PROTECTING SLEEP QUALITY IN LATER LIFE

良好的睡眠质量对老年人的持续适应能力和身心健康非常重要。然而，75岁以后，睡眠连续性和深度的丧失会加速，这预示着适应性的减弱和健康状况的下降。因此，在晚年保护睡眠质量可能对持续健康的衰老很重要。我们建议通过检验睡眠卫生教育和卧床时间限制的能力来检验这一假设：(1)减缓或扭转年龄相关性睡眠连续性和深度丧失的趋势，从而(2)促进晚年白天健康、心理和身体健康的稳定或改善。在这次修订的Ageise Project 4中，我们将招募99名275岁没有睡眠觉醒症状的老年人，随机将他们(每个单元33人)分配到三种情况之一(健康睡眠实践教育[教育]， 健康睡眠实践的教育加上卧床时间的限制[“教育”+“限制”]或只注意控制条件)，并跟踪他们30个月，在基线(T1)、6个月(T2)、18个月(T3)和30个月(T4)测量睡眠、幸福感和身心健康。我们预测，综合干预条件(“教育”加“限制”)将与保持更好的睡眠质量相关，因此，在两年半的时间里，与单纯的睡眠实践教育或只关注注意力的控制条件相比，更好的适应和健康。我们将使用随机回归分析对长期轨迹进行建模 与三种干预条件相关的健康、幸福感和功能状态的结果测量。在这些分析中，我们将根据激素替代疗法的存在/不存在以及睡眠和预期影响的知识而变化。这一预测体现了老龄计划项目的基本前提，即通过保护和提高晚年的睡眠质量来促进持续成功的衰老。该项目的全计划研究还将测试，更稳定的睡眠-醒来时间表和适度减少的卧床时间通常与更好的睡眠、心理健康、身体健康和生命最后几年的幸福感相关。

Good sleep quality is important to continued adaptability, physical and mental health in late life. After age 75, however, loss of sleep continuity and depth accelerates, presaging diminished adaptability and decrements in health status. Protecting sleep quality in late life therefore may be important to continued healthy aging. We propose to test this hypothesis by examining the ability of sleep hygiene education and restriction of time in bed: (1) to slow or reverse age-dependent loss of sleep continuity and depth and thereby (2) to promote stability or improvement in daytime wellness, mental and physical health in the later years of life. In this revision of AgeWise Project 4, we will recruit 99 elders aged 275 without sleep-wake complaints, randomly assign them (33 per cell) to one of three conditions (education in healthy sleep practices ["education"], education in healthy sleep practices plus restriction of time in bed ["education" plus "restriction"] or an attentiononly control condition) and follow them for 30 months, measuring sleep, well being, and physical and mental health at baseline (T1), six months (T2), 18 months (T3), and 30 months (T4). We predict that the combined intervention condition ("education" plus "restriction") will be associated with preservation of better sleep quality and, hence, with better adaptation and health over 2.5 years than education in sleep practices alone or an attention-only control condition. We will employ random regression analyses to model long term trajectories in outcome measures of health, well being, and functional status associated with the three intervention conditions. In these analyses we will covary for the presence/absence of hormone replacement therapy, as well as for knowledge of sleep and expectancy effects. This prediction embodies the basic premise of the AgeWise program project, namely, that continued successful aging is promoted by protecting and enhancing sleep quality in late life. Program-wide research in this project will also test that more stable sleep-wake schedules and modest reductions in time in bed will in general be associated with better sleep, mental health, physical health and well being in the final years of life.