The relationship between sleep habits, anxiety, and depression in the elderly

Purpose: The objective of this study is to determine which sleep-related behaviors are most often used by the elderly according to the presence or absence of anxiety and mood disorders. In particular, we are attempting to determine whether these behaviors are associated with the probability of suffering from a mental disorder. The behaviors being examined in the present study are taking naps, television watching or reading at bedtime, physical exercise at bedtime, relaxing activities at bedtime, and caffeine consumption in the evening.

Methods: The sample in this study consists of 2,759 participants aged 65 and over, with a mean age of 73.8. They were recruited through a method of random generation of telephone numbers according to a sampling strategy based on geographic location. After the goal of the study was explained to them, the participants agreed to have health professionals visit their home and to answer questions in an hour-and-a-half-long structured interview (after signing a consent form).

Results: Taking naps is the activity most often practiced by the elderly. Watching television and reading at bedtime are also frequent practices among them. The probabilities of suffering from anxiety are greater if the person never or rarely consumes caffeine after 6 pm, if the individual takes naps during the day, or if the person practices relaxation before bedtime. Television watching, reading, and physical exercise before bedtime are activities that are not associated with the probability of suffering from a mental disorder.

Conclusion: It would be beneficial for research to be conducted to support the findings on behavioral differences between depressive and anxious seniors so that these behaviors can become further indicators of the presence of mental disorders.

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Alex’s Notes: Our sleep hygiene is proving time and time again to be critical for health. With this in mind, I thought it prudent to cover the brief cross-sectional study presented here. Its objective was to find associations between certain pre-sleep behaviors such as napping, watching television, reading, exercising, or performing relaxation activities and levels of anxiety and depression among the elderly. As we know, depression is a serious concern among seniors, and the prevalence of major depression ranges from 0.9% to 9.4% in private households, from 14% to 42% in institutional living, and from 1% to 16% among elderly living in private households or in institutions. Minor depression is more even more common.

For the current study, data was obtained from a Seniors’ Health survey of people over 65 years of age living in the Quebec, Canada region. The total sample size was 2,759 persons with an average age of 73.8 years.

Naps, watching TV, and reading were the most common activities, with over 50% of the subjects practicing these activities sometimes, often, or very often. Conversely, exercise was only performed by 10.7% of the people. However, none of the five activities predicted levels of depression in the elderly. On the other hand, those who rarely or never took naps or practiced relaxation techniques were half as likely to be anxious than those who performed the activities more frequently. Surprisingly, not consuming caffeine before bed also increased the risk of being anxious by more than two-fold. Exercise and TV or reading before bed had no associations with either depression or anxiety. Notably, being female also increased the risk of being depressed and anxious, and being over 75 years (compared to under) increased the risk of being anxious.

Correlation is not causation

It is entirely possible that the elderly were anxious before taking naps and practicing relaxation techniques, which is why they practiced these things, to help with the anxiety. Moreover, anxious older persons appear to avoid caffeine, which can indeed aggravate anxiety. Nonetheless, if you have loved ones in a community care setting, where mental disturbances are more prevalent, then it may be worth keeping an eye on lack of caffeine consumption, napping, and the attempt to relax before bed as signs that maybe the person is feeling a bit anxious, especially if they are also over 75 years old and female.


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