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Fang F, Sun Z, Gao Y, Han J, Zhao L, Zhao Z, He Z, Zhang Z, Bian H, Liu L. Effects of combined morbid insomnia and sleep apnea on long-term cardiovascular risk and all-cause mortality in elderly patients: a prospective cohort study. BMC Geriatr 2024; 24:622. [PMID: 39034410 PMCID: PMC11265059 DOI: 10.1186/s12877-024-05147-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 06/13/2024] [Indexed: 07/23/2024] Open
Abstract
PURPOSE It is reported that insomnia and obstructive sleep apnea (OSA) increase the incidence of adverse cardiovascular events. The aim of this study was to analyze the risk of cardiovascular disease and mortality in elderly patients with comorbid insomnia and obstructive sleep apnea (COMISA). METHODS We included 868 elderly patients with OSA who underwent sleep monitoring at a multicenter sleep room from January 2015 to October 2017. We collected demographic data, clinical features, medical history, sleep parameters, and laboratory findings. Cox proportional hazards analysis was used to identify the relationship between COMISA and adverse cardiovascular events and all-cause mortality. RESULTS There were 181 elderly patients with COMISA. The median follow-up was 43 months, during which we observed major adverse cardiac events (MACE) in 90 patients. The Kaplan-Meier survival curve indicated a significant relationship between COMISA and MACE (Plog Rank < 0.001). Multivariate Cox regression analysis showed that COMISA increased the incidence of MACE (HR = 2.328, 95% CI: 1.349-4.018, P = 0.002), hospitalization for unstable angina (HR = 2.915, 95% CI: 1.397-6.081, P = 0.004), and the combination of all events (HR = 2.301, 95% CI: 1.393-3.803, P = 0.001). However, there were no significant differences in cardiovascular death, all-cause mortality, myocardial infarction, or hospitalized heart failure in patients with COMISA (P > 0.05). Subgroup analyses showed that among COMISA patients, male sex (HR = 2.800, 95% CI: 1.458-5.377, P = 0.002), age < 70 years (HR = 4.050, 95% CI: 2.022-8.115, P < 0.001), and overweight and obesity (HR = 2.482, 95% CI: 1.383-4.453, P = 0.002) were associated with a higher risk of MACE. CONCLUSIONS Our results showed that COMISA increased the risk of MACE, unstable angina, and the compound occurrence of all events. Male, overweight or obese COMISA patients under 70 years of age have an increased risk of MACE.
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Affiliation(s)
- Fengfeng Fang
- Department of Pulmonary and Critical Care Medicine of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
- Medical College, Yan'an University, Yan'an, China
| | - Zhihong Sun
- Department of Pulmonary and Critical Care Medicine of the Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yinghui Gao
- PKU-UPenn Sleep Center, Peking University International Hospital, Beijing, China
| | - Jiming Han
- Medical College, Yan'an University, Yan'an, China
| | - Libo Zhao
- Cardiology Department of the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Zhe Zhao
- Cardiology Department of the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Zijun He
- Medical College, Yan'an University, Yan'an, China
| | - Zuo Zhang
- People's Hospital of Ningxia Hui Autonomous Region, Beijing, China.
| | - Hongyan Bian
- Medical College, Yan'an University, Yan'an, China.
- Cardiovascular and Cerebrovascular Disease Hospital of the Affiliated Hospital of Yan'an University, Yan'an, China.
| | - Lin Liu
- Department of Pulmonary and Critical Care Medicine of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.
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Canever JB, Zurman G, Vogel F, Sutil DV, Diz JBM, Danielewicz AL, Moreira BDS, Cimarosti HI, de Avelar NCP. Worldwide prevalence of sleep problems in community-dwelling older adults: A systematic review and meta-analysis. Sleep Med 2024; 119:118-134. [PMID: 38669835 DOI: 10.1016/j.sleep.2024.03.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/09/2024] [Accepted: 03/23/2024] [Indexed: 04/28/2024]
Abstract
The understanding of the prevalence of sleep problems in older adults can provide a broad and reliable perspective into the occurrence of such issues among older adults. This systematic review and meta-analysis aimed to estimate the worldwide prevalence of sleep problems in community-dwelling older adults. Studies that provide information on the prevalence of sleep problems in community-dwelling older adults (≥60 years) were screened between December 2022 and March 2023. A total of 20,379 studies were identified in database searches, from which 252 were included in this review. These studies covered the last 35 years (from 1988 to 2023) and pooled a sample of 995,544 participants from 36 countries. The most frequent sleep problem worldwide was obstructive sleep apnea (46.0%), followed by poor sleep quality (40.0%), other sleep problems (37.0%), insomnia (29.0%), and excessive daytime sleepiness (19.0%). No significant difference in the prevalence estimates of all sleep problems was observed between the sexes. This systematic review and meta-analysis showed a high prevalence of some sleep problems, mainly obstructive sleep apnea, poor sleep quality, and other sleep problems. Our estimates can be useful for managers and policymakers in planning healthcare strategies for sleep problems aimed at the older population.
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Affiliation(s)
- Jaquelini Betta Canever
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Rod. Governador Jorge Lacerda, Araranguá, Santa Catarina, Urussanguinha, 320188906-072, Brazil; Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
| | - Gabriela Zurman
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Felipe Vogel
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Daiana Vieira Sutil
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | | | - Ana Lúcia Danielewicz
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Bruno de Souza Moreira
- Center for Studies in Public Health and Aging, Federal University of Minas Gerais and Oswaldo Cruz Foundation - Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Helena Iturvides Cimarosti
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Rod. Governador Jorge Lacerda, Araranguá, Santa Catarina, Urussanguinha, 320188906-072, Brazil
| | - Núbia Carelli Pereira de Avelar
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Musty A, Lund JL, Yang YC, Niznik J, Shmuel S, Duchesneau ED. The association between wealth and sleep medication use in a nationally-representative sample of older Medicare beneficiaries. Pharmacoepidemiol Drug Saf 2024; 33:e5703. [PMID: 37743351 PMCID: PMC10841169 DOI: 10.1002/pds.5703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/31/2023] [Accepted: 09/13/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Sleep disorders are common among older adults, leading to high prevalence of over-the-counter and prescription sleep medication use. Socioeconomically disadvantaged individuals have higher prevalence of sleep disorders. Frequent use of sleep medications can increase the risk of falls. Little is known about the association between wealth and sleep medication use in older adults. METHODS We conducted a cross-sectional analysis using a nationwide sample of 7603 Medicare beneficiaries (65+ years) from Round 1 (2011) of the National Health and Aging Trends Study. We measured self-reported wealth as the sum of assets (retirement savings, stocks/bonds, checking/savings accounts, business assets, and home value) minus liabilities (mortgage, credit card, and medical debt). Self-reported sleep medication use in the past month was categorized as frequent (5-7 nights/week), sometimes (1-4 nights/week), or never (0 night/week). We estimated differences in the prevalence of sleep medication use by quintiles of wealth using crude and adjusted binomial regression models. Individuals missing sleep medication information were excluded. RESULTS Median wealth was $152 582 (IQR: $24 023-412 992). Sixteen percent reported frequent sleep medication use, 15% reported some use, and 70% reported no use. Frequent sleep medication use was more common in lower wealth quintiles (lowest: 20%, highest: 12%). Alternatively, some use was more common in higher wealth quintiles (lowest: 11%, highest: 18%). Results were similar after adjustment for demographic factors, anxiety, depression, and sleep disorders. CONCLUSIONS In this study, less wealthy older adults had higher prevalence of frequent sleep medication use. This may lead to dependency or increased fall risk in this vulnerable population.
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Affiliation(s)
- Allison Musty
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jennifer L Lund
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Yang Claire Yang
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Sociology, Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Joshua Niznik
- Division of Geriatric Medicine and Center for Aging and Health, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Shahar Shmuel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Emilie D Duchesneau
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Gao X, Li J, Xu S, Li X, Wang X, Li Y, Huang Y, Liu S, Zeng Q. Oral nicotinamide mononucleotide (NMN) to treat chronic insomnia: protocol for the multicenter, randomized, double-blinded, placebo-controlled trial. Trials 2023; 24:340. [PMID: 37202819 DOI: 10.1186/s13063-023-07351-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 04/20/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND The treatment of insomnia, which is the most common sleep disorder, includes drug and behavioral treatment, but each treatment measure has its limitations. So new treatment method needs to be taken to improve the treatment effect. MN supplementation is a potential promising new method for the treatment of insomnia, resulting in a rising need for methodological research towards verifying its efficacy. METHODS/DESIGN We describe a proposal for a multicenter, patient-assessor-blinded, randomized controlled trial with two parallel arms. A total of 400 chronic insomnia patients will be allocated 1:1 to the intervention group (treatment with oral NMN 320 mg/day) or control group (treatment with oral placebo). All subjects are clinical chronic insomnia patients who meet all inclusion criteria. All subjects are treated by taking NMN or placebo. The primary outcome is the score on the Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes are the score on the Insomnia Severity Index (ISI) and Epworth Sleeping Scale (ESS), the total sleep time (TST), sleep efficiency (SE), sleep latency, and REM sleep latency to assess sleep quality changes. Subjects are assessed at two time points: baseline and follow-up. The duration of the clinical trial is 60 days. DISCUSSION This study will provide more evidence on the effects of NMN on improving sleep quality among patients with chronic insomnia. If proven effective, NMN supplement can be used as a new treatment for chronic insomnia in the future. TRIAL REGISTRATION Chinese Clinical Trial Registry (chictr.org.cn) ChiCTR2200058001. Registered on 26 March 2022.
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Affiliation(s)
- Xiangyang Gao
- Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Junhua Li
- Health Management Center, Handan Central Hospital, Hebei Province, Handan, China
| | - Sanping Xu
- Health Management Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hebei Province, Wuhan, China
| | - Xueying Li
- Department of Biostatistics, Peking University First Hospital, Beijing, 100034, China
| | - Xicheng Wang
- Beijing Dublin International Collage, Beijing University of Technology, Beijing, 100124, China
| | - Yongli Li
- Health Management Center, Henan Provincial People's Hospital, Zhengzhou, China
| | - Yan Huang
- Health Management Center, West China Hospital, Sichuan University, Sichuan Province, Chengdu, China
| | - Shaohui Liu
- Health Management Center, Xiangya Hospital, Central South Hospital, Hunan Province, Changsha, China
| | - Qiang Zeng
- Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.
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5
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Miner B, Doyle M, Knauert M, Yaggi HK, Stone KL, Ancoli-Israel S, Cauley JA, Redline S, Blackwell T, Gill TM. Insomnia with objective short sleep duration in community-living older persons: A multifactorial geriatric health condition. J Am Geriatr Soc 2023; 71:1198-1208. [PMID: 36524599 PMCID: PMC10089942 DOI: 10.1111/jgs.18195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Insomnia or poor sleep quality with objective short sleep duration (hereafter referred to as ISSD) has been identified as a high-risk phenotype among middle-aged persons. We evaluated the prevalence and clinical correlates of ISSD among community-living older persons. METHODS In 3053 men from the Osteoporotic Fractures in Men Sleep Study (MrOS; average age 76.4 ± 5.5 years) and 3044 women from the Study of Osteoporotic Fractures (SOF; average age 83.6 ± 3.8 years), we evaluated the prevalence of ISSD (trouble getting to sleep within 30 minutes, waking up in the middle of the night or early morning, and/or taking a medication to help with sleep ≥3 times per week and actigraphy-estimated sleep duration <6 h). Using separate logistic regression models in men and women, we evaluated the cross-sectional associations between predisposing, precipitating, and perpetuating factors for ISSD, as compared with normal sleep (no insomnia and actigraphy-estimated sleep duration of 6-9 h). RESULTS Overall, 20.6% of older men and 12.8% of older women had insomnia with short sleep duration. Multiple predisposing, precipitating, and perpetuating factors were cross-sectionally associated with ISSD in both men and women. In multivariable models that adjusted for predisposing factors (demographics, multimorbidity, obesity), precipitating (depression, anxiety, central nervous system-active medication use, restless legs syndrome) and perpetuating (napping, falls) factors were significantly associated with ISSD in men and women (adjusted odds ratios ranging 1.63-4.57). CONCLUSIONS In this cross-sectional study of community-living older men and women, ISSD was common and associated with multiple predisposing, precipitating, and perpetuating factors, akin to a multifactorial geriatric health condition. Future work should examine causal pathways and determine whether the identified correlates represent modifiable risk factors.
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Affiliation(s)
- Brienne Miner
- Yale School of Medicine, Department of Internal Medicine, New Haven, CT
| | - Margaret Doyle
- Yale School of Medicine, Department of Internal Medicine, New Haven, CT
| | - Melissa Knauert
- Yale School of Medicine, Department of Internal Medicine, New Haven, CT
| | - H. Klar Yaggi
- Yale School of Medicine, Department of Internal Medicine, New Haven, CT
- Veterans Affairs Clinical Epidemiology Research Center, West Haven, CT
| | - Katie L. Stone
- California Pacific Medical Center Research Institute, San Francisco, CA
| | - Sonia Ancoli-Israel
- University of California San Diego School of Medicine, Department of Psychiatry, San Diego, CA
| | - Jane A. Cauley
- University of Pittsburgh, School of Public Health, Pittsburgh, PA
| | - Susan Redline
- Brigham and Women’s Hospital, Harvard Medical School, Department of Medicine, Boson, MA
| | - Terri Blackwell
- California Pacific Medical Center Research Institute, San Francisco, CA
| | - Thomas M. Gill
- Yale School of Medicine, Department of Internal Medicine, New Haven, CT
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Papadopoulos D, Sosso FAE. Socioeconomic status and sleep health: a narrative synthesis of 3 decades of empirical research. J Clin Sleep Med 2023; 19:605-620. [PMID: 36239056 PMCID: PMC9978435 DOI: 10.5664/jcsm.10336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 12/24/2022]
Abstract
STUDY OBJECTIVES This review aims to assess the association between socioeconomic status (SES) and sleep health in the general population and the mediating effects of lifestyle and mental and physical health in this relationship. METHODS Observational studies testing the independent association between objective or subjective SES indicators and behavioral/physiological or clinical sleep health variables in the general population were included. PubMed/MEDLINE was searched for reports published from January 1990 to December 2019. The direction of effect was used as the primary effect measure, testing the hypothesis that low SES is associated with poor sleep health outcomes. Results are presented in the form of direction effect plots and synthesized as binomial proportions. RESULTS Overall, 336 studies were identified. A high proportion of effects at the expected direction was noted for measures of sleep continuity (100% for sleep latency, 50-100% for awakenings, 66.7-100% for sleep efficiency), symptoms of disturbed sleep (75-94.1% for insomnia, 66.7-100% for sleep-disordered breathing, 60-100% for hypersomnia), and general sleep satisfaction (62.5-100%), while the effect on sleep duration was inconsistent and depended on the specific SES variable (92.3% for subjective SES, 31.7% for employment status). Lifestyle habits, chronic illnesses, and psychological factors were identified as key mediators of the SES-sleep relationship. CONCLUSIONS Unhealthy behaviors, increased stress levels, and limited access to health care in low-SES individuals may explain the SES-sleep health gradient. However, the cross-sectional design of most studies and the high heterogeneity in employed measures of SES and sleep limit the quality of evidence. Further research is warranted due to important implications for health issues and policy changes. CITATION Papadopoulos D, Etindele Sosso FA. Socioeconomic status and sleep health: a narrative synthesis of 3 decades of empirical research. J Clin Sleep Med. 2023;19(3):605-620.
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Auvinen P, Koponen H, Kautiainen H, Korniloff K, Ahonen T, Vanhala M, Mäntyselkä P. A longitudinal study of restless legs symptoms among patients with depression. Nord J Psychiatry 2022; 76:584-590. [PMID: 35191781 DOI: 10.1080/08039488.2022.2038265] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The aim of this study was to analyse the relationship between depressive symptoms and clinical depression and restless legs symptoms in a longitudinal primary care setting. METHODS The prevalence of restless legs symptoms at baseline and after a six-year follow-up was studied in 474 patients with depressive symptoms and 333 population-based control subjects without depressive symptoms. Depressive symptoms at the baseline and after the six-year follow-up were evaluated with the Beck Depression Inventory (BDI) Second Edition. A psychiatric diagnosis was confirmed with a diagnostic interview (M.I.N.I.). Statistical comparisons between groups were made using analysis of variance (ANOVA) for continuous variables and a chi-square test or logistic models for categorical variables. Repeated measures were analysed using generalizing estimating equations (GEE) models. RESULTS At baseline the prevalence of restless legs symptoms was 24.3% in control subjects, 43.8% in the patients with depressive symptoms without a depression diagnosis, and 49.3% in clinically depressed patients. During the follow-up up the prevalence of restless legs symptoms declined significantly (p = 0.003). In addition to baseline restless legs symptoms, the prognostic factors for restless legs symptoms among patients with clinical depression were age and BDI score. In the control subjects, moderate and high leisure time physical activity was inversely associated with restless legs symptoms at the follow-up. CONCLUSIONS A higher level of baseline depressive symptoms was a risk factor for restless legs symptoms in patients with clinical depression. In the prevention and treatment of restless legs symptoms among the patients with depression, the priority is the effective treatment of depression.
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Affiliation(s)
- Piritta Auvinen
- Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Kuopio, Finland
| | - Hannu Koponen
- Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Katariina Korniloff
- School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland
| | - Tiina Ahonen
- Primary Health Care Unit, Central Finland Central Hospital, Jyväskylä, Finland
| | - Mauno Vanhala
- Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Kuopio, Finland
| | - Pekka Mäntyselkä
- Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Kuopio, Finland.,Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
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Abstract
With aging, there are normative changes to sleep physiology and circadian rhythmicity that may predispose older adults to sleep deficiency, whereas many health-related and psychosocial/behavioral factors may precipitate sleep deficiency. In this article, we describe age-related changes to sleep and describe how the health-related and psychosocial/behavioral factors typical of aging may converge in older adults to increase the risk for sleep deficiency. Next, we review the consequences of sleep deficiency in older adults, focusing specifically on important age-related outcomes, including mortality, cognition, depression, and physical function. Finally, we review treatments for sleep deficiency, highlighting safe and effective nonpharmacologic interventions.
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Affiliation(s)
- Jane Alexandra Pappas
- San Juan Bautista School of Medicine, Salida 21 Carr. 172 Urb. Turabo Gardens, Caguas 00726, Puerto Rico
| | - Brienne Miner
- Section of Geriatrics, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA.
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Gharzeddine R, McCarthy MM, Yu G, Dickson VV. Associations of insomnia symptoms with sociodemographic, clinical, and lifestyle factors in persons with HF: Health and retirement study. Res Nurs Health 2022; 45:364-379. [DOI: 10.1002/nur.22211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 01/10/2022] [Accepted: 01/13/2022] [Indexed: 11/07/2022]
Affiliation(s)
| | | | - Gary Yu
- Rory Meyers College of Nursing New York University New York City New York USA
| | - Victoria V. Dickson
- Rory Meyers College of Nursing New York University New York City New York USA
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10
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Bendaoud I, Etindele Sosso FA. Socioeconomic Position and Excessive Daytime Sleepiness: A Systematic Review of Social Epidemiological Studies. Clocks Sleep 2022; 4:240-259. [PMID: 35645243 PMCID: PMC9149899 DOI: 10.3390/clockssleep4020022] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/01/2022] [Accepted: 05/05/2022] [Indexed: 11/30/2022] Open
Abstract
The objectives of this empirical study are to describe and discuss the current literature available on the relationship between excessive daytime sleepiness (EDS) and the socioeconomic position (SEP) as well as to provide recommendations for consideration of SEP in sleep medicine and biomedical research. Databases Medline/PubMed, Web of Science, Google scholar and Scopus were screened from January 1990 to December 2020 using PRISMA guidelines and 20 articles were included in the final synthesis. Nineteen studies were cross-sectional and one study was longitudinal. Among these studies, 25.00% (n = 5) are focused on children and adolescent and the remaining 75.00% (n = 15) focused on adults and seniors. Ages ranged from 8 to 18 years old for children/adolescent and ranged from 18 to 102 years old for adults. Main SEP measures presented in these studies were education, income, perceived socioeconomic status and employment. The sample size in these studies varied from N = 90 participants to N = 33,865 participants. Overall, a lower educational level, a lower income and full-time employment were associated with EDS. Symptoms of EDS are prevalent in women, especially those with a low income or no job; and children and adolescents with difficult living conditions or working part time reported more sleep disturbances. SEP is already considered as an important determinant for many health outcomes, but if SEP is embedded in the experimental design in psychosomatic research, biomedical research and clinical practice as a constant variable regardless of outcome; it will move forward future investigations.
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Affiliation(s)
- Imene Bendaoud
- Clinical Pharmacology, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada
- Global Health and Ecoepidemiology, Redavis Institute, Montreal, QC H3S 1X5, Canada;
- Correspondence:
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11
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Miner B, Stone KL, Zeitzer JM, Han L, Doyle M, Blackwell T, Gill TM, Redeker NS, Hajduk A, Yaggi HK. Self-reported and actigraphic short sleep duration in older adults. J Clin Sleep Med 2022; 18:403-413. [PMID: 34338629 PMCID: PMC8804982 DOI: 10.5664/jcsm.9584] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
STUDY OBJECTIVES Persons > 65 years with short sleep duration (≤ 6 hours) are at risk for adverse outcomes, but the accuracy of self-reported sleep duration may be affected by reduced symptom awareness. We evaluated the performance characteristics of self-reported vs objectively measured sleep duration in this age group. METHODS In 2,980 men from the Osteoporotic Fractures in Men Sleep Study and 2,855 women from the Study of Osteoporotic Fractures we examined the agreement and accuracy of self-reported vs actigraphy-measured short and normal (> 6 but < 9 hours) sleep duration. We evaluated associations of select factors (demographics; medical, physical, and neuropsychiatric conditions; medication and substance use; and sleep-related measures) with risk of false-negative (normal sleep duration by self-report but short sleep duration by actigraphy) and false-positive (short sleep duration by self-report and normal sleep duration by actigraphy) designations, respectively, using logistic regression. RESULTS Average ages were 76.3 ± 5.5 and 83.5 ± 3.7 years in men and women, respectively. There was poor agreement between self-reported and actigraphic sleep duration (kappa ≤ 0.24). False negatives occurred in nearly half and false positives in over a quarter of older persons. In multivariable models in men and women, false negatives were independently associated with obesity, daytime sleepiness, and napping, while false positives were significantly lower with obesity. CONCLUSIONS Under- and overreporting of short sleep is common among older persons. Reliance on self-report may lead to missed opportunities to prevent adverse outcomes or unnecessary interventions. Self-reported sleep duration should be objectively confirmed when evaluating the effect of sleep duration on health outcomes. CITATION Miner B, Stone KL, Zeitzer JM, et al. Self-reported and actigraphic short sleep duration in older adults. J Clin Sleep Med. 2022;18(2):403-413.
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Affiliation(s)
- Brienne Miner
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut,Address correspondence to: Brienne Miner, MD, 333 Cedar Street, New Haven, CT 06520; Tel: (203) 688-9423; Fax (203) 688-4209;
| | - Katie L. Stone
- California Pacific Medical Center Research Institute, San Francisco, California
| | - Jamie M. Zeitzer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California
| | - Ling Han
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut,Veterans Affairs Clinical Epidemiology Research Center, West Haven, Connecticut
| | - Margaret Doyle
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Terri Blackwell
- California Pacific Medical Center Research Institute, San Francisco, California
| | - Thomas M. Gill
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Nancy S. Redeker
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut,Yale School of Nursing, West Haven, Connecticut
| | - Alexandra Hajduk
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Henry Klar Yaggi
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut,Veterans Affairs Clinical Epidemiology Research Center, West Haven, Connecticut
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12
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Abstract
BACKGROUND/OBJECTIVE Insomnia and insomnia symptoms are highly prevalent in persons with heart failure (HF), and they are associated with several untoward outcomes. The purpose of this integrative review is to describe the correlates, predictors, and outcomes of insomnia and insomnia symptoms in persons with HF. METHODS Using integrative review methods, an extensive electronic search of 5 databases was conducted for the period of 2000-2019. Sixteen studies were identified that met the inclusion criteria for review and investigated insomnia or insomnia symptoms in HF. RESULTS Various sociodemographic factors, chronic comorbidities, clinical factors, and cognitive-behavioral factors are correlates and predictors of insomnia and insomnia symptoms in persons with HF. Depression, fatigue, daytime sleepiness, poor self-reported physical functioning, decreased exercise capacity, cardiac events, and poor health-related quality of life are significant outcomes of insomnia and insomnia symptoms in persons with HF. The associations of insomnia and insomnia symptoms with age, sex, sleep-disordered breathing, and cognition were not consistent across all studies. CONCLUSION Larger studies with diverse age and race groups as well as longitudinal studies and designs that test mediation effects are needed to disentangle complex relationships between insomnia and insomnia symptoms and several of their potential predictors and correlates in HF.
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Korkmaz Aslan G, İncİ FH, Kartal A. The prevalence of insomnia and its risk factors among older adults in a city in Turkey's Aegean Region. Psychogeriatrics 2020; 20:111-117. [PMID: 31137084 DOI: 10.1111/psyg.12464] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 03/23/2019] [Accepted: 04/10/2019] [Indexed: 02/02/2023]
Abstract
AIM Experienced by many older adults, insomnia is a significant public health problem that requires the attention of health-care professionals and researchers. This study aimed to identify insomnia and its risk factors among community-dwelling older adults. METHODS This cross-sectional study was conducted in Denizli, Turkey. The study sample consisted of 360 elderly individuals aged 60 years and older who were admitted to one of six family health centres for any reason between 29 March 2016 and 17 June 2016. Data were collected by using a descriptive form for the elderly and the Insomnia Severity Index. The χ2 test was used to compare independent variables and insomnia status. Logistic regression analysis was used for the variables that were found to be significant at the end of the single-variable analysis. RESULTS The mean age of the subjects, all of whom lived at home, was 69.52 ± 8.36 years. Insomnia was quite common among them (51%), and its severity was low (8.51 ± 5.56). At the end of logistic regression analysis, a moderate perception of health (OR = 10.859, 95%CI: 3.532-33.385) and the number of medications used (OR = 3.326, 95%CI: 1.014-10.907) were identified as risk factors for insomnia. CONCLUSION Based on the results of this study, we can state that insomnia is common among older adults. Therefore, older adults who are admitted to health-care institutions should be evaluated for insomnia. Factors identified as affecting insomnia were health perception and the number of medications used. Given that health perception and polypharmacy are associated with chronic disease management, helping the elderly to effectively manage chronic diseases may alleviate insomnia.
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Affiliation(s)
| | - Fadime H İncİ
- Pamukkale University Faculty of Health Sciences, Denizli, Turkey
| | - Asiye Kartal
- Pamukkale University Faculty of Health Sciences, Denizli, Turkey
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Dangol M, Shrestha S, Rai Koirala SK. Insomnia and its associated factors among older people of selected ward of Banepa municipality, Nepal. Nurs Open 2020; 7:355-363. [PMID: 31871720 PMCID: PMC6917932 DOI: 10.1002/nop2.396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 09/10/2019] [Accepted: 09/23/2019] [Indexed: 11/07/2022] Open
Abstract
Aims The aim of this study was to calculate the prevalence of insomnia and identify the factors associated with it among older people of Banepa Municipality, Province No.3 of Nepal. Design A quantitative descriptive cross-sectional study was done; data were collected for three months from September-November 2018. Methods One hundred and fourteen older people were recruited. The data were collected through a structured interview questionnaire that included socio-demographic characteristics and Nepalese version of standard Pittsburgh Insomnia Rating Scale (20-item version). Information on general health conditions, alcohol intake and personal habits was also collected. Results The mean age of the respondents (N = 114) was 76.04 (SD 7.81), years and 51.8% were females. The prevalence of insomnia was 71.1% in the older population. Significant associations were found between insomnia and advanced age (p = .002), illiteracy (p < .001), not working (p < .001), financially dependent on others (p < .001), presence of comorbid disease (p < .001) and taking regular medicine at present (p < .001).
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Affiliation(s)
- Manisha Dangol
- Department of NursingJanamaitri Foundation Institute of Health SciencesTribhuvan UniversityHattiban, LalitpurNepal
| | - Sunil Shrestha
- Department of Pharmaceutical and Health Service ResearchNepal Health Research and Innovation FoundationLalitpurNepal
- Department of PharmacyNepal Cancer Hospital and Research CenterHarisiddhi, LalitpurNepal
| | - Sita Kumari Rai Koirala
- Department of NursingJanamaitri Foundation Institute of Health SciencesTribhuvan UniversityHattiban, LalitpurNepal
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Anticholinergic and sedative medications exposure in older patients: a cross-sectional study. Int J Clin Pharm 2019; 41:1152-1158. [DOI: 10.1007/s11096-019-00885-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 07/27/2019] [Indexed: 10/26/2022]
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McPhillips MV, Dickson VV, Cacchione PZ, Li J, Gooneratne N, Riegel B. Nursing Home Eligible, Community-Dwelling Older Adults' Perceptions and Beliefs About Sleep: A Mixed-Methods Study. Clin Nurs Res 2019; 29:177-188. [PMID: 31104492 DOI: 10.1177/1054773819849348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sleep disturbances are highly prevalent in older adults; little is known about sleep in those who remain living in the community despite qualifying for nursing home placement. We conducted a concurrent, nested, mixed-methods study to describe sleep characteristics and sleep disturbances in this population. Our final sample (n = 40) was Black (100%), female (85%) older adults with a mean (±SD) age of 72 ± 9.5 years. Of these, 35 had objectively measured short or long sleep duration, and 30 had subjectively reported poor sleep quality. Our evidence suggests that sleep disturbances are common in this group, and these older adults had adjusted their expectations and adapted to their sleep disturbances. Given that at-risk older adults may not perceive their sleep disturbances as problematic, clinicians must proactively assess sleep and educate about the importance of sleep. These results reveal modifiable factors with potential to improve health outcomes in this vulnerable population.
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Affiliation(s)
| | | | | | - Junxin Li
- Johns Hopkins University, Baltimore, MD, USA
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