Smagula Stephen F, Harrison Stephanie, Cauley Jane A, Ancoli-Israel Sonia, Cawthon Peggy M, Cummings Steve, Stone Katie L
Am J Epidemiol. 2017 May 15;185(10):933-940. doi: 10.1093/aje/kwx014.
We examined potential risk factors for changes in objectively assessed sleep duration within a large sample of community-dwelling older men. Participants (n = 1,055; mean baseline age = 74.6 (standard deviation (SD), 4.7) years) had repeated ActiGraph assessments (ActiGraph LLC, Pensacola, Florida) taken at the baseline (2003-2005) and follow-up (2009-2012) waves of the Outcomes of Sleep Disorders in Older Men Study (an ancillary study to the Osteoporotic Fractures in Men (MrOS) Study conducted in 6 US communities). Among men with a baseline nighttime sleep duration of 5-8 hours, we assessed the odds of becoming a short-duration (<5 hours) or long-duration (>8 hours) sleeper at follow-up. The odds of becoming a short-duration sleeper were higher among men with peripheral vascular disease (adjusted odds ratio (aOR) = 6.54, 95% confidence interval (CI): 2.30, 18.55) and ≥1 impairment in Instrumental Activities of Daily Living (IADL) (aOR = 2.57, 95% CI: 0.97, 6.78). The odds of becoming a long-duration sleeper were higher among those with greater baseline age (per SD increment, aOR = 1.49, 95% CI: 1.12, 2.00), depression symptoms (aOR = 3.13, 95% CI: 1.05, 9.36), and worse global cognitive performance (per SD increment of Modified Mini-Mental State Examination score, aOR = 0.74, 95% CI: 0.58, 0.94). Peripheral vascular disease and IADL impairment, but not chronological age, may be involved in the etiology of short sleep duration in older men. The risk factors for long-duration sleep suggest that deteriorating brain health predicts elongated sleep duration in older men.
我们在一大群居家老年男性样本中,研究了客观评估的睡眠时间变化的潜在风险因素。参与者(n = 1055;平均基线年龄 = 74.6(标准差(SD),4.7)岁)在老年男性睡眠障碍研究(一项在美国6个社区进行的男性骨质疏松性骨折(MrOS)研究的辅助研究)的基线期(2003 - 2005年)和随访期(2009 - 2012年)接受了多次ActiGraph评估(ActiGraph LLC,佛罗里达州彭萨科拉)。在基线夜间睡眠时间为5 - 8小时的男性中,我们评估了随访时成为短睡眠者(<5小时)或长睡眠者(>8小时)的几率。患有外周血管疾病的男性成为短睡眠者的几率更高(调整后的优势比(aOR)= 6.54,95%置信区间(CI):2.30,18.55),以及日常生活工具性活动(IADL)有≥1项受损的男性(aOR = 2.57,95% CI:0.97,6.78)。基线年龄越大(每增加一个标准差,aOR = 1.49,95% CI:1.12,2.00)、有抑郁症状(aOR = 3.13,95% CI:1.05,9.36)以及整体认知功能越差(每增加一个标准差的改良简易精神状态检查得分,aOR = 0.74,95% CI:0.58,0.94) 的男性成为长睡眠者的几率更高。外周血管疾病和IADL受损,而非实际年龄,可能与老年男性短睡眠时间的病因有关。长睡眠时间的风险因素表明,脑健康恶化预示着老年男性睡眠时间延长。