The Effects of Age, Sex, Ethnicity, and Sleep-Disordered Breathing on Sleep Architecture

Susan Redline, H. Lester Kirchner, Stuart F. Quan, Daniel J. Gottlieb, Vishesh Kapur, Anne Newman

Research output: Contribution to journalArticlepeer-review

451 Scopus citations


Background: Polysomnography is used to assess sleep quality and to gauge the functional effect of sleep disorders. Few population-based data are available to estimate the variation in sleep architecture across the population and the extent to which sleep-disordered breathing (SDB), a common health condition, contributes to poor sleep independent of other factors. The objective of this study was to describe the population variability in sleep quality and to quantify the independent associations with SDB. Methods: Cross-sectional analyses were performed on data from 2685 participants, aged 37 to 92 years, in a community-based multicenter cohort study. Dependent measures included the percentage time in each sleep stage, the arousal index, and sleep efficiency. Independent measures were age, sex, ethnicity, comorbidity status, and the respiratory disturbance index. Results: Lighter sleep was found in men relative to women and in American Indians and blacks relative to other ethnic groups. Increasing age was associated with impaired sleep in men, with less consistent associations in women. Notably, women had, on average, 106% more slow wave sleep. Sleep-disordered breathing was associated with poorer sleep; however, these associations were generally smaller than associations with sex, ethnicity, and age. Current smokers had lighter sleep than ex-smokers or never smokers. Obesity had little effect on sleep. Conclusions: Sleep architecture varies with sex, age, ethnicity, and SDB. Individual assessment of the effect of SDB on sleep quality needs to account: for other host characteristics. Men, but not women, show evidence of poorer sleep with aging, suggesting important sex differences in sleep physiology.

Original languageEnglish (US)
Pages (from-to)406-418
Number of pages13
JournalArchives of internal medicine
Issue number4
StatePublished - Feb 23 2004

ASJC Scopus subject areas

  • Internal Medicine


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