Longtitudinal Changes in Sleep Structure: Implications for Health Outcomes

描述（由申请人提供）：随着年龄的增长，睡眠-觉醒行为会发生一些变化，包括夜间睡眠中断和白天睡眠倾向的增加。年龄还与许多影响睡眠质量的医学疾病有关。基于人群的数据显示，睡眠呼吸障碍（SDB）是一种以睡眠结构深刻改变为特征的慢性疾病，在中老年人中也很常见。尽管睡眠生物学一直是一个研究热点，但年龄与年龄相关疾病对睡眠结构的不同影响尚未得到充分解决。本应用程序的总体目标是描述年龄和SDB对睡眠结构的不同影响，并确定睡眠结构的改变是否预测心血管和非心血管终点，特别是白天嗜睡和生活质量，贯穿整个成人寿命。本文提出了一种新的分析方法，利用不同学科的专业知识来分析睡眠期间收集的脑电图数据，以：(1)表征年龄和SDB对睡眠结构的独立影响；(2)确定睡眠结构在心血管和非心血管结局因果通路中作为假定中介的作用。目前的应用程序将利用睡眠心脏健康研究收集的数据，这是一项关于SDB心血管后果的多中心纵向研究。调查团队跨越多个学科，包括流行病学，生物统计学，睡眠医学和工程科学，带来必要的专业知识来研究健康老龄化和年龄相关疾病的睡眠结构轨迹。这项应用的意义在于，它将通过更好地理解睡眠在增加与年龄相关的脆弱性方面的机制作用，从而做出有价值的贡献，这些脆弱性会影响到总体健康。我们还将了解心血管和肺部疾病等其他疾病对睡眠的影响程度。虽然基本的“机制”联系不能直接解决，但与睡眠的哪些方面（例如，脑电图活动，反复的睡眠阶段转换）有关的问题最能区分临床结果。最后，我们还希望提供新的和急需的信息，如性别和种族等因素如何影响睡眠，并量化饮酒、吸烟和咖啡因摄入等行为对睡眠的不良影响。

DESCRIPTION (provided by applicant): Advancing age is accompanied by several alterations in sleep-wake behavior including nocturnal sleep disruption and an increase in daytime sleep tendency. Age is also associated with a number of medical disorders that can impact sleep quality. Population-based data show that sleep-disordered breathing (SDB), a chronic condition that is characterized by profound alterations in sleep structure, is also common in middle- aged and older adults. Although the biology of sleep has been a topic of intense research, the distinct effects of age versus age-associated illness on sleep structure have not been adequately addressed. The overall objective of this application is to delineate the distinct effects of age and SDB on sleep structure and determine whether the alterations in sleep structure predict cardiovascular and non-cardiovascular endpoints, specifically daytime sleepiness and quality of life, across the adult life span. Novel analytical methods that draw upon the expertise of various scientific disciplines are proposed to analyze the electroencephalographic data collected during sleep to: (1) characterize the independent effects of age and SDB on sleep structure; and (2) determine the role of sleep structure as a putative intermediate in the causal pathway toward cardiovascular and non-cardiovascular outcomes. The current application will utilize data collected by the Sleep Heart Health Study, a multi-center longitudinal study on the cardiovascular consequences of SDB. The investigative team, which spans multiple disciplines including epidemiology, biostatistics, sleep medicine, and the engineering sciences, brings the necessary expertise to examine trajectories of sleep structure with healthy aging and age-associated illnesses. The significance of this application is that it will make a valuable contribution by providing a better understanding of the mechanistic role of sleep in increasing the age-related vulnerability to various conditions that impact general health. Insight will also be gained into the degree to which other conditions such as cardiovascular and pulmonary disease impact sleep. Although basic 'mechanistic' links cannot be directly addressed, questions related to which aspects of sleep (e.g., EEC activity, recurrent sleep-stage shift) best discriminate clinical outcomes. Finally, we expect to also provide new and much needed information on how factors such as gender and race influence sleep and quantify the adverse sleep-related effects of behaviors such alcohol use, cigarette smoking, and caffeine consumption.