This study examined the association between disturbed sleep and poorer daytime function in older women. Observational study. 2,889 women, mean age 83.5 years, participating in the 2002–2004 examination of the Study of Osteoporotic Fractures. N/A Participants wore actigraphs for an average ± SD of 4.1 ± 0.83 24-hour periods. Actigraphy measured sleep variables were total sleep time and hours awake after sleep onset during the night and daytime napping behavior. Neuromuscular performance measurements included gait speed, chair stands, and grip strength. Functional limitations were assessed as self-reported difficulty with one or more of 6 instrumental activities of daily living (IADL). In fully adjusted, multivariable models, women who slept <6 hours per night walked 3.5% slower than those who slept 6.0–6.8 hours. Those who slept ≥7.5 hours took 4.1% longer to complete 5 chair stands than those who slept 6.8–7.5 hours. With higher wake after sleep onset (≥1.6 hours compared to <0.7 hours) gait speed was 9.1% slower; it took 7.6% longer to complete 5 chair stands, and odds of functional limitation were 1.8 (95% CI: 1.4, 2.4) higher. Women with 1.0–1.8 hours of daytime sleep had higher odds (1.4 [95% CI: 1.1, 1.8]) of a functional limitation than those with <0.5 hours. Sleep variables did not appear to be associated with grip strength. Objectively measured poorer sleep was associated with worse physical function. Future research is needed to identify the underlying mechanisms for the association between poor sleep and functional decline.
7 November 2011 in Journal of the American Geriatrics Society
Falls pose a major health risk among older adults and are a leading cause of mortality, morbidity, and premature nursing home placement.1,2 It is estimated that falls occur in approximately a third of persons older than 65 years each year.3
15 January 2014 in Journal of the American Geriatrics Society
FGfor the Osteoporotic Fractures in Men Research Group
for the Osteoporotic Fractures in Men Research Group
+2
The importance of sleep to health and cardiovascular disease has become increasingly apparent. Sleep-disordered breathing, sleep duration, and sleep architecture may all influence metabolism and neurohormonal systems, yet no previous study has evaluated these sleep characteristics concurrently in relation to incident hypertension. Our objective was to determine whether incident hypertension is associated with polysomnography measures of sleep-disordered breathing, sleep duration, and sleep architecture in older men. Participants were 784 community-dwelling, ambulatory men ≥65 years of age (mean age: 75.1±4.9 years) from the Outcomes of Sleep Disorders in Older Men Study who did not have hypertension at the time of their in-home polysomnography sleep studies (2003–2005) and who returned for follow-up (2007–2009). Of 784 older men included in this report, 243 met criteria for incident hypertension after a mean follow-up of 3.4 years. In unadjusted analyses, incident hypertension was associated with increased hypoxemia, increased sleep stages N1 and N2, and decreased stage N3 (slow wave sleep [SWS]). After adjustment for age, nonwhite race, study site, and body mass index, the only sleep index to remain significantly associated with incident hypertension was SWS percentage (odds ratio for lowest to highest quartile of SWS: 1.83 [95% CI: 1.18 to 2.85]). No attenuation of this association was seen after accounting for sleep duration, sleep fragmentation, and indices of sleep-disordered breathing. Percentage time in SWS was inversely associated with incident hypertension, independent of sleep duration and fragmentation, and sleep-disordered breathing. Selective deprivation of SWS may contribute to adverse blood pressure in older men.