Behavioral correlates of sleep-disordered breathing in older men.
OBJECTIVE
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.


METHODS
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.


METHODS
Community-based sample in home and research clinic settings.


METHODS
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.


METHODS
N/A.


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.
Kezirian
Eric J
EJ
Department of Otolaryngology--Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA. ekezirian@ohns.ucsf.edu
Harrison
Stephanie L
SL
Ancoli-Israel
Sonia
S
Redline
Susan
S
Ensrud
Kristine
K
Goldberg
Andrew N
AN
Claman
David M
DM
Spira
Adam P
AP
Stone
Katie L
KL
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D008297:Male; D017286:Polysomnography; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D020182:Sleep Apnea, Central / Q000175:diagnosis* / Q000523:psychology; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000523:psychology; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis* / Q000523:psychology; D012894:Sleep Stages; D014851:Wakefulness