Abstract
BACKGROUND: Sleep disturbances are very common in older adults, and their effects can affect cognition and physical health, and also reduce quality of life. It has been reported in past research that inadequate or low-quality sleep is linked to cardiovascular disease and depression, as well as a higher risk of death in late life. What is less understood is the extent to which the distribution of self-reported sleep disturbances varies across demographic and socioeconomic factors in the population. OBJECTIVE: The purpose of the study was to assess the changes in sleep disturbances among U.S. adults aged 60 years and above using nationally representative data from the National Health Interview Survey (NHIS). METHODS: We used a secondary analysis of publicly available, de-identified NHIS data (2005-2020). Sleep disturbance variables were self-reported difficulty falling asleep, difficulty staying asleep, and non-restorative sleep at least three nights/week. Prevalence over time and by subgroups (age, sex, race/ethnicity, and socioeconomic status (SES)) was estimated with descriptive statistics and logistic regression models. RESULTS: A total of 31,446 adults participated in the NHIS analysis, of whom 10,482 were aged ≥60 years. Overall, 28.3% (n = 8,899) reported short sleep (<7 hours), 22.7% (n = 7,138) reported difficulty falling asleep, 26.1% (n = 8,207) reported difficulty staying asleep, and 15.8% (n = 4,968) reported use of sleep medication. The occurrence of insomnia symptoms was significantly more frequent in women than in men (OR = 1.45, 95% CI: 1.32-1.58). After adjusting for SES, Black and Hispanic older adults were more likely to report non-restorative sleep than White adults. Lower levels of education and income were both independently related to higher levels of sleep complaints. CONCLUSION: Sleep disturbances in older adults have shown a slight increase over the last decade, and they have been disparate across sex, race/ethnicity, and SES. The findings highlight the need for targeted, age-appropriate clinical screening and culturally sensitive interventions to reduce disparities in late-life sleep health.