Sleep quality

Sleep quality

LASA filenames:
LASA117 / LASA317

Contact: Almar Kok


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 sleep are asked: Q 1) the number of hours which people usually sleep per day, and Qs 2-4) whether the respondent has problems with falling asleep, waking through the night or waking up too early in the morning. Answer categories were: almost never (1), sometimes (2), frequently (3) or almost always (4).

From LASA-G onwards, two questions on sleeping problems were added: Q 5) ‘At what time do you usually go to sleep in the evening?’, answered in hours and minutes, and Q 6) ‘How would you assess the quality of your sleep over the last month?’, answered as very good (1), somewhat good (2), somewhat bad (3) or very bad (4).
Scale construction
A scale of sleep quality is calculated from the three categorical questions (problems falling asleep, waking through the night and waking up too early) by summing all answers to these questions, ranging from 3 (no problems) to 12 (many problems). Missing values are not imputed; the scale score for respondents who miss one or more answers are not computed.


LASAB117 / LASAC117 / LASAD117 / LASAE117 / LAS2B117 / LASAF117 / LASAG117 / LASAH117 / LAS3B117 / LASAI117 / LASAJ117 / LASAK117 (self-administered questionnaire, in Dutch)

Variable information

LASAB117 / LASAC117 / LASAD117 / LASAE117 / LAS2B117 / LASAF117 / LASAG117 / LASAH117 / LAS3B117 / LASAI117 / LASAJ117 / LASAK117;
LASAB317 / LASAC317 / LASAD317 / LASAE317 / LAS2B317 / LASAF317 / LASAG317 / LASAH317 / LAS3B317 / LASAI317 / LASAJ317 / LASAK317 (scale scores)

Availability of information per wave


The number of
people usually
sleep per day
3 questions
about sleeping
2 additional questions


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.


  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.

Date of last update: December, 2019