Medicalization of sleep problems in an aging population : a longitudinal cross-national study of medication use for sleep problems in older European adults

OBJECTIVE: The association between age and sleep problems is considered to be positive, and medication use is a common health care intervention among older individuals. Because daytime consequences are often stated as a reason to seek care, we study to what extent the medicalization of sleep problems is found in an aging European population, with a focus on daily activities. METHOD: Data from the Survey of Health Ageing and Retirement in Europe are used in three-level, generalized linear mixed models. Medicalization is operationalized as the use of medication for sleep problems at least once per week. RESULTS: Men are more likely than women to use medication for sleep problems, and the process of aging is associated with a decrease in medicalization. DISCUSSION: Sleep problems seem to be medicalized particularly when they prevent aging individuals from engaging in work-related responsibilities, as medication is especially used by employed individuals with sleep problems.status: publishe

The impact of informal caregiving on sleeping problems in European older adults

Objectives: In our ageing population people are increasingly confronted with caregiving responsibilities, especially for older relatives. Previous research describes how for women the provision of informal care implies worse sleep. In this study we therefore aim to look at how different types of informal caregiving are associated with sleeping problems and how these associations may differ by gender. Furthermore we intend to study between-country differences in this association. Methods: The second (2006/2007) and fourth (2011/2012) wave of the Survey of Health Ageing and Retirement in Europe (SHARE) are used. Longitudinal mixed effects logistic regression analyses with three levels -country, individual and period- are performed to examine the association between informal caregiving and sleeping problems. Data consists of 18,302 individuals aged 50 and older from 18 European countries. Results: Preliminary results show that - controlled for gender, age, educational attainment, marital status and the current job situation – personal care or practical household help outside the household as well as personal care within the household are associated with more sleeping problems. No differences in this association are found between men and women. Finally, sleeping problems are less prevalent in countries where a higher percentage of the GDP is spent on care for the elderly. Conclusion: Our study suggests that informal caregiving implies worse sleep. Care for relatives inside the household is likely to involve caregiving during the night, but the fact that care for people outside the household also affects sleep may signify sleep lost due to worries. Lastly, in countries where formal care services for the elderly receive more funding, people experience less sleeping problems, most likely due to less informal caregiving responsibilities

How well does Europe sleep? A comparative study of sleeping problems in European older adults

Background: Poor sleep has been found to be strongly related to a wide range of negative health outcomes. In the association between sleep and health, it is not so much the amount of hours one sleeps, but how well one sleeps that is important. Although this highlights the importance of identifying the determinants of poor sleep quality, relatively little research has in fact paid attention to this aspect of sleep. Objectives: In this study we try to provide more insight into the socio-demographic and socioeconomic determinants of suffering from sleeping problems in Europe’s older adults. Using cross-national data we add to the fairly limited literature examining cross-country differences in the prevalence of sleeping problems. By specifically focussing on individuals over the age of 50, we hope to disentangle the positive association between age and trouble sleeping that has been found repeatedly. Methods: Data from the fourth wave of the Survey of Health Ageing and Retirement in Europe (2011/2012) are used to perform logistic regression analyses, the dependent variable being whether or not one has been bothered by sleeping problems for at least six months. The dataset consists of data from 37370 individuals aged 50 and older and their current partners or spouses from 16 European countries. Results: Preliminary results show that about 24% of respondents were bothered by sleeping problems in the past six months. This prevalence varied between the different European countries, from 16,8% in both Denmark and the Netherlands to 31,1% in Poland. Age is found to be positively associated with sleeping problems. Women are 1,7 times more likely to suffer from sleeping problems than men. Compared to married individuals, the divorced and widowed respondents reported suffering from sleeping problems significantly more often. For widowed respondents, the chance of reporting trouble sleeping was 1,3 times higher than for married individuals. No difference was found between the married and those who remained single throughout their lives. Less sleeping problems are reported by the higher educated. Another socio-economic variable that appears to be associated with the perception of sleep quality is the current job situation. Compared to the retired respondents, homemakers and the employed experience less trouble sleeping, whereas the unemployed and the permanently sick or disabled individuals experience more trouble sleeping. Retirement appears to be associated with a 1,6 times higher chance of reporting sleeping problems compared to those in employment. Additional analyses will be performed to further examine the aforementioned results, to try to disentangle the positive association between age and sleeping problems and to look into the between-country differences that seem to be present. Discussion/Conclusion: Our study has shown that age, sex, marital status, educational level and the current job situation are factors associated with the experience of sleeping problems. In trying to disentangle the positive association between age and sleep quality, the findings that retirement compared to employment and widowhood compared to marriage are related to more sleeping problems needs to be investigated further. Both retirement and widowhood are potentially stressful life events that usually occur at a later age and may influence the age-sleep association

Reasons for the transition to retirement and its association with sleep problems in an ageing European population

Objectives: Since society considers people to reach old age through the transition from being a working individual to being retired, this is probably the most important change in the life course of an ageing individual. Besides, retirement involves a radical change in the daily schedule of people who have worked their entire lives, which is likely to have an impact on how they get through the night. In this study we will therefore shed light on how retirement relates to the experience of sleep problems in an ageing European population, with a specific focus on individual reasons for retirement. Methods: The first (2004/2005), second (2006/2007) and fourth (2011/2012) wave of SHARE are used to perform longitudinal mixed effects logistic regression analyses with three levels -country, individual and period-, the dependent variable being whether or not one one has been bothered by sleeping problems for at least six months. Data consists of 58,613 individuals aged 50 and older from 19 European countries. Results: Preliminary results show that, controlled for gender, age, educational attainment, marital status, household net worth and current health status, individuals who are forced into retirement by their employer or because of health reasons are more likely to report sleep problems than individuals who are not retired. However, individuals who became eligible for pension or those who retired because they wanted to enjoy life and spend more time with their family are less likely to report sleep problems than those who are not retired. Conclusions: Our study suggests that whether retirement is associated with sleep problems depends on the reason why people retire. Although retirement is a crucial transition in the life of an ageing individual, it seems that it is the ability to control the moment of this transition that is particularly important for sleep problems

Early predictors of impaired sleep: a study on life course socioeconomic conditions and sleeping problems in older adults

Objectives: This study aimed to assess how childhood socioeconomic conditions are associated with sleeping problems in older adults and how this association may be mediated by socioeconomic conditions across the lives of individuals using a life course perspective. Since the life course opportunities differ systematically between men and women, attention was given to gender differences in the association. Methods: Data from 23,766 individuals aged over 50 years of the longitudinal Survey of Health, Ageing and Retirement in Europe (SHARE) were used. Logistic mixed-effect models were estimated to examine the associations between childhood socioeconomic conditions and the presence of sleeping problems. Results: For women, the analyses showed an association between childhood socioeconomic conditions and sleeping problems. For men, only current socioeconomic conditions were found to be relevant for sleep. The importance of childhood socioeconomic conditions for sleeping problems did not affect the evolution of sleeping problems over ageing. Conclusion: In this study no empirical support was found for processes of cumulative advantage/disadvantage or age-as-leveler. However, childhood does seem to be a critical period for the sleep of women, because the association with childhood socioeconomic conditions remains even when the circumstances later in life are considered. These findings, in particular the gender differences in the association, underline the importance of tracking life course patterns in the study of sleeping problems in older adults