Insomnia with Short Sleep Duration in Aging Populations
2018 Physician Scientist Training Grant
Brienne Miner, MD, MHS
Key Project Outcome
Insomnia symptoms, including trouble falling asleep, staying asleep or early morning awakenings, are reported by nearly half of all adults over age 65. Not only are insomnia symptoms distressing, but they are also linked to cognitive problems, depression and poor physical function. Older adults who have both insomnia symptoms and short overnight sleep may be at heightened risk for negative consequences as a result of their sleep disruption. However, insomnia with short sleep has not been studied in older adults.
We studied insomnia with short sleep duration (less than 6 hours) in adults over age 65. We wanted to see whether also measuring short sleep duration would improve our ability to identify older adults with a more severe form of insomnia. The key outcomes of our research are three-fold. First, we studied the relationships between insomnia with short sleep and a wide range of medical conditions and medication effects in adults over age 65. We found this type of insomnia is common and linked to high medical burden and use of high-risk medications. Second, our results show that older adults with insomnia and short sleep have a higher risk for hospitalization, nursing home placement, and death. Third, we found high rates of disagreement between self-reported versus objectively-measured overnight sleep time. This disagreement suggests that relying on self-reported measures alone may lead to missed treatment opportunities or unnecessary and potentially harmful treatments. Thus, in older adults with insomnia, we also need to objectively measure overnight sleep time. Not only will this improve accuracy of our methods, it will also identify older adults in whom treatment should be prioritized. Ultimately, adding objective measures of overnight sleep time could transform the way that we assess sleep in older adults, leading to methods that improve identification of high-risk sleep problems and prevent their negative consequences.