Volume 56, Issue 7 p. 1218-1227

Subjective and Objective Sleep Quality and Aging in the Sleep Heart Health Study

Mark L. Unruh MD, MSc

Mark L. Unruh MD, MSc

From the * Renal-Electrolyte Division, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania Center for Clinical Investigation, School of Medicine, Case Western Reserve University, Cleveland, Ohio Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland § Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh Pennsylvania Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin # Center for American Indian Health Research, Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma ** Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.

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Susan Redline MD

Susan Redline MD

From the * Renal-Electrolyte Division, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania Center for Clinical Investigation, School of Medicine, Case Western Reserve University, Cleveland, Ohio Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland § Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh Pennsylvania Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin # Center for American Indian Health Research, Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma ** Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.

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Ming-Wen An PhD

Ming-Wen An PhD

From the * Renal-Electrolyte Division, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania Center for Clinical Investigation, School of Medicine, Case Western Reserve University, Cleveland, Ohio Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland § Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh Pennsylvania Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin # Center for American Indian Health Research, Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma ** Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.

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Daniel J. Buysse MD

Daniel J. Buysse MD

From the * Renal-Electrolyte Division, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania Center for Clinical Investigation, School of Medicine, Case Western Reserve University, Cleveland, Ohio Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland § Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh Pennsylvania Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin # Center for American Indian Health Research, Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma ** Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.

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F. Javier Nieto MD, PhD

F. Javier Nieto MD, PhD

From the * Renal-Electrolyte Division, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania Center for Clinical Investigation, School of Medicine, Case Western Reserve University, Cleveland, Ohio Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland § Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh Pennsylvania Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin # Center for American Indian Health Research, Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma ** Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.

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Jeun-Liang Yeh PhD

Jeun-Liang Yeh PhD

From the * Renal-Electrolyte Division, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania Center for Clinical Investigation, School of Medicine, Case Western Reserve University, Cleveland, Ohio Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland § Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh Pennsylvania Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin # Center for American Indian Health Research, Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma ** Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.

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Anne B. Newman MD, MPH

Anne B. Newman MD, MPH

From the * Renal-Electrolyte Division, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania Center for Clinical Investigation, School of Medicine, Case Western Reserve University, Cleveland, Ohio Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland § Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh Pennsylvania Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin # Center for American Indian Health Research, Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma ** Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.

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First published: 07 August 2008
Citations: 188
Address correspondence to Mark L. Unruh, MD, MSc, Renal-Electrolyte Division, University of Pittsburgh Medical Center, 3550 Terrace Street, A909 Scaife Hall, Pittsburgh, PA 15261. E-mail: [email protected]

Abstract

OBJECTIVES: To examine the extent to which subjective and objective sleep quality are related to age independent of chronic health conditions.

DESIGN: Cross-sectional study.

SETTING: The Sleep Heart Health Study (SHHS) is a multicenter study designed to determine the cardiovascular consequences and the natural history of sleep disordered breathing.

PARTICIPANTS: Five thousand four hundred seven community-dwelling adults who participated in the SHHS (mean age 63, range 45–99; 52% women).

MEASUREMENTS: Unattended home polysomnography (PSG) and sleep questionnaires.

RESULTS: Older age was associated with shorter sleep time, diminished sleep efficiency, and more arousals in men and women. In men, age was independently associated with more Stage 1 and Stage 2 sleep and less slow-wave (Stage 3 to 4) and rapid eye movement sleep. In women, older age was less strongly associated according to linear trend with sleep stage. Conversely, poor subjective sleep quality was not associated with older age in men, but older women had more trouble falling asleep, and there was a trend toward older women having more problems with waking up during the night and waking up too early. Associations between self-report and directly measured sleep time and sleep latency were low to moderate across age groups (correlation coefficient=0.06–0.32).

CONCLUSION: Older age was more strongly associated with poorer sleep according to PSG in men than women, yet the subjective report of poor sleep with older age was stronger in women. The higher prevalence of chronic health conditions, including sleep apnea, in older adults did not explain changes of sleep parameters with aging and age–sex differences in these relationships.