Older adults with specific EEG sleep characteristics have an excess risk of dying beyond that associated with age, gender, or medical burden. The findings suggest that interventions to optimize and protect older adults' sleep initiation, continuity, and quality may be warranted.

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Little is known about sleep and the effects of total sleep loss in the 'old old' (i.e., 80-year-olds). We investigated sleep, mood, and performance responses to acute sleep deprivation in healthy 80-year-olds (n = 10) and 20-year-olds (n = 14). The protocol consisted of three nights of baseline sleep, one night of total sleep deprivation, and two nights of recovery sleep. Mood and vigilance were tested using visual analog scales and a Mackworth clock procedure in the morning and evening of each study day. Daytime sleepiness was measured by five naps on the days following the third and sixth nights. Old subjects had lower sleep efficiency and less delta sleep than young subjects. However, sleep continuity and delta sleep were enhanced in both groups on the first recovery night, indicating that sleep changes in old subjects are at least partially reversible by this procedure. Surprisingly, young subjects had shorter daytime sleep latencies than the old, suggesting a greater unmet sleep need in the former group. Mood and performance were disturbed by sleep loss in both groups, but to a greater extent among the young. This suggests that acute total sleep loss is a more disruptive procedure for the young than for the old.

Although insomnia is a major public health problem in the elderly, little information concerning the relation between subjective reports of sleep and laboratory measures in the elderly has been published. Also, while laboratory studies of the healthy elderly typically show that women steep better than men, epidemiologic studies suggest that women complain more often than men about disturbed sleep. We report here a study of 20 healthy elderly subjects without sleep complaints (10M. 10F), in which relations between subjective and objective measures of sleep were explored. Both men and women showed significant correlations between objective measures of Sleep Latency (SL) and subjective estimates of fall asleep time; similarly, in both groups, subjective estimates of sleep duration were significantly and positively correlated with Time Spent Asleep (TSA). However, in the women, but not in the men, “restlessness” of sleep was significantly correlated with WASO (wake time after sleep onset), while “soundness” of sleep was positively related to amount of slow wave sleep. In general, women showed a higher proportion of significant and more stable correlations between subjective and objective measures than did men. These findings suggest that elderly women may report sleep loss more accurately than elderly men.