Meredith L Wallace1, Soomi Lee2, Katie L Stone3, Martica H Hall1, Stephen F Smagula1, Susan Redline4, Kristine Ensrud5,6,7, Sonia Ancoli-Israel8, Daniel J Buysse1. 1. Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA. 2. School of Aging Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA. 3. California Pacific Medical Center Research Institute, San Francisco, CA, USA. 4. Department of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. 5. Department of Medicine, University of Minnesota, Minneapolis, MN, USA. 6. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA. 7. Center for Care Delivery & Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA. 8. Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
Abstract
STUDY OBJECTIVES: To identify actigraphy sleep health profiles in older men (Osteoporotic Fractures in Men Study; N = 2640) and women (Study of Osteoporotic Fractures; N = 2430), and to determine whether profile predicts mortality. METHODS: We applied a novel and flexible clustering approach (Multiple Coalesced Generalized Hyperbolic mixture modeling) to identify sleep health profiles based on actigraphy midpoint timing, midpoint variability, sleep interval length, maintenance, and napping/inactivity. Adjusted Cox models were used to determine whether profile predicts time to all-cause mortality. RESULTS: We identified similar profiles in men and women: High Sleep Propensity [HSP] (20% of women; 39% of men; high napping and high maintenance); Adequate Sleep [AS] (74% of women; 31% of men; typical actigraphy levels); and Inadequate Sleep [IS] (6% of women; 30% of men; low maintenance and late/variable midpoint). In women, IS was associated with increased mortality risk (Hazard Ratio [HR] = 1.59 for IS vs. AS; 1.75 for IS vs. HSP). In men, AS and IS were associated with increased mortality risk (1.19 for IS vs. HSP; 1.22 for AS vs. HSP). CONCLUSIONS: These findings suggest several considerations for sleep-related interventions in older adults. Low maintenance with late/variable midpoint is associated with increased mortality risk and may constitute a specific target for sleep health interventions. High napping/inactivity co-occurs with high sleep maintenance in some older adults. Although high napping/inactivity is typically considered a risk factor for deleterious health outcomes, our findings suggest that it may not increase risk when it occurs in combination with high sleep maintenance.
STUDY OBJECTIVES: To identify actigraphy sleep health profiles in older men (Osteoporotic Fractures in Men Study; N = 2640) and women (Study of Osteoporotic Fractures; N = 2430), and to determine whether profile predicts mortality. METHODS: We applied a novel and flexible clustering approach (Multiple Coalesced Generalized Hyperbolic mixture modeling) to identify sleep health profiles based on actigraphy midpoint timing, midpoint variability, sleep interval length, maintenance, and napping/inactivity. Adjusted Cox models were used to determine whether profile predicts time to all-cause mortality. RESULTS: We identified similar profiles in men and women: High Sleep Propensity [HSP] (20% of women; 39% of men; high napping and high maintenance); Adequate Sleep [AS] (74% of women; 31% of men; typical actigraphy levels); and Inadequate Sleep [IS] (6% of women; 30% of men; low maintenance and late/variable midpoint). In women, IS was associated with increased mortality risk (Hazard Ratio [HR] = 1.59 for IS vs. AS; 1.75 for IS vs. HSP). In men, AS and IS were associated with increased mortality risk (1.19 for IS vs. HSP; 1.22 for AS vs. HSP). CONCLUSIONS: These findings suggest several considerations for sleep-related interventions in older adults. Low maintenance with late/variable midpoint is associated with increased mortality risk and may constitute a specific target for sleep health interventions. High napping/inactivity co-occurs with high sleep maintenance in some older adults. Although high napping/inactivity is typically considered a risk factor for deleterious health outcomes, our findings suggest that it may not increase risk when it occurs in combination with high sleep maintenance.
Authors: Mary E Tinetti; Gail J McAvay; Terrence E Murphy; Cary P Gross; Haiqun Lin; Heather G Allore Journal: J Am Geriatr Soc Date: 2012-06-26 Impact factor: 5.562
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Authors: Kristine E Ensrud; Terri L Blackwell; Sonia Ancoli-Israel; Susan Redline; Peggy M Cawthon; Misti L Paudel; Thuy-Tien L Dam; Katie L Stone Journal: Sleep Med Date: 2012-06-15 Impact factor: 3.492
Authors: Stephen F Smagula; Katie L Stone; Susan Redline; Sonia Ancoli-Israel; Elizabeth Barrett-Connor; Nancy E Lane; Eric S Orwoll; Jane A Cauley Journal: Psychosom Med Date: 2016 Jul-Aug Impact factor: 4.312
Authors: M L Wallace; S Lee; M H Hall; K L Stone; L Langsetmo; S Redline; J T Schousboe; K Ensrud; E S LeBlanc; D J Buysse Journal: Sleep Health Date: 2019-10-31