Daytime Sleepiness Predicts Mortality and Cardiovascular Disease in Older Adults

Newman, Anne B.; Spiekerman, Charles; Enright, Paul; Lefkowitz, David; Reynolds, Charles F.; Robbins, John A.

doi:10.1111/j.1532-5415.2000.tb03901.x

Cited by 418 publications

(320 citation statements)

References 43 publications

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“…These findings are consistent with research indicating that daytime sleep restriction and engagement in daytime activity improve nighttime sleep behaviors (e.g., Alessi et al, 2005;Benloucif et al, 2004;Newman et al, 2000). Studies have furthermore shown that better sleep consolidation has a positive impact on health (Blackwell et al, 2011;Lim et al, 2013;Yaffe et al, 2011).…”

Section: Discussionsupporting

confidence: 81%

Napping and Nighttime Sleep: Findings From an Occupation-Based Intervention

Leland

Fogelberg

Sleight

et al. 2016

The American Journal of Occupational Therapy

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OBJECTIVE. To describe sleeping behaviors and trends over time among an ethnically diverse group of community-living older adults. METHOD. A descriptive secondary data analysis of a subsample (n = 217) from the Lifestyle Redesign randomized controlled trial was done to explore baseline napping and sleeping patterns as well as 6-mo changes in these outcomes. RESULTS. At baseline, the average time sleeping was 8.2 hr daily (standard deviation = 1.7). Among all participants, 29% reported daytime napping at baseline, of which 36% no longer napped at follow-up. Among participants who stopped napping, those who received an occupation-based intervention (n = 98) replaced napping time with nighttime sleep, and those not receiving an intervention (n = 119) experienced a net loss of total sleep (p < .05). CONCLUSION. Among participants who stopped napping, the occupation-based intervention may be related to enhanced sleep. More research examining the role of occupation-based interventions in improving sleep is warranted.

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Section: Discussionsupporting

confidence: 81%

Napping and Nighttime Sleep: Findings From an Occupation-Based Intervention

Leland

Fogelberg

Sleight

et al. 2016

The American Journal of Occupational Therapy

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“…Excessive daytime sleepiness (EDS) is a common symptom in patients with SDB and has been associated with an increased risk of motor vehicle accidents, occupational injuries, and the development of cerebrovascular diseases and CVD 3, 4. Moreover, longitudinal studies have shown that EDS is an independent risk factor for adverse outcomes in patients with coronary artery disease5 and predicts cardiovascular mortality 6, 7. Although continuous positive airway pressure (CPAP) is recommended for patients with moderate to severe SDB,8 evidence for its use in SDB patients with CVD but without EDS is questionable 9, 10.…”

Section: Introductionmentioning

confidence: 99%

Excessive Daytime Sleepiness Independently Predicts Increased Cardiovascular Risk After Myocardial Infarction

Xie

Kuniyoshi

Covassin

et al. 2018

JAHA

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BackgroundExcessive daytime sleepiness (EDS), a common symptom among patients with sleep‐disordered breathing, is closely associated with the development of cardiovascular diseases, but its long‐term prognostic value is not completely understood. The aim of this study was to investigate whether EDS would be an independent prognostic factor after myocardial infarction.Methods and ResultsWe prospectively recruited 112 post–myocardial infarction patients. The Epworth Sleepiness Scale was completed before polysomnography, and EDS was defined as a score ≥11. After exclusion of 8 patients who accepted treatment with continuous positive airway pressure, 104 patients were followed up for 48 months. The primary composite end point was major adverse cardiac events. Patients with EDS had higher rates of major adverse cardiac events (48.4% versus 27.4%, χ2=5.27, P=0.022) and reinfarction (29.0% versus 5.5%, χ2=13.51, P=0.0002) compared with those without EDS. In the Cox proportional hazards model, patients with EDS had 2.15 times (95% confidence interval, 1.08–4.18; P=0.030) higher crude risk of major adverse cardiac events, with prognostic significance persisting after adjusting for age, diabetes mellitus, depression, left ventricular ejection fraction, apnea–hypopnea index, and nocturnal nadir oxygen saturation (hazard ratio: 2.13, 95% confidence interval, 1.04–4.26, P=0.039). Furthermore, among participants with moderate to severe sleep‐disordered breathing, the presence of EDS was associated with higher risk of major adverse cardiac events than those without EDS, after adjusting for age and nadir oxygen saturation (hazard ratio: 3.17, 95% confidence interval, 1.22–7.76, P=0.019).Conclusions EDS may be an independent prognostic factor of adverse outcome in post–myocardial infarction patients with moderate to severe sleep‐disordered breathing. Evaluation of EDS may shed new light on risk stratification and identify treatment responders for this patient population.

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“…Epidemiological studies have shown that 30%-60% of all older persons have one or more sleep complaints, including difficulty falling asleep, problems staying asleep at night or falling back asleep after awakening, early morning awakenings, excessive daytime sleepiness, and daytime fatigue (Ancoli-Israel & Roth, 1999;Dodge, Cline, & Quan, 1995;Foley et al, 1995;Maggi et al, 1998). Sleep disturbances in this population are often secondary to medical and psychiatric comorbidities (Foley, Ancoli-Israel, Britz, & Walsh, 2004;Newman et al, 1997;Ohayon, Carskadon, Guilleminault, & Vitiello, 2004;Quan et al, 2005;Vitiello, Moe, & Prinz, 2002) and are associated with an increased risk for the onset of depression and anxiety, substance abuse, falls, cognitive decline, and suicide (Brassington, Kings, & Bliwise, 2000;Byles, Mishra, Harris, & Nair, 2003;Jelicic et al, 2002;Newman et al, 2000;Taylor, Lichstein, & Durrence, 2003).…”

mentioning

confidence: 99%

Evidence-based psychological treatments for insomnia in older adults.

McCurry¹,

Logsdon²,

Teri³

et al. 2007

Psychology and Aging

142

113

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The review describes evidence-based psychological treatments (EBTs) for insomnia in older adults. Following coding procedures developed by the American Psychological Association's Committee on Science and Practice of the Society for Clinical Psychology, two treatments were found to meet EBT criteria: sleep restriction-sleep compression therapy and multicomponent cognitive-behavioral therapy. One additional treatment (stimulus control therapy) partially met criteria, but further corroborating studies are needed. At the present time, there is insufficient evidence to consider other psychological treatments, including cognitive therapy, relaxation, and sleep hygiene education, as stand-alone interventions beneficial for treating insomnia in older adults. Additional research is also needed to examine the efficacy of alternative-complementary therapies, such as bright light therapy, exercise, and massage. This review highlights potential problems with using coding procedures proposed in the EBT coding manual when reviewing the existing insomnia literature. In particular, the classification of older adults as persons age 60 and older and the lack of rigorous consideration of medical comorbidities warrant discussion in the future.

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Daytime Sleepiness Predicts Mortality and Cardiovascular Disease in Older Adults

Cited by 418 publications

References 43 publications

Napping and Nighttime Sleep: Findings From an Occupation-Based Intervention

Napping and Nighttime Sleep: Findings From an Occupation-Based Intervention

Excessive Daytime Sleepiness Independently Predicts Increased Cardiovascular Risk After Myocardial Infarction

Evidence-based psychological treatments for insomnia in older adults.

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