Nakakubo Sho, Doi Takehiko, Makizako Hyuma, Tsutsumimoto Kota, Hotta Ryo, Ono Rei, Suzuki Takao, Shimada Hiroyuki
Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan; Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan.
Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
J Am Med Dir Assoc. 2016 Aug 1;17(8):768.e1-5. doi: 10.1016/j.jamda.2016.05.020. Epub 2016 Jul 5.
Although sleep disturbances are associated with disability among older adults, no longitudinal study has examined the impact of sleep assessed based on both sleep quality and quantity on incident disability. This study examined whether sleep duration and excessive daytime sleepiness were associated with incidence of disability in community-dwelling older adults.
A total of 4756 older adults (53.3% women, mean age 71.9 years) met the entry criteria for this study. We measured monthly incident disability, defined as the onset of being certified for personal support or care as required by Japanese public long-term care insurance during the preceding 24 months. Sleep duration, excessive daytime sleepiness (EDS), and demographic factors were assessed at baseline. Cox's proportional hazard regression analysis estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of incidence of disability according to the 3 categories of sleep duration (short: ≤6.0 hours, mid: 6.1 to 8.9 hours, long: ≥9.0 hours), and we used mid duration sleepers as the reference group.
Long sleep duration (HR 1.43, 95% CI 1.04-1.97) and presence of EDS (HR 1.41, 95% CI 1.01-1.98) were associated with higher rates of incident disability. Furthermore, a combination of sleep duration and EDS was associated with a higher rate of incident disability than the mid and no EDS group (HR 2.25, 95% CI 1.36-3.70).
Long sleep duration and EDS affected the incident of disability; thus, older adults with both sleep patterns may require an intervention to alter their sleep habit.
尽管睡眠障碍与老年人的残疾相关，但尚无纵向研究考察基于睡眠质量和睡眠时间评估的睡眠对残疾发生率的影响。本研究探讨睡眠时间和白天过度嗜睡是否与社区居住的老年人残疾发生率相关。
共有4756名老年人（53.3%为女性，平均年龄71.9岁）符合本研究的纳入标准。我们每月测量一次新发残疾情况，定义为在前24个月内根据日本公共长期护理保险要求获得个人支持或护理认证的起始情况。在基线时评估睡眠时间、白天过度嗜睡（EDS）和人口统计学因素。Cox比例风险回归分析根据睡眠时间的3个类别（短：≤6.0小时，中：6.1至8.9小时，长：≥9.0小时）估计残疾发生率的风险比（HR）和95%置信区间（CI），我们将中等睡眠时间者作为参照组。
睡眠时间长（HR 1.43，95% CI 1.04 - 1.97）和存在白天过度嗜睡（HR 1.41，95% CI 1.01 - 1.98）与更高的新发残疾率相关。此外，睡眠时间和白天过度嗜睡同时存在时，新发残疾率高于中等睡眠时间且无白天过度嗜睡的组（HR 2.25，95% CI 1.36 - 3.70）。
睡眠时间长和白天过度嗜睡影响残疾发生率；因此，具有这两种睡眠模式的老年人可能需要进行干预以改变他们的睡眠习惯。
