Whitney C W, Enright P L, Newman A B, Bonekat W, Foley D, Quan S F
Department of Biostatistics, University of Washington, Seattle, USA.
Sleep. 1998;21(1):27-36. doi: 10.1093/sleep/21.1.27.
To describe the prevalence of self-reported daytime sleepiness in older men and women and to describe their relationships with demographic factors, nocturnal complaints, health status, and cardiovascular diseases (CVD).
Cross-sectional survey and clinical exam.
Participants in the Cardiovascular Health Study, 4578 adults aged 65 and older, recruited from a random sample of non-institutionalized Medicare enrollees in four U.S. communities.
Daytime sleepiness measured by the Epworth Sleepiness Scale (ESS), magnetic resonance imaging of the brain (MRI), cognitive function tests, and standardized questionnaires for cardiopulmonary symptoms and diseases, depressive symptoms, social support, activities of daily living, physical activity, and current medications.
Approximately 20% of the participants reported that they were "usually sleepy in the daytime". Although elderly black men were less likely to report frequent awakenings than those in the other three race and gender groups, they had significantly higher mean ESS scores. The following were independently associated with higher ESS scores in gender-specific models: non-white race, depression, loud snoring, awakening with dyspnea or snorting, frequent nocturnal awakenings, medications used to treat congestive heart failure, non-use of sleeping pills, a sedentary lifestyle, and limitation of activities of daily living in both men and women; additional correlates included hip circumference and current smoking in men, and hayfever in women. The following were not independently associated with ESS in the models: age, education, use of wine or beer to aid sleep, use of tricyclic antidepressants, long- or short-acting benzodiazepines, asthma, angina, myocardial infarction, congestive heart failure itself, forced vital capacity, social support, cognitive function, or MRI evidence of global brain atrophy or white matter abnormality.
Daytime sleepiness is common in the elderly, probably due to nocturnal disturbances such as frequent awakenings and snoring. The occasional use of sleeping pills for insomnia is associated with reduced daytime sleepiness in the elderly, while the use of medications for congestive heart failure is associated with daytime sleepiness. Surprisingly, anatomic abnormalities such as evidence of previous strokes and brain atrophy (as seen on brain MRI scans) were not associated with daytime sleepiness in these non-institutionalized elderly persons.
描述老年男性和女性自我报告的日间嗜睡情况，并描述其与人口统计学因素、夜间不适、健康状况和心血管疾病（CVD）之间的关系。
横断面调查和临床检查。
心血管健康研究的参与者，4578名65岁及以上的成年人，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。
采用爱泼沃斯思睡量表（ESS）测量日间嗜睡情况、进行脑部磁共振成像（MRI）、认知功能测试，以及使用标准化问卷评估心肺症状和疾病、抑郁症状、社会支持、日常生活活动、身体活动和当前用药情况。
约20%的参与者报告称他们“白天通常很困”。尽管老年黑人男性比其他三个种族和性别组的人报告频繁觉醒的可能性更低，但他们的ESS平均得分显著更高。在性别特异性模型中，以下因素与较高的ESS得分独立相关：非白人种族、抑郁、大声打鼾、因呼吸困难或打鼾而觉醒、频繁夜间觉醒、用于治疗充血性心力衰竭的药物、不使用安眠药、久坐不动的生活方式以及男女的日常生活活动受限；其他相关因素包括男性的臀围和当前吸烟情况，以及女性的花粉症。在这些模型中，以下因素与ESS没有独立关联：年龄、教育程度、使用葡萄酒或啤酒助眠、使用三环类抗抑郁药、长效或短效苯二氮䓬类药物、哮喘、心绞痛、心肌梗死、充血性心力衰竭本身、用力肺活量、社会支持、认知功能，或脑部MRI显示的全脑萎缩或白质异常的证据。
日间嗜睡在老年人中很常见，可能是由于夜间干扰，如频繁觉醒和打鼾。偶尔使用安眠药治疗失眠与老年人日间嗜睡减少有关，而使用治疗充血性心力衰竭的药物与日间嗜睡有关。令人惊讶的是，在这些非机构化老年人中，诸如既往中风和脑萎缩（如脑部MRI扫描所示）等解剖学异常与日间嗜睡无关。
