Lee Jenny S W, Auyeung T W, Leung Jason, Chan Dicken, Kwok Timothy, Woo Jean, Wing Y K
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.
J Am Med Dir Assoc. 2014 Sep;15(9):649-54. doi: 10.1016/j.jamda.2014.05.006. Epub 2014 Jun 25.
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.
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.
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.
Frailty and long nighttime sleep duration of 10 or more hours were independently associated with 5-year mortality in older adults.
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。
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。
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。
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。
