geroprobПроблемы геронаукиProblems of Geroscience2949-47452949-4753АНО «ОСО ИТЕМ»10.37586/2949-4745-4-2024-181-191geroprob-76Research ArticleОригинальное исследованиеOriginal StudiesВлияние привычек, связанных со сном, на 5-летнюю выживаемость лиц старческого возраста и долгожителейImpact of sleep-related habits on the 5-year survival rate in elderly and long-living individualshttps://orcid.org/0000-0002-6021-7864ВоробьёваН. М.VorobyevaN. M.

Воробьёва Наталья Михайловна

Москва

 Moscow 

vorobyeva_nm@rgnkc.ruhttps://orcid.org/0000-0002-5702-0630ИсаевР. И.IsaevR. I.

Москва

 Moscow 

isaev_ri@rgnkc.ruhttps://orcid.org/0000-0001-7413-646XМараховскаяЕ. А.MarakhovskayaE. A.

Москва

 Moscow 

marakhovskaya_ea@rgnkc.ruhttps://orcid.org/0000-0001-5964-5725МалаяИ. П.MalayaI. P.

Москва

 Moscow 

malaya_ip@rgnkc.ruhttps://orcid.org/0000-0002-1628-5093КотовскаяЮ. В.KotovskayaYu. V.

Москва

 Moscow 

kotovskaya@bk.ruhttps://orcid.org/0000-0002-4193-688XТкачеваО. Н.TkachevaO. N.

Москва

 Moscow 

tkacheva@rgnkc.ruФГАОУ ВО «РНИМУ им. Н.И. Пирогова» Минздрава России, Российский геронтологический научно-клинический центрРоссияPirogov Russian National Research Medical University of Ministry of Health of the Russian Federation, Russian Gerontology Clinical Research CenterRussian FederationФГАОУ ВО «РНИМУ им. Н.И. Пирогова» Минздрава РоссииРоссияPirogov Russian National Research Medical University of Ministry of Health of the Russian FederationRussian Federation20241312202404181191Copyright © Воробьёва Н.М., Исаев Р.И., Мараховская Е.А., Малая И.П., Котовская Ю.В., Ткачева О.Н., 20252025Воробьёва Н.М., Исаев Р.И., Мараховская Е.А., Малая И.П., Котовская Ю.В., Ткачева О.Н.Vorobyeva N.M., Isaev R.I., Marakhovskaya E.A., Malaya I.P., Kotovskaya Y.V., Tkacheva O.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.geronauka.com/jour/article/view/76АКТУАЛЬНОСТЬ

АКТУАЛЬНОСТЬ. Здоровый полноценный сон — одно из необходимых условий достижения долголетия и повышения выживаемости. Многочисленные исследования, выполненные в общей популяции, обнаружили взаимосвязь между некоторыми привычками, связанными со сном, и смертностью, однако результаты аналогичных исследований, выполненных у лиц старших возрастных групп, не столь однозначны.

ЦЕЛЬ

ЦЕЛЬ. Изучить влияние привычек, связанных со сном, на 5-летнюю выживаемость лиц в возрасте ≥75 лет.

МАТЕРИАЛЫ И МЕТОДЫ

МАТЕРИАЛЫ И МЕТОДЫ. В исследование включили 223 человека (24% мужчин) в возрасте 75–98 лет (медиана 87 лет), проживающих в г. Москве и Московской области и находившихся на плановом стационарном лечении в Российском геронтологическом научно-клиническом центре в 2011– 2013 гг. При госпитализации проводили анкетирование пациентов по специально разработанному опроснику с целью изучения социальных и поведенческих факторов, таких как образ жизни, привычки, характер питания и физическая активность. Вопросы анкеты, касающиеся сна, включали: 1) время отхода ко сну; 2) время пробуждения; 3) длительность ночного сна; 4) сон в дневное время. После выписки из стационара пациентов наблюдали в течение 5 лет. Регистрировали случаи смерти от всех причин.

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ. В течение 5 лет наблюдения (медиана 3,63 года) умерли 88 (39,5%) человек. Соответственно, 5-летняя выживаемость составила 60,5%, а среднее время выживания — 4,44 [95% доверительный интервал (ДИ) 4,19–4,71] года. Анкетирование показало, что большинство обследуемых ложатся спать в 22–24 ч (65%), просыпаются в 6–8 ч утра (58%) и спят днем (61%), а длительность ночного сна составляет 7–9 ч у 68% участников. Однофакторный регрессионный анализ показал, что поздний (после 24 ч) отход ко сну, пробуждение после 8 ч утра и длинная (≥10 ч) продолжительность ночного сна ассоциируются с повышением риска смерти в ближайшие 5 лет в 1,7–2,1 раза, в то время как ранний (до 24 ч) отход ко сну, пробуждение с 4 до 8 ч утра и длительность ночного сна 5–9 ч, напротив, ассоциируются со снижением 5-летнего риска смерти на 43–52%. Сон в дневное время не оказывал влияния на 5-летнюю выживаемость. Многофакторный регрессионный анализ продемонстрировал, что наряду с возрастом (отношение рисков [ОтнР] 1,09; 95% ДИ 1,02–1,17; р = 0,019) ранний (до 24 ч) отход ко сну (ОтнР 0,55; 95% ДИ 0,31–0,97; р = 0,040) и средняя (5–9 ч) продолжительность ночного сна (ОтнР 0,44; 95% ДИ 0,26–0,76; р = 0,003) являются независимыми предикторами 5-летней выживаемости.

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ. Ранний (до 24 ч) отход ко сну и средняя (5–9 ч) продолжительность ночного сна являются независимыми предикторами 5-летней выживаемости лиц в возрасте ≥75 лет, проживающих в г. Москве и Московской области, и ассоциируются со снижением риска смерти на 45% и 56% соответственно, что позволяет рассматривать сон как геропротективный фактор.

BACKGROUND

BACKGROUND. Healthy, good quality sleep is one of the necessary conditions for achieving longevity and enhancing survival. Numerous general population studies revealed a relationship between some sleep-related habits and mortality, but the results of similar studies conducted in older participants are not so unambiguous.

AIM

AIM. To study the impact of sleep-related habits on the 5-year survival rate in participants aged ≥75 years.

MATERIALS AND METHODS

MATERIALS AND METHODS. The study included 223 participants (24% men) aged 75–98 years (median age: 87 years) who lived in Moscow and the Moscow region and were receiving routine inpatient care at the Russian Gerontology Clinical Research Center in 2011–2013. At admission, patients were surveyed using a specially developed questionnaire in order to assess social and behavioral factors such as lifestyle, habits, diet, and physical activity. The questionnaire included the following sleep-related items: 1) bedtime; 2) wake-up time; 3) nighttime sleep duration; 4) daytime napping. After discharge, patients were under follow-up for 5 years. Cases of all-cause mortality were registered.

RESULTS

RESULTS. During 5 years of follow-up (median: 3.63 years), 88 (39.5%) people died. Accordingly, the 5-year survival rate was 60.5%, and the mean survival time was 4.44 [95% confidence interval (CI) 4.19–4.71] years. The study demonstrated that the most of the participants went to bed at 10–12 p.m. (65%), woke up at 6–8 a.m. (58%) and had a daytime napping (61%), and 68% of the participants had the duration of nighttime sleep within 7–9 h. Univariate regression analysis showed that late (after midnight) bedtime, waking up after 8 a.m., and long (≥10 h) nighttime sleep were associated with a 1.7–2.1-fold increase in the risk of death over the next 5 years. On the contrary, early (before midnight) bedtime, waking up between 4–8 a.m., and nighttime sleep for 5–9 h were associated with a 43–52% decrease in the risk of death over this period. Daytime napping had no effect on the 5-year survival rate. Multivariate regression analysis demonstrated that age (hazard ratio [HR] 1.09; 95% CI 1.02–1.17; p = 0.019), early (before midnight) bedtime (HR 0.55; 95% CI 0.31–0.97; p = 0.040) and 5–9 h nighttime sleep duration (HR 0,44; 95% CI 0.26–0.76; p=0.003) were independent predictors of the 5-year survival rate.

CONCLUSION

CONCLUSION. In participants aged ≥75 years, who lived in Moscow and the Moscow region, early (before midnight) bedtime and medium (5–9 h) nighttime sleep duration are independent predictors for the 5-year survival rate and are associated with 45% and 56% reduction in the mortality risk, respectively, suggesting that a proper sleep may be a geroprotective factor.

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The authors declare that there are no conflicts of interest present.