期刊
SLEEP
卷 36, 期 8, 页码 1187-1198出版社
OXFORD UNIV PRESS INC
DOI: 10.5665/sleep.2884
关键词
Insomnia; sleep duration; sleep pattern; older adults; use of hypnotics
Study Objectives: To simultaneously explore the associations between mortality and insomnia, sleep duration, and the use of hypnotics in older adults. Design: A fixed cohort study. Setting: A community in Shih-Pai area, Taipei, Taiwan. Participants: A total of 4,064 participants over the age of 65 completed the study. Intervention: N/A. Measurements and Results: Insomnia was classified using an exclusionary hierarchical algorithm, which categorized insomnia as no insomnia, subjective poor sleep quality, Pittsburgh Sleep Quality Index > 5 insomnia, 1-month insomnia disorder, and 6-month insomnia disorder. The main outcome variables were 9-year all-cause mortality rates. In the all-cause mortality analyses, when hypnotic use, depressive symptoms and total sleep time were excluded from a proportional hazards regression model, subjects with Pittsburgh Sleep Quality Index > 5 insomnia had a higher mortality risk (HR: 1.21, 95% CI: 1.01-1.45). In the full model, frequent hypnotic use and long sleep duration predicted higher mortality rates. However, the increased mortality risk for subjects with Pittsburgh Sleep Quality Index > 5 insomnia was not observed in the full model. On the contrary, individuals with a 6-month DSM-IV insomnia disorder had a lower risk for premature death (HR: 0.64, 95% CI: 0.43-0.96). Conclusions: Long sleep duration and frequent hypnotics use predicted an increased mortality risk within a community-dwelling sample of older adults. The association between insomnia and mortality was affected by insomnia definition and other parameters related to sleep patterns.
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