Newman A B, Enright P L, Manolio T A, Haponik E F, Wahl P W
Department of Medicine, University of Pittsburgh, Pennsylvania 15213, USA.
J Am Geriatr Soc. 1997 Jan;45(1):1-7. doi: 10.1111/j.1532-5415.1997.tb00970.x.
To describe the prevalence of self reported sleep disturbances in older men and women and to describe their relationships with health status and cardiovascular disease (CVD).
Cross-sectional study of sleep disturbance, CVD, general health, psychosocial factors, physical function, and use of psychotropic medications.
Participants of the Cardiovascular Health Study, 5201 adults aged 65 and older recruited from a random sample of noninstitutionalized Medicare enrollees in four US communities.
Self-reported sleep disturbances and standardized questionnaires for cardiopulmonary symptoms and diseases, depression, social support, activities of daily living, physical activity, cognitive function, and current medications, spirometry, ECG, echocardiography, and carotid ultrasound.
Women were twice as likely as men to report difficulty falling asleep (30% vs 14%). Daytime sleepiness, difficulty falling asleep, and frequent awakenings increased in prevalence with age. All symptoms were related strongly to depression. Symptoms of daytime sleepiness were also related strongly to poor health and limitations in activities of daily living in men and women. In multivariate analysis, men taking benzodiazepines were likely to report difficulty falling asleep and daytime sleepiness, whereas women taking benzodiazepines reported difficulty falling asleep and waking up too early. After accounting for these factors, the only cardiovascular disease independently associated with sleep disturbances was angina. Men and women with confirmed angina were 1.6 times more likely to report trouble falling asleep. Independent relationships between sleep disturbances and cardiovascular risk factors such as obesity, hypertension, smoking, and diabetes were relatively weak and inconsistent, though smokers were less likely to report frequent awakenings.
Sleep disturbances are relatively common in older men and women and are associated with poor health, depression, angina, limitations in activities of daily living, and the use of benzodiazepines.
描述老年男性和女性自我报告的睡眠障碍患病率，并描述其与健康状况和心血管疾病（CVD）的关系。
关于睡眠障碍、心血管疾病、总体健康、心理社会因素、身体功能以及精神药物使用情况的横断面研究。
心血管健康研究的参与者，从美国四个社区非机构化医疗保险参保者的随机样本中招募的5201名65岁及以上的成年人。
自我报告的睡眠障碍以及用于心肺症状和疾病、抑郁、社会支持、日常生活活动、身体活动、认知功能和当前用药情况的标准化问卷，肺活量测定、心电图、超声心动图和颈动脉超声检查。
女性报告入睡困难的可能性是男性的两倍（30%对14%）。白天嗜睡、入睡困难和频繁醒来的患病率随年龄增加。所有症状都与抑郁密切相关。白天嗜睡症状也与男性和女性的健康状况不佳及日常生活活动受限密切相关。在多变量分析中，服用苯二氮䓬类药物的男性可能报告入睡困难和白天嗜睡，而服用苯二氮䓬类药物的女性报告入睡困难和过早醒来。在考虑这些因素后，唯一与睡眠障碍独立相关的心血管疾病是心绞痛。确诊为心绞痛的男性和女性报告入睡困难的可能性高1.6倍。睡眠障碍与肥胖、高血压、吸烟和糖尿病等心血管危险因素之间的独立关系相对较弱且不一致，不过吸烟者报告频繁醒来的可能性较小。
睡眠障碍在老年男性和女性中相对常见，且与健康状况不佳、抑郁、心绞痛、日常生活活动受限以及苯二氮䓬类药物的使用有关。
