Race and sex differences in the longitudinal changes in multidimensional self-reported sleep health characteristics in aging older adults

Sleep Health. 2023 Dec;9(6):947-958. doi: 10.1016/j.sleh.2023.08.008. Epub 2023 Oct 4.


Objectives: We examined within-individual changes in self-reported sleep health as community-dwelling older adults age as well as potential differences in these changes by self-reported sex and racial identity.

Methods: Participants were from the United States and enrolled in the Rush Memory and Aging Project, Minority Aging Research Study, or Religious Orders Study (N = 3539, 20% Black, 75% female, mean 78years [range 65-103]), and they received annual, in-person clinical evaluations (median 5 visits [range 1-27]). A sleep health composite score measured the number of poor sleep characteristics among satisfaction, daytime sleepiness, efficiency, and duration. Mixed effects models estimated associations of age, race, sex, and their interactions on the composite and individual sleep measures, accounting for key confounders.

Results: As they aged, Black participants shifted from reporting two poor sleep characteristics to one poor sleep characteristic, while White participants shifted from one poor characteristic to two. Regardless of age, sex, and race, participants reported that they "often" felt satisfied with their sleep and "sometimes" had trouble staying asleep. Females over age 85 and males of all ages reported the most daytime sleepiness, and older White participants (>age 90) reported the most difficulty falling asleep.

Conclusions: Although self-reported sleep characteristics were typically stable across age, identifying race and sex differences in self-reported sleep health can help guide future research to understand the mechanisms that underlie these differences.

Keywords: Aging; Health inequities; Healthy aging; Sleep duration; Sleep latency; Sleep quality.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging
  • Disorders of Excessive Somnolence*
  • Female
  • Humans
  • Male
  • Self Report
  • Sex Characteristics
  • Sleep
  • Sleep Initiation and Maintenance Disorders*
  • United States