Financial strain is a significant correlate of sleep continuity disturbances in late-life
Introduction
The elderly are at increased risk for disturbed sleep, which may adversely affect health, functioning and quality of life (Chevalier et al., 1999, Dew et al., 2003, Groeger et al., 2004, Kojima et al., 2000, Newman et al., 2000, Riemann and Voderholzer, 2003, Spiegel et al., 2002). Sleep disturbances in the elderly may be related to normal aging processes such as neuroanatomic changes in sleep and arousal systems (Nofzinger and Keshavan, 2002) and/or diminished transduction of circadian rhythm signals to the sleep system (Bliwise et al., 1983, Monk and Kupfer, 2000). Others have proposed that age-related changes in sleep are the result of pathological processes such as medical and psychiatric morbidity, and that normal aging processes are less important (Ohayon et al., 2004, Roberts et al., 1999, Vitiello et al., 2002). A greater understanding of the processes that influence sleep in the elderly is important for identifying individuals at risk, designing effective treatment strategies, and, ultimately, improving health and functioning during the later years of life.
Although fewer studies have considered the role of psychological stress in late-life sleep disturbances (Hall et al., 1997, McDermott et al., 1997), psychological stress has been shown to play a significant role in the onset and maintenance of primary insomnia in younger samples (Drake et al., 2004, Linton, 2004, Morin et al., 2003). Psychological stress has been similarly associated with subjective sleep complaints, reports of shorter sleep duration, PSG-assessed sleep continuity disturbances and reductions in slow-wave sleep, as well as increased indices of physiological hyperarousal during sleep across the adult life span (Akerstedt et al., 2002, Davidson et al., 1987, Geroldi et al., 1996, Hall et al., 2000, Kecklund and Akerstedt, 2004, Nakata et al., 2001, Nakata et al., 2004, Ohayon, 2005, Roberts et al., 2000). Although some researchers have hypothesized that a general negative affective bias associated with depression accounts for the effects of naturalistic stress on sleep, empirical data suggest that psychological stress may impact sleep independently of symptoms of depression (Hall et al., 1997, Hall et al., 2000, Hall et al., 2004, Hall et al., 2007, Kecklund and Akerstedt, 2004).
In the present study, we modeled relationships among concurrent measures of chronic stress, mental health, physical health, and sleep in a heterogenous sample of community-dwelling elders. In particular, ongoing financial strain was used as a measure of chronic stress, given the prevalence and salience of financial strain in the elderly (Centers for Disease Control and Prevention, 2004, Kubzansky et al., 2000). We hypothesized that ongoing financial strain would be a significant correlate of disturbed sleep in the elderly, above and beyond the effects of age, mental health and physical health on sleep.
Section snippets
Methods
Participants were drawn from five component projects that comprise the “Aging Well, Sleeping Efficiently: Intervention Studies” (AgeWise) program project (AG020677). The unifying theme of the AgeWise program project is the hypothesis that sleep is related to health and functioning in the elderly and behavioral interventions that target late-life sleep disturbances will have positive effects on health and functioning. Component projects each focused on a specific late-life challenge including
Results
Background and sleep characteristics of the study sample are shown in Table 1. The sample age range was 61–85 years, roughly one-third of whom were male. Participants’ physical and mental health ratings were comparable to age-normed values for the general US population (Ware et al., 1994). One-fourth of the sample endorsed experiencing ongoing financial strain (bereaved elders = 22%; caregivers = 26%; patients with insomnia = 30%; healthy “Old, Old” = 21%). On average, participants took approximately 25
Discussion
Ongoing financial strain was associated with sleep continuity disturbances in a heterogenous sample of community-dwelling elders. After adjusting for the effects of age, sex, project, mental health and physical health on sleep, ongoing financial strain was significantly associated with poorer overall sleep efficiency. Elders experiencing ongoing financial strain took longer to fall asleep and spent an average of 88 min awake after sleep onset, as compared to 69 min of wakefulness among elders who
Acknowledgements
This research was supported by grants from the National Institutes of Health (AG020677, AG019362, HL076852, RR00056). The authors would like to thank the AgeWise subjects for their generous participation and the AgeWise staff for their dedication to this program project. In addition, the authors thank our colleagues Patricia Houck, Jean Miewald, Annette Wood and Mary Fletcher for their assistance with data management and analyses.
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2022, International Journal of Hospitality ManagementCitation Excerpt :Indeed, financial problems lead to conflicts between partners which can lead to several negative outcomes. For instance, increased levels of financial stress results in poor sleep quality (Hall et al., 2008) and reduced well-being (Agrigoroaei et al., 2017). Considering Greece, the case is even worse.