The impact of sleep health on executive functions in older adults

Sleep health is essential for overall physical and mental well-being for people of all ages. However, the impact of different aspects of sleep health, such as sleep duration, efficiency, and timing, on executive function remains unclear due to conflicting findings in the existing literature.

To address this knowledge gap, a recent study published in the Journal of Neuropsychiatry Clinical Neuroscience aimed to investigate the differential effects of various sleep health domains on executive functions among older adults.

A group of 115 participants, ranging in age from 55 to 90, underwent cognitive assessment to evaluate their memory, flexibility in thinking, and the ability to pay attention and ignore distractions. The researchers also examined four aspects of sleep health: sleep satisfaction and quality, sleep efficiency, sleep duration, and daytime sleepiness and fatigue. Additionally, the participants’ symptoms of depression and anxiety were evaluated using questionnaires.

The study findings suggest that higher levels of daytime sleepiness and fatigue were associated with decreased cognitive flexibility, while global cognition and sleep efficiency were identified as important predictors of response inhibition performance.

On the other hand, sleep quality and satisfaction, sleep duration, anxiety and depression did not appear to have a significant impact on executive function.

Interestingly, while the total amount of sleep did not directly affect cognitive abilities, the researchers discovered that both shorter and longer sleep durations were linked to poorer performance on cognitive tasks compared to those with an average sleep duration of around 6 to 8 hours.

It is important to note that these findings were based on a predominantly white non-Hispanic population, so more research is needed to see if similar results apply to other groups. Additionally, the study did not find significant differences between men and women in terms of sleep health and cognitive abilities.

Further research is needed to gain a better understanding of the complex relationship between sleep and cognitive health. However, these findings highlight the importance of healthcare providers routinely screening for sleep efficiency and daytime sleepiness and fatigue to identify individuals at risk of cognitive problems, accidents, and falls.

Such screening can also help identify underlying psychiatric concerns like anxiety and depression. Cognitive-behavioral therapy for insomnia is an intervention approach that can target specific sleep problems and potentially improve cognitive control and efficiency in older adults.

“Our findings extend prior research linking sleep health with executive function and have potential implications for sleep assessment and its intervention,” the researchers concluded. “Consistent with prior work, sleep efficiency and daytime sleepiness/fatigue emerged as having the strongest relationships with cognitive control within this study.”

“Difficulties with these sleep health domains are frequently reported by primary care patients, with approximately 31%-33% of patients reporting sleep disturbances such as poor sleep efficiency, roughly 15% reporting sleep disturbance along with daytime sleepiness/fatigue the following day, and about 10% meeting clinical diagnostic criteria for insomnia.”

“Given associations observed between these sleep health factors with cognitive control, routine screening of sleep efficiency and daytime sleepiness/fatigue may be particularly useful in identifying those at greater risk of executive dysfunction and associated sequelae such as accidents and injurious falls, in addition to screening for psychiatric concerns such as anxiety and depression,” the researchers said.

The study, “Specific Sleep Health Domains as Predictors of Executive Function in Older Adults“, was authored by Angelica Boeve, Amy Halpin, Sahvannah Michaud, Michael Fagan, and Rebecca K. MacAulay.

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