Abstract
Background: Method: Results: Conclusion: Key Words: insomnia; older adults; diagnosis; perception of sleepThe results cast doubts about the usefulness of the common criteria (30 minutes sleeponset latency and wake after sleep onset) used in clinical contexts to diagnose insomnia. Unrealisticpositive expectations about sleep changes with age can lower the threshold for complaining and thuscontribute to dissatisfaction and worry about sleep. Sedative-hypnotic drugs did seem to have limitedbenefit for the participants in this study.For those generally satisfied with their sleep, mean sleep onset latency was 37 minutes andmean wake after sleep onset was 38 minutes. It was further demonstrated that 59.2% of the sample hadunrealistic positive expectations (did not expect worsening of sleep with age) regarding sleep in oldage. Those using sedative-hypnotic medication (23.3%) were less satisfied with their sleep and felt lessrefreshed during the day than non-users. Contrary to most studies, no general gender differences inperception of sleep was revealed. The only exception was total sleep time where men reported moresleep than women (6.78 vs. 6.15 hours) per day.A questionnaire focusing on the subjective experience of sleep was administered to 116 older(60 years and above) visitors at 4 senior centres in Bergen, Norway.Discrepancies between objectively and subjectively measured sleep variables make diagnosinginsomnia in the elderly difficult. Also relevant to diagnosing insomnia in the elderly are expectationsabout sleep, gender and use of sedative-hypnotic medication. The present study focuses on howthese variables relate to insomnia and sleep satisfaction.ABSTRACT
Highlights
An important point that is related to diagnosing insomnia is the individual expectations and beliefs about sleep
The total sample consisted of 116 older adults, 64 females and 52 males
It is concluded that subjective sleep rating should be more strongly emphasised in diagnosing and evaluating complaints of insomnia
Summary
An important point that is related to diagnosing insomnia is the individual expectations and beliefs about sleep. Unrealistic positive beliefs about the soundness of sleep can lower the threshold for complaining about insomnia This concern is warranted for the elderly (Morin et al, 1993) because sleep normally changes in a negative direction with advancing age. Increased sleep onset latency (SOL) and increased wake time after sleep onset (WASO) constitute normal age-related changes in sleep (Miles & Dement, 1980). This may indicate that patients whose complaints are based on unrealistic sleep expectations, do not suffer from any sleep disorder. Sedative-hypnotic drugs did seem to have limited benefit for the participants in this study
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