Sleep, Healthy Aging And Longevity
By Arvind M. Dhople, Ph.D., Professor Emeritus, Florida Tech
September is The Sleep Charity’s annual awareness month, and is also marked by the American Academy of Sleep Medicine’s “Student Sleep Health Week” September 15-21, 2024. Sleep is an aspect of health that deserves more attention than it currently receives; while we are constantly remained of the importance of a healthy diet and adequate activity levels, the value of high-quality sleep is often overlooked.
Although most people are conscious of the importance of sufficient sleep for children and adolescents, less consideration is given to the fact that sleep is also essential to the maintenance of health and prevention of disease in adults. Data show the negative outcomes associated with disordered sleep, such as increased risk of stroke, impaired immune function, and elevated risk of obesity, and increased risk of suicide in adolescents as well as in older adults.
Recently, a group of scientists had reported an increased risk of all-cause and major-cause mortality associated with prolonged sleep latency (i.e., the time between going to bed and the onset of sleep). It has also shown that the benefits of high-intensity physical activity were insufficient to attenuate the cognitive decline associated with short sleep duration. In other words: we cannot outrun a bad night’s sleep. Barriers to adults achieving recommended sleep guidelines (a minimum of 7 hours per night, according to the American Academy of Sleep Medicine) are often psychosocial, with individuals foregoing part of their sleep hours to engage in activities or accomplish tasks that they could not complete during the day; other major sources of sleep disruption are pathological, with causes such as insomnia, sleep-disordered breathing, and movement disorders getting in the way of quality sleep. And although the prevalence of short sleep is, according to the US Centers for Disease Control and Prevention (CDC), highest in adults aged 25-44 years, older adults also tend to face accumulating causes of sleep disruption.
Physiological production of the crucial sleep-inducing hormone melatonin seems decrease with age. Medicines such as antidepressants and blockers, commonly prescribed to older adults, can reduce sleep quality by inducing or worsening primary sleep disorders (e.g., sleep apnea and restless legs syndromes). Increased urination frequently due to diabetes or an enlarged prostate can further disturb sleep. Congestive heart failure and chronic kidney disease, which can make lying down uncomfortable can both affect sleep quality and be worsened by a lack of sleep. Yet, balance is essential, and both too little and too much sleep are associated with health issue, such as the development of type 2 diabetes.
Sleep is, of course, not an isolated factor in the promotion of a long and healthy life, but rather an essential element of a balanced lifestyle. Like many such elements, sleep quality is also tied to socioeconomic factors with data from the USA showing that individuals from minority ethnic groups and low-income households face disproportionate burden of sleep-related chronic illness and that poor sleep quality is strongly associated with poverty and race. There is an urgent need to improve public awareness and education regarding the importance of quality sleep and the dangers of the lack thereof, at all demographic levels, although it cannot be ignored that no amount of awareness will suffice to address the underlying causes of many of the socioeconomic and racial disparities driving high levels of stress, financial concern, and, in many cases, subsequent poor sleep.
Although sleep interventions will not be able to help all of those in need, there is value in looking at such approaches as a way to start tacking the issue. Repeated studies have shown the benefits of, among other interventions, increasing daytime light exposure, physical exercise, and cognitive behavioral therapy to improve sleep quality, particularly in middle-aged and older adults. In the context, conversations about sleep begin taking place a systematic ways, as part of clinical practice and community support, in the management of chronic conditions, and in long-term care – in short, can help until better sleep is recognized and embraced as a means to achieve longer and healthier lives.
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