AMBULATORY MONITORING OF SLEEP-WAKEFULNESS PATTERNS IN HEALTHY ELDERLY MALES AND FEMALES (GREATER-THAN 88 YEARS) - THE SENIEUR PROTOCOL

Objective: The study was designed to investigate sleep-wake patterns in healthy elderly men and women (> 88 years) using ambulatory recording techniques, Design: Cross-sectional observations on 2 consecutive days. Methods: Two consecutive 24-hour recordings were made. Each 30-second period of the recording was scored as characteristic of wakefulness, REM, and non-REM sleep (stages 1-4). Setting: Interviews and recordings were done in the home of the elderly, not interfering with the habitual routine. Participants: Among eligible members of the "Senieur" protocol, screened for wellness, seven females (88-102 years) and seven males (88-98 years) volunteered to participate. Main Outcome Measures: Organization of sleep, sleep structure, and daytime napping. Results: There was no difference between the first and second night recording. Important gender differences were observed: males had significantly less total sleep, shorter REM latency, more transitions to wake from REM, less NREM 3 sleep, and virtually no NREM 4. Daytime napping, REM amount, and distribution did not show sex differences. Although the variability in the amount of napping was considerable, it occupied less than 10 percent of the total sleep time in both women and men. Daytime napping was unrelated to sleep characteristics. Conclusions: Ambulatory sleep-wake recordings allow an objective and critical evaluation of sleep function in normal aging. Interesting findings include a shift of REM sleep to the first part of the sleep period an increased cycle variability, and non-correlation of night-time sleep with daytime napping. In contrast to earlier findings in elderly persons, a polygraphic and subjective first-night effect was lacking.