Furthermore, existing findings are inconsistent, due in part to limitations of self-report indices of sleep duration and quality that do not differentiate insomnia cases from those with more mild sleep disturbances. 28, 29Īlthough several studies have found associations of short sleep duration, as well as poor sleep quality, with shorter telo-mere length, 10 – 13, 30, 31 no study to date has examined whether clinical insomnia is associated with telomere length in older adults. This effect of sleep disturbances may be particularly pronounced in older adults, as they have reduced capacity to respond to various physiological insults and perturbations (e.g., drug clearance, tissue healing, prolonged recovery). 22 – 27 Cellular aging is, therefore, an indicator of risk for disease, and may be a mechanism through which insomnia increases risk for diseases of aging. 18 – 21 A faster decline in telomere length, and shortened telomere length, is predictive of greater disease progression and mortality. The length of telomeres, repeat sequences of DNA that cap the ends of chromosomes, shortens over the lifetime and is one indicator of cellular aging in humans. 10 – 17 To our knowledge, no study to date has assessed markers of biological aging in individuals with clinical insomnia compared to controls. 1, 5 – 9 Proposed mechanisms through which inadequate sleep elevates risk for disease and death include the promotion of basic biological processes that contribute to aging at the cellular level, including cellular injury, DNA damage, inflammation, and telomere shortening. Insomnia symptoms are associated with an increased risk for disease and death in later life. Estimated prevalence of insomnia across the population is 6% to 10% however, prevalence estimates increase with age with approximately half of adults older than 65 y reporting insomnia symptoms, and 10% to 25% experiencing clinical insomnia. A diagnosis of insomnia requires these symptoms to last 1 month or longer, the patient to report disturbances in daytime function, and the symptoms not be the consequence of substance use, other sleep disorders, or comorbid medical conditions.
Insomnia is characterized by difficulties in falling or staying asleep, waking too early, and experiencing nonrestorative sleep.
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