Diurnal variation of spontaneous eye blink rate in the elderly and its relationships with sleepiness and arousal

Sleep-wake rhythms in the elderly are deeply modified compared to young subjects, irrespective of physical or mental illnesses. However, still controversial are the results about age-related circadian variations of sleepiness levels. The objective of this study is to investigate the profile of diurnal sleepiness in healthy elderly subjects through subjective scales and by measuring spontaneous eye-blink rate (BR). In fact, we have previously found that BR, a reliable and non-invasive peripheral measure of central dopamine activity, increases in the young at times when subjective sleepiness is increased. Twelve healthy elderly volunteers (F = 9, M = 3, age range 64-79) participated in the experiment. At four times during the day (10 a.m., 1.30 p.m., 5 p.m., 8.30 p.m.), Karolinska sleepiness scale and a visual analogue scale for mood were administered to the subjects and BR was measured through vertical EOG. Alpha EEG power was used as objective measure of sleepiness. Sleepiness significantly changes across the day; according to post hoc contrasts, this is due to more sleepiness at 5 p.m. Future research should be aimed at clarifying whether this peak is related to phase-advanced core body temperature in elderly people. Differently from the young, no significant differences were found in BR across the day, suggesting that an age-related modification of dopaminergic arousal mechanisms counteracting the rising sleep drive should be further explored.