scholarly journals Associations of Actigraphic Sleep Parameters With Fatigability in Older Adults

2020 ◽  
Vol 75 (9) ◽  
pp. e95-e102 ◽  
Author(s):  
Alfonso J Alfini ◽  
Jennifer A Schrack ◽  
Jacek K Urbanek ◽  
Amal A Wanigatunga ◽  
Sarah K Wanigatunga ◽  
...  

Abstract Background Poor sleep may increase the likelihood of fatigue, and both are common in later life. However, prior studies of the sleep–fatigue relationship used subjective measures or were conducted in clinical populations; thus, the nature of this association in healthier community-dwelling older adults remains unclear. We studied the association of actigraphic sleep parameters with perceived fatigability—fatigue in response to a standardized task—and with conventional fatigue symptoms of low energy or tiredness. Methods We studied 382 cognitively normal participants in the Baltimore Longitudinal Study of Aging (aged 73.1 ± 10.3 years, 53.1% women) who completed 6.7 ± 0.9 days of wrist actigraphy and a perceived fatigability assessment, including rating of perceived exertion (RPE) after a 5-minute treadmill walk or the Pittsburgh Fatigability Scale (PFS). Participants also reported non-standardized symptoms of fatigue. Results After adjustment for age, sex, race, height, weight, comorbidity index, and depressive symptoms, shorter total sleep time (TST; <6.3 hours vs intermediate TST ≥6.3 to 7.2 hours) was associated with high RPE fatigability (odds ratio [OR] = 2.56, 95% confidence interval [CI] = 1.29, 5.06, p = .007), high PFS physical (OR = 1.88, 95% CI = 1.04, 3.38, p = .035), and high mental fatigability (OR = 2.15, 95% CI = 1.02, 4.50, p = .044), whereas longer TST was also associated with high mental fatigability (OR = 2.19, 95% CI = 1.02, 4.71, p = .043). Additionally, longer wake bout length was associated with high RPE fatigability (OR = 1.53, 95% CI = 1.14, 2.07, p = .005), and greater wake after sleep onset was associated with high mental fatigability (OR = 1.14, 95% CI = 1.01, 1.28, p = .036). Conclusion Among well-functioning older adults, abnormal sleep duration and sleep fragmentation are associated with greater perceived fatigability.

2017 ◽  
Vol 48 (3-4) ◽  
pp. 147-154 ◽  
Author(s):  
V. Eloesa McSorley ◽  
Jayant Pinto ◽  
L. Philip Schumm ◽  
Kristen Wroblewski ◽  
David Kern ◽  
...  

Background: Sleep and olfaction are both critical physiological processes that tend to worsen with age. Decline in olfaction can be an early indicator of neurodegenerative diseases, whereas poor sleep quality is associated with reduced physical and mental health. Given associations with aging-related health declines, we explored whether variations in sleep were associated with olfactory function among older adults. Methods: We assessed the relationship between sleep characteristics and olfaction among 354 community-dwelling older adults. Olfaction was measured using a validated field and survey research tool. Sleep characteristics were measured using wrist actigraphy and with self-report of sleep problems. We fit structural equation models of latent constructs of olfaction based on olfactory task items and let this be a function of each sleep characteristic. Results: Actigraph sleep quality measures were associated with odor identification, but not with odor sensitivity. Longer duration sleepers had worse odor sensitivity compared to medium (58 h) sleepers, but sleep duration was not associated with odor identification. Reported sleep problems and reported usual duration were not associated with olfaction. Conclusions: Diminished sleep quality was associated with reduced capacity to identify odors. Determining whether this is a causal association will require further study and longitudinal data.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 209-209
Author(s):  
Fangyu Liu ◽  
Yang An ◽  
Amal Wanigatunga ◽  
Alden Gross ◽  
Eleanor Simonsick ◽  
...  

Abstract Perceived fatigability is linked to declining physical and cognitive performance, yet whether fatigability reflects early subclinical change in brain structure is unknown. Using mixed effects models, we assessed the longitudinal association of 3T MRI-derived brain volumes with perceived fatigability after a 5-min treadmill walk (0.67 m/s, 0% grade) using the Borg Rating of Perceived Exertion scale (range 6-20) in 802 BLSA participants (age 68.2+/-12.4 years, 45% men 66% White). In models adjusted for intracranial volume, demographics, chronic conditions, and CESD score, declining gray matter volumes in the frontal (β=-0.01) and temporal (β=-0.02) lobes, as well as the hippocampus (β=-0.25), precuneus (β=-0.10) and thalamus (β=-0.19) were associated with higher fatigability. Larger ventricular volumes were also associated with higher fatigability (β=0.02). Brain atrophy, particularly in gray matter and the hippocampal region, is longitudinally associated with increased fatigability in cognitively normal older adults, making it a potential marker of brain atrophy.


SLEEP ◽  
2020 ◽  
Author(s):  
Jade A Benson ◽  
V Eloesa McSorley ◽  
Louise C Hawkley ◽  
Diane S Lauderdale

Abstract Study Objectives To examine associations of social isolation and loneliness with sleep in older adults and whether associations differ for survey and actigraph sleep measures. Methods This study used data from the National Social Life, Health, and Aging Project (NSHAP), a nationally representative study of community-dwelling older adults born 1920–1947. A random one-third of participants in 2010–2011 were invited to participate in a sleep study (N = 759) that included survey questions, 72 hours of wrist actigraphy, and a sleep log. Perceived loneliness was measured using three questions from the UCLA Loneliness Scale. An index of social isolation was constructed from nine items that queried social network characteristics and social interactions. We used ordinary least squares and ordinal logistic regression to examine whether sleep measures were associated with loneliness and social isolation adjusted for potential sociodemographic confounders. Results Social isolation and loneliness had a low correlation (Spearman’s correlation = 0.20). Both loneliness and social isolation were associated with actigraphy measures of more disrupted sleep: wake after sleep onset and percent sleep. Neither was associated with actigraph total sleep time. Increased loneliness was strongly associated with more insomnia symptoms and with shorter sleep duration assessed by a single question, but social isolation was not. More isolated individuals spent a longer time in bed. Conclusions We found that both loneliness and social isolation were associated with worse actigraph sleep quality, but their associations with self-reported sleep differed. Only loneliness was associated with worse and shorter self-reported sleep.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 527-527
Author(s):  
Xiaopeng Ji ◽  
Mary Bowen ◽  
Mari Griffieon

Abstract Sleep studies examine how pain is associated with poor sleep. However, emergent research suggests poor sleep increases pain and may interfere with activities of daily living (ADL) among older adults. This study will examine how poor sleep may affect next-day pain interference and how this relationship may vary by cognitive function. Ten community-dwelling older adults with lower extremity chronic pain wore an Actigraph GT9X Link for 7 days to measure poor sleep and next-day pain interference (Brief Pain Inventory; BPI). Multi-level mixed models accounted for intra-individual changes in sleep and pain interference and controlled for age, mild cognitive impairment (MCI) and depressive symptoms. Poor sleep among older adults with MCI (14 total observations) was also explored. Across 79 observations, increased number of awakenings (β=0.03; p≤ 0.05) and movement index scores (β=0.08; p≤ 0.05) were associated with increased next-day pain interference. In exploratory analyses, MCI intensified relationships between sleep efficiency (β=-0.10; p≤ 0.05), increased awakenings after sleep onset (β=0.01; p≤ 0.05) and increased length of sleep awakenings (β=0.39; p≤ 0.01) on next-day pain interference. This study’s findings suggest poor sleep is associated with next-day pain interference and the ability to perform ADL. Older adults with MCI may be at an increased risk for poor sleep and pain-related interference in ADL. Interventions designed to moderate the association between poor sleep and pain in general and for adults with MCI in particular may be warranted.


Sensors ◽  
2021 ◽  
Vol 21 (18) ◽  
pp. 5993
Author(s):  
Mahnoosh Kholghi ◽  
Claire M. Ellender ◽  
Qing Zhang ◽  
Yang Gao ◽  
Liesel Higgins ◽  
...  

Older adults are susceptible to poor night-time sleep, characterized by short sleep duration and high sleep disruptions (i.e., more frequent and longer awakenings). This study aimed to longitudinally and objectively assess the changes in sleep patterns of older Australians during the 2020 pandemic lockdown. A non-invasive mattress-based device, known as the EMFIT QS, was used to continuously monitor sleep in 31 older adults with an average age of 84 years old before (November 2019–February 2020) and during (March–May 2020) the COVID-19, a disease caused by a form of coronavirus, lockdown. Total sleep time, sleep onset latency, wake after sleep onset, sleep efficiency, time to bed, and time out of bed were measured across these two periods. Overall, there was no significant change in total sleep time; however, women had a significant increase in total sleep time (36 min), with a more than 30-min earlier bedtime. There was also no increase in wake after sleep onset and sleep onset latency. Sleep efficiency remained stable across the pandemic time course between 84–85%. While this sample size is small, these data provide reassurance that objective sleep measurement did not deteriorate through the pandemic in older community-dwelling Australians.


SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A457-A458 ◽  
Author(s):  
S Haghayegh ◽  
S Khoshnevis ◽  
M H Smolensky ◽  
K R Diller ◽  
R J Castriotta

Abstract Introduction Several different interpretive algorithms (IAs) are available for scoring actigraphy-obtained body movement data for sleep and wake epochs. Although most have high sensitivity in detecting sleep epochs, they identify wake epochs poorly. We derived a machine learning (ML) based IA that improves differentiation of sleep and wake epoch to better estimate sleep parameters. Methods Forty-one adults (18 females) 26.6±12.0 years old underwent at-home single-night sleep assessment. Motionlogger® Micro Watch Actigraph recorded in zero crossing mode body movement per 30s epoch, with automated sleep scoring by single-channel electroencephalography (EEG) device (Zmachine® Insight+) as reference. The popular Cole-Kripke IA was applied to score body movement time series data of the following combination of current 1, preceding 4, and following 2 minute long epochs. Data of 21 subjects were utilized to train/derive the ML IA (logistic regression), and data of the other 20 subjects were used to test performance of it and the Cole-Kripke IA. Results In reference to the EEG, the Cole-Kripke actigraphy IA showed sensitivity of 0.98±0.02, specificity of 0.48±0.19, and kappa agreement of 0.53±0.16 in detecting sleep epochs, while the ML-derived IA showed corresponding values of 0.90±0.06, 0.71±0.14, and 0.57±0.11. The Cole-Kripke IA, relative to EEG, method significantly (P<0.05) underestimated sleep onset latency (SOL) by 18.0 min and wake after sleep onset (WASO) by 35.1 min, and overestimated total sleep time (TST) by 53.1 min and sleep efficiency (SE) by 9.6%. The ML-derived IA, relative to EEG significantly underestimated SOL by 15.1 min, but comparably (P>0.05) estimated WASO, TST, and SE. Conclusion The ML-derived IA, in comparison to Cole-Kripke IA, when applied to sleep-time wrist actigraphy data significantly better differentiates wake from sleep epochs and better estimates sleep parameters. Support This work was supported by the Robert and Prudie Leibrock Professorship in Engineering at the University of Texas at Austin.


2017 ◽  
Vol 12 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Nathan W. Pitchford ◽  
Sam J. Robertson ◽  
Charli Sargent ◽  
Justin Cordy ◽  
David J. Bishop ◽  
...  

Purpose:To assess the effects of a change in training environment on the sleep characteristics of elite Australian Rules football (AF) players.Methods:In an observational crossover trial, 19 elite AF players had time in bed (TIB), total sleep time (TST), sleep efficiency (SE), and wake after sleep onset (WASO) assessed using wristwatch activity devices and subjective sleep diaries across 8-d home and camp periods. Repeated-measures ANOVA determined mean differences in sleep, training load (session rating of perceived exertion [RPE]), and environment. Pearson product–moment correlations, controlling for repeated observations on individuals, were used to assess the relationship between changes in sleep characteristics at home and camp. Cohen effect sizes (d) were calculated using individual means.Results:On camp TIB (+34 min) and WASO (+26 min) increased compared with home. However, TST was similar between home and camp, significantly reducing camp SE (–5.82%). Individually, there were strong negative correlations for TIB and WASO (r = -.75 and r = -.72, respectively) and a moderate negative correlation for SE (r = -.46) between home and relative changes on camp. Camp increased the relationship between individual s-RPE variation and TST variation compared with home (increased load r = -.367 vs .051, reduced load r = .319 vs –.033, camp vs home respectively).Conclusions:Camp compromised sleep quality due to significantly increased TIB without increased TST. Individually, AF players with higher home SE experienced greater reductions in SE on camp. Together, this emphasizes the importance of individualized interventions for elite team-sport athletes when traveling and/or changing environments.


Author(s):  
Catrine Tudor-Locke ◽  
Jose Mora-Gonzalez ◽  
Scott W. Ducharme ◽  
Elroy J. Aguiar ◽  
John M. Schuna ◽  
...  

Abstract Background Heuristic (i.e., evidence-based, rounded) cadences of ≥100 and ≥ 130 steps/min have consistently corresponded with absolutely-defined moderate (3 metabolic equivalents [METs]) and vigorous (6 METs) physical activity intensity, respectively, in adults 21–60 years of age. There is no consensus regarding similar thresholds in older adults. Purpose To provide heuristic cadence thresholds for 3, 4, 5, and 6 METs in 61–85-year-old adults. Methods Ninety-eight community-dwelling ambulatory and ostensibly healthy older adults (age = 72.6 ± 6.9 years; 49% women) walked on a treadmill for a series of 5-min bouts (beginning at 0.5 mph with 0.5 mph increments) in this laboratory-based cross-sectional study until: 1) transitioning to running, 2) reaching ≥75% of their age-predicted maximum heart rate, or 3) reporting a Borg rating of perceived exertion > 13. Cadence was directly observed and hand-tallied. Intensity (oxygen uptake [VO2] mL/kg/min) was assessed with indirect calorimetry and converted to METs (1 MET = 3.5 mL/kg/min). Cadence thresholds were identified via segmented mixed effects model regression and using Receiver Operating Characteristic (ROC) curves. Final heuristic cadence thresholds represented an analytical compromise based on classification accuracy (sensitivity, specificity, positive and negative predictive value, and overall accuracy). Results Cadences of 103.1 (95% Prediction Interval: 70.0–114.2), 116.4 (105.3–127.4), 129.6 (118.6–140.7), and 142.9 steps/min (131.8–148.4) were identified for 3, 4, 5, and 6 METs, respectively, based on the segmented regression. Comparable values based on ROC analysis were 100.3 (95% Confidence Intervals: 95.7–103.1), 111.5 (106.1–112.9), 116.0 (112.4–120.2), and 128.6 steps/min (128.3–136.4). Heuristic cadence thresholds of 100, 110, and 120 were associated with 3, 4, and 5 METs. Data to inform a threshold for ≥6 METs was limited, as only 6/98 (6.0%) participants achieved this intensity. Conclusions Consistent with previous data collected from 21–40 and 41–60-year-old adults, heuristic cadence thresholds of 100, 110, and 120 steps/min were associated with 3, 4, and 5 METs, respectively, in 61–85-year-old adults. Most older adults tested did not achieve the intensity of ≥6 METs; therefore, our data do not support establishing thresholds corresponding with this intensity level. Trial registration Clinicaltrials.gov NCT02650258. Registered 24 December 2015.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 173-173
Author(s):  
Kexin Yu ◽  
Bernadette Fausto

Abstract Loneliness is a risk factor for cognitive decline in older adults, however, the underlying mechanisms are less understood. Individuals who experience frequent loneliness tend to have poorer sleep quality. Empirical evidence supports the influence of sleep on cognitive health. This study examined the possible mediating effect of sleep characteristics on the relationship between loneliness and cognition. The study sample included 557 participants from wave 2 of the National Social Life, Health, and Aging Project who had actigraphy sleep measures (mean age = 73.17, 52.6% female). Loneliness was assessed with the 3-item UCLA Loneliness Scale. Cognitive function was measured with the Montreal Cognitive Assessment. Five sleep quality indicators were objectively recorded with wearable devices: assumed sleep time; actigraphy sleep time; time spent awake after sleep onset (WASO); sleep fragmentation; and sleep percentage (actigraphy sleep/(assumed sleep + WASO)). Path analysis model results show that WASO, fragmentation, and sleep percentage mediate the link between loneliness and cognitive function. Loneliness was positively related to WASO, and WASO was negatively associated with cognition. Loneliness correlated with increased sleep fragmentation which was associated with worse cognitive function. Individuals who had more frequent loneliness had a lower sleep percentage, and sleep percentage was positively associated with cognitive function. Nonetheless, the path from loneliness to these three sleep characteristics became insignificant after controlling for depressive symposiums. Depressive symptoms and fragmentation were found to double mediate the association between loneliness and cognitive function. Sleep and depression could be underlying pathways for the association between loneliness and cognition.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A215-A215
Author(s):  
Alice Ding ◽  
Emily Smail ◽  
Alfonso Alfini ◽  
Adam Spira

Abstract Introduction A number of cross-sectional studies have found that elevated levels of anxiety are associated with poor sleep among healthy older adults, but most have used self-reported sleep measures. We investigated the longitudinal association between objectively measured sleep (by wrist actigraphy) and subsequent change in anxiety symptoms in this population. Methods We studied 555 community-dwelling older adults (mean age 72.52±7.35, 77.48% white, 53.15% women) in the National Social Health and Aging Project (NSHAP) study who completed 3 nights of wrist actigraphy at wave 2 (2010–2011) and the Hospital Anxiety and Depression Scale at waves 2 and 3 (2015–2016). Actigraphic sleep parameters were averaged across nights and included: total sleep time (TST; minutes), percent sleep (%), wake after sleep onset (WASO; minutes), and sleep fragmentation. Change in anxiety was calculated as the difference between anxiety scores at wave 3 and wave 2. Results After adjusting for age, race, sex, education, body mass index, number of medical conditions, depression symptoms, and anxiety scores at wave 2, we found no significant associations between any actigraphic sleep parameter and subsequent change in anxiety symptoms (all p ≥ 0.390). Additional analyses revealed no significant cross-sectional associations at wave 2 (p ≥ 0.390). Conclusion We found no evidence for an association between actigraphic sleep and anxiety symptoms, or change in anxiety symptoms, in community-dwelling older adults. Additional studies using clinical anxiety disorder diagnoses are needed to evaluate the extent to which objectively measured sleep disturbance predicts clinically significant anxiety in older adults. Support (if any) American Academy of Sleep Medicine Foundation (#223-BS-19).


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