Sex differences in deterioration of sleep properties associated with aging: A 12-year longitudinal cohort study

Hyeon Jin Kim, Regina E.Y. Kim, Soriul Kim, Sol Ah Kim, Song E. Kim, Seung Ku Lee, Hyang Woon Lee, Chol Shin

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


Study Objectives: The sleep patterns of humans are greatly influenced by age and sex and have various effects on overall health as they change continuously during the lifespan. We investigated age-dependent changes in sleep properties and their relation to sex in middle-aged individuals. Methods:We analyzed data from 2,640 participants (mean age of 49.8 ± 6.8 years at baseline, 50.6% women) in the Korean Genome and Epidemiology Study, which assessed sleep habits using the Pittsburgh SleepQuality Index and other clinical characteristics.We analyzed the sleep habit changes that occurred between baseline and a follow-up point (mean interval: 12.00 ± 0.16 years). Associations of age and sex with 9 sleep characteristics were evaluated. Results: Age was associated with most of the sleep characteristics cross-sectionally and longitudinally (P <.05), except for the time in bed at baseline (P =.455) and change in sleep duration (P =.561). Compared with men, women had higher Pittsburgh Sleep Quality Index scores, shorter time in bed, shorter sleep duration, and longer latency at baseline (P ≤.001). Longitudinal deterioration in Pittsburgh Sleep Quality Index score, habitual sleep efficiency, duration, and latency was more prominent in women (P <.001). The sex differences in these longitudinal sleep changes weremainly noticeable before age 60 years (P <.05).Worsening of Pittsburgh Sleep Quality Index scores, habitual sleep efficiency, and latency was most evident in perimenopausalwomen.Men presented with greater advancement of chronotype (P = .006), with the peak sex-related difference occurring when they were in their late 40s (P = .048). Conclusions: Aging is associated with substantial deterioration in sleep quantity and quality as well as chronotype advancement, with the degree and timing of these changes differing by sex.

Original languageEnglish
Pages (from-to)964-972
Number of pages9
JournalJournal of Clinical Sleep Medicine
Issue number5
Publication statusPublished - 2021 May 1

Bibliographical note

Funding Information:
This study was funded by grants from the Korean Centers for Disease Control and Prevention, Korean Ministry for Health and Welfare (grant numbers 2003-347-6111-221, 2004-E71001-00, 2015-P71001-00, and 2016-E71003-00; to C.S.), grants from the Basic Science Research Program, Convergent Technology R&D Program for Human Augmentation and the BK21 Plus Program through the National Research Foundation of Korea funded by the Ministry of Science, Information, and Communication Technologies & Future Planning (NRF-2017R1A2A2A05069647, 2017R1B5A2086553, 2018M3C1B8016147, 2019M3C1B8090803, and 2020R1A2C2013216; to H.W.L.), and a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea (HI19C1065; to H.J.K.). The authors confirm that they have read the journal’s position on issues involved in ethical publication and affirm that this article is consistent with those guidelines. The authors report no conflicts of interest.

Publisher Copyright:
© 2021 American Academy of Sleep Medicine.


  • Age
  • Chronotype
  • Cohort
  • Menopause
  • Sex
  • Sleep

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology


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