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VOLUME 32, ISSUE 02

BEHAVIORAL CORRELATES OF SDB IN OLDER MEN
Behavioral Correlates of Sleep-Disordered Breathing in Older Men

Eric J. Kezirian, MD, MPH1; Stephanie L. Harrison, MPH2; Sonia Ancoli-Israel, PhD3; Susan Redline, MD, MPH4; Kristine Ensrud, MD, MPH5; Andrew N. Goldberg, MD, MSCE1; David M. Claman, MD6; Adam P. Spira, PhD7; Katie L. Stone, PhD8; for the Study of Osteoporotic Fractures in Men (MrOS) Research Group

1Department of Otolaryngology—Head and Neck Surgery, University of California, San Francisco, San Francisco, California; 2California Pacific Medical Center Research Institute, San Francisco, California; 3Department of Psychiatry, University of California, San Diego, San Diego, California; 4Department of Medicine and Center for Clinical Investigation, Case Western Reserve University, Cleveland, Ohio; 5Departments of Medicine and Epidemiology & Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, and Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota; 6Department of Medicine, University of California, San Francisco, San Francisco, California; 7Division of Geriatric and Department of Psychiatry University of California, San Francisco, San Francisco, California; 8California Pacific Medical Center Research Institute, San Francisco, California



 
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Study Objectives: To examine the association between sleep-disordered breathing (SDB) and subjective measures of daytime sleepiness, sleep quality, and sleep-related quality of life in a large cohort of community-dwelling older men and to determine whether any association remained after adjustment for sleep duration.
Design: Cross-sectional. The functional outcome measures of interest were daytime sleepiness (Epworth Sleepiness Scale, ESS), sleep-related symptoms (Pittsburgh Sleep Quality Index, PSQI), and sleep-related quality of life (Functional Outcomes of Sleep Questionnaire, FOSQ). Analysis of variance and adjusted regression analyses examined the association between these outcome measures and SDB severity and actigraphy-determined total sleep time (TST). We then explored whether associations with SDB were confounded by sleep duration by adjusting models for TST.
Setting: Community-based sample in home and research clinic settings.
Participants: Two-thousand eight-hundred forty-nine older men from the multicenter Osteoporotic Fractures in Men Study that began in 2000. All participants underwent in-home polysomnography for 1 night and wrist actigraphy for a minimum of 5 consecutive nights.
Interventions: N/A.
Measurements and Results: Participants were aged 76.4 ± 5.5 years and had an apnea-hypopnea index (AHI) of 17.0 ± 15.0. AHI and TST were weakly correlated. ESS scores individually were modestly associated with AHI and TST, but the association with AHI was attenuated by adjustment for TST. PSQI and FOSQ scores were largely not associated with measures of SDB severity but were modestly associated with TST.
Conclusions: Daytime sleepiness, nighttime sleep disturbances, and sleep-related quality of life were modestly associated with TST. After adjustment for TST, there was no independent association with SDB severity. These results underscore the potential differences in SDB functional outcomes in older versus young and middle-aged adults.
Keywords: sleep-disordered breathing, obstructive sleep apnea, older adults, sleepiness, quality of life
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