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Hypoxia During Sleep and the Risk of Falls and Fractures in Older Men: The Osteoporotic Fractures in Men Sleep Study
Author(s) -
Cauley Jane A.,
Blackwell Terri L.,
Redline Susan,
Ensrud Kristine E.,
AncoliIsrael Sonia,
Fink Howard A.,
Orwoll Eric S.,
Stone Katie L.
Publication year - 2014
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.13069
Subject(s) - medicine , hypoxia (environmental) , sleep (system call) , gerontology , physical therapy , chemistry , organic chemistry , oxygen , computer science , operating system
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.