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Prevalent sleep problems in the aged

  • On Aging And Self-Regulation: A Special Series
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Abstract

Quality of sleep influences the level of daytime functioning, including stress levels, psychosomatic complaints, general health, and overall well-being. As people age, they complain more about disturbed sleep, insomnia, increased time in bed, and sleep fragmentation. These complaints can be related to circadian rhythm desynchronization, hypnotic or other medication use, chronic bedrest, napping, dementia, or to sleep apnea, a disorder of respiratory cessation which is quite prevalent in the elderly. We review here the results of 12 years of research on sleep in the elderly. In studies of three populations of elderly, it was found that between 24% and 42% had five or more apneas per hour of sleep and 4%–14% had 20 or more apneas per hour of sleep. Since apnea is related to dementia and even to mortality, this high prevalence of apnea is of extreme importance.

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References

  • Ancoli-Israel, S. (1989a). Ambulatory cassette recording of sleep apnea. In J. S. Ebersole (Ed.),Ambulatory EEG monitoring (pp. 299–315). New York: Raven Press.

    Google Scholar 

  • Ancoli-Israel, S. (1989b). Epidemiology of sleep disorders. In T. Roth (Ed.),Clinics in geriatric medicine (pp. 347–362). Philadelphia, PA: W. B. Saunders Company.

    Google Scholar 

  • Ancoli-Israel, S., Klauber, M. R., Butters, N., Parker, L., & Krupke, D. F. (1991a). Dementia in institutionalized elderly: Relation to sleep apnea.Journal of the American Geriatrics Society, 39(3), 258–263.

    Google Scholar 

  • Ancoli-Israel, S., Klauber, M. R., Kripke, D. F., Parker, L., & Cobarrubias, M. (1989). Sleep apnea in female patients in a nursing home: Increased risk of nortality.Chest, 96(5), 1054–1058.

    Google Scholar 

  • Ancoli-Israel, S., & Kripke, D. F. (1989). Now I lay me down to sleep: The problem of sleep fragmentation in elderly and demented residents of nursing homes.Bulletin of Clinical Neurosciences, 54 127–132.

    Google Scholar 

  • Ancoli-Israel, S., Kripke, D. F., Klauber, M. R., Mason, W. J., Fell, R., & Kaplan, O. (1991b). Respiratory disturbances in sleep in community dwelling elderly.Sleep 14(4).

  • Ancoli-Israel, S., Kripke, D. F., & Mason, W. (1987). Characteristics of obstructive and central sleep apnea in the elderly: An interim report.Biological Psychiatry, 22 741–750.

    Google Scholar 

  • Ancoli-Israel, S., Kripke, D. F., Mason, W., & Kaplan, O. J. (1985). Sleep apnea and periodic movements in an aging sample.Journal of Gerontology, 40 419–425.

    Google Scholar 

  • Ancoli-Israel, S., Kripke, D. F., Mason, W., & Messin, S. (1981). Comparisons of home sleep recordings and polysomnograms in older adults with sleep disorders.Sleep, 4(3), 283–291.

    Google Scholar 

  • Ancoli-Israel, S., Parker, L., Sinaee, R., Fell, R., & Kripke, D. F. (1989). Sleep fragmentation in patients from a nursing home.Journal of Gerontology, 44 M18-M21.

    Google Scholar 

  • Barrett-Connor, E., Khaw, K. T., & Yen, S. S. C. (1986). A prospective study of dehydroepiandrosterone sulfate, mortality, and cardiovascular disease.New England Journal of Medicine, 315 1519–1524.

    Google Scholar 

  • Bliwise, D. L., Feldman, D. E., Bliwise, N. G., Carskadon, M. A., Kraemer, H. C., North, C. S., Petta, D. E., Seidel, W. F., & Dement, W. C. (1987). Risk factors for sleep disordered breathing in heterogeneous geriatric populations.Journal of the American Geriatrics Society, 35 132–141.

    Google Scholar 

  • Bootzin, R. R., & Nicassio, P. M. (1978). Behavioral treatments for insomnia. In M. Hersen, R. M. Eisler, & P. M. Miller (Eds.),Progress in behavior modification (Vol. 6) (pp. 1–45). New York: Academic Press.

    Google Scholar 

  • Campbell, S. S., Kripke, D. F., Gillin, J. C., & Hrubovcak, J. C. (1988). Exposure to light in healthy elderly subjects and Alzheimer's patients.Physiology and Behavior, 42 141–144.

    Google Scholar 

  • Carskadon, M. A., Brown, E. D., & Dement, W. C. (1982). Sleep fragmentation in the elderly: Relationship to daytime sleep tendency.Neurobiology of Aging, 3 321–327.

    Google Scholar 

  • Coblentz, J. M., Mattis, S., Zingesser, L. H., Kasoff, S. S., Wisniewski, H. M., & Katzman, R. (1973). Presenile dementia. Clinical aspects and evaluation of cerebrospinal fluid dynamics.Archives of Neurology, 29 299–308.

    Google Scholar 

  • Dement, W. C., Carskadon, M. A., & Richardson, G. (1978). Excessive daytime sleepiness in the sleep apnea syndrome. In C. Guilleminault & W. C. Dement (Eds.),Sleep apnea syndromes (pp. 23–46). New York: Alan R. Liss.

    Google Scholar 

  • Guilleminault, C. (1983). Natural history, cardiac impact and long term follow-up of sleep apnea syndrome. In C. Guilleminault & E. Lugaresi (Eds.),Sleep/wake disorders: Natural history, epidemiology, and long-term evolution (pp. 107–24). New York: Raven Press.

    Google Scholar 

  • Guilleminault, C., Riley, R. W., & Powell, N. B. (1989). Surgical treatment of obstructive sleep apnea. In M. H. Kryger, T. Roth, & W. C. Dement (Eds.),Principles and practice of sleep medicine (pp. 571–583). Philadelphia: W. B. Saunders Company.

    Google Scholar 

  • Hauri, P. (1982).Current concepts: The sleep disorders. Kalamazoo, MI: Upjohn.

    Google Scholar 

  • He, J., Kryger, M. H., Zorick, F. J., Conway, W., & Roth, T. (1988). Mortality and apnea index in obstructive sleep apnea: Experience in 385 male patients.Chest, 94 9–14.

    Google Scholar 

  • Jacobs, D., Ancoli-Israel, S., Parker, L., & Kripke, D. F. (1989). 24-hour sleep/wake patterns in a nursing home population.Psychology and Aging, 4(3), 352–356.

    Google Scholar 

  • Jamieson, A. O. (1988). Obesity and sleep disordered breathing.Annals of Behavioral Medicine, 10 107–112.

    Google Scholar 

  • Kripke, D. F. (1985). Therapeutic effects of bright light in depressed patients.Annals of the New York Academy of Sciences, 453 270–281.

    Google Scholar 

  • Kryger, M. H. (1989). Management of obstructive sleep apnea: Overview. In M. H. Kryger, T. Roth, & W. C. Dement (Eds.),Principles and practice of sleep medicine (pp. 584–590). Philadelphia: W. B. Saunders Company.

    Google Scholar 

  • Lavie, P., Ben-Yosef, R., & Rubin, A. E. (1984). Prevalence of sleep apnea syndrome among patients with essential hypertension.American Heart Journal, 108 373.

    Google Scholar 

  • Lewy, A. J., & Sack, R. L. (1987). Phase typing and bright light therapy of chronobiologic sleep and mood disorders. In A. Halaris (Ed.),Chronobiology and psychiatric disorders (pp. 181–206). New York: Elsevier.

    Google Scholar 

  • Lugaresi, E., Cirignotta, F., Gerardi, R., & Montagna, P. (1990). Snoring and sleep apnea: Natural history of heavy snorers' disease. In C. Guilleminault & M. Partinen (Eds.),Obstructive sleep apnea syndrome: Clinical Research and Treatment (pp. 25–36). New York: Raven Press.

    Google Scholar 

  • Mason, W. J., Kripke, D. F., Messin, S., & Ancoli-Israel, S. (1986). The application and utilization of an ambulatory recording system for the screening of sleep disorders.American Journal of Electroencephalography Technology, 26 145–156.

    Google Scholar 

  • Mattis, S. (1976). Mental status examination for organic mental syndrome in the elderly patient. In L. Bellak & T. B. Katasu (Eds.),Geriatric psychiatry: A handbook for psychiatrists and primary care physicians (pp. 77–121). New York: Grune & Stratton.

    Google Scholar 

  • Mendelson, W. B. (1980).The use and misuse of sleeping pills. New York: Plenum Press.

    Google Scholar 

  • Miles, L., & Dement, W. C. (1980). Sleep and aging.Sleep, 3 119–220.

    Google Scholar 

  • Moldofsky, H., Goldstein, R., McNicholas, W. T., Lue, F., Zamel, N., & Phillipson, E. (1983). Disordered breathing during sleep and overnight intellectual deterioration in patients with pathological aging. In C. Guilleminault & E. Lugaresi (Eds.),Sleep/wake disorders: Natural history, epidemiology, and long-term evolution (pp. 143–150). New York: Raven Press.

    Google Scholar 

  • Mullaney, D. J., Kripke, D. F., & Messin, S. (1980). Wrist-actigraphic estimation of sleep time.Sleep, 3 83–92.

    Google Scholar 

  • Orr, W. C., Martin, R. J., Imes, N. K., Rogers, R. M., & Stahl, M. L. (1979). Hypersomnolent and nonhypersomnolent patients with upper airway obstruction during sleep.Chest, 75 418–422.

    Google Scholar 

  • Partinen, M., Jamieson, A., & Guilleminault, C. (1988). Long-term outcome for obstructive sleep apnea syndrome patients — Mortality.Chest, 94 1200–1204.

    Google Scholar 

  • Richardson, G. S., Carskadon, M. A., Flagg, W., van den Hoed, J., Dement, W. C., & Mitler, M. M. (1978). Excessive daytime sleepiness in man: multiple sleep latency measurement in narcoleptic and control subjects.Electroencephalography and Clinical Neurophysiology, 45 621–627.

    Google Scholar 

  • Roehrs, T., Conway, W., Wittig, R., Zorick, F., Sicklesteel, J., & Roth, T. (1985). Sleep-wake complaints in patients with sleep-related respiratory disturbances.American Review of Respiratory Disease, 132 520–523.

    Google Scholar 

  • Spielman, A. J., Saskin, P., & Thorpy, M. J. (1987). Treatment of chronic insomnia by restriction of time in bed.Sleep, 10 45–56.

    Google Scholar 

  • Sullivan, C. E., & Grunstein, R. R. (1989). Continuous positive airways pressure in sleep-dis-ordered breathing. In M. H. Kryger, T. Roth, & W. C. Dement (Eds.),Principles and practice of sleep medicine (pp. 559–570). Philadelphia: W. B. Saunders.

    Google Scholar 

  • Thorpy, M. J. (1989). Mortality in sleep apnea.Chest, 95(6), 1364.

    Google Scholar 

  • Tune, G. S. (1968). Sleep and wakefulness in normal human adults.British Medical Journal, 2 269–71.

    Google Scholar 

  • Webb, W. B., & Swinburne, H. (1971). An observational study of sleep of the aged.Perceptual and Motor Skills, 32 895–8.

    Google Scholar 

  • Williams, A. J., Houston, D., Finberg, S., Lam, C., Kinney, J. L., & Santiago, S. (1985). Sleep apnea syndrome and essential hypertension.American Journal of Cardiology, 55 1019–1022.

    Google Scholar 

  • Wittels, E. H. (1985). Obesity and hormonal factors in sleep and sleep apnea.Medical Clinics of North America, 69 1265–1280.

    Google Scholar 

  • Yesavage, J., Bliwise, D., Guilleminault, C., Carskadon, M., & Dement, W. (1985). Preliminary communication: intellectual deficit and sleep-related respiratory disturbance in the elderly.Sleep, 8 30–33.

    Google Scholar 

  • Yesavage, J. A., Brink, T. L., Rose, T. L., & Adey, M. (1983a). The geriatric depression rating scale. Comparison with other self-report and psychiatric rating scales. In T. Crook, S. Ferris, & R. Bartus (Eds.),Assessment in geriatric psychopharmacology (pp. 153–67). New Haven, CT: Mark Powles Associates.

    Google Scholar 

  • Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1983b). Development and validation of a geriatric depression screening scale: A preliminary report.Journal of Psychiatric Research, 17 37–49.

    Google Scholar 

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Authors and Affiliations

  1. Department of Psychiatry, University of California, San Diego

    Sonia Ancoli-Israel & Daniel F. Kripke

  2. Veterans Affairs Medical Center, USA

    Sonia Ancoli-Israel & Daniel F. Kripke

Authors
  1. Sonia Ancoli-Israel
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  2. Daniel F. Kripke
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Additional information

Supported by grants Nos. NIA 02711, NIA 08415, NBHLI 40930, RSDA NIMH 00117 (to DFK) and by the Veterans Affairs Research Administration. Special appreciation is given to Dr. Elizabeth Barrett-Connor, Dr. Melville R. Klauber, Robert Fell, William Mason, Linda Parker, and Jennifer Bloomquist for help with these studies.

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Ancoli-Israel, S., Kripke, D.F. Prevalent sleep problems in the aged. Biofeedback and Self-Regulation 16, 349–359 (1991). https://doi.org/10.1007/BF00999989

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