Diminished capability to recognize the optimal temperature for sleep initiation may contribute to poor sleep in elderly people

Study Objectives. Sleep propensity and skin temperature are functionally related. In young adults, changes of skin temperature within the comfortable thermoneutral zone affect sleep-onset latency and vigilance performance. Aging is associated with both decreased thermosensitivity and poorer sleep. Our goal was to test whether subtle manipulations of core body and skin temperature affect sleep onset in elderly people without sleep complaints and in elderly insomniacs and whether the subjective perception of these mild body temperature manipulations is preserved with aging and insomnia. Design: In a 2-day semiconstant¡©routine protocol, 288 sleep-onset latencies were polysomnographically determined while manipulating core body and skin temperatures differentially in warm and cold directions within a comfortable thermoneutral range. Setting: Sleep laboratory of the Netherlands Institute for Neuroscience. Patients or Participants: Eight elderly subjects without sleep complaints (65.8 ¡¾ 2.8 years, mean SEM) and 8 elderly insomniacs (59.1 - 1.9 years). Measurements and Results: Warming the proximal skin by 0.4C facilitates sleep onset equally effective in healthy elderly (by 18% ie, by 1.84 min utes [95% confidence interval {CI}, 0. 76-2.92]) an d el derly in somnia cs (28%, 2.85 min utes [CI: 2.55-3.18]). These effe cts were comparable to the results in healthy young subjects, in spite of a marked decrease in the subjective perception of temperature changes in elderly subjects, especially in insomniacs. Conclusion: The findings show that mild changes in skintemperature have an effect on sleep propensity in elderly and indicate that elderly insomniacs may have a diminished capability to recognize that a slight increase in bed temperature facilitates the initiation or reinitiation of sleep.