Outcomes of Sleep Disorders in Older Men-Birmingham

描述(由申请人提供)： 据估计，在65岁及以上的成年人中，超过50%的人报告说有一些睡眠障碍，而大约20%的人患有慢性失眠。阻塞性睡眠呼吸暂停是白天嗜睡的一个主要原因，根据所用的定义和正在研究的特定人群，估计有20%-60%的老年人会发生阻塞性睡眠呼吸暂停。尽管睡眠障碍在老年人中的患病率很高，但关注其后果的研究相对较少。大多数研究都受到横断面设计、样本量小或缺乏对睡眠的全面和客观评估的限制。这项名为《老年男性睡眠障碍的结果》的拟议研究将利用为男性骨质疏松性骨折(MROS)研究(5U01AR045647-DR)招募的已建立的队列。埃里克·奥沃尔，PI)。MROS是一项为期7年的研究，始于1999年7月，是一项对大约6000名65岁及以上男性进行的多中心前瞻性研究。在MRO基线访问期间，收集了各种测量，包括身体成分和身体脂肪分布(通过DEXA和定量计算机断层扫描)、骨密度、人体测量、基于性能的力量和平衡测试、病史、用药情况、吸烟和饮酒以及其他参数。血液、尿液和DNA样本已被存档，以供未来对老年男性健康重要的研究使用。在3000名MROS参与者的子队列中，我们建议在MROS队列研究中已经实施或计划的广泛措施的基础上，增加使用家庭多导睡眠图、腕部动作图、问卷和其他测量方法对睡眠进行全面和准确的评估；以及对心血管事件的前瞻性判断。这些新措施将使我们能够检验几个重要的假设：1)表征睡眠障碍与随后3.5年随访的心血管事件之间的关系，2)确定睡眠障碍是否与老年男性总死亡率和原因死亡率的增加相关，3)测试睡眠障碍是否与摔倒和身体功能下降的风险增加相关，4)测试睡眠障碍是否与老年男性的认知功能受损有关，以及5)测试睡眠障碍是否与老年男性的骨密度和骨折风险相关。我们还将补充MRO样本库，以便对未来关于睡眠在年龄相关疾病和状况发展中的作用的假设进行测试。

DESCRIPTION (provided by applicant): It is estimated that over 50% of adults aged 65 and older report some sleep disruption, while about 20% suffer from chronic insomnia. Obstructive sleep apnea, a major cause of daytime drowsiness, occurs in an estimated 20-60% of older people, depending on the definition used and the specific population being studied. Despite the high prevalence of sleep disorders in the elderly, there have been relatively few studies focused on the consequences. Most studies have been limited by cross-sectional design, small sample size, or lack of comprehensive and objective assessment of sleep. The proposed study, Outcomes of Sleep Disorders in Older Men, will take advantage of the established cohort that has been recruited for the Osteoporotic Fractures in Men (MrOS) study (5U01AR045647-Dr. Eric Orwoll, PI). MrOS, a 7-year study that began in July 1999, is a multi-center prospective study of approximately 6000 men aged 65 and older. During the MrOS baseline visit, a broad variety of measurements were collected, including body composition and body fat distribution (by DEXA and quantitative computed tomography), bone density, anthropometry, performance-based tests of strength and balance, medical history, medication use, smoking and alcohol use, and other parameters. Blood, urine, and DNA specimens have been archived for use in future studies of importance to the health of older men. In a subcohort of 3000 MrOS participants, we propose to add comprehensive and accurate assessments of sleep using in-home polysomnography, wrist actigraphy, questionnaires and other measures; and prospective adjudication of CVD events, to the extensive measures that have already been performed or planned in the MrOS cohort study. These new measures will enable us to test several important hypotheses: 1) to characterize the associations between sleep disruption and subsequent CVD events during 3.5 years of follow-up, 2) to determine if sleep disturbances are associated with an increased risk of total and cause-specific mortality in older men, 3) to test whether sleep disturbances are associated with increased risk of falls and decreased physical function, 4) to test whether sleep disturbances are associated with impaired cognitive function in older men, and 5) to test whether sleep disorders are associated with bone density and fracture risk in older men. We will also supplement the bank of MrOS specimens to allow for testing of future hypotheses concerning the role of sleep in the development of age-related diseases and conditions.