Study of Insomnia and Mortality in Community-dwelling Elderly

1187 Sleep Patterns and Mortality in Older Adults—Chen et al INTRODUCTION Sleep disturbance is a prevalent health problem that has substantial consequences for older adults.1,2 Longitudinal studies have shown that sleep difficulties predict several adverse health outcomes.3-7 The quality and quantity of sleep have been associated with coping ability, timely engagement with activities, and resilience in the face of adversity8; and these outcomes are often indicative of successful aging. Therefore, it is important to examine the factors that influence sleep quality and health outcomes among older adults. However, the risk predictors identified within older adult samples seem to differ from those of the general population. Predictors of the association between sleep patterns and mortality have been summarized within three dimensions: insomnia, sleep duration, and use of hypnotics. Evidence for the link between sleep duration and mortality is consistent and robust. Meta-analytic studies have observed that both longer and shorter sleep durations are related to increased mortality.9,10 In contrast, the association between insomnia and mortality is not as conclusive. Increased risk,11-15 no association,15-22 and even decreased risk of mortality19,23 have been reported among subSTUDY OF INSOMNIA AND MORTALITY IN COMMUNITY-DWELLING ELDERLY