Actigraphy- and polysomnography-measured sleep disturbances, inflammation, and mortality among older men

Stephen F. Smagula, Katie L. Stone, Susan Redline, Sonia Ancoli-Israel, Elizabeth Barrett-Connor, Nancy E Lane, Eric S. Orwoll, Jane A. Cauley

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objectives To evaluate whether objectively measured sleep characteristics are associated with mortality risk independent of inflammatory burden and comorbidity. Methods The Osteoporotic Fractures in Men Sleep Study (conducted in 2003-2005) included community-dwelling older men (n = 2531; average [standard deviation {SD}] age = 76.3 (5.5) years). Sleep measures from in-home polysomnography and wrist actigraphy and assessments of serum inflammatory markers levels (C-reactive protein, interleukin-6, tumor necrosis factor α, tumor necrosis factor α soluble receptor II, and interferon-γ) were obtained. Vital status was ascertained over an average (SD) follow-up of 7.4 (1.9 SD) years. Results Three of the seven main sleep measures examined were independently associated with greater inflammatory burden. Mortality risk associated with prolonged (≥10% total sleep time) blood oxygen desaturation and short (<5 hours) sleep duration was attenuated to nonsignificance after adjusting for inflammatory burden or medical burden/lifestyle factors. Severe blood oxygen desaturation (adjusted hazard ratio [aHR] = 1.57, 95% confidence interval [CI] = 1.11-2.22), sleep fragmentation (aHR = 1.32, 95% CI = 1.12-1.57), and a lower percentage of sleep in rapid eye movement (aHR per SD = 0.90, 95% CI = 0.93-0.97) were independently associated with mortality. Conclusions Short sleep duration and prolonged blood oxygen desaturation were independently associated with inflammatory burden, which attenuated associations between these sleep characteristics and mortality. Medical and life-style factors also substantially attenuated most sleep-mortality associations, suggesting complex relations between sleep, inflammation, and disease. Sleep fragmentation, severe blood oxygen desaturation, and the percentage of sleep time in rapid eye movement were independently related to mortality risk. Future studies with repeated measures of mediators/confounds will be necessary to achieve a mechanistic understanding of sleep-related mortality risk.

Original languageEnglish (US)
Pages (from-to)686-696
Number of pages11
JournalPsychosomatic Medicine
Volume78
Issue number6
DOIs
StatePublished - Jul 1 2016

Fingerprint

Actigraphy
Polysomnography
Sleep
Inflammation
Mortality
Oxygen
Sleep Deprivation
REM Sleep
Confidence Intervals
Life Style
Independent Living
Osteoporotic Fractures
Tumor Necrosis Factor Receptors
Wrist
C-Reactive Protein
Interferons

Keywords

  • actigraphy
  • aging
  • epidemiology
  • inflammation
  • mortality
  • polysomnography
  • sleep

ASJC Scopus subject areas

  • Medicine(all)
  • Developmental and Educational Psychology
  • Arts and Humanities (miscellaneous)
  • Applied Psychology
  • Psychiatry and Mental health

Cite this

Smagula, S. F., Stone, K. L., Redline, S., Ancoli-Israel, S., Barrett-Connor, E., Lane, N. E., ... Cauley, J. A. (2016). Actigraphy- and polysomnography-measured sleep disturbances, inflammation, and mortality among older men. Psychosomatic Medicine, 78(6), 686-696. https://doi.org/10.1097/PSY.0000000000000312

Actigraphy- and polysomnography-measured sleep disturbances, inflammation, and mortality among older men. / Smagula, Stephen F.; Stone, Katie L.; Redline, Susan; Ancoli-Israel, Sonia; Barrett-Connor, Elizabeth; Lane, Nancy E; Orwoll, Eric S.; Cauley, Jane A.

In: Psychosomatic Medicine, Vol. 78, No. 6, 01.07.2016, p. 686-696.

Research output: Contribution to journalArticle

Smagula, SF, Stone, KL, Redline, S, Ancoli-Israel, S, Barrett-Connor, E, Lane, NE, Orwoll, ES & Cauley, JA 2016, 'Actigraphy- and polysomnography-measured sleep disturbances, inflammation, and mortality among older men', Psychosomatic Medicine, vol. 78, no. 6, pp. 686-696. https://doi.org/10.1097/PSY.0000000000000312
Smagula, Stephen F. ; Stone, Katie L. ; Redline, Susan ; Ancoli-Israel, Sonia ; Barrett-Connor, Elizabeth ; Lane, Nancy E ; Orwoll, Eric S. ; Cauley, Jane A. / Actigraphy- and polysomnography-measured sleep disturbances, inflammation, and mortality among older men. In: Psychosomatic Medicine. 2016 ; Vol. 78, No. 6. pp. 686-696.
@article{602b6eab9577470e833bf9f095ca1857,
title = "Actigraphy- and polysomnography-measured sleep disturbances, inflammation, and mortality among older men",
abstract = "Objectives To evaluate whether objectively measured sleep characteristics are associated with mortality risk independent of inflammatory burden and comorbidity. Methods The Osteoporotic Fractures in Men Sleep Study (conducted in 2003-2005) included community-dwelling older men (n = 2531; average [standard deviation {SD}] age = 76.3 (5.5) years). Sleep measures from in-home polysomnography and wrist actigraphy and assessments of serum inflammatory markers levels (C-reactive protein, interleukin-6, tumor necrosis factor α, tumor necrosis factor α soluble receptor II, and interferon-γ) were obtained. Vital status was ascertained over an average (SD) follow-up of 7.4 (1.9 SD) years. Results Three of the seven main sleep measures examined were independently associated with greater inflammatory burden. Mortality risk associated with prolonged (≥10{\%} total sleep time) blood oxygen desaturation and short (<5 hours) sleep duration was attenuated to nonsignificance after adjusting for inflammatory burden or medical burden/lifestyle factors. Severe blood oxygen desaturation (adjusted hazard ratio [aHR] = 1.57, 95{\%} confidence interval [CI] = 1.11-2.22), sleep fragmentation (aHR = 1.32, 95{\%} CI = 1.12-1.57), and a lower percentage of sleep in rapid eye movement (aHR per SD = 0.90, 95{\%} CI = 0.93-0.97) were independently associated with mortality. Conclusions Short sleep duration and prolonged blood oxygen desaturation were independently associated with inflammatory burden, which attenuated associations between these sleep characteristics and mortality. Medical and life-style factors also substantially attenuated most sleep-mortality associations, suggesting complex relations between sleep, inflammation, and disease. Sleep fragmentation, severe blood oxygen desaturation, and the percentage of sleep time in rapid eye movement were independently related to mortality risk. Future studies with repeated measures of mediators/confounds will be necessary to achieve a mechanistic understanding of sleep-related mortality risk.",
keywords = "actigraphy, aging, epidemiology, inflammation, mortality, polysomnography, sleep",
author = "Smagula, {Stephen F.} and Stone, {Katie L.} and Susan Redline and Sonia Ancoli-Israel and Elizabeth Barrett-Connor and Lane, {Nancy E} and Orwoll, {Eric S.} and Cauley, {Jane A.}",
year = "2016",
month = "7",
day = "1",
doi = "10.1097/PSY.0000000000000312",
language = "English (US)",
volume = "78",
pages = "686--696",
journal = "Psychosomatic Medicine",
issn = "0033-3174",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Actigraphy- and polysomnography-measured sleep disturbances, inflammation, and mortality among older men

AU - Smagula, Stephen F.

AU - Stone, Katie L.

AU - Redline, Susan

AU - Ancoli-Israel, Sonia

AU - Barrett-Connor, Elizabeth

AU - Lane, Nancy E

AU - Orwoll, Eric S.

AU - Cauley, Jane A.

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Objectives To evaluate whether objectively measured sleep characteristics are associated with mortality risk independent of inflammatory burden and comorbidity. Methods The Osteoporotic Fractures in Men Sleep Study (conducted in 2003-2005) included community-dwelling older men (n = 2531; average [standard deviation {SD}] age = 76.3 (5.5) years). Sleep measures from in-home polysomnography and wrist actigraphy and assessments of serum inflammatory markers levels (C-reactive protein, interleukin-6, tumor necrosis factor α, tumor necrosis factor α soluble receptor II, and interferon-γ) were obtained. Vital status was ascertained over an average (SD) follow-up of 7.4 (1.9 SD) years. Results Three of the seven main sleep measures examined were independently associated with greater inflammatory burden. Mortality risk associated with prolonged (≥10% total sleep time) blood oxygen desaturation and short (<5 hours) sleep duration was attenuated to nonsignificance after adjusting for inflammatory burden or medical burden/lifestyle factors. Severe blood oxygen desaturation (adjusted hazard ratio [aHR] = 1.57, 95% confidence interval [CI] = 1.11-2.22), sleep fragmentation (aHR = 1.32, 95% CI = 1.12-1.57), and a lower percentage of sleep in rapid eye movement (aHR per SD = 0.90, 95% CI = 0.93-0.97) were independently associated with mortality. Conclusions Short sleep duration and prolonged blood oxygen desaturation were independently associated with inflammatory burden, which attenuated associations between these sleep characteristics and mortality. Medical and life-style factors also substantially attenuated most sleep-mortality associations, suggesting complex relations between sleep, inflammation, and disease. Sleep fragmentation, severe blood oxygen desaturation, and the percentage of sleep time in rapid eye movement were independently related to mortality risk. Future studies with repeated measures of mediators/confounds will be necessary to achieve a mechanistic understanding of sleep-related mortality risk.

AB - Objectives To evaluate whether objectively measured sleep characteristics are associated with mortality risk independent of inflammatory burden and comorbidity. Methods The Osteoporotic Fractures in Men Sleep Study (conducted in 2003-2005) included community-dwelling older men (n = 2531; average [standard deviation {SD}] age = 76.3 (5.5) years). Sleep measures from in-home polysomnography and wrist actigraphy and assessments of serum inflammatory markers levels (C-reactive protein, interleukin-6, tumor necrosis factor α, tumor necrosis factor α soluble receptor II, and interferon-γ) were obtained. Vital status was ascertained over an average (SD) follow-up of 7.4 (1.9 SD) years. Results Three of the seven main sleep measures examined were independently associated with greater inflammatory burden. Mortality risk associated with prolonged (≥10% total sleep time) blood oxygen desaturation and short (<5 hours) sleep duration was attenuated to nonsignificance after adjusting for inflammatory burden or medical burden/lifestyle factors. Severe blood oxygen desaturation (adjusted hazard ratio [aHR] = 1.57, 95% confidence interval [CI] = 1.11-2.22), sleep fragmentation (aHR = 1.32, 95% CI = 1.12-1.57), and a lower percentage of sleep in rapid eye movement (aHR per SD = 0.90, 95% CI = 0.93-0.97) were independently associated with mortality. Conclusions Short sleep duration and prolonged blood oxygen desaturation were independently associated with inflammatory burden, which attenuated associations between these sleep characteristics and mortality. Medical and life-style factors also substantially attenuated most sleep-mortality associations, suggesting complex relations between sleep, inflammation, and disease. Sleep fragmentation, severe blood oxygen desaturation, and the percentage of sleep time in rapid eye movement were independently related to mortality risk. Future studies with repeated measures of mediators/confounds will be necessary to achieve a mechanistic understanding of sleep-related mortality risk.

KW - actigraphy

KW - aging

KW - epidemiology

KW - inflammation

KW - mortality

KW - polysomnography

KW - sleep

UR - http://www.scopus.com/inward/record.url?scp=84958811333&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84958811333&partnerID=8YFLogxK

U2 - 10.1097/PSY.0000000000000312

DO - 10.1097/PSY.0000000000000312

M3 - Article

VL - 78

SP - 686

EP - 696

JO - Psychosomatic Medicine

JF - Psychosomatic Medicine

SN - 0033-3174

IS - 6

ER -