Principal lifetime occupation and sleep quality in the elderly

Sleep symptoms, cognitive, psychic, and physical health variables were assessed in a sample of 449 community-dwelling elders aged 75 and over. The subjects were in a good cognitive and functional condition. Three night sleep symptoms were evaluated: difficulty falling asleep, waking up frequently in the night, and early morning awakenings. For each symptom, respondents were asked to estimate the frequency of the symptom during the past month on a five-point scale. White-collar workers reported the best, and blue-collar workers the poorest quality of sleep: the difference in the difficulty of falling asleep between the two groups was 0.86, of waking up frequently in the night 0.93, of early morning awakenings 1.01 (corresponding to 3 days/month, 5 days/month, and 3.5 days/month, respectively), and of total sleep symptoms 2.81. These unadjusted differences were reduced, respectively, to 0.57, 0.42, 0.54, and 1.53 after adjustment for other factors. Of these, only waking up frequently in the night was not statistically significant. These data show more frequent sleep symptoms in socially disadvantaged occupational groups, suggesting that social factors can significantly affect the quality of sleep in the elderly.