Age and Objectively Measured Sleep: Investigating Associations and Interactions by Sex and Race in Middle-Aged and Older Adults

Linchen He, Jill A Rabinowitz, Yang An, C. Jackson, Ryan Hellinger, Sarah K. Wanigatunga, J. Schrack, Luigi Ferrucci, Eleanor M Simonsick, Kirsten Koehler, A. Spira
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Abstract

Few studies of middle-aged and older adults have examined the association between age and sleep using objective sleep measures. We examined these associations in adults aged ≥40 years using wrist actigraphy, and investigated whether these associations differed by sex and race. Participants were 468 cognitively normal adults aged ≥40 years enrolled in the Baltimore Longitudinal Study of Aging who completed wrist actigraphy. We used Generalized Least Squares Models to examine the associations of age with actigraphic sleep parameters, including total sleep time (TST), sleep efficiency, sleep onset latency, and wake after sleep onset (WASO). We conducted interaction and stratification analyses to test whether cross-sectional age-sleep associations were modified by sex and race. In analyses adjusting for sex, body mass index, and individual medical conditions, older age was associated with longer TST from ages 40-70 that plateaued after age 70. Older age also was associated with lower sleep efficiency, longer sleep onset latency, and greater WASO. In men only, after age 70, older age was associated with shorter TST, lower sleep efficiency, longer onset latency, and greater WASO. However, we did not observe any significant interactions of race with age. Older age was associated with longer TST from ages 40-70 and with poorer sleep quality after age 40, and these relationships might vary by sex. Future studies with larger sample sizes are needed to investigate mechanisms that may account for sex differences in the observed age-sleep associations.
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年龄与客观测量睡眠:调查中老年人中不同性别和种族之间的关联与相互作用
很少有针对中老年人的研究使用客观睡眠测量方法来研究年龄与睡眠之间的关系。我们使用腕动计对年龄≥40 岁的成年人进行了研究,并调查了这些关联是否因性别和种族而异。 参加巴尔的摩老龄化纵向研究的 468 名年龄≥40 岁、认知正常的成年人完成了腕部动图测量。我们使用广义最小二乘法模型研究了年龄与动图睡眠参数的关系,包括总睡眠时间(TST)、睡眠效率、睡眠开始潜伏期和睡眠开始后唤醒(WASO)。我们进行了交互分析和分层分析,以检验横截面年龄与睡眠的关系是否会因性别和种族而改变。 在对性别、体重指数和个人健康状况进行调整后的分析中,年龄越大,40-70 岁期间的 TST 越长,70 岁以后趋于稳定。年龄越大,睡眠效率越低,睡眠开始潜伏期越长,WASO 越大。仅就男性而言,70 岁以后,年龄越大,TST 越短,睡眠效率越低,起始潜伏期越长,WASO 越大。但是,我们没有观察到种族与年龄之间有任何明显的相互作用。 年龄越大,40-70 岁的 TST 越长,40 岁以后的睡眠质量越差,这些关系可能因性别而异。今后需要进行样本量更大的研究,以调查可能导致观察到的年龄与睡眠关系中的性别差异的机制。
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