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. 2009 Nov;57(11):2085-93.
doi: 10.1111/j.1532-5415.2009.02490.x. Epub 2009 Sep 28.

Sleep disturbances and frailty status in older community-dwelling men

Kristine E Ensrud  1 , Terri L Blackwell, Susan Redline, Sonia Ancoli-Israel, Misti L Paudel, Peggy M Cawthon, Thuy-Tien L Dam, Elizabeth Barrett-Connor, Ping C Leung, Katie L Stone; Osteoporotic Fractures in Men Study Group
Affiliations

Sleep disturbances and frailty status in older community-dwelling men

Kristine E Ensrud et al. J Am Geriatr Soc. 2009 Nov.

Abstract

Objectives: To test the hypothesis that sleep disturbances are independently associated with frailty status in older men.

Design: Cross-sectional analysis of prospective cohort study.

Setting: Six U.S. centers.

Participants: Three thousand one hundred thirty-three men aged 67 and older.

Measurements: Self-reported sleep parameters (questionnaire); objective parameters of sleep-wake patterns (actigraphy data collected for an average of 5.2 nights); and objective parameters of sleep-disordered breathing, nocturnal hypoxemia, and periodic leg movements with arousals (PLMAs) (in-home overnight polysomnography). Frailty status was classified as robust, intermediate stage, or frail using criteria similar to those used in the Cardiovascular Health Study frailty index.

Results: The prevalence of sleep disturbances, including poor sleep quality, excessive daytime sleepiness, short sleep duration, lower sleep efficiency, prolonged sleep latency, sleep fragmentation (greater nighttime wakefulness and frequent, long wake episodes), sleep-disordered breathing, nocturnal hypoxemia, and frequent PLMAs, was lowest in robust men, intermediate in men in the intermediate-stage group, and highest in frail men (P-for-trend < or =.002 for all sleep parameters). After adjusting for multiple potential confounders, self-reported poor sleep quality (Pittsburgh Sleep Quality Index > 5, multivariable odds ratio (MOR)=1.28, 95% confidence interval (CI)=1.09-1.50), sleep efficiency less than 70% (MOR=1.37, 95% CI=1.12-1.67), sleep latency of 60 minutes or longer (MOR=1.42, 95% CI=1.10-1.82), and sleep-disordered breathing (respiratory disturbance index > or =15, MOR=1.38, 95% CI=1.15-1.65) were each independently associated with higher odds of greater frailty status.

Conclusion: Sleep disturbances, including poor self-reported sleep quality, lower sleep efficiency, prolonged sleep latency, and sleep-disordered breathing, are independently associated with greater evidence of frailty.

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Conflict of interest statement

Conflict of Interest:

Drs. Ensrud, Redline, and Ancoli-Israel have received grant support from the NIH (and supporting agencies) as listed under Funding Sources on the title page.

Dr. Ancoli-Israel is on the scientific advisory board or has consulted for Arena, Cephalon Inc., Ferring Pharmaceuticals Inc., Orphagen Pharmaceuticals, Pfizer, Respironics, Sanofi-Aventis, Sepracor Inc., Schering-Plough, Somaxon, and Takeda Pharmaceuticals North America Inc.

Dr. Barrett-Connor has received grant support from the NIH (and supporting agencies) as listed under Funding Sources on the title page

Dr. Stone has received grant support from the NIH (and supporting agencies) as listed under Funding Sources on the title page

References

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