group status, indicating that sleep discrepancy has meaningful clinical correlates.

DISCUSSION

Discrepancy occurred across all groups but was pronounced among the group with both insomnia symptoms and complaints. This discrepancy may provide a means of quantifying and conceptualizing the transition from wake to sleep among older adults, particularly those with sleeping problems.

Variability of sleep duration is related to subjective sleep quality and subjective well-being: an actigraphy study

While there is a large body of evidence that poor subjective sleep quality is related to lower subjective well-being, studies on the relation of objective sleep measures and subjective well-being are fewer in number and less consistent in their findings. Using data of the Survey of Mid-Life in the United States (MIDUS), we investigated whether duration and quality of sleep, assessed by actigraphy, were related to subjective well-being and whether this relationship was mediated by subjective sleep quality. Three hundred and thirteen mainly white American individuals from the general population and 128 urban-dwelling African American individuals between 35 and 85 years of age were studied cross-sectionally. Sleep duration, variability of sleep duration, sleep onset latency, and time awake after sleep onset were assessed by actigraphy over a period of 7 days. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index, positive psychological well-being and symptoms of psychological distress were assessed with the Satisfaction with Life Scale and the Mood and Anxiety Symptom Questionnaire. In both white and African Americans high day-to-day variability in sleep duration was related to lower levels of subjective well-being controlling age, gender, educational and marital status, and BMI. By contrast, sleep duration, sleep onset latency, and time awake after sleep onset were not related to subjective well-being controlling covariates and other sleep variables. Moreover, the relationship between variability in sleep duration and well-being was partially mediated by subjective sleep quality. The findings show that great day-to-day variability in sleep duration – more than average sleep duration – is related to poor subjective sleep quality and poor subjective well-being.