Evaluating Sleep Deficiency in Older Persons

评估老年人的睡眠不足

基本信息

批准号：
10468234
负责人：
BRIENNE MINER
金额：
$ 16.75万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-15 至 2024-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10468234
关键词：
Address Aging Agreement Arousal Communities Consensus Diagnosis Distress Drowsiness Elderly Electroencephalography Enrollment Etiology Evaluation Future Goals Gold Head Health Health Care Costs Home Hour Impaired cognition Institutionalization Intervention Laboratories Measurement Measures Mental Depression Methods Monitor Nature Outcome Patient Self-Report Pattern Persons Polysomnography Population REM Sleep Reference Standards Research Rest Risk Risk Factors Risk Reduction Sleep Sleep Apnea Syndromes Sleep Architecture Sleep Deprivation Sleep Disorders Sleep Stages Sleeplessness Symptoms Time United States National Institutes of Health Work actigraphy adverse outcome alertness associated symptom base circadian cost disability improved limb movement new technology non rapid eye movement novel physically handicapped poor sleep prevent sleep abnormalities sleep health sleep pattern sleep quality therapeutic evaluation therapeutic target

项目摘要

PROJECT SUMMARY Sleep complaints occur in nearly half of older persons and are associated with cognitive decline, disability, and many other adverse outcomes. Accurate and feasible evaluation is needed to identify persons at risk for these adverse outcomes. However, the traditional approach to evaluating sleep complaints in older persons is limited for several reasons. First, because the underlying etiology is likely to be multifactorial in older persons, a comprehensive strategy that considers the multiple domains contributing to sleep complaints is needed. Second, reliance on self-report alone may miss severe sleep problems or specific sleep disorders in older persons. Third, polysomnography is the gold standard for evaluation of sleep apnea and sleep architecture (i.e., arousals from sleep and deeper, more restorative sleep stages), but it is costly, burdensome, and may not be feasible or reflect habitual sleep patterns. To address these limitations, we propose to evaluate sleep deficiency, a comprehensive construct aimed at identifying factors contributing to sleep complaints in three domains: 1) poor sleep quality, including sleep disorders; 2) insufficient sleep duration; and 3) non-circadian sleep (abnormalities of sleep timing, sleep regularity, and daytime alertness). Novel, home-based measures from sleep headbands and actigraphy will objectively evaluate sleep architecture and duration, detect sleep apnea, and assess non- circadian sleep. Measures of sleep quality, duration, and non-circadian sleep from the headbands and actigraphy can be performed over multiple nights in the home. They may be more feasible than laboratory- based measures and more reliable than self-reported measures. We will enroll 50 community dwelling persons 65 years with sleep complaints (insomnia or daytime sleepiness) to undergo evaluation of sleep deficiency using validated self-reported measures, single-night home-based polysomnography, 7 nights of the headband, and 7 days and nights of actigraphy. The aims of this study are to compare self-reported versus objective measures of sleep deficiency. We hypothesize that the headband measures will have stronger concordance with polysomnography than self-report and that concordance between self-reported and actigraphy measures of non-circadian sleep will be low. Collectively, such results would suggest the need for objective measures of sleep deficiency in older persons. The proposed work will develop robust objective measures of sleep deficiency that are feasible in this vulnerable and understudied population. These measures may advance the management of sleep deficiency in future work through enhanced identification of underlying sleep problems, improved targeting and monitoring of future interventions, and reduction of the risk of adverse health outcomes.

项目概要近一半的老年人会出现睡眠问题，并且与认知能力下降有关，需要准确和可行的评估来识别人员。然而，评估老年人睡眠问题的传统方法首先，老年人的潜在病因可能是多因素的。人们，考虑到导致睡眠投诉的多个领域的综合策略是其次，仅依靠自我报告可能会漏掉严重的睡眠问题或特定的睡眠障碍。第三，多导睡眠监测是评估睡眠呼吸暂停和睡眠的金标准。架构（即从睡眠中唤醒和更深、更具恢复性的睡眠阶段），但它成本高昂、繁重，并且可能不可行或反映习惯性睡眠模式。为了解决这些局限性，我们建议评估睡眠不足，这是一个综合的构建旨在确定三个领域中导致睡眠投诉的因素：1）睡眠质量差，包括睡眠障碍；2）睡眠时间不足；3）非昼夜节律睡眠（睡眠时间异常，睡眠规律和白天警觉性）。体动记录仪将客观评估睡眠结构和持续时间，检测睡眠呼吸暂停，并评估非睡眠状态通过头带测量睡眠质量、持续时间和非昼夜节律睡眠。体动记录仪可以在家里进行多个晚上，它们可能比实验室更可行。基于的措施比自我报告的措施更可靠。我们将招募 50 名 65 岁以上有睡眠问题（失眠或白天失眠）的社区居民嗜睡）使用经过验证的自我报告措施对单晚睡眠不足进行评估家庭多导睡眠监测、7 个晚上的头带以及 7 个昼夜的体动记录仪。这项研究旨在比较睡眠不足的自我报告与客观测量。头带测量与多导睡眠图比自我报告具有更强的一致性总体而言，自我报告的非昼夜节律睡眠活动记录仪测量值之间的一致性较低。这些结果表明需要对老年人睡眠不足采取客观措施。拟议的工作将制定针对睡眠不足的强有力的客观措施，这些措施对于这一弱势群体是可行的这些措施可能会促进未来睡眠不足的管理。通过加强对潜在睡眠问题的识别、改进对未来的目标和监测来开展工作干预措施，并减少不良健康结果的风险。