Excessive Daytime Sleepiness Is an Independent Risk Indicator for Cardiovascular Mortality in Community-Dwelling Elderly The Three City Study
Excessive Daytime Sleepiness Is an Independent Risk Indicator for Cardiovascular Mortality in Community-Dwelling Elderly The Three City Study
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DOI：
10.1161/strokeaha.108.530824
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发表时间：
2009-04-01
期刊：
影响因子：
8.3
通讯作者：
Ducimetiere, Pierre
中科院分区：
文献类型：
--
作者：
Empana, Jean-Philippe;Dauvilliers, Yves;Ducimetiere, Pierre
背景和目的-白天过度嗜睡是老年人最常见的睡眠主诉之一，可能会影响生存，但到目前为止，在该人群中观察到的结果不一致。因此，我们估计了参与三个城市研究的社区居住的老年人因日间过度嗜睡(EDS)而死亡的风险。方法：三个城市研究是一项基于法国人口的多中心前瞻性研究，包括9294名(60%女性)在1999年至2001年招募时年龄和年龄=65岁的受试者。在基线时，8269名受试者在接受问卷调查时将EDS和夜间睡眠主诉评为从不、罕见、有规律和频繁，并提供了治疗睡眠或焦虑的药物使用信息。结果：在基线水平，18.7%的研究参与者有规律或频繁的EDS。经过6年的随访，共有762名受试者死亡，其中260人死于癌症，196人死于心血管疾病。在调整了年龄、性别、研究中心、体重指数、既往心血管疾病、简易精神状态检查评分和心血管危险因素后，EDS与死亡风险显著增加33%(95%CI：1.13至1.61)相关。对目前睡眠和抑郁症状的药物使用进行进一步调整后，HR略有降低。在那些打鼾声很大的人和不打呼噜的人中，EDS对死亡率的预测是一样的。EDS与心血管死亡率相关，但与癌症死亡率无关。结论EDS可能与社区老年人的总死亡率和心血管死亡率独立相关。(笔划。2009年；40：1219-1224。)
Background and Purpose-Excessive daytime sleepiness, one of the most frequent sleep complaints in the elderly, may affect survival, but inconsistent results have been observed in that population so far. We therefore estimated the risk of mortality for excessive daytime sleepiness (EDS) in community-dwelling elderly participating in the Three City Study.Methods-The Three City Study is a French population-based multicenter prospective study including 9294 subjects (60% women) aged >= 65 years at recruitment between 1999 to 2001. At baseline, 8269 subjects rated EDS and nocturnal sleep complaints as never, rare, regular, and frequent in response to an administered questionnaire and provided information on medication use for sleep or anxiety. Hazard ratios (HR) of EDS (regular or frequent) for mortality over 6 years were estimated by a Cox proportional hazard model.Results-At baseline, 18.7% of the study participants had regular or frequent EDS. After 6 years of follow-up, 762 subjects had died including 260 from cancer and 196 from cardiovascular disease. EDS was associated with a significant 33% increased risk of mortality (95% CI: 1.13 to 1.61) after adjustment for age, gender, study center, body mass index, previous cardiovascular disease, Mini Mental State Examination score, and cardiovascular risk factors. Further adjustment for current use of medication for sleep and for depressive symptoms slightly diminished the HRs. EDS was equally predictive of mortality in those who snored loudly and in those who did not. EDS was related to cardiovascular mortality but not to mortality attributable to cancer.Conclusion-EDS might be independently associated with total and cardiovascular mortality in community-dwelling elderly. (Stroke. 2009;40:1219-1224.)