Outcomes of Sleep Disorders in Older Men-Birmingham

描述（由申请人提供）： 据估计，超过50%的65岁及以上的成年人报告睡眠中断，而约20%的人患有慢性失眠症。 阻塞性睡眠呼吸暂停，白天嗜睡的主要原因，发生在估计20-60%的老年人，这取决于所使用的定义和正在研究的特定人群。 尽管老年人睡眠障碍的患病率很高，但关注其后果的研究相对较少。 大多数研究受到横断面设计、样本量小或缺乏对睡眠的全面客观评估的限制。 拟定的研究，老年男性睡眠障碍的结局，将利用男性骨质疏松性骨折（MrOS）研究（5 U 01 AR 045647-Dr. Eric Orwoll，PI）招募的既定队列。 MrOS是一项为期7年的研究，始于1999年7月，是一项多中心前瞻性研究，涉及约6000名65岁及以上的男性。 在MrOS基线访视期间，收集了各种各样的测量结果，包括身体成分和体脂分布（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、药物使用、吸烟和饮酒以及其他参数。 血液、尿液和DNA标本已被存档，用于未来对老年男性健康具有重要意义的研究。 在3000名MrOS参与者的子队列中，我们建议使用家庭多导睡眠描记术、腕关节活动描记术、问卷调查和其他措施对睡眠进行全面准确的评估;并对CVD事件进行前瞻性裁定，这些措施已经在MrOS队列研究中进行或计划进行。 这些新措施将使我们能够检验几个重要的假设：1）在3.5年的随访期间表征睡眠中断和随后的CVD事件之间的关联，2）确定睡眠障碍是否与老年男性的总死亡率和原因特异性死亡率的风险增加相关，3）测试睡眠障碍是否与福尔斯风险增加和身体功能降低相关，4）测试睡眠障碍是否与老年男性认知功能受损有关，5）测试睡眠障碍是否与老年男性的骨密度和骨折风险有关。 我们还将补充MrOS标本库，以测试未来关于睡眠在年龄相关疾病和病症发展中的作用的假设。

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 Blood, urine, and DNA specimens have been archived for use in future studies of importance to the health of older men.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.