Age-Related Differences in Sleep-Wake Symptoms of Adults Undergoing Polysomnography

作者：Fragoso Carlos A Vaz^*; Van Ness Peter H; Araujo Katy L B; Iannone Lynne P; Yaggi Henry Klar

来源：Journal of the American Geriatrics Society, 2015, 63(9): 1845-1851.

DOI：10.1111/jgs.13632

• sleep-disordered breathing
• periodic limb movements
• sleep-wake symptoms
• driving capacity

OBJECTIVES: To evaluate age-related differences in sleep-wake symptoms.
DESIGN: Cross-sectional.
SETTING: Technologist-attended, laboratory-based polysomnography (PSG).
PARTICIPANTS: Community-dwelling adults aged 20 to 89 (N = 201): 52 aged 18 to 39, 72 aged 40 to 59, and 77 aged 60 and older.
MEASUREMENTS: Medical burden (Charlson Comorbidity Index, medications, health status), PSG-defined sleep disorders (sleep-disordered breathing (SDB), sleep-associated hypoxemia, periodic limb movements in sleep (PLMS)), sleep-wake symptoms (Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), fatigue (Facit-F Scale)).
RESULTS: Medical burden increased significantly with age (Charlson Comorbidity Index and number of medications, P < .001; health status, P = .005). Severity of sleep disorders also increased significantly with age (SDB and hypoxemia, P < .001; PLMS, P = .008). Conversely, sleep-wake symptoms decreased with age (daytime drowsiness (ESS = 10), P = .02; insomnia (ISI = 8), P = .04; fatigue, P < .001). In adjusted models, a 1-year increase in age was significantly associated with a 4% decrease in the odds of having daytime drowsiness (odds ratio (OR) = 0.96, 95% confidence interval (CI) = 0.93-0.98). Similarly, but only in those with mild SDB, a 1-year increase in age was significantly associated with a 5% decrease in the odds of having insomnia (OR = 0.95, 95% CI = 0.92-0.99).
CONCLUSION: Older age was characterized by less-severe sleep-wake symptoms (daytime drowsiness, insomnia, fatigue), despite an age-related increase in disease severity (medical burden, sleep disorders). Because the increase in disease severity included well-established risk factors for having sleep-wake symptoms, the age-related decrease in sleep-wake symptoms may reflect a decrease in symptom awareness.

• 出版日期2015-9