老年人的睡眠时间、午睡习惯与死亡率。
Sleep duration, nap habits, and mortality in older persons.
机构信息
The Herczeg Institute on Aging, Tel-Aviv University, Tel-Aviv, Israel.
出版信息
Sleep. 2012 Jul 1;35(7):1003-9. doi: 10.5665/sleep.1970.
OBJECTIVE
To examine the effect of nighttime sleep duration on mortality and the effect modification of daytime napping on the relationship between nighttime sleep duration and mortality in older persons.
DESIGN
Prospective survey with 20-yr mortality follow-up.
SETTING
The Cross-Sectional and Longitudinal Aging Study, a multidimensional assessment of a stratified random sample of the older Jewish population in Israel conducted between 1989-1992.
PARTICIPANTS
There were 1,166 self-respondent, community-dwelling participants age 75-94 yr (mean, 83.40, standard deviation, 5.30).
MEASUREMENTS
Nighttime sleep duration, napping, functioning (activities of daily living, instrumental activities of daily living, Orientation Memory Concentration Test), health, and mortality.
RESULTS
Duration of nighttime sleep of more than 9 hr was significantly related to increased mortality in comparison with sleeping 7-9 hr (hazard ratio [HR] = 1.31, P < 0.01) after adjusting for demographic, health, and function variables, whereas for short nighttime sleep of fewer than 7 hr mortality did not differ from that of 7-9 hr of sleep. For those who nap, sleeping more than 9 hr per night significantly increased mortality risk (HR = 1.385, P < 0.05) and shorter nighttime sleep reduced mortality significantly in the unadjusted model (HR = 0.71, P < 0.001) but only approached significance in the fully adjusted model (HR = 0.82, P = 0.054). For those who do not or sometimes nap, a short amount of sleep appears to be harmful up to age 84 yr and may be protective thereafter (HR = 1.51, confidence interval [CI] = 1.13-2.02, P < 0.01; HR = 0.76, CI = 0.49-1.17, in the fully adjusted model, respectively).
CONCLUSIONS
The findings are novel in demonstrating the protective effect of short nighttime sleep duration in individuals who take daily naps and suggest that the examination of the effect of sleep needs to take into account sleep duration per 24 hr, rather than daytime napping or nighttime sleep per se.
CITATION
Cohen-Mansfield J; Perach R. Sleep duration, nap habits, and mortality in older persons. SLEEP 2012;35(7):1003-1009.
目的
探讨夜间睡眠时间对死亡率的影响，以及日间小睡对夜间睡眠时间与死亡率之间关系的修饰作用在老年人中的作用。
设计
前瞻性调查，20 年死亡率随访。
地点
以色列的 Cross-Sectional 和 Longitudinal Aging Study，这是对分层随机抽样的老年犹太人口进行的多维评估，于 1989-1992 年进行。
参与者
共有 1166 名自我报告的、居住在社区的 75-94 岁参与者（平均年龄 83.40，标准差 5.30）。
测量
夜间睡眠时间、小睡、功能（日常生活活动、工具性日常生活活动、定向记忆浓度测试）、健康和死亡率。
结果
与睡眠时间为 7-9 小时相比，睡眠时间超过 9 小时与死亡率增加显著相关（风险比[HR] = 1.31，P < 0.01），调整了人口统计学、健康和功能变量后，睡眠时间较短（<7 小时）与 7-9 小时的死亡率无差异。对于那些午睡的人，每晚睡眠时间超过 9 小时会显著增加死亡风险（HR = 1.385，P < 0.05），而在未调整的模型中，睡眠时间较短会显著降低死亡率（HR = 0.71，P < 0.001），但仅在完全调整的模型中接近显著（HR = 0.82，P = 0.054）。对于那些不午睡或有时午睡的人来说，短时间的睡眠似乎在 84 岁之前是有害的，此后可能是保护性的（HR = 1.51，置信区间[CI] = 1.13-2.02，P < 0.01；HR = 0.76，CI = 0.49-1.17，在完全调整的模型中，分别）。
结论
这些发现是新颖的，表明在每天小睡的个体中，短时间的夜间睡眠时间具有保护作用，并表明对睡眠需求的检查需要考虑 24 小时内的睡眠时间，而不是日间小睡或夜间睡眠时间本身。
引文
Cohen-Mansfield J; Perach R. 老年人的睡眠持续时间、午睡习惯和死亡率。睡眠 2012；35(7):1003-1009.
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