Multidimensional sleep health domains in older men and women: an actigraphy factor analysis

Sleep - Tập 44 Số 2 - 2021
Meredith L. Wallace1, Lan Yu2, Daniel J. Buysse1, Katie L. Stone3, Susan Redline4, Stephen F. Smagula1, Marcia L. Stefanick5, Donna Kritz‐Silverstein6, Martica H. Hall1
1Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
2Department of Medicine, University of Pittsburgh, Pittsburgh, Pa
3California Pacific Medical Center Research Institute, San Francisco, CA
4Departments of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
5Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA
6Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA

Tóm tắt

Abstract The multidimensional sleep health framework emphasizes that sleep can be characterized across several domains, with implications for developing novel sleep treatments and improved prediction and health screening. However, empirical evidence regarding the domains and representative measures that exist in actigraphy-assessed sleep is lacking. We aimed to establish these domains and representative measures in older adults by examining the factor structure of 28 actigraphy-derived sleep measures from 2,841 older men from the Osteoporotic Fractures in Men Sleep Study and, separately, from 2,719 older women from the Study of Osteoporotic Fractures. Measures included means and standard deviations of actigraphy summary measures and estimates from extended cosine models of the raw actigraphy data. Exploratory factor analyses revealed the same five factors in both sexes: Timing (e.g. mean midpoint from sleep onset to wake-up), Efficiency (e.g. mean sleep efficiency), Duration (e.g. mean minutes from sleep onset to wake-up), Sleepiness/Wakefulness (e.g. mean minutes napping and amplitude of rhythm), and Regularity (e.g. standard deviation of the midpoint). Within each sex, confirmatory factor analyses confirmed the one-factor structure of each factor and the entire five-factor structure (Comparative Fit Index and Tucker–Lewis Index ≥ 0.95; Root Mean Square Error of Approximation 0.08–0.38). Correlation magnitudes among factors ranged from 0.01 to 0.34. These findings demonstrate the validity of conceptualizing actigraphy sleep as multidimensional, provide a framework for selecting sleep health domains and representative measures, and suggest targets for behavioral interventions. Similar analyses should be performed with additional measures of rhythmicity, other age ranges, and more racially/ethnically diverse samples.

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Tập 44 Số 2

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