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. 2022 Oct 21;20(1):354.
doi: 10.1186/s12916-022-02557-0.

Maintaining healthy sleep patterns and frailty transitions: a prospective Chinese study

Yunqing Zhu  1 , Junning Fan  1 , Jun Lv  1   2 , Yu Guo  3 , Pei Pei  4 , Ling Yang  5   6 , Yiping Chen  5   6 , Huaidong Du  5   6 , Feifei Li  7 , Xiaoming Yang  6 , Daniel Avery  6 , Junshi Chen  8 , Zhengming Chen  6 , Canqing Yu  9   10 , Liming Li  1   2 ; China Kadoorie Biobank Collaborative Group
Collaborators, Affiliations

Maintaining healthy sleep patterns and frailty transitions: a prospective Chinese study

Yunqing Zhu et al. BMC Med. .

Abstract

Background: Little is known about the effects of maintaining healthy sleep patterns on frailty transitions.

Methods: Based on 23,847 Chinese adults aged 30-79 in a prospective cohort study, we examined the associations between sleep patterns and frailty transitions. Healthy sleep patterns included sleep duration at 7 or 8 h/d, without insomnia disorder, and no snoring. Participants who persisted with a healthy sleep pattern in both surveys were defined as maintaining a healthy sleep pattern and scored one point. We used 27 phenotypes to construct a frailty index and defined three statuses: robust, prefrail, and frail. Frailty transitions were defined as the change of frailty status between the 2 surveys: improved, worsened, and remained. Log-binomial regression was used to calculate the prevalence ratio (PR) to assess the effect of sleep patterns on frailty transitions.

Results: During a median follow-up of 8.0 years among 23,847 adults, 45.5% of robust participants, and 10.8% of prefrail participants worsened their frailty status, while 18.6% of prefrail participants improved. Among robust participants at baseline, individuals who maintained sleep duration of 7 or 8 h/ds, without insomnia disorder, and no-snoring were less likely to worsen their frailty status; the corresponding PRs (95% CIs) were 0.92 (0.89-0.96), 0.76 (0.74-0.77), and 0.85 (0.82-0.88), respectively. Similar results were observed among prefrail participants maintaining healthy sleep patterns. Maintaining healthy sleep duration and without snoring, also raised the probability of improving the frailty status; the corresponding PRs were 1.09 (1.00-1.18) and 1.42 (1.31-1.54), respectively. Besides, a dose-response relationship was observed between constantly healthy sleep scores and the risk of frailty transitions (P for trend < 0.001).

Conclusions: Maintaining a comprehensive healthy sleep pattern was positively associated with a lower risk of worsening frailty status and a higher probability of improving frailty status among Chinese adults.

Keywords: Frailty; Prospective cohort study; Sleep patterns.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Sample selection of the study. CKB, China Kadoorie Biobank; FI, frailty index
Fig. 2
Fig. 2
Dose-response Relationships between sleep scores and frailty transitions. The forest plots showed the relationships between baseline (panel A), constantly healthy sleep scores (panel B), and robust worsening (left panel), prefrail worsening (middle panel), prefrail regression (right panel), which were with the semi-log horizontal axis. Multivariable model was adjusted for sex, age, study area, highest education, smoking status, and alcohol consumption. P for trend were all < 0.001
See this image and copyright information in PMC

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