The proposed study is a 5-year competitive renewal of the study, Outcomes of Sleep Disorders in Older Men (MrOS Sleep Study). The MrOS Sleep Study was designed to test several hypotheses regarding consequences of sleep disorders in community-dwelling older, by taking advantage of the established cohort that was enrolled for the Osteoporotic Fractures in Men (MrOS) study. From December 2003 through March 2005, 3135 MrOS participants (>100% of goal) were enrolled into the ancillary MrOS Sleep Study. Comprehensive and objective assessments of sleep (including overnight in-home polysomnography (PSG), 5-day wrist actigraphy and self-reported measures of sleep quality), adjudication of incident cardiovascular (CVD) events, and other measures including biological specimens were added to the expansive dataset of the MrOS parent study. During the initial cycle, we identified sleep disordered breathing (SDB) and hypoxemia as significant independent predictors of CVD, arrhythmias, mortality and non-spine fractures. We now propose continued follow-up of the MrOS Sleep Study cohort to provide sufficient power to determine risk of specific CVD outcomes and disease-specific mortality associated with SDB, rather than aggregate outcomes (Aim 1). Initial findings will also be extended in the renewal by testing several potential mechanisms for the observed relationships between SDB/hypoxemia and outcomes, including i) biochemical determinants that may elucidate mechanistic pathways;ii) lung function and daytime oxygen saturation levels;and iii) objectively measured sleep duration (Aim 2). We further propose to strengthen several of our cross- sectional findings relating sleep to age-related conditions including frailty, physical and cognitive function, by performing longitudinal assessments of these conditions (Aim 3). Finally, repeat measures of PSG and actigraphy will enable us to characterize patterns of change in sleep characteristics among older men during 5 years of follow-up, and to determine the correlates and consequences of these changes (Aim 4). This rare opportunity to continue follow-up in over 3000 men who participated in the original wave of the MrOS Sleep Study, and to re-examine a subset of the cohort who have already contributed such a wealth of data, will provide new insights into the relationships between SDB and sleep patterns with subsequent morbidity and mortality.

Public Health Relevance

Sleep disorders are very common, particularly in older adults. The proposed renewal of the study, Outcomes of Sleep Disorders in Older Men, will provide new insights into the relationships between sleep disordered breathing, hypoxemia, and sleep patterns (measured comprehensively and objectively) with subsequent risk of morbidity and mortality in a large cohort of community-dwelling older men. Several mechanistic pathways will be explored, in addition to extending follow-up to allow for analysis of more specific CVD outcomes and disease-specific mortality (rather than aggregate outcomes).

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL071194-08
Application #
7821374
Study Section
Cardiovascular and Sleep Epidemiology (CASE)
Program Officer
Twery, Michael
Project Start
2002-07-01
Project End
2014-04-30
Budget Start
2010-05-01
Budget End
2011-04-30
Support Year
8
Fiscal Year
2010
Total Cost
$2,057,130
Indirect Cost
Name
California Pacific Medical Center Research Institute
Department
Type
DUNS #
071882724
City
San Francisco
State
CA
Country
United States
Zip Code
94107
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Rogers, Tara S; Blackwell, Terri L; Lane, Nancy E et al. (2017) Rest-activity patterns and falls and fractures in older men. Osteoporos Int 28:1313-1322
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Winkelman, John W; Blackwell, Terri; Stone, Katie et al. (2017) Associations of Incident Cardiovascular Events With Restless Legs Syndrome and Periodic Leg Movements of Sleep in Older Men, for the Outcomes of Sleep Disorders in Older Men Study (MrOS Sleep Study). Sleep 40:
Bozorgmehri, Shahab; Fink, Howard A; Parimi, Neeta et al. (2017) Association of Sleep Disordered Breathing with Erectile Dysfunction in Community Dwelling Older Men. J Urol 197:776-782
Baumgartner, Christine; da Costa, Bruno R; Collet, Tinh-Hai et al. (2017) Thyroid Function Within the Normal Range, Subclinical Hypothyroidism, and the Risk of Atrial Fibrillation. Circulation 136:2100-2116

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