Subjective and objective napping and sleep in older adults: are evening naps "bad" for nighttime sleep?

Abstract

Objectives: To compare objective and subjective measurements of napping and to examine the relationship between evening napping and nocturnal sleep in older adults.

Design: For 12 days, participants wore actigraphs and completed sleep diaries.

Setting: Community.

Participants: One hundred individuals who napped, aged 60 to 89 (including good and poor sleepers with typical age-related medical comorbidities).

Measurements: Twelve days of sleep diary and actigraphy provided subjective and objective napping and sleep data.

Results: Evening naps (within 2 hours of bedtime) were characteristic of the sample, with peak nap time occurring between 20:30 and 21:00 (average nap time occurred between 14:30 and 15:00). Two categories of nappers were identified: those who took daytime and evening naps and daytime-only. No participants napped during the evening only. Day-and-evening nappers significantly underreported evening napping and demonstrated lower objectively measured sleep onset latencies (20.0 vs 26.5 minutes), less wake after sleep onset (51.4 vs 72.8 minutes), and higher sleep efficiencies (76.8 vs 82%) than daytime-only nappers.

Conclusion: Day and evening napping was prevalent in this sample of community-dwelling good and poor sleepers but was not associated with impaired nocturnal sleep. Although the elimination or restriction of napping is a common element of cognitive-behavioral therapy for insomnia, these results suggest that a uniform recommendation to restrict or eliminate napping (particularly evening napping) may not meet the needs of all older individuals with insomnia.

Figure 1

Percentage of total actigraphically-measured naps taken by all participants that occurred during each half-hour interval of the 24-hour clock.