Sleep and affect in older adults: using multilevel modeling to examine daily associations

The main objective of the present study was to examine daily associations (intraindividual variability or IIV) between sleep and affect in older adults. Greater understanding of these associations is important, because both sleep and affect represent modifiable behaviors that can have a major influence on older adults’ health and well‐being. We collected sleep diaries, actigraphy, and affect data concurrently for 14 days in 103 community‐dwelling older adults. Multilevel modeling was used to assess the sleep–affect relationship at both the group (between‐persons) and individual (within‐person or IIV) levels. We hypothesized that nights characterized by better sleep would be associated with days characterized by higher positive affect and lower negative affect, and that the inverse would be true for poor sleep. Daily associations were found between affect and subjective sleep, only and were in the hypothesized direction. Specifically, nights with greater reported awake time or lower sleep quality ratings were associated with days characterized by less positive affect and more negative affect. Gender was not a significant main effect in the present study, despite previous research suggesting gender differences in the sleep–affect relationship. The fact that self‐ratings of sleep emerged as the best predictors of affect may suggest that perceived sleep is a particularly important predictor. Finally, our results suggest exploration of affect as a potential intervention target in late‐life insomnia is warranted.

[1]  Larry E. Toothaker,et al.  Multiple Regression: Testing and Interpreting Interactions , 1991 .

[2]  P. Hauri,et al.  Wrist actigraphy in insomnia. , 1992, Sleep.

[3]  F. Snyder,et al.  Recorded and reported sleep in chronic primary insomnia. , 1976, Archives of general psychiatry.

[4]  M. Ferrara,et al.  The relationship between alexithymia, depression, and sleep complaints , 2004, Psychiatry Research.

[5]  R. Meddis.  Bipolar factors in mood adjective checklists. , 1972, The British journal of social and clinical psychology.

[6]  C. Espie,et al.  Use of the Sleep Assessment Device (Kelley and Lichstein, 1980) to validate insomniacs' self-report of sleep pattern , 1989 .

[7]  D. Watson,et al.  Cross-cultural convergence in the structure of mood: A Japanese replication and a comparison with U.S. findings , 1984 .

[8]  Dylan M. Jones,et al.  Refining the measurement of mood: The UWIST Mood Adjective Checklist , 1990 .

[9]  Lisa M. Johnson,et al.  Positive affect as a source of resilience for women in chronic pain. , 2005, Journal of consulting and clinical psychology.

[10]  W. B. Webb,et al.  Sleep and cognitive functions in normal older adults. , 1985, Journal of gerontology.

[11]  J. Singer,et al.  The design and analysis of longitudinal studies of development and psychopathology in context: Statistical models and methodological recommendations , 1998, Development and Psychopathology.

[12]  S. MacDonald,et al.  Intraindividual variability in cognitive performance in older adults: comparison of adults with mild dementia, adults with arthritis, and healthy adults. , 2000, Neuropsychology.

[13]  M. Lorr,et al.  An Analysis of Mood States , 1967 .

[14]  Meredeth A Rowe,et al.  Sleep complaints, subjective and objective sleep patterns, health, psychological adjustment, and daytime functioning in community-dwelling older adults. , 2005, The journals of gerontology. Series B, Psychological sciences and social sciences.

[15]  S. Davidson,et al.  Physician retention in community and migrant health centers: who stays and for how long? , 1998, Medical care.

[16]  B. Törestad.  Problems and methods in longitudinal research : stability and change , 1991 .

[17]  E. Pedhazur.  Multiple Regression in Behavioral Research: Explanation and Prediction , 1982 .

[18]  C. Morin,et al.  Role of Stress, Arousal, and Coping Skills in Primary Insomnia , 2003, Psychosomatic medicine.

[19]  Keith F. Widaman,et al.  New Methods for the Analysis of Change , 2003 .

[20]  Daniel W. Russell,et al.  The cognition–emotion process in achievement-related contexts. , 1979 .

[21]  T. Coates,et al.  First night effects in good sleepers and sleep-maintenance insomniacs when recorded at home. , 1981, Sleep.

[22]  C. Morin,et al.  Nonpharmacological treatment of late-life insomnia. , 1999, Journal of psychosomatic research.

[23]  P. Montgomery,et al.  A systematic review of non-pharmacological therapies for sleep problems in later life. , 2004, Sleep medicine reviews.

[24]  W. B. Webb,et al.  Mood and sleep in aging women. , 1985, Journal of personality and social psychology.

[25]  C. Espie.  The Psychological Treatment of Insomnia , 1991 .

[26]  N. Kalin,et al.  Emotion, plasticity, context, and regulation: perspectives from affective neuroscience. , 2000, Psychological bulletin.

[27]  R. Erber,et al.  Mood and processing: A view from a self-regulation perspective. , 2001 .

[28]  R. Larsen.  Toward a Science of Mood Regulation , 2000 .

[29]  M. Griffin,et al.  The mental and physical health outcomes of green exercise , 2005, International journal of environmental health research.

[30]  W. Mischel,et al.  A cognitive-affective system theory of personality: reconceptualizing situations, dispositions, dynamics, and invariance in personality structure. , 1995, Psychological review.

[31]  J. Cacioppo,et al.  Relationship between attitudes and evaluative space: A critical review, with emphasis on the separability of positive and negative substrates. , 1994 .

[32]  R. J. Sullivan,et al.  Sleep in the laboratory and sleep at home: comparisons of older insomniacs and normal sleepers. , 1997, Sleep.

[33]  K. Greenwood,et al.  Identifying effective psychological treatments for insomnia: a meta-analysis. , 1995, Journal of consulting and clinical psychology.

[34]  R. Kessler,et al.  Effects of daily stress on negative mood. , 1989, Journal of personality and social psychology.

[35]  J. Singer,et al.  Applied Longitudinal Data Analysis , 2003 .

[36]  H. Kraemer,et al.  Can state and trait variables be disentangled? A methodological framework for psychiatric disorders , 1994, Psychiatry Research.

[37]  Daniel J. Taylor,et al.  'Young old' and 'old old' poor sleepers with and without insomnia complaints. , 2003, Journal of psychosomatic research.

[38]  C. Lombardo,et al.  Are polysomnographic measures of sleep correlated to alexithymia? A study on laboratory-adapted sleepers. , 2002, Journal of psychosomatic research.

[39]  G. Kvale,et al.  Nonpharmacological interventions for insomnia in older adults: A meta-analysis of treatment efficacy. , 1998 .

[40]  A. Harvey.  A cognitive model of insomnia. , 2002, Behaviour research and therapy.

[41]  L. Creti,et al.  A COGNITIVE MODEL OF INSOMNIA , 2022 .

[42]  K. Lichstein,et al.  Psychological Treatment of Late-Life Insomnia , 1998, Annual Review of Gerontology and Geriatrics.

[43]  W. B. Webb,et al.  State Measures and Sleep Stages , 1983, Psychological reports.

[44]  R B Briner,et al.  Associations of sleep with everyday mood, minor symptoms and social interaction experience. , 1994, Sleep.

[45]  J. Russell.  Affective space is bipolar. , 1979 .

[46]  C. Cooper,et al.  Mood variability and the intensity of depressive states , 1996 .

[47]  G. Freeman.  THE PSYCHOLOGICAL TREATMENT OF INSOMNIA , 1991 .

[48]  Judith D. Singer,et al.  Using SAS PROC MIXED to Fit Multilevel Models, Hierarchical Models, and Individual Growth Models , 1998 .

[49]  C. Morin,et al.  Variability and predictability in sleep patterns of chronic insomniacs , 2005, Journal of sleep research.

[50]  M. Lumley,et al.  Alexithymia and Polysomnographic Measures of Sleep in Healthy Adults , 2001, Psychosomatic medicine.

[51]  R. Bootzin,et al.  Derivation of research diagnostic criteria for insomnia: report of an American Academy of Sleep Medicine Work Group. , 2004, Sleep.

[52]  I G Kreft,et al.  The Effect of Different Forms of Centering in Hierarchical Linear Models. , 1995, Multivariate behavioral research.

[53]  D. Watson,et al.  Development and validation of brief measures of positive and negative affect: the PANAS scales. , 1988, Journal of personality and social psychology.

[54]  J. Desmond,et al.  Hemispheric asymmetry for emotional stimuli detected with fMRI , 1998, Neuroreport.

[55]  J. Edinger,et al.  Accuracy of sleep perceptions among insomnia sufferers and normal sleepers. , 2003, Sleep medicine.

[56]  R. Bosker.  Boekbespreking van "A.S. Bryk & S.W. Raudenbusch - Hierarchical linear models: Applications and data analysis methods" : Sage Publications, Newbury Parki, London/New Delhi 1992 , 1995 .

[57]  G. Marsh,et al.  Sleep variability across consecutive nights of home monitoring in older mixed DIMS patients. , 1991, Sleep.

[58]  J. Desmond,et al.  An fMRI study of personality influences on brain reactivity to emotional stimuli. , 2001, Behavioral neuroscience.

[59]  John R. Nesselroade,et al.  Short-Term Fluctuations in Elderly People’s Sensorimotor Functioning Predict Text and Spatial Memory Performance: The MacArthur Successful Aging Studies , 2001, Gerontology.

[60]  J. Cacioppo,et al.  The affect system has parallel and integrative processing components: Form follows function. , 1999 .

[61]  J. Singer,et al.  Early child-care selection: variation by geographic location, maternal characteristics, and family structure. , 1998, Developmental psychology.