Heightened sleep propensity: a novel and high-risk sleep health phenotype in older adults

MrOS and SOF Research Groups

Research output: Contribution to journalArticle

Abstract

Objectives: To reveal sleep health phenotypes in older adults and examine their associations with time to 5-year all-cause and cardiovascular mortality. Design: Prospective longitudinal cohorts. Setting: The Study of Osteoporotic Fractures and Outcomes of Sleep Disorders in Older Men Study. Participants: N = 1722 men and women aged ≥65 years matched 1:1 on sociodemographic and clinical measures. Measurements: Self-reported habitual sleep health characteristics (satisfaction, daytime sleepiness, timing, efficiency, and duration) measured at an initial visit and longitudinal follow-up for mortality. Results: Latent class analysis revealed 3 sleep health phenotypes: (1) heightened sleep propensity (HSP; medium to long duration, high sleepiness, high efficiency/satisfaction; n = 322), (2) average sleep (AS; medium duration, average efficiency, high satisfaction, low sleepiness; n = 1,109), and (3) insomnia with short sleep (ISS; short to medium duration, low efficiency/satisfaction, moderate sleepiness; n = 291). Phenotype predicted time to all-cause mortality (χ2 = 9.4, P =.01), with HSP conferring greater risk than AS (hazard ratio [95% confidence interval] = 1.48 [1.15-1.92]) or ISS (1.52 [1.07-2.17]), despite ISS reporting the poorest mental and physical health. Although sex did not formally moderate the relationship between phenotype and mortality, subgroup analyses indicated that these findings were driven primarily by women. Phenotype did not predict cardiovascular mortality. Conclusions: These analyses support the utility of examining multidimensional sleep health profiles by suggesting that the combination of long sleep, high efficiency/satisfaction, and daytime sleepiness—previously identified as independent risk factors—may be components of a single high-risk sleep phenotype, HSP. Further investigation of sex differences and the mechanisms underlying mortality risk associated with HSP is warranted.

Original languageEnglish (US)
Pages (from-to)630-638
Number of pages9
JournalSleep Health
Volume5
Issue number6
DOIs
StatePublished - Dec 2019

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Sleep
Phenotype
Health
Mortality
Osteoporotic Fractures
Sleep Initiation and Maintenance Disorders
Sex Characteristics
Mental Health
Confidence Intervals

Keywords

  • Aging
  • Latent class analysis
  • Mortality
  • Sleep health
  • Sleep propensity

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Heightened sleep propensity : a novel and high-risk sleep health phenotype in older adults. / MrOS and SOF Research Groups.

In: Sleep Health, Vol. 5, No. 6, 12.2019, p. 630-638.

Research output: Contribution to journalArticle

MrOS and SOF Research Groups. / Heightened sleep propensity : a novel and high-risk sleep health phenotype in older adults. In: Sleep Health. 2019 ; Vol. 5, No. 6. pp. 630-638.
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abstract = "Objectives: To reveal sleep health phenotypes in older adults and examine their associations with time to 5-year all-cause and cardiovascular mortality. Design: Prospective longitudinal cohorts. Setting: The Study of Osteoporotic Fractures and Outcomes of Sleep Disorders in Older Men Study. Participants: N = 1722 men and women aged ≥65 years matched 1:1 on sociodemographic and clinical measures. Measurements: Self-reported habitual sleep health characteristics (satisfaction, daytime sleepiness, timing, efficiency, and duration) measured at an initial visit and longitudinal follow-up for mortality. Results: Latent class analysis revealed 3 sleep health phenotypes: (1) heightened sleep propensity (HSP; medium to long duration, high sleepiness, high efficiency/satisfaction; n = 322), (2) average sleep (AS; medium duration, average efficiency, high satisfaction, low sleepiness; n = 1,109), and (3) insomnia with short sleep (ISS; short to medium duration, low efficiency/satisfaction, moderate sleepiness; n = 291). Phenotype predicted time to all-cause mortality (χ2 = 9.4, P =.01), with HSP conferring greater risk than AS (hazard ratio [95{\%} confidence interval] = 1.48 [1.15-1.92]) or ISS (1.52 [1.07-2.17]), despite ISS reporting the poorest mental and physical health. Although sex did not formally moderate the relationship between phenotype and mortality, subgroup analyses indicated that these findings were driven primarily by women. Phenotype did not predict cardiovascular mortality. Conclusions: These analyses support the utility of examining multidimensional sleep health profiles by suggesting that the combination of long sleep, high efficiency/satisfaction, and daytime sleepiness—previously identified as independent risk factors—may be components of a single high-risk sleep phenotype, HSP. Further investigation of sex differences and the mechanisms underlying mortality risk associated with HSP is warranted.",
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T2 - a novel and high-risk sleep health phenotype in older adults

AU - MrOS and SOF Research Groups

AU - Wallace, M. L.

AU - Lee, S.

AU - Hall, M. H.

AU - Stone, K. L.

AU - Langsetmo, L.

AU - Redline, S.

AU - Schousboe, J. T.

AU - Ensrud, K.

AU - LeBlanc, E. S.

AU - Buysse, D. J.

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AB - Objectives: To reveal sleep health phenotypes in older adults and examine their associations with time to 5-year all-cause and cardiovascular mortality. Design: Prospective longitudinal cohorts. Setting: The Study of Osteoporotic Fractures and Outcomes of Sleep Disorders in Older Men Study. Participants: N = 1722 men and women aged ≥65 years matched 1:1 on sociodemographic and clinical measures. Measurements: Self-reported habitual sleep health characteristics (satisfaction, daytime sleepiness, timing, efficiency, and duration) measured at an initial visit and longitudinal follow-up for mortality. Results: Latent class analysis revealed 3 sleep health phenotypes: (1) heightened sleep propensity (HSP; medium to long duration, high sleepiness, high efficiency/satisfaction; n = 322), (2) average sleep (AS; medium duration, average efficiency, high satisfaction, low sleepiness; n = 1,109), and (3) insomnia with short sleep (ISS; short to medium duration, low efficiency/satisfaction, moderate sleepiness; n = 291). Phenotype predicted time to all-cause mortality (χ2 = 9.4, P =.01), with HSP conferring greater risk than AS (hazard ratio [95% confidence interval] = 1.48 [1.15-1.92]) or ISS (1.52 [1.07-2.17]), despite ISS reporting the poorest mental and physical health. Although sex did not formally moderate the relationship between phenotype and mortality, subgroup analyses indicated that these findings were driven primarily by women. Phenotype did not predict cardiovascular mortality. Conclusions: These analyses support the utility of examining multidimensional sleep health profiles by suggesting that the combination of long sleep, high efficiency/satisfaction, and daytime sleepiness—previously identified as independent risk factors—may be components of a single high-risk sleep phenotype, HSP. Further investigation of sex differences and the mechanisms underlying mortality risk associated with HSP is warranted.

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KW - Latent class analysis

KW - Mortality

KW - Sleep health

KW - Sleep propensity

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