Study: Poor sleep quality can lead to cognitive problems in older men

2 Apr

Moi has posted quite a bit about the effect of sleep deprivation on children and teens. A study of older men published in the Journal Sleep details the effect of sleep deprivation on older men. The bottom line is that no matter one’s age, in order to fully function, people need adequate rest.

Science Daily reported in the article, Poor sleep quality linked to cognitive decline in older men:

A new study of older men found a link between poor sleep quality and the development of cognitive decline over three to four years. Results show that higher levels of fragmented sleep and lower sleep efficiency were associated with a 40 to 50 percent increase in the odds of clinically significant decline in executive function, which was similar in magnitude to the effect of a five-year increase in age. In contrast, sleep duration was not related to subsequent cognitive decline.
“It was the quality of sleep that predicted future cognitive decline in this study, not the quantity,” said lead author Terri Blackwell, MA, senior statistician at the California Pacific Medical Center Research Institute (CPMCRI) in San Francisco, Calif. “With the rate of cognitive impairment increasing and the high prevalence of sleep problems in the elderly, it is important to determine prospective associations with sleep and cognitive decline.”
The study involved 2,822 community-dwelling older men at six clinical centers in the U.S. Participants had a mean age of 76 years. The study is published in the April 1 issue of the journal Sleep.
“This study provides an important reminder that healthy sleep involves both the quantity and quality of sleep,” said American Academy of Sleep Medicine President Dr. M. Safwan Badr. “As one of the pillars of a healthy lifestyle, sleep is essential for optimal cognitive functioning.”
The population-based, longitudinal study was conducted by a research team led by Dr. Katie Stone, senior scientist at CPMCRI in San Francisco, Calif. Institutions represented by study collaborators include the University of California, San Francisco; University of California, San Diego; Harvard Medical School; University of Minnesota; and several Veterans Affairs medical centers….
http://www.sciencedaily.com/releases/2014/03/140331170557.htm

Citation:

VOLUME 37, ISSUE 04

ASSOCIATION OF SLEEP QUALITY WITH SUBSEQUENT COGNITIVE DECLINE IN OLDER MEN
Associations of Objectively and Subjectively Measured Sleep Quality with Subsequent Cognitive Decline in Older Community-Dwelling Men: The MrOS Sleep Study
http://dx.doi.org/10.5665/sleep.3562
Terri Blackwell, MA1; Kristine Yaffe, MD2; Alison Laffan, PhD1; Sonia Ancoli-Israel, PhD3; Susan Redline, MD, MPH4; Kristine E. Ensrud, MD, MPH5; Yeonsu Song, PhD1; Katie L. Stone, PhD1
1Research Institute, California Pacific Medical Center, San Francisco, CA; 2Departments of Psychiatry, Neurology, and Epidemiology, University of California, San Francisco, San Francisco VA Medical Center, San Francisco, CA; 3Department of Psychiatry and Medicine, University of California, San Diego, La Jolla, CA and the Veterans Affairs San Diego Center of Excellence for Stress and Mental Health, San Diego, CA; 4Departments of Medicine, Brigham and Women’s Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; 5Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MN; Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
Study Objectives:
To examine associations of objectively and subjectively measured sleep with subsequent cognitive decline.
Design:
A population-based longitudinal study.
Setting:
Six centers in the United States.
Participants:
Participants were 2,822 cognitively intact community-dwelling older men (mean age 76.0 ± 5.3 y) followed over 3.4 ± 0.5 y.
Interventions:
None.
Measurements and Results:
Objectively measured sleep predictors from wrist actigraphy: total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), number of long wake episodes (LWEP). Self-reported sleep predictors: sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daytime sleepiness (Epworth Sleepiness Scale [ESS]), TST. Clinically significant cognitive decline: five-point decline on the Modified Mini-Mental State examination (3MS), change score for the Trails B test time in the worse decile. Associations of sleep predictors and cognitive decline were examined with logistic regression and linear mixed models. After multivariable adjustment, higher levels of WASO and LWEP and lower SE were associated with an 1.4 to 1.5-fold increase in odds of clinically significant decline (odds ratio 95% confidence interval) Trails B test: SE < 70% versus SE ≥ 70%: 1.53 (1.07, 2.18); WASO ≥ 90 min versus WASO < 90 min: 1.47 (1.09, 1.98); eight or more LWEP versus fewer than eight: 1.38 (1.02, 1.86). 3MS: eight or more LWEP versus fewer than eight: 1.36 (1.09, 1.71), with modest relationships to linear change in cognition over time. PSQI was related to decline in Trails B performance (3 sec/y per standard deviation increase).
Conclusions:
Among older community-dwelling men, reduced sleep efficiency, greater nighttime wakefulness, greater number of long wake episodes, and poor self-reported sleep quality were associated with subsequent cognitive decline.
Citation:
Blackwell T; Yaffe K; Laffan A; Ancoli-Israel S; Redline S; Ensrud KE; Song Y; Stone KL. Associations of objectively and subjectively measured sleep quality with subsequent cognitive decline in older community-dwelling men: the MrOS sleep study. SLEEP 2014;37(4):655-663.

Here is the press release from the American Academy of Sleep Medicine:

Poor sleep quality linked to cognitive decline in older men
American Academy of Sleep Medicine
Monday, March 31, 2014
FOR IMMEDIATE RELEASE
CONTACT: Lynn Celmer, 630-737-9700, ext. 9364, lcelmer@aasmnet.org
DARIEN, IL – A new study of older men found a link between poor sleep quality and the development of cognitive decline over three to four years.
Results show that higher levels of fragmented sleep and lower sleep efficiency were associated with a 40 to 50 percent increase in the odds of clinically significant decline in executive function, which was similar in magnitude to the effect of a five-year increase in age. In contrast, sleep duration was not related to subsequent cognitive decline.
“It was the quality of sleep that predicted future cognitive decline in this study, not the quantity,” said lead author Terri Blackwell, MA, senior statistician at the California Pacific Medical Center Research Institute (CPMCRI) in San Francisco, Calif. “With the rate of cognitive impairment increasing and the high prevalence of sleep problems in the elderly, it is important to determine prospective associations with sleep and cognitive decline.”
The study involved 2,822 community-dwelling older men at six clinical centers in the U.S. Participants had a mean age of 76 years. The study is published in the April 1 issue of the journal Sleep.
“This study provides an important reminder that healthy sleep involves both the quantity and quality of sleep,” said American Academy of Sleep Medicine President Dr. M. Safwan Badr. “As one of the pillars of a healthy lifestyle, sleep is essential for optimal cognitive functioning.”
The population-based, longitudinal study was conducted by a research team led by Dr. Katie Stone, senior scientist at CPMCRI in San Francisco, Calif. Institutions represented by study collaborators include the University of California, San Francisco; University of California, San Diego; Harvard Medical School; University of Minnesota; and several Veterans Affairs medical centers.
An average of five nights of objective sleep data were collected from each participant using a wrist actigraph. Cognitive function assessment included evaluation of attention and executive function using the Trails B test. According to the authors, executive function is the ability for planning or decision making, error correction or trouble shooting, and abstract thinking. Results were adjusted for potential confounding factors such as depressive symptoms, comorbidities and medication use.
The underlying mechanisms relating disturbed sleep to cognitive decline remain unknown, the authors noted. They added that additional research is needed to determine if these associations hold after a longer follow-up period.
Funding was provided by the National Heart, Lung, and Blood Institute (NHLBI) for the Outcomes of Sleep Disorders in Men Study, an ancillary study of the parent Osteoporotic Fractures in Men (MrOS) Study, which was supported by the National Institutes of Health (NIH).
To request a copy of the study,“Associations of Objectively and Subjectively Measured Sleep Quality with Subsequent Cognitive Decline in Older Community-Dwelling Men: The MrOS Sleep Study,” or to arrange an interview with the study author or an AASM spokesperson, please contact Communications Coordinator Lynn Celmer at 630-737-9700, ext. 9364, or lcelmer@aasmnet.org.
The monthly, peer-reviewed, scientific journal Sleep is published online by the Associated Professional Sleep Societies LLC, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. The AASM is a professional membership society that improves sleep health and promotes high quality patient centered care through advocacy, education, strategic research, and practice standards (www.aasmnet.org). A searchable directory of AASM accredited sleep centers is available at http://www.sleepeducation.com.

According to the Centers for Disease Control (CDC), insufficient sleep is a public health epidemic.

In the article, Insufficient Sleep Is a Public Health Epidemic, the CDC reports:

How Much Sleep Do We Need? And How Much Sleep Are We Getting?
How much sleep we need varies between individuals but generally changes as we age. The National Institutes of Health suggests that school-age children need at least 10 hours of sleep daily, teens need 9-105 hours, and adults need 7-8 hours. According to data from the National Health Interview Survey, nearly 30% of adults reported an average of ≤6 hours of sleep per day in 2005-2007.3 In 2009, only 31% of high school students reported getting at least 8 hours of sleep on an average school night.4
Sleep Hygiene Tips
The promotion of good sleep habits and regular sleep is known as sleep hygiene. The following sleep hygiene tips can be used to improve sleep.
• Go to bed at the same time each night and rise at the same time each morning.
• Avoid large meals before bedtime.
• Avoid caffeine and alcohol close to bedtime.
• Avoid nicotine.
(Sleep Hygiene Tips adapted from the National Sleep Foundation ) http://www.cdc.gov/features/dssleep/

More Americans of all ages need to begin getting a good night’s sleep.

Resources:

National Sleep Foundation’s Teens and Sleep http://www.sleepfoundation.org/article/sleep-topics/teens-and-sleep

Teen Health’s Common Sleep Problems http://kidshealth.org/teen/your_body/take_care/sleep.html

CBS Morning News’ Sleep Deprived Kids and Their Disturbing Thoughts
http://www.cbsnews.com/2100-500165_162-6052150.html

Psychology Today’s Sleepless in America
http://www.psychologytoday.com/blog/sleepless-in-america

National Association of State Board’s of Education Fit, Healthy and Ready to Learn
http://eric.ed.gov/?id=ED465734

U.S. Department of Education’s Tools for Success http://www2.ed.gov/parents/academic/help/tools-for-success/index.html

Related:

Another study: Sleep problems can lead to behavior problems in children
https://drwilda.com/2013/03/30/another-study-sleep-problems-can-lead-to-behavior-problems-in-children/

Stony Brook Medicine study: Teens need sleep to function properly and make healthy food choices https://drwilda.com/2013/06/21/stony-brook-medicine-study-teens-need-sleep-to-function-properly-and-make-healthy-food-choices/

University of Massachusetts Amherst study: Preschoolers need naps Does school start too early? https://drwilda.com/tag/too-little-sleep-raises-obesity-risk-in-children/

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One Response to “Study: Poor sleep quality can lead to cognitive problems in older men”

Trackbacks/Pingbacks

  1. University of St. Thomas study: Sleep problems equal to marijuana use and drinking in predicting poor academic performance in college | drwilda - June 4, 2014

    […] Moi has posted quite a bit about the effect of sleep deprivation on children and teens. A study of older men published in the Journal Sleep details the effect of sleep deprivation on older men. The bottom line is that no matter one’s age, in order to fully function, people need adequate rest. See, Study: Poor sleep quality can lead to cognitive problems in older men https://drwilda.com/2014/04/02/study-poor-sleep-quality-can-lead-to-cognitive-problems-in-older-men/ […]

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