First it was sex, now it's sleep. It seems there's no end to the bedtime activities at which aging Americans excel, at least according to new research that finds subjective sleep quality improves with age.
In the study published Thursday in the journal SLEEP, researchers analyzed the responses of more than 155,000 adults, age 18 and over, who participated in a telephone survey assessing their sleep disturbances and level of tiredness.
According to the researchers' findings, both sleep disturbances and tiredness declined with age. The fewest complaints came from the oldest participants -- those 80 and above.
Sleep problems seemed to increase slightly in middle age, from around 40 to 59 years old -- particularly in women -- but then decreased after that.
"This flies in the face of popular belief,” Dr. Michael Grandner, a research associate at the Center for Sleep and Circadian Neurobiology at the University of Pennsylvania's Perelman School of Medicine and lead author of the study, said in a release. "These results force us to re-think what we know about sleep in older people -- men and women."
Indeed, the paper cites several epidemiological studies suggesting that sleep complaints and daytime sleepiness are more common among older men and women, including a Japan-based study from 2000 that found symptoms of insomnia were more prevalent in the elderly, while young people were more likely to report insufficient sleep.
The authors of the new study venture some guesses as to why their survey respondents seemed to see sleep issues wane with age.
One is that overall health is strongly related to sleep quality and outcomes, and individuals in bad health are the least likely to survive to old age. Additionally, younger adults have to contend with their own stressors that can undermine sleep, such as school and work pressures, children and eventually menopause.
"In addition, younger individuals may be experiencing more sleep-related problems due to society influences, such as increased technology, work hours or other factors experienced less by the older cohort," the study authors note. They caution, however, that data assessing the potential impact of such forces are still limited.
Another key to consider is that the study is based on self-reporting.
"This is based on older people's perception of sleep, not based on actually studying their sleep, which is potentially a significant difference," said Dr. Josh Werber of Eos Sleep, which offers sleep study, diagnosis and treatment. "Studies have been done on sleep in the older population and found it's more fragmented -- they don't have the same steady state of sleep that younger people have."
Older adults may wake repeatedly to visit the bathroom, Werber explained, or may take medications that affect their sleep cycle. Sleep apnea is also more common among older adults, he said.
But, the study authors acknowledge, older adults may have adjusted their expectations of what it means to be in good health or to have a good night's sleep and, thus, may be less likely to complain.
Werber agreed with the authors that a major takeaway from the study is that older adults should not necessarily expect that sleep will decline as they age and should tell health care providers if they have sleep or fatigue complaints.
"I think to some extent what this study tells you is that when a senior citizen complains of feeling tired or not feeling well rested, that should not be written off," Werber said. "Often, I think the answer would be, 'Well, you're older, so you're not getting enough sleep.'"
Overall, the experts seem to agree, the message here is an encouraging one.
"It's good news for the person getting older that they're not inevitably going to start having sleep problems," said Dr. David White, clinical professor of sleep medicine at Harvard Medical School, who was not associated with the study. "If you stay healthy and active, you should expect to sleep as well as you ever did, if not better."