Due to a convergence of factors including the aging of the baby-boomer generation, dramatic economic shifts, and multi-sectorial policy changes influencing retirement benefits, retirement presents heightened insecurity for the aging US population. Concurrently, the high prevalence of sleep problems and disorders -- the most public health-consequential of which are sleep disordered breathing, insomnia, and voluntary sleep curtailment -- is likely to underlie a wide range of health outcomes including cardiovascular disease, metabolic dysregulation, cognitive decrements, depression, poor daytime functioning, and, ultimately, mortality. However, retirement is rarely investigated as a protective factor, cause or consequence of sleep quality or disorders. With the proposed study, "The REST study: A longitudinal, bidirectional examination of retirement and sleep," we aim to prospectively investigate whether sleep disorders are a predictor of retirement (Specific Aim 1) and how sleep changes (for better or worse) as a result of retirement (Aim 2). We also seek to understand the moderating influences of social resources in both directions (Aim 3). To accomplish our aims we will nest the REST study within the ongoing examinations of the Wisconsin Sleep Cohort Study sampling frame and the Wisconsin Sleep Cohort (WSC) study. The subjects of the WSC study provide a unique and invaluable context because: 1) the WSC provides >20 years of longitudinal in- laboratory sleep studies with which to characterize pre- and post-retirement trajectories of sleep behaviors and problems;2) the WSC has roughly equal numbers of retired and employed 45-82 year-old community-dwelling adults;and, 3) about half of currently employed WSC participants are expected to retire in the proposed REST study period. Thus, now is the ideal time to investigate the only existing population that has been characterized for sleep habits and problems over two decades of mid-life through a period of peak retirement transition. The WSC study has established a high prevalence of sleep-disordered breathing and other disorders, as well as their correlates and outcomes. However, the WSC does not collect data frequently enough to monitor changes directly before and after retirement, nor does it collect sufficiently specific information on employment characteristics. The proposed REST study will recruit members of the ongoing WSC as well as persons from the WSC sampling frame who have previously provided survey data regarding sleep habits and problems in 1988, 1994 and 2000. A total target sample of 2838 participants (expected final response, N=2221) will be administered five annual surveys. These REST surveys will ask detailed questions about employment, sleep characteristics, socio-demographics, well-being, social environment, health behaviors, and major health and other life events. Combined with the data from the WSC, our data collection effort will provide detail and power to address our specific aims, filling a wide gap in knowledge regarding the relation of sleep and retirement.
The findings from the application, The REST study: A longitudinal, bidirectional examination of retirement and sleep, a substudy of the ongoing Wisconsin Sleep Cohort (WSC) study sampling frame, will contribute needed new knowledge of public health significance about the bi-directional relationship between sleep and retirement. The findings will identify how sleep disorders and sleep quality affect retirement age and how retirement contributes to changes in sleep behavior and sleep disorders, and, consequently, to changes in physical and mental health and functional outcomes. They will also inform clinical decision making regarding treatment and behavioral recommendations for patients with sleep disorders before and after retirement.
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