37 Million Senior Citizens Suffer Sleep Problems

April 1, 2003 - Exploding many common myths that associate poor sleep and less sleep with aging, the 2003 Sleep in America poll shows that older adults typically do not sleep less than their younger counterparts, averaging about seven hours of sleep each night. It did find that some 37 million older Americans suffer from frequent sleep problems that if ignored, can complicate the treatment of a host of common, serious age-related medical conditions, from arthritis to diabetes, heart and lung disease and depression.

Poor sleep is also associated with three other problems affecting many older adults: bodily pain, excess weight and ambulatory restrictions, such as difficulty walking or going up and down stairs.

While some older adults are very healthy and have normal sleep patterns, frequent untreated sleep problems may be interfering with the ability of many others to cope with chronic medical conditions, according to the poll released today by the National Sleep Foundation (NSF).

"The 2003 Sleep in America poll indicates that poor health and not age is a major reason why many older people in this country report sleep problems, providing an important wake up call that identifying and treating these sleep problems must be a priority concern," said Richard L. Gelula, NSF's executive director. "The fact that a person is 60 or 70 years old doesn't preclude the possibility of sleeping well and benefiting from this restorative process to remain vital and active. That's why we must drive home the message that sleeping well is vital to aging well."

Marking the Foundation's first effort to look at the sleep habits and patterns of America's older adults - those between the ages of 55 and 84 - NSF's 2003 Sleep in America poll finds a direct association between the number of diagnosed medical conditions that older adults report and the quality of their sleep. The more medical conditions, the more sleep problems.

However, NSF's new poll shows that poor sleep among older adults often goes unnoticed by the medical community. Although the majority of older adults (67 percent) report frequent sleep problems, only a small fraction (one in eight) says his or her sleep problems have been diagnosed. This means of the 37 million older adults reporting sleep problems, only about seven million have been diagnosed, leaving 30 million to count sheep. NSF is urging the medical community to treat sleep as an integral part of disease management, especially in older patients.

"In spite of the emerging science linking sleep and health, only a small fraction of the many reported sleep complaints of older adults are actually diagnosed and treated," says NSF President, James K. Walsh, PhD. "The 2003 Sleep in America poll reinforces the position that sleep problems should not be viewed as an aspect of normal aging, and they can significantly increase the overall burden of illness on patients," Walsh adds.

Dr. Walsh is executive director and senior scientist of the Sleep Medicine and Research Center at St. Luke's Hospital in Chesterfield, Mo.

SLEEP AND HEALTH FOR OLDER AMERICANS

NSF's 2003 Sleep in America poll shows that inadequate sleep is clearly associated with many of the major diseases prevalent in older adults. Of special significance, the poll links ongoing sleep problems with 82 percent of those who report being diagnosed with depression, 81 percent who have suffered a stroke, 76 percent diagnosed with heart disease, and 75 percent diagnosed with lung disease. Sleep problems are also a factor for 72 percent of older adults diagnosed with diabetes or arthritis, and 71 percent of those who have been diagnosed with hypertension.

Sleep problems are especially acute among those older adults who have more than one medical condition: eight in ten with four or more medical conditions report a sleep problem compared to about one half of those with no reported medical conditions (80 percent vs. 53 percent). In addition, the poll connects poor sleep with three physical problems affecting many older people: bodily pain, excess weight and ambulatory limitations.

According to the newest findings: -- More than three-quarters (77 percent) of those who report having frequent bodily pain also report a sleep problem. -- Sleep problems are equally common among older adults who are classified as obese (77 percent) and are linked with two-thirds (64 percent) of those who are considered overweight by medical standards; and -- The vast majority of older people with impaired mobility are likely to report a sleep problem (84 percent), with two-thirds experiencing a symptom of insomnia. -- Moreover, about four in ten of those with impaired mobility report unpleasant feelings in their legs, a symptom of Restless Legs Syndrome, a serious, treatable sleep disorder.

Insomnia is the most common sleep problem, with about one-half of older adults (48 percent) reporting they frequently experience at least one symptom. (Symptoms of insomnia include difficulty falling asleep, waking a lot during the night, waking up too early and not getting back to sleep, and waking feeling unrefreshed).

While waking up a lot in the middle of the night is the most common insomnia complaint, the biggest overall problem disrupting the sleep of older adults is the need to get up and go to the bathroom, with nearly two thirds (65 percent) reporting this disturbance at least a few nights a week.

Rounding out the link between sleep and health, the poll finds that the better the sleep, the better the perceived health of older adults. Those who rate their health as "very good" or "excellent," for example, report less daytime sleepiness than those with "fair" or "poor" health (9 percent vs. 29 percent). They also report fewer insomnia symptoms (38 percent vs. 71 percent), and fewer sleep problems (59 percent vs. 85 percent). And the healthy are less likely to categorize their sleep as "fair" or "poor" (13 percent vs. 47 percent).

COMPARING SLEEP PATTERNS OF OLDER AND YOUNGER ADULTS

Besides charting the sleep patterns of older adults, the 2003 Sleep in America poll dispels the notion that the older we are, the less we sleep. In fact, the poll shows older adults sleep about the same amount as their younger counterparts(note), though their sleep habits are substantially different.

Providing an up-to-date look at how older adults are sleeping, the poll finds that: -- The sleep patterns of older adults are more consistent than those of their younger counterparts. Older adults get about the same amount of sleep on weeknights (7.0 hrs/night) and weekends (7.1 hrs/night), while younger adults sleep less during the week (6.7 hrs/night), increasing their sleep on weekends (7.6 hrs/night). About 13 percent of older adults sleep less than six hours on weeknights compared to l6 percent of those 18-54.

-- The frequency of adults' sleep problems tends to diminish slightly with age. Of those aged 55-64, seven in ten (71 percent) report experiencing a frequent sleep problem compared to 65 percent of those aged 65-74, and 64 percent of those aged 75-84.

When it comes to the sleep patterns of older men and women, the poll finds no major gender differences. However, older women are more likely to report at least one symptom of insomnia (50 percent vs. 45 percent), while older men are more likely to report they snore (40 percent vs. 26 percent) and experience pauses in breathing during sleep (10 percent vs. 5 percent).

About one-third of older adults nap regularly, and the frequency of naps increases with age.

LIFESTYLE

To complete the picture of America's older adults and their sleep, the 2003 Sleep in America poll examines lifestyle factors that can impact the quantity and quality of sleep. Key findings include:

-- Older adults feel connected, not isolated. Three-fourths of older adults polled say it is very easy for them to find a family member or friend to talk to when needed. However the 25 percent who feel more isolated say they are more likely to sleep less than six hours a night (l9 percent vs.12 percent), and experience a symptom of insomnia (59 percent vs. 45 percent).

-- Older adults exercise. About one-half of older adults (52 percent) report exercising to improve their fitness three or more times a week. Only one-quarter of those polled say they exercise less than once a week. The more older people exercise, the less likely they are to describe their sleep quality as fair or poor (20 percent vs. 32 percent), and the less likely they are to report symptoms of insomnia (43 percent vs. 58 percent) than those who exercise infrequently.

The National Sleep Foundation issued its 2003 Sleep in America poll in conjunction with National Sleep Awareness Week(r), (March 31-April 6), its major public awareness campaign that coincides with the return of Daylight Saving Time when clocks "spring forward" an hour at 2 a.m. Sunday morning in much of the nation.

WB&A Market Research conducted the 2003 Sleep in America poll for the National Sleep Foundation using telephone interviews with a random sample of 1506 adults aged 55-84, living in community dwellings (not institutions). The interviews were conducted between September l7 and December 10, 2002. The margin of error is plus or minus 2.5 percent.