The Complex Interplay Between Sleep and Healthy Aging: A Scoping Review

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Abstract
Background: The relationship between sleep and healthy aging is complex, involving changes in sleep patterns, architecture, and disturbances. Recognizing these changes is crucial for maintaining physical, cognitive, social, and psychological well-being in older adults. However, links between sleep parameters and aging outcomes remain unclear. Objective: This review synthesizes current knowledge on associations between sleep parameters (duration, continuity, architecture, quality) and healthy aging outcomes, including physical health, cognitive function, psychological well-being, and social engagement. Methods: Following the Arksey and O’Malley framework and Joanna Briggs Institute guidelines, this scoping review analyzed observational studies on healthy older adults. Sleep-related measures were examined without confounders from mental or physical illnesses. Results: Twenty studies were included. Across cohorts, older adults consistently exhibited advanced sleep phases (bedtime ≈39 minutes earlier, wake time ≈76 minutes earlier) and reduced total sleep time (by approximately 2.4 hours vs younger adults). Both short and long sleep durations were associated with poorer aging outcomes, supporting a U-shaped relationship between sleep length and healthy aging. Sleep efficiency decreased by 13% and wake after sleep onset increased fourfold with age, particularly among women. Age-related reductions in slow-wave and REM sleep were linked to lower cognitive performance and altered mood regulation. Moderate daytime napping (< 60 min/day) was generally associated with better sleep quality, whereas excessive napping correlated with reduced odds of “successful aging”. Discrepancies between subjective and objective sleep assessments emerged, indicating that older adults may underreport sleep disturbances. Conclusion: Gaps in understanding longitudinal sleep data, the mechanisms of sleep’s impact on aging, and napping’s role need further exploration. Future research could inform interventions for promoting healthy aging.

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