Longtitudinal Changes in Sleep Structure: Implications for Health Outcomes

描述（由申请人提供）：年龄的增长伴随着睡眠-觉醒行为的几种变化，包括夜间睡眠中断和白天睡眠倾向的增加。年龄也与许多可能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）是一种慢性疾病，其特征在于睡眠结构的深刻改变，在中年和老年人中也很常见。虽然睡眠的生物学一直是一个深入研究的主题，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。本申请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成年人寿命期间的心血管和非心血管终点，特别是日间嗜睡和生活质量。提出了利用各种科学学科的专业知识来分析睡眠期间收集的脑电图数据的新分析方法，以：（1）表征年龄和SDB对睡眠结构的独立影响;（2）确定睡眠结构作为心血管和非心血管结局因果通路中的假定中间体的作用。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。该调查小组跨越多个学科，包括流行病学，生物统计学，睡眠医学和工程科学，带来了必要的专业知识，以检查健康老龄化和年龄相关疾病的睡眠结构轨迹。这一应用的重要性在于，它将通过更好地理解睡眠在增加与年龄相关的对影响一般健康的各种状况的脆弱性方面的机械作用，做出有价值的贡献。还将深入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“机械”联系不能直接解决，但与睡眠的哪些方面有关的问题（例如，EEC活动、反复睡眠阶段移位）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，说明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.