title: Factors associated with incidence and persistence of symptoms of disturbed sleep in an elderly cohort: the Cardiovascular Health Study.
abstract: BACKGROUND
  There are limited data pertaining to the factors influencing the incidence and persistence of sleep symptoms in the elderly. The purpose of this study was to determine the incidence and nonremission rates of the following sleep symptoms: trouble falling asleep (TFA), frequent awakenings (FA), and excessive daytime sleepiness (EDS) in the Cardiovascular Health Study (CHS), a prospective multicenter study of cardiovascular disease in a large cohort of elderly adults. Factors influencing these rates were assessed as well.
  
  
  METHODS
  4467 participants in CHS were surveyed for the presence of TFA, FA, and EDS as well as other health problems at their baseline examination and at a follow-up examination 1 to 4 years later.
  
  
  RESULTS
  Annualized incidence and nonremission rates were the following: TFA (2.8% and 15.4%), FA (12.3% and 22.7%), and EDS (4.4% and 13.4%). Women were more likely to have incident and persistent TFA. Depression was the primary factor predicting the incidence of all three sleep symptoms. However, other health conditions, including respiratory symptoms and cardiovascular disease, and limitation in activities of daily living were important as well. Depression also was the most important factor associated with persistence of these sleep symptoms. The role of other health conditions in determining nonremission was much more limited.
  
  
  CONCLUSIONS
  Incidence of sleep disturbances in the elderly is related to depression, health conditions, and physical functioning. However, persistence of sleep disturbances is best predicted by the presence of depression.
authors.affiliation: Department of Medicine, Sleep and Arizona Respiratory Centers, University of Arizona College of Medicine, Tucson, Arizona 85724, USA. squan@resp-sci.arizona.edu
authors.forename: Stuart F
authors.initials: SF
authors.lastname: Quan
authors.forename: Ronit
authors.initials: R
authors.lastname: Katz
authors.forename: Jean
authors.initials: J
authors.lastname: Olson
authors.forename: William
authors.initials: W
authors.lastname: Bonekat
authors.forename: Paul L
authors.initials: PL
authors.lastname: Enright
authors.forename: Terry
authors.initials: T
authors.lastname: Young
authors.forename: Anne
authors.initials: A
authors.lastname: Newman
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications; D015331:Cohort Studies; D003863:Depression / Q000150:complications; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000453:epidemiology*; D011795:Surveys and Questionnaires