Predictors of poor sleep quality

With age comes poor sleep. Age-related changes in sleep may be associated with poor cognitive outcomes, and therefore it is imperative to outline causes of poor sleep. Identifying causes may help to alleviate them. So why does aging bring poor sleep? And who is at risk? A recent review article aggregated articles on sleep disturbances in older adults in an attempt to discern the most prominent causes. This post will outline and review the risk factors for poor sleep that is associated with age.

Overview: The researchers first identified which self-reported demographic information was linked with insomnia. They found the most likely candidates to have insomnia are female, depressed, those with marriage stress, and those in poor physical health (described in more detail below). A few studies suggested that low physical activity (exercise) is linked with insomnia, but others failed to capture this link. Additionally, African Americans were more likely to suffer from insomnia, and so were widows/widowers and those with a lower economic status. There were also studies in which sleep was measured objectively through the use of motion-detecting watches. They found those with higher weight and poorer cognitive functioning had poorer quality sleep (although this is a chicken and egg situation in which it is unclear what came first). 

Depression: This risk factor deserves its own category given that it is so strongly linked with sleep disturbances. In fact, in 10 out of 13 studies reviewed in this piece, depression was found to be a strong predictor. One study found “risk for future sleep disturbances was increased by 7% per additional depressive symptom.” What’s worse, there may be an unending cycle where depression can worsen sleep, and sleep loss can worsen depression. Therefore, this risk factor is critical and should be addressed if possible.

Physical Health: It is not surprising that poor health is related to poor sleep, but which health factors specifically? It seems that, according to these past studies, the strongest predictors of poor sleep are number of medical conditions and chronic diseases (heart disease, to name a predominant predictor). Additionally, the use of medications, especially benzodiazepines and sedatives, predict poorer sleep outcomes.

Summary: For many people, as age increases, sleep quality decreases. It may seem like a futile fight, but physicians and sleep specialists can help create an individualized sleep improvement plan that can include treating depression, improving physical health, and reducing stress. For those with sleep apnea, improving sleep quality is especially important. If sleep is lightened by the aforementioned factors, wearing a sleep treatment device (e.g., CPAP) will be more disturbing to sleep. Therefore, for apneics, improving sleep quality in conjunction with apnea treatment would be twice as beneficial.

Source: Smagula, S. F., Stone, K. L., Fabio, A., & Cauley, J. A. (2015). Risk factors for sleep disturbances in older adults: evidence from prospective studies. Sleep Medicine Reviews.

Janna Mantua


Janna is a PhD Student / Graduate Research Assistant at University of Massachusetts Amherst with a background in clinical sleep research and psychology. Janna Mantua is a PhD student in the Behavioral Neuroscience department at the University of Massachusetts. Her research focuses on sleep and aging, with specific projects on cognitive health, inflammation, memory formation, and neuroimaging. Prior to her PhD work, Janna was involved in research on sleep apnea and cognitive decline at the NYU Sleep Disorders Center.

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