Differences in sleep measures and waking electroencephalography of patients with insomnia according to age and sex

Abstract

Study Objectives: Sleep characteristics are known to be different according to age and sex. The objective of this study was to investigate differences in sleep parameters and quantitative electroencephalography of patients with insomnia according to age and sex.

Methods: Patients with insomnia disorder ages 40-79 years were recruited. Each participant was assessed with the Pittsburgh Sleep Quality Index, 4-day wrist actigraphy, and quantitative electroencephalography derived from a 64-channel electroencephalogram system. These variables were compared between age groups (40-64 years vs 65-79 years) and sexes.

Results: Among 173 participants, 61(35%) were ages 65-79 years and 64 (35%) were males. The older group reported shorter (P=.009) total sleep time than the middle-aged group based on the Pittsburgh Sleep Quality Index, while women slept longer than men based on actigraphy (P = .040). Regarding electroencephalography, women had higher relative beta power than men (P = .006). Older patients showed slower dominant occipital frequency than younger patients (P = .008). The age effect was more noticeable on both clinical variables and quantitative electroencephalography for women. Compared with younger women, older women reported shorter total sleep time in the Pittsburgh Sleep Quality Index (P = .025), underestimated their sleep time (Pittsburgh Sleep Quality Index total sleep time/actigraphic total sleep time, P = .034), and showed reduced alpha power in the frontal area (P = .009).

Conclusions: Clinicians should be aware of the age and sex difference on manifestation of insomnia, which may further impact an individual's behaviors, such as staying in bed for a longer time or seeking sleep aids.