Sleep quality


LASA117
LASA317

Contact: Hannie Comijs

Background
Sleep quality changes with ageing, and the number of people having sleeping problems increases with ageing. With ageing sleep becomes more fragmented and sleep interruptions increase. There is an increased number of sleep stage shifts, indicating difficulty in maintaining stages, there are fewer REM/non-REM cycles. Health problems negatively affect the sleep of the elderly, in particular nocturia, diabetes, cardiovascular symptoms, depression, arthritis, osteoarthritis, bronchitis, gastrointestinal illness and medication side effects (Bliwise et al., 1993). The annual incidence of insomnia in people aged 65 years and older is 5% (Foley et al., 1995; Foley et al., 1999). Risk factors for sleeping problems are depression, respiratory symptoms, disability, fair to poor perceived health, widowhood and use of sedatives (Philips et al., 2001).

Measurement in LASA
In the self-administered questionnaire four questions about sleeping problems are asked. First the number of hours which people usually sleep per day was asked, furthermore, the respondents were asked if they ever had problems with falling asleep, waking through the night and waking up to early in the morning. The different answers were: almost never (1), sometimes, frequently or almost always (4). It was administered at LASA-B (1992/1993), C (1995/1996), D (1998/1999) and E (2001/2002), 2B (2002/2003), F (2005/2006) and G (2008/2009). From LASA G on two questions on sleeping problems were added. These question were formulated as: ‘At what time do you usually go to sleep in the evening?’ and ‘How would you assess the quality of your sleep over the last month?’

A scale is calculated from the three categorical questions by summing all answers to these questions, ranging from 3 (no problems) to 12 (many problems) (LASA317). Missing values are not imputed, respondents who miss one or more answers get no scale score. The most optimal cut-off point for dichotomisation of the total score of sleeping disorders can be determined by examining the risk gradients across deciles and quartiles (i.e. decile or quartile which showed the strongest association with the independent variable).

Questionnaires
LASAB117 / LASAC117 / LASAD117 / LASAE117 / LAS2B117 / LASAF117 / LASAG117 / LASAH117 / LAS3B117 / LASAI117 (self-administered questionnaire, in Dutch)

Variable information
LASAB117 / LASAC117 / LASAD117 / LASAE117 / LAS2B117 / LASAF117 / LASAG117 / LASAH117 / LAS3B117 / LASAI117;
LASAB317 / LASAC317 / LASAD317 / LASAE317 / LAS2B317 / LASAF317 / LASAG317 / LASAH317 / LAS3B317 / LASAI317 (scale scores)
(pdf)

Availability of information per wave 1

 

B

C

D

E

 
2B*

F

G

H

 

3B*

MB*

I

The number of hours people usually sleep per day

Sa

Sa

Sa

Sa

Sa

Sa

Sa

Sa

Sa

-

Sa

3 questions about sleeping problems

Sa

Sa

Sa

Sa

Sa

Sa

Sa

Sa

Sa

-

Sa

2 additional questions

-

-

-

-

-

-

Sa

Sa

Sa

-

Sa

1 More information about the LASA data collection waves is available here.

* 2B=baseline second cohort;
   3B=baseline third cohort;
   MB=migrants: baseline first cohort

Sa=data collected in self-administered questionnaire

Previous use in LASA
It was used in a study of the consequences of vertebral deformities but the results showed that it had no significant effect on sleeping problems (Pluijm et al., 2000). It was also studied in relation with benzodiazepine use in the elderly, in which was showed that Benzodiazepine use remained stable over 10 years, with a persisting preponderance in women and in people with low education, low income, chronic physical diseases, functional limitations, cognitive impairment, depression, anxiety complaints, sleep problems and when using antidepressants.

 

References

  1. Bliwise, D. L. (1993). Sleep in normal aging and dementia. Sleep, 16, 40-81.
  2. Foley, D. J., Monjan, A. A., & Brown, S. L. (1995). Sleep complaints among elderly persons: an Epidemiologic study of three communities. Sleep, 18, 425-432.
  3. Foley, D. J., Monjan, A. & Simonsick, E. M. (1999). Incidence and remission of insomnia among elderly adults: an Epidemiologic study of 6,800 person over 3 years. Sleep, 22 (Suppl2), S366-S372.
  4. Philips, B., & Ancoli-Israel, S. (2001). Sleep disorders in the elderly, review. Sleep Medicine, 2, 99-114.
  5. Pluijm, S. M. F., Tromp, A.M., Smit, J. H., Deeg, D. J .H., & Lips, P. (2000) Consequences of vertebral deformities in older men and women. Journal of Bone and Mineral Research, 15, 1564-1572.
  6. Sonnenberg, C.M., Bierman, E.J., Deeg, D.J., Comijs, H.C., van Tilburg, W., Beekman, A.T. (2012) Ten-year trends in benzodiazepine use in the Dutch population. Social Psychiatry and Psychiatric Epidemiology, 47(2):293-301.