Insomnia and sleep medication use connected to disability in older adults

“When we evaluated the relationships between disability, insomnia and sleep medication use, we found that as older people used more sleep medication or experienced more insomnia symptoms, they moved more rapidly towards greater disability,” said Orfeu Buxton, Elizabeth Fenton Susman Professor of Biobehavioral Health at Penn State, Social Science Research Institute co-funded faculty and co-author of the study.

The researchers analyzed data from 6,722 participants in the National Health and Aging Trends Study (NHATS), which captured a national sample of Medicare beneficiaries over the age of 65. The team used more than 22,000 individual observations from the first five waves of data collection — gathered between 2011 and 2015.

The NHATS data included annual measures of disability data using a validated questionnaire. The questionnaire asked about self-care activities including dressing, eating, using the toilet and showering. It also asked about mobility activities including getting out of bed, moving around indoors and going outside.

To quantify the relationship between these variables, participants’ data were measured on an established numeric scale for disability. For each self-care activity, participants were classified as “fully able” to complete the activity on their own; “vulnerable” to disability if they used accommodations, reduced their participation in the activity, or had difficulty with tasks; or “assistance” if they could not complete an activity without help. A classification of “fully able” was scored as one point; “vulnerable” was scored as two points; and “assistance” was scored as four, with higher scores representing higher levels of disability.

Any score increase of two or more on a person’s overall score represented a clinically meaningful level of disability related to self-care or mobility, according to a previous study by other researchers.

The NHATS data included five frequency levels of both insomnia symptoms and sleep-medication use — never, once a week, some nights, most nights, and every night. "Never" was scored as one point, and each level was worth one more point up to "every night" being scored as five points.

For every level of increase in the frequency of reported insomnia symptoms, the disability score was — on average — .2 higher the next year. For every level of increase in the frequency of reported sleep medication use, their disability score was — on average — .19 higher the next year.

This article was originally published on Pennsylvania State University Health and Medicine News.