Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
Sleep Health. 2016 Dec;2(4):266-271. doi: 10.1016/j.sleh.2016.09.001. Epub 2016 Oct 21.
Associations between sleep and body mass index (BMI) are age dependent. In older adults, BMI norms representing normal and overweight combine into a single normal-weight category. We aimed to assess the nonlinear associations between age-appropriate BMI categories and sleep duration (SD) and sleep efficiency (SE) in older men and women, controlling for health and functional status.
Secondary data analysis of the Hospitalization Process Effects on Functional Outcomes and Recovery included 719 community-dwelling adults age 70+ years hospitalized because of nondisabling diagnoses. Self-report intake data regarding their condition prior to circumstances that led to hospitalization were used to obtain BMI categories (underweight: BMId23, normal weight: 23<BMI<30, and obese: BMI≥30), SD, SE, health, and functional status. Analysis of covariance was used for modeling SD and SE separately, additively entering (1) BMI, (2) sex and BMI×sex, and (3) health and functional confounders.
For SD and SE, significant BMI group differences in the first model (P<.001) remained significant in the second (P<.001) and third (P<.01) models. High BMI was associated with shorter SD and lower SE compared with normal- and low-BMI groups. Controlling for sex, an inverted J-shaped relationship appeared in women, whereby low- and, more prominently, high-BMI categories were associated with shorter SD and lower SE compared with normal BMI. Although associations remained consistent in the fully adjusted models, effect sizes were small.
Findings provide insights into possible mechanisms underlying BMI, sleep, and health and may contribute to informed clinical recommendations, particularly for older women.
睡眠与体重指数（BMI）的关系随年龄而变化。在老年人中，代表正常和超重的 BMI 标准合并为一个单一的正常体重类别。我们旨在评估在控制健康和功能状态的情况下，年龄适当的 BMI 类别与老年人的睡眠持续时间（SD）和睡眠效率（SE）之间的非线性关系。
对住院过程对功能结果和恢复的影响进行了二次数据分析，纳入了 719 名 70 岁以上的社区居住成年人，因非致残性诊断而住院。使用住院前导致住院的情况的自我报告摄入数据来获得 BMI 类别（体重不足：BMI<23，正常体重：23<BMI<30，肥胖：BMI≥30）、SD、SE、健康和功能状况。协方差分析用于分别对 SD 和 SE 进行建模，依次加入（1）BMI，（2）性别和 BMI×性别，以及（3）健康和功能混杂因素。
对于 SD 和 SE，在第一个模型中（P<.001），BMI 组之间存在显著差异，在第二个模型（P<.001）和第三个模型（P<.01）中仍然显著。与正常和低 BMI 组相比，高 BMI 与 SD 缩短和 SE 降低有关。在控制性别后，女性出现了一种倒 J 形的关系，低和高 BMI 类别与 SD 缩短和 SE 降低有关，与正常 BMI 相比更为明显。尽管在完全调整的模型中，关联仍然一致，但效应大小较小。
这些发现为 BMI、睡眠和健康之间的潜在机制提供了一些见解，并可能为有针对性的临床建议提供依据，特别是对于老年女性。
