Sleep disturbances and risk of frailty and mortality in older men

被引:169
作者
Ensrud, Kristine E. [1 ,2 ,8 ]
Blackwell, Terri L. [3 ]
Ancoli-Israel, Sonia [4 ]
Redline, Susan [5 ,6 ]
Cawthon, Peggy M. [3 ]
Paudel, Misti L. [2 ]
Dam, Thuy-Tien L. [7 ]
Stone, Katie L. [3 ]
机构
[1] Univ Minnesota, Dept Med, Minneapolis, MN 55455 USA
[2] Univ Minnesota, Div Epidemiol & Community Hlth, Minneapolis, MN USA
[3] Calif Pacific Med Ctr, Res Inst, San Francisco, CA USA
[4] Univ Calif San Diego, Dept Psychiat, La Jolla, CA 92093 USA
[5] Brigham & Womens Hosp, Dept Med, Boston, MA 02115 USA
[6] Harvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Boston, MA 02215 USA
[7] Columbia Univ, Dept Med, New York, NY USA
[8] Vet Affairs Hlth Care Syst, Ctr Chron Dis Outcomes Res, Minneapolis, MN USA
基金
美国国家卫生研究院;
关键词
Sleep disturbances; Frailty; Mortality; Men; Elderly; OSTEOPOROTIC FRACTURES; DAYTIME SLEEPINESS; HEART HEALTH; FOLLOW-UP; ADULTS; ASSOCIATION; COHORT; RELIABILITY; PREVALENCE; ACTIGRAPHY;
D O I
10.1016/j.sleep.2012.04.010
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: To test the hypothesis that non-frail older men with poorer sleep at baseline are at increased risk of frailty and death at follow-up. Methods: In this prospective cohort study, subjective (questionnaires) and objective sleep parameters (actigraphy, in-home overnight polysomnography) were measured at baseline in 2505 non-frail men aged >= 67 years. Repeat frailty status assessment performed an average of 3.4 years later; vital status assessed every four months. Sleep parameters expressed as dichotomized predictors using clinical cut-points. Status at follow-up exam classified as robust, intermediate (pre-frail) stage, frail, or died in interim. Results: None of the sleep disturbances were associated with the odds of being intermediate/frail/dead (vs. robust) at follow-up. Poor subjective sleep quality (multivariable odds ratio [MOR] 1.26, 95% CI 1.01-1.58), greater nighttime wakefulness (MOR 1.31, 95% CI 1.04-1.66), and greater nocturnal hypoxemia (MOR 1.47, 95% CI 1.02-2.10) were associated with a higher odds of frailty/death at follow-up (vs. robust/intermediate). Excessive daytime sleepiness (MOR 1.60, 95% CI 1.03-2.47), greater nighttime wakefulness (MOR 1.57, 95% CI 1.12-2.20), severe sleep apnea (MOR 1.74, 95% CI 1.04-2.89), and nocturnal hypoxemia (MOR 2.28, 95% CI 1.45-3.58) were associated with higher odds of death (vs. robust/intermediate/frail at follow-up). The association between poor sleep efficiency and mortality nearly reached significance (MOR 1.48, 95% CI 0.99-2.22). Short sleep duration and prolonged sleep latency were not associated with frailty/death or death at follow-up. Conclusions: Among non-frail older men, poor subjective sleep quality, greater nighttime wakefulness, and greater nocturnal hypoxemia were independently associated with higher odds of frailty or death at follow-up, while excessive daytime sleepiness, greater nighttime wakefulness, severe sleep apnea and greater nocturnal hypoxemia were independently associated with an increased risk of mortality. Published by Elsevier B. V.
引用
收藏
页码:1217 / 1225
页数:9
相关论文
共 36 条
[1]   The role of actigraphy in the study of sleep and circadian rhythms [J].
Ancoli-Israel, S ;
Cole, R ;
Alessi, C ;
Chambers, M ;
Moorcroft, W ;
Pollak, CP .
SLEEP, 2003, 26 (03) :342-392
[2]   The association of testosterone levels with overall sleep quality, sleep architecture, and sleep-disordered breathing [J].
Barrett-Connor, Elizabeth ;
Dam, Thuy-Tien ;
Stone, Katie ;
Harrison, Stephanie Litwack ;
Redline, Susan ;
Orwoll, Eric .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2008, 93 (07) :2602-2609
[3]   Actigraphy scoring reliability in the study of osteoporotic fractures [J].
Blackwell, T ;
Ancoli-Israel, S ;
Gehrman, PR ;
Schneider, JL ;
Pedula, KL ;
Stone, KL .
SLEEP, 2005, 28 (12) :1599-1605
[4]   Overview of recruitment for the osteoporotic fractures in men study (MrOS) [J].
Blank, JB ;
Cawthon, PM ;
Carrion-Petersen, ML ;
Harper, L ;
Johnson, JP ;
Mitson, E ;
Delay, RR .
CONTEMPORARY CLINICAL TRIALS, 2005, 26 (05) :557-568
[5]   THE PITTSBURGH SLEEP QUALITY INDEX - A NEW INSTRUMENT FOR PSYCHIATRIC PRACTICE AND RESEARCH [J].
BUYSSE, DJ ;
REYNOLDS, CF ;
MONK, TH ;
BERMAN, SR ;
KUPFER, DJ .
PSYCHIATRY RESEARCH, 1989, 28 (02) :193-213
[6]   Reduced renal function and sleep-disordered breathing in community-dwelling elderly men [J].
Canales, Muna T. ;
Taylor, Brent C. ;
Ishani, Areef ;
Mehra, Reena ;
Steffes, Michael ;
Stone, Katie L. ;
Redline, Susan ;
Ensrud, Kristine E. .
SLEEP MEDICINE, 2008, 9 (06) :637-645
[7]   Frailty in older men: Prevalence, progression, and relationship with mortality [J].
Cawthon, Peggy M. ;
Marshall, Lynn M. ;
Michael, Yvonne ;
Dam, Tbuy-Tien ;
Ensrud, Kristine E. ;
Barrett-Connor, Elizabeth ;
Orwoll, Eric S. .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2007, 55 (08) :1216-1223
[8]   Association between sleep and physical function in older men: The osteoporotic fractures in men sleep study [J].
Dam, Thuy-Tien L. ;
Ewing, Susan ;
Ancoli-Israel, Sonia ;
Ensrud, Kristine ;
Redline, Susan ;
Stone, Katie .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2008, 56 (09) :1665-1673
[9]   Healthy older adults' sleep predicts all-cause mortality at 4 to 19 years of follow-up [J].
Dew, MA ;
Hoch, CC ;
Buysse, DJ ;
Monk, TH ;
Begley, AE ;
Houck, PR ;
Hall, M ;
Kupfer, DJ ;
Reynolds, CF .
PSYCHOSOMATIC MEDICINE, 2003, 65 (01) :63-73
[10]   Excessive Daytime Sleepiness Is an Independent Risk Indicator for Cardiovascular Mortality in Community-Dwelling Elderly The Three City Study [J].
Empana, Jean-Philippe ;
Dauvilliers, Yves ;
Dartigues, Jean-Francois ;
Ritchie, Karen ;
Gariepy, Jerome ;
Jouven, Xavier ;
Tzourio, Christophe ;
Amouyel, Philippe ;
Besset, Alain ;
Ducimetiere, Pierre .
STROKE, 2009, 40 (04) :1219-1224