Aging and Sleep: Physiology and Pathophysiology

Edwards, Bradley A.; O'Driscoll, Denise Marie; Ali, Asad; Jordan, Amy S.; Trinder, John; Malhotra, Atul

doi:10.1055/s-0030-1265902

Cited by 181 publications

(106 citation statements)

References 152 publications

(136 reference statements)

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“…These modifications could lead to a disability in blood gas homeostasis ( Janssens et al, 1999) but a greater ventilation allows arterial O 2 saturation to be maintained at a same or a higher level in hypoxia than in young people. The increase in HVR with aging could be linked to a greater occurrence of obstructive sleep apneas in elderly people (Edwards et al, 2010). Chronic intermittent hypoxia, associated with sleep apneas, is known to increase hypoxic chemosensitivity (Foster et al, 2005), probably through an increased production of reactive oxygen species (Pialoux et al, 2009).…”

Section: Marczakmentioning

confidence: 99%

Aging, Tolerance to High Altitude, and Cardiorespiratory Response to Hypoxia

Richalet

Lhuissier

2015

High Altitude Medicine & Biology

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Richalet, Jean-Paul, and François J. Lhuissier. Aging, tolerance to high altitude, and cardiorespiratory response to hypoxia. High Alt Med Biol. 16:117-124, 2015.--It is generally accepted that aging is rather protective, at least at moderate altitude. Some anecdotal reports even mention successful ascent of peaks over 8000 m and even Everest by elderly people. However, very few studies have explored the influence of aging on tolerance to high altitude and prevalence of acute high altitude related diseases, taking into account all confounding factors such as speed of ascent, altitude reached, sex, training status, and chemo-responsiveness. Changes in physiological responses to hypoxia with aging were assessed through a cross-sectional 20-year study including 4675 subjects (2789 men, 1886 women; 14-85 yrs old) and a longitudinal study including 30 subjects explored at a mean 10.4-year interval. In men, ventilatory response to hypoxia increased, while desaturation was less pronounced with aging. Cardiac response to hypoxia was blunted with aging in both genders. Similar results were found in the longitudinal study, with a decrease in cardiac and an increase in ventilatory response to hypoxia with aging. These adaptive responses were less pronounced or absent in post-menopausal untrained women. In conclusion, in normal healthy and active subjects, aging has no deleterious effect on cardiac and ventilatory responses to hypoxia, at least up to the eighth decade. Aging is not a contraindication for high altitude, as far as no pathological condition interferes and physical fitness is compatible with the intensity of the expected physical demand of one's individual. Physiological evaluation through hypoxic exercise testing before going to high altitude is helpful to detect risk factors of severe high altitude-related diseases.

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Section: Marczakmentioning

confidence: 99%

Aging, Tolerance to High Altitude, and Cardiorespiratory Response to Hypoxia

Richalet

Lhuissier

2015

High Altitude Medicine & Biology

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“…Total daily sleep time is reduced and sleep becomes increasingly disrupted with aging (Ancoli-Israel, 2009; Bliwise, 1993; Edwards et al, 2010). Sleep disruption of healthy young and older adults is associated with increased production of inflammatory mediators (Frey et al, 2007; Haack et al, 2007; Irwin et al, 2006; Mullington et al, 2009; Simpson and Dinges, 2007; Vgontzas et al, 2003), including the cytokine tumor necrosis factor-α (TNF).…”

Section: Introductionmentioning

confidence: 99%

Sleep fragmentation and sepsis differentially impact blood–brain barrier integrity and transport of tumor necrosis factor-α in aging

Opp

George

Ringgold

et al. 2015

Brain, Behavior, and Immunity

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The factors by which aging predisposes to critical illness are varied, complex, and not well understood. Sepsis is considered a quintessential disease of old age because the incidence and mortality of severe sepsis increases in old and the oldest old individuals. Aging is associated with dramatic changes in sleep quality and quantity and sleep increasingly becomes fragmented with age. In healthy adults, sleep disruption induces inflammation. Multiple aspects of aging and of sleep dysregulation interact via neuroimmune mechanisms. Tumor necrosis factor-α (TNF), a cytokine involved in sleep regulation and neuroimmune processes, exerts some of its effects on the CNS by crossing the blood–brain barrier (BBB). In this study we examined the impact of sepsis, sleep fragmentation, and aging on BBB disruption and TNF transport into brain. We used the cecal ligation and puncture (CLP) model of sepsis in young and aged mice that were either undisturbed or had their sleep disrupted. There was a dichotomous effect of sepsis and sleep disruption with age: sepsis disrupted the BBB and increased TNF transport in young mice but not in aged mice, whereas sleep fragmentation disrupted the BBB and increased TNF transport in aged mice, but not in young mice. Combining sleep fragmentation and CLP did not produce a greater effect on either of these BBB parameters than did either of these manipulations alone. These results suggest that the mechanisms by which sleep fragmentation and sepsis alter BBB functions are fundamentally different from one another and that a major change in the organism’s responses to those insults occurs with aging.

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“…In this regard, it is widely known that the sleep phase can be somewhat advanced in elderly patients. 25,26 The TEQ prescribed to the subjects in our current study was found to negatively correlate with sleep onset time. Although we cannot precisely determine the causal relationship, higher doses of medication may be related to more advanced sleep onset time.…”

Section: Discussionmentioning

confidence: 54%

Sleeping Pill Administration Time and Patient Subjective Satisfaction

Chung

Youn

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: Taking hypnotic agents 30 min before bedtime is the usual suggested administration time, but some patients report dissatisfaction with their sleeping pills. We investigated whether the timing of sleeping pill administration influences patient subjective satisfaction with these drugs. Methods: One hundred twelve patients with primary insomnia currently taking benzodiazepine or nonbenzodiazepine gamma-aminobutyric acid (GABA) agonists as sleeping pills were selected. The time of administration for their sleeping pills, bedtime, sleep onset time, and wake up time were obtained from their medical records. Subjects were also categorized into satisfied or dissatisfied groups. Results: Hypnotic agents administration time (p < 0.001) and bedtime (p < 0.001), but not sleep onset or wake up time, occurred later in the night in the satisfied group. The durations from administration of pills to sleep onset (33.6 ± 20.7 min) and to wake up time (7.2 ± 1.2 h) were significantly shorter in the satisfied group when compared to the dissatisfied group (135.9 ± 73.4 min and 9.3 ± 1.5 h for time to sleep onset and wake up, respectively). Logistic regression analysis revealed that patient subjective satisfaction with hypnotic agents could be predicted by a short duration from administration of pills to sleep onset (odds ratio = 0.01; 95% confidence interval [0.001-0.09]) and a short duration from administration of pills to wake up time (0.53; [0.31-0.89], F = 49.9, p < 0.001). Conclusions:Taking sleeping pills at a later time and a shorter interval between pill administration and wake up time may increase patient subjective satisfaction with hypnotic agents. We propose that physicians advise patients to take sleeping pills approximately 7 h before their usual getting-out-of-bed time instead of the current standard of 30 min before bedtime.

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Aging and Sleep: Physiology and Pathophysiology

Cited by 181 publications

References 152 publications

Aging, Tolerance to High Altitude, and Cardiorespiratory Response to Hypoxia

Aging, Tolerance to High Altitude, and Cardiorespiratory Response to Hypoxia

Sleep fragmentation and sepsis differentially impact blood–brain barrier integrity and transport of tumor necrosis factor-α in aging

Sleeping Pill Administration Time and Patient Subjective Satisfaction

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