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绝经后妇女中失眠症状和睡眠持续时间的纵向变化轨迹与客观身体功能的关系:全国妇女健康研究。

Associations between longitudinal trajectories of insomnia symptoms and sleep duration with objective physical function in postmenopausal women: the Study of Women's Health Across the Nation.

机构信息

Department of Health and Human Development, University of Pittsburgh, Pittsburgh, USA.

Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.

出版信息

Sleep. 2021 Aug 13;44(8). doi: 10.1093/sleep/zsab059.

Abstract

STUDY OBJECTIVES

Examine the association between trajectories of self-reported insomnia symptoms and sleep duration over 13 years with objective physical function.

METHODS

We utilized data from 1,627 Study of Women's Health Across the Nation participants, aged 61.9 ± 2.7 years at the end of the 13-year follow-up. Latent class growth models identified trajectories of insomnia symptoms (trouble falling asleep, frequent night-time awakenings, and/or early morning awakening) and sleep duration over 13 years. Physical function tests were performed at the end of the 13-year period: 40-ft walk, 4-m walk, repeated chair stand, grip strength, and balance. Multivariable regression analyses examined each physical function measure according to the insomnia symptom or sleep duration trajectory group.

RESULTS

Five insomnia symptom trajectories and two sleep duration trajectories were identified. Women with a consistently high likelihood of insomnia symptoms and women with a decreased likelihood of insomnia symptoms (i.e. improving) had slower gait speed (3.5% slower 40-ft walk [consistently high], 3.7% slower 4-m walk [improving]; each p ≤ .05) than those with a consistently low likelihood of insomnia symptoms. In contrast, women with a steep increase in the likelihood of insomnia symptoms over time and women with persistent insufficient sleep duration had lower odds of having a balance problem (odds ratio [OR] = 0.36 and OR = 0.61, respectively; each p < .02) compared to those with a consistently low likelihood of insomnia symptoms and those with persistent sufficient sleep duration, respectively.

CONCLUSION

These results suggest that women's sleep during midlife has important implications for maintaining physical function during the transition into older adulthood.

摘要

研究目的

探究 13 年内自我报告的失眠症状和睡眠时间的轨迹与客观身体功能之间的关联。

方法

我们利用了 1627 名参与妇女健康研究的女性的数据,她们在 13 年随访结束时的年龄为 61.9 ± 2.7 岁。潜在类别增长模型确定了 13 年内失眠症状(入睡困难、夜间频繁醒来和/或清晨醒来)和睡眠时间的轨迹。在 13 年结束时进行了身体功能测试:40 英尺步行、4 米步行、重复椅子站立、握力和平衡。多变量回归分析根据失眠症状或睡眠持续时间轨迹组检查了每个身体功能指标。

结果

确定了五种失眠症状轨迹和两种睡眠持续时间轨迹。一直有较高失眠症状可能性的女性和失眠症状可能性降低(即改善)的女性的步速较慢(40 英尺步行慢 3.5%[一直较高],4 米步行慢 3.7%[改善];两者均 p ≤.05),而一直有较低失眠症状可能性的女性则相反。相比之下,随着时间的推移,失眠症状可能性急剧增加的女性和一直睡眠不足的女性发生平衡问题的几率较低(比值比[OR]分别为 0.36 和 0.61;两者均 p <.02),而一直有较低失眠症状可能性和一直有充足睡眠的女性则相反。

结论

这些结果表明,女性中年时期的睡眠对进入老年期时维持身体功能具有重要意义。

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