Aging-Related Sleep Changes

      Normal aging is accompanied by changes in the sleep quality, quantity, and architecture. Specifically, there appears to be a measurable decrease in the ability of the healthy elderly to initiate and maintain sleep, accompanied by a decrease in the proportion of the deeper, more restorative slow-wave sleep and rapid eye movement sleep. There is epidemiologic evidence that this impaired ability to initiate, maintain, and ultimately achieve good quality, optimal sleep may be a marker of increased mortality and neurocognitive dysfunction. Possible mechanisms related to these age-related changes in sleep include age-related changes in circadian modulation, homeostatic factors, cardiopulmonary function, and endocrine function. This article describes the normal changes in sleep physiology in the elderly.
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      References

        • Foley D.J.
        • Monjan A.A.
        • Brown S.L.
        • et al.
        Sleep complaints among elderly persons: an epidemiologic study of three communities.
        Sleep. 1995; 18: 425-432
        • Tafaro L.
        • Cicconetti P.
        • Baratta A.
        • et al.
        Sleep quality of centenarians: cognitive and survival implications.
        Arch Gerontol Geriatr. 2007; 44S: 385-389
        • Hood B.
        • Bruck D.
        • Kennedy G.
        Determinants of sleep quality in the healthy aged: the role of physical, psychological, circadian, and naturalistic light variables.
        Age and Ageing. 2004; 33: 159-165
        • Reid K.J.
        • Martinovich Z.
        • Finkel S.
        • et al.
        Sleep: a marker of physical and mental health in the elderly.
        Am J Geriatr Psychiatry. 2006; 14: 860-868
        • Landolt H.P.
        • Borbely A.A.
        Age-dependent changes in sleep EEG topography.
        Clin Neurophysiol. 2001; 112: 369-377
        • Webb W.B.
        Sleep in older persons: sleeps structures of 50- to 60-year-old men and women.
        J Gerontol. 1982; 37: 581-586
        • Ehlers C.L.
        • Kupfer D.J.
        Effects of age on delta and REM sleep parameters.
        Electroencephalogr Clin Neurophysiol. 1989; 72: 118-125
        • Floyd J.A.
        • Janisse J.J.
        • Marshall M.S.
        • et al.
        Nonlinear components of age-related change in sleep initiation.
        Nurs Res. 2000; 49: 290-294
        • Floyd J.A.
        • Medler S.M.
        • Ager J.W.
        • et al.
        Age-related changes in initiation and maintenance of sleep: a meta-analysis.
        Res Nurs Health. 2000; 23: 106-117
        • Vitiello M.V.
        • Larsen L.H.
        • Moe K.E.
        Age-related change: gender and estrogen effects on subjective-objective sleep quality relationships of healthy noncomplaining older men and women.
        J Psychosom Res. 2004; 56: 503-510
        • Klerman E.B.
        • Davis J.B.
        • Duffy J.F.
        • et al.
        Older people awaken more frequently but fall back asleep at the same rate as younger people.
        Sleep. 2004; 27: 793-798
        • Ohayon M.M.
        • Vecchierini M.F.
        Normative sleep data, cognitive function, and daily living activities in older adults in the community.
        Sleep. 2005; 28: 981-989
        • Dew M.A.
        • Hoch C.C.
        • Buysse D.J.
        • et al.
        Healthy older adults' sleep predicts all-cause mortality at 4–19 years of follow-up.
        Psychosom Med. 2003; 65: 63-73
        • Campbell S.
        • Murphy P.
        The nature of spontaneous sleep across adulthood.
        J Sleep Res. 2007; 16: 24-32
        • Tamakoshi A.
        • Ohno Y.
        • JACC Study Group
        Self-reported sleep duration as a predictor of all-cause mortality.
        Sleep. 2004; 27: 51-54
        • Burazeri G.
        • Gofin J.
        • Kark J.D.
        Over 8 hours of sleep—marker of increased mortality in Mediterranean population: follow-up population study.
        Croat Med J. 2003; 44: 193-198
        • Ishihara K.
        • Miyake S.
        • Miyasita A.
        • et al.
        Morningness-eveningness preference and sleep habits in Japanese office workers of different ages.
        Chronobiologia. 1992; 19: 9-16
        • Monk T.H.
        • Thompson W.K.
        • Buysse D.J.
        • et al.
        Sleep in healthy seniors: a diary study of the relation between bedtime and the amount of sleep obtained.
        J Sleep Res. 2006; 15: 256-260
        • Buysse D.J.
        • Browman K.E.
        • Monk T.H.
        • et al.
        Napping and 24-hour sleep/wake patterns in healthy elderly and young adults.
        J Am Geriatr Soc. 1992; 40: 779-786
        • Evans B.D.
        • Rogers A.E.
        24-hour sleep/wake patterns in healthy elderly persons.
        Appl Nurs Res. 1994; 7: 75-83
        • Naska A.
        • Oikonomou E.
        • Trichopoulou A.
        • et al.
        Siesta in healthy adults and coronary mortality in the general population.
        Arch Intern Med. 2007; 167: 296-301
        • Monk T.H.
        • Buysse D.J.
        • Carrier J.
        • et al.
        Effects of afternoon “siesta” on sleep, alertness, performance, and circadian rhythms.
        Sleep. 2001; 24: 680-687
        • Campbell S.S.
        • Murphy P.J.
        • Stauble T.N.
        Effects of a nap on nighttime sleep and waking function in older subjects.
        J Am Geriatr Soc. 2005; 53: 48-53
        • Ohayon M.M.
        • Carskadon M.A.
        • Guillemenault C.
        • et al.
        Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan.
        Sleep. 2004; 27: 1255-1273
        • Van Cauter E.
        • Leproult R.
        • Plat L.
        Age-related changes in slow wave sleep and REM sleep and relationship with growth hormone and cortisol levels in healthy men.
        JAMA. 2000; 284: 861-868
        • Brandenburg G.
        • Viola A.U.
        • Ehrhart J.
        • et al.
        Age-related changes in autonomic control during sleep.
        J Sleep Res. 2003; 12: 173-180
        • Dijk D.J.
        • Duffy J.F.
        • Riel E.
        • et al.
        Ageing and the circadian and homeostatic regulation of human sleep during forced desynchrony of rest, melatonin and temperature rhythms.
        J Physiol. 1999; 516: 611-627
        • Wauqier A.
        • van Sweden B.
        • Lagaay A.M.
        • et al.
        Ambulatory monitoring of sleep-wakefulness patterns in healthy elderly males and females (greater than 88 years): the “Senieur” protocol.
        J Am Geriatr Soc. 1992; 40: 109-114
        • Murphy P.J.
        • Rogers N.L.
        • Campbell S.S.
        Age differences in the spontaneous termination of sleep.
        J Sleep Res. 2000; 9: 27-34
        • Crowley K.
        • Trinder J.
        • Kim Y.
        • et al.
        The effects of normal aging on sleep spindle and K-complex production.
        Clin Neurophysiol. 2002; 113: 1615-1622
        • Nicolas A.
        • Petit D.
        • Rompré S.
        • et al.
        Sleep spindle characteristics in healthy subjects of different age groups.
        Clin Neurophysiol. 2001; 112: 521-527
        • Knoblauch V.
        • Münch M.
        • Blatter K.
        • et al.
        Age-related changes in the circadian modulation of sleep-spindle frequency during nap sleep.
        Sleep. 2005; 28: 1093-1101
        • Smith J.R.
        • Karacan I.
        • Yang M.
        Ontogeny of delta activity during human sleep.
        Electroencephalogr Clin Neurophysiol. 1977; 43: 229-237
        • Darchia N.
        • Campbell I.G.
        • Feinberg I.
        Rapid eye movement density is reduced in the normal elderly.
        Sleep. 2003; 26: 973-977
        • Gori S.
        • Ficca G.
        • Giganti F.
        • et al.
        Body movements during night sleep in healthy elderly subjects and their relationships with sleep stages.
        Brain Res Bull. 2004; 63: 393-397
        • Monk T.H.
        • Reynolds III, C.F.
        • Machen M.A.
        • et al.
        Daily social rhythms in the elderly and their relation to objectively recorded sleep.
        Sleep. 1992; 15: 322-329
        • Münch M.
        • Knoblauch V.
        • Blatter K.
        • et al.
        Age-related attenuation of the evening circadian arousal signal in humans.
        Neurobiol Aging. 2005; 26: 1307-1319
        • Cajochen C.
        • Munch M.
        • Knoblauch V.
        • et al.
        Age-related changes in the circadian and homeostatic regulation of human sleep.
        Chronobiol Int. 2006; 23: 461-474
        • Vitiello M.V.
        • Smallwood R.G.
        • Avery D.H.
        • et al.
        Circadian temperature rhythms in young adult and aged men.
        Neurobiol Aging. 1986; 7: 87-100
        • Czeisler C.A.
        • Dumont M.
        • Duffy J.F.
        • et al.
        Association of sleep-wake habits in older people with changes in output of circadian pacemaker.
        Lancet. 1992; 340: 933-936
        • Duffy J.F.
        • Derk-Jan D.
        • Lerman E.B.
        • et al.
        Later endogenous circadian temperature nadir relative to an earlier wake time in older people.
        Am J Physiol. 1998; 44: R1478-R1487
        • Bonnett M.H.
        The effect of sleep fragmentationon sleep and performance in younger and older subjects.
        Neurobiol Aging. 1989; 10: 21-25
        • Adam M.
        • Retey J.V.
        • Khatami R.
        • et al.
        Age-related changes in the time course of vigilant attention during 40 hours without sleep in men.
        Sleep. 2006; 29: 55-57
        • Münch M.
        • Knoblauch V.
        • Blatter K.
        • et al.
        The frontal predominance in human EEG delta activity after sleep loss decreases with age.
        Eur J Neurosci. 2004; 20: 1402-1410
        • Naifeh K.H.
        • Severinghaus J.W.
        • Kamiya J.
        Effect of aging on sleep-related changes in respiratory variables.
        Sleep. 1987; 10: 160-171
        • Hudgel D.E.
        • Devadatta P.
        • Hamilton H.
        Pattern of breathing and upper airway mechanics during wakefulness and sleep in healthy elderly humans.
        J Appl Physiol. 1993; 74: 2198-2204
        • Browne H.A.K.
        • Adams L.
        • Simonds A.K.
        • et al.
        Ageing does not influence the sleep-related decrease in the hypercapnic ventilatory response.
        Eur Respir J. 2003; 21: 523-529
        • Sherman B.
        • Wysham C.
        • Pfohl B.
        Age-related changes in the circadian rhythm of plasma cortisol in man.
        J Clin Endocrinol Metab. 1985; 61: 439-443
        • Kern W.
        • Dodt C.
        • Born J.
        • et al.
        Changes in cortisol and growth hormone secretion during nocturnal sleep in the course of aging.
        J Gerontol A Biol Sci Med Sci. 1996; 51: M3-M9
        • Prinz P.N.
        • Bailey S.L.
        • Woods D.L.
        Sleep impairments in healthy seniors: roles of stress, cortisol, and interleukin-1 beta.
        Chronobiol Int. 2000; 17: 391-404