Protecting sleep, promoting health in later life: a randomized clinical trial.
OBJECTIVE
To determine in healthy people aged > or = 75 years 1) if restricting time in bed and education in health sleep practices are superior to an attention-only control condition (i.e., education in healthy dietary practices) for maintaining or enhancing sleep continuity and depth over 2.5 years; and 2) if maintenance or enhancement of sleep continuity and depth promotes the maintenance or enhancement of health-related quality of life.


METHODS
Single-blind, randomized, clinical trial in a university-based sleep center, enrolling 64 adults (n = 30 women, 34 men; mean age = 79 years) without sleep/wake complaints (e.g., insomnia or daytime sleepiness), followed by randomized assignment to either: 1) restriction of time in bed by delaying bedtime 30 minutes nightly for 18 months, together with education in healthy sleep practices (SLEEP); or 2) attention-only control condition with education in health dietary practices (NUTRITION).


RESULTS
SLEEP did not enhance sleep continuity or depth; however, compared with NUTRITION, SLEEP was associated with decreased time spent asleep (about 30 minutes nightly over 18 months). Contrary to hypothesis, participants in SLEEP reported a decrement in physical health-related quality of life and an increase in medical burden (cardiovascular illness), relative to NUTRITION. Neither markers of inflammation, body mass index, or exercise explained treatment-related changes in medical burden.


CONCLUSIONS
Although we cannot exclude a positive effect of education in healthy nutrition, for healthy elderly >75 years of age without sleep complaints, reducing sleep time may be detrimental, whereas allowing more time to sleep (about 7.5 hours nightly) is associated with better maintenance of physical health-related quality of life and stability of medical illness burden over 30 months.
Reynolds
Charles F
CF
Sleep and Chronobiology Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. Reynoldscf@upmc.edu
Serody
Linda
L
Okun
Michele L
ML
Hall
Martica
M
Houck
Patricia R
PR
Patrick
Susan
S
Maurer
Jennifer
J
Bensasi
Salem
S
Mazumdar
Sati
S
Bell
Bethany
B
Nebes
Robert D
RD
Miller
Mark D
MD
Dew
Mary Amanda
MA
Nofzinger
Eric A
EA
D000223:Adaptation, Psychological; D000367:Age Factors; D000368:Aged; D005260:Female; D015577:Geriatric Assessment; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D008297:Male; D017286:Polysomnography; D011788:Quality of Life; D016037:Single-Blind Method; D012890:Sleep / Q000502:physiology*; D012892:Sleep Deprivation; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy*; D012944:Social Support; D011795:Surveys and Questionnaires