title: Age-Related Differences in Sleep-Wake Symptoms of Adults Undergoing Polysomnography.
abstract: OBJECTIVE
  To evaluate age-related differences in sleep-wake symptoms.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Technologist-attended, laboratory-based polysomnography (PSG).
  
  
  METHODS
  Community-dwelling adults aged 20 to 89 (N = 201): 52 aged 18 to 39, 72 aged 40 to 59, and 77 aged 60 and older.
  
  
  METHODS
  Medical burden (Charlson Comorbidity Index, medications, health status), PSG-defined sleep disorders (sleep-disordered breathing (SDB), sleep-associated hypoxemia, periodic limb movements in sleep (PLMS)), sleep-wake symptoms (Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), fatigue (Facit-F Scale)).
  
  
  RESULTS
  Medical burden increased significantly with age (Charlson Comorbidity Index and number of medications, P < .001; health status, P = .005). Severity of sleep disorders also increased significantly with age (SDB and hypoxemia, P < .001; PLMS, P = .008). Conversely, sleep-wake symptoms decreased with age (daytime drowsiness (ESS ≥ 10), P = .02; insomnia (ISI ≥ 8), P = .04; fatigue, P < .001). In adjusted models, a 1-year increase in age was significantly associated with a 4% decrease in the odds of having daytime drowsiness (odds ratio (OR) = 0.96, 95% confidence interval (CI) = 0.93-0.98). Similarly, but only in those with mild SDB, a 1-year increase in age was significantly associated with a 5% decrease in the odds of having insomnia (OR = 0.95, 95% CI = 0.92-0.99).
  
  
  CONCLUSIONS
  Older age was characterized by less-severe sleep-wake symptoms (daytime drowsiness, insomnia, fatigue), despite an age-related increase in disease severity (medical burden, sleep disorders). Because the increase in disease severity included well-established risk factors for having sleep-wake symptoms, the age-related decrease in sleep-wake symptoms may reflect a decrease in symptom awareness.
authors.affiliation: Clinical Epidemiology Research Center, Veterans Affairs Connecticut, West Haven, Connecticut.|Department of Medicine, School of Medicine, Yale University, New Haven, Connecticut.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Vaz Fragoso
authors.affiliation: Department of Medicine, School of Medicine, Yale University, New Haven, Connecticut.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Van Ness
authors.affiliation: Department of Medicine, School of Medicine, Yale University, New Haven, Connecticut.
authors.forename: Katy L B
authors.initials: KL
authors.lastname: Araujo
authors.affiliation: Clinical Epidemiology Research Center, Veterans Affairs Connecticut, West Haven, Connecticut.|Department of Medicine, School of Medicine, Yale University, New Haven, Connecticut.
authors.forename: Lynne P
authors.initials: LP
authors.lastname: Iannone
authors.affiliation: Clinical Epidemiology Research Center, Veterans Affairs Connecticut, West Haven, Connecticut.|Department of Medicine, School of Medicine, Yale University, New Haven, Connecticut.
authors.forename: Henry
authors.initials: H
authors.lastname: Klar Yaggi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012893:Sleep Wake Disorders / Q000150:complications / Q000175:diagnosis*; D055815:Young Adult
keywords: driving capacity; periodic limb movements; sleep-disordered breathing; sleep-wake symptoms