Impaired psychomotor vigilance associated with sleep-disordered breathing in women working in the care of older adults in Japan

Abstract

With a rapidly aging society, there is increasing interest in the health of female workers in the field of care services for older adults due to increasing demands to maintain 24-h care and to support older adults without errors or accidents. Therefore, the purpose of this cross-sectional study was to examine the association between sleep-disordered breathing (SDB) and sustained attention in women caring for older adults in Japan. The study was conducted in women aged 18–67 years old working in care service facilities for older adults in Japan. The sustained attention of participants was measured by the 10-min psychomotor vigilance task (PVT). SDB was assessed based on the respiratory disturbance index (RDI), which was measured using an ambulatory airflow monitor with a polyvinylidene fluoride (PVDF) film sensor to monitor the respiratory airflow of nasal and oral breathing. The participants wore the monitor to record the breathing status while asleep at home. The severity of SDB was categorized as follows: normal, RDI\u2009<\u20095 events/h; mild SDB, RDI 5–10 events/h; and moderate-to-severe SDB, RDI\u2009≥\u200910 events/h. Of 688 women enrolled, medians of age, body mass index (BMI), sleep duration, and prevalence of hypertension tended to be higher with increasing RDI. No significant association was found between RDI and PVT parameters. However, when we limited the analysis to women with BMI\u2009≥\u200922 kg/m2, those with moderate-to-severe SDB had significantly higher odds of having the slowest 10% reaction times compared to those without SDB (OR\u2009=\u20092.03; 95% CI\u2009=\u20091.17–3.53). The association did not decrease after adjusting to account for sleep duration, alcohol drinking habits, and history of hypertension (OR\u2009=\u20091.97; 95% CI\u2009=\u20091.10–3.52). A significant increasing trend was also found between RDI and the slowest 10% of reaction times (p for trend\u2009=\u20090.03). Our findings suggest that SDB is associated with reduced sustained attention in participants with BMI\u2009≥\u200922 kg/m2, although the number of assessments of SDB and PVT was only once per participant due to the nature of the cross-sectional study.