Abstract
Background and aimsReduced sleep quality is common in advanced age. Poor sleep quality is associated with adverse outcomes, chiefly cardiovascular, in young and middle-aged subjects, possibly because of its association with metabolic syndrome (MetS). However, the correlates of sleep quality in oldest populations are unknown. We evaluated the association of sleep quality with MetS in a cohort of subjects aged 90+.Methods and resultsWe analysed data of 343 subjects aged 90+ living in the Mugello area (Tuscany, Italy). Quality of sleep was assessed using the Pittsburgh Sleep Quality Assessment Index (PSQI). Good quality of sleep was defined by a PSQI score < 5. MetS was diagnosed according to the National Cholesterol Education Program’s ATP-III criteria; 83 (24%) participants reported good quality of sleep. MetS was diagnosed in 110 (24%) participants. In linear and logistic models, MetS was inversely associated with PSQI score ((B = − 1.04; 95% CI − 2.06 to − .03; P = .044), with increased probability of good sleep quality (OR = 2.52; 95% CI 1.26–5.02; P = .009), and with a PSQI below the median (OR = 2.11; 95% CI 1.11–3.40, P = .022), after adjusting. None of the single components of MetS were associated with PSQI (all P values > .050). However, an increasing number of MetS components was associated with increasing probability of good quality of sleep (P for trend = .002), and of PSQI below the median (P for trend = .007). Generalized Additive Model analysis documented no smoothing function suggestive of nonlinear association between PSQI and MetS.ConclusionOur results confirm a high prevalence of poor sleep quality in oldest age; however, in these subjects, MetS seems to be associated with better sleep quality. Additional larger, dedicated studies are required to confirm our results, and, if so, to identify the subsystems involved and the potential therapeutic implications of such an association.
Highlights
Metabolic syndrome (MetS) is an intriguing entity, because it includes potentially reversible risk factors and is associated, at least in middle-aged populations, with several adverse outcomes, including cardiovascular and cerebrovascular morbidity and mortality [1].On the other hand, several studies have indicated that sleep duration and architecture are associated withLaudisio et al Diabetol Metab Syndr (2020) 12:46 obesity, diabetes, hypertension, cardiovascular disease, and in turn, with metabolic syndrome (MetS) [2,3,4]
Our results confirm a high prevalence of poor sleep quality in oldest age; in these subjects, MetS seems to be associated with better sleep quality
Results of generalized additive model (GAM) analysis were summarized in Additional file 1: Table S1; overall, there was no smoothing function suggestive of nonlinear association between MetS and Pittsburgh Sleep Quality Index (PSQI); when the single components of MetS were analyzed, there was a nonsignificant smoothed association of low HDL-cholesterol and hypertension with PSQI (Additional file 1: Table S1)
Summary
Metabolic syndrome (MetS) is an intriguing entity, because it includes potentially reversible risk factors and is associated, at least in middle-aged populations, with several adverse outcomes, including cardiovascular and cerebrovascular morbidity and mortality [1].On the other hand, several studies have indicated that sleep duration and architecture are associated withLaudisio et al Diabetol Metab Syndr (2020) 12:46 obesity, diabetes, hypertension, cardiovascular disease, and in turn, with MetS [2,3,4]. Metabolic syndrome (MetS) is an intriguing entity, because it includes potentially reversible risk factors and is associated, at least in middle-aged populations, with several adverse outcomes, including cardiovascular and cerebrovascular morbidity and mortality [1]. Several data indicate an association between the characteristics of sleep and the risk of cardiovascular events. In oldest subjects a self-rated poor quality of sleep is associated with reduced survival [7], and an objective measure of sleep quality has been associated with physical performance [8]. Poor sleep quality is associated with adverse outcomes, cardiovascular, in young and middle-aged subjects, possibly because of its association with metabolic syndrome (MetS). We evalu‐ ated the association of sleep quality with MetS in a cohort of subjects aged 90+
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