Abstract
ObjectivesHyperkyphosis is associated with restricted pulmonary function and posture, potentially contributing to poor sleep. A previous study reported older women with hyperkyphosis had worse self-reported sleep quality, but it is less clear if this association exists in men. We examined the association between hyperkyphosis and subjective and objective sleep quality in a cohort of older men.DesignLongitudinal analysis of data from large cohort of older men participating in the Osteoporotic Fractures in Men Study (MrOS).SettingCommunity.ParticipantsWe studied 754 men participants in MrOS who had kyphosis measured during the 3rd clinic visit (2007–2009) and future subjective and objective sleep quality assessed between 2009–2012 (an average of 2.9 years later).InterventionN/A.MeasurementsTo measure kyphosis, 1.7 cm thick wooden blocks were placed under the participant’s head to achieve a neutral spine position while lying supine on a DXA table. We collected data on both subjective (Pittsburgh Sleep Quality Index [PSQI], and Epworth Sleepiness Scale [ESS]) and objective (wrist actigraphy: Total Sleep Time [TST], Wake After Sleep Onset [WASO], Sleep Efficiency [SE], Sleep Onset Latency [SOL]; and polysomnography: Apnea Hypopnea Index [AHI]) sleep measurements. Those who required >3 blocks were considered hyperkyphotic (n = 145 or 19.2%).ResultsIn unadjusted and multivariable analyses, men with hyperkyphosis did not report having worse self-reported sleep characteristics based on PSQI and ESS. Similarly, there were no significant associations between hyperkyphosis and objective sleep measures. When examined as a continuous predictor (blocks ranging from 0–8), results were no different.ConclusionsAlthough we hypothesized that poor posture in those with hyperkyphosis would interfere with sleep, in this sample of older men, worse kyphosis was not associated with self-reported or objectively measured poor sleep quality.
Highlights
Hyperkyphosis, the excessive anterior curvature of the thoracic spine, affects an estimated 20– 40 percent of older people [1,2,3]
We studied 754 men participants in MrOS who had kyphosis measured during the 3rd clinic visit (2007–2009) and future subjective and objective sleep quality assessed between 2009–2012
In unadjusted and multivariable analyses, men with hyperkyphosis did not report having worse self-reported sleep characteristics based on Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS)
Summary
Hyperkyphosis, the excessive anterior curvature of the thoracic spine, affects an estimated 20– 40 percent of older people [1,2,3]. Hyperkyphosis is associated with restricted pulmonary function [7] and posture [8], which may impact sleep quality possibly by increasing sleep fragmentation. Available treatments for hyperkyphosis, including physical therapy, therapeutic exercises, use of bracing, and surgery [9], may all impact sleep as well. There has only been one study examining the association between hyperkyphosis and sleep quality [10], and this study was cross-sectional. Wankie and colleagues showed that older women with hyperkyphosis had worse self-reported sleep quality whereas no association was found in men [10]. While there was no association in men, the measure of sleep was subjective, and it is possible that the impact of hyperkyphosis in men might be better captured by objectively measured sleep dysfunction. Given the importance of sleep for healthy aging, it is important to explore whether relationships of hyperkyphosis with sleep be examined longitudinally to determine whether individuals with hyperkyphosis are susceptible to developing sleep problems over time
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