Maintaining healthy sleep patterns and frailty transitions: a prospective Chinese study
Authors: Zhu Yunqing , Fan Junning , Lv Jun , Guo Yu , Pei Pei , Yang Ling , Chen Yiping , Du Huaidong , Li Feifei , Yang Xiaoming , Avery Daniel , Chen Junshi , Chen Zhengming , Yu Canqing , Li Liming ,   on behalf of the China Kadoorie Biobank Collaborative Group, Clarke Robert , Collins Rory , Peto Richard , Walters Robin , Bennett Derrick , Boxall Ruth , Burgess Sue , Chan Ka Hung , Chang Yumei , Clarke Johnathan , Clarke Robert , Mohamed Ahmed Edris , Fairhurst-Hunter Zammy , Fry Hannah , Gilbert Simon , Hacker Alex , Hill Mike , Holmes Michael , Im Pek Kei , Iona Andri , Kakkoura Maria , Kartsonaki Christiana , Kerosi Rene , Lin Kuang , Mazidi Mohsen , Millwood Iona , Morris Sam , Nie Qunhua , Pozarickij Alfred , Ryder Paul , Said Saredo , Sansome Sam , Schmidt Dan , Sherliker Paul , Sohoni Rajani , Stevens Becky , Turnbull Iain , Walters Robin , Wang Lin , Wright Neil , Yao Pang , Guo Yu , Han Xiao , Hou Can , Lv Jun , Pei Pei , Liu Chao , Xia Qingmei , Pang Zengchang , Gao Ruqin , Li Shanpeng , Duan Haiping , Wang Shaojie , Liu Yongmei , Du Ranran , Zang Yajing , Cheng Liang , Tian Xiaocao , Zhang Hua , Zhai Yaoming , Ning Feng , Sun Xiaohui , Lv Silu , Wang Junzheng , Hou Wei , Sun Wei , Yan Shichun , Cui Xiaoming , Wang Chi , Wu Zhenyuan , Li Yanjie , Kang Quan , Luo Huiming , Ou Tingting , Zheng Xiangyang , Guo Zhendong , Wu Shukuan , Li Yilei , Li Huimei , Wu Ming , Zhou Yonglin , Zhou Jinyi , Tao Ran , Yang Jie , Su Jian , Liu Fang , Zhang Jun , Hu Yihe , Lu Yan , Ma Liangcai , Tang Aiyu , Zhang Shuo , Jin Jianrong , Liu Jingchao , Lin Mei , Lu Zhenzhen , Zhou Lifang , Xie Changping , Lan Jian , Zhu Tingping , Liu Yun , Wei Liuping , Zhou Liyuan , Chen Ningyu , Qin Yulu , Wang Sisi , Wu Xianping , Zhang Ningmei , Chen Xiaofang , Chang Xiaoyu , Yuan Mingqiang , Wu Xia , Chen Xiaofang , Jiang Wei , Liu Jiaqiu , Sun Qiang , Chen Faqing , Ren Xiaolan , Dong Caixia , Zhang Hui , Mao Enke , Wang Xiaoping , Wang Tao , Zhang Xi , Kang Kai , Feng Shixian , Tian Huizi , Fan Lei , Li Xiao Lin , Sun Huarong , He Pan , Zhang Xukui , Yu Min , Hu Ruying , Wang Hao , Zhang Xiaoyi , Cao Yuan , Xie Kaixu , Chen Lingli , Shen Dun , Li Xiaojun , Jin Donghui , Yin Li , Liu Huilin , Fu Zhongxi , Xu Xin , Zhang Hao , Chen Jianwei , Peng Yuan , Zhang Libo , Qu Chan 
Published: October 2022

Background

Little is known about the effects of maintaining healthy sleep patterns on frailty transitions.

Methods

Based on 23,847 Chinese adults aged 30–79 in a prospective cohort study, we examined the associations between sleep patterns and frailty transitions. Healthy sleep patterns included sleep duration at 7 or 8 h/d, without insomnia disorder, and no snoring. Participants who persisted with a healthy sleep pattern in both surveys were defined as maintaining a healthy sleep pattern and scored one point. We used 27 phenotypes to construct a frailty index and defined three statuses: robust, prefrail, and frail. Frailty transitions were defined as the change of frailty status between the 2 surveys: improved, worsened, and remained. Log-binomial regression was used to calculate the prevalence ratio (PR) to assess the effect of sleep patterns on frailty transitions.

Results

During a median follow-up of 8.0 years among 23,847 adults, 45.5% of robust participants, and 10.8% of prefrail participants worsened their frailty status, while 18.6% of prefrail participants improved. Among robust participants at baseline, individuals who maintained sleep duration of 7 or 8 h/ds, without insomnia disorder, and no-snoring were less likely to worsen their frailty status; the corresponding PRs (95% CIs) were 0.92 (0.89–0.96), 0.76 (0.74–0.77), and 0.85 (0.82–0.88), respectively. Similar results were observed among prefrail participants maintaining healthy sleep patterns. Maintaining healthy sleep duration and without snoring, also raised the probability of improving the frailty status; the corresponding PRs were 1.09 (1.00–1.18) and 1.42 (1.31–1.54), respectively. Besides, a dose-response relationship was observed between constantly healthy sleep scores and the risk of frailty transitions (Pfor trend < 0.001).

Conclusions

Maintaining a comprehensive healthy sleep pattern was positively associated with a lower risk of worsening frailty status and a higher probability of improving frailty status among Chinese adults.