Sleep disorders in older adults: a population-based study of clinical and social factors and characteristics of comorbidity with internal organ diseases

In older and senile age, the prevalence of night-time sleep disturbances increases significantly (up to 30–48%), which is associated with both physiological changes in sleep and medical and behavioural factors.

Objective: to identify clinical and social factors contributing to sleep disorders in older people and establish their relationship with internal organ diseases

Materials and methods. The study included 1,002 patients aged 60–90 who underwent a comprehensive geriatric examination, screening for sleep disorders (Pittsburgh Sleep Quality Index) and depression (Geriatric Depression Scale), as well as a neuropsychological examination. An analysis of clinical and social factors and an analysis of associations with somatic diseases were performed, and sleep disorder phenotypes were identified by data clustering (UMAP + K-means).

Results. A decrease in sleep efficiency with age (p<0.001) was identified, while sleep duration remained unchanged within the age range studied. Presomnic disturbances (prevalence – 9.6%) were associated with female gender, lower income, education and physical activity level, intrasomnic disturbances (prevalence – 12.3%) were associated with cardiovascular diseases, body mass index, having a partner, introversion, and taking walks. Common predictors for both falling asleep and staying asleep were pain syndrome, depression, and geriatric syndromes of asthenia and sarcopenia. Cluster analysis identified five phenotypes that differed not only in their sleep disturbance patterns but also in their clinical and social characteristics, subjective attitudes toward sleep, and ageing profiles with varying risks of developing geriatric syndromes.

Conclusion. Clear clinical and social correlates have been identified in elderly patients: presomnic disturbances are associated with female gender and socio-economic factors, while intrasomnic disturbances are predominantly associated with somatic pathology. Of particular importance is the identification of five discrete phenotypes of sleep disorders, each characterised by a unique combination of clinical parameters, ageing pro- file, and risk of geriatric syndromes.

1. Crowley K. Sleep and sleep disorders in older adults. Neuropsychol Rev. 2011 Mar;21(1):41-53. doi: 10.1007/s11065-010-9154-6

2. Shochat T, Loredo J, Ancoli-Israel S. Sleep Disorders in the Elderly. Curr Treat Options Neurol. 2001 Jan;3(1):19-36. doi: 10.1007/s11940-001-0021-x

3. Patel D, Steinberg J, Patel P. Insomnia in the Elderly: A Review. J Clin Sleep Med. 2018 Jun 15;14(6):1017-24. doi: 10.5664/jcsm.7172

4. Roth T, Coulouvrat C, Hajak G, et al. Prevalence and perceived health associated with insomnia based on DSM-IV-TR; International Statistical Classification of Diseases and Related Health Problems, Tenth Revision; and Research Diagnostic Criteria/International Classification of Sleep Disorders, Second Edition criteria: results from the America Insomnia Survey. Biol Psychiatry. 2011 Mar 15;69(6):592-600. doi: 10.1016/j.biopsych.2010.10.023

5. Spielman AJ, Caruso LS, Glovinsky PB. A behavioral perspective on insomnia treatment. Psychiatr Clin North Am. 1987 Dec;10(4):541-53.

6. Magomedova KA, Spektor ED, Poluektov MG. Insomnia in the elderly: the role of social factors. Effective Pharmacotherapy. 2024;20(33):30-4. (In Russ.) doi: 10.33978/2307-3586-2024-20-33-30-34

7. Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep. 2004 Nov 1;27(7):1255-73. doi: 10.1093/sleep/27.7.1255

8. Myllyntausta S, Stenholm S. Sleep Before and After Retirement. Curr Sleep Med Rep. 2018;4(4):278-83. doi: 10.1007/s40675-018-0132-5

9. Yao KW, Yu S, Cheng SP, Chen IJ. Relationships between personal, depression and social network factors and sleep quality in community-dwelling older adults. J Nurs Res. 2008 Jun;16(2):131-9. doi: 10.1097/01.jnr.0000387298.37419.ff

10. Griffin SC, Williams AB, Ravyts SG, et al. Loneliness and sleep: A systematic review and meta-analysis. Health Psychol Open. 2020 Apr 4;7(1):2055102920913235. doi: 10.1177/2055102920913235

11. Eshkoor SA, Hamid TA, Nudin SS, Mun CY. The effects of social support and having a partner on sleep quality in dementia. Am J Alzheimers Dis Other Demen. 2013 May;28(3):253-7. doi: 10.1177/1533317513481098

12. Pchelina PV, Poluektov MG. On the question of a primary and secondary origin of insomnia. S.S. Korsakov Journal of Neurology and Psychiatry. 2021;121(4-2):41-8. (In Russ.) doi: 10.17116/jnevro202112104241

13. Katz DA, McHorney CA. Clinical correlates of insomnia in patients with chronic illness. Arch Intern Med. 1998 May 25;158(10):1099-107. doi: 10.1001/archinte.158.10.1099

14. Buysse DJ, Reynolds CF 3rd, Monk TH, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989 May;28(2):193-213. doi: 10.1016/0165-1781(89)90047-4

15. Hoyl MT, Alessi CA, Harker JO, et al. Development and testing of a five-item version of the Geriatric Depression Scale. J Am Geriatr Soc. 1999 Jul;47(7):873-8. doi: 10.1111/j.1532-5415.1999.tb03848.x

16. Eysenck HJ, Eysenck SBG. Eysenck Personality Inventory (EPQ, EPI) [Database record]. APA PsycTests; 1963.

17. Nowack KM. Coping style, cognitive hardiness, and health status. J Behav Med. 1989 Apr;12(2):145-58. doi: 10.1007/BF00846548

18. De Frutos-Galindo I, Catalina-Palomares D, Yubero-Garcia P, et al. Effects of sleep on sarcopenia in individuals with metabolic syndrome: A systematic review. Semergen. 2025 May-Jun;51(4):102483. doi: 10.1016/j.semerg.2025.102483

19. Sun H, Zeng X, Gao W, Lu X. Causal associations between sarcopenia-related traits and obstructive sleep apnea: a mendelian randomization study. Aging Clin Exp Res. 2025 Mar 8;37(1):68. doi: 10.1007/s40520-025-02963-3

20. Zheng W, Sun Y, Liu X, et al. Cross-sectional and longitudinal trajectory analyses of sleep duration and frailty among middle-aged and older Chinese adults. Sci Rep. 2025 Apr 15;15(1):12958. doi: 10.1038/s41598-025-97130-z

21. Figorilli M, Velluzzi F, Redolfi S. Obesity and sleep disorders: A bidirectional relationship. Nutr Metab Cardiovasc Dis. 2025 Jun;35(6):104014. doi: 10.1016/j.numecd.2025.104014

22. Nijs J, Mairesse O, Neu D, et al. Sleep Disturbances in Chronic Pain: Neurobiology, Assessment, and Treatment in Physical Therapist Practice. Phys Ther. 2018 May 1;98(5):325-35. doi: 10.1093/ptj/pzy020