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. 2022 Feb 1;18(2):403-413.
doi: 10.5664/jcsm.9584.

Self-reported and actigraphic short sleep duration in older adults

Brienne Miner  1 , Katie L Stone  2 , Jamie M Zeitzer  3 , Ling Han  1   4 , Margaret Doyle  1 , Terri Blackwell  2 , Thomas M Gill  1 , Nancy S Redeker  1   5 , Alexandra Hajduk  1 , Henry Klar Yaggi  1   4
Affiliations

Self-reported and actigraphic short sleep duration in older adults

Brienne Miner et al. J Clin Sleep Med. .

Abstract

Study objectives: Persons > 65 years with short sleep duration (≤ 6 hours) are at risk for adverse outcomes, but the accuracy of self-reported sleep duration may be affected by reduced symptom awareness. We evaluated the performance characteristics of self-reported vs objectively measured sleep duration in this age group.

Methods: In 2,980 men from the Osteoporotic Fractures in Men Sleep Study and 2,855 women from the Study of Osteoporotic Fractures we examined the agreement and accuracy of self-reported vs actigraphy-measured short and normal (> 6 but < 9 hours) sleep duration. We evaluated associations of select factors (demographics; medical, physical, and neuropsychiatric conditions; medication and substance use; and sleep-related measures) with risk of false-negative (normal sleep duration by self-report but short sleep duration by actigraphy) and false-positive (short sleep duration by self-report and normal sleep duration by actigraphy) designations, respectively, using logistic regression.

Results: Average ages were 76.3 ± 5.5 and 83.5 ± 3.7 years in men and women, respectively. There was poor agreement between self-reported and actigraphic sleep duration (kappa ≤ 0.24). False negatives occurred in nearly half and false positives in over a quarter of older persons. In multivariable models in men and women, false negatives were independently associated with obesity, daytime sleepiness, and napping, while false positives were significantly lower with obesity.

Conclusions: Under- and overreporting of short sleep is common among older persons. Reliance on self-report may lead to missed opportunities to prevent adverse outcomes or unnecessary interventions. Self-reported sleep duration should be objectively confirmed when evaluating the effect of sleep duration on health outcomes.

Citation: Miner B, Stone KL, Zeitzer JM, et al. Self-reported and actigraphic short sleep duration in older adults. J Clin Sleep Med. 2022;18(2):403-413.

Keywords: actigraphy; aging; sleep disorders; sleep duration.

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Conflict of interest statement

All authors have read and approved the manuscript. Dr. Miner is supported by the Claude D. Pepper Older Americans Independence Center at Yale School of Medicine (P30AG021342), the American Academy of Sleep Medicine Foundation, a foundation of the American Academy of Sleep Medicine, and the National Institute on Aging (R03AG073991). Dr. Gill was a recipient of an Academic Leadership Award (K07AG043587) from the National Institute on Aging. Dr. Yaggi is supported by a Midcareer Investigator Award in Patient Oriented Research by the National Heart, Lung, and Blood Institute (K24HL132093). The Study of Osteoporotic Fractures (SOF) is supported by National Institutes of Health funding. The National Institute on Aging (NIA) provides support under the following grant numbers: R01 AG005407, R01 AR35582, R01 AR35583, R01 AR35584, R01 AG005394, R01 AG027574, R01 AG027576, and R01 AG026720. The Osteoporotic Fractures in Men Study (MrOS) is supported by National Institutes of Health (NIH) funding. The following institutes provide support: the National Institute on Aging (NIA), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Center for Advancing Translational Sciences (NCATS), and NIH Roadmap for Medical Research under the following grant numbers: U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, and UL1 TR000128. The National Heart, Lung, and Blood Institute (NHLBI) provides funding for the MrOS Sleep ancillary study “Outcomes of Sleep Disorders in Older Men” under the following grant numbers: R01 HL071194, R01 HL070848, R01 HL070847, R01 HL070842, R01 HL070841, R01 HL070837, R01 HL070838, and R01 HL070839. The authors report no conflicts of interest.

Figures

Figure 1
Figure 1. Bland-Altman plots showing the agreement between objective (actigraphy) and self-reported measures of sleep duration in MrOS and SOF.
(A) MrOS, men. (B) SOF, women. Dotted lines represent upper and lower 95% limits of agreement. The unbroken red line represents mean differences. MrOS = Osteoporotic Fractures in Men Sleep Study, OBJ = actigraphic sleep duration, SOF= Study of Osteoporotic Fractures, SUBJ = self-reported sleep duration.
See this image and copyright information in PMC

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