Older Adults Always Napping: Dispelling the stereotype of aging and daytime sleepiness — Kait Casaus

Younger people often perceive older adults as being excessively sleepy and frequent nappers. Many individuals think of the baby boomer cohort as moving toward the stage where they spend more and more time at home, and often experience daytime sleepiness. However, research does not necessarily support the stereotype that aging increases daytime sleepiness and naps.

Daytime sleepiness and napping can be more common in older age, but research has not yet shown that there is a direct correlation between aging and increased nap frequency, or prevalence of daytime sleepiness. One study states that although sleep quality and quantity tends to decline as individuals age, an increase in sleepiness during the day may be an early symptom of neurodegenerative disease or dementia. Additionally, depression and Alzheimer’s disease may contribute to decreased sleep quality, and the presence of daytime drowsiness. This particular study also showed the association between daytime sleepiness and decline in cognitive status and processing speed (Tsapanou et al., 2015).

Additionally, although insomnia and decreased sleep quality and quantity are reported by older adults, there may be confounding factors other than age that impact sleep quality and therefore potentially daytime sleepiness. For example, in a study by Jaussent et al. (2012), participants with cerebrovascular disease were studied in a longitudinal analysis to determine relationships between cerebrovascular disease and excessive daytime sleepiness (Jaussent et al., 2012). Although history of cerebrovascular disease was not significantly associated with daytime sleepiness, it may be a predictor of future cerebrovascular disease. Similarly, cognitive decline was associated with insomnia when participants also had depressive symptoms, but the statistical significance was minimized when analyzed with depression as a confounding variable. Therefore, it is uncertain whether researchers can determine a direct relationship between age and insomnia, or quality of sleep, rather than depression or other illness as an influence on sleep quality and quantity. Additionally, excessive daytime sleepiness in older adults can be influenced by dementia or abnormalities of circadian rhythm in association with plaques or other neurological circulation. Other confounding variables related to daytime drowsiness were sleep apnea, reduced quantity of sleep, and body pain. Therefore, although some of these variables may be related to aging, there is no significant evidence for a causal relationship between age and daytime sleepiness (Jaussent et al., 2012).

Other researchers found that the results of particular time frames of napping can be beneficial to the health of older adults. In a study of neurotypical older adults, researchers found that napping can be proactive in reducing cognitive decline, and reduce the likelihood of Alzheimer’s disease progression in increments of less than 60 minutes, and resulted in improved cognition. Using a self report measure and longitudinal study, researchers found that excessive drowsiness during the day was associated with negative consequences in cognitive functioning. However, they also found slight napping during the day without excessive sleepiness was associated with reduced cognitive decline. Therefore, napping was shown to be beneficial, but excessive daytime sleepiness can be related to early stages of cognitive decline. Additionally, researchers stated that excessive daytime sleepiness may be related to short sleep duration as a sign, rather than a symptom in itself (Keage et al., 2012).

In a study by Merlino et al. (2010), researchers found that when analyzing the prevalence of sleep disturbances in older adults with dementia, excessive daytime sleepiness was positively correlated with the severity of dementia. However, in this study, insomnia was not significantly related to cognitive decline. Therefore, the study shows that as individuals age, the presence of excessive daytime sleepiness may not be a trait of aging, but the presence of an underlying neurological condition (Merlino et al., 2011).

Overall, research refutes the stereotype that all older adults are more tired during the day and therefore take more naps. Excessive sleepiness may be due to an underlying slow cognitive decline, or other related medical condition. The sleepiness of older adults during the day may be attributed to lifestyle factors, including decreased participation in the workforce, retirement, more free time during the day, or increased insomnia during the night or other related sleep disturbances.

References

Merlino, G., Piano, A., Gigli, G. L., Cancelli, I Rinaldi, A., Baroselli, A., . . . Valente, M. (2011).

Daytime sleepiness associated with dementia and cognitive decline in older Italian adults: A population-based study. Sleep Medicine, 11(4), 372-377.

Jaussent, I., Bouyer, J., Ancelin, M., Berr, C., Foubert-Samier, A., Ritchie, K., . . . Dauvilliers, Y.

(2012). Excessive sleepiness is predictive of cognitive decline in the elderly. Sleep, 35(9).

Keage, H. A., Banks, S., Yang, K. L., Morgan, K., Brayne, C., Matthews, F. E. (2012). What sleep

characteristics predict cognitive decline in the elderly? Sleep Medicine, 13(7) 886-92. DOI: 10.1016/j.sleep.2012.02.003

Tsapanou, A., Gu, Y., O’Shea, D., Eich, T., Ming-Xin, T., Schupf, N., . . . Stern, Y. (2015). Daytime

somnolence as an early sign of cognitive decline in a community-based study of older

people. International Journal of Geriatric Psychiatry, 31(3), 247-255.

DOI 10.1002/gps.4318

Photo: http://www.seniorhealth365.com/wp-content/uploads/2012/03/9911050_s.jpg

 

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