MONDAY, Feb. 10, 2003 (HealthDayNews) -- Elderly people who don't sleep well may have more than mental alertness to worry about: They are also more likely to die sooner than their sound-slumbering counterparts, a new study suggests.
Sleep difficulties, such as having trouble falling asleep or middle-of-the-night waking, significantly increased the risk of death in seemingly healthy older individuals, say the authors of a study in the current issue of Psychosomatic Medicine.
"We were surprised because the people we studied were so healthy at the time we looked at them," says study author Mary Amanda Dew, a professor of psychiatry, psychology and endocrinology at the University of Pittsburgh School of Medicine.
Of 185 people primarily in their 60s to 80s who began the study, 66 had died in the follow-up period that averaged about 12 years.
None of the participants had major health problems when they entered the study and none thought they had sleep problems, Dew says. People with sleep apnea or serious medical problems were excluded from the study. The volunteers each spent three nights in the sleep laboratory where their quality of sleep was recorded.
Taking a long time to fall asleep was found to be the deadliest sleep-related problem. Those who required more than 30 minutes to nod off had a 2.14 greater risk of death than those who needed less time to do so. People who slept for less than 80 percent of the time they spent in bed were also almost twice as likely to die as sound sleepers. Participants with too much or too little rapid eye movement (REM), which is the dream portion of sleep, also faced greater risk for death, although to a lesser degree.
There were a variety of causes for the deaths, Dew says. "We thought maybe they'd die of brain-related problems," but this was not necessarily so, she notes.
Although the connection between the numerous deaths and poor sleepers could be chance, she doesn't think that's the case. "The sleep was a very subtle indicator that they were on the verge of developing other medical problems not yet evident," she believes. "This could be reflecting degenerative diseases that didn't become obvious until later."
The researchers did not look at the amount of sleep the volunteers received each night, although they reported sleeping an average of seven to eight and a half hours.
Many people don't know how well or poorly they sleep, Dew says. She suggests people who think they are having sleep problems see their doctor, but thinks even people who seem to sleep well should work on improving their sleep habits. "Don't do work in bed for example, and no napping during the day," she says. Dew also suggests limiting caffeine intake and avoiding the use of sleeping pills.
Being elderly is not a prescription for sleeping poorly, Dew stresses: "There's this myth that older people need less sleep or shouldn't be concerned if they have sleep problems. That's incorrect."
Timothy Roehrs, director of research at the Sleep Disorders and Research Center at Henry Ford Hospital in Detroit, thinks this study is important. Other studies looking at sleep and health have included people in poor health, and many rely on self-reported sleep. Some other studies have also included people who took medication for sleep, which subjects in this study were not permitted to do.
There are some limitations, however. "These were volunteers and there may be some bias. These are possibly people concerned about their sleep," Roehrs says. Furthermore, the researchers "were unable to look at duration of sleep as a critical variable."
Roehrs believes poor sleep leads to health problems, rather than signifying underlying health problems that already exist. "Sleep serves some vital function," he explains.
Either way, "obtaining inadequate sleep affects mortality."
More information
Learn about the importance of sleep from the National Sleep Foundation and the National Institute on Aging.
