Successful aging starts with a good night's sleep, research suggests

Researchers from Wenzhou Medical University in China have found that changes in sleep patterns as we age are associated with a lower chance of successful aging.

Successful aging, as defined in the study, includes five key components:

• The absence of serious chronic diseases such as diabetes, cancer, chronic lung disease, heart disease and stroke.
• No physical limitations, as assessed by the ability to independently perform daily activities such as dressing, bathing and eating.
• High cognitive function, evaluated by cognitive tests including the cognitive status telephone interview, picture drawing and word recall.
• Good mental health, defined by a low score on the Center for Epidemiological Studies Depression Scale, indicating no significant depressive symptoms.
• Active involvement in life, demonstrated by participating in social activities such as socializing with friends, playing games such as mahjong or chess, and attending community events.

These criteria are collectively designed to reflect a holistic approach to the health and well-being of older adults. Previous studies have linked insufficient or excessive sleep to adverse health outcomes, but the impact of changes in sleep duration over time on successful aging is unclear.

This is particularly concerning in China, where a rapidly aging population, expected to be 28% of the population aged 60 and over by 2040, faces significant health challenges. Average life expectancy has increased, reaching 77.6 years in 2019, which is great, but healthy life expectancy is only 68.4 years, a delay of almost nine years.

In the study: “The association between sleep duration trajectories and successful aging: a population-based cohort study,” published in BMC Public Healthresearchers analyzed 3,306 participants who were free of serious chronic diseases in 2011 and had reached the age of 60 or older in 2020. Sleep duration was assessed in 2011, 2013, and 2015 by combining nighttime sleep and daytime naps to calculate total daily sleep hours.

The researchers identified five different sleep duration trajectories over the nine-year period: normal-stable (26.1% of participants), long-stable (26.7%), decreasing (7.3%), increasing (13.7% ) and short-stable (26.2%). Logistic regression models adjusted for factors such as age, gender, marital status, education level, household expenses, lifestyle behaviors and body type were used to examine the association between these sleep patterns and successful aging.

Using mixed latent class models (an algorithm that allows comparison between dissimilar groups), researchers decided that individuals who maintained normal-stable sleep patterns would serve as the reference group.

Participants with increasing and short stable sleep trajectories showed significantly lower odds of successful aging, with adjusted odds ratios of 0.64 and 0.48, respectively. Decreasing sleep patterns also showed reduced odds (adjusted OR of 0.64), although this did not reach statistical significance. The long-stable sleep pattern did not differ significantly from the normal-stable group.

Overall, only 13.8% of the 2020 cohort met the definition of successful aging.

Routine shorter and longer sleep durations over time can hinder successful aging by disrupting physiological and psychological well-being. The patterns found in the study are consistent with previous research linking irregular sleep habits to adverse health outcomes.

Maintaining stable and adequate sleep duration may be an often overlooked component of promoting healthy aging in the Chinese elderly population. The study provides good evidence for public health strategies aimed at maintaining stable and adequate sleep duration as part of successful aging initiatives.

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