title: Self-Reported Sleep Disordered Breathing as Risk Factor for Mortality in the Elderly.
abstract: BACKGROUND
  This study aimed to examine the association between self-reported sleep disordered breathing (SDB) ("awaken short of breath or with a headache") and mortality in a large and ethnically diverse group of community-dwelling elderly people.
  
  
  METHODS
  A total of 1288 participants, 65 years and older, were examined longitudinally. Sleep problems were estimated using the Medical Outcomes Study Sleep Scale examining sleep disturbance, snoring, awaken short of breath or with a headache, sleep adequacy, and sleep somnolence. Cox regression analysis was used to examine the association between sleep problems and mortality. Age, gender, education, ethnicity, and body mass index were included as covariates. In further analyses we included hypertension, diabetes, heart disease, and stroke as additional covariates.
  
  
  RESULTS
  The participants were followed for up to 6 years (mean = 2.9, standard deviation = 1.1), and 239 (18.6%) participants died during the follow-up. In unadjusted models, SDB at the initial visit was associated with mortality (hazard ratio [HR] = 1.37; 95% confidence interval [CI] 1.21-1.55; P < .0001). After adjusting for all the covariates, the relationship between SDB and mortality remained significant (HR = 1.48; 95% CI 1.29-1.70; P < .0001). Participants with Caribbean-Hispanic ancestry have higher risk for mortality.
  
  
  CONCLUSIONS
  Our results suggest that SDB is a risk factor for mortality in a large and ethnically diverse group of older adults, independent of demographic and clinical factors. Further research is needed to examine the underlying mechanisms of this association.
authors.affiliation: Cognitive Neuroscience Division, Department of Neurology and The Taub Institute for Research on Alzheimer's disease and the Aging Brain, Columbia University College of Physicians and Surgeons, New York, New York; National and Kapodistrian University of Athens Medical School, Athens, Greece. Electronic address: at2859@cumc.columbia.edu.
authors.forename: Angeliki
authors.initials: A
authors.lastname: Tsapanou
authors.affiliation: Cognitive Neuroscience Division, Department of Neurology and The Taub Institute for Research on Alzheimer's disease and the Aging Brain, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: Yian
authors.initials: Y
authors.lastname: Gu
authors.affiliation: Cognitive Neuroscience Division, Department of Neurology and The Taub Institute for Research on Alzheimer's disease and the Aging Brain, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: Deirdre
authors.initials: D
authors.lastname: O'Shea
authors.affiliation: The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York; The Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Manly
authors.affiliation: Cognitive Neuroscience Division, Department of Neurology and The Taub Institute for Research on Alzheimer's disease and the Aging Brain, Columbia University College of Physicians and Surgeons, New York, New York; The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York; The Division of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, New York.
authors.forename: Nicole
authors.initials: N
authors.lastname: Schupf
authors.affiliation: Cognitive Neuroscience Division, Department of Neurology and The Taub Institute for Research on Alzheimer's disease and the Aging Brain, Columbia University College of Physicians and Surgeons, New York, New York; National and Kapodistrian University of Athens Medical School, Athens, Greece; The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York; The Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Scarmeas
authors.affiliation: Cognitive Neuroscience Division, Department of Neurology and The Taub Institute for Research on Alzheimer's disease and the Aging Brain, Columbia University College of Physicians and Surgeons, New York, New York; The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York; The Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York.
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Stern
mesh_terms: D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017691:Caribbean Region / Q000208:ethnology; D016009:Chi-Square Distribution; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000503:physiopathology*; D008297:Male; D009519:New York City / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D012119:Respiration; D018570:Risk Assessment; D012307:Risk Factors; D057566:Self Report; D012890:Sleep; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality* / Q000503:physiopathology; D013997:Time Factors; D044465:White People
keywords: Sleep disordered breathing; elderly; longitudinal study; mortality; self-reported sleep problems