Stone Katie L, Ewing Susan K, Lui Li-Yung, Ensrud Kristine E, Ancoli-Israel Sonia, Bauer Douglas C, Cauley Jane A, Hillier Teresa A, Cummings Steven R
Research Institute, California Pacific Medical Center, San Francisco, 94107, USA.
J Am Geriatr Soc. 2006 Aug;54(8):1177-83. doi: 10.1111/j.1532-5415.2006.00818.x.
To test the association between self-reported sleep and nap habits and risk of falls and fractures in a large cohort of older women.
Study of Osteoporotic Fractures prospective cohort study.
Clinical centers in Baltimore, Maryland; Minneapolis, Minnesota; Portland, Oregon; and the Monongahela Valley, near Pittsburgh, Pennsylvania.
Eight thousand one hundred one community-dwelling Caucasian women aged 69 and older (mean 77.0).
Sleep and nap habits were assessed using a questionnaire at the fourth clinic visit (1993/94). Fall frequency during the subsequent year was ascertained using tri-annual questionnaire. Incident hip and nonspinal fractures during 6 years of follow-up were confirmed using radiographic reports.
Five hundred fifty-three women suffered hip fractures, and 1,938 suffered nonspinal fractures. In multivariate models, women who reported napping daily had significantly higher odds of suffering two or more falls during the subsequent year (odds ratio=1.32, 95% confidence interval (CI)=1.03-1.69) and were more likely to suffer a hip fracture (hazard ratio (HR)=1.33, 95% CI=0.99-1.78) than women who did not nap daily. Those sleeping at least 10 hours per 24 hours had a higher risk of nonspinal fracture than (HR=1.26, 95% CI=1.00-1.58) and a similar but nonsignificant increased risk of hip fracture to (HR=1.43, 95% CI=0.95-2.15) those who reported sleeping between 8 and 9 hours.
Self-reported long sleep and daily napping are associated with greater risk of falls and fractures in older women. Interventions to improve sleep may reduce their risk of falls and fractures. Future research is needed to determine whether specific sleep disorders contribute to these relationships.
在一大群老年女性中，测试自我报告的睡眠和午睡习惯与跌倒及骨折风险之间的关联。
骨质疏松性骨折前瞻性队列研究。
马里兰州巴尔的摩、明尼苏达州明尼阿波利斯、俄勒冈州波特兰以及宾夕法尼亚州匹兹堡附近的莫农加希拉山谷的临床中心。
8101名年龄在69岁及以上的社区居住白人女性（平均年龄77.0岁）。
在第四次诊所就诊（1993/94年）时使用问卷评估睡眠和午睡习惯。通过每三年一次的问卷确定随后一年的跌倒频率。利用X光报告确认6年随访期间的髋部骨折和非脊柱骨折事件。
553名女性发生髋部骨折，1938名女性发生非脊柱骨折。在多变量模型中，报告每天午睡的女性在随后一年中发生两次或更多次跌倒的几率显著更高（优势比=1.32，95%置信区间（CI）=1.03 - 1.69），并且比不每天午睡的女性更有可能发生髋部骨折（风险比（HR）=1.33，95% CI = 0.99 - 1.78）。那些每24小时睡眠至少10小时的女性发生非脊柱骨折的风险更高（HR = 1.26，95% CI = 1.00 - 1.58），发生髋部骨折的风险增加情况与报告睡眠8至9小时的女性相似但无显著差异（HR = 1.43，95% CI = 0.95 - 2.15）。
自我报告的长时间睡眠和每日午睡与老年女性跌倒及骨折的风险增加有关。改善睡眠的干预措施可能会降低她们跌倒和骨折的风险。需要进一步的研究来确定特定的睡眠障碍是否导致了这些关联。
