Sleep duration and health among older adults: associations vary by how sleep is measured
Sleep duration and health among older adults: associations vary by how sleep is measured
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DOI：
10.1136/jech-2015-206109
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发表时间：
2016-04-01
影响因子：
6.3
通讯作者：
Thisted, Ronald A.
中科院分区：
文献类型：
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作者：
Lauderdale, Diane S.;Chen, Jen-Hao;Thisted, Ronald A.
背景队列研究发现，与中等睡眠时间相比，短睡眠和长睡眠都会导致更差的结果。虽然已证实的生物学机制可以解释短睡眠对健康的影响，但长睡眠的风险却令人费解。大多数报告 U 形的研究都使用一个关于睡眠持续时间的问题，这种测量方法与客观测量的睡眠没有高度相关。我们假设 U 形，尤其是长时间睡眠者的不良结果，可能是睡眠测量方式的人为因素。 方法 我们在美国 62-90 岁成年人全国样本中按睡眠时间类别（6、7、8、9、>9 小时）检查了健康状况一般/较差的横断面患病率，其中包括几种类型的睡眠测量 (n=727)。调查措施为： 单一问题；通常的就寝时间和起床时间；和 3 天的睡眠日志。体动记录仪测量的是睡眠间隔和总睡眠时间。根据人口统计数据调整睡眠时间类别，对健康状况良好/不良进行回归，并进行线性趋势和 U 形测试。 结果单个问题的睡眠时间类别的健康状况良好/不良的调整后 OR 分别为 4.6、2.2、参考值（8 小时）、1.8 和 6.9。对于所有睡眠测量，6 小时内健康状况良好/不良的患病率很高，但睡眠日志和体动记录测量没有长时间睡眠效应。结论 长时间睡眠与健康状况不佳之间的关联可能特定于通过调查问题测量睡眠的研究。随着体动记录研究队列的成熟，我们对睡眠如何影响健康的理解可能会改变。
Background Cohort studies have found that short and long sleep are both associated with worse outcomes, compared with intermediate sleep times. While demonstrated biological mechanisms could explain health effects for short sleep, long-sleep risk is puzzling. Most studies reporting the U shape use a single question about sleep duration, a measurement method that does not correlate highly with objectively measured sleep. We hypothesised that the U shape, especially the poor outcomes for long sleepers, may be an artefact of how sleep is measured.Methods We examined the cross-sectional prevalence of fair/poor health by sleep hour categories (6, 7, 8, 9, >9h) in a national US sample of adults aged 62-90 that included several types of sleep measures (n=727). Survey measures were: a single question; usual bedtimes and waking times; and a 3-day sleep log. Actigraphy measures were the sleep interval and total sleep time. Fair/poor health was regressed on sleep hour categories adjusted for demographics, with tests for both linear trend and U shape.Results Adjusted OR of fair/poor health across sleep hour categories from the single question were 4.6, 2.2, referent (8h), 1.8 and 6.9. There was high prevalence of fair/poor health for 6h for all sleep measures, but the long-sleep effect was absent for sleep logs and actigraphy measures.Conclusions Associations between long sleep and poor health may be specific to studies measuring sleep with survey questions. As cohorts with actigraphy mature, our understanding of how sleep affects health may change.