Objectively measured sleep and physical function: Associations in low-income older adults with disabilities

Safiyyah M. Okoye, Sarah L. Szanton, Nancy A. Perrin, Manka Nkimbeng, Jennifer A. Schrack, Hae Ra Han, Casandra Nyhuis, Sarah Wanigatunga, Adam P. Spira

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Objective: Late-life sleep health has been tied to physical function, but little is known about these associations among socially disadvantaged populations. Design: We determined cross-sectional associations of sleep with physical function in low-income, predominantly Black older adults with disabilities. Participants: One hundred thirty-six older adults (mean age 76.0 years, 83.8% women, 82.4% Black). Measurements: Primary predictors were actigraphic total sleep time (TST), wake after sleep onset (WASO), and subjective sleep complaints. Outcomes were objective physical performance (Short Physical Performance Battery (SPPB)) and participant-reported difficulties in basic and instrumental activities of daily living (ADLs and IADLs). Results: In regression models adjusted for potential confounders, both longer TST and greater WASO were associated with lower SPPB scores and increased IADL difficulty. Participants with a mean TST in the longest (>7.5 hours) vs. intermediate (6.3-7.5 hours) tertile had 27% higher odds of additional IADL difficulty (incident rate ratio = 1.27, 95% confidence interval [CI] 1.03, 1.58). Each additional 10 minutes of WASO was associated with 0.13 point lower SPPB scores (B = −0.13, 95% CI −0.25, −0.01) and increased IADL difficulty (B = 0.02, 95% CI 0.0003, 0.04). Sex moderated the associations of WASO with IADL and ADL difficulties: associations were stronger for males. Subjective sleep complaints were not statistically significantly associated with function. Conclusions: Among disabled, low-income, mostly Black older adults, objective measures of long sleep and greater WASO are associated with poorer physical function. Effect sizes for the associations were modest; however, findings may have important implications given the significant consequences of decreased function on quality of life and caregiving demands.

Original languageEnglish (US)
Pages (from-to)735-741
Number of pages7
JournalSleep Health
Issue number6
StatePublished - Dec 2021

Bibliographical note

Funding Information:
Support for Dr Okoye was supported by the Robert Wood Johnson Foundation Future of Nursing Scholars program. Support for Dr Nkimbeng was provided by the Robert Wood Johnson Foundation Health Policy Research Scholar program. This work was supported by the National Institutes of Health ( P30 NR014131 ; T32 AG000247 to S.M.O; R01 AG040100 to S.L.S; R01 AG061786 and U01 AG057545 to J.A.S; R01 AG062649 and UL1 TR003098 to H.H; and R01 AG050507 , RF1 AG050745 , U01 AG052445 , and R01 AG049872 to A.P.S). The work described herein does not necessarily represent the official views of the National Institutes of Health or its Institutes.

Publisher Copyright:
© 2021 National Sleep Foundation


  • African American
  • Sleep
  • actigraphy
  • disability
  • older adults
  • physical performance


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