This dissertation includes six epidemiological studies of sleep in a normal elderly population. The research was conducted within the setting of the Rotterdam Study, a large prospective cohort study of community-dwelling inhabitants of a district of Rotterdam, aged 55 and over. A total of 1076 persons participated in an additional sleep study, in which their sleep was ‘measured’ with a sleep diary and with actigraphy, a method that infers sleep and wakefulness from the presence or absence of arm movement. The following topics are addressed in this dissertation: gender differences in sleep duration and sleep quality, disagreement between diary and actigraphy measures of sleep parameters, the relationship between sleep duration and cardiovascular disease and risk factors (obesity, hypertension and cholesterol levels) and sleep in depression and anxiety disorders. One of the remarkable conclusions is that women report shorter and poorer sleep in their diaries, but when measured with actigraphy, women show longer and less fragmented sleep than men. Furthermore, both persons who habitually sleep less than 6 hours per night and persons who tend to sleep more than 8 hours per night, have a higher risk of obesity. Also, these groups had more depressive and anxiety disorders. All studies showed a considerable disagreement between measurement methods. This implies that sleep remains a mysterious phenomenon that cannot easily be precisely measured in the home situation. Longitudinal r! esearch is needed to further elucidate the effects of (lack of) sleep on physical and mental health.

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Financial support for the publication of this thesis was kindly provided by the Department of Epidemiology of the Erasmus MC, the Parnassia Bavo Groep, The Dutch Society for Sleep- Wake Research (NSWO), and Servier Nederland Farma B.V.
Erasmus MC: University Medical Center Rotterdam
A. Hofman (Albert)
Erasmus MC: University Medical Center Rotterdam

van den Berg, J. (2008, December 4). Sleep in later life: a population-based approach. Retrieved from