Sleep Alterations in Non-demented Older Individuals: The Role of Cortisol
Sleep Alterations in Non-demented Older Individuals: The Role of Cortisol
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DOI：
10.2174/1871530316666161130155003
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发表时间：
2016-01-01
影响因子：
1.9
通讯作者：
Cauli, Omar
中科院分区：
文献类型：
--
作者：
Belen Castello-Domenech, Ana;Ibanez del Valle, Vanessa;Cauli, Omar
背景：睡眠改变会损害生活质量并导致疾病进展，但很少在机构化老年人中分析睡眠改变及其特征和影响因素。在这项研究中，我们调查了住院个体的睡眠改变、相关因素以及皮质醇在睡眠相关问题中的作用。方法：我们对居住在巴伦西亚（西班牙）疗养院的参与者进行了一项描述性横断面研究；睡眠改变是根据两种经过验证的工具确定的：雅典失眠量表和奥维耶多睡眠问卷。早上测量血浆皮质醇，并通过高效液相色谱-质谱法以及其他血液分析参数进行测定。我们还分析了任何混杂因素（睡眠持续时间、早晨醒来时间、安眠药和精神药物的摄入量以及认知功能）。结果：平均年龄为 82.5 岁（范围：65-99）；大约 80% 是女性，25-60% 的人口存在睡眠改变，具体取决于所使用的量表或所考虑的睡眠障碍类型。早晨皮质醇浓度与睡眠障碍、性别、年龄或精神药物摄入（包括安眠药）之间没有显着相关性。然而，皮质醇和用于评估失眠相关不良事件的奥维耶多问卷子量表之间存在显着相关性，在调整多种潜在混杂因素后，这种相关性仍然显着。结论：睡眠障碍在收容机构的老年人中很常见，与睡眠持续时间无关，也不会因摄入催眠药物而减少。早晨血液中的皮质醇水平与失眠相关的睡眠障碍（例如觉醒打鼾、噩梦、不宁腿综合征等）之间存在显着关系，但与失眠或嗜睡没有直接关系。
Background: Sleep alterations can impair quality of life and contribute to disease progression but they, and their features and contributing factors, are rarely analysed in institutionalised older individuals. In this study, we investigated sleep alterations, the factors involved, and the role of cortisol in sleep-related problems in institutionalised individuals.Methods: We conducted a descriptive cross-sectional study in participants living in nursing homes in Valencia (Spain); sleep alterations were determined based on two validated tools: the Athens insomnia scale and Oviedo sleep questionnaire. Plasma cortisol was measured in the morning and determined by high performance liquid chromatography-mass spectroscopy, along with other blood analytical parameters. We also analysed any confounding factors (sleep duration, morning awakening time, intake of hypnotic and psychotropic medication, and cognitive function).Results: The mean age was 82.5 years (range: 65-99); approximately 80% were women and sleep alterations were present in 25-60% of the population, depending on the scale used or type of sleep disorder considered. There was no significant correlation between morning cortisol concentrations and sleep disorders, sex, age, or psychotropic drug ingestion (including hypnotic drugs). However, there was a significant correlation between cortisol and an Oviedo questionnaire subscale for evaluating insomnia-related adverse events, which remained significant after adjusting for multiple potentially confounding factors.Conclusion: Sleep disorders are common in institutionalised older individuals and are not related to sleep duration or decreased by ingestion of hypnotic medications. There is a significant relationship between morning cortisol levels in blood and insomnia-related sleep disorders (e.g. snoring with awakenings, nightmares, restless legs syndrome, etc.) but not directly with insomnia or hypersomnia.