Interactions between sleep normative data and sociocultural characteristics in the elderly

https://doi.org/10.1016/j.psychores.2004.04.365Get rights and content

Abstract

Objective

To present sleep patterns in elderly individuals and factors associated with short sleep and long daytime and nighttime sleep.

Methods

A total of 8091 subjects aged between 55 and 101 years representative of the noninstitutionalized general population of seven European countries (France, Finland, Italy, Germany, Portugal, Spain, and UK) were interviewed by telephone about their sleep habits and sleep disorders.

Results

The average sleep duration was 6 h and 57 min. Sleep duration was longer in men than in women. Five percent of the sample slept 5 h or less and 5% slept 9 h or more per night. Factors associated with short sleep (lower fifth percentile) were age, living in UK, no physical exercise, drinking six cups of coffee or more per day, taking a medication for sleep, difficulty initiating sleep, disrupted sleep, early morning awakening, and presence of an anxiety disorder. Factors associated with long sleep (≥95th percentile) were age, living in France, Portugal, or Spain, being underweight, no physical exercise, disrupted sleep, taking a medication for sleep, and presence of an anxiety disorder. Long daytime sleep (54 min or more) were age, being a man, being overweight or obese, physical disease, being dissatisfied with one's social life, smoking, drinking alcohol, and having a major depressive disorder.

Conclusion

Sleep patterns considerably varied among the countries in the elderly population. Extreme values of sleep duration (short and long sleep) were associated with several sleep and mental health problems.

Introduction

The aging process is accompanied by modifications in the social and family status, biological changes, and in the sleep architecture. On the sociofamilial level, impending to retirement, children leaving the family home, and the death of a spouse, relatives, and friends are all stressors that are more frequently experienced in elderly people [1], [2], [3], [4], [5]. On biological levels, changes occur in the immune, respiratory, and cardiovascular systems [6], [7], [8]. Changes in the sleep architecture can be observed on several levels: The sleep efficiency and slow-wave sleep are decreasing, and the time awake after sleep onset is increasing [9], [10], [11], [12]. A shift toward earlier bedtime and earlier wake-up time has also been observed [13]. However, these changes are not necessarily accompanied by complaints of poor sleep; many elderly individuals are satisfied with their sleep [14], [15]. In fact, most people adapt their perception of a good sleep as they age. Although sleep architectural changes with age in healthy individuals are well documented, few studies have focused on qualitative and quantitative sleep in elderly people living in a community.

This study has two aims: first, to present normative sleep data of a community-based elderly sample representative of the general population of seven European countries in terms of sleep–wake characteristics. Second, to determine if growing older is associated with extreme values (i.e., in the fifth lower and upper percentiles) of the sleep–wake characteristics, which would support, at least in part, that changes in sleep are associated with increased age. If age is not associated with the extreme values, this would support the hypothesis that factors other than age are responsible for changes in the sleep–wake characteristics.

Section snippets

Design of the samples

This study was performed in the noninstitutionalized general population representative of seven European countries: France, UK, Germany, Italy, Portugal, Spain, and Finland. These seven countries total 255.5 million of Europeans aged 15 years or older.

In all these countries, the samples were drawn using a two-stage procedure. At the first stage, telephone numbers were selected with respect to the distribution of the population according to the different states (or areas) of each studied

Sociodemographic characteristics

The sample used for analyses included 8091 subjects aged between 55 and 101 years. French subjects represented 21.4% of the sample; British subjects, 19.9%; German subjects, 16%; Italians, 15.9%; Spanish, 15.5%; Portuguese, 7.1%; and Finnish subjects, 4% of the sample.

Age and gender distributions were similar for each country (Table 1). Subjects older than 74 years represented 20.7% of the sample.

Italy and Spain had the lowest rates of separated or divorced individuals and Finland had the

Discussion

Information related to the distribution of different sleep parameters in the general population is scarce. We collected such information from 8090 subjects aged 55 years or older representative of seven European countries of which 20.7% were 75 years or older. This group of elderly was composed mostly of women (64.4%). Cultural differences can already be observed in sociodemographic characteristics. For example, Italy and Spain had very low rates of divorce and women were less likely to work

Acknowledgements

This research was supported by the Fond de la Recherche en Santé du Quebec (FRSQ, grant #971067) and by an unrestricted grant from Sanofi-Synthelabo Group.

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