Sleep, Muscle Mass and Muscle Function in Older People A Cross-Sectional Analysis Based on Data From the Berlin Aging Study II (BASE-II)

Background: Loss of muscle mass, particularly in old age, can restrict mobility and physical function. Sleep is thought to play a key role in the maintenance of muscle mass; sleep disturbances have a prevalence of 6-30% in Germany. In this study, based on data from the Berlin Aging Study II (BASE-II), we analyze the relationship between sleep efficiency and quality on the one hand, and muscle mass and muscle function on the other. Methods: We analyzed cross-sectional data from 1196 subjects (52.5% women; 68 +/- 4 years). Sleep behavior was assessed with questions from the Pittsburgh Sleep Quality Index; appendicular lean mass (ALM) with dual x-ray absorp tiometry; and muscle function with a measure of grip strength and with questionnaires about physical activity and impairment of physical activities. Low muscle mass was determined from the ALM corrected by the body-mass index (BMI), i.e., from the ratio ALM/BMI. Results: 19.1% of the women and 13.4% of the men reported poor sleep quality. Men whose ALM/BMI ratio was below the cutoff value for low muscle mass more frequently reported very poor sleep efficiency (9.1%, versus 4.8% in women; p<0.002). The adjusted odds ratio for low muscle mass was 2.8 for men with poor sleep quality (95% confidence interval: [1.1; 6.7]) and 4.3 for men with poor sleep efficiency [1.2; 15.1]. In women, there was no statistically significant association between sleep quality and efficiency on the one hand and ALM/BMI values below cutoff on the other, but poor sleep quality was found to be associated with reduced grip strength (16.25 kg +/- 2.33 kg versus 15.67 kg +/- 2.38 kg; p = 0.009) and low appendicular lean mass (ALM: 16.25 kg +/- 2.33 kg versus 15.67 kg +/- 2.38 kg; p = 0.016). Conclusion: These findings support the hypothesis of a link between sleep and muscle mass. The dependence of muscle mass on sleep behavior needs to be investigated in longitudinal studies.