Sleep disturbance is common in older adults, with the most common types, outside of insomnia, being sleep apnea, restless legs syndrome, or REM behavior disorder. African Americans have been found to have higher prevalence rates of sleep disturbance, and an increased susceptibility to the development of sleep apnea, including higher severity rates when diagnosed, than their White counterparts.
Sleep disturbances and disorders have been associated with higher rates of mental and physical health problems, specifically in older adults sleep disturbance has been associated with depression, cognitive impairment, heart disease, increased risk of Alzheimer’s disease, impaired physical functioning and mortality. Therefore, it is important to explore all avenues for reducing sleep disturbances in these highly prevalent groups.
Purpose in life
Purpose in life is one of the main facets of positive psychological well-being and is conceptualized as a sense of meaning and directedness in your own life
Studies on positive psychology have revealed a possible interplay between positive psychological well-being and physiological functioning. Purpose in life is one of the main facets of positive psychological well-being and is conceptualized as a sense of meaning and directedness in your own life, essentially having aspirations and goals for the future and feeling that experiences in life are meaningful.
Purpose in life is often measured via a version of Ryff & Keyes’ self-report scale, as was done in this study. An examples of an item that would appear on such a scale is “Some people wander aimlessly through life, but I am not one of them.”
Purpose in life has been associated with numerous positive health outcomes and healthy behaviors, as well as longevity. Specifically, having higher levels of purpose in life has been associated with a reduced risk of stroke, Alzheimer’s disease, disability, and all-cause mortality.
These results of purpose in life research are in direct opposition to the aforementioned outcomes of sleep disturbance research in older adults with higher levels of purpose in life showing reduced risk of Alzheimer’s disease, disability, and all-cause mortality, while higher levels of sleep disturbance show increased risk of Alzheimer’s disease, impaired physical functioning, and mortality.
Relation to sleep quality
Previous research does indicate a relationship between higher levels of purpose in life and better sleep quality, but the relationship between purpose in life and sleep disorders has not been previously examined.
Given the high prevalence of sleep disturbances and disorders in older adults and African Americans, we explored the relationship between purpose in life, sleep quality, sleep apnea risk, restless leg syndrome risk, and REM behavior disorder risk. To do this we examined a combined dataset of two cohort studies – the Rush Memory and Aging Project (MAP) and the Rush Minority Aging Research Study (MARS) – of community-dwelling older adults which led to an over sampling of African Americans.
These cohorts were particularly of interest because they would allow us to examine a large number of individuals who fall into the category where sleep disturbance/disorder risk is high and by examining older individuals who were mostly above the retirement age, we were more likely to have a wider range of purpose in life scores as work status would not be an influence.
We found that higher levels of purpose in life were associated with better sleep quality at baseline
We found that higher levels of purpose in life were associated with better sleep quality at baseline. Additionally, higher levels of purpose in life were associated with lower risk of sleep apnea at baseline at 1-and 2-year follow-ups, and reduced risk of restless leg syndrome at 1and 2-year follow-ups.
Though it was beyond the scope for us to examine mechanism, previous research indicates that individuals with higher levels of purpose in life tend to have better mental and physical health and fewer physical symptoms. Research also shows that they tend to engage in more healthy behaviors, exercise and preventative behaviors like doctor visits.
As a result one interpretation of this seemingly protective factor of purpose in life at baseline and follow up for biological based sleep issues like sleep apnea and restless leg syndrome may be a consequence of fewer medical comorbidities and more healthy behaviors.
In addition, these findings indicate that purpose in life may have utility in a clinical setting. The construct of purpose in life is one that can be cultivated and enhanced; therefore, future research should examine the use of interventions using positive psychology, such as mindfulness-based therapies, to target purpose in life in older adults.
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