Sleep and Olfaction among Older Adults

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.

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Assessing sleep quality in older adults: A comparison of three measurement approaches

Innovation in Aging ◽

10.1093/geroni/igaa057.3256 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 882-882

Author(s):

Amy Berkley ◽

Patricia Carter

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Assessment Tool ◽

Sleep Problems ◽

Adult Population ◽

Sleep Onset ◽

Self Report ◽

Sleep Onset Latency ◽

Wrist Actigraphy ◽

Sleep Assessment

Abstract Discrepancies between subjective and objective sleep measures have been reported for some time; however, it is critical to consider the implications of inaccurate or incomplete sleep assessment for frail older adults who are struggling to maintain independence. To compare sleep assessment methods, we collected objective sleep measurements (via wrist actigraphy), subjective measures via self-report sleep surveys (Pittsburgh Sleep Quality Index; Insomnia Severity Index, Sleep Hygiene Index), and qualitative data through semi-structured audio-recorded interviews, from 8 older adults who self-reported sleep problems while living in a retirement community in southwestern US. Participants’ objective sleep (Total Sleep Time, Sleep Onset Latency, Wake After Sleep Onset, and Sleep Efficiency) and qualitative narratives were congruent, but self-report measures failed to capture several unique sleep problems identified in the sample. Disordered sleep in older adults has been linked to increased incidence of falls, depression and anxiety, cognitive impairment, institutionalization, and mortality, but traditional sleep assessment instruments, designed for the general adult population, fail to capture many of the experiences and causes that are unique to older adults. functioning. A sleep assessment tool designed to measure older people’s sleep experiences could provide more accurate and sensitive data.

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Understanding factors relevant to poor sleep and coping methods in people with schizophrenia

BMC Psychiatry ◽

10.1186/s12888-021-03384-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yen-Ching Chang ◽

Megan C. Chang ◽

Yun-Jou Chang ◽

Ming-De Chen

Keyword(s):

Mental Health ◽

Sleep Quality ◽

Mental Health Professionals ◽

Sleep Problems ◽

Psychiatric Symptoms ◽

Structured Interview ◽

Community Dwelling ◽

Poor Sleep ◽

Coping Methods

Abstract Background Sleep disruption is pervasive in people with schizophrenia, but few studies have explored their sleep experiences. This study aims to identify factors relevant to sleep problems and explore coping methods used by community-dwelling people with schizophrenia. Methods Eighteen participants with schizophrenia were recruited from three mental health centers in Taiwan. They completed a semi-structured interview and the Pittsburgh Sleep Quality Index (PSQI) assessment. The Person-Environment-Occupation model offered a framework to assess factors related to sleep. Thematic analysis was used for the qualitative data analysis. Results Factors related to sleep were classified under person, environment, and occupation domains. The person domain included three subthemes: psychiatric symptoms, unpleasant emotions, and frustration about sleep. The environment domain included three subthemes: sensory intrusions from the environment, quality of bedding, and roommates. The occupation domain included sleep interruption and sleep preparation. There were notable discrepancies in sleep quality between the participants’ narratives and their PSQI global scores. Regarding coping methods for poor sleep, sleep medication was the primary strategy while some participants also used other strategies, such as modifying the environment, adjusting routines, or engaging in activities that improve sleep quality. Conclusions Psychiatric symptoms and nightmares were identified as unique sleep disruptions in people with schizophrenia, and poor economic status was also found to impact their sleep. The sleep quality of people with schizophrenia tends to be poor, as identified by the PSQI, even though they may have positive perceptions of their sleep quality. Our participants appeared to prefer to take hypnotics to address their sleep problems, which may be due to limited knowledge about alternatives. Mental health professionals are encouraged to receive training in the application of non-pharmacological approaches to support their clients’ issues related to sleep.

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Mobile App Use for Insomnia Self-Management in Urban Community-Dwelling Older Korean Adults: Retrospective Intervention Study (Preprint)

10.2196/preprints.17755 ◽

2020 ◽

Author(s):

Kyungmi Chung ◽

Seoyoung Kim ◽

Eun Lee ◽

Jin Young Park

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Sleep Problems ◽

Mobile App ◽

Community Dwelling ◽

Intervention Period ◽

Post Intervention ◽

Subjective Sleep Quality ◽

Subjective Sleep ◽

Self Help

BACKGROUND As an evidence-based psychotherapy for treating insomnia, cognitive behavioral therapy for insomnia (CBT-I), which helps people with sleep problems to change their unhelpful sleep-related beliefs and habits, has been well-established in older adults. Recently, the utilization of mobile CBT-I apps has been getting attention from mental health professionals and researchers; however, whether mobile CBT-I apps are usable among older users has yet to be determined. OBJECTIVE The aims of this study were to explore the relationships between subjective sleep quality and subjective memory complaints and depressive symptoms; to explore the relationship between perceived difficulty in mobile app use and usability of the mobile phone–based self-help CBT-I app, named MIND MORE, in urban community-dwelling Korean older adults; to compare changes in subjective sleep quality from pre-intervention to post-intervention, during which they used the mobile app over a 1-week intervention period; and evaluate adherence to the app. METHODS During the 2-hour training program delivered on 1 day titled “Overcoming insomnia without medication: How to use the ‘MIND MORE’ mobile app for systematic self-management of insomnia” (pre-intervention), 41 attendants were asked to gain hands-on experience with the app facilitated by therapists and volunteer workers. They were then asked to complete questionnaires on sociodemographic characteristics, subjective evaluation of mental health status (ie, depression, memory loss and impairment, and sleep problems), and app usability. For the 1-week home-based self-help CBT-I using the app (post-intervention), 9 of the 41 program attendants, who had already signed up for the pre-intervention, were guided to complete the given questionnaires on subjective evaluation of sleep quality after the 1-week intervention, specifically 8 days after the training program ended. RESULTS Due to missing data, 40 of 41 attendants were included in the data analysis. The main findings of this study were as follows. First, poor subjective sleep quality was associated with higher ratings of depressive symptoms (40/40; ρ=.60, P<.001) and memory complaints (40/40; ρ=.46, P=.003) at baseline. Second, significant improvements in subjective sleep quality from pre-intervention to post-intervention were observed in the older adults who used the MIND MORE app only for the 1-week intervention period (9/9; t8=3.74, P=.006). Third, apart from the program attendants who did not have a smartphone (2/40) or withdrew from their MIND MORE membership (3/40), those who attended the 1-day sleep education program adhered to the app from at least 2 weeks (13/35, 37%) to 8 weeks (2/35, 6%) without any further contact. CONCLUSIONS This study provides empirical evidence that the newly developed MIND MORE app not only is usable among older users but also could improve subjective sleep quality after a 1-week self-help intervention period.

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THE MODERATING EFFECT OF RAISING ONE’S GRANDCHILDREN ON THE RELATION BETWEEN SLEEP AND DEPRESSION

Innovation in Aging ◽

10.1093/geroni/igz038.2505 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S678-S678

Author(s):

Melanie Stearns ◽

Danielle K Nadorff

Keyword(s):

Older Adults ◽

Risk Factor ◽

Depressive Symptoms ◽

Sleep Quality ◽

Sleep Problems ◽

Depression Scale ◽

Poor Sleep ◽

Older Individuals ◽

Poor Sleep Quality ◽

Custodial Grandparents

Abstract Recent evidence has shown that poor quality sleep is associated with depression, particularly among older individuals (Bao et al., 2017; Nadorff, Fiske, Sperry, & Petts, 2012). Moreover, given the high prevalence of depressive symptoms among older adults, it is important to identify possible risk factors of poor sleep quality. One possible risk factor is being a custodial grandparent (raising one’s grandchildren), as increased caregiving responsivities are associated with increased depressive symptoms (Brand-Winterstein, Edelstein, & Bachner, 2018). Based upon these previous findings, the current study examines the effect of custodial status on the relation between sleep quality and depressive symptoms. The sample (N = 466) was a subset of individuals recruited in the second wave of the MIDUS biomarkers project completed in 2009 who answered the sleep, caregiving, and depressive symptoms variables of interest. Measures included the Center for Epidemiological Studies Depression Scale (CESD), the Pittsburgh Sleep Quality Index (PSQI), and a question regarding custodial grandparent status. The current study aimed to examine whether poor sleep quality might serve as a risk factor for experiencing depressive symptoms and how custodial grandparents might differ from other older adults. Moderation analyses were conducted using SPSS’ Process macro on the sample. The interaction between global sleep quality and custodial grandparent status was significant in predicting depressive symptoms, t (1, 465) = 3.90, p = .04, such that custodial grandparents reported a stronger positive correlation between greater global sleep problems and depressive symptoms than non-custodial grandparents. Implications, future directions, and limitations are discussed.

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342 The Association Between Benzodiazepine Use and Falls, and the Impact of Sleep Quality on this Association: Data from TILDA

Age and Ageing ◽

10.1093/ageing/afz103.224 ◽

2019 ◽

Vol 48 (Supplement_3) ◽

pp. iii17-iii65

Author(s):

Louise Marron ◽

Ricardo Segurado ◽

Paul Claffey ◽

Rose Anne Kenny ◽

Triona McNicholas

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Effect Size ◽

Community Dwelling ◽

Public Health Issue ◽

P Value ◽

Poor Sleep ◽

Daytime Somnolence ◽

Falling Asleep ◽

The Impact

Abstract Background Benzodiazepines (BZD) are associated with adverse effects, particularly in older adults. Previous research has shown an association between BZDs and falls and BZDs have been shown to impact sleep quality. The aim of this study is to assess the association between BZD use and falls, and the impact of sleep quality on this association, in community dwelling adults aged over 50. Methods Data from the first wave of The Irish Longitudinal Study on Ageing were used. Participants were classed as BZD users or non-users and asked if they had fallen in the last year, and whether any of these falls were unexplained. Sleep quality was assessed via self-reported trouble falling asleep, daytime somnolence, and early-rising. Logistic regression assessed for an association between BZD use and falls, and the impact of sleep quality on this association was assessed by categorising based on BZD use and each sleep quality variable. Results Of 8,175 individuals, 302 (3.69%) reported taking BZDs. BZD use was associated with falls, controlling for con-founders (OR 1.40; 1.08, 1.82; p-value 0.012). There was no significant association between BZDs and unexplained falls, controlling for con-founders (OR 1.41; 95% CI 0.95, 2.10; p-value 0.09), however a similar effect size to all falls was evident. Participants who take BZDs and report daytime somnolence (OR 1.93; 95% CI 1.12, 3.31; p-value 0.017), early-rising (OR 1.93; 95% CI 1.20, 3.11; p-value 0.007) or trouble falling asleep (OR 1.83; 95% CI 1.12, 2.97; p-value 0.015), have an increased odds of unexplained falls. Conclusion BZD use is associated with falls, with larger effect size in BZD users reporting poor sleep quality in community dwelling older adults. Appropriate prescription of and regular review of medications such as BZDs is an important public health issue.

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Mobile App Use for Insomnia Self-Management in Urban Community-Dwelling Older Korean Adults: Retrospective Intervention Study

JMIR mhealth and uhealth ◽

10.2196/17755 ◽

2020 ◽

Vol 8 (8) ◽

pp. e17755

Author(s):

Kyungmi Chung ◽

Seoyoung Kim ◽

Eun Lee ◽

Jin Young Park

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Sleep Problems ◽

Mobile App ◽

Community Dwelling ◽

Intervention Period ◽

Post Intervention ◽

Subjective Sleep Quality ◽

Subjective Sleep ◽

Self Help

Background As an evidence-based psychotherapy for treating insomnia, cognitive behavioral therapy for insomnia (CBT-I), which helps people with sleep problems to change their unhelpful sleep-related beliefs and habits, has been well-established in older adults. Recently, the utilization of mobile CBT-I apps has been getting attention from mental health professionals and researchers; however, whether mobile CBT-I apps are usable among older users has yet to be determined. Objective The aims of this study were to explore the relationships between subjective sleep quality and subjective memory complaints and depressive symptoms; to explore the relationship between perceived difficulty in mobile app use and usability of the mobile phone–based self-help CBT-I app, named MIND MORE, in urban community-dwelling Korean older adults; to compare changes in subjective sleep quality from pre-intervention to post-intervention, during which they used the mobile app over a 1-week intervention period; and evaluate adherence to the app. Methods During the 2-hour training program delivered on 1 day titled “Overcoming insomnia without medication: How to use the ‘MIND MORE’ mobile app for systematic self-management of insomnia” (pre-intervention), 41 attendants were asked to gain hands-on experience with the app facilitated by therapists and volunteer workers. They were then asked to complete questionnaires on sociodemographic characteristics, subjective evaluation of mental health status (ie, depression, memory loss and impairment, and sleep problems), and app usability. For the 1-week home-based self-help CBT-I using the app (post-intervention), 9 of the 41 program attendants, who had already signed up for the pre-intervention, were guided to complete the given questionnaires on subjective evaluation of sleep quality after the 1-week intervention, specifically 8 days after the training program ended. Results Due to missing data, 40 of 41 attendants were included in the data analysis. The main findings of this study were as follows. First, poor subjective sleep quality was associated with higher ratings of depressive symptoms (40/40; ρ=.60, P<.001) and memory complaints (40/40; ρ=.46, P=.003) at baseline. Second, significant improvements in subjective sleep quality from pre-intervention to post-intervention were observed in the older adults who used the MIND MORE app only for the 1-week intervention period (9/9; t8=3.74, P=.006). Third, apart from the program attendants who did not have a smartphone (2/40) or withdrew from their MIND MORE membership (3/40), those who attended the 1-day sleep education program adhered to the app from at least 2 weeks (13/35, 37%) to 8 weeks (2/35, 6%) without any further contact. Conclusions This study provides empirical evidence that the newly developed MIND MORE app not only is usable among older users but also could improve subjective sleep quality after a 1-week self-help intervention period.

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The Association Between Poor Sleep and Accelerated Brain Ageing

10.1101/2021.06.16.448332 ◽

2021 ◽

Author(s):

Jivesh Ramduny ◽

Matteo Bastiani ◽

Robin Huedepohl ◽

Stamatios Sotiropoulos N Sotiropoulos ◽

Magdalena Chechlacz

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Sleep Problems ◽

Sleep Fragmentation ◽

Poor Sleep ◽

Age Related ◽

Brain Ageing ◽

Neuroimaging Data ◽

Brain Age ◽

Ageing Brain

The ageing brain undergoes widespread gray (GM) and white matter (WM) degeneration. But numerous studies indicate large heterogeneity in the age-related brain changes, which can be attributed to modifiable lifestyle factors, including sleep. Inadequate sleep has been previously linked to GM atrophy and WM changes. However, the reported findings are highly inconsistent. By contrast to previous research independently characterizing patterns of either the GM or the WM changes, we used here linked independent component analysis (FLICA) to examine covariation in GM and WM in a group of older adults. Next, we employed a novel technique to estimate the brain age delta (i.e. difference between chronological and apparent brain age assessed using neuroimaging data) and study its associations with sleep quality and sleep fragmentation, hypothesizing that poor sleep accelerates brain ageing. FLICA revealed a number of multimodal (including both GM and WM) neuroimaging components, associated with age, but also with sleep quality and sleep fragmentation. Brain age delta estimates were highly sensitive in detecting the effects of sleep problems on the ageing brain. Specifically, we show significant associations between brain age delta and poor sleep quality, suggesting two years deviation above the chronological age. Our findings indicate that sleep problems in healthy older adults should be considered a risk factor for accelerated brain ageing.

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Associations of loneliness and social isolation with actigraph and self-reported sleep quality in a national sample of older adults

SLEEP ◽

10.1093/sleep/zsaa140 ◽

2020 ◽

Author(s):

Jade A Benson ◽

V Eloesa McSorley ◽

Louise C Hawkley ◽

Diane S Lauderdale

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Social Isolation ◽

Social Life ◽

Sleep Onset ◽

Ordinary Least Squares ◽

Community Dwelling ◽

Sleep Study ◽

Time In Bed ◽

Wrist Actigraphy

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.

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Associations of Actigraphic Sleep Parameters With Fatigability in Older Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa137 ◽

2020 ◽

Vol 75 (9) ◽

pp. e95-e102 ◽

Cited By ~ 1

Author(s):

Alfonso J Alfini ◽

Jennifer A Schrack ◽

Jacek K Urbanek ◽

Amal A Wanigatunga ◽

Sarah K Wanigatunga ◽

...

Keyword(s):

Older Adults ◽

Perceived Exertion ◽

Sleep Onset ◽

Later Life ◽

Sleep Time ◽

Community Dwelling ◽

Rating Of Perceived Exertion ◽

Poor Sleep ◽

Wrist Actigraphy ◽

Sleep Parameters

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.

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Bedtime Music for Sleep Problems in older Adults with Dementia: a feasibility Study

Music and Medicine ◽

10.47513/mmd.v12i4.765 ◽

2020 ◽

Vol 12 (4) ◽

pp. 222

Author(s):

Kira Vibe Jespersen ◽

Jens Madsen ◽

Peter Vuust

Keyword(s):

Older Adults ◽

Sleep Problems ◽

Low Cost ◽

Poor Sleep ◽

Music Listening ◽

Elderly Persons ◽

Music Intervention ◽

Intervention Period ◽

Subject Design ◽

Wrist Actigraphy

Sleep problems are highly prevalent in elderly persons with dementia. Poor sleep constitute a major problem as it causes distress and may aggravate the dementia symptoms. Music has been proposed as a potential sleep aid, and in this study, we assessed the feasibility and effect of bedtime music listening for improving sleep problems in older adults with dementia. We used a within-subject design including 40 participants. Participants and caregivers evaluated the feasibility and effect after the intervention period, and we measured sleep with wrist actigraphy 14 days at baseline and during the 14 days intervention period. In the intervention period participants listened to music for 30 minutes every night at bedtime. We developed five playlists with slow, soothing music of different genres, and participants could choose the genre they liked the best. We found that the music intervention was well-liked and sleep improvement was observed in around half the participants. Wrist actigraphy showed no significant changes in the objective sleep pattern. Music listening at bedtime could provide a safe, comfortable and low-cost intervention for sleep problems among elderly persons with dementia, the intervention is feasible, but more research is needed to determine the effect on sleep outcomes.

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