Relationship of psychopathology to insomnia in the elderly

Three groups of 18 volunteers each (nine men and nine women) were selected on the basis of age and the response to a sleep status questionnaire. Younger subjects (mean age, 43.8 years) who complained of difficulty in falling asleep or in staying asleep or of awakening too early were compared for evidence of psychopathologic signs with older subjects (mean age, 68.5 years) who had sleep-related complaints and with older subjects (mean age, 71.3 years) who did not have sleep-related complaints. Older subjects with insomnia complained more frequently of having trouble staying asleep and of awakening too early (P less than 0.05), whereas the younger subjects with insomnia complained primarily about difficulty in falling asleep (P less than 0.005). On a short form of the Minnesota Multiphasic Personality Inventory (MMPI-168), the number of elevated scores indicating pathologic disturbances (T score less than 70) was higher (p less than 0.05) for the younger subjects with insomnia (2.5 high scores) than for older subjects with insomnia (0.7 high scores) or for older normal sleepers (0.4 high scores). These results imply that although in younger persons psychopathologic disorders are associated with insomnia, psychopathic disorders usually are not the cause of insomnia in the elderly.