title: Differences Between Men and Women Aged 65 and Older in the Relationship Between Self-Reported Sleep and Cognitive Impairment: A Nationwide Survey in Taiwan.
abstract: To examine the prevalence of self-reported sleep disturbances and cognitive impairment in men and women aged 65 and older and to determine sex-specific effects on the relationship between self-reported sleep and cognitive impairment.
  
  
  
  A secondary data analysis from the 2009 Taiwan National Health Interview Survey.
  
  
  
  Individuals aged 65 and older (N = 2,413, n = 1,094 men, n = 1,319 women).
  
  
  
  Subjective sleep characteristics including sleep duration, difficulty initiating sleep, difficulty maintaining sleep, early-morning awakening, daytime sleepiness, difficulty breathing during sleep, habitual snoring, and daytime napping were measured using survey questions. The Mini-Mental State Examination was used to identify cognitive impairment.
  
  
  
  The prevalence of cognitive impairment was 16.3% for men and 27.1% for women. Men and women with cognitive impairment had higher prevalence of self-reported sleep disturbances than those without. There was a significant effect of the interaction between sex and difficulty breathing during sleep on cognitive impairment (adjusted odds ratio (aOR) = 0.39, 95% confidence interval (CI) = 0.20-0.77). In men, difficulty breathing during sleep (aOR = 2.31, 95% CI = 1.39-3.84), habitual snoring (aOR = 2.30, 95% CI = 1.49-3.54), and prolonged sleep duration (> 8.5 hours) (aOR = 1.95, 95% CI = 1.11-3.43) correlated significantly with cognitive impairment. In women, only prolonged sleep duration (>8.5 hours) was associated with higher likelihood of cognitive impairment (aOR = 2.32, 95% CI = 1.33-4.03).
  
  
  
  This nationwide survey confirmed sex differences in the association between various self-reported sleep disturbances and cognitive impairment in people aged 65 and older.
authors.affiliation: School of Nursing, College of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Hsiao-Yean
authors.initials: HY
authors.lastname: Chiu
authors.affiliation: School of Nursing, College of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Fu-Chih
authors.initials: FC
authors.lastname: Lai
authors.affiliation: Department of Neurosurgery, Chang-Gung Memorial Hospital, Taoyuan, Taiwan.|School of Medicine, Chang-Gung University, Taoyuan, Taiwan.
authors.forename: Pin-Yuan
authors.initials: PY
authors.lastname: Chen
authors.affiliation: School of Nursing, College of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. ptsai@tmu.edu.tw.|Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. ptsai@tmu.edu.tw.|Sleep Science Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan. ptsai@tmu.edu.tw.
authors.forename: Pei-Shan
authors.initials: PS
authors.lastname: Tsai
mesh_terms: D000368:Aged; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D009483:Neuropsychological Tests; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data*; D012307:Risk Factors; D057566:Self Report; D012737:Sex Factors; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology
keywords: cognitive impairment; elderly people; sex difference; sleep