Hypoxia during sleep and the risk of falls and fractures in older men: The osteoporotic fractures in men sleep study

Jane A. Cauley, Terri L. Blackwell, Susan Redline, Kristine E. Ensrud, Sonia Ancoli-Israel, Howard A. Fink, Eric Orwoll, Katie L. Stone

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objectives To test the hypothesis that low arterial oxygen saturation during sleep is associated with a greater risk of falls and fractures.

Design Prospective cohort study.

Setting Six U.S. clinical centers.

Participants Men aged 67 and older (N = 2,911).

Measurements The primary exposure measure was percentage of sleep time with arterial oxygen saturation less than 90% measured using polysomnography. The main outcome measures were incident falls within 1 year and incident nonspine fractures over an average follow-up of 6.8 years.

Results Men with 10% or more of sleep time at an arterial oxygen saturation of less than 90% were older, reported more comorbidities, had poorer physical function, and were more likely to have sleep disordered breathing than men with less than 10% sleep time at an arterial oxygen saturation of less than 90%. After multivariate adjustment, men with 10% or more of sleep time with arterial oxygen saturation of less than 90% had a greater risk of having one or more falls (relative risk (RR) = 1.25, 95% confidence interval (CI) = 1.04-1.51) and two or more falls (RR = 1.43, 95% CI = 1.06-1.92) than those with less than 10% of sleep time with less than 90% arterial oxygen saturation. Men with greater percentage of sleep time with arterial oxygen saturation less than 90% had a 30% to 40% greater risk of nonspine fracture than those with normal nocturnal oxygen saturation in models adjusting for sleep disordered breathing.

Conclusion Hypoxia during sleep may be a risk factor for falls and fractures in older men. Interventions aimed at decreasing nocturnal hypoxia may decrease falls and fractures.

Original languageEnglish (US)
Pages (from-to)1853-1859
Number of pages7
JournalJournal of the American Geriatrics Society
Volume62
Issue number10
DOIs
StatePublished - Oct 1 2014

Fingerprint

Osteoporotic Fractures
Sleep
Oxygen
Sleep Apnea Syndromes
Confidence Intervals
Social Adjustment
Hypoxia
Polysomnography
Comorbidity
Cohort Studies
Outcome Assessment (Health Care)
Prospective Studies

Keywords

  • falls
  • fractures
  • mortality
  • nocturnal hypoxia
  • older men

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Cauley, J. A., Blackwell, T. L., Redline, S., Ensrud, K. E., Ancoli-Israel, S., Fink, H. A., ... Stone, K. L. (2014). Hypoxia during sleep and the risk of falls and fractures in older men: The osteoporotic fractures in men sleep study. Journal of the American Geriatrics Society, 62(10), 1853-1859. https://doi.org/10.1111/jgs.13069

Hypoxia during sleep and the risk of falls and fractures in older men : The osteoporotic fractures in men sleep study. / Cauley, Jane A.; Blackwell, Terri L.; Redline, Susan; Ensrud, Kristine E.; Ancoli-Israel, Sonia; Fink, Howard A.; Orwoll, Eric; Stone, Katie L.

In: Journal of the American Geriatrics Society, Vol. 62, No. 10, 01.10.2014, p. 1853-1859.

Research output: Contribution to journalArticle

Cauley, Jane A. ; Blackwell, Terri L. ; Redline, Susan ; Ensrud, Kristine E. ; Ancoli-Israel, Sonia ; Fink, Howard A. ; Orwoll, Eric ; Stone, Katie L. / Hypoxia during sleep and the risk of falls and fractures in older men : The osteoporotic fractures in men sleep study. In: Journal of the American Geriatrics Society. 2014 ; Vol. 62, No. 10. pp. 1853-1859.
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AU - Cauley, Jane A.

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AU - Redline, Susan

AU - Ensrud, Kristine E.

AU - Ancoli-Israel, Sonia

AU - Fink, Howard A.

AU - Orwoll, Eric

AU - Stone, Katie L.

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N2 - Objectives To test the hypothesis that low arterial oxygen saturation during sleep is associated with a greater risk of falls and fractures.Design Prospective cohort study.Setting Six U.S. clinical centers.Participants Men aged 67 and older (N = 2,911).Measurements The primary exposure measure was percentage of sleep time with arterial oxygen saturation less than 90% measured using polysomnography. The main outcome measures were incident falls within 1 year and incident nonspine fractures over an average follow-up of 6.8 years.Results Men with 10% or more of sleep time at an arterial oxygen saturation of less than 90% were older, reported more comorbidities, had poorer physical function, and were more likely to have sleep disordered breathing than men with less than 10% sleep time at an arterial oxygen saturation of less than 90%. After multivariate adjustment, men with 10% or more of sleep time with arterial oxygen saturation of less than 90% had a greater risk of having one or more falls (relative risk (RR) = 1.25, 95% confidence interval (CI) = 1.04-1.51) and two or more falls (RR = 1.43, 95% CI = 1.06-1.92) than those with less than 10% of sleep time with less than 90% arterial oxygen saturation. Men with greater percentage of sleep time with arterial oxygen saturation less than 90% had a 30% to 40% greater risk of nonspine fracture than those with normal nocturnal oxygen saturation in models adjusting for sleep disordered breathing.Conclusion Hypoxia during sleep may be a risk factor for falls and fractures in older men. Interventions aimed at decreasing nocturnal hypoxia may decrease falls and fractures.

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