Effects of aging on sleep structure throughout adulthood: a population-based study.

OBJECTIVE Although many studies have shown the evolution of sleep parameters across the lifespan, not many have included a representative sample of the general population. The objective of this study was to describe age-related changes in sleep structure, sleep respiratory parameters and periodic limb movements of the adult population of São Paulo. METHODS We selected a representative sample of the city of São Paulo, Brazil that included both genders and an age range of 20-80 years. Pregnant and lactating women, people with physical or mental impairments that prevent self-care and people who work every night were not included. This sample included 1024 individuals who were submitted to polysomnography and structured interviews. We subdivided our sample into five-year age groups. One-way analysis of variance was used to compare age groups. Pearson product-moment was used to evaluate correlation between age and sleep parameters. RESULTS Total sleep time, sleep efficiency, percentage of rapid eye movement (REM) sleep and slow wave sleep showed a significant age-related decrease (P<0.05). WASO (night-time spent awake after sleep onset), arousal index, sleep latency, REM sleep latency, and the percentage of stages 1 and 2 showed a significant increase (P<0.05). Furthermore, apnea-hypopnea index increased and oxygen saturation decreased with age. The reduction in the percentage of REM sleep significantly correlated with age in women, whereas the reduction in the percentage of slow wave sleep correlated with age in men. The periodic limb movement (PLM) index increased with age in men and women. CONCLUSIONS Sleep structure and duration underwent significant alterations throughout the aging process in the general population. There was an important correlation between age, sleep respiratory parameters and PLM index. In addition, men and women showed similar trends but with different effect sizes.

[1]  Daniel J Buysse,et al.  Sleep stage physiology, mood, and vigilance responses to total sleep deprivation in healthy 80-year-olds and 20-year-olds. , 1990, Psychophysiology.

[2]  Daniel J Buysse,et al.  A longitudinal study of laboratory- and diary-based sleep measures in healthy "old old" and "young old" volunteers. , 1994, Sleep.

[3]  Jacob Cohen Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[4]  A. Chesson,et al.  The American Academy of Sleep Medicine (AASM) Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications , 2007 .

[5]  J. Thornby,et al.  THE ELECTROENCEPHALOGRAM SLEEP PATTERNS OF MIDDLE-AGED MALES , 1972, The Journal of nervous and mental disease.

[6]  J. Gaillard,et al.  Chronic primary insomnia: possible physiopathological involvement of slow wave sleep deficiency. , 1978, Sleep.

[7]  V. Březinová The number and duration of the episodes of the various EEG stages of sleep in young and older people. , 1975, Electroencephalography and clinical neurophysiology.

[8]  C. Guilleminault,et al.  Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. , 2004, Sleep.

[9]  J. Kamiya,et al.  Effect of aging on sleep-related changes in respiratory variables. , 1987, Sleep.

[10]  S. Tufik,et al.  Sao Paulo Epidemiologic Sleep Study: rationale, design, sampling, and procedures. , 2009, Sleep medicine.

[11]  J. Montplaisir,et al.  The influence of sex, age and sleep/wake state on characteristics of periodic leg movements in restless legs syndrome patients , 1999, Clinical Neurophysiology.

[12]  R. Natarajan Review of periodic limb movement and restless leg syndrome. , 2010, Journal of postgraduate medicine.

[13]  D. Kripke,et al.  Actigraphy suggests age‐related differences in napping and nocturnal sleep , 2003, Journal of sleep research.

[14]  N. Punjabi The epidemiology of adult obstructive sleep apnea. , 2008, Proceedings of the American Thoracic Society.

[15]  M. Vitiello,et al.  Sleep complaints cosegregate with illness in older adults: clinical research informed by and informing epidemiological studies of sleep. , 2002, Journal of psychosomatic research.

[16]  D Kurtz,et al.  Breathing during sleep in normal young and elderly subjects: hypopneas, apneas, and correlated factors. , 1983, Sleep.

[17]  Frederick K. Goodwin,et al.  Age-related changes in sleep in depressed and normal subjects , 1981, Psychiatry Research.

[18]  M. Ohayon,et al.  Daytime sleepiness and cognitive impairment in the elderly population. , 2002, Archives of internal medicine.

[19]  T H Monk,et al.  Napping and 24‐Hour Sleep/Wake Patterns in Healthy Elderly and Young Adults , 1992, Journal of the American Geriatrics Society.

[20]  D. Dijk,et al.  Age-related increase in awakenings: impaired consolidation of nonREM sleep at all circadian phases. , 2001, Sleep.

[21]  L Parrino,et al.  Effect of age on EEG arousals in normal sleep. , 1998, Sleep.