Sex differences in deterioration of sleep properties associated with aging: A 12-year longitudinal cohort study

Abstract

Study Objectives: The sleep patterns of humans are greatly influenced by age and sex and have various effects on overall health as they change continuously during the lifespan. We investigated age-dependent changes in sleep properties and their relation to sex in middle-aged individuals. Methods:We analyzed data from 2,640 participants (mean age of 49.8 ± 6.8 years at baseline, 50.6% women) in the Korean Genome and Epidemiology Study, which assessed sleep habits using the Pittsburgh SleepQuality Index and other clinical characteristics.We analyzed the sleep habit changes that occurred between baseline and a follow-up point (mean interval: 12.00 ± 0.16 years). Associations of age and sex with 9 sleep characteristics were evaluated. Results: Age was associated with most of the sleep characteristics cross-sectionally and longitudinally (P <.05), except for the time in bed at baseline (P =.455) and change in sleep duration (P =.561). Compared with men, women had higher Pittsburgh Sleep Quality Index scores, shorter time in bed, shorter sleep duration, and longer latency at baseline (P ≤.001). Longitudinal deterioration in Pittsburgh Sleep Quality Index score, habitual sleep efficiency, duration, and latency was more prominent in women (P <.001). The sex differences in these longitudinal sleep changes weremainly noticeable before age 60 years (P <.05).Worsening of Pittsburgh Sleep Quality Index scores, habitual sleep efficiency, and latency was most evident in perimenopausalwomen.Men presented with greater advancement of chronotype (P = .006), with the peak sex-related difference occurring when they were in their late 40s (P = .048). Conclusions: Aging is associated with substantial deterioration in sleep quantity and quality as well as chronotype advancement, with the degree and timing of these changes differing by sex. © 2021 American Academy of Sleep Medicine.