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

描述（由申请人提供）：由于婴儿潮一代的老龄化、戏剧性的经济变化以及影响退休福利的多部门政策变化等因素的融合，退休对美国老龄化人口来说是一种高度的不安全感。与此同时，普遍存在的睡眠问题和障碍——最严重的公共卫生后果是睡眠呼吸障碍、失眠和自愿减少睡眠——可能是一系列健康后果的基础，包括心血管疾病、代谢失调、认知能力下降、抑郁、白天功能不佳，最终导致死亡。然而，很少有人调查退休是睡眠质量或睡眠障碍的保护因素、原因或后果。在拟议的研究“REST研究：退休和睡眠的纵向、双向检查”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），以及退休后睡眠如何变化（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调节作用（目标3）。为了实现我们的目标，我们将把REST研究纳入正在进行的威斯康星睡眠队列研究抽样框架和威斯康星睡眠队列（WSC）研究中。WSC的研究对象提供了一个独特而宝贵的背景，因为：1)WSC提供了20年的纵向实验室睡眠研究，以表征退休前和退休后的睡眠行为和问题轨迹；2) 45-82岁社区居民的退休和在职人数大致相当；3)大约一半的在职WSC参与者预计将在REST研究期间退休。因此，现在是调查现有人群的理想时机，这些人群的睡眠习惯和问题在20年的中年时期经历了退休高峰过渡时期。WSC的研究已经确定了睡眠呼吸障碍和其他疾病的高患病率，以及它们的相关性和结果。然而，WSC没有足够频繁地收集数据来直接监测退休前后的变化，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WSC的成员，以及WSC抽样框架中曾经在1988年、1994年和2000年提供过关于睡眠习惯和问题的调查数据的人员。总共有2838名参与者（预期最终答复，N=2221）的目标样本将进行五次年度调查。这些REST调查将询问有关就业、睡眠特征、社会人口统计学、幸福感、社会环境、健康行为以及主要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为实现我们的具体目标提供细节和力量，填补关于睡眠和退休关系的知识空白。

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.