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白天嗜睡和睡眠呼吸暂停与老年人头晕有关。

Daytime Somnolence and Sleep Apnea Are Associated With Dizziness in the Elderly.

机构信息

Department of Otolaryngology-Head and Neck Surgery, University of Virginia, Charlottesville, Virginia.

出版信息

Otol Neurotol. 2024 Dec 1;45(10):1153-1158. doi: 10.1097/MAO.0000000000004325. Epub 2024 Sep 3.

Abstract

OBJECTIVE

Dizziness is a debilitating multifactorial disorder commonly affecting the elderly. Daytime somnolence and sleep apnea have been linked to dizziness, but previous studies were limited by small sample sizes. The purpose of this study was to examine the relationship between dizziness and daytime somnolence and sleep-disordered breathing, in a nationally representative sample of elderly adults, while adjusting for possible confounders and mediators.

STUDY DESIGN

Data from the National Health and Nutrition Examination Study (NHANES; 2017-2020 prepandemic data) were analyzed in a cross-sectional manner using survey methods.

SETTING

Community-based setting in the United States.

PARTICIPANTS

A total of 1,490 nationally representative participants aged ≥70 years.

MAIN OUTCOMES

Multivariable logistic regression was used to examine the relationship between dizziness and daytime somnolence, snoring, and apnea, while adjusting for covariates (gender, age, body mass index, and various medical conditions that may confound this relationship).

RESULTS

Frequent daytime somnolence five or more times monthly (odds ratio, 2.13; 95% confidence interval, 1.49-3.06) and presence of apnea (odds ratio, 1.65; 95% confidence interval, 1.20-2.27) were found to be associated with greater odds of dizziness when adjusting for medical comorbidities. A significant association was not found between snoring and dizziness.

CONCLUSIONS AND RELEVANCE

In the elderly, daytime somnolence and apnea were independently associated with increased odds of dizziness, even after adjusting for medical comorbidities. Daytime somnolence and sleep apnea should be added to the differential diagnosis in this patient population. Optimizing sleep may help reduce symptoms of dizziness in this population, but prospective studies would be required to confirm these findings.Level of evidence: 4.

摘要

目的

头晕是一种常见的使人虚弱的多因素疾病,常影响老年人。白天嗜睡和睡眠呼吸暂停与头晕有关,但以前的研究因样本量小而受到限制。本研究的目的是在一个具有全国代表性的老年人群体中,检查头晕与白天嗜睡和睡眠呼吸障碍之间的关系,同时调整可能的混杂因素和中介因素。

研究设计

使用调查方法对国家健康和营养检查调查(NHANES;2017-2020 年大流行前数据)进行了横断面分析。

地点

美国社区环境。

参与者

共有 1490 名年龄≥70 岁的具有全国代表性的参与者。

主要结果

使用多变量逻辑回归来检查头晕与白天嗜睡、打鼾和呼吸暂停之间的关系,同时调整了协变量(性别、年龄、体重指数和可能使这种关系复杂化的各种医疗状况)。

结果

经常每月有五次或更多次白天嗜睡(比值比,2.13;95%置信区间,1.49-3.06)和存在呼吸暂停(比值比,1.65;95%置信区间,1.20-2.27),在调整了合并症后,与头晕的几率增加相关。打鼾与头晕之间没有显著相关性。

结论和相关性

在老年人中,白天嗜睡和呼吸暂停与头晕的几率增加独立相关,即使在调整了合并症后也是如此。白天嗜睡和睡眠呼吸暂停应添加到该患者群体的鉴别诊断中。优化睡眠可能有助于减轻该人群的头晕症状,但需要前瞻性研究来证实这些发现。

证据等级

4 级

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