Untreated Sleep Problems Compound Health Problems of Older Americans

New National Sleep Foundation Poll Contradicts Commonly Held Beliefs About Sleep in Older Adults 

(Washington, DC) — While some older adults are very healthy and have normal sleep patterns, frequent untreated sleep problems may be interfering with the ability of many others to cope with chronic medical conditions, according to a poll released today by the National Sleep Foundation (NSF).

Exploding many common myths that associate poor sleep and less sleep with
aging, the 2003 Sleep in America poll shows that older adults typically do
not sleep less than their younger counterparts, averaging about seven hours
of sleep each night. However, it also finds that some 37 million older
Americans suffer from frequent sleep problems that if ignored, can
complicate the treatment of a host of common, serious age-related medical
conditions, from arthritis to diabetes, heart and lung disease and
depression. Poor sleep is also associated with three other problems
affecting many older adults: bodily pain, excess weight and ambulatory
restrictions, such as difficulty walking or going up and down stairs.

“The 2003 Sleep in America poll indicates that poor health and not age is a
major reason why many older people in this country report sleep problems,
providing an important wake up call that identifying and treating these
sleep problems must be a priority concern,” said Richard L. Gelula, NSF’s
executive director. “The fact that a person is 60 or 70 years old doesn’t
preclude the possibility of sleeping well and benefiting from this
restorative process to remain vital and active. That’s why we must drive
home the message that sleeping well is vital to aging well.” 

Marking the Foundation’s first effort to look at the sleep habits and
patterns of America’s older adults – those between the ages of 55 and 84 –
NSF’s 2003 Sleep in America poll finds a direct association between the
number of diagnosed medical conditions that older adults report and the
quality of their sleep. The more medical conditions, the more sleep
problems.

However, NSF’s new poll shows that poor sleep among older adults often goes
unnoticed by the medical community. Although the majority of older adults
(67%) report frequent
sleep problems, only a small fraction (one in eight) says his or her sleep
problems have been diagnosed. This means of the 37 million older adults
reporting sleep problems, only about seven million have been diagnosed,
leaving 30 million to count sheep. NSF is urging the medical community to
treat sleep as an integral part of disease management, especially in older
patients.

“In spite of the emerging science linking sleep and health, only a small
fraction of the many reported sleep complaints of older adults are actually
diagnosed and treated,” says NSF President, James K. Walsh, PhD. “The 2003
Sleep in America poll reinforces the position that sleep problems should not
be viewed as an aspect of normal aging, and they can significantly increase
the overall burden of illness on patients,” Walsh adds. 
Dr. Walsh is Executive Director and Senior Scientist of the Sleep Medicine
and Research Center at St. Luke’s Hospital in Chesterfield, Mo.

Sleep and Health for Older Americans
NSF’s 2003 Sleep in America poll shows that inadequate sleep is clearly
associated with many of the major diseases prevalent in older adults. Of
special significance, the poll links ongoing sleep problems with 82 percent
of those who report being diagnosed with depression, 81 percent who have
suffered a stroke, 76 percent diagnosed with heart disease, and 75 percent
diagnosed with lung disease. Sleep problems are also a factor for 72
percent of older adults diagnosed with diabetes or arthritis, and 71 percent
of those who have been diagnosed with hypertension. 

Sleep problems are especially acute among those older adults who have more
than one medical condition: eight in ten with four or more medical
conditions report a sleep problem compared to about one half of those with
no reported medical conditions (80% vs. 53%). In addition, the poll
connects poor sleep with three physical problems affecting many older
people: bodily pain, excess weight and ambulatory limitations.

According to the newest findings:

• More than three-quarters (77%) of those who report having
  frequent bodily pain also report a sleep problem.

• Sleep problems are equally common among older adults who are
  classified as obese (77%) and are linked with two-thirds (64%) of those who
  are considered overweight by medical standards; and

• The vast majority of older people with impaired mobility are
  likely to report a sleep problem (84%), with two-thirds experiencing a
  symptom of insomnia.

• Moreover, about four in ten of those with impaired mobility
  report unpleasant feelings in their legs, a symptom of Restless Legs
  Syndrome, a serious, treatable sleep disorder. 

Insomnia is the most common sleep problem, with about one-half of older
adults (48%) reporting they frequently experience at least one symptom.
(Symptoms of insomnia include difficulty falling asleep, waking a lot during
the night, waking up too early and not getting back to sleep, and waking
feeling unrefreshed).

While waking up a lot in the middle of the night is the most common insomnia
complaint, the biggest overall problem disrupting the sleep of older adults
is the need to get up and go to the bathroom, with nearly two thirds (65%)
reporting this disturbance at least a few nights a week. 

Rounding out the link between sleep and health, the poll finds that the
better the sleep, the better the perceived health of older adults. Those
who rate their health as “very good” or “excellent,” for example, report
less daytime sleepiness than those with “fair” or “poor” health (9% vs.
29%). They also report fewer insomnia symptoms (38% vs. 71%), and fewer
sleep problems (59% vs. 85%). And the healthy are less likely to categorize
their sleep as “fair” or “poor” (13% vs. 47%).

COMPARING SLEEP PATTERNS OF OLDER AND YOUNGER ADULTS
Besides charting the sleep patterns of older adults, the 2003 Sleep in
America poll dispels the notion that the older we are, the less we sleep.
In fact, the poll shows older adults sleep about the same amount as their
younger counterparts, though their sleep habits are substantially different.

Providing an up-to-date look at how older adults are sleeping, the poll
finds that:

• The sleep patterns of older adults are more consistent than those of
  their younger counterparts. Older adults get about the same amount of sleep
  on weeknights (7.0 hrs/night) and weekends (7.1 hrs/night), while younger
  adults sleep less during the week (6.7 hrs/night), increasing their sleep on
  weekends (7.6 hrs/night). About 13 percent of older adults sleep less than
  six hours on weeknights compared to l6 percent of those 18-54.

• The frequency of adults’ sleep problems tends to diminish
  slightly with age. Of those aged 55-64, seven in ten (71%) report
  experiencing a frequent sleep problem compared to 65 percent of those aged
  65-74, and 64 percent of those aged 75-84.

     
When it comes to the sleep patterns of older men and women, the poll finds
no major gender differences. However, older women are more likely to report
at least one symptom of insomnia (50% vs. 45%), while older men are more
likely to report they snore (40% vs. 26%) and experience pauses in breathing
during sleep (10% vs. 5%).

About one-third of older adults nap regularly, and the frequency of naps
increases with age.

LIFESTYLE
To complete the picture of America’s older adults and their sleep, the 2003
Sleep in America poll examines lifestyle factors that can impact the
quantity and quality of sleep.
Key findings include:

• Older adults feel connected, not isolated. Three-fourths of older
  adults polled say it is very easy for them to find a family member or friend
  to talk to when needed. However the 25 percent who feel more isolated say
  they are more likely to sleep less than six hours a night (l9% vs.12%), and
  experience a symptom of insomnia (59% vs. 45%).

• Older adults exercise. About one-half of older adults (52%) report
  exercising to improve their fitness three or more times a week. Only
  one-quarter of those polled say they exercise less than once a week. The
  more older people exercise, the less likely they are to describe their sleep
  quality as fair or poor (20% vs. 32%), and the less likely they are to
  report symptoms of insomnia (43% vs. 58%) than those who exercise
  infrequently.

WB&A Market Research conducted the 2003 Sleep in America poll for the
National Sleep Foundation using telephone interviews with a random sample of
1506 adults aged 55-84, living in community dwellings (not institutions).
The interviews were conducted between September l7 and December 10, 2002.
The margin of error is plus or minus 2.5 percent.

The National Sleep Foundation is an independent nonprofit organization
dedicated to improving public health and safety by achieving understanding
of sleep and sleep disorders, and by supporting public education,
sleep-related research, and advocacy. Visit NSF’s Web site for an Executive
Summary of the 2003 poll and other sleep related information,
http://www.sleepfoundation.org.