0844 Links of Napping With Subsequent All-Cause Hospitalizations and Emergency Department Visits in Older Adults. (27th May 2020)

• Record Type: Journal Article
• Authors: Tzuang, M; Owusu, J T; Huang, J; Sheehan, O C; Rebok, G W; Kasper, J; Spira, A P
• Is Part Of: Sleep. Volume 43(2020)Supplement 1
• Page Start: A321
• Page End: A322
• Publication Date: 2020-05-27
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsaa056.840
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Few studies have examined whether napping is associated with objective measures of health services use. We investigated links of napping characteristics with all-cause hospitalizations and emergency department (ED) visits in Medicare claims from a nationally representative sample of older adults. Methods: Participants were 869 community-dwelling Medicare beneficiaries aged ≥65 years from Round 3 (2013) and Round 4 (2014) of the National Health and Aging Trends Study (NHATS) who had continuous fee-for-service coverage 1 year before and after the NHATS interview. Participants reported past-month napping frequency (re-categorized as non-nappers, infrequent nappers, frequent nappers), napping type (intentional, unintentional), and nap duration. Outcomes were from linked Medicare claims measured after napping assessment: all-cause ED visits and hospitalizations (yes vs. no), and number of hospitalizations and ED visits. Results: Overall, 45.4% of participants were nappers, and 55.2% of the nappers reported taking unintentional naps. After adjustment for demographics, depressive/anxiety symptoms, medical comorbidities and BMI, compared with non-nappers, infrequent and frequent nappers had a higher odds of hospitalization (odds ratio (OR)=1.65 and 1.73, respectively, both p <0.05), as did unintentional nappers (OR=1.85, p <0.05). We found no significant adjusted associations of napping frequency with ED visits. However, compared with non-nappers, unintentional nappers had a higher odds of visiting the ED (OR=1.94, p <0.01). Additionally, compared to nappers taking short naps (≤30 minutes), those with naps >60 minutes had a greater number of ED visits (Incidence Rate Ratio=1.99, p <0.05). Conclusion: Among older adults, napping—and particularly unintentional napping—may be a modifiable risk factor for health services use. More studies that consider multiple napping characteristics (e.g., duration, frequency), and using objective measures (e.g., actigraphy), are needed to advance understanding of how napping might influence health services use. Support: National Institute on Aging: R01AG050507 & R01AG050507-02S (PI: Spira); F31-AG058389; U01AG032947 (PI: Kasper) for the National Health and Aging Trends Study. Johns Hopkins Center on Aging and Health Data Use Agreement (PI: Roth, Co-I: Sheehan) with Centers for Medicare & Medicaid Services titled, "Potentially modifiable factors influencing outcomes in NHATS."