SLEEP DISTURBANCE, PSYCHOSOCIAL CORRELATES, AND CARDIOVASCULAR-DISEASE IN 5201 OLDER ADULTS - THE CARDIOVASCULAR HEALTH STUDY

OBJECTIVES: To describe the prevalence of self reported sleep disturba nces in older men and women and to describe their relationships with h ealth status and cardiovascular diseases (CVD). DESIGN: Cross-sectiona l study of sleep disturbance, CVD, general health, psychosocial factor s, physical function, and use of psychotropic medications. SETTING: Pa rticipants of the Cardiovascular Health Study, 5201 adults aged 65 and older recruited from a random sample of noninstitutionalized Medicare enrollees in four US communities. MEASURES: Self-reported sleep distu rbances and standardized questionnaires for cardiopulmonary symptoms a nd diseases, depression, social support, activities of daily living, p hysical activity, cognitive function, and current medications, spirome try, EGG, echocardiography, and carotid ultrasound. RESULTS: Women wer e twice as likely as men to report difficulty falling asleep (30% vs 1 4%). Daytime sleepiness, difficulty falling asleep, and frequent awake nings increased in prevalence with age. All symptoms were related stro ngly to depression. Symptoms of daytime sleepiness were also related s trongly to poor health and limitations in activities of daily living i n men and women. In multivariate analysis, men taking benzodiazepines were likely to report difficulty falling asleep and daytime sleepiness , whereas women taking benzodiazepines reported difficulty falling asl eep and waking up too early. After accounting for these factors, the o nly cardiovascular disease independently associated with sleep disturb ances was angina. Men and women with confirmed angina were 1.6 times m ore likely to report trouble falling asleep. Independent relationships between sleep disturbances and cardiovascular risk factors such as ob esity, hypertension, smoking, and diabetes were relatively weak and in consistent, though smokers were less likely to report frequent awakeni ngs. CONCLUSIONS: Sleep disturbances are relatively common in older me n and women and are associated with poor health, depression, angina, l imitations in activities of daily living, and the use of benzodiazepin es.