Sleep disorders in the elderly with and without chronic airflow obstruction: the SARA study.
OBJECTIVE
Our objectives were to test the hypothesis that, in the geriatric population, chronic airway obstruction is associated with a higher prevalence of sleep disturbances; to identify the main correlates of sleep disturbances, and to verify whether asthma and COPD patients have different patterns of sleep disturbances.


METHODS
The EPESE questionnaire was administered to 734 patients aged 65 years and over with asthma or chronic obstructive pulmonary disease (cases) and 1237 individuals of comparable age who were free of respiratory disease but not of other chronic conditions (controls). Four sleep disturbances were quantified: difficulty in falling asleep, nocturnal awakening, morning tiredness, and early awakening. Multidimensional assessment of demographic data, personal history, clinical, and functional status was performed. Independent correlates of sleep disturbances were identified by logistic regression analysis.


RESULTS
One or more sleep disturbances were reported by 445 cases and 697 controls (60.6% vs. 56.4%, ns). Morning tiredness and early awakenings were more prevalent among cases (38% vs. 27.8%, p < 0.001, and 35.1% vs. 28%, p < 0.001, respectively). Depression, as assessed by the 15-item Geriatric Depression Scale, was the most significant independent correlate for all sleep scores. Both being a case and having arthritis were independent correlates of three out of the four sleep disturbances.


CONCLUSIONS
Selected sleep disturbances are more common among elderly patients with chronic airway diseases than in those with chronic non-respiratory diseases. Depressed mood and coexisting arthritis are the most relevant independent correlates of sleep disturbances.
Bellia
Vincenzo
V
Istituto di Medicina Generale e Pneumologia, University of Palermo, Italy. belliav@tin.it
Catalano
Filippo
F
Scichilone
Nicola
N
Incalzi
Raffaele Antonelli
RA
Spatafora
Mario
M
Vergani
Carlo
C
Rengo
Franco
F
D000368:Aged; D001993:Bronchodilator Agents / Q000627:therapeutic use; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology*; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000523:psychology; D013147:Spirometry; D011795:Surveys and Questionnaires; D014851:Wakefulness / Q000502:physiology
D001993:Bronchodilator Agents