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Bowman MA, Buysse DJ, Marsland AL, Wright AG, Foust J, Mehra R, Srinivasan S, Kohli N, Carroll L, Jasper A, Hall MH. 0820 Meta-Analysis of the Association of Age and Actigraphy-Assessed Sleep Across the Lifespan. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Sleep quantity and continuity vary across the lifespan. Actigraphy is reliable, ecologically valid, and is the most widely-used behavioral measure of sleep in research and personal health monitoring. The extent to which age is associated with actigraphy-assessed sleep has not been evaluated across the lifespan. The aim of this meta-analysis was to evaluate the associations between age and actigraphy-assessed sleep in relatively healthy individuals.
Methods
A systematic search of PubMed, Embase.com, Cochrane CENTRAL, and PsycINFO using “actigraphy” and “sleep” terms provided 7,079 titles/abstracts, which were screened to exclude studies of only individuals with mental health disorders, medical conditions, sleep disorders, or shift workers. We evaluated 1,379 full-text articles for reports on the association between age and actigraphy-assessed sleep duration, efficiency, timing, and/or regularity. Overall, 88 articles met these criteria (182 effect sizes; N=18,443). Four meta-analyses were conducted, examining sleep duration (k=86), sleep efficiency (k=58), bedtime (k=27), and wake-up time (k=11). There were insufficient numbers of studies (less than 5) to evaluate sleep midpoint or sleep regularity. We tested continent of the study, study design, actigraphy device type, and number of nights of data collection as moderators of meta-analytic associations.
Results
With increasing age, sleep duration was shorter (r = -0.13) and sleep efficiency was lower (r = -0.06). Bedtime was later with age for ages 6-21 (r = 0.31) and earlier for ages 22 and up (r = -0.65). Wake-up time was not associated with age for ages 6-21 (r = 0.20) but was earlier with increasing age for ages 22 and up (r = -0.71). The strength of these associations was modified by continent and study design, but not by type of actigraphy device or number of nights of data collection.
Conclusion
Weak associations between age and actigraphy-assessed duration and efficiency suggest that inadequate sleep quantity or poor sleep continuity should not be dismissed as typical consequences of aging. Large associations between age and sleep timing, despite a small literature, highlights a promising area for further study, particularly to determine the age at which sleep timing shifts from delaying to advancing.
Support
MAB was supported by T32 HL07560.
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Affiliation(s)
- M A Bowman
- University of Pittsburgh, Pittsburgh, PA
| | - D J Buysse
- University of Pittsburgh, Pittsburgh, PA
| | | | - A G Wright
- University of Pittsburgh, Pittsburgh, PA
| | - J Foust
- University of Pittsburgh, Pittsburgh, PA
| | - R Mehra
- University of Pittsburgh, Pittsburgh, PA
| | | | - N Kohli
- University of Pittsburgh, Pittsburgh, PA
| | - L Carroll
- University of Pittsburgh, Pittsburgh, PA
| | - A Jasper
- University of Pittsburgh, Pittsburgh, PA
| | - M H Hall
- University of Pittsburgh, Pittsburgh, PA
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Abstract
A previously healthy man who became bedridden because of malaise, fatigue, and weakness was found to have an autoimmune hemolytic anemia (AIHA). In the course of his evaluation for the AIHA, he was found, coincidentally, to have a renal cell carcinoma. The AIHA was marginally responsive to therapy with corticosteroids, but it resolved promptly after excision of the cancer. This case represents probably a rarely observed association between a nonhematologic malignancy and autoimmune hemolytic anemia.
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Affiliation(s)
- R Lands
- Department of Medicine, Methodist Medical Center of Oak Ridge, TN, USA
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