Actigraphy- and Polysomnography-Measured Sleep Disturbances, Inflammation, and Mortality Among Older Men
Open accessAbstract
Objectives: To evaluate whether objectively measured sleep characteristics are associated with mortality risk independent of inflammatory burden and comorbidity. Methods: The Osteoporotic Fractures in Men Sleep Study (conducted in 2003–2005) included community-dwelling older men (n = 2531; average [standard deviation {SD}] age = 76.3 (5.5) years). Sleep measures from in-home polysomnography and wrist actigraphy and assessments of serum inflammatory markers levels (C-reactive protein, interleukin-6, tumor necrosis factor α, tumor necrosis factor α soluble receptor II, and interferon-γ) were obtained. Vital status was ascertained over an average (SD) follow-up of 7.4 (1.9 SD) years. Results: Three of the seven main sleep measures examined were independently associated with greater inflammatory burden. Mortality risk associated with prolonged (≥10% total sleep time) blood oxygen desaturation and short (<5 hours) sleep duration was attenuated to nonsignificance after adjusting for inflammatory burden or medical burden/lifestyle factors. Severe blood oxygen desaturation (adjusted hazard ratio [aHR] = 1.57, 95% confidence interval [CI] = 1.11–2.22), sleep fragmentation (aHR = 1.32, 95% CI = 1.12–1.57), and a lower percentage of sleep in rapid eye movement (aHR per SD = 0.90, 95% CI = 0.93–0.97) were independently associated with mortality. Conclusions: Short sleep duration and prolonged blood oxygen desaturation were independently associated with inflammatory burden, which attenuated associations between these sleep characteristics and mortality. Medical and life-style factors also substantially attenuated most sleep-mortality associations, suggesting complex relations between sleep, inflammation, and disease. Sleep fragmentation, severe blood oxygen desaturation, and the percentage of sleep time in rapid eye movement were independently related to mortality risk. Future studies with repeated measures of mediators/confounds will be necessary to achieve a mechanistic understanding of sleep-related mortality risk.
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The association between short sleep duration and mortality risk was attenuated to non-significance after adjusting for inflammatory burden or medical burden/lifestyle factors.
“The association between short (o5 h) sleep duration and mortality risk was attenuated to non-significance after adjusting for inflammatory burden or medical burden/ lifestyle factors.”
From Sleep health: Reciprocal regulation of sleep and innate immunity (2017) · cites this paper as Smagula et al, 2016
In older men, short sleep duration (<5 h) and sleep fragmentation (awake >=90 min) were prospectively associated with increased inflammatory burden.
“Short sleep duration (o5 h) and sleep fragmentation (awake for ⩾ 90 min during the night) was prospectively associated with increase in inflammatory burden”
From Sleep health: Reciprocal regulation of sleep and innate immunity (2017) · cites this paper as Smagula et al, 2016
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The Sleep-Immune Crosstalk in Health and Disease
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- Authors
- Smagula, S. F., Stone, K. L., Redline, S., Ancoli-Israel, S., Barrett-Connor, E., Lane, N. E., Orwoll, E. S., & Cauley, J. A.
- Affiliations
- Brigham and Women's Hospital (US)
- California Pacific Medical Center (US)
- University of California San Diego (US)
- University of California Davis Medical Center (US)
- Oregon Health & Science University (US)
- University of Pittsburgh (US)
- Corresponding author
- Cauley, Jane A.
- ORCID
- Venue
- Psychosomatic Medicine
- Published
- 2016-07
- Volume
- 78
- Issue
- 6
- Pages
- 686-696
- ISSN
- 0033-3174 (ISSN-L)
- 1534-7796
- PMC
- PMC4765903
- OpenAlex
- W2337851162
- Cited by
- 116
- References
- 62
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 13 · 2023: 21 · 2022: 14 · 2021: 14 · 2020: 11 · 2019: 11 · 2018: 4 · 2017: 7 · 2016: 3
- FWCI
- 11.86
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (UL1TR000128)
- National Institute on Aging (U01AG042168, U01AG018197, U01AG027810, U01AG042139, T32AG000181)
- National Heart, Lung, and Blood Institute (R01HL070847, R01HL070839, R01HL070838, R01HL070841, R01HL070848, R01HL071194, R01HL070837, R01HL070842)
- National Institute of Mental Health (T32MH019986)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (U01AR045583, U01AR045580, U01AR045632, U01AR045654, U01AR045614, U01AR045647)
- National Center for Advancing Translational Sciences
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- sleep disorders, mortality risk, inflammation, older men, actigraphy, polysomnography, sleep fragmentation, sleep duration, REM sleep, C-reactive protein, interleukin-6, TNF-α, interferon-gamma, comorbidities
- MeSH terms
- Aged, Aged, 80 and over, Humans, Inflammation, Male, Mortality, Sleep Wake Disorders, Polysomnography, Actigraphy
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