Hypoxia During Sleep and the Risk of Falls and Fractures in Older Men: The Osteoporotic Fractures in Men Sleep Study

被引:41
作者
Cauley, Jane A. [1 ]
Blackwell, Terri L. [2 ]
Redline, Susan [3 ,4 ]
Ensrud, Kristine E. [5 ,6 ]
Ancoli-Israel, Sonia [7 ]
Fink, Howard A. [5 ,6 ,8 ]
Orwoll, Eric S. [9 ]
Stone, Katie L. [2 ]
机构
[1] Univ Pittsburgh, Pittsburgh, PA 15261 USA
[2] Calif Pacific Med Ctr, San Francisco, CA USA
[3] Brigham & Womens Hosp, Dept Med, Boston, MA 02115 USA
[4] Harvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Boston, MA 02215 USA
[5] Univ Minnesota, Minneapolis, MN USA
[6] Vet Affairs Healthcare Syst, Minneapolis, MN USA
[7] Univ Calif San Diego, San Diego, CA 92103 USA
[8] Vet Affairs Healthcare Syst, Geriatr Res Educ & Clin Ctr, Minneapolis, MN USA
[9] Oregon Hlth & Sci Univ, Portland, OR 97201 USA
关键词
nocturnal hypoxia; fractures; falls; mortality; older men; INFLAMMATORY MARKERS; TESTOSTERONE LEVELS; ASSOCIATION; WOMEN; DEFICIENCY; STROKE; APNEA;
D O I
10.1111/jgs.13069
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
ObjectivesTo test the hypothesis that low arterial oxygen saturation during sleep is associated with a greater risk of falls and fractures. DesignProspective cohort study. SettingSix U.S. clinical centers. ParticipantsMen aged 67 and older (N=2,911). MeasurementsThe primary exposure measure was percentage of sleep time with arterial oxygen saturation less than 90% measured using polysomnography. The main outcome measures were incident falls within 1year and incident nonspine fractures over an average follow-up of 6.8years. ResultsMen with 10% or more of sleep time at an arterial oxygen saturation of less than 90% were older, reported more comorbidities, had poorer physical function, and were more likely to have sleep disordered breathing than men with less than 10% sleep time at an arterial oxygen saturation of less than 90%. After multivariate adjustment, men with 10% or more of sleep time with arterial oxygen saturation of less than 90% had a greater risk of having one or more falls (relative risk (RR)=1.25, 95% confidence interval (CI)=1.04-1.51) and two or more falls (RR=1.43, 95% CI=1.06-1.92) than those with less than 10% of sleep time with less than 90% arterial oxygen saturation. Men with greater percentage of sleep time with arterial oxygen saturation less than 90% had a 30% to 40% greater risk of nonspine fracture than those with normal nocturnal oxygen saturation in models adjusting for sleep disordered breathing. ConclusionHypoxia during sleep may be a risk factor for falls and fractures in older men. Interventions aimed at decreasing nocturnal hypoxia may decrease falls and fractures.
引用
收藏
页码:1853 / 1859
页数:7
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