The REST Study: A Longitudinal, Bidirectional Examination of Retirement And Sleep

描述(申请人提供：由于婴儿潮一代的老龄化、巨大的经济变化和影响退休福利的多部门政策变化等因素的汇聚，退休对日益老龄化的美国人口构成了高度的不安全感。与此同时，睡眠问题和疾病的高度流行--其中最严重的公共健康问题是睡眠呼吸障碍、失眠和自愿减少睡眠--很可能是一系列健康后果的基础，包括心血管疾病、代谢失调、认知减退、抑郁症、日间功能不良，最终导致死亡。然而，很少将退休作为睡眠质量或睡眠障碍的保护性因素、原因或后果进行调查。在这项名为《休息研究：对退休和睡眠的纵向、双向研究》的研究中，我们的目标是前瞻性地调查睡眠障碍是否是退休的预测因素(具体目标1)，以及退休后睡眠变化(无论是好是坏)(目标2)。我们还试图了解社会资源在两个方向上的缓和影响(目标3)。为了实现我们的目标，我们将在威斯康星州睡眠队列研究抽样框架和威斯康星州睡眠队列(WSC)研究的正在进行的检查中嵌套REST研究。WSC研究的对象提供了一个独特而宝贵的背景，因为：1)WSC提供了20年的实验室内纵向睡眠研究，用来描述退休前和退休后的睡眠行为和问题的轨迹；2)WSC的退休和受雇45-82岁社区成年人的人数大致相同；以及，3)目前受雇的WSC参与者中，约有一半预计将在拟议的休息研究期间退休。因此，现在是调查现有人口的理想时机，这些人口在20年的中年高峰期退休过渡期间表现出睡眠习惯和问题的特征。WSC的研究已经确定了睡眠呼吸障碍和其他障碍的高患病率，以及它们的相关性和结果。然而，WSC收集数据的频率不够高，无法直接监测退休前和退休后的变化，也没有收集关于就业特征的足够具体的信息。拟议的REST研究将招募正在进行的自来水委员会成员，以及自来水公司抽样框架中曾在1988年、1994年和2000年提供有关睡眠习惯和问题的调查数据的人员。总共2838名参与者的目标样本(预期最终答复，N=2221)将进行五次年度调查。这些REST调查将询问关于就业、睡眠特征、社会人口统计学、幸福感、社会环境、健康行为以及重大健康和其他生活事件的详细问题。结合WSC的数据，我们的数据收集工作将提供细节和力量，以满足我们的特定目标，填补关于睡眠和退休关系的广泛知识空白。 公共健康相关性：这项名为“REST研究：对退休和睡眠的纵向双向检查”的应用程序的研究结果，是正在进行的威斯康星州睡眠队列(WSC)研究抽样框架的子研究，将有助于提供关于睡眠和退休之间双向关系的公共健康意义所需的新知识。这些发现将确定睡眠障碍和睡眠质量如何影响退休年龄，以及退休如何促进睡眠行为和睡眠障碍的变化，从而改变身心健康和功能结果。他们还将向临床决策提供退休前和退休后睡眠障碍患者的治疗和行为建议。

DESCRIPTION (provided by applicant: Due to a convergence of factors including the aging of the baby-boomer generation, dramatic economic shifts, and multi-sectorial policy changes influencing retirement benefits, retirement presents heightened insecurity for the aging US population. Concurrently, the high prevalence of sleep problems and disorders -- the most public health-consequential of which are sleep disordered breathing, insomnia, and voluntary sleep curtailment -- is likely to underlie a wide range of health outcomes including cardiovascular disease, metabolic dysregulation, cognitive decrements, depression, poor daytime functioning, and, ultimately, mortality. However, retirement is rarely investigated as a protective factor, cause or consequence of sleep quality or disorders. With the proposed study, "The REST study: A longitudinal, bidirectional examination of retirement and sleep," we aim to prospectively investigate whether sleep disorders are a predictor of retirement (Specific Aim 1) and how sleep changes (for better or worse) as a result of retirement (Aim 2). We also seek to understand the moderating influences of social resources in both directions (Aim 3). To accomplish our aims we will nest the REST study within the ongoing examinations of the Wisconsin Sleep Cohort Study sampling frame and the Wisconsin Sleep Cohort (WSC) study. The subjects of the WSC study provide a unique and invaluable context because: 1) the WSC provides >20 years of longitudinal in- laboratory sleep studies with which to characterize pre- and post-retirement trajectories of sleep behaviors and problems; 2) the WSC has roughly equal numbers of retired and employed 45-82 year-old community-dwelling adults; and, 3) about half of currently employed WSC participants are expected to retire in the proposed REST study period. Thus, now is the ideal time to investigate the only existing population that has been characterized for sleep habits and problems over two decades of mid-life through a period of peak retirement transition. The WSC study has established a high prevalence of sleep-disordered breathing and other disorders, as well as their correlates and outcomes. However, the WSC does not collect data frequently enough to monitor changes directly before and after retirement, nor does it collect sufficiently specific information on employment characteristics. The proposed REST study will recruit members of the ongoing WSC as well as persons from the WSC sampling frame who have previously provided survey data regarding sleep habits and problems in 1988, 1994 and 2000. A total target sample of 2838 participants (expected final response, N=2221) will be administered five annual surveys. These REST surveys will ask detailed questions about employment, sleep characteristics, socio-demographics, well-being, social environment, health behaviors, and major health and other life events. Combined with the data from the WSC, our data collection effort will provide detail and power to address our specific aims, filling a wide gap in knowledge regarding the relation of sleep and retirement. PUBLIC HEALTH RELEVANCE: The findings from the application, "The REST study: A longitudinal, bidirectional examination of retirement and sleep," a substudy of the ongoing Wisconsin Sleep Cohort (WSC) study sampling frame, will contribute needed new knowledge of public health significance about the bi-directional relationship between sleep and retirement. The findings will identify how sleep disorders and sleep quality affect retirement age and how retirement contributes to changes in sleep behavior and sleep disorders, and, consequently, to changes in physical and mental health and functional outcomes. They will also inform clinical decision making regarding treatment and behavioral recommendations for patients with sleep disorders before and after retirement.