Associations between anemia and insomnia or excessive daytime sleepiness in older adults

ABSTRACT

Objective

Sleep disorders including excessive daytime sleepiness (EDS), insomnia and anemia are both common. The aim of this study is to investigate associations between anemia and insomnia/EDS in the elderly.

Methods

A total of 744 older outpatients were included in this cross-sectional study. Anemia was defined as a hemoglobin concentration below 12 g/dL in females and <13 g/dl in males. Patients were divided into two groups as anemic and non-anemic. The Epworth Sleepiness Scale score of ≥11 points indicates EDS. Insomnia Severity Index with scores of ≥8 indicates insomnia.

Results

The mean age was 79.8±7.7 years. The prevalence of insomnia, EDS and anemia was 62.1%, 23.8%, and 47.2%, respectively. Insomnia (66.3% vs 58.5%) and EDS (29.6% vs 18.6%) were more common in patients with anemia compared to those without anemia (p<0.05). In univariate analysis, there were significant associations between anemia and insomnia [odds ratio (OR):1.4, 95% confidence interval (CI):1.0–1.9], and EDS (OR:1.8,95% CI:1.3–2.6). In multivariate analysis, the relationship between insomnia and nocturia, chronic obstructive pulmonary disease (COPD), and number of drugs used persisted, whereas being male, of an older age, coronary arterial disease, COPD, Parkinson’s disease, dementia, and urinary incontinence were associated with EDS (p<0.05), but there was no significant relationships between anemia and insomnia/EDS (p>0.05).

Conclusion

The present data suggests that an elderly who has anemia is 1.4 times more likely to experience insomnia and 1.8 times more likely to experience EDS than those without anemia.

KEYWORDS:

• Anemia
• excessive daytime sleepiness
• insomnia
• older adults

Disclosure statement

The authors report no declarations of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Ethical approval

The local Ethics in Research Committees of the institutes approved this study. Informed consent was provided by each participant or a legal guardian before participating in the study. We declare that all methods of this study were performed in accordance with the relevant guidelines and regulations (Declaration of Helsinki).

Additional information

Funding

This work was not supported by a funding agency.