Hita-Contreras Fidel, Zagalaz-Anula Noelia, Martínez-Amat Antonio, Cruz-Díaz David, Sánchez-Montesinos Indalecio, Aibar-Almazán Agustín, Lomas-Vega Rafael
Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain.
Department of Human Anatomy and Embryology, School of Medicine, University of Granada, Granada, Spain.
Menopause. 2018 Jan;25(1):62-69. doi: 10.1097/GME.0000000000000941.
To analyze the association of sleep quality with postural balance, as measured with objective stabilometric parameters, and fear of falling (FoF), among Spanish postmenopausal women.
In all, 250 women (60 ± 8 years) took part in this cross-sectional study. Sociodemographic and anthropometric data were collected, as well as information concerning history of falls and FoF. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale, and the Pittsburgh Sleep Quality Index was used to analyze sleep quality. Measurements of sway area (S), velocity (V), and mediolateral (RMSX) and anteroposterior (RMSY) displacements of the center of pressure were obtained with a resistive multisensor platform under both eyes-open (EO) and eyes-closed (EC) conditions to assess postural control. The independent associations of sleep quality with FoF and postural control were evaluated by multivariate linear and logistic regressions, respectively, adjusting for potential confounding variables.
SEO was independently associated (adjusted R = 0.073) with sleep duration (P < 0.001) and subjective sleep quality (P = 0.001), VEO (adjusted R = 0.156) with daytime dysfunction (P = 0.006) and sleep duration (P = 0.013), RMSXEO (adjusted R = 0.118) with subjective sleep quality (P = 0.005), and RMSYEO (adjusted R = 0.166) with sleep duration (P = 0.001) and daytime dysfunction (P = 0.046). Under EC condition, SEC (adjusted R = 0.014) was independently related with anxiety (P = 0.034), VEC (adjusted R = 0.148) with daytime dysfunction (P = 0.002) and sleep duration (P = 0.024), RMSXEC (adjusted R = 0.134) with subjective sleep quality (P < 0.001), and RMSYEC (adjusted R = 0.128) with sleep duration (P = 0.013) and daytime dysfunction (P = 0.033). Logistic regression showed that time since menopause (P = 0.003), body mass index (P = 0.001), and anxiety (P < 0.001), unlike sleep quality, were independently associated with FoF. The effect size of the model was medium (adjusted R= 0.162).
In Spanish postmenopausal women, sleep duration, subjective sleep quality, and daytime dysfunction were independent risk factors for worsened postural stability. FoF, anxiety, time since menopause onset, and body mass index, unlike sleep quality, were independently associated with poor postural stability.
分析西班牙绝经后女性的睡眠质量与通过客观稳定参数测量的姿势平衡以及跌倒恐惧（FoF）之间的关联。
共有250名女性（60±8岁）参与了这项横断面研究。收集了社会人口统计学和人体测量学数据，以及有关跌倒史和跌倒恐惧的信息。使用医院焦虑抑郁量表评估焦虑和抑郁情况，并使用匹兹堡睡眠质量指数分析睡眠质量。在睁眼（EO）和闭眼（EC）条件下，通过电阻式多传感器平台获取压力中心的摆动面积（S）、速度（V）以及左右（RMSX）和前后（RMSY）位移的测量值，以评估姿势控制。分别通过多元线性回归和逻辑回归评估睡眠质量与跌倒恐惧和姿势控制的独立关联，并对潜在的混杂变量进行调整。
睡眠效率（SEO）与睡眠时间（P<0.001）和主观睡眠质量（P=0.001）独立相关（调整R=0.073），睁眼时的速度（VEO）与日间功能障碍（P=0.006）和睡眠时间（P=0.013）独立相关（调整R=0.156），睁眼时的左右位移（RMSXEO）与主观睡眠质量（P=0.005）独立相关（调整R=0.118），睁眼时的前后位移（RMSYEO）与睡眠时间（P=0.001）和日间功能障碍（P=0.046）独立相关（调整R=0.166）。在闭眼条件下，睡眠效率（SEC）与焦虑（P=0.034）独立相关（调整R=0.014），闭眼时的速度（VEC）与日间功能障碍（P=0.002）和睡眠时间（P=0.024）独立相关（调整R=0.148），闭眼时的左右位移（RMSXEC）与主观睡眠质量（P<0.001）独立相关（调整R=0.134），闭眼时的前后位移（RMSYEC）与睡眠时间（P=0.013）和日间功能障碍（P=0.033）独立相关（调整R=0.128）。逻辑回归显示，与睡眠质量不同，绝经时间（P=0.003）、体重指数（P=0.001）和焦虑（P<0.001）与跌倒恐惧独立相关。模型的效应大小为中等（调整R=0.162）。
在西班牙绝经后女性中，睡眠时间、主观睡眠质量和日间功能障碍是姿势稳定性恶化独立的危险因素。与睡眠质量不同，跌倒恐惧、焦虑、绝经开始后的时间和体重指数与姿势稳定性差独立相关。
