New York University School of Medicine, New York, NY 10016, USA.
Sleep Med. 2012 Oct;13(9):1130-7. doi: 10.1016/j.sleep.2012.05.008. Epub 2012 Aug 15.
To examine the relationship between trajectories of cigarette smoking among a community sample of women (N=498) with insomnia in late mid-life.
Participants were administered structured interviews at four time waves in adulthood, spanning approximately 25 years (mean ages=40, 43, 48, and 65 years). At each wave, data were collected on participants' cigarette smoking. At the most recent time wave, in late mid-life, participants reported on their insomnia (difficulty falling asleep, staying asleep, early morning wakening, and daytime consequences of these sleep problems).
Growth mixture modeling extracted four trajectory groups of cigarette smoking (from mean ages 40-65 years): chronic heavy smokers, moderate smokers, late quitters, and non-smokers. Multivariate logistic regression analysis then examined the relationship between participants' probabilities of trajectory group membership and insomnia in late mid-life, with controls for age, educational level, marital status, depressive symptoms, body mass index, and the number of health conditions. Compared with the non-smokers group, members of the chronic heavy smoking trajectory group were more likely to report insomnia at mean age 65 (Adjusted Odds Ratio=2.76; 95% confidence interval=1.10-6.92; p<0.05).
Smoking cessation programs and clinicians treating female patients in mid-life should be aware that chronic heavy smoking in adulthood is a significant risk factor for insomnia.
探讨中年后期患有失眠的社区女性样本(N=498)中吸烟轨迹的关系。
在成年期的四个时间波次中对参与者进行了结构访谈,时间跨度约为 25 年(平均年龄为 40、43、48 和 65 岁)。在每个波次中,收集了参与者吸烟的数据。在最近的中年后期波次中,参与者报告了他们的失眠(入睡困难、睡眠维持困难、清晨醒来和这些睡眠问题导致的日间后果)。
增长混合物模型提取了四个吸烟轨迹组(从平均年龄 40-65 岁):慢性重度吸烟者、中度吸烟者、晚期戒烟者和不吸烟者。然后,多变量逻辑回归分析检验了参与者轨迹组归属与中年后期失眠之间的关系,控制了年龄、教育水平、婚姻状况、抑郁症状、体重指数和健康状况数量。与不吸烟者相比,慢性重度吸烟轨迹组的成员在平均年龄 65 岁时更有可能报告失眠(调整后的优势比=2.76;95%置信区间=1.10-6.92;p<0.05)。
戒烟计划和治疗中年女性患者的临床医生应该意识到,成年期的慢性重度吸烟是失眠的一个重要危险因素。