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.