Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota 55417, USA.
J Am Geriatr Soc. 2009 Nov;57(11):2085-93. doi: 10.1111/j.1532-5415.2009.02490.x. Epub 2009 Sep 28.
To test the hypothesis that sleep disturbances are independently associated with frailty status in older men.
Cross-sectional analysis of prospective cohort study.
Six U.S. centers.
Three thousand one hundred thirty-three men aged 67 and older.
Self-reported sleep parameters (questionnaire); objective parameters of sleep-wake patterns (actigraphy data collected for an average of 5.2 nights); and objective parameters of sleep-disordered breathing, nocturnal hypoxemia, and periodic leg movements with arousals (PLMAs) (in-home overnight polysomnography). Frailty status was classified as robust, intermediate stage, or frail using criteria similar to those used in the Cardiovascular Health Study frailty index.
The prevalence of sleep disturbances, including poor sleep quality, excessive daytime sleepiness, short sleep duration, lower sleep efficiency, prolonged sleep latency, sleep fragmentation (greater nighttime wakefulness and frequent, long wake episodes), sleep-disordered breathing, nocturnal hypoxemia, and frequent PLMAs, was lowest in robust men, intermediate in men in the intermediate-stage group, and highest in frail men (P-for-trend < or =.002 for all sleep parameters). After adjusting for multiple potential confounders, self-reported poor sleep quality (Pittsburgh Sleep Quality Index > 5, multivariable odds ratio (MOR)=1.28, 95% confidence interval (CI)=1.09-1.50), sleep efficiency less than 70% (MOR=1.37, 95% CI=1.12-1.67), sleep latency of 60 minutes or longer (MOR=1.42, 95% CI=1.10-1.82), and sleep-disordered breathing (respiratory disturbance index > or =15, MOR=1.38, 95% CI=1.15-1.65) were each independently associated with higher odds of greater frailty status.
Sleep disturbances, including poor self-reported sleep quality, lower sleep efficiency, prolonged sleep latency, and sleep-disordered breathing, are independently associated with greater evidence of frailty.
验证睡眠障碍与老年男性虚弱状态独立相关的假设。
前瞻性队列研究的横断面分析。
美国 6 个中心。
3133 名年龄在 67 岁及以上的男性。
自我报告的睡眠参数（问卷调查）；睡眠-觉醒模式的客观参数（平均采集 5.2 个晚上的活动记录仪数据）；睡眠呼吸障碍、夜间低氧血症和周期性肢体运动伴觉醒（PLMA）的客观参数（家庭过夜多导睡眠图）。虚弱状态使用与心血管健康研究虚弱指数相似的标准分类为稳健、中间阶段或虚弱。
睡眠障碍的患病率最低，包括睡眠质量差、白天嗜睡、睡眠时间短、睡眠效率低、睡眠潜伏期延长、睡眠碎片化（夜间觉醒更多，频繁、长时间觉醒）、睡眠呼吸障碍、夜间低氧血症和频繁的 PLMA，在稳健男性中最高，在中间阶段男性中次之，在虚弱男性中最高（所有睡眠参数的趋势 P 值均 <.002）。在调整了多种潜在混杂因素后，自我报告的睡眠质量差（匹兹堡睡眠质量指数 > 5，多变量比值比（MOR）=1.28，95%置信区间（CI）=1.09-1.50）、睡眠效率低于 70%（MOR=1.37，95% CI=1.12-1.67）、睡眠潜伏期 60 分钟或更长（MOR=1.42，95% CI=1.10-1.82）和睡眠呼吸障碍（呼吸干扰指数 >或=15，MOR=1.38，95% CI=1.15-1.65）均与更高的虚弱状态几率独立相关。
睡眠障碍，包括自我报告的睡眠质量差、睡眠效率低、睡眠潜伏期延长和睡眠呼吸障碍，与更明显的虚弱状态独立相关。
