Global Sleep Satisfaction of Older People: The Jerusalem Cohort Study

OBJECTIVES: To describe the nature of global sleep satisfaction (GSS) of older people and the factors associated with it. DESIGN: A 7-year follow-up of an age-homogenous cohort. SETTING: Community based. PARTICIPANTS: Two hundred ninety subjects aged 70 at baseline and 77 at follow-up. MEASUREMENTS: Self-reported sleep domains and a comprehensive assessment of health variables, including psychosocial, physical, and functional factors, at ages 70 and 77. RESULTS: GSS was found to be poor in 25% of subjects at ages 70 and 77, with an estimated average annual remission rate of 7% and an annual incidence of 2.4%. Poor GSS at ages 70 and 77 was significantly associated with difficulty falling asleep, awakening feeling tired, two or more nocturnal awakenings, and taking sleeping tablets. Significant cross-sectional associations were found at age 70 and 77 between poor GSS and poor self-rated health, general fatigue, depression, dependence in one or more activities of daily living, and low level of physical activity. In a regression analysis, risk factors at age 70 for subsequent poor GSS were loneliness, depression, poor self-rated health, economic difficulties, back pain, obesity, and prior poor GSS. The only significant long-term association was between poor GSS and poor self-rated health. GSS did not influence mortality data. CONCLUSION: Poor GSS in older people is common and chronic. Its chief determinants are loneliness, depression, poor self-rated health, economic difficulties, back pain, and obesity. It predicts poor self-rated health but not increased mortality.