Whibley Daniel, Shieu Monica M, Dunietz Galit Levi, Braley Tiffany J
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA.
Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
Sleep Epidemiol. 2024 Dec;4. doi: 10.1016/j.sleepe.2023.100071. Epub 2023 Dec 14.
To examine longitudinal associations between self-reported sleep disturbances and mobility disability progression among women, including subgroups with multiple sclerosis (MS), diabetes, and osteoarthritis (OA).
Prospective cohort study using data from Nurses' Health Study long-form questionnaires (2008, 2012, 2014, 2016). Logistic regression was used to quantify associations between sleep-related variables at baseline and subsequent increase in mobility disability.
Of 70,303 women (mean age 73), 392 had MS, 7,302 had diabetes, and 24,099 had OA. Between 2008-2016, mobility disability increased by 16.9 % overall, 27.8 % in the MS subgroup, 27.0 % in the diabetes subgroup, and 23.7 % in the OA subgroup. Known/suspected obstructive sleep apnea was significantly associated with an increase in mobility disability between 2008 and 2016, overall (OR:1.4, 95 %CI:1.2,1.5), and in the diabetes (OR:1.5, 95 %CI:1.2,1.9) and OA subgroups (OR:1.2, 95 %CI:1.0,1.4), but not in the MS subgroup (OR:2.3, 95 %CI:0.6,8.9); however, across 2012-2016, this association was significant for MS (OR:4.0, 95 % CI:1.0,16.1). Suboptimal sleep duration was significantly associated with increased odds of mobility disability progression overall, but not in disease subgroups. Perception of adequate sleep was associated with lower odds of mobility disability progression overall (OR:0.82, 95 %CI:0.78,0.87) and for the OA subgroup (OR:0.83, 95 % CI:0.76,0.91). Excessive daytime sleepiness was associated with mobility disability progression overall (OR:1.2, 95 %CI:1.1,1.4) and for the OA subgroup (OR:1.2, 95 %CI:1.0,1.4).
Prevalent sleep disturbances could increase disability progression among women. Chronic disease populations may be uniquely vulnerable. Informed by these data, future research could offer new insight into sleep-based strategies to ameliorate mobility decline.
研究自我报告的睡眠障碍与女性行动能力残疾进展之间的纵向关联，包括患有多发性硬化症（MS）、糖尿病和骨关节炎（OA）的亚组。
前瞻性队列研究，使用护士健康研究长篇问卷（2008年、2012年、2014年、2016年）的数据。采用逻辑回归分析来量化基线时与睡眠相关变量和随后行动能力残疾增加之间的关联。
在70303名女性（平均年龄73岁）中，392人患有MS，7302人患有糖尿病，24099人患有OA。在2008年至2016年期间，总体行动能力残疾增加了16.9%，MS亚组增加了27.8%，糖尿病亚组增加了27.0%，OA亚组增加了23.7%。已知/疑似阻塞性睡眠呼吸暂停与2008年至2016年期间行动能力残疾增加显著相关，总体而言（比值比：1.4，95%置信区间：1.2，1.5），在糖尿病（比值比：1.5，95%置信区间：1.2，1.9）和OA亚组中也是如此（比值比：1.2，95%置信区间：1.0，1.4），但在MS亚组中并非如此（比值比：2.3，95%置信区间：0.6，8.9）；然而，在2012年至2016年期间，这种关联在MS组中显著（比值比：4.0，95%置信区间：1.0，16.1）。总体而言，睡眠时长不佳与行动能力残疾进展几率增加显著相关，但在疾病亚组中并非如此。对充足睡眠的感知与总体行动能力残疾进展几率较低相关（比值比：0.82，95%置信区间：0.78，0.87），在OA亚组中也是如此（比值比：0.83，95%置信区间：0.76，0.91）。白天过度嗜睡与总体行动能力残疾进展相关（比值比：1.2，95%置信区间：1.1，1.4），在OA亚组中也是如此（比值比：1.2，95%置信区间：1.0，1.4）。
普遍存在的睡眠障碍可能会增加女性的残疾进展。慢性病患者群体可能特别脆弱。基于这些数据进行的未来研究可能会为改善行动能力下降的基于睡眠的策略提供新的见解。
