Percentile reference charts for selected sleep parameters for 20- to 80-Year-Old healthy subjects from the SIESTA database

SummaryQuestion of the studyOne of the aims of the SIESTA project was to establish a normative database of sleep parameters for healthy and sleep-disturbed patients. Reference data for sleep parameters in non-sleep-disturbed subjects are scarce and usually refer to means and standard deviations. However, since most of the parameters do not follow a Gaussian distribution, percentiles of the distribution provide more detailed information.Subjects and methodsThe present results are based on data from 198 healthy, non-sleep-disturbed subjects (104 females) in the age range of 20 to 95 years. For every subject, two consecutive nights were polysomnographically recorded in one of the eight participating clinical centres. Percentile charts were created on the basis of moving averages computed for 10 year age intervals with the presented age being the midpoint of the underlying interval. The resulting percentile curves were smoothed by a spline function. Since sample size in the oldest age groups is comparatively small, the percentile curves are restricted to the age range of 20 to 80 years.ResultsPercentile curves have been created for the parameters sleep period time (SPT), total sleep time (TST), sleep onset latency, REM sleep latency, sleep efficiency index, and percentages of NREM1, NREM2, REM sleep, SWS, and WAKE (with reference to SPT). The charts reflect the known changes of sleep parameters with age, e.g. decrease of TST and sleep efficiency with increasing age.ConclusionThe reference charts are intended to be a helpful tool to evaluate selected aspects of sleep quality in sleep-disturbed patients.ZusammenfassungFragestellungEines der Ziele des SIESTA-Projekts war die Erstellung einer normativen Datenbank für Schlafparameter von gesunden Probanden und Patienten mit Schlafstörungen. Referenzdaten zum Schlaf von nicht schlafgestörten Personen sind rar und werden gewöhnlich in Form von Mittelwerten und Standardabweichungen angegeben. Da die meisten Schlafparameter jedoch keine Normalverteilung aufweisen, sind Perzentilkurven informativer.Probanden und MethodikDie vorliegenden Ergebnisse basieren auf Daten von 198 nicht schlafgestörten Personen (104 Frauen) im Alter von 20 bis 95 Jahren. Bei jedem Probanden wurden in einem der acht teilnehmenden Zentren zwei aufeinanderfolgende Nächte polysomnographisch aufgezeichnet. Die Perzentilkurven wurden auf der Basis gleitender Mittelwerte für 10 Jahresintervalle ermittelt, wobei das Bezugsalter den Mittelpunkt des zugrundeliegenden Altersintervalls darstellt. Die resultierenden Perzentile wurden mit einer Spline-Funktion geglättet. Da der Stichprobenumfang in der höchsten Altersklasse vergleichsweise klein war, sind die Perzentilkurven auf die Altersspanne 20 bis 80 Jahre beschränkt.ErgebnissePerzentilkurven für die Parameter Schlafperiodenzeit, Gesamtschlafzeit, Einschlaflatenz, REM-Schlaf-Latenz und Schlafeffizienz-Index sowie für die prozentualen Anteile der Stadien NREM1, NREM2, REM-Schlaf, Tiefschlaf und Wach nach Schlafbeginn an der Schlafperiodenzeit erstellt. Die Kurven spiegeln die bekannten Veränderungen der Schlafparameter mit dem Alter wider, so z. B. die Abnahme der Gesamtschlafzeit und der Schlafeffizienz mit zunehmendem Alter.SchlussfolgerungDie Referenz-Kurven sind als einfach zu handhabende Bewertungshilfen für ausgewählte Aspekte der Schlafqualität bei Patienten mit Schlafstörungen gedacht.

[1]  H. Agnew,et al.  SLEEP PATTERNS IN YOUNG ADULTS: AN EEG STUDY. , 1964, Electroencephalography and clinical neurophysiology.

[2]  I Feinberg,et al.  EEG sleep patterns as a function of normal and pathological aging in man. , 1967, Journal of psychiatric research.

[3]  W W Webb,et al.  Sleep patterns in late middle age males: an EEG study. , 1967, Electroencephalography and clinical neurophysiology.

[4]  R. Walter,et al.  MEASUREMENTS OF ALL‐NIGHT SLEEP IN NORMAL ELDERLY PERSONS: EFFECTS OF AGING * , 1967, Journal of the American Geriatrics Society.

[5]  A. Rechtschaffen,et al.  A manual of standardized terminology, technique and scoring system for sleep stages of human subjects , 1968 .

[6]  E. Kahn,et al.  THE SLEEP CHARACTERISTICS OF THE NORMAL AGED MALE , 1969, The Journal of nervous and mental disease.

[7]  C. Fisher,et al.  Sleep characteristics of the human aged female. , 1970, Comprehensive psychiatry.

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

[9]  H W Agnew Integrator analysis of the sleep electroencephalogram. , 1973, Electroencephalography and clinical neurophysiology.

[10]  I Feinberg,et al.  Changes in sleep cycle patterns with age. , 1974, Journal of psychiatric research.

[11]  P. Prinz Sleep Patterns in the Healthy Aged: Relationship With Intellectual Function , 1977 .

[12]  R. Spiegel Sleep and Sleeplessness in Advanced Age , 1980 .

[13]  W. B. Webb,et al.  A modified method for scoring slow wave sleep of older subjects. , 1982, Sleep.

[14]  W. B. Webb Sleep in older persons: sleep structures of 50- to 60-year-old men and women. , 1982, Journal of gerontology.

[15]  S. Endo,et al.  All-night sleep polygraphic recordings of healthy aged persons: REM and slow-wave sleep. , 1982, Sleep.

[16]  J A Jacoby,et al.  Nocturnal sleep and wakefulness: effects of age and sex in normal sleepers. , 1984, The International journal of neuroscience.

[17]  D. Kupfer,et al.  Sleep of healthy seniors: a revisit. , 1985, Sleep.

[18]  D. Kupfer,et al.  Effects of age on delta and REM sleep parameters. , 1989, Electroencephalography and clinical neurophysiology.

[19]  Daniel J Buysse,et al.  Electroencephalographic sleep in the healthy "old old": a comparison with the "young old" in visually scored and automated measures. , 1991, Journal of gerontology.

[20]  M. Hirshkowitz,et al.  Polysomnography of Adults and Elderly: Sleep Architecture, Respiration, and Leg Movement , 1992, Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society.

[21]  R. Thisted,et al.  Sleep and Psychiatric Disorders: A Meta-analysis , 1992 .

[22]  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.

[23]  M. Billiard,et al.  Sleep and psychiatric disorders. , 1994, Journal of psychosomatic research.

[24]  P. Achermann,et al.  Effect of age on the sleep EEG: slow-wave activity and spindle frequency activity in young and middle-aged men , 1996, Brain Research.

[25]  Daniel J Buysse,et al.  Sleep and morningness‐eveningness in the ‘middle’ years of life (20–59y) , 1997, Journal of sleep research.

[26]  E. van Cauter,et al.  Age-related changes in slow wave sleep and REM sleep and relationship with growth hormone and cortisol levels in healthy men. , 2000, JAMA.

[27]  T H Monk,et al.  The effects of age and gender on sleep EEG power spectral density in the middle years of life (ages 20-60 years old). , 2001, Psychophysiology.

[28]  A. Varri,et al.  The SIESTA project polygraphic and clinical database , 2001, IEEE Engineering in Medicine and Biology Magazine.

[29]  Hans-Peter Landolt,et al.  Age-dependent changes in sleep EEG topography , 2001, Clinical Neurophysiology.

[30]  Alpo Värri,et al.  Das Projekt SIESTA , 2001 .

[31]  H. Magnussen,et al.  Literature-based values of control subjects in sleep medicine , 2003 .

[32]  D. Riemann,et al.  Sleep in depression: the influence of age, gender and diagnostic subtype on baseline sleep and the cholinergic REM induction test with RS 86 , 2005, European Archives of Psychiatry and Clinical Neuroscience.