Evaluating Sleep Deficiency in Older Persons

评估老年人的睡眠不足

基本信息

批准号：
10468234
负责人：
BRIENNE MINER
金额：
$ 16.75万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-15 至 2024-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10468234
关键词：
Address Aging Agreement Arousal Communities Consensus Diagnosis Distress Drowsiness Elderly Electroencephalography Enrollment Etiology Evaluation Future Goals Gold Head Health Health Care Costs Home Hour Impaired cognition Institutionalization Intervention Laboratories Measurement Measures Mental Depression Methods Monitor Nature Outcome Patient Self-Report Pattern Persons Polysomnography Population REM Sleep Reference Standards Research Rest Risk Risk Factors Risk Reduction Sleep Sleep Apnea Syndromes Sleep Architecture Sleep Deprivation Sleep Disorders Sleep Stages Sleeplessness Symptoms Time United States National Institutes of Health Work actigraphy adverse outcome alertness associated symptom base circadian cost disability improved limb movement new technology non rapid eye movement novel physically handicapped poor sleep prevent sleep abnormalities sleep health sleep pattern sleep quality therapeutic evaluation therapeutic target

项目摘要

PROJECT SUMMARY Sleep complaints occur in nearly half of older persons and are associated with cognitive decline, disability, and many other adverse outcomes. Accurate and feasible evaluation is needed to identify persons at risk for these adverse outcomes. However, the traditional approach to evaluating sleep complaints in older persons is limited for several reasons. First, because the underlying etiology is likely to be multifactorial in older persons, a comprehensive strategy that considers the multiple domains contributing to sleep complaints is needed. Second, reliance on self-report alone may miss severe sleep problems or specific sleep disorders in older persons. Third, polysomnography is the gold standard for evaluation of sleep apnea and sleep architecture (i.e., arousals from sleep and deeper, more restorative sleep stages), but it is costly, burdensome, and may not be feasible or reflect habitual sleep patterns. To address these limitations, we propose to evaluate sleep deficiency, a comprehensive construct aimed at identifying factors contributing to sleep complaints in three domains: 1) poor sleep quality, including sleep disorders; 2) insufficient sleep duration; and 3) non-circadian sleep (abnormalities of sleep timing, sleep regularity, and daytime alertness). Novel, home-based measures from sleep headbands and actigraphy will objectively evaluate sleep architecture and duration, detect sleep apnea, and assess non- circadian sleep. Measures of sleep quality, duration, and non-circadian sleep from the headbands and actigraphy can be performed over multiple nights in the home. They may be more feasible than laboratory- based measures and more reliable than self-reported measures. We will enroll 50 community dwelling persons 65 years with sleep complaints (insomnia or daytime sleepiness) to undergo evaluation of sleep deficiency using validated self-reported measures, single-night home-based polysomnography, 7 nights of the headband, and 7 days and nights of actigraphy. The aims of this study are to compare self-reported versus objective measures of sleep deficiency. We hypothesize that the headband measures will have stronger concordance with polysomnography than self-report and that concordance between self-reported and actigraphy measures of non-circadian sleep will be low. Collectively, such results would suggest the need for objective measures of sleep deficiency in older persons. The proposed work will develop robust objective measures of sleep deficiency that are feasible in this vulnerable and understudied population. These measures may advance the management of sleep deficiency in future work through enhanced identification of underlying sleep problems, improved targeting and monitoring of future interventions, and reduction of the risk of adverse health outcomes.

项目摘要睡眠抱怨发生在几乎一半的老年人中，并且与认知能力下降有关，残疾和许多其他不利结果。需要准确且可行的评估来识别这些不利结果的风险。但是，评估老年睡眠投诉的传统方法由于几个原因，人们的限制是有限的。首先，因为潜在的病因可能在较旧的情况下是多因素人，一种考虑为睡眠投诉造成多个领域的多个领域的综合策略是需要。其次，仅对自我报告的缓解可能会错过严重的睡眠问题或特定的睡眠障碍老年人。第三，多肌术是评估睡眠呼吸暂停和睡眠的金标准建筑（即来自睡眠，更深，更恢复性睡眠阶段的唤醒），但它是昂贵的，朴素的，并且可能不可行或反映习惯性睡眠方式。为了解决这些限制，我们建议评估睡眠不足，这是一种全面的结构旨在确定导致三个领域睡眠投诉的因素：1）睡眠质量不佳，包括睡眠障碍； 2）睡眠时间不足； 3）非circadian睡眠（睡眠时间异常，睡眠规律性和白天警觉性）。来自睡眠头带的新颖，基于家庭的措施行动学将客观地评估睡眠结构和持续时间，检测睡眠呼吸暂停，并评估非 - 昼夜节律。从头带和可以在家里多晚进行行动摄影。它们可能比实验室更可行 - 基于措施，比自我报告的措施更可靠。我们将通过睡眠投诉（失眠或白天）注册50个社区住宅65年嗜睡）以使用经过验证的自我报告的措施，单晚进行睡眠不足进行评估基于家庭的多个术语，7晚的头带和7天和夜晚的行动学。目的这项研究是为了比较自我报告与睡眠不足的客观度量。我们假设与自我报告相比自我报告和行为摄影措施之间的一致性量将很低。共同这样的结果将表明需要客观的老年人睡眠不足测量。这拟议的工作将发展出强大的睡眠不足的客观度量，这在此脆弱的情况下是可行的并了解人口。这些措施可能会推动未来睡眠不足的管理通过增强对潜在睡眠问题的识别，改善定位和监测未来来工作干预措施和降低不良健康结果的风险。