scholarly journals Mean nocturnal respiratory rate predicts cardiovascular and all-cause mortality in community-dwelling older men and women

2019 ◽  
Vol 54 (1) ◽  
pp. 1802175 ◽  
Author(s):  
Mathias Baumert ◽  
Dominik Linz ◽  
Katie Stone ◽  
R. Doug McEvoy ◽  
Steve Cummings ◽  
...  

Respiratory frequency (fR) predicts in-hospital and short-term mortality in patients with a variety of pathophysiological conditions, but its predictive value for long-term cardiovascular and all-cause mortality in the general population is unknown. Here, we investigated the relationship between mean nocturnal fR and mortality in community-dwelling older men and women.We measured mean nocturnal fR during sleep from overnight polysomnography in 2686 men participating in the Osteoporotic Fractures in Men Study (MrOS) Sleep study and 406 women participating in the Study of Osteoporotic Fractures (SOF) to investigate the relationship between mean nocturnal fR and long-term cardiovascular and all-cause mortality.166 (6.1%) men in the MrOS cohort (8.9±2.6 years’ follow-up) and 46 (11.2%) women in the SOF cohort (6.4±1.6 years’ follow-up) died from cardiovascular disease. All-cause mortality was 51.2% and 26.1% during 13.7±3.7 and 6.4±1.6 years’ follow-up in the MrOS Sleep study and the SOF cohorts, respectively. Multivariable Cox regression analysis adjusted for significant covariates demonstrated that fR dichotomised at 16 breaths·min−1 was independently associated with cardiovascular mortality (MrOS: hazard ratio (HR) 1.57, 95% CI 1.14–2.15; p=0.005; SOF: HR 2.58, 95% CI 1.41–4.76; p=0.002) and all-cause mortality (MrOS: HR 1.18, 95% CI 1.04–1.32; p=0.007; SOF: HR 1.50, 95% CI 1.02–2.20; p=0.04).In community-dwelling older men and women, polysomnography-derived mean nocturnal fR ≥16 breaths·min−1 is an independent predictor of long-term cardiovascular and all-cause mortality. Whether nocturnal mean fR can be used as a risk marker warrants further prospective studies.

Author(s):  
Sobhan Salari Shahrbabaki ◽  
Dominik Linz ◽  
Simon Hartmann ◽  
Susan Redline ◽  
Mathias Baumert

Abstract Aims  To quantify the arousal burden (AB) across large cohort studies and determine its association with long-term cardiovascular (CV) and overall mortality in men and women. Methods and results  We measured the AB on overnight polysomnograms of 2782 men in the Osteoporotic Fractures in Men Study (MrOS) Sleep study, 424 women in the Study of Osteoporotic Fractures (SOF) and 2221 men and 2574 women in the Sleep Heart Health Study (SHHS). During 11.2 ± 2.1 years of follow-up in MrOS, 665 men died, including 236 CV deaths. During 6.4 ± 1.6 years of follow-up in SOF, 105 women died, including 47 CV deaths. During 10.7 ± 3.1 years of follow-up in SHHS, 987 participants died, including 344 CV deaths. In women, multivariable Cox proportional hazard analysis adjusted for common confounders demonstrated that AB is associated with all-cause mortality [SOF: hazard ratio (HR) 1.58 (1.01–2.42), P = 0.038; SHHS-women: HR 1.21 (1.06–1.42), P = 0.012] and CV mortality [SOF: HR 2.17 (1.04–4.50), P = 0.037; SHHS-women: HR 1.60 (1.12–2.28), P = 0.009]. In men, the association between AB and all-cause mortality [MrOS: HR 1.11 (0.94–1.32), P = 0.261; SHHS-men: HR 1.31 (1.06–1.62), P = 0.011] and CV mortality [MrOS: HR 1.35 (1.02–1.79), P = 0.034; SHHS-men: HR 1.24 (0.86–1.79), P = 0.271] was less clear. Conclusions Nocturnal AB is associated with long-term CV and all-cause mortality in women and to a lesser extent in men.


2007 ◽  
Vol 3 (3S_Part_2) ◽  
pp. S154-S154
Author(s):  
Olivia I. Okereke ◽  
Jae H. Kang ◽  
Nancy R. Cook ◽  
J. Michael Gaziano ◽  
JoAnn E. Manson ◽  
...  

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A150-A151
Author(s):  
S Hartmann ◽  
M Baumert

Abstract Introduction With steadily growing numbers of patients with a depressive disorder, the effect of antidepressants on sleep architecture is of increasing concern. One major oral antidepressant medication is trazadone, which has also been prescribed in low doses for sleep insomnia treatment. Here, we investigate the effect of trazadone on NREM sleep instability also known as cyclic alternating pattern (CAP) in community-dwelling older men. Methods CAP was scored in overnight EEG recordings from 41 older men on trazadone (TRZ) and 50 age-matched men who did not use trazadone (NTRZ), participating in the Osteoporotic Fractures in Men Sleep Study. A high performance automated detection system determined the ratio between CAP time and NREM sleep time (CAP rate), the number of A1-phases per hour of NREM sleep (A1 index), and the number of A2+A3-phases per hour of NREM sleep (A2+A3 index). The effect of TRZ on CAP parameters was determined using the Mann-Whitney U test. Results CAP rate was significantly decreased in men using trazadone (NTRZ: 58.2±19.7%, TRZ: 47.9±15.9%) as compared to non-trazadone user (p < 0.01). Subtype indices did not show any significant difference between both groups but to some extent less frequent A2-A3 phases for TRZ user (A1-phases: NTRZ 13.0±18.7 no./h vs. TRZ 10.8±20.4 no./h, p = 0.35; A2+A3-phases: NTRZ 51.5±33.7 no./h vs. TRZ 44.7±23.3 no./h, p = 0.068). Conclusion CAP rate was significantly decreased in older men on trazadone as compared to older men who did not use trazadone, suggesting that trazadone usage has a stabilising effect on sleep micro-structure. Support The National Heart, Lung, and Blood Institute (NHLBI) provides funding for the MrOS Sleep ancillary study “Outcomes of Sleep Disorders in Older Men” under the following grant numbers: R01 HL071194, R01 HL070848, R01 HL070847, R01 HL070842, R01 HL070841, R01 HL070837, R01 HL070838, and R01 HL070839.


2004 ◽  
Vol 24 (6) ◽  
pp. 903-920 ◽  
Author(s):  
OMAR RAHMAN ◽  
JANE MENKEN ◽  
RANDALL KUHN

The purpose of this study is to examine whether the co-residence of spouses and children affects self-reported general health among older men and women in a rural area of Bangladesh. Binary logistic regression has been used to explore the impact of spouses and children on self-reported health, with particular attention to the gender of children and interactions with chronic disease. The data are from the Matlab Health and Socio-Economic Survey. A sample of 765 women and 979 men aged 60 or more years with at least one surviving child was available. The principal result is that for an older woman, optimum self-reported health is most likely when a spouse and at least one son and one daughter are present. Any deviation from this family pattern (either no spouse or children of only one sex) leads to a significantly increased risk of poor self-reported health. On the other hand, among older men there were no differences in self-reported health among the various spouse-child combinations. The relationship between a balanced gender distribution of children and optimum self-reported health among older women may explain the levelling out of fertility at roughly three children per women despite intensive family planning promotion in the area. Further reductions in fertility (an important policy concern) may depend on improving the substitutability of sons and daughters in the support of their elderly mothers.


2014 ◽  
Vol 43 (5) ◽  
pp. 661-666 ◽  
Author(s):  
Miles D. Witham ◽  
Holly E. Syddall ◽  
Elaine Dennison ◽  
Cyrus Cooper ◽  
Marion E. T. McMurdo ◽  
...  

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