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Measuring sleep quality in older adults: a comparison using subjective and objective methods.

Landry GJ, Best JR, Liu-Ambrose T - Front Aging Neurosci (2015)

Bottom Line: We compared two subjective measures of sleep quality-the PSQI and Consensus Sleep Diary (CSD)-with actigraphy (MotionWatch 8©; camntech).Our results suggest perceived sleep quality is quite different from objective reality, at least for adults 55+.Hence, we conclude best practice is to include both subjective and objective measures when examining sleep quality in older adults (i.e., the PSQI, CSD, and actigraphy).

View Article: PubMed Central - PubMed

Affiliation: Department of Physical Therapy, University of British Columbia Vancouver, BC, Canada ; Djavad Mowafaghian Centre for Brain Health, University of British Columbia Vancouver, BC, Canada.

ABSTRACT
Sleep quality decreases with aging and thus sleep complaints are prevalent in older adults, particularly for those with cognitive impairment and dementia. For older adults, emerging evidence suggests poor sleep quality increases risk of developing cognitive impairment and dementia. Given the aging population-and the impending economic burden associated with increasing numbers of dementia patients-there is pressing need to improve sleep quality among older adults. As such, research efforts have increased focus on investigating the association between age-related sleep changes and cognitive decline in older adults. Sleep quality is a complex construct to evaluate empirically, and yet the Pittsburg Sleep Quality Index (PSQI) is commonly used in studies as their only measure of sleep quality. Furthermore, the PSQI may not be the best sleep quality measure for older adults, due to its reliance on the cognitive capacity to reflect on the past month. Further study is needed to determine the PSQI's validity among older adults. Thus, the current study examined sleep quality for 78 community dwelling adults 55+ to determine the PSQI's predictive validity for objective sleep quality (as measured by actigraphy). We compared two subjective measures of sleep quality-the PSQI and Consensus Sleep Diary (CSD)-with actigraphy (MotionWatch 8©; camntech). Our results suggest perceived sleep quality is quite different from objective reality, at least for adults 55+. Importantly, we show this difference is unrelated to age, gender, education, or cognitive status (assessed using standard screens). Previous studies have shown the PSQI to be a valuable tool for assessing subjective sleep quality; however, our findings indicate for older adults the PSQI should not be used as a substitute for actigraphy, or vice versa. Hence, we conclude best practice is to include both subjective and objective measures when examining sleep quality in older adults (i.e., the PSQI, CSD, and actigraphy).

No MeSH data available.


Related in: MedlinePlus

A representative example of MW8 actigraphy for “poor” sleep quality, as defined by the MW8 composite. This actogram provides a graphical representation of the MW8 data, with conventions as reported for Figure 1.
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Figure 2: A representative example of MW8 actigraphy for “poor” sleep quality, as defined by the MW8 composite. This actogram provides a graphical representation of the MW8 data, with conventions as reported for Figure 1.

Mentions: A composite MW8 sleep quality score was created by averaging the standardized duration, efficiency, and fragmentation scores. The fragmentation score was multiplied by −1 prior to averaging; thus, higher composite scores represent better sleep quality. Because the PSQI categorizes individuals as either “good” or “poor” quality sleepers – for comparison purposes—we created a categorical composite score for the MW8 data. In addition to considering the distribution of MW8 data in our sample, our criteria for categorizing the composite MW8 sleep quality score was based on sleep characteristics previously shown to predict cognitive decline in older adults (Keage et al., 2012). Individuals were classified as having: (1) good sleep quality based on fragmentation ≤ 25, efficiency ≥ 85, and duration ≥ 420 min (see Figure 1); (2) poor sleep quality based on fragmentation ≥ 40 and efficiency ≤ 75, or duration ≤ 360 min (see Figure 2); or (3) the remaining individuals were classified as having average sleep quality.


Measuring sleep quality in older adults: a comparison using subjective and objective methods.

Landry GJ, Best JR, Liu-Ambrose T - Front Aging Neurosci (2015)

A representative example of MW8 actigraphy for “poor” sleep quality, as defined by the MW8 composite. This actogram provides a graphical representation of the MW8 data, with conventions as reported for Figure 1.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4561455&req=5

Figure 2: A representative example of MW8 actigraphy for “poor” sleep quality, as defined by the MW8 composite. This actogram provides a graphical representation of the MW8 data, with conventions as reported for Figure 1.
Mentions: A composite MW8 sleep quality score was created by averaging the standardized duration, efficiency, and fragmentation scores. The fragmentation score was multiplied by −1 prior to averaging; thus, higher composite scores represent better sleep quality. Because the PSQI categorizes individuals as either “good” or “poor” quality sleepers – for comparison purposes—we created a categorical composite score for the MW8 data. In addition to considering the distribution of MW8 data in our sample, our criteria for categorizing the composite MW8 sleep quality score was based on sleep characteristics previously shown to predict cognitive decline in older adults (Keage et al., 2012). Individuals were classified as having: (1) good sleep quality based on fragmentation ≤ 25, efficiency ≥ 85, and duration ≥ 420 min (see Figure 1); (2) poor sleep quality based on fragmentation ≥ 40 and efficiency ≤ 75, or duration ≤ 360 min (see Figure 2); or (3) the remaining individuals were classified as having average sleep quality.

Bottom Line: We compared two subjective measures of sleep quality-the PSQI and Consensus Sleep Diary (CSD)-with actigraphy (MotionWatch 8©; camntech).Our results suggest perceived sleep quality is quite different from objective reality, at least for adults 55+.Hence, we conclude best practice is to include both subjective and objective measures when examining sleep quality in older adults (i.e., the PSQI, CSD, and actigraphy).

View Article: PubMed Central - PubMed

Affiliation: Department of Physical Therapy, University of British Columbia Vancouver, BC, Canada ; Djavad Mowafaghian Centre for Brain Health, University of British Columbia Vancouver, BC, Canada.

ABSTRACT
Sleep quality decreases with aging and thus sleep complaints are prevalent in older adults, particularly for those with cognitive impairment and dementia. For older adults, emerging evidence suggests poor sleep quality increases risk of developing cognitive impairment and dementia. Given the aging population-and the impending economic burden associated with increasing numbers of dementia patients-there is pressing need to improve sleep quality among older adults. As such, research efforts have increased focus on investigating the association between age-related sleep changes and cognitive decline in older adults. Sleep quality is a complex construct to evaluate empirically, and yet the Pittsburg Sleep Quality Index (PSQI) is commonly used in studies as their only measure of sleep quality. Furthermore, the PSQI may not be the best sleep quality measure for older adults, due to its reliance on the cognitive capacity to reflect on the past month. Further study is needed to determine the PSQI's validity among older adults. Thus, the current study examined sleep quality for 78 community dwelling adults 55+ to determine the PSQI's predictive validity for objective sleep quality (as measured by actigraphy). We compared two subjective measures of sleep quality-the PSQI and Consensus Sleep Diary (CSD)-with actigraphy (MotionWatch 8©; camntech). Our results suggest perceived sleep quality is quite different from objective reality, at least for adults 55+. Importantly, we show this difference is unrelated to age, gender, education, or cognitive status (assessed using standard screens). Previous studies have shown the PSQI to be a valuable tool for assessing subjective sleep quality; however, our findings indicate for older adults the PSQI should not be used as a substitute for actigraphy, or vice versa. Hence, we conclude best practice is to include both subjective and objective measures when examining sleep quality in older adults (i.e., the PSQI, CSD, and actigraphy).

No MeSH data available.


Related in: MedlinePlus