ABSTRACT
This study investigated whether a sensitive, physiological measure of alertness/sleepiness, the Multiple Sleep Latency Test (MSLT), was related to neuropsychological test performance in elderly individuals. We hypothesized that the greater likelihood of falling asleep during the daytime on the MSLT would be related to relatively poorer performances on a variety of neuropsychological tests. Results from a homogeneous sample of 35 relatively well-educated, high functioning, elderly community volunteers confirmed the presence of characteristic levels of daytime alertness which were stable within individuals (r = .70 to .73) and showed large variation across individuals (coefficients of variation: 54-84%). Despite this wide intersubject variability, MSLT-defined alertness/sleepiness was unrelated to neuropsychological test results. We discuss these results in terms of the performance deficits known to accompany sleepiness in experimental studies of sleep deprivation and in terms of the behavioral slowing known to occur in normal aging.
Subject(s)
Psychomotor Performance/physiology , Sleep/physiology , Aged , Aging/physiology , Arousal/physiology , Female , Humans , Intelligence Tests , Male , Middle AgedABSTRACT
The purpose of this study was to evaluate the relative validity of responses to three different questions about snoring as indicators for sleep apnea in a population referred to a sleep clinic. Secondary goals were to evaluate the meaning of a "don't know" response to these questions and to examine how the associations between snoring and sleep apnea are influenced by demographics. Results from 1,409 patients in a sleep clinic indicated that nearly all levels of estimated snoring frequency were associated with a greater likelihood of sleep apnea. In addition, a "don't know" response indicated a likelihood of sleep apnea. In the sample from this clinic, sensitivities approximating 90 percent were obtained in men, and specificities approximating 90 percent were obtained in women, but high diagnostic accuracy (high specificity in men; high sensitivity in women) could not be achieved with the three snoring questions used here. Generally, associations between snoring and sleep apnea were independent of age and sex. Single persons, persons living alone, and persons customarily sleeping alone of both sexes all showed associations between self-reported snoring and the presence of sleep apnea.
Subject(s)
Self-Assessment , Sleep Apnea Syndromes/diagnosis , Snoring/diagnosis , Confidence Intervals , Electrocardiography , Electroencephalography , Electromyography , Electrooculography , Fatigue/diagnosis , Female , Humans , Male , Marriage , Middle Aged , Odds Ratio , Reproducibility of Results , Sex Factors , Sleep Initiation and Maintenance Disorders/diagnosis , Sleep StagesABSTRACT
"Sundowning," a term that is sometimes equated with sleep disturbance or nocturnal delirium in dementia, is a poorly understood psychiatric phenomenon. In this study, we performed systematic, temporally specific, behavioral observations of nine profoundly demented nursing home patients 4 times an hour over a 12-hour period (1300 to 0100h) to determine whether their agitation was more likely to occur at a particular time of day. Results indicated only equivocal evidence that agitation was any worse nocturnally or during the time near sunset, thus raising the possibility that at least some components of sundowning may reflect disruptive behaviors occurring with identical frequency throughout the day but with differential impact upon nursing staff. Additional data indicated that awakening from sleep during darkness was also associated with agitation. A final result was a trend indicating the apparent worsening of agitation seasonally (greater agitation during winter), which may suggest involvement of the circadian timing system.
Subject(s)
Dementia/psychology , Sleep Wake Disorders/complications , Activities of Daily Living , Aged , Circadian Rhythm , Dementia/complications , Dementia/rehabilitation , Female , Humans , Light , Male , Nurse-Patient Relations , Nursing Homes , Nursing Staff , Professional-Patient Relations , Seasonal Affective Disorder/complicationsABSTRACT
Factors related to successful behavioral intervention for individuals with insomnia are not well understood. In this study we employed the Neuroticism, Extraversion and Openness (NEO) Personality Inventory, to predict successful treatment outcome. Two behavioral treatments for insomnia, sleep restriction therapy (SRT) and relaxation training (RT) were employed in 32 elderly insomniacs. Following two baseline weeks, subjects underwent four weeks of individual treatment. Daily telephone call-ins generated data on sleep times and sleep latency. Follow-up occurred three months after the end of treatment. Results indicated that subjects showing the greatest improvement in total sleep time with both treatments were more traditional, conventional and rigid. Improvement in sleep onset latency was unrelated to NEO Scores. SRT appeared to be more effective for increasing total sleep time in these older subjects.