Associations of Actigraphic Sleep Parameters With Fatigability in Older Adults

Abstract

Background Poor sleep may increase the likelihood of fatigue, and both are common in later life. However, prior studies of the sleep–fatigue relationship used subjective measures or were conducted in clinical populations; thus, the nature of this association in healthier community-dwelling older adults remains unclear. We studied the association of actigraphic sleep parameters with perceived fatigability—fatigue in response to a standardized task—and with conventional fatigue symptoms of low energy or tiredness. Methods We studied 382 cognitively normal participants in the Baltimore Longitudinal Study of Aging (aged 73.1 ± 10.3 years, 53.1% women) who completed 6.7 ± 0.9 days of wrist actigraphy and a perceived fatigability assessment, including rating of perceived exertion (RPE) after a 5-minute treadmill walk or the Pittsburgh Fatigability Scale (PFS). Participants also reported non-standardized symptoms of fatigue. Results After adjustment for age, sex, race, height, weight, comorbidity index, and depressive symptoms, shorter total sleep time (TST; <6.3 hours vs intermediate TST ≥6.3 to 7.2 hours) was associated with high RPE fatigability (odds ratio [OR] = 2.56, 95% confidence interval [CI] = 1.29, 5.06, p = .007), high PFS physical (OR = 1.88, 95% CI = 1.04, 3.38, p = .035), and high mental fatigability (OR = 2.15, 95% CI = 1.02, 4.50, p = .044), whereas longer TST was also associated with high mental fatigability (OR = 2.19, 95% CI = 1.02, 4.71, p = .043). Additionally, longer wake bout length was associated with high RPE fatigability (OR = 1.53, 95% CI = 1.14, 2.07, p = .005), and greater wake after sleep onset was associated with high mental fatigability (OR = 1.14, 95% CI = 1.01, 1.28, p = .036). Conclusion Among well-functioning older adults, abnormal sleep duration and sleep fragmentation are associated with greater perceived fatigability.

Correlates of objective sleep quality in older peritoneal dialysis patients

“…Using actigraphy data, this study confirms that a higher number of older peritoneal dialysis patients experience disturbed sleep than older adults in general. The average sleep efficiency in our study participants (75.5%±14.2%) was worse than that of the healthy older adult population reported in Alfini et al.’s study [ 28 ]. They found a mean actigraphy measured sleep efficiency of 83.4%±7.6% for 392 cognitively normal community-dwelling older adults with a mean age of 73.1 years old.…”

Impact of exercise on older adults’ mood is moderated by sleep and mediated by altered brain connectivity

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Traits and treadmills: Association between personality and perceived fatigability in well-functioning community-dwelling older adults.

“…In well-functioning older adults, higher perceived fatigability (i.e., feeling more significant levels of exhaustion after completing slow treadmill walk) has been associated with lower objective physical activity (Richardson et al, 2015; Wanigatunga et al, 2018), subjective and performance-based mobility (Simonsick et al, 2016, 2018), and worse inflammatory biomarker levels (Cooper et al, 2019; Wanigatunga et al, 2019). High perceived fatigability is also more prevalent in those with a history of disease including preclinical cardiovascular disease (Qiao et al, 2019), peripheral artery disease (Martinez-Amezcua et al, 2018), cancer (Gresham et al, 2018), cognition (Salerno et al, 2020), and sleep (Alfini et al, 2020). Although several popular adages: It takes as much energy to wish as it does to plan—Eleanor Roosevelt, American Political Figure Our fatigue is often caused not by work, but by worry, frustration and resentment—Dale Carnegie, American Writer Age is not measured by years.…”