一项为期5年的队列研究表明，在老年人中，睡眠时间长与较高的死亡率相关，且与身体虚弱无关。
Long sleep duration is associated with higher mortality in older people independent of frailty: a 5-year cohort study.
作者信息
Lee Jenny S W, Auyeung T W, Leung Jason, Chan Dicken, Kwok Timothy, Woo Jean, Wing Y K
机构信息
Division of Geriatrics, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; The S. H. Ho Centre for Gerontology and Geriatrics, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Medicine and Geriatrics, Shatin Hospital, Hong Kong SAR, China.
The S. H. Ho Centre for Gerontology and Geriatrics, The Chinese University of Hong Kong, Hong Kong SAR, China.
出版信息
J Am Med Dir Assoc. 2014 Sep;15(9):649-54. doi: 10.1016/j.jamda.2014.05.006. Epub 2014 Jun 25.
OBJECTIVES
Although general adult population studies show a U-shaped association between sleep duration and mortality, prolonged rather than short sleep duration was more consistently associated with higher mortality in older populations. Failing health or frailty is a possible mechanism. Thus, we examined the relationship among sleep duration, frailty status, and mortality in an elderly cohort.
METHODS
A total of 3427 community-living adults 65 years or older were examined for general health, mood, subjective sleep measures (insomnia, napping, sleep apnea, nighttime sleep duration, sleep medications), frailty, and 5-year mortality.
RESULTS
After 5 years, 12.9% of men and 4.5% of women had died. Mean nighttime sleep duration was 7.3 hours. Proportion of participants who slept 10 or more hours increased with increasing frailty. Age-adjusted hazard ratio (HR) for 5-year mortality of long nighttime sleep (≥ 10 hours) was 2.10 (95% confidence interval [CI] 1.33-3.33) in men, and 2.70 (95% CI 0.98-7.46) in women. The HR in men was attenuated (HR 1.75; 95% CI 1.09-2.81) after adjustment for frailty and other covariates, whereas that of women strengthened (HR 2.88; 95% CI 1.01-8.18). Mortality increased sharply with nighttime sleep of 10 hours or more. Nighttime sleep of 10 or more hours (HR 1.75, men; HR 2.88, women) and frailty (HR 2.43, men; HR 2.08, P = .08 in women) were independently associated with 5-year mortality after full adjustment for covariates.
CONCLUSION
Frailty and long nighttime sleep duration of 10 or more hours were independently associated with 5-year mortality in older adults.
目的
尽管一般成年人群研究显示睡眠时间与死亡率之间呈U型关联，但在老年人群中，睡眠时间延长而非缩短与较高死亡率的关联更为一致。健康状况不佳或身体虚弱可能是一种机制。因此，我们研究了老年队列中睡眠时间、虚弱状态和死亡率之间的关系。
方法
对3427名65岁及以上的社区居住成年人进行了一般健康状况、情绪、主观睡眠指标（失眠、打盹、睡眠呼吸暂停、夜间睡眠时间、睡眠药物）、虚弱状况和5年死亡率的检查。
结果
5年后，12.9%的男性和4.5%的女性死亡。平均夜间睡眠时间为7.3小时。睡眠时间达到或超过10小时的参与者比例随虚弱程度增加而升高。男性夜间睡眠时间长（≥10小时）的5年死亡率的年龄调整风险比（HR）为2.10（95%置信区间[CI]1.33 - 3.33），女性为2.70（95%CI 0.98 - 7.46）。在调整了虚弱状况和其他协变量后，男性的HR降低（HR 1.75；95%CI 1.09 - 2.81），而女性的HR升高（HR 2.88；95%CI 1.01 - 8.18）。夜间睡眠时间达到或超过10小时时死亡率急剧上升。在对协变量进行完全调整后，夜间睡眠时间达到或超过10小时（男性HR 1.75，女性HR 2.88）和虚弱状态（男性HR 2.43，女性HR 2.08，P = 0.08）与5年死亡率独立相关。
结论
虚弱状态和夜间睡眠时间达到或超过10小时与老年人的5年死亡率独立相关。
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