scholarly journals 0392 The Effect of Benzodiazepine Use on Non-REM Sleep Instability in Community-Dwelling Older Men

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A150-A150
Author(s):  
S Hartmann ◽  
M Baumert
Keyword(s):  
Detection System ◽  
Osteoporotic Fractures ◽  
Nrem Sleep ◽  
Older Men ◽  
Community Dwelling ◽  
Control Group ◽  
Sleep Study ◽  
Short Acting ◽  
Cap Rate ◽  
Long Acting

Abstract Introduction Previous studies on the implications of benzodiazepine (BZD), a widely prescribed pharmacotherapeutic treatment method for sleep insomnia, on sleep architecture demonstrated significantly reduced EEG activity in low-frequency bands. In this study, we explore the effect of BZD 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 30 older men on long-acting BZD (LBZD), 35 older men on short-acting BZD (SBZD), and 50 age-matched men who did not use BZD (NBZD), participating in the Osteoporotic Fractures in Men Sleep Study (MrOS sleep). 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 relationship between CAP parameters and BZD use was determined using the Kruskal-Wallis test by ranks with Bonferroni correction for post-hoc analysis. Results CAP rate was significantly decreased in older men using long-acting BZD (NBZD: 59.6±18.0%, LBZD: 46.9±13.1%, SBZD: 53.0±20.1%) as compared to non-BZD user (p < 0.01). All BZD users demonstrated significantly lower frequencies of A1-phases (NBZD: 19.9±23.0 no./h, LBZD: 6.9±13.3 no./h, SBZD: 4.5±9.9 no./h) as compared to non-BZD users (LBZD: p < 0.01, SBZD: p < 0.001). The A2+A3 index did not show any variations between the three groups. Conclusion Older men using long-acting BZD demonstrate a significantly reduced CAP rate during sleep, particularly less frequent A1-phases, compared to the control group. Moreover, short-acting BZD user show significantly less frequent A1-phases but no difference in CAP rate and A2+A3-phases than older men using no BZD. Hence, BZD usage has a major adverse effect on the occurrence of EEG slow waves. 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.

scholarly journals 0393 The Effect of Trazadone Use on Non-REM Sleep Instability in Community-Dwelling Older Men

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A150-A151
Author(s):  
S Hartmann ◽  
M Baumert
Keyword(s):  
High Performance ◽  
Detection System ◽  
Antidepressant Medication ◽  
Osteoporotic Fractures ◽  
Nrem Sleep ◽  
Older Men ◽  
Community Dwelling ◽  
Sleep Study ◽  
Significant Difference ◽  
Cap Rate

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.

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 ◽  
...  
Keyword(s):  
Osteoporotic Fractures ◽  
Older Men ◽  
Community Dwelling ◽  
Sleep Study ◽  
Men And Women ◽  
All Cause Mortality ◽  
The Relationship ◽  
Older Men And Women

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.

scholarly journals Characterization of cyclic alternating pattern during sleep in older men and women using large population studies

SLEEP ◽  
2020 ◽  
Vol 43 (7) ◽  
Author(s):  
Simon Hartmann ◽  
Oliviero Bruni ◽  
Raffaele Ferri ◽  
Susan Redline ◽  
Mathias Baumert
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbance ◽  
Osteoporotic Fractures ◽  
Nrem Sleep ◽  
Analysis Of Covariance ◽  
Sleep Study ◽  
Men And Women ◽  
Cyclic Alternating Pattern ◽  
New Findings ◽  
Cap Rate

Abstract Study Objectives To assess the microstructural architecture of non-rapid eye movement (NREM) sleep known as cyclic alternating pattern (CAP) in relation to the age, gender, self-reported sleep quality, and the degree of sleep disruption in large community-based cohort studies of older people. Methods We applied a high-performance automated CAP detection system to characterize CAP in 2,811 men from the Osteoporotic Fractures in Men Sleep Study (MrOS) and 426 women from the Study of Osteoporotic Fractures (SOF). CAP was assessed with respect to age and gender and correlated to obstructive apnea–hypopnea index, arousal index (AI-NREM), and periodic limb movements in sleep index. Further, we evaluated CAP across levels of self-reported sleep quality measures using analysis of covariance. Results Age was significantly associated with the number of CAP sequences during NREM sleep (MrOS: p = 0.013, SOF = 0.051). CAP correlated significantly with AI-NREM (MrOS: ρ = 0.30, SOF: ρ = 0.29). CAP rate, especially the A2+A3 index, was inversely related to self-reported quality of sleep, independent of age and sleep disturbance measures. Women experienced significantly fewer A1-phases compared to men, in particular, in slow-wave sleep (N3). Conclusions We demonstrate that automated CAP analysis of large-scale databases can lead to new findings on CAP and its subcomponents. We show that sleep disturbance indices are associated with the CAP rate. Further, the CAP rate is significantly linked to subjectively reported sleep quality, independent from traditionally scored markers of sleep fragmentation. Finally, men and women show differences in the microarchitecture of sleep as identified by CAP, despite similar macro-architecture.

scholarly journals 0818 Cyclic Alternating Pattern as Indicator for Subjective Sleep Quality in Community-Dwelling Older Men

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A312-A312
Author(s):  
S Hartmann ◽  
M Baumert
Keyword(s):  
Sleep Quality ◽  
Nrem Sleep ◽  
Older Men ◽  
Quality Parameters ◽  
Community Dwelling ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Cap Rate ◽  
The Relationship

Abstract Introduction The micro-architecture of NREM sleep displays a cyclic alternating pattern (CAP) comprising activation phases of slow high-amplitude waves (A1), fast low-amplitude brain activity rhythms (A3) or a mixture of both (A2). In this study, we investigated the relationship between CAP and subjective sleep quality parameters reported by community-dwelling older men from the Osteoporotic Fractures in Men Sleep Study. Methods CAP was scored in 2,811 overnight EEG recordings using a high performance automated CAP detection system. We quantified 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). Also, participants were asked to score the quality of their sleep on a Likert scale with five items from light to deep, from short to long, and from restless to restful. The relationship between CAP parameters and the subjective sleep quality measures was determined using ANCOVA with traditional sleep disturbance indices such as obstructive apnea-hypopnea index and arousal index as covariate. Results CAP rate decreased significantly with increasing quality of sleep for all three subjective measures (light vs. deep: 58.8±22.3% vs. 54.6±20.5%, p < 0.001; short vs. long: 58.4±21.4% vs. 55.1±20.5%, p < 0.001, restless vs. restful: 59.4±20.8% vs. 55.6±21.0%, p = 0.002). The A1 index did not show any significant variations across all three sleep quality parameters. The A2+A3 index behaved similarly to the CAP rate with decreasing values for each subjective measure (all: p < 0.001). Conclusion CAP rate, especially A2+A3-phases, are reduced in older men who report good sleep quality, while A1 index did not show any significant relationship with subjective sleep quality measures. Hence, CAP is an indicator of sleep quality. 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.

scholarly journals 0286 Cross-Sectional and Longitudinal Relationships between Rest-Activity Rhythms and Metabolic Biomarkers in Older Men: The Osteoporotic Fractures in Men Sleep Study

SLEEP ◽  
2019 ◽  
Vol 42 (Supplement_1) ◽  
pp. A116-A117
Author(s):  
Qian Xiao ◽  
Daniel S Evans ◽  
Susan Redline ◽  
Nancy Lane ◽  
Sonia Ancoli-Israel ◽  
...  
Keyword(s):  
Osteoporotic Fractures ◽  
Older Men ◽  
Cross Sectional ◽  
Sleep Study ◽  
Activity Rhythms ◽  
Metabolic Biomarkers ◽  
Longitudinal Relationships ◽  
Rest Activity

scholarly journals Prevalence and Correlates of Sleep-Disordered Breathing in Older Men: Osteoporotic Fractures in Men Sleep Study

2007 ◽  
Vol 55 (9) ◽  
pp. 1356-1364 ◽  
Author(s):  
Reena Mehra ◽  
Katie L. Stone ◽  
Terri Blackwell ◽  
Sonia Ancoli Israel ◽  
Thuy-Tien L. Dam ◽  
...  
Keyword(s):  
Sleep Disordered Breathing ◽  
Osteoporotic Fractures ◽  
Older Men ◽  
Sleep Study ◽  
Disordered Breathing

scholarly journals Performance of FRAX in a cohort of community-dwelling, ambulatory older men: the Osteoporotic Fractures in Men (MrOS) study

2012 ◽  
Vol 24 (4) ◽  
pp. 1185-1193 ◽  
Author(s):  
B. Ettinger ◽  
◽  
K. E. Ensrud ◽  
T. Blackwell ◽  
J. R. Curtis ◽  
...  
Keyword(s):  
Osteoporotic Fractures ◽  
Older Men ◽  
Community Dwelling

scholarly journals Estimated GFR and Mortality in Older Men: Are All eGFR Formulae Equal?

2016 ◽  
Vol 43 (5) ◽  
pp. 325-333 ◽  
Author(s):  
Muna T. Canales ◽  
Terri Blackwell ◽  
Areef Ishani ◽  
Brent C. Taylor ◽  
Allyson Hart ◽  
...  
Keyword(s):  
Older Adults ◽  
Cystatin C ◽  
Proportional Hazards ◽  
Older Men ◽  
Cardiovascular Death ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Sleep Study ◽  
Disease Epidemiology ◽  
Net Reclassification Improvement

Background: Recently, the first estimated glomerular filtration rate (eGFR) formula specifically developed for community-dwelling older adults, the Berlin Initiative Study Equation 2 (BIS2), was reported. To date, however, no study has examined the performance of the BIS2 to predict death in older adults as compared to equations used clinically and in research. Methods: We prospectively followed 2,994 community-dwelling men (age 76.4 ± 5.6) enrolled in the MrOS Sleep Study. We calculated baseline eGFR from serum creatinine and cystatin-C using the BIS2, Chronic Kidney Disease Epidemiology (CKD-EPIcr,cysc), CKD-EPIcysc and CKD-EPIcr equations. Analyses included Cox-proportional hazards regression and net reclassification improvement (NRI) for the outcomes of all-cause and cardiovascular death. Results: Follow-up time was 7.3 ± 1.9 years. By BIS2, 42 and 11% had eGFR <60 and <45, respectively, compared to CKD-EPIcr (23 and 6%), CKD-EPIcysc (36 and 13%) and CKD-EPIcr,cysc (28 and 8%). BIS2 eGFR <45 was associated with twofold higher rate of all-cause mortality when compared to eGFR ≥75 after multivariate adjustment (HR 2.1, 95% CI 1.5-2.8). Results were similar for CKD-EPIcr,cysc <45 (HR 2.1, 95% CI 1.6-2.7) and CKD-EPIcysc <45 (HR 2.1, 95% CI 1.7-2.7) and weaker for CKD-EPIcr <45 (HR 1.5, 95% CI 1.2-2.0). In NRI analyses, when compared to CKD-EPIcr,cysc, both BIS2 and CKD-EPIcr equations more often misclassified participants with respect to mortality. We found similar results for cardiovascular death. Conclusion: The BIS2 did not outperform and the CKD-EPIcr was inferior to the cystatin C-based CKD-EPI equations to predict death in this cohort of older men. Thus, the cystatin C-based CKD-EPI equations are the formulae of choice to predict death in community-dwelling older men.

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