Abstract

Abstract Introduction Impacts of age and gender on sleep have been reported in normal population, but rarely in chronic insomnia disorder (CID). This study aimed to investigate difference in sleep characteristics of CID according to gender and age. Methods The participants with drug-naïve CID and aged between 40 and 79 years were recruited. We compared subjective and objective sleep parameters between the middle-aged (40-64 years, N=86) and the elderly (65-79 years, N=50), and between men (N=45) and women (N=91). The subjective sleep quality and habitual sleep time were measured by Pittsburgh Sleep Quality Index (PSQI). The participants were asked to wear an actigraph for 4 days to obtain objective sleep parameters. Results In the PSQI, the elderly reported earlier bedtime and wake-up time (p=0.018; p=0.026), reduced total sleep time (TST) and sleep efficiency (p=0.003; p=0.011), and low sleep quality (p=0.034) compared to the middle-aged. However, according to the actigraphy, differences were observed only in the bedtime (p=0.016) and the wake-up time (p=0.002) between the two age groups. Between genders, the actigraphy showed that the male patients woke up earlier than the female group (p=0.015); except for this finding, there was no significant gender effect. Meanwhile, regarding gender and age interactions, the elderly women with CID showed longer time in bed (TIB) with increase in both TST and wake after sleep onset (WASO) compared to the middle-aged women. The elderly men showed decreased TIB and TST, and slightly decreased WASO than the middle-aged men. Conclusion The elderly with CID show more subjective sleep complaints than the middle-aged CID despite little difference in objective sleep characteristics, which suggests that the elderly CID may seek medical help more than the middle aged. As women with CID get older, they increase time spent in bed to maintain sleep time, but with resultant increase in wake. Support None

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