1
|
Xie Y, Sun P, Huang H, Wu J, Ba Y, Zhou G, Yu F, Zhang D, Zhang Y, Qie R, Hu Z, Zou K, Zhang Y. Network analysis of smoking-related sleep characteristics in Chinese adults. Ann Med 2024; 56:2332424. [PMID: 38527416 DOI: 10.1080/07853890.2024.2332424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 02/29/2024] [Indexed: 03/27/2024] Open
Abstract
The associations between multiple sleep characteristics and smoking behavior are inconsistent, and it is unclear which sleep characteristics are most crucial for tobacco prevention. This study aimed to explore the associations between smoking status/intensity and multiple sleep characteristics and to identify the potential core domain of smoking-related sleep using network analysis. Data were obtained from a survey of cancer-related risk factors among Chinese adults. Logistic regression models were used to quantify the associations between sleep characteristics and smoking status/intensity. Network analyses were employed to identify the core sleep characteristics. A total of 5,228 participants with a median age of 44 years old were included in the study. Current smoking was significantly positively associated with long nap time, difficulty falling asleep, late bedtime, getting up after 7 am, and waking up earlier than expected. There was significant positive association between current smoking and short sleep duration in young adults under 45 years old. Late bedtime and getting up after 7 am were only associated with current heavy smoking, but not current light smoking. Network analyses showed that multiple smoking-related sleep characteristics were interconnected, with difficulty falling asleep and late bedtime as central characteristics in the network. The study found that the associations between sleep characteristics and smoking varied by age and smoking intensity and highlights the potential benefits of sleep health promotion in smoking cessation, with a particular focus on difficulty falling asleep and late bedtime.
Collapse
Affiliation(s)
- Yuting Xie
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Peiyuan Sun
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huang Huang
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianjun Wu
- School of Public Health, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Yue Ba
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Guoyu Zhou
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Fangfang Yu
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Daming Zhang
- Department of Neurosurgery, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yaqun Zhang
- Department of Ecology and Environment of Gansu Province, Lanzhou, Gansu, China
| | - Ranran Qie
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhuolun Hu
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kaiyong Zou
- Office for Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yawei Zhang
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
2
|
Lin L, Hu X, Liu X, Hu G. Key influences on dysglycemia across Fujian's urban-rural divide. PLoS One 2024; 19:e0308073. [PMID: 39083543 PMCID: PMC11290630 DOI: 10.1371/journal.pone.0308073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 07/17/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Screening and treatment of dysglycemia (prediabetes and diabetes) represent significant challenges in advancing the Healthy China initiative. Identifying the crucial factors contributing to dysglycemia in urban-rural areas is essential for the implementation of targeted, precise interventions. METHODS Data for 26,157 adults in Fujian Province, China, were collected using the Social Factors Special Survey Form through a multi-stage random sampling method, wherein 18 variables contributing to dysglycemia were analyzed with logistic regression and the random forest model. OBJECTIVE Investigating urban-rural differences and critical factors in dysglycemia prevalence in Fujian, China, with the simultaneous development of separate predictive models for urban and rural areas. RESULT The detection rate of dysglycemia among adults was 35.26%, with rates of 34.1% in urban areas and 35.8% in rural areas. Common factors influencing dysglycemia included education, age, BMI, hypertension, and dyslipidemia. For rural residents, higher income (OR = 0.80, 95% CI [0.74, 0.87]), average sleep quality (OR = 0.89, 95% CI [0.80, 0.99]), good sleep quality (OR = 0.89, 95% CI [0.80, 1.00]), and high physical activity (PA) (OR = 0.87, 95% CI [0.79, 0.96]) emerged as protective factors. Conversely, a daily sleep duration over 8 hours (OR = 1.46, 95% CI [1.03, 1.28]) and middle income (OR = 1.12, 95% CI [1.03, 1.22]) were specific risk factors. In urban areas, being male (OR = 1.14, 95% CI [1.02, 1.26]), cohabitation (OR = 1.18, 95% CI [1.02, 1.37]), and central obesity (OR = 1.35, 95% CI [1.19, 1.53]) were identified as unique risk factors. Using logistic regression outcomes, a random forest model was developed to predict dysglycemia, achieving accuracies of 75.35% (rural) and 76.95% (urban) with ROC areas of 0.77 (rural) and 0.75 (urban). CONCLUSION This study identifies key factors affecting dysglycemia in urban and rural Fujian residents, including common factors such as education, age, BMI, hypertension, and dyslipidemia. Notably, rural-specific protective factors are higher income and good sleep quality, while urban-specific risk factors include being male and central obesity. These findings support the development of targeted prevention and intervention strategies for dysglycemia, tailored to the unique characteristics of urban and rural populations.
Collapse
Affiliation(s)
- LiHan Lin
- College of Physical Education, Huaqiao University, Quanzhou, China
| | - XiangJu Hu
- School of Public Health, Fujian Medical University, Fuzhou, China
- Department for Chronic and Noncommunicable Disease Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian, China
| | - XiaoYang Liu
- College of Physical Education, Huaqiao University, Quanzhou, China
| | - GuoPeng Hu
- College of Physical Education, Huaqiao University, Quanzhou, China
| |
Collapse
|
3
|
Qie R, Huang H, Sun P, Bi X, Chen Y, Liu Z, Chen Q, Zhang S, Liu Y, Wei J, Chen M, Zhong J, Qi Z, Yao F, Gao L, Yu H, Liu F, Zhao Y, Chen B, Wei X, Qin S, Du Y, Zhou G, Yu F, Ba Y, Shang T, Zhang Y, Zheng S, Xie D, Chen X, Liu X, Zhu C, Wu W, Feng Y, Wang Y, Xie Y, Hu Z, Wu M, Yan Q, Zou K, Zhang Y. Combined healthy lifestyles and risk of depressive symptoms: A baseline survey in China. J Affect Disord 2024; 363:152-160. [PMID: 39038619 DOI: 10.1016/j.jad.2024.07.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 07/10/2024] [Accepted: 07/16/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Little evidence exists about whether a combination of healthy lifestyle factors is associated with a lower risk of depressive symptoms among Chinese population. We aimed to investigate the association between combined healthy lifestyle factors and risk of depressive symptoms. METHODS We conducted a baseline survey from July 2021 to December 2023, including 53,642 Chinese adults from general population. A healthy lifestyle score was constructed based on six lifestyle factors (physical activity, smoking status, alcohol consumption, diet, sleep duration, and body mass index). Logistic regression models were used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) adjusted for confounding variables. RESULTS Each additional healthy lifestyle score was associated with a 20 % lower risk of having depressive symptoms (OR (95 % CI): 0.80 (0.78-0.81)). Compared with individuals with ≤2 healthy lifestyle factors, individuals with all the six healthy lifestyle factors had a 58 % reduced risk of having depressive symptoms (0.42 (0.37-0.47)). After stratification by gender, education and urbanization, the significant inverse association with healthy lifestyle score was stronger in women, individuals with high education, and urban residents. Besides, the significant negative association between healthy lifestyle score and depressive symptoms remained for different severity of depressive symptoms. LIMITATIONS Given the cross-sectional nature of data, we cannot make causal inferences. CONCLUSIONS Our study indicated that adherence to healthy lifestyle factors was associated with a reduced risk of having depressive symptoms among Chinese adults. The observed associations were modified by gender, education and urbanization. These findings warrant further verification in interventional studies.
Collapse
Affiliation(s)
- Ranran Qie
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, Henan, China
| | - Huang Huang
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Peiyuan Sun
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaofeng Bi
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yingtai Chen
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zheng Liu
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiong Chen
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, Henan, China
| | - Shaokai Zhang
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, Henan, China
| | - Yin Liu
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, Henan, China
| | - Jiankun Wei
- Dongguan Center for Disease Control and Prevention, Dongguan, Guangdong, China
| | - Miaochang Chen
- Dongguan Center for Disease Control and Prevention, Dongguan, Guangdong, China
| | - Jieying Zhong
- Dongguan Center for Disease Control and Prevention, Dongguan, Guangdong, China
| | - Zhi Qi
- Beijing Chaoyang District Center for Disease Control and Prevention, Beijing, China
| | - Fan Yao
- Beijing Chaoyang District Center for Disease Control and Prevention, Beijing, China
| | - Lijuan Gao
- Beijing Chaoyang District Center for Disease Control and Prevention, Beijing, China
| | - Huanling Yu
- Department of Nutrition and Food Hygiene, School of Public Health, Capital Medical University, Beijing, China
| | - Fen Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Yao Zhao
- Beijing Fangshan District Center for Disease Control and Prevention, Beijing, China
| | - Baozhong Chen
- Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Xiaoli Wei
- Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Shasha Qin
- Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Yuhui Du
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Guoyu Zhou
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Fangfang Yu
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yue Ba
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Tingting Shang
- Department of Ecology and Environment of Gansu Province, Lanzhou, Gansu, China
| | - Yaqun Zhang
- Department of Ecology and Environment of Gansu Province, Lanzhou, Gansu, China
| | - Shan Zheng
- Lanzhou University, Lanzhou, Gansu, China
| | - Dongmei Xie
- Genertec Medical Cheng Fei Hospital, Chengdu, Sichuan, China
| | - Xiaolan Chen
- Genertec Medical Cheng Fei Hospital, Chengdu, Sichuan, China
| | - Xiaoling Liu
- Genertec Medical Cheng Fei Hospital, Chengdu, Sichuan, China
| | - Cairong Zhu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Weiwei Wu
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yongliang Feng
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Ying Wang
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yuting Xie
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhuolun Hu
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mengyao Wu
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qi Yan
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kaiyong Zou
- Office for Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yawei Zhang
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| |
Collapse
|
4
|
Thompson LM, Slavish DC, Messman BA, Dietch JR, Kelly K, Ruggero C, Taylor DJ, Ramarushton B, Blumenthal H. Alcohol Use Predicts Longer But More Fragmented Sleep: A Daily Diary Study of Alcohol, Sleep, and PTSD in Nurses. Int J Behav Med 2024:10.1007/s12529-024-10308-z. [PMID: 38977540 DOI: 10.1007/s12529-024-10308-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND Due to the demanding nature of their profession, nurses are at risk of experiencing irregular sleep patterns, substance use, and fatigue. Evidence supports a reciprocal relationship between alcohol use and sleep disturbances; however, no research has examined such a link in a sample of nurses. One factor that may further impact the dynamic between alcohol and sleep patterns is posttraumatic stress disorder (PTSD) symptoms. We investigated the daily bidirectional associations between alcohol use and several sleep domains (i.e., self-report and actigraphy-determined sleep), and moderation by baseline PTSD symptom severity. METHOD Over a 14-day period, 392 nurses (92% female; 78% White) completed sleep diaries and actigraphy to assess alcohol use and sleep patterns. Within-person bidirectional associations between alcohol and sleep were examined using multilevel models, with symptoms of PTSD as a cross-level moderator. RESULTS Daily alcohol use (i.e., ≥ 1 alcoholic beverage; 25.76%) was associated with shorter self-reported sleep onset latency (b = -4.21, p = .003) but longer self-reported wake after sleep onset (b = 2.36, p = .009). Additionally, days with any alcohol use were associated with longer self-reported sleep duration (b = 15.60, p = .006) and actigraphy-determined sleep duration (b = 10.06, p = .037). No sleep variables were associated with next-day alcohol use. Bidirectional associations between alcohol consumption and sleep were similar regardless of baseline PTSD symptoms. CONCLUSION Our results suggested that on days when nurses drank alcohol, they experienced longer but also more fragmented sleep.
Collapse
Affiliation(s)
- Linda M Thompson
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, USA.
| | - Danica C Slavish
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, USA.
| | - Brett A Messman
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, USA
| | - Jessica R Dietch
- School of Psychological Science, Oregon State University, 2950 SW Jefferson Way, Corvallis, OR, 97331, USA
| | - Kimberly Kelly
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, USA
| | - Camilo Ruggero
- School of Behavioral and Brain Sciences, University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080, USA
| | - Daniel J Taylor
- Department of Psychology, University of Arizona, 1503 E University Blvd, Tucson, AZ, 85721, USA
| | - Banan Ramarushton
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, USA
| | - Heidemarie Blumenthal
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, USA
| |
Collapse
|
5
|
Rouhi S, Egorova-Brumley N, Jordan AS. Chronic sleep deficiency and its impact on pain perception in healthy females. J Sleep Res 2024:e14284. [PMID: 38972675 DOI: 10.1111/jsr.14284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/19/2024] [Accepted: 06/25/2024] [Indexed: 07/09/2024]
Abstract
Acute sleep deprivation in experimental studies has been shown to induce pain hypersensitivity in females. However, the impact of natural sleep deficiency and fluctuations across the week on pain perception remains unclear. A sleep-monitoring headband and self-reports were utilized to assess objective and subjective sleep in longer (> 6 hr) and short sleepers (< 6 hr). Pain sensitivity measures including heat, cold, pressure pain thresholds, pain inhibition (conditioned pain modulation) and facilitation (tonic pain summation) were assessed on Mondays and Fridays. Forty-one healthy young (23.9 ± 0.74 years) women participated. Short sleepers slept on average 2 hr less than longer sleepers (297.9 ± 8.2 min versus 418.5 ± 10.9 min) and experienced impaired pain inhibitory response (mean = -21.14 ± 7.9°C versus mean = 15.39 ± 9.5°C; p = 0.005). However, no effect was observed in pain thresholds and pain summation (p > 0.05). Furthermore, pain modulatory responses differed between Mondays and Fridays. Chronic sleep deficiency (< 6 hr) compromises pain responses, notably on Mondays. Maintaining a consistent sleep pattern with sufficient sleep (> 6 hr) throughout the week may protect against pain sensitization and the development of chronic pain in females. Further research is needed, especially in patients with chronic pain.
Collapse
Affiliation(s)
- Shima Rouhi
- The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Amy S Jordan
- The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
6
|
Cho H, Steege LM, Pavek KU. Psychological detachment from work during nonwork time as a moderator and mediator of the relationship of workload with fatigue and sleep in hospital nurses. Sleep Health 2024:S2352-7218(24)00113-X. [PMID: 38960800 DOI: 10.1016/j.sleh.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 07/05/2024]
Abstract
OBJECTIVES To examine differences in psychological detachment from work during nonwork time by nurses' personal and work-related characteristics, and to examine the moderating and mediating effects of psychological detachment on the relationships between nursing workload and fatigue and sleep. METHODS This study employed a cross-sectional design with a self-administered online survey. Survey data from 827 hospital nurses providing direct patient care in the United States were used. Moderating and mediating effects of psychological detachment between workload and fatigue/sleep relationships were assessed using Hayes' PROCESS macro in SPSS. RESULTS There were significant differences in psychological detachment from work based on age, highest nursing degree, work experience, shift length, weekly work hours, and frequency of providing care to patients with COVID-19. The associations of workload with physical fatigue, mental fatigue, and sleep quality were weakened when psychological detachment was high. Psychological detachment statistically mediated the associations between workload and fatigue and sleep problems. CONCLUSION Healthcare organizations are encouraged to facilitate nurses' psychological detachment during time-off to protect them from fatigue and sleep problems.
Collapse
Affiliation(s)
- Hyeonmi Cho
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea.
| | - Linsey M Steege
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Katie U Pavek
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
| |
Collapse
|
7
|
Hu P, Vinturache A, Chen Y, Ding G, Zhang Y. Joint Association of Sleep Onset Time and Sleep Duration With Cardiometabolic Health Outcome. J Am Heart Assoc 2024; 13:e034165. [PMID: 38874059 PMCID: PMC11255762 DOI: 10.1161/jaha.123.034165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 05/07/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND The association of sleep onset time and duration with cardiometabolic health is not well characterized. METHODS AND RESULTS This study included 6696 adults aged 20 to 80 years from the NHANES (National Health and Nutrition Examination Study) 2015 to 2018. Participants were categorized into 9 groups according to the cross-tabulation of sleep onset time (<22:00 [early], 22:00-23:59 [optimal], and ≥24:00 [late]) and duration (<7 hours [insufficient], 7-8 hours [sufficient], and ≥9 hours [excessive]), with optimal sleep onset time and sufficient duration as the reference. The primary outcomes included hypertension, hypertriglyceridemia, low high-density lipoprotein cholesterol, hyperglycemia, central obesity, and metabolic syndrome. Inappropriate sleep onset time and sleep duration were associated with increased odds of hypertension, hypertriglyceridemia, and metabolic syndrome, especially among participants aged 40 to 59 years. Compared with men reporting optimal onset and sufficient duration, men reporting optimal onset with excessive duration (odds ratio [OR]: 2.01 [95% CI, 1.12-3.58]) and late onset with insufficient duration (OR, 1.74 [95% CI, 1.13-2.68]) had higher odds of metabolic syndrome. Compared with women reporting optimal onset and sufficient duration, women reporting optimal onset and insufficient duration (OR, 1.61 [95% CI, 1.11-2.32]) and early onset and excessive duration (OR, 2.16 [95% CI, 1.30-3.57]) had higher odds of hypertension, and women reporting late onset and excessive duration (OR, 5.64 [95% CI, 1.28-6.77]) were at the highest odds of hypertriglyceridemia. CONCLUSIONS Late sleep onset as well as insufficient or excessive sleep duration are associated with adverse cardiometabolic outcomes, particularly in participants aged 40 to 59 years.
Collapse
Affiliation(s)
- Peipei Hu
- Department of Pediatrics, Xinhua HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai Institute for Pediatric ResearchShanghaiChina
| | - Angela Vinturache
- Department of Obstetrics and GynecologyUniversity of AlbertaEdmontonAlbertaCanada
- Department of NeuroscienceUniversity of LethbridgeLethbridgeAlbertaCanada
| | - Yan Chen
- Department of Pediatrics, Xinhua HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai Institute for Pediatric ResearchShanghaiChina
| | - Guodong Ding
- Department of Pediatrics, Xinhua HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai Institute for Pediatric ResearchShanghaiChina
| | - Yongjun Zhang
- Department of Pediatrics, Xinhua HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai Institute for Pediatric ResearchShanghaiChina
| |
Collapse
|
8
|
Glazer SA, Vallis M. Impact of COVID-19 pandemic on sleep parameters and characteristics in individuals living with overweight and obesity. Clin Obes 2024; 14:e12646. [PMID: 38348598 DOI: 10.1111/cob.12646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 05/14/2024]
Abstract
Coronavirus disease 2019 (COVID-19) has been very challenging for those living with overweight and obesity. The magnitude of this impact on sleep requires further attention to optimise patient care and outcomes. This study assessed the impact of the COVID-19 lockdown on sleep duration and quality as well as identify predictors of poor sleep quality in individuals with reported diagnoses of obstructive sleep apnoea and those without sleep apnoea. An online survey (June-October 2020) was conducted with two samples; one representative of Canadians living with overweight and obesity (n = 1089) and a second of individuals recruited through obesity clinical services or patient organisations (n = 980). While overall sleep duration did not decline much, there were identifiable groups with reduced or increased sleep. Those with changed sleep habits, especially reduced sleep, had much poorer sleep quality, were younger, gained more weight and were more likely to be female. Poor sleep quality was associated with medical, social and eating concerns as well as mood disturbance. Those with sleep apnoea had poorer quality sleep although this was offset to some degree by use of CPAP. Sleep quality and quantity has been significantly impacted during the early part of the COVID-19 pandemic in those living with overweight and obesity. Predictors of poor sleep and the impact of sleep apnoea with and without CPAP therapy on sleep parameters has been evaluated. Identifying those at increased risk of sleep alterations and its impact requires further clinical consideration.
Collapse
Affiliation(s)
- Stephen A Glazer
- Department of Internal Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michael Vallis
- Department of Family Medicine, Dalhousie University, Halifix, Nova Scotia, Canada
| |
Collapse
|
9
|
Allison KC, Parnarouskis L, Moore MD, Minnick AM. Insomnia, Short Sleep, and Their Treatments: Review of Their Associations with Weight. Curr Obes Rep 2024; 13:203-213. [PMID: 38776004 PMCID: PMC11150288 DOI: 10.1007/s13679-024-00570-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 06/05/2024]
Abstract
PURPOSE OF REVIEW Insomnia and short sleep have been linked with weight gain and obesity. However, these findings have not been consistent across studies. We review recent evidence for the association between insomnia, short sleep, and weight gain, as well as the relationship between behavioral and pharmacological treatments for sleep and weight. RECENT FINDINGS The relationship between insomnia and obesity is mixed, with stronger associations between insomnia with short sleep and obesity than other presentations of insomnia. Short sleep is associated with weight gain. Z-drugs and benzodiazapines do not appear to impact weight, but many antidepressants and antipsychotics that are used for insomnia treatment do cause weight gain. The relationships between insomnia and short sleep with weight gain and obesity are inconsistent. More prospective trials are needed to identify mediators and moderators of this relationship to better develop and deliver effective interventions for both sleep and weight problems.
Collapse
Affiliation(s)
- Kelly C Allison
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3029, Philadelphia, PA, 19104-3309, USA.
| | - Lindsey Parnarouskis
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3029, Philadelphia, PA, 19104-3309, USA
- Department of Psychology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Molly D Moore
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3029, Philadelphia, PA, 19104-3309, USA
| | - Alyssa M Minnick
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3029, Philadelphia, PA, 19104-3309, USA
- InBody BWA, Audubon, PA, 19403, USA
| |
Collapse
|
10
|
Grant LK, Kent BA, Rahman SA, St. Hilaire MA, Kirkley CL, Gregory KB, Clark T, Hanifin JP, Barger LK, Czeisler CA, Brainard GC, Lockley SW, Flynn-Evans EE. The effect of a dynamic lighting schedule on neurobehavioral performance during a 45-day simulated space mission. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae032. [PMID: 38903700 PMCID: PMC11187988 DOI: 10.1093/sleepadvances/zpae032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 03/15/2024] [Indexed: 06/22/2024]
Abstract
Study Objectives We previously reported that during a 45-day simulated space mission, a dynamic lighting schedule (DLS) improved circadian phase alignment and performance assessed once on selected days. This study aimed to evaluate how DLS affected performance on a 5-minute psychomotor vigilance task (PVT) administered multiple times per day on selected days. Methods Sixteen crewmembers (37.4 ± 6.7 years; 5F) underwent six cycles of 2 × 8-hour/night followed by 5 × 5-hour/night sleep opportunities. During the DLS (n = 8), daytime white light exposure was blue-enriched (~6000 K; Level 1: 1079, Level 2: 76 melanopic equivalent daytime illuminance (melEDI) lux) and blue-depleted (~3000-4000 K; L1: 21, L2: 2 melEDI lux) 3 hours before bed. In the standard lighting schedule (SLS; n = 8), lighting remained constant (~4500K; L1: 284, L2 62 melEDI lux). Effects of lighting condition (DLS/SLS), sleep condition (5/8 hours), time into mission, and their interactions, and time awake on PVT performance were analyzed using generalized linear mixed models. Results The DLS was associated with fewer attentional lapses (reaction time [RT] > 500 milliseconds) compared to SLS. Lapses, mean RT, and 10% fastest/slowest RTs were worse following 5 compared to 8 hours of sleep but not between lighting conditions. There was an effect of time into mission on RTs, likely due to sleep loss. Overall performance differed by time of day, with longer RTs at the beginning and end of the day. There were more lapses and slower RTs in the afternoon in the SLS compared to the DLS condition. Conclusions Future missions should incorporate DLS to enhance circadian alignment and performance. This paper is part of the Sleep and Circadian Rhythms: Management of Fatigue in Occupational Settings Collection.
Collapse
Affiliation(s)
- Leilah K Grant
- Division of Sleep and Circadian Disorders, Brigham & Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Brianne A Kent
- Division of Sleep and Circadian Disorders, Brigham & Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Shadab A Rahman
- Division of Sleep and Circadian Disorders, Brigham & Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Melissa A St. Hilaire
- Division of Sleep and Circadian Disorders, Brigham & Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Crystal L Kirkley
- Fatigue Countermeasures Laboratory, Human Systems Integration Division, NASA Ames Research Center, Moffett Field, CA, USA
| | - Kevin B Gregory
- Fatigue Countermeasures Laboratory, Human Systems Integration Division, NASA Ames Research Center, Moffett Field, CA, USA
| | | | - John P Hanifin
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Laura K Barger
- Division of Sleep and Circadian Disorders, Brigham & Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Brigham & Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - George C Brainard
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Steven W Lockley
- Division of Sleep and Circadian Disorders, Brigham & Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Erin E Flynn-Evans
- Fatigue Countermeasures Laboratory, Human Systems Integration Division, NASA Ames Research Center, Moffett Field, CA, USA
| |
Collapse
|
11
|
Li K, Liu W, Wu C, Wang L, Huang Y, Li Y, Zheng H, Shang Y, Zhang L, Chen Z. The anti-fatigue and sleep-aiding effects vary significantly among different recipes containing Ganoderma lucidum extracts. Heliyon 2024; 10:e30907. [PMID: 38770283 PMCID: PMC11103526 DOI: 10.1016/j.heliyon.2024.e30907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/07/2024] [Accepted: 05/07/2024] [Indexed: 05/22/2024] Open
Abstract
Aims This study aims to delve into the anti-fatigue and sleep-aiding effects of various formulations containing Ganoderma lucidum extracts. Materials and methods PGB [incorporating Ganoderma lucidum extract (GE), broken Ganoderma lucidum spore powder (GB) and Paecilomyces hepiali mycelium (PH)] and GBS [composed of GE, GB, and Ganoderma sinense powder (GS)] were chosen as representative recipes for this study. Mice were treated with these recipes or key components of Ganoderma lucidum for 14 consecutive days. Subsequently, a weight-bearing swimming experiment was conducted to assess the mice's exhaustion time and evaluate the anti-fatigue properties of the recipes. Sleep-aiding effects were analyzed by measuring the sleep latency and duration. Furthermore, levels of blood lactic acid, serum urea nitrogen, hepatic glycogen, muscle glycogen, and malondialdehyde (MDA) were measured in the livers and muscles. Key findings The anti-fatigue abilities of the tested mice were significantly improved after treatment with PGB and their sleep quality improved as well with GBS treatment. PGB treatment for 14 days could significantly prolong the exhaustion time in weight-bearing swimming (from 10.1 ± 0.5 min to 15.2 ± 1.3 min). Meanwhile, glycogen levels in the livers and muscles were significantly increased, while the levels of serum lactic acid, serum urea nitrogen, and MDA in the livers and muscles were significantly decreased. In contrast, mice treated with GBS for 14 days experienced significant improvements in sleep quality, with shortened sleep latency (from 6.8 ± 0.7 min to 4.2 ± 0.4 min), extended sleep duration (from 88.3 ± 1.4 min to 152.5 ± 9.3 min), and decreased muscle MDA levels. These results indicated that Ganoderma lucidum extracts can be used for anti-fatigue and or aid in sleeping, depending on how they are prepared and administered. Significance This study provides experimental evidence and theoretical basis for the development of Ganoderma lucidum recipes that are specifically designed to help with anti-fatigue and sleep.
Collapse
Affiliation(s)
- Kexin Li
- State Key Laboratory of Structural Chemistry, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fujian Academy, University of Chinese Academy of Sciences, Fuzhou, Fujian, 350108, China
- College of Life Sciences, Fujian Agriculture and Forestry University Fuzhou, Fujian, 350002, China
| | - Wenzhen Liu
- State Key Laboratory of Structural Chemistry, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fujian Academy, University of Chinese Academy of Sciences, Fuzhou, Fujian, 350108, China
| | - Changhui Wu
- Fujian Xianzhilou Biological Science and Technology Co. Ltd., Fuzhou, Fujian, 350108, China
| | - Le Wang
- State Key Laboratory of Structural Chemistry, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fujian Academy, University of Chinese Academy of Sciences, Fuzhou, Fujian, 350108, China
| | - Yunmei Huang
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
| | - Ye Li
- Fujian Xianzhilou Biological Science and Technology Co. Ltd., Fuzhou, Fujian, 350108, China
| | - Huimin Zheng
- College of Biological Science and Engineering, Fuzhou University, Fuzhou, Fujian, 350108, China
| | - Yanyu Shang
- College of Biological Science and Engineering, Fuzhou University, Fuzhou, Fujian, 350108, China
| | - Lei Zhang
- State Key Laboratory of Structural Chemistry, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fujian Academy, University of Chinese Academy of Sciences, Fuzhou, Fujian, 350108, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Zhuo Chen
- State Key Laboratory of Structural Chemistry, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fujian Academy, University of Chinese Academy of Sciences, Fuzhou, Fujian, 350108, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| |
Collapse
|
12
|
Jacobson IG, Harbertson J, Sharifian N, Rull RP, Steele CT, Russell DW. Sleep health among US Navy afloat versus ashore personnel in the Millennium Cohort Study. J Sleep Res 2024:e14207. [PMID: 38764130 DOI: 10.1111/jsr.14207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 03/18/2024] [Accepted: 03/26/2024] [Indexed: 05/21/2024]
Abstract
Despite emerging public concern regarding the sleep health of military personnel over the past two decades, there remains a dearth of research examining sleep health among naval personnel assigned to sea duty. This study examined sleep metrics (e.g. fatigue, short sleep duration) and mental (e.g. posttraumatic stress disorder, depression) and physical health (e.g. type 2 diabetes, bodily pain) outcomes among naval personnel with recent sea duty (i.e. afloat) compared with naval personnel with recent shore duty (i.e. ashore). Prevalence ratios and mean differences for all outcomes were estimated and adjusted for demographic and military variables, and subsequently stratified by obesity. Sleep metrics were similar between afloat and ashore sailors except for short sleep duration, while sailors with recent shore duty had poorer physical health compared with those with recent sea duty. Stratified analyses suggested naval personnel with obesity had a higher proportion of nearly all adverse sleep-related health outcomes than those without obesity. Among participants without obesity, afloat personnel were more likely to report very short sleep (≤ 5 hours) and fewer hours of average nightly sleep, but were less likely to report physical health outcomes compared with ashore personnel. These findings suggest potential differences in sleep metrics and sleep-related health outcomes between afloat and ashore naval personnel. Additional research examining sleep outcomes using more objective measures is required to further investigate these findings, which may inform strategies to foster consolidated sleep despite environmental and occupational challenges in order to maintain high-performing naval personnel.
Collapse
Affiliation(s)
- Isabel G Jacobson
- Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA
- Leidos, Inc., San Diego, California, USA
| | - Judith Harbertson
- Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA
- Leidos, Inc., San Diego, California, USA
| | - Neika Sharifian
- Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA
- Leidos, Inc., San Diego, California, USA
| | - Rudolph P Rull
- Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA
| | | | - Dale W Russell
- US Navy, Commander, Naval Surface Forces, Coronado, California, USA
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| |
Collapse
|
13
|
Lee SA, Mukherjee D, Rush J, Lee S, Almeida DM. Too little or too much: nonlinear relationship between sleep duration and daily affective well-being in depressed adults. BMC Psychiatry 2024; 24:323. [PMID: 38664716 PMCID: PMC11044558 DOI: 10.1186/s12888-024-05747-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/08/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND In addition to having higher negative affect and lower positive affect overall, depressed individuals exhibit heightened affective reactivity to external stimuli than non-depressed individuals. Sleep may contribute to day-to-day fluctuations in depressed individuals, given that sleep disturbance is a common symptom of depression. Yet, little is known about changes in daily affect as a function of nightly sleep duration in depressed adults and non-depressed adults. The current study examined whether and how naturally-occurring sleep duration is associated with negative and positive affect, and how these associations differ between depressed vs. non-depressed adults. METHODS Data were drawn from the second wave of the National Study of Daily Experiences (NSDE), a daily diary project of the Midlife in the United States (MIDUS) study. The sample of 2,012 adults (Mage=56.5; 57% female; 84% white) completed eight-day diary interviews via telephone on their daily experiences including nightly sleep duration and negative and positive affect. They also completed assessments of the Composite International Diagnostic Interview-Short form, and depressed status was determined based on DSM-III. Multilevel regression models with linear, quadratic, and cubic terms of sleep duration examined the nonlinear relationship between nightly sleep duration and daily affect. Interaction terms with depression status were added to examine differences between depressed and non-depressed adults. RESULTS Depressed adults exhibited significant and greater fluctuations in daily affect as a function of nightly sleep duration than non-depressed adults. Specifically, the degree of decrease in positive affect and increase in negative affect was greater when depressed adults slept 2 or more hours less or longer than their usual sleep hours. Non-depressed adults exhibited relatively stable daily affect regardless of their nightly sleep hours. CONCLUSIONS Sleep duration is nonlinearly associated with affect in daily lives of depressed adults, highlighting that both having too little sleep and excessive sleep are associated with adverse daily affective well-being. Implementing sleep interventions to promote an appropriate sleep duration may help improve daily affect among depressed adults.
Collapse
Affiliation(s)
- Sun Ah Lee
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA.
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA.
| | - Dahlia Mukherjee
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine and Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Jonathan Rush
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - Soomi Lee
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA
| | - David M Almeida
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA
| |
Collapse
|
14
|
Wang S, Rossheim ME, Nandy RR, Nguyen US. Interaction between sleep duration and trouble sleeping on depressive symptoms among U.S. adults, NHANES 2015-2018. J Affect Disord 2024; 351:285-292. [PMID: 38302062 DOI: 10.1016/j.jad.2024.01.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 01/25/2024] [Accepted: 01/28/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND This study aims to examine the associations and interaction effects of sleep duration and trouble sleeping on depressive symptoms among U.S. adults. METHODS National Health and Nutrition Examination Survey (NHANES) data from 2015 to 2018 were analyzed (N = 10,044). Trouble sleeping and sleep duration were self-reported. Sleep duration was defined as short (≤6 h) or long (≥9 h), compared with normal (>6 and < 9 h). Depressive symptoms were determined by the Patient Health Questionnaire-9 score ≥ 10. Both multiplicative interaction and additive interaction were reported. RESULTS There was a significant positive additive interaction between short sleep duration and trouble sleeping on depressive symptoms in the fully adjusted model (Relative excess risk due to interaction, RERIOR = 4.42, 95 % CI: 1.12, 7.73), with 43 % of the association with depressive symptoms attributed to the interaction (attributable proportion of interaction, AP = 0.43, 95 % CI: 0.22, 0.64). Similarly, a significant positive additive interaction between long sleep duration and trouble sleeping on depressive symptoms was found (RERIOR = 4.17, 95 % CI: 0.96, 7.38), with 41 % of the association with depressive symptoms attributed to the interaction (AP = 0.41, 95 % CI: 0.21, 0.60). No multiplicative interaction was detected between short or long sleep duration and trouble sleeping. LIMITATIONS The cross-sectional design limits the ability to draw causal inferences. CONCLUSIONS Findings suggest that different aspects of sleep health interact synergistically, accounting for a substantial portion of the association with depressive symptoms. This underscores the importance of simultaneously considering multiple dimensions of sleep health in relation to depressive symptoms.
Collapse
Affiliation(s)
- Shanshan Wang
- Department of Population & Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA.
| | - Matthew E Rossheim
- Department of Health Administration & Health Policy, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Rajesh R Nandy
- Department of Population & Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Uyen-Sa Nguyen
- Department of Population & Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| |
Collapse
|
15
|
Hu H, Wu Y, Zhao M, Liu J, Xie P. Sleep duration time and human papillomavirus infection risk: The U-shaped relationship revealed by NHANES data. PLoS One 2024; 19:e0301212. [PMID: 38578744 PMCID: PMC10997073 DOI: 10.1371/journal.pone.0301212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/12/2024] [Indexed: 04/07/2024] Open
Abstract
PURPOSE This study aims to investigate the relationship between sleep factors (sleep duration time [SDT] and obstructive sleep apnea [OSA]) and human papillomavirus (HPV)/high-risk HPV(HR-HPV) infection, utilizing data from the National Health and Nutrition Examination Survey (NHANES). METHODS We conducted a cross-sectional analysis using NHANES data, focusing on SDT and OSA's association with HPV/HR-HPV infection. The primary statistical methods included weighted multivariate linear regression and logistic regression to assess the association between SDT, OSA, and HPV/HR-HPV infection. The study employed restricted cubic splines (RCS) for evaluating potential non-linear relationships between SDT and HPV/HR-HPV infection. Subgroup analyses were conducted. Interaction terms were used to examine the heterogeneity in associations across different subgroups. RESULTS The study identified a U-shaped relationship between SDT and HPV infection. Specifically, 7 hours of sleep was associated with the lowest risk of HPV infection. In comparison, SDT less than 7 hours resulted in a 26.3% higher risk of HPV infection (Odds Ratio [OR] = 1.26, 95% Confidence Interval [CI]: 1.029, 1.549), and more than 9 hours of sleep showed a 57.4% increased risk (OR = 1.574, 95% CI: 1.116, 2.220). The relationship between SDT and HR-HPV infection was significant in the first two models, but not in the fully adjusted model. No significant interaction was found between sleep duration and other covariates. There was no association between OSA and HPV/HR-HPV infection. CONCLUSION The study underscores the complex relationship between sleep duration and HPV infection risk, suggesting both very short and very long sleep durations may increase HPV infection likelihood. The findings highlight the need for further research to explore the biological mechanisms underpinning this association and to consider broader population groups and more precise sleep assessment methods in future studies.
Collapse
Affiliation(s)
- Huangyu Hu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture School of Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yue Wu
- Sichuan University West China Second University Hospital, Chengdu, China
| | - Min Zhao
- Acupuncture School of Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiaqi Liu
- Acupuncture School of Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ping Xie
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| |
Collapse
|
16
|
Saint-Maurice PF, Freeman JR, Russ D, Almeida JS, Shams-White MM, Patel S, Wolff-Hughes DL, Watts EL, Loftfield E, Hong HG, Moore SC, Matthews CE. Associations between actigraphy-measured sleep duration, continuity, and timing with mortality in the UK Biobank. Sleep 2024; 47:zsad312. [PMID: 38066693 PMCID: PMC10925955 DOI: 10.1093/sleep/zsad312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 11/23/2023] [Indexed: 01/12/2024] Open
Abstract
STUDY OBJECTIVES To examine the associations between sleep duration, continuity, timing, and mortality using actigraphy among adults. METHODS Data were from a cohort of 88 282 adults (40-69 years) in UK Biobank that wore a wrist-worn triaxial accelerometer for 7 days. Actigraphy data were processed to generate estimates of sleep duration and other sleep characteristics including wake after sleep onset (WASO), number of 5-minute awakenings, and midpoint for sleep onset/wake-up and the least active 5 hours (L5). Data were linked to mortality outcomes with follow-up to October 31, 2021. We implemented Cox models (hazard ratio, confidence intervals [HR, 95% CI]) to quantify sleep associations with mortality. Models were adjusted for demographics, lifestyle factors, and medical conditions. RESULTS Over an average of 6.8 years 2973 deaths occurred (1700 cancer, 586 CVD deaths). Overall sleep duration was significantly associated with risk for all-cause (p < 0.01), cancer (p < 0.01), and CVD (p = 0.03) mortality. For example, when compared to sleep durations of 7.0 hrs/d, durations of 5 hrs/d were associated with a 29% higher risk for all-cause mortality (HR: 1.29 [1.09, 1.52]). WASO and number of awakenings were not associated with mortality. Individuals with L5 early or late midpoints (<2:30 or ≥ 3:30) had a ~20% higher risk for all-cause mortality, compared to those with intermediate L5 midpoints (3:00-3:29; p ≤ 0.01; e.g. HR ≥ 3:30: 1.19 [1.07, 1.32]). CONCLUSIONS Shorter sleep duration and both early and late sleep timing were associated with a higher mortality risk. These findings reinforce the importance of public health efforts to promote healthy sleep patterns in adults.
Collapse
Affiliation(s)
- Pedro F Saint-Maurice
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
- Breast Unit, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon, Portugal
| | - Joshua R Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Daniel Russ
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jonas S Almeida
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Marissa M Shams-White
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Shreya Patel
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Dana L Wolff-Hughes
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Eleanor L Watts
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Erikka Loftfield
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Hyokyoung G Hong
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Steven C Moore
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| |
Collapse
|
17
|
Shantakumari N, Elawaddlly SHS, Kanawati AJA, Abufanas AS, Dakak A, Ibham FM, Bani I. Sleep Quality and its Daytime Effects among University Students in the UAE. Oman Med J 2024; 39:e612. [PMID: 38988796 PMCID: PMC11234169 DOI: 10.5001/omj.2024.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/03/2023] [Indexed: 07/12/2024] Open
Abstract
Objectives To determine the irregularity in the sleep schedule among university students in the UAE and determine its correlation with poor sleep quality, daytime sleepiness, and fatigue. Methods This observational cross-sectional survey was electronically conducted among undergraduate students of Ajman University during the academic year 2022-2023. The participants were selected using a simple random sampling method. The instruments for data collection comprised of sleep schedule questionnaire, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Fatigue Severity Scale. Data was subjected to chi-square analysis, Mann-Whitney U test, Wilcoxon rank-sum test, and Spearman's correlation. Results Of the 537 participants, 353 (65.7%) were female. The majority (57.2%) kept highly irregular bedtimes. The cohort's mean global PSQI score was 8.9±3.0 indicating poor sleep quality. There was a positive correlation between the irregular bedtime frequency and the global PSQI score (r = 0.311; p < 0.010). Most (70.8%) participants had a total high Fatigue Severity Scale score of ≥ 36. The scores of women (41.0±10.5) were significantly higher than those of men (38.5±11.0) (p =0.006). Around 53.0% of the participants had high ESS scores indicating excessive daytime sleepiness. There was also a significant correlation between ESS score and irregular bedtime frequency (r = 0.113; p =0.009). Conclusions The students at Ajman University had a high prevalence of irregular bedtime and inadequate sleeping hours. This was affecting their sleep quality and causing excessive daytime sleepiness. The students, especially women, were suffering from fatigue, potentially affecting their normal functionality. It is crucial to encourage students to establish regular sleep patterns and improve sleep habits to promote their productivity and general well-being.
Collapse
Affiliation(s)
- Nisha Shantakumari
- Department of Basic Medical Sciences, College of Medicine, Ajman University, Ajman, UAE
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, UAE
| | | | | | | | | | - Fathima Manal Ibham
- Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, UAE
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, UAE
| | - Ibrahim Bani
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, UAE
- Department of Pathological Sciences, College of Medicine, Ajman University, Ajman, UAE
| |
Collapse
|
18
|
Höhn C, Hahn MA, Lendner JD, Hoedlmoser K. Spectral Slope and Lempel-Ziv Complexity as Robust Markers of Brain States during Sleep and Wakefulness. eNeuro 2024; 11:ENEURO.0259-23.2024. [PMID: 38471778 PMCID: PMC10978822 DOI: 10.1523/eneuro.0259-23.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 01/22/2024] [Accepted: 02/09/2024] [Indexed: 03/14/2024] Open
Abstract
Nonoscillatory measures of brain activity such as the spectral slope and Lempel-Ziv complexity are affected by many neurological disorders and modulated by sleep. A multitude of frequency ranges, particularly a broadband (encompassing the full spectrum) and a narrowband approach, have been used especially for estimating the spectral slope. However, the effects of choosing different frequency ranges have not yet been explored in detail. Here, we evaluated the impact of sleep stage and task engagement (resting, attention, and memory) on slope and complexity in a narrowband (30-45 Hz) and broadband (1-45 Hz) frequency range in 28 healthy male human subjects (21.54 ± 1.90 years) using a within-subject design over 2 weeks with three recording nights and days per subject. We strived to determine how different brain states and frequency ranges affect slope and complexity and how the two measures perform in comparison. In the broadband range, the slope steepened, and complexity decreased continuously from wakefulness to N3 sleep. REM sleep, however, was best discriminated by the narrowband slope. Importantly, slope and complexity also differed between tasks during wakefulness. While narrowband complexity decreased with task engagement, the slope flattened in both frequency ranges. Interestingly, only the narrowband slope was positively correlated with task performance. Our results show that slope and complexity are sensitive indices of brain state variations during wakefulness and sleep. However, the spectral slope yields more information and could be used for a greater variety of research questions than Lempel-Ziv complexity, especially when a narrowband frequency range is used.
Collapse
Affiliation(s)
- Christopher Höhn
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, University of Salzburg, 5020 Salzburg, Austria
- Centre for Cognitive Neuroscience Salzburg (CCNS), University of Salzburg, 5020 Salzburg, Austria
| | - Michael A Hahn
- Hertie-Institute for Clinical Brain Research, University Medical Center Tübingen, 72076 Tübingen, Germany
| | - Janna D Lendner
- Hertie-Institute for Clinical Brain Research, University Medical Center Tübingen, 72076 Tübingen, Germany
- Department of Anesthesiology and Intensive Care Medicine, University Medical Center Tübingen, 72076 Tübingen, Germany
| | - Kerstin Hoedlmoser
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, University of Salzburg, 5020 Salzburg, Austria
- Centre for Cognitive Neuroscience Salzburg (CCNS), University of Salzburg, 5020 Salzburg, Austria
| |
Collapse
|
19
|
Kang C, Lee W, Park C, Oh J, Min J, Park J, Choi M, Jang J, Kim H. Beneficial impacts of residential greenness on sleep deprivation in adults aged 19 or older living in South Korea: A nationwide community health survey in 2011-2018. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 914:169700. [PMID: 38160836 DOI: 10.1016/j.scitotenv.2023.169700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/22/2023] [Accepted: 12/24/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Evidence of the relationship between greenness and sleep is limited, and, given the worsening sleep insufficiency worldwide, this relationship needs elucidation. In this study, we investigated the association of greenness with sleep deprivation using nationwide survey data. METHODS This study included 1,727,273 participants in the Korea Community Health Survey who resided in all 229 districts of South Korea from 2011 to 2018. Sleep deprivation variables were defined as strong deprivation or mild deprivation, based on average daily sleep duration of <5 or 5-6 h, respectively. District-specific annual average of satellite-derived enhanced vegetation index (EVI) was used as a green space exposure. A logistic regression with complex survey weights was used to estimate the association between greenness and sleep deprivation, and it was further examined by sex, age group, educational status, income level, and population density. The regression analysis was performed annually, and the annual estimates were pooled by a combined data analysis. RESULTS A higher level of greenness was associated (odds ratio [95 % confidence interval]) with strong and mild sleep deprivation (0.96 [0.93-0.99] and 0.96 [0.95-0.97]), respectively, and males and the younger age group (<65 years) showed a more prominent association with greenness than in females and the elderly group (65 years or older). In addition, only high-population-density areas showed evident associations of greenness with both strong and mild sleep deprivation. CONCLUSIONS This large population-based study provides important epidemiological evidence for improving sleep quantity through an increase in greenness exposure and supports policymakers in establishing strategies for urban planning.
Collapse
Affiliation(s)
- Cinoo Kang
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea.
| | - Whanhee Lee
- School of Biomedical Convergence Engineering, College of Information and Biomedical Engineering, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do 50612, Republic of Korea.
| | - Chaerin Park
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea.
| | - Jieun Oh
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea.
| | - Jieun Min
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, 25 Magokdong-ro 2-gil, Ganseo-gu, Seoul 07804, Republic of Korea.
| | - Jinah Park
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea.
| | - Munjeong Choi
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea.
| | - Jeongju Jang
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea.
| | - Ho Kim
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea.
| |
Collapse
|
20
|
Durkin AC, Richards AJ. Sleep quality and the intention to modify sleep behaviors among night-shift nurses. Nursing 2024; 54:54-58. [PMID: 38386454 DOI: 10.1097/01.nurse.0001006268.77409.dc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
PURPOSE To explore the relationship between sleep quality and intent to change sleep behaviors among night-shift nurses. METHODS Full-time night-shift nurses in a hospital setting completed a cross-sectional online survey including demographics, Snoring, Tiredness during daytime, Observed apnea, and High Blood Pressure (STOP) Questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the Intention to Change Behavior Scale (ICBS). The relationship between PSQI and ICBS scores was tested using Spearman's rho correlation coefficient. RESULTS Most participants reported poor sleep and did not engage in health behaviors that promote good sleep. There was a weak, positive relationship between PSQI and ICBS scores. Those who reported poor sleep quality indicated a high intent to improve sleep. CONCLUSION These findings support the need for night-shift nurses to prioritize enhancing their sleep quality by advocating for policy and practice improvements. The findings also highlight the importance of support from nurse leaders, educators, and researchers to raise awareness and implement holistic strategies for better sleep health.
Collapse
Affiliation(s)
- Adelaide Caroci Durkin
- Adelaide Durkin is an associate professor at Kettering College in Kettering, Ohio. Andrew Richards is an associate professor at Southern Adventist University in Collegedale, Tenn
| | | |
Collapse
|
21
|
Bernstein EE, Klare D, Weingarden H, Greenberg JL, Snorrason I, Hoeppner SS, Vanderkruik R, Harrison O, Wilhelm S. Impact of sleep disruption on BDD symptoms and treatment response. J Affect Disord 2024; 346:206-213. [PMID: 37952909 PMCID: PMC10842714 DOI: 10.1016/j.jad.2023.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 08/08/2023] [Accepted: 11/09/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Body dysmorphic disorder (BDD) is severe, undertreated, and relatively common. Although gold-standard cognitive behavioral therapy (CBT) for BDD has strong empirical support, a significant number of patients do not respond. More work is needed to understand BDD's etiology and modifiable barriers to treatment response. Given its high prevalence and impact on the development, maintenance, and treatment of related, frequently comorbid disorders, sleep disruption is a compelling, but not-yet studied factor. METHODS Data were drawn from a randomized controlled trial of guided smartphone app-based CBT for BDD. Included participants were offered 12-weeks of treatment, immediately (n = 40) or after a 12-week waitlist (n = 37). Sleep disruption and BDD symptom severity were assessed at baseline, week-6, and week-12. RESULTS Hypotheses and analysis plan were pre-registered. Two-thirds of patients reported significant insomnia symptoms at baseline. Baseline severity of sleep disruption and BDD symptoms were not related (r = 0.02). Pre-treatment sleep disruption did not predict BDD symptom reduction across treatment, nor did early sleep improvements predict greater BDD symptom improvement. Early BDD symptom improvement also did not predict later improvements in sleep. LIMITATIONS Limitations include the small sample, restricted ranges of BDD symptom severity and treatment response, and few metrics of sleep disruption. CONCLUSIONS Although insomnia was disproportionately high in this sample and both BDD symptoms and sleep improved in treatment, results suggest sleep and BDD symptoms may function largely independent of one another. More work is encouraged to replicate and better understand findings as well as potential challenges and benefits of addressing sleep in BDD.
Collapse
Affiliation(s)
- Emily E Bernstein
- Massachusetts General Hospital, United States of America; Harvard Medical School, United States of America.
| | - Dalton Klare
- Massachusetts General Hospital, United States of America
| | - Hilary Weingarden
- Massachusetts General Hospital, United States of America; Harvard Medical School, United States of America
| | - Jennifer L Greenberg
- Massachusetts General Hospital, United States of America; Harvard Medical School, United States of America
| | - Ivar Snorrason
- Massachusetts General Hospital, United States of America; Harvard Medical School, United States of America
| | - Susanne S Hoeppner
- Massachusetts General Hospital, United States of America; Harvard Medical School, United States of America
| | - Rachel Vanderkruik
- Massachusetts General Hospital, United States of America; Harvard Medical School, United States of America
| | | | - Sabine Wilhelm
- Massachusetts General Hospital, United States of America; Harvard Medical School, United States of America
| |
Collapse
|
22
|
Khot SP, Lisabeth LD, Kwicklis M, Chervin RD, Case E, Schütz SG, Brown DL. Heterogeneity of obstructive sleep apnea phenotypes after ischemic stroke: Outcome variation by cluster analysis. Sleep Med 2024; 114:145-150. [PMID: 38183805 PMCID: PMC10872508 DOI: 10.1016/j.sleep.2023.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/20/2023] [Accepted: 12/29/2023] [Indexed: 01/08/2024]
Abstract
INTRODUCTION Obstructive sleep apnea (OSA) is common but under-recognized after stroke. The aim of this study was to determine whether post-stroke phenotypic OSA subtypes are associated with stroke outcome in a population-based observational cohort. METHODS Ischemic stroke patients (n = 804) diagnosed with OSA (respiratory event index ≥10) soon after ischemic stroke were identified from the Brain Attack Surveillance in Corpus Christi (BASIC) project. Functional, cognitive, and quality of life outcomes were assessed at 90 days post-stroke and long-term stroke recurrence was ascertained. Latent profile analysis was performed based on demographic and clinical features, pre-stroke sleep characteristics, OSA severity, and vascular risk factors. Regression models were used to assess the association between phenotypic clusters and outcomes. RESULTS Four distinct phenotypic clusters provided the best fit. Cluster 1 was characterized by more severe stroke; cluster 2 by severe OSA and higher prevalence of medical comorbidities; cluster 3 by mild stroke and mild OSA; and cluster 4 by moderate OSA and mild stroke. Compared to cluster 3 and after adjustment for baseline stroke severity, cluster 1 and cluster 2 had worse 90-day functional outcome and cluster 1 also had worse quality of life. No difference in cognitive outcome or stroke recurrence rate was noted by cluster. CONCLUSION Post-stroke OSA is a heterogeneous disorder with different clinical phenotypes associated with stroke outcomes, including both daily function and quality of life. The unique presentations of OSA after stroke may have important implications for stroke prognosis and personalized treatment strategies.
Collapse
Affiliation(s)
- S P Khot
- Department of Neurology, Harborview Medical Center, University of Washington, Seattle, WA, USA.
| | - L D Lisabeth
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - M Kwicklis
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - R D Chervin
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA; Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - E Case
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - S G Schütz
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA; Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - D L Brown
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
23
|
Wang S, Nandy RR, Rossheim ME. Associations between e-cigarette use and sleep health among adults in the United States, NHANES 2015-2018. Sleep Med 2024; 114:220-228. [PMID: 38232605 DOI: 10.1016/j.sleep.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/01/2023] [Accepted: 01/05/2024] [Indexed: 01/19/2024]
Abstract
OBJECTIVE To examine the associations between e-cigarette use or dual (e-cigarette and combustible cigarette) use and short sleep duration and trouble sleeping among U.S. adults. METHODS We used 2015-2018 data from the National Health and Nutrition Examination Survey (NHANES) (n = 11,659). E-cigarette use and dual use were categorized as current, former, and never use. Short sleep duration was defined as sleep duration ≤6 h. Trouble sleeping was self-reported. Weighted logistic regression analyses were performed. RESULTS Among those with current e-cigarette use, 53.9 % were with current dual use and 23.8 % were with former dual use. Compared to never e-cigarette use, current e-cigarette use was associated with significantly higher odds of trouble sleeping (OR = 2.16, 95 % CI: 1.49-3.13), adjusting for potential confounders. Significant associations were also observed for former e-cigarette use versus never use with trouble sleeping (OR = 1.54, 95 % CI: 1.15-2.07) after full adjustment. Current cigarette use was associated with both short sleep duration (OR = 1.65, 95 % CI: 1.28-2.14) and trouble sleeping (OR = 1.36, 95 % CI: 1.03-1.79) after full adjustment. Additionally, the fully adjusted ORs for short sleep duration and trouble sleeping were 1.64 (95 % CI: 1.06-2.54) and 2.14 (95 % CI: 1.34-3.42) among those with current dual use, and 1.46 (95 % CI: 1.17-1.81) and 2.11 (95 % CI: 1.66-2.67) among those with former dual use, compared to those without dual use. CONCLUSIONS Current cigarette use or dual use is associated with significantly higher odds of short sleep duration and trouble sleeping. Moreover, former e-cigarette use or dual use is associated with increased odds of trouble sleeping.
Collapse
Affiliation(s)
- Shanshan Wang
- Department of Population & Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA.
| | - Rajesh R Nandy
- Department of Population & Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Matthew E Rossheim
- Department of Health Administration & Health Policy, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| |
Collapse
|
24
|
Lee JH, Nam H, Kim DH, Koo DL, Choi JW, Hong SN, Jeon ET, Lim S, Jang GS, Kim BH. Developing a deep learning model for sleep stage prediction in obstructive sleep apnea cohort using 60 GHz frequency-modulated continuous-wave radar. J Sleep Res 2024; 33:e14050. [PMID: 37752626 DOI: 10.1111/jsr.14050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/18/2023] [Accepted: 08/24/2023] [Indexed: 09/28/2023]
Abstract
Given the significant impact of sleep on overall health, radar technology offers a promising, non-invasive, and cost-effective avenue for the early detection of sleep disorders, even prior to relying on polysomnography (PSG)-based classification. In this study, we employed an attention-based bidirectional long short-term memory (Attention Bi-LSTM) model to accurately predict sleep stages using 60 GHz frequency-modulated continuous-wave (FMCW) radar. Our dataset comprised 78 participants from an ongoing obstructive sleep apnea (OSA) cohort, recruited between July 2021 and November 2022, who underwent overnight polysomnography alongside radar sensor monitoring. The dataset encompasses comprehensive polysomnography recordings, spanning both sleep and wakefulness states. The predictions achieved a Cohen's kappa coefficient of 0.746 and an overall accuracy of 85.2% in classifying wakefulness, rapid-eye-movement (REM) sleep, and non-REM (NREM) sleep (N1 + N2 + N3). The results demonstrated that the models incorporating both Radar 1 and Radar 2 data consistently outperformed those using only Radar 1 data, indicating the potential benefits of utilising multiple radars for sleep stage classification. Although the performance of the models tended to decline with increasing OSA severity, the addition of Radar 2 data notably improved the classification accuracy. These findings demonstrate the potential of radar technology as a valuable screening tool for sleep stage classification.
Collapse
Affiliation(s)
- Ji Hyun Lee
- Department of Radiology, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Hyunwoo Nam
- Department of Neurology, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Dong Hyun Kim
- Department of Radiology, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Dae Lim Koo
- Department of Neurology, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Won Choi
- Department of Radiology, Armed Forces Yangju Hospital, Yangju, Korea
| | - Seung-No Hong
- Department of Otorhinolaryngology - Head and Neck Surgery, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Eun-Tae Jeon
- Department of Radiology, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | | | | | | |
Collapse
|
25
|
Najafabadi MM, Angoorani H, Charest J, Samuels CH, Bagherzadeh K, Nazari A, Mazaherinezhad A. The validity and reliability of the Persian version of the Athlete Sleep Screening Questionnaire. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2024; 29:1. [PMID: 38524740 PMCID: PMC10956700 DOI: 10.4103/jrms.jrms_246_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/20/2023] [Accepted: 09/26/2023] [Indexed: 03/26/2024]
Abstract
Background Sleep as a biological phenomenon is effective in the performance and recovery of athletes. Questionnaires can be used as a cost-effective initial assessment tool for sleep. The Athlete Sleep Screening Questionnaire (ASSQ) demonstrated a clinically valid instrument for screening relevant sleep issues in athletic populations. Due to the lack of validated tools for adequate screening for sleep difficulties in the Iranian athlete population, the present study was conducted to evaluate the validity and reliability of the Persian version of the ASSQ. Materials and Methods The translation process was performed using instructions by Beaton et al. Content validity was assessed by a panel of experts. Exploratory and confirmatory factor analysis was performed for two 5-item sleep difficulty scores (SDS) and a 4-item chronotype score. Internal consistency based on Cronbach's alpha and McDonald's omega and stability reliability were used to evaluate reliability. Results The ASSQ achieved conceptual and semantic equivalence with the original scale. The item-level content validity index (I-CVI) of each item ranged from 0.87 to 1, and the averaging scale-level CVI/average was 0.95. In factor analysis, one factor for SDS and one factor for chronotype score were identified and confirmed. The internal consistency of the SDS scale (α =0.77, Ω =0.83) and chronotype (α =0.74, Ω =0.77) was acceptable. Stability reliability was confirmed for SDS scale (intra-class correlation [ICC] =0.87) and for chronotype (ICC = 0.83). Conclusion Persian ASSQ has acceptable psychometric measurement properties as a screening tool to assess sleep in Iranian athletes.
Collapse
Affiliation(s)
- Mohammad Mandegar Najafabadi
- Department of Sports and Exercise Medicine, School of Medicine, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Hooman Angoorani
- Department of Sports and Exercise Medicine, School of Medicine, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran
- Iran Football Medical Assessment and Rehabilitation Center (IFMARC), FIFA Medical Centre of Excellence, Tehran, Iran
| | - Jonathan Charest
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Centre for Sleep & Human Performance, Calgary, Alberta, Canada
| | | | - Kiana Bagherzadeh
- Department of Motor Behavior and Sports Psychology, University of Tehran, Tehran, Iran
| | - Ahmad Nazari
- Department of Sports and Exercise Medicine, School of Medicine, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Mazaherinezhad
- Department of Sports and Exercise Medicine, School of Medicine, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
26
|
Wang J, Wang Y, Chen S, Fu T, Sun G. Urban-rural differences in key factors of depressive symptoms among Chinese older adults based on random forest model. J Affect Disord 2024; 344:292-300. [PMID: 37820963 DOI: 10.1016/j.jad.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/04/2023] [Accepted: 10/08/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Depression is a major challenge in the global healthy aging process, and exploring the key factors of depression in urban and rural older adults is essential for differentiated and precise interventions. OBJECTIVE To explore the urban-rural differences and key influencing factors of depressive symptoms among Chinese older adults. METHODS The data of 5267 older adults were obtained from the China Health and Retirement Longitudinal Survey (CHARLS2018). Random forest model and logistic regression were used to analyze the key factors influencing depressive symptoms 19 variables. RESULTS The detection rate of depressive symptoms in older adults was 31.0 %, with 22.3 % and 34.8 % in urban and rural areas, respectively. Education, self-rated health, self-rated pain, and self-rated vision were common factors. Physical activity (OR = 0.716 for Moderate PA), social activity (OR = 0.671 for social activity), and self-rated hearing (OR = 0.602 for good) were key factors specific to urban older adults, and alcohol consumption (OR = 0.716 for drinking more than once a month) and marital status (OR = 0.689 for cohabitation) were key factors specific to depressive symptoms in rural older adults (all P < 0.05). LIMITATION Cross-sectional data cannot reflect dynamic processes among variables; The cultural background might affect the cross-cultural validity of the study. CONCLUSION The key factors of depressive symptoms among older adults in urban and rural areas differed, which provides priority and references for differential prevention and precise intervention of depressive symptoms to promote the process of healthy aging.
Collapse
Affiliation(s)
- Jun Wang
- School of Physical Education, Shandong University, Jinan 250061, China
| | - Yiwen Wang
- School of Physical Education, Shandong University, Jinan 250061, China
| | - Shufeng Chen
- School of Physical Education, Shandong University, Jinan 250061, China
| | - Tiantian Fu
- School of Physical Education, Shandong University, Jinan 250061, China
| | - Guoxiao Sun
- School of Physical Education, Shandong University, Jinan 250061, China.
| |
Collapse
|
27
|
Chandra Shekhar H, Joshua L, Thomas JV. Standardized Extract of Valeriana officinalis Improves Overall Sleep Quality in Human Subjects with Sleep Complaints: A Randomized, Double-Blind, Placebo-Controlled, Clinical Study. Adv Ther 2024; 41:246-261. [PMID: 37899385 PMCID: PMC10796483 DOI: 10.1007/s12325-023-02708-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/03/2023] [Indexed: 10/31/2023]
Abstract
INTRODUCTION Sleep deficit or poor sleep leads to ill-health, whereas sleep deprivation for longer periods of time increases the risk of developing adverse conditions associated with poor quality of life, and high socioeconomic impact. The treatments for sleep disturbances include melatonin and over-the-counter medicines like diphenhydramine and doxylamine, all of which have negative side effects. Valerian (Valeriana officinalis L.) is a traditional herb and the most preferred alternate sleep solution to manage sleep complaints. METHODS Eighty adult subjects with sleep complaints were randomized in 1:1 ratio to receive either V. officinalis extract (VE) or placebo for 8 weeks in a double-blind, placebo-controlled, parallel, clinical study. Primary efficacy endpoints included the Pittsburgh Sleep Quality Index (PSQI) and sleep latency using wrist actigraphy (WA), as well as a number of secondary endpoints, including sleep parameters such as actual sleep time and sleep efficiency using WA, the Epworth Sleepiness Scale (ESS), the Beck Anxiety Inventory (BAI), the Visual Analogue Scale (VAS) for the feeling of waking up refreshed, and a tertiary endpoint of sleep parameters using polysomnography (PSG) in a subset of 20 subjects per group. Safety parameters included physical examination, vital sign measurements, hematology, and clinical chemistry tests. Adverse events and serious adverse events were monitored throughout the study period. RESULTS Seventy-two subjects (35 and 37 subjects in the placebo and VE groups, respectively) completed the study and were included in the efficacy assessments. On Days 14, 28, and 56, the PSQI Total Score in the VE group decreased significantly (p < 0.05) compared to the placebo group. Further, the VE group showed significant improvements (p < 0.05) in sleep latency and actual sleep time on Days 3, 14, 28, and 56, and sleep efficiency on Days 14, 28, and 56, as evaluated by WA. There was a decrease (p < 0.05) in anxiety (BAI) on Days 14, 28, and 56, daytime drowsiness (ESS) on Days 28 and 56, and an increased feeling of waking up refreshed (VAS) on Days 28 and 56 compared to placebo. PSG results carried out in subset of subjects revealed significant improvements (p < 0.05) in total sleep time, sleep latency, and sleep efficiency on Day 56 in the VE group compared to the placebo group. No safety concerns were observed throughout the study. CONCLUSION VE supplementation significantly improved various subjective and objective parameters of sleep in young subjects with mild insomnia symptoms, such as overall sleep quality, sleep latency, sleep efficiency, and total sleep time. We also observed decreased anxiety and daytime sleepiness, and improved feeling of being refreshed after waking up with VE supplementation. VE was found to be safe and well tolerated throughout the study. TRIAL REGISTRATION Clinical Trials Registry of India: CTRI/2022/05/042818.
Collapse
Affiliation(s)
- Harshith Chandra Shekhar
- BGS Global Institute of Medical Sciences, No. 67, BGS Health and Education City, Uttarahalli Road, Kengeri, Bengaluru, 560060, Karnataka, India
| | - Lincy Joshua
- Leads Clinical Research and Bio Services Pvt. Ltd., No. 9, 1st Floor Mythri Legacy, Kalyan Nagar, Chelekere Main Road, Bengaluru, 560043, Karnataka, India
| | - Jestin V Thomas
- Leads Clinical Research and Bio Services Pvt. Ltd., No. 9, 1st Floor Mythri Legacy, Kalyan Nagar, Chelekere Main Road, Bengaluru, 560043, Karnataka, India.
| |
Collapse
|
28
|
Arocha Rodulfo JI, Aure Fariñez G, Carrera F. Sleep and cardiometabolic risk. Narrative revision. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2024; 36:38-49. [PMID: 37696704 DOI: 10.1016/j.arteri.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 08/04/2023] [Accepted: 08/04/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVES Sleep disturbances, including disrupted sleep and short sleep duration, are highly prevalent and are prospectively associated with an increased risk for various chronic diseases, including cardiometabolic, neurodegenerative, and autoimmune diseases. MATERIAL AND METHODS This is a narrative review of the literature based on numerous articles published in peer-reviewed journals since the beginning of this century. RESULTS The relationship between sleep disorders and metabolic dysregulation has been clearly established, mainly in the setting of modern epidemic of cardiometabolic disease, a cluster of conditions include obesity, insulin resistance, arterial hypertension, and dyslipidaemia, all of them considered as main risk factor for atherosclerotic cardiovascular disease (ACVD) and its clinical expression such as ischemic ictus, myocardial infarction and type 2 diabetes. Clinically viable tools to measure sleep duration and quality are needed for routine screening and intervention. CONCLUSIONS In view of what has been exposed in this review, it is evident that the timing, amount, and quality of sleep are critical to reduce the burden of risk factors for several chronic disease, including ACVD and type 2 diabetes, and most relevant in young people. Future research studies should elucidate the effectiveness of multimodal interventions to counteract the risk of short sleep for optimal patient outcomes across the healthcare continuum, especially in young people.
Collapse
Affiliation(s)
| | | | - Fernando Carrera
- Fellowship en Diabetes y Metabolismo, Hospital Vargas de Caracas, Caracas, Venezuela
| |
Collapse
|
29
|
Wu J, Yang D, Yang F. Exercise may not just be good for sleep; It can also help lower cardiovascular event risk. Curr Probl Cardiol 2024; 49:102166. [PMID: 37871708 DOI: 10.1016/j.cpcardiol.2023.102166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 10/20/2023] [Indexed: 10/25/2023]
Abstract
Cardiovascular diseases (CVD) stand at the forefront of global mortality, presenting an immense and urgent public health challenge on a global scale. Effectively addressing the associated risk factors is pivotal in not only preventing but also stabilizing and potentially reversing the progression of these conditions. Emerging research illuminates a compelling correlation between sleep disorders and CVD. Clinically, individuals afflicted with existing CVD or those possessing risk factors frequently grapple with sleep disturbances, exacerbating their conditions, particularly in severe cases where disease progression is accelerated. Even among ostensibly healthy individuals, chronic sleep deprivation exacts a toll on cardiovascular function. The strategic implementation of exercise interventions emerges as a potent tool in enhancing sleep quality, surpassing the efficacy of pharmaceutical treatments. Furthermore, the maintenance of optimal sleep patterns significantly contributes to lowering the risk of cardiovascular diseases. This comprehensive review delves deeply into the intricate relationship between exercise and the amelioration of cardiovascular disease risk associated with sleep. Moreover, it meticulously elucidates the complex mechanisms through which exercise operates, effectively reducing cardiovascular disease risk from the unique perspective of sleep science.
Collapse
Affiliation(s)
- Jianjun Wu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Dawei Yang
- Department of Orthopedics, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Fan Yang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China; State Key Laboratory of Component-based Chinese Medicine, Tianjin, China.
| |
Collapse
|
30
|
Charchar FJ, Prestes PR, Mills C, Ching SM, Neupane D, Marques FZ, Sharman JE, Vogt L, Burrell LM, Korostovtseva L, Zec M, Patil M, Schultz MG, Wallen MP, Renna NF, Islam SMS, Hiremath S, Gyeltshen T, Chia YC, Gupta A, Schutte AE, Klein B, Borghi C, Browning CJ, Czesnikiewicz-Guzik M, Lee HY, Itoh H, Miura K, Brunström M, Campbell NR, Akinnibossun OA, Veerabhadrappa P, Wainford RD, Kruger R, Thomas SA, Komori T, Ralapanawa U, Cornelissen VA, Kapil V, Li Y, Zhang Y, Jafar TH, Khan N, Williams B, Stergiou G, Tomaszewski M. Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension. J Hypertens 2024; 42:23-49. [PMID: 37712135 PMCID: PMC10713007 DOI: 10.1097/hjh.0000000000003563] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/12/2023] [Accepted: 08/22/2023] [Indexed: 09/16/2023]
Abstract
Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools.
Collapse
Affiliation(s)
- Fadi J. Charchar
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
- Department of Physiology, University of Melbourne, Melbourne, Australia
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Priscilla R. Prestes
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
| | - Charlotte Mills
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang
- Department of Medical Sciences, School of Medical and Live Sciences, Sunway University, Bandar Sunway, Selangor, Malaysia
| | - Dinesh Neupane
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - Francine Z. Marques
- Hypertension Research Laboratory, School of Biological Sciences, Monash University
- Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne
| | - James E. Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Liffert Vogt
- Department of Internal Medicine, Section Nephrology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Microcirculation, Amsterdam, The Netherlands
| | - Louise M. Burrell
- Department of Medicine, University of Melbourne, Austin Health, Melbourne, Australia
| | - Lyudmila Korostovtseva
- Department of Hypertension, Almazov National Medical Research Centre, St Petersburg, Russia
| | - Manja Zec
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, USA
- Colorado Program for Musculoskeletal Research, Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Mansi Patil
- Department of Nutrition and Dietetics, Asha Kiran JHC Hospital, Chinchwad
- Hypertension and Nutrition, Core Group of IAPEN India, India
| | - Martin G. Schultz
- Department of Internal Medicine, Section Nephrology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Microcirculation, Amsterdam, The Netherlands
| | | | - Nicolás F. Renna
- Unit of Hypertension, Hospital Español de Mendoza, School of Medicine, National University of Cuyo, IMBECU-CONICET, Mendoza, Argentina
| | | | - Swapnil Hiremath
- Department of Medicine, University of Ottawa and the Ottawa Hospital, Ottawa, Canada
| | - Tshewang Gyeltshen
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Yook-Chin Chia
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Selangor
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Abhinav Gupta
- Department of Medicine, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, India
| | - Aletta E. Schutte
- School of Population Health, University of New South Wales, The George Institute for Global Health, Sydney, New South Wales, Australia
- Hypertension in Africa Research Team, SAMRC Unit for Hypertension and Cardiovascular Disease, North-West University
- SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Britt Klein
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, Faculty of Medicine, University of Bologna, Bologna, Italy
| | - Colette J. Browning
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
| | - Marta Czesnikiewicz-Guzik
- School of Medicine, Dentistry and Nursing-Dental School, University of Glasgow, UK
- Department of Periodontology, Prophylaxis and Oral Medicine; Jagiellonian University, Krakow, Poland
| | - Hae-Young Lee
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hiroshi Itoh
- Department of Internal Medicine (Nephrology, Endocrinology and Metabolism), Keio University, Tokyo
| | - Katsuyuki Miura
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Mattias Brunström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Norm R.C. Campbell
- Libin Cardiovascular Institute, Department of Medicine, University of Calgary, Calgary, Canada
| | | | - Praveen Veerabhadrappa
- Kinesiology, Division of Science, The Pennsylvania State University, Reading, Pennsylvania
| | - Richard D. Wainford
- Department of Pharmacology and Experimental Therapeutics, The Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston
- Division of Cardiology, Emory University, Atlanta, USA
| | - Ruan Kruger
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Shane A. Thomas
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
| | - Takahiro Komori
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Udaya Ralapanawa
- Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | | | - Vikas Kapil
- William Harvey Research Institute, Centre for Cardiovascular Medicine and Devices, NIHR Barts Biomedical Research Centre, BRC, Faculty of Medicine and Dentistry, Queen Mary University London
- Barts BP Centre of Excellence, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Yan Li
- Department of Cardiovascular Medicine, Shanghai Institute of Hypertension, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai
| | - Yuqing Zhang
- Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Chinese Hypertension League, Beijing, China
| | - Tazeen H. Jafar
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Nadia Khan
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Bryan Williams
- University College London (UCL), Institute of Cardiovascular Science, National Institute for Health Research (NIHR), UCL Hospitals Biomedical Research Centre, London, UK
| | - George Stergiou
- Hypertension Centre STRIDE-7, School of Medicine, Third Department of Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maciej Tomaszewski
- Division of Cardiovascular Sciences, Faculty of Medicine, Biology and Health, University of Manchester
- Manchester Academic Health Science Centre, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
| |
Collapse
|
31
|
Teece AR, Beaven CM, Argus CK, Gill N, Driller MW. Daytime naps improve afternoon power and perceptual measures in elite rugby union athletes-a randomized cross-over trial. Sleep 2023; 46:zsad133. [PMID: 37155971 PMCID: PMC10710987 DOI: 10.1093/sleep/zsad133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 03/29/2023] [Indexed: 05/10/2023] Open
Abstract
Daytime naps are used by elite athletes in both training and match-day settings. Currently, there are limited interventional studies on the efficacy of napping on physical performance in elite team-sport athletes. Therefore, the objective was to investigate the effect of a daytime nap (<1 hour) on afternoon performance of peak power, reaction time, self-reported wellness, and aerobic performance in professional rugby union athletes. A randomized cross-over design was carried out among 15 professional rugby union athletes. Athletes performed nap (NAP) and no nap (CON) conditions on two occasions, separated by 1 week. Baseline testing of reaction time, self-reported wellness, and a 6-second peak power test on a cycle ergometer were completed in the morning, followed by 2 × 45-minute training sessions, after which athletes completed the NAP or CON condition at 1200 hours. Following the nap period, baseline measures were retested in addition to a 30-minute fixed-intensity interval cycle and a 4-minute maximal effort cycling test. A significant group × time interaction was determined for 6-second peak power output (+157.6 W, p < 0.01, d = 1.53), perceived fatigue (-0.2 AU, p = 0.01, d = 0.37), and muscle soreness (-0.1 AU, p = 0.04, d = 0.75) in favor of the NAP condition. A significantly lower perceived exertion rating (-1.2 AU, p < 0.01, d = 1.72) was recorded for the fixed-intensity session in favor of NAP. This study highlights that utilizing daytime naps between training sessions on the same day improved afternoon peak power and lowered perceptions of fatigue, soreness, and exertion during afternoon training in professional rugby union athletes.
Collapse
Affiliation(s)
- Angus R Teece
- Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand
| | - Christopher M Beaven
- Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand
| | | | - Nicholas Gill
- Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand
- New Zealand Rugby, Wellington, New Zealand
| | - Matthew W Driller
- Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| |
Collapse
|
32
|
Getahun GK, Genene A, Tadesse T. Poor sleep quality and associated determinants among textile and garment manufacturing workers in Addis Ababa, Ethiopia. Sleep Med X 2023; 5:100075. [PMID: 37249945 PMCID: PMC10220473 DOI: 10.1016/j.sleepx.2023.100075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 04/22/2023] [Accepted: 05/17/2023] [Indexed: 05/31/2023] Open
Abstract
Background Sleep is a physiological process that is essential to human physical, emotional, and mental health. Sleep difficulties affect an estimated 150 million individuals globally, with roughly 17% of the population in developing countries. As a result, the purpose of this study was to determine the prevalence and associated factors of poor sleep quality among textile and garment manufacturing workers in Addis Ababa, Ethiopia, in 2022. Methods A facility-based cross-sectional study was done from July 15th to August 15th, 2022, using a simple random sample technique. The degree of self-reported poor sleep quality was quantified using a validated, interviewer-administered, standardized Pittsburgh Sleep Quality Index. To determine the relationship between independent variables and poor sleep quality, multivariable logistic regression analysis was carried out with a p-value of less than 0.05 and a 95% confidence interval (CI). Results The prevalence of poor sleep quality was 75.4% (95% CI: 70.8, 80). Working more than 8 h per day (AOR = 2.83, 95% CI: 1.01, 7.94), work dissatisfaction (AOR = 3.27, 95% CI: 1.52-7.05), and using electronic materials before sleeping (AOR = 2.08, 95% CI: 1.01-4.30) were all associated with poor sleep quality. Conclusion Poor sleep quality was common among garment and textile industrial workers. Work dissatisfaction, working hours, and the utilization of electronic materials before bedtime were all substantially related to poor sleep quality, which should be taken into account and addressed early to reduce poor sleep quality.
Collapse
Affiliation(s)
- Genanew Kassie Getahun
- Kotebe Metropolitan University, Menelik II Medical and Health Science College, Addis Ababa, Ethiopia
| | - Adisu Genene
- Addis Ababa Medical and Business College, Addis Ababa, Ethiopia
| | | |
Collapse
|
33
|
Mul Fedele ML, López Gabeiras MDP, Simonelli G, Diez JJ, Bellone GJ, Cagliani J, Larrateguy L, Eiguchi K, Golombek DA, Cardinali DP, Pérez-Chada D, Vigo DE. "Multivariate analysis of the impact of sleep and working hours on medical errors: a MICE approach". BMC Public Health 2023; 23:2317. [PMID: 37996804 PMCID: PMC10666331 DOI: 10.1186/s12889-023-17130-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/01/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND The main objective of this study was to describe the relationship between working conditions, sleep and psycho-affective variables and medical errors. METHODS This was an observational, analytical and cross-sectional study in which 661 medical residents answered questionnaires about working conditions, sleep and psycho-affective variables. Actigraphic sleep parameters and peripheral temperature circadian rhythm were measured in a subgroup of 38 subjects. Bivariate and multivariate predictors of medical errors were assessed. RESULTS Medical residents reported working 66.2 ± 21.9 weekly hours. The longest continuous shift was of 28.4 ± 10.9 h. They reported sleeping 6.1 ± 1.6 h per day, with a sleep debt of 94 ± 129 min in workdays. A high percentage of them reported symptoms related to psycho-affective disorders. The longest continuous shift duration (OR = 1.03 [95% CI, 1.00-1.05], p = 0.01), working more than six monthly on-call shifts (OR = 1.87 [95% CI, 1.16-3.02], p = 0.01) and sleeping less than six hours per working day (OR = 1.66 [95% CI, 1.10-2.51], p = 0.02) were independently associated with self-reported medical errors. The report of medical errors was associated with an increase in the percentage of diurnal sleep (2.2% [95% CI, 0.1-4.3] vs 14.5% [95% CI, 5.9-23.0]; p = 0.01) in the actigraphic recording. CONCLUSIONS Medical residents have a high working hour load that affect their sleep opportunities, circadian rhythms and psycho-affective health, which are also related to the report of medical errors. These results highlight the importance of implementing multidimensional strategies to improve medical trainees' sleep and wellbeing, increasing in turn their own and patients' safety.
Collapse
Affiliation(s)
- Malena Lis Mul Fedele
- Chronophysiology Lab, Institute for Biomedical Research (UCA-CONICET), Buenos Aires, Argentina
| | | | - Guido Simonelli
- Centre d'études Avancées en Médecine du Sommeil, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord de L'Île-de-Montréal, Montreal, Canada
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Canada
- Department of Neuroscience, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Joaquín José Diez
- Pan-American Institute of Sleep Medicine and Chronobiology, Buenos Aires, Argentina
| | - Giannina Julieta Bellone
- Pontifical Catholic University of Argentina, Buenos Aires, Argentina
- Chronobiology Lab, Department of Science and Technology, National University of Quilmes, Bernal, Argentina
| | - Joaquín Cagliani
- Anesthesiology Department, North Shore University Hospital, Manhasset, NY, USA
| | - Luis Larrateguy
- Private Center of Respiratory Medicine of Paraná, Entre Ríos, Argentina
| | | | - Diego Andrés Golombek
- Chronobiology Lab, Department of Science and Technology, National University of Quilmes, Bernal, Argentina
- Interdisciplinary Time Lab, San Andrés University, Buenos Aires, Argentina
| | | | | | - Daniel Eduardo Vigo
- Chronophysiology Lab, Institute for Biomedical Research (UCA-CONICET), Buenos Aires, Argentina.
- Katholieke Universiteit Leuven, Leuven, Belgium.
| |
Collapse
|
34
|
Guo P, Jin Z, Bellia G, Luo J, Inoue K, Pollitt KJG, Deziel NC, Liew Z. Per- and polyfluoroalkyl substances and sleep health in U.S. adults, NHANES 2005-2014. ENVIRONMENTAL RESEARCH 2023; 237:117092. [PMID: 37683785 DOI: 10.1016/j.envres.2023.117092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 09/03/2023] [Accepted: 09/05/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are synthetic chemicals that induce oxidative inflammatory responses and disrupt the endocrine and central nervous systems, all of which can influence sleep. OBJECTIVE To investigate the association between PFAS exposure and sleep health measures in U.S. adults. METHODS We analyzed serum concentration data of four PFAS [perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA)] reported for 8913 adults in NHANES 2005-2014. Sleep outcomes, including trouble sleeping, having a diagnosis of sleep disorder, and recent daily sleep duration classified as insufficient or excessive sleep (<6 or >9 h/day) were examined. Weighted logistic regression was used to estimate the association between the sleep outcomes and each PFAS modeled continuously (log2) or in exposure tertiles. We applied quantile g-computation to estimate the effect of the four PFAS as a mixture on the sleep outcomes. We conducted a quantitative bias analysis to assess the potential influence of self-selection and uncontrolled confounding. RESULTS We observed some inverse associations between serum PFAS and trouble sleeping or sleep disorder, which were more consistent for PFOS (e.g., per log2-PFOS (ng/ml) and trouble sleeping OR = 0.93, 95%CI: 0.89, 0.98; sleep disorder OR = 0.89, 95%CI: 0.83, 0.95). Per quartile increase of the PFAS mixture was inversely associated with trouble sleeping and sleep disorder. No consistent associations were found for sleep duration across analyses. Our bias analysis suggests that the finding on sleep disorder could be explained by a moderate level of self-selection and negative confounding effects. CONCLUSIONS We found no evidence to suggest exposure to four legacy PFAS worsened self-reported sleep health among U.S. adults. While some inverse associations between specific PFAS and sleep disorder were observed, self-selection and uncontrolled confounding biases may play a role in these findings.
Collapse
Affiliation(s)
- Pengfei Guo
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, USA; Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Yale School of Public Health, New Haven, USA.
| | - Zhihao Jin
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, USA.
| | - Giselle Bellia
- Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Yale School of Public Health, New Haven, USA.
| | - Jiajun Luo
- Institute for Population and Precision Health, University of Chicago, USA.
| | - Kosuke Inoue
- Department of Social Epidemiology, Graduate School of Medicine, Kyoto University, Japan.
| | - Krystal J Godri Pollitt
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, USA; Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Yale School of Public Health, New Haven, USA.
| | - Nicole C Deziel
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, USA; Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Yale School of Public Health, New Haven, USA.
| | - Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, USA; Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Yale School of Public Health, New Haven, USA.
| |
Collapse
|
35
|
Calcaterra V, Rossi V, Tagi VM, Baldassarre P, Grazi R, Taranto S, Zuccotti G. Food Intake and Sleep Disorders in Children and Adolescents with Obesity. Nutrients 2023; 15:4736. [PMID: 38004130 PMCID: PMC10675320 DOI: 10.3390/nu15224736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
Over the last few decades, numerous scientific studies have investigated the possible association between sleep duration and adiposity during childhood, since it has been reported that sleep deprivation causes a related increase in caloric intake. Even though the underlying pathogenetic mechanisms are still under study and not completely known, the effect of dietetic habits and nutrient intake on sleep quality and patterns has been reported. The aim of this study is to explore the intricate interplay between food intake/diet patterns and pediatric sleep disturbances in children and adolescents with obesity, emphasizing the importance of not underestimating this aspect in the prevention and treatment of this complex disease. Recent evidence supports a high correlation between specific diet patterns and foods with sleep disturbances in children at all ages. Diets rich in fiber, fruit, vegetables, and anti-inflammatory nutrients and low in saturated fats seem to promote better sleep quality. Sleep disturbances are, in turn, risk factors for the development of obesity. Therefore, food strategies should be applied to counteract this harmful process. Unraveling the complex links between dietary habits, sleep patterns, and obesity is essential for developing effective strategies to combat this critical public health issue.
Collapse
Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
| | - Virginia Rossi
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
| | - Veronica Maria Tagi
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
| | - Paola Baldassarre
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
| | - Roberta Grazi
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
| | - Silvia Taranto
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
- Department of Biomedical and Clinical Science, University of Milano, 20157 Milano, Italy
| |
Collapse
|
36
|
Lei X, Xu Z, Chen W. Association of oxidative balance score with sleep quality: NHANES 2007-2014. J Affect Disord 2023; 339:435-442. [PMID: 37442450 DOI: 10.1016/j.jad.2023.07.040] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 06/20/2023] [Accepted: 07/08/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Oxidative stress is correlated with sleep quality. A common tool for evaluating dietary and lifestyle exposures to oxidative stress is the Oxidative Balance Score (OBS), with higher OBS suggesting more substantial antioxidant exposures. The relationship between OBS and sleep quality is unclear. Investigating the association between OBS and sleep quality was the purpose of this study. METHODS To figure out the relationship between OBS and sleep quality, we utilized weighted linear models and weighted logistic regression. Adjusted models were also examined. RESULTS 6300 participants who took part in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2014 were recruited. OBS was negatively associated with sleep disorder (OR: 0.97; 95 % CI: 0.94-0.99), and positively associated with sleep duration (MD: 0.02; 95%CI: 0.01-0.03). Within the range of OBS > 24, each unit increase in OBS will result in a 40 % reduction in sleep disorder, and a 26 % increasement in sleep duration after adjustment (all P for trend <0.05). Dietary and lifestyle components were closely related to sleep quality independently. The relationship between OBS and sleep quality was prominent in the female population under 50 years of age. After stratification by education level, this relationship persisted. LIMITATION This research was cross-sectional design, and it was not possible to deduce causality. CONCLUSION Diet and lifestyle might influence sleep quality by modulating oxidative balance. Antioxidant diets and lifestyles were important in reducing sleep problems and our study also provided new ideas for improving sleep quality.
Collapse
Affiliation(s)
- Xiong Lei
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhixiao Xu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wenwen Chen
- Department of Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
| |
Collapse
|
37
|
Chakravorty S, Kember RL, Mazzotti DR, Dashti HS, Toikumo S, Gehrman PR, Kranzler HR. The relationship between alcohol- and sleep-related traits: Results from polygenic risk score and Mendelian randomization analyses. Drug Alcohol Depend 2023; 251:110912. [PMID: 37591043 PMCID: PMC10638060 DOI: 10.1016/j.drugalcdep.2023.110912] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 08/19/2023]
Abstract
STUDY OBJECTIVES We investigated whether genetic risk for insomnia and sleep duration abnormalities are associated with AUD and alcohol consumption. We also evaluated the causal relationships between sleep- and alcohol-related traits. METHODS Individual-level phenotype and genotype data from the Million Veteran Program were used. Polygenic risk scores (PRS) were computed using summary statistics from two recent discovery GWAS of insomnia (N= 453,379 European-ancestry (EA) individuals) and sleep duration (N= 446,118 EAs) and tested for association with lifetime AUD diagnosis (N= 34,658 EA cases) and past-year Alcohol Use Disorders Identification Test-Consumption scale scores (AUDIT-C, N= 200,680 EAs). Bi-directional two-sample Mendelian Randomization (MR) analyses assessed causal associations between the two sleep traits and the two alcohol-related traits. RESULTS The insomnia PRS was positively associated with AUD at 2/9 PRS thresholds, with p<0.01 being the most significant (OR = 1.02, p = 3.48 × 10-5). Conversely, insomnia PRS was negatively associated with AUDIT-C at 6/9 PRS thresholds (most significant threshold being p = 0.001 (β = -0.02, p = 5.6 × 10-8). Sleep duration PRS was positively associated with AUDIT-C at 2/9 PRS thresholds, with the most significant threshold being p = 1 × 10-6 (β = 0.01, p = 0.0009). MR analyses supported a significant positive causal effect of insomnia on AUD (14 SNPs; β = 104.14; SE = 16.19; p = 2.22 × 10-5), although with significant heterogeneity. MR analyses also showed that shorter sleep duration had a causal effect on the risk of AUD (27 SNPs; β = -63.05; SE = 3.54; p = 4.55 × 10-16), which was robust to sensitivity analyses. CONCLUSION The genetic risk for insomnia shows pleiotropy with AUD, and sleep continuity abnormalities have a causal influence on the development of AUD.
Collapse
Affiliation(s)
- Subhajit Chakravorty
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA; Perelman School of Medicine, Philadelphia, PA 19104, USA.
| | - Rachel L Kember
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA; Perelman School of Medicine, Philadelphia, PA 19104, USA
| | | | - Hassan S Dashti
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | | | - Philip R Gehrman
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA; Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Henry R Kranzler
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA; Perelman School of Medicine, Philadelphia, PA 19104, USA
| |
Collapse
|
38
|
Kisiolek JN, Flores VA, Ramani A, Butler B, Haughian JM, Stewart LK. Eight Weeks of Daily Cannabidiol Supplementation Improves Sleep Quality and Immune Cell Cytotoxicity. Nutrients 2023; 15:4173. [PMID: 37836465 PMCID: PMC10574483 DOI: 10.3390/nu15194173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The endocannabinoid system is active in nervous and immune cells and involves the expression of two cannabinoid receptor genes (CB1 and CB2), along with endogenous endocannabinoid ligands, 2-arachidonoyl glycerol (2-AG) and arachidonoyl ethanolamide (anandamide), and their synthetic enzymes. Cannabidiol (CBD) is a non-intoxicating exogenous cannabinoid agonist derived from plants that, at high doses, has received FDA approval as an anticonvulsant for epileptic seizures, and at low doses is marketed as a food-grade supplement for improved mental health, sleep quality, and immunological function. At present, the predominance of published CBD clinical research has focused on ameliorative or disease-specific intervention, with few trials investigating CBD effects in healthy populations. METHODS This clinical study aimed to investigate the effects of 8 weeks of 50 mg oral CBD on mental health, sleep quantity and quality, and immune cell function in healthy, college-aged individuals. Twenty-eight participants (average age 25.9 ± 6.1 y) were randomized to receive either daily oral capsules of 50 mg of CBD (CB, n = 14) or a calorie-matched placebo (CN, n = 14). Participants completed pre- and post-intervention assessments, including anthropometric measurements, mental health surveys, sleep analysis, and immunological function assessments. RESULTS After completing the 8-week intervention, there were no significant changes in body weight and BMI (CN: 1.09 ± 0.89%: CB: 1.41 ± 1.07%), or body fat percentage (CN: 9.01 ± 7.51%: CB: 8.57 ± 7.81%), respectively (values are % change pre to post, p > 0.05). There were also no significant differences between CB and CN groups with respect to mental health measures, sleep quantity, or circulating immunophenotype as a result of the intervention. However, the CB group experienced significant improvements in sleep quality measured objectively using a sleep questionnaire (p = 0.0023) and enhanced Natural Killer (NK) immune cell function assessed in situ (p = 0.0125). CONCLUSIONS Eight weeks of daily 50 mg CBD may improve sleep quality, and NK immunosurveillance in healthy, younger adults.
Collapse
Affiliation(s)
- Jacob N. Kisiolek
- Department of Kinesiology, Nutrition, and Dietetics, University of Northern Colorado, Greeley, CO 80639, USA; (V.A.F.); (A.R.); (B.B.)
- Department of Pathology, Division of Microbiology and Immunology, University of Utah, Salt Lake City, UT 84112, USA
| | - Victoria A. Flores
- Department of Kinesiology, Nutrition, and Dietetics, University of Northern Colorado, Greeley, CO 80639, USA; (V.A.F.); (A.R.); (B.B.)
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Arjun Ramani
- Department of Kinesiology, Nutrition, and Dietetics, University of Northern Colorado, Greeley, CO 80639, USA; (V.A.F.); (A.R.); (B.B.)
| | - Blake Butler
- Department of Kinesiology, Nutrition, and Dietetics, University of Northern Colorado, Greeley, CO 80639, USA; (V.A.F.); (A.R.); (B.B.)
| | - James M. Haughian
- Department of Biological Sciences, College of Natural and Health Sciences, University of Northern Colorado, Greeley, CO 80639, USA;
| | - Laura K. Stewart
- Department of Kinesiology, Nutrition, and Dietetics, University of Northern Colorado, Greeley, CO 80639, USA; (V.A.F.); (A.R.); (B.B.)
| |
Collapse
|
39
|
Claydon EA, Kahwash JM, Lilly CL, Alamir Y, Zullig KJ. Subjective Sleep Quality, Caffeine, and Dieting Behaviors Among University-Attending Young Adults. Nat Sci Sleep 2023; 15:737-747. [PMID: 37766873 PMCID: PMC10521926 DOI: 10.2147/nss.s420568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Background Research has shown that university students engage in behaviors that are associated with poor sleep quality, such as higher caffeine and alcohol intake. Yet studies exploring eating habits and weight loss mechanisms related to sleep quality have generally been inconclusive. This study explored total daily caffeine consumption (along with different sources of caffeine) as well as dieting and exercising to lose weight in the last 30 days as risk factors for poor sleep quality among an undergraduate university population. Methods Full-time undergraduate students (n = 400) participated in an anonymous online survey about various health behaviors at a large, mid-Atlantic university. Multivariable linear regressions were run to consider subjective sleep quality in relation to caffeine consumption and dieting behavior along with other covariates. A sensitivity analysis was run to explore how different types of caffeinated beverages were associated with sleep quality as well. All analyses were conducted using SAS JMP Version 16. Results A stepwise multivariable linear regression controlling for alcohol use, grade point average, biological sex, and stress showed significant increases in sleep quality scores (indicating worsening sleep quality). Total caffeine consumption remained significant through the models until psychosocial factors were added (B = 0.003, p = 0.0035). The sensitivity analysis indicated that total caffeine consumption from soda remained significant across all models, significantly increasing sleep quality scores (B = 0.01; p = 0.0054). Discussion Higher amounts of caffeine from sodas were associated with more significant decreases in sleep quality than other types of caffeine, including energy drinks, coffee, and tea. Dieting or exercising to lose weight was not significantly associated with sleep quality. The results of this study can help to refine intervention efforts designed to improve sleep quality among undergraduate university students. Behavioral interventions specific to reducing caffeine intake, specifically from caffeinated sodas, may prove to be beneficial with this population.
Collapse
Affiliation(s)
- Elizabeth A Claydon
- Department of Social and Behavioral Sciences, West Virginia University School of Public Health, Morgantown, WV, USA
| | - Jenna M Kahwash
- Department of Social and Behavioral Sciences, West Virginia University School of Public Health, Morgantown, WV, USA
| | - Christa L Lilly
- Department of Epidemiology and Biostatistics, West Virginia University School of Public Health, Morgantown, WV, USA
| | - Yahya Alamir
- Department of Health Education & Promotion, Faculty of Public Health & Tropical Medicine, Jazan University, Jazan, Saudi Arabia
| | - Keith J Zullig
- Department of Social and Behavioral Sciences, West Virginia University School of Public Health, Morgantown, WV, USA
| |
Collapse
|
40
|
Hulsegge G, Coenen P, Gascon GM, Pahwa M, Greiner B, Bohane C, Wong IS, Liira J, Riera R, Pachito DV. Adapting shift work schedules for sleep quality, sleep duration, and sleepiness in shift workers. Cochrane Database Syst Rev 2023; 9:CD010639. [PMID: 37694838 PMCID: PMC10494487 DOI: 10.1002/14651858.cd010639.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
BACKGROUND Shift work is associated with insufficient sleep, which can compromise worker alertness with ultimate effects on occupational health and safety. Adapting shift work schedules may reduce adverse occupational outcomes. OBJECTIVES To assess the effects of shift schedule adaptation on sleep quality, sleep duration, and sleepiness among shift workers. SEARCH METHODS We searched CENTRAL, PubMed, Embase, and eight other databases on 13 December 2020, and again on 20 April 2022, applying no language restrictions. SELECTION CRITERIA We included randomised controlled trials (RCTs) and non-RCTs, including controlled before-after (CBA) trials, interrupted time series, and cross-over trials. Eligible trials evaluated any of the following shift schedule components. • Permanency of shifts • Regularity of shift changes • Direction of shift rotation • Speed of rotation • Shift duration • Timing of start of shifts • Distribution of shift schedule • Time off between shifts • Split shifts • Protected sleep • Worker participation We included studies that assessed sleep quality off-shift, sleep duration off-shift, or sleepiness during shifts. DATA COLLECTION AND ANALYSIS Two review authors independently screened the titles and abstracts of the records recovered by the search, read through the full-text articles of potentially eligible studies, and extracted data. We assessed the risk of bias of included studies using the Cochrane risk of bias tool, with specific additional domains for non-randomised and cluster-randomised studies. For all stages, we resolved any disagreements by consulting a third review author. We presented the results by study design and combined clinically homogeneous studies in meta-analyses using random-effects models. We assessed the certainty of the evidence with GRADE. MAIN RESULTS We included 11 studies with a total of 2125 participants. One study was conducted in a laboratory setting and was not considered for drawing conclusions on intervention effects. The included studies investigated different and often multiple changes to shift schedule, and were heterogeneous with respect to outcome measurement. Forward versus backward rotation Three CBA trials (561 participants) investigated the effects of forward rotation versus backward rotation. Only one CBA trial provided sufficient data for the quantitative analysis; it provided very low-certainty evidence that forward rotation compared with backward rotation did not affect sleep quality measured with the Basic Nordic Sleep Questionnaire (BNSQ; mean difference (MD) -0.20 points, 95% confidence interval (CI) -2.28 to 1.89; 62 participants) or sleep duration off-shift (MD -0.21 hours, 95% CI -3.29 to 2.88; 62 participants). However, there was also very low-certainty evidence that forward rotation reduced sleepiness during shifts measured with the BNSQ (MD -1.24 points, 95% CI -2.24 to -0.24; 62 participants). Faster versus slower rotation Two CBA trials and one non-randomised cross-over trial (341 participants) evaluated faster versus slower shift rotation. We were able to meta-analyse data from two studies. There was low-certainty evidence of no difference in sleep quality off-shift (standardised mean difference (SMD) -0.01, 95% CI -0.26 to 0.23) and very low-certainty evidence that faster shift rotation reduced sleep duration off-shift (SMD -0.26, 95% CI -0.51 to -0.01; 2 studies, 282 participants). The SMD for sleep duration translated to an MD of 0.38 hours' less sleep per day (95% CI -0.74 to -0.01). One study provided very low-certainty evidence that faster rotations decreased sleepiness during shifts measured with the BNSQ (MD -1.24 points, 95% CI -2.24 to -0.24; 62 participants). Limited shift duration (16 hours) versus unlimited shift duration Two RCTs (760 participants) evaluated 80-hour workweeks with maximum daily shift duration of 16 hours versus workweeks without any daily shift duration limits. There was low-certainty evidence that the 16-hour limit increased sleep duration off-shift (SMD 0.50, 95% CI 0.21 to 0.78; which translated to an MD of 0.73 hours' more sleep per day, 95% CI 0.30 to 1.13; 2 RCTs, 760 participants) and moderate-certainty evidence that the 16-hour limit reduced sleepiness during shifts, measured with the Karolinska Sleepiness Scale (SMD -0.29, 95% CI -0.44 to -0.14; which translated to an MD of 0.37 fewer points, 95% CI -0.55 to -0.17; 2 RCTs, 716 participants). Shorter versus longer shifts One RCT, one CBA trial, and one non-randomised cross-over trial (692 participants) evaluated shorter shift duration (eight to 10 hours) versus longer shift duration (two to three hours longer). There was very low-certainty evidence of no difference in sleep quality (SMD -0.23, 95% CI -0.61 to 0.15; which translated to an MD of 0.13 points lower on a scale of 1 to 5; 2 studies, 111 participants) or sleep duration off-shift (SMD 0.18, 95% CI -0.17 to 0.54; which translated to an MD of 0.26 hours' less sleep per day; 2 studies, 121 participants). The RCT and the non-randomised cross-over study found that shorter shifts reduced sleepiness during shifts, while the CBA study found no effect on sleepiness. More compressed versus more spread out shift schedules One RCT and one CBA trial (346 participants) evaluated more compressed versus more spread out shift schedules. The CBA trial provided very low-certainty evidence of no difference between the groups in sleep quality off-shift (MD 0.31 points, 95% CI -0.53 to 1.15) and sleep duration off-shift (MD 0.52 hours, 95% CI -0.52 to 1.56). AUTHORS' CONCLUSIONS Forward and faster rotation may reduce sleepiness during shifts, and may make no difference to sleep quality, but the evidence is very uncertain. Very low-certainty evidence indicated that sleep duration off-shift decreases with faster rotation. Low-certainty evidence indicated that on-duty workweeks with shift duration limited to 16 hours increases sleep duration, with moderate-certainty evidence for minimal reductions in sleepiness. Changes in shift duration and compression of workweeks had no effect on sleep or sleepiness, but the evidence was of very low-certainty. No evidence is available for other shift schedule changes. There is a need for more high-quality studies (preferably RCTs) for all shift schedule interventions to draw conclusions on the effects of shift schedule adaptations on sleep and sleepiness in shift workers.
Collapse
Affiliation(s)
- Gerben Hulsegge
- The Netherlands Organization for Applied Scientific Research, TNO, Leiden, Netherlands
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Gregg M Gascon
- OhioHealth, Columbus, Ohio, USA
- Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Manisha Pahwa
- Occupational Cancer Research Centre, Ontario Health, Toronto, Canada
- Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Birgit Greiner
- School of Public Health, University College Cork, Cork, Ireland
| | | | - Imelda S Wong
- Division of Science Integration, National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Juha Liira
- Department of Occupational Health, University of Turku, Turku, Finland
| | - Rachel Riera
- Cochrane Brazil Rio de Janeiro, Cochrane, Petrópolis, Brazil
- Center of Health Technology Assessment, Hospital Sírio-Libanês, São Paulo, Brazil
- Núcleo de Ensino e Pesquisa em Saúde Baseada em Evidência, Avaliação Tecnológica e Ensino em Saúde (NEP-Sbeats), Universidade Federal de São Paulo, São Paulo, Brazil
| | - Daniela V Pachito
- Prossono Centro de Diagnóstico e Medicina do Sono, Ribeirão Preto, São Paulo, Brazil
| |
Collapse
|
41
|
Barber KE, Rackoff GN, Newman MG. Day-to-day directional relationships between sleep duration and negative affect. J Psychosom Res 2023; 172:111437. [PMID: 37478504 PMCID: PMC10529882 DOI: 10.1016/j.jpsychores.2023.111437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/21/2023] [Accepted: 07/07/2023] [Indexed: 07/23/2023]
Abstract
OBJECTIVE There is a strong association between sleep disturbance and negative affect. However, the day-to-day directional connections between sleep and negative affect remain unclear. We examined day-to-day relationships between sleep duration and negative affect in community adults. METHODS Participants were two subsamples of the Midlife in the United States Study (Sample 1: n = 2,022; Sample 2: n = 782). Daily negative affect and previous night sleep duration were assessed via end-of-day telephone interviews for eight days. Random intercept cross-lagged panel models tested sleep duration as a predictor of next-day negative affect and vice versa, controlling for age, gender, and race. RESULTS In both samples, shorter sleep duration predicted higher next-day negative affect, but daily negative affect was not a significant predictor of upcoming-night sleep duration. Follow-up analyses indicated that the relationship between sleep duration and negative affect was nonlinear. Sleeping fewer than 7.5 hours or more than 10.5 hours was associated with greater next-day negative affect than sleeping between 7.5 and 10.5 hours. CONCLUSIONS In two large samples of community adults, sleep duration unidirectionally predicted higher next-day negative affect, and this relationship was nonlinear. Sleeping at least 7.5 hours and no more than 10.5 hours appeared to be an optimal range associated with lowest next-day negative affect.
Collapse
Affiliation(s)
- Kathryn E Barber
- The Pennsylvania State University, Department of Psychology, University Park, PA, USA; Marquette University, Department of Psychology, Milwaukee, WI, USA.
| | - Gavin N Rackoff
- The Pennsylvania State University, Department of Psychology, University Park, PA, USA
| | - Michelle G Newman
- The Pennsylvania State University, Department of Psychology, University Park, PA, USA
| |
Collapse
|
42
|
Liu X, Hong C, Liu Z, Fan L, Yin M, Chen Y, Ren X, Gu X. Association of sleep disorders with asthma: a meta-analysis. BMJ Open Respir Res 2023; 10:e001661. [PMID: 37735102 PMCID: PMC10514641 DOI: 10.1136/bmjresp-2023-001661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 09/08/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Animal experiments and clinical trials have revealed a potential relationship between sleep disorders and asthma. However, the associations between these factors remain unclear. MATERIAL AND METHODS We searched PubMed, Embase, Web of Science and Cochrane Library databases for eligible studies published before 30 December 2022. Studies investigating the association between sleep disorders (insomnia, poor sleep quality and insufficient sleep time) and asthma were selected. Sleep disorders were assessed using questionnaires, interviews, or medical records. Asthma was diagnosed based on medical history and drug use. The Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality checklist were employed for quality assessment. We used OR with 95% CI as the effect measures and forest plots to display the results. Heterogeneity was evaluated using I2 statistics and subgroup analyses were performed for bias analysis. Publication bias was evaluated using the funnel plots and Egger's test. RESULTS Twenty-three studies were included in the primary analysis, which suggested a positive association between sleep disorders and asthma (OR: 1.38, 95% CI 1.10 to 1.74). Subgroup analyses were conducted according to the study design, age, family history of asthma and type of sleep disorders. We did not find any association between sleep disorders and asthma in children aged ˂12 years (OR: 1.13, 95% CI 0.97 to 1.32). The association was insignificant in studies where the family history of asthma was adjusted for (OR: 1.16, 95% CI 0.94 to 1.42). Funnel plot and Egger's test indicated a significant publication bias. CONCLUSION Sleep disorders are associated with an increased prevalence and incidence of asthma. However, the quality of the evidence was low because of potential biases. PROSPERO REGISTRATION NUMBER CRD42023391989.
Collapse
Affiliation(s)
- Xueqian Liu
- Emergency Department, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, Jiangsu, China
| | - Cheng Hong
- Cardiovascular Medicine Department, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, Jiangsu, China
| | - Zhiyu Liu
- Department of Gastroenterology, The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Lihua Fan
- Cardiovascular Medicine Department, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, Jiangsu, China
| | - Moqing Yin
- Cardiovascular Medicine Department, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, Jiangsu, China
| | - Yunhu Chen
- Cardiovascular Medicine Department, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, Jiangsu, China
| | - Xiang Ren
- Emergency Department, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, Jiangsu, China
| | - Xuefang Gu
- Outpatient Department, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, Jiangsu, China
| |
Collapse
|
43
|
Wang Y, Ma Z, Xu T, Ma Y, Jin L. Exposure to adverse childhood experiences and diabetes: Mediational role of short sleep duration. Prev Med 2023; 174:107643. [PMID: 37494972 DOI: 10.1016/j.ypmed.2023.107643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/25/2023] [Accepted: 07/19/2023] [Indexed: 07/28/2023]
Abstract
Adverse childhood experiences (ACEs) are associated with an increased risk of diabetes in adulthood. However, the potential mediational role of sleep duration in this association is unclear. A total of 116, 014 participants in the United States, from the Behavioral Risk Factor Surveillance System (BRFSS) survey in 2020 were involved in the study. The effects of ACE status, different ACEs, and ACE scores on short sleep duration were examined using binary logistic regression analysis, and the association of ACE status, different types of ACEs, and ACE scores with diabetes and the mediating role of short sleep duration were observed. Path analysis was used to investigate short sleep duration as pathways between different types of ACEs and diabetes in adulthood. For the different types of ACEs, alcohol abuse in the household (OR = 1.13, 95%CI 1.08; 1.18), witnessing domestic violence (OR = 1.17, 95%CI 1.11; 1.23), emotional abuse (OR = 1.11, 95%CI 1.06; 1.16), physical abuse (OR = 1.22, 95%CI 1.17; 1.28), sexual abuse (OR = 1.25, 95%CI 1.18; 1.32) and short sleep duration (OR = 1.26, 95%CI 1.21; 1.32) independently increased the odds of diabetes. There was also an indirect relationship between alcohol abuse in the household, witnessing domestic violence, physical abuse, sexual abuse, and diabetes via short sleep duration. Short sleep duration plays a partial mediating role between ACEs and diabetes, including alcohol abuse in the household, witnessing domestic violence, physical and sexual abuse.
Collapse
Affiliation(s)
- Yanfang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Jilin, Changchun, China.
| | - Zhaoyu Ma
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Liaoning, Shenyang, China.
| | - Tong Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Jilin, Changchun, China.
| | - Yanan Ma
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Liaoning, Shenyang, China.
| | - Lina Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Jilin, Changchun, China.
| |
Collapse
|
44
|
Bani Issa W, Hijazi H, Radwan H, Saqan R, Al-Sharman A, Samsudin ABR, Fakhry R, Al-Yateem N, Rossiter RC, Ibrahim A, Moustafa I, Naja F, Alameddine M, Abbas N, Abdelrahim DN, Al-Shujairi A, Awad M. Evaluation of the effectiveness of sleep hygiene education and FITBIT devices on quality of sleep and psychological worry: a pilot quasi-experimental study among first-year college students. Front Public Health 2023; 11:1182758. [PMID: 37680271 PMCID: PMC10482237 DOI: 10.3389/fpubh.2023.1182758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/17/2023] [Indexed: 09/09/2023] Open
Abstract
Background College students report disturbed sleep patterns that can negatively impact their wellbeing and academic performance. Objectives This study examined the effect of a 4-week sleep hygiene program that included sleep education and actigraph sleep trackers (FITBITs) on improving sleep quality and reducing psychological worry without control group. Design settings and participants A pilot quasi-experimental design, participants were randomly selected medical and health sciences from a university students in the United-Arab-Emirates. Methods Students were asked to wear FITBITs and log their daily sleep data and completed the Pittsburgh Sleep Quality Index (PSQI) and Penn State Worry Questionnaire (PSWQ). Extensive sleep hygiene education was delivered via lectures, a WhatsApp group, and the Blackboard platform. In total, 50 students completed pre-and post-assessments and returned FITBIT data. Results There was a significant difference in the prevalence of good sleep postintervention compared with pre-intervention (46% vs. 28%; p = 0.0126). The mean PSQI score was significantly lower post-intervention compared with pre-intervention (6.17 ± 3.16 vs. 7.12.87; p = 0.04, Cohen's d 0.33). After the intervention, subjective sleep quality, sleep latency, and daytime dysfunction were significantly improved compared with pre-intervention (p < 0.05). In addition, FITBIT data showed total sleep time and the number of restless episodes per night were significantly improved postintervention compared with pre-intervention (p = 0.013). The mean PSWQ score significantly decreased from pre-intervention to p = 0.049, Cohen' d = 0.25. The correlation between PSQI and PSWQ scores was significant post-intervention (β = 0.40, p = 0.02). Conclusion Our results may inform university educational policy and curricular reform to incorporate sleep hygiene awareness programs to empower students and improve their sleep habits.
Collapse
Affiliation(s)
- Wegdan Bani Issa
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Heba Hijazi
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Hadia Radwan
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Roba Saqan
- Research Institute of Medical and Health Sciences University of Sharjah, Sharjah, United Arab Emirates
| | - Alham Al-Sharman
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - A. B. Rani Samsudin
- College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Randa Fakhry
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Nabeel Al-Yateem
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Rachel C. Rossiter
- School of Nursing, Paramedicine and Healthcare Sciences, Faculty of Science and Health, Charles Sturt University, Bathurst, NSW, Australia
| | - Ali Ibrahim
- College of Business and Economics, United Arab Emirates University, Abu Dhabi, United Arab Emirates
| | - Ibrahim Moustafa
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Farah Naja
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohamad Alameddine
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Nada Abbas
- Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Dana N. Abdelrahim
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Manal Awad
- University Dental Hospital Sharjah, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| |
Collapse
|
45
|
Henríquez-Beltrán M, Dreyse J, Jorquera J, Jorquera-Diaz J, Salas C, Fernandez-Bussy I, Labarca G. The U-Shaped Association between Sleep Duration, All-Cause Mortality and Cardiovascular Risk in a Hispanic/Latino Clinically Based Cohort. J Clin Med 2023; 12:4961. [PMID: 37568362 PMCID: PMC10419896 DOI: 10.3390/jcm12154961] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Sleep is essential for life, and inappropriate sleep duration patterns may lead to chronic consequences regarding human health. Several studies have confirmed the presence of a U-shaped association between sleep duration and mortality. Moreover, many consequences related to cardiometabolic aspects have been suggested in patients with abnormal sleep durations. In this study, we analyzed the associations between sleep duration, total sleep time (TST), the risk of all-cause mortality, and 10-year cardiovascular risk in a cohort of patients at a sleep medicine center in Santiago, Chile. We conducted a prospective cohort study of patients (SantOSA). A short TST was defined as ≤6 h, a normal TST as 6 to 9 h, and a long TST as ≥9 h. Adjusted hazard ratios (aHRs) for all-cause mortality were calculated. A cross-sectional analysis between TST and 10-year cardiovascular risk (calculated using the Framingham 2008 formula) was determined using logistic regression models. A total of 1385 subjects were included in the results (78% male; median age: 53, interquartile range (IQR): 42-64 years; median BMI: 29.5, IQR: 16.7-33.1). A total of 333 subjects (24%) reported short TSTs, 938 (67.7%) reported normal TSTs, and 114 (8.3%) reported long TSTs. In the fully adjusted model, the association remained significant for short (aHR: 2.51 (1.48-4.25); p-value = 0.01) and long TSTs (aHR: 3.97 (1.53-10.29); p-value = 0.04). Finally, a U-shaped association was found between short and long TSTs, with an increase in cardiovascular risk at 10 years. Compared with normal TSTs, short (≤6 h) and long (≥9 h) TSTs were significantly associated with all-cause mortality and increased 10-year cardiovascular risk.
Collapse
Affiliation(s)
- Mario Henríquez-Beltrán
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Los Angeles 4440000, Chile;
| | - Jorge Dreyse
- Centro de Enfermedades Respiratorias, Clínica Las Condes, Facultad de Medicina Universidad Finis Terrae, Santiago 7591047, Chile; (J.D.); (J.J.); (C.S.)
| | - Jorge Jorquera
- Centro de Enfermedades Respiratorias, Clínica Las Condes, Facultad de Medicina Universidad Finis Terrae, Santiago 7591047, Chile; (J.D.); (J.J.); (C.S.)
| | | | - Constanza Salas
- Centro de Enfermedades Respiratorias, Clínica Las Condes, Facultad de Medicina Universidad Finis Terrae, Santiago 7591047, Chile; (J.D.); (J.J.); (C.S.)
| | | | - Gonzalo Labarca
- Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, University of Concepción, Concepción 4070112, Chile
- Division of Sleep Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Boston, MA 02215, USA
| |
Collapse
|
46
|
Sansom K, Reynolds A, McVeigh J, Mazzotti DR, Dhaliwal SS, Maddison K, Walsh J, Singh B, Eastwood P, McArdle N. Estimating sleep duration: performance of open-source processing of actigraphy compared to in-laboratory polysomnography in the community. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2023; 4:zpad028. [PMID: 37485312 PMCID: PMC10362889 DOI: 10.1093/sleepadvances/zpad028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 05/19/2023] [Indexed: 07/25/2023]
Abstract
Comparisons of actigraphy findings between studies are challenging given differences between brand-specific algorithms. This issue may be minimized by using open-source algorithms. However, the accuracy of actigraphy-derived sleep parameters processed in open-source software needs to be assessed against polysomnography (PSG). Middle-aged adults from the Raine Study (n = 835; F 58%; Age 56.7 ± 5.6 years) completed one night of in-laboratory PSG and concurrent actigraphy (GT3X+ ActiGraph). Actigraphic measures of total sleep time (TST) were analyzed and processed using the open-source R-package GENEActiv and GENEA data in R (GGIR) with and without a sleep diary and additionally processed using proprietary software, ActiLife, for comparison. Bias and agreement (intraclass correlation coefficient) between actigraphy and PSG were examined. Common PSG and sleep health variables associated with the discrepancy between actigraphy, and PSG TST were examined using linear regression. Actigraphy, assessed in GGIR, with and without a sleep diary overestimated PSG TST by (mean ± SD) 31.0 ± 50.0 and 26.4 ± 69.0 minutes, respectively. This overestimation was greater (46.8 ± 50.4 minutes) when actigraphy was analyzed in ActiLife. Agreement between actigraphy and PSG TST was poor (ICC = 0.27-0.44) across all three methods of actigraphy analysis. Longer sleep onset latency and longer wakefulness after sleep onset were associated with overestimation of PSG TST. Open-source processing of actigraphy in a middle-aged community population, agreed poorly with PSG and, on average, overestimated TST. TST overestimation increased with increasing wakefulness overnight. Processing of actigraphy without a diary in GGIR was comparable to when a sleep diary was used and comparable to actigraphy processed with proprietary algorithms in ActiLife.
Collapse
Affiliation(s)
- Kelly Sansom
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, WA, Australia
- West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Perth, WA, Australia
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Amy Reynolds
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Joanne McVeigh
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, South Africa
| | - Diego R Mazzotti
- Division of Medical Informatics, Department of Internal Medicine, University of Kansas Medical Center, KS, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, KS, USA
| | - Satvinder S Dhaliwal
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, B305, Curtin University, Bentley, WA, Australia
- Office of the Provost, Singapore University of Social Sciences, Clementi Road, Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Kathleen Maddison
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, WA, Australia
- West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Perth, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Jennifer Walsh
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, WA, Australia
- West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Perth, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Bhajan Singh
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, WA, Australia
- West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Perth, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Peter Eastwood
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Nigel McArdle
- Corresponding author. Nigel McArdle, Centre for Sleep Science, School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia.
| |
Collapse
|
47
|
Pan XB, Wang HX, Cao YJ, Liu YY. Secular Trends in Sleep Conditions in Chinese Elderly Individuals: A National Population-Based Study. Nat Sci Sleep 2023; 15:555-566. [PMID: 37441269 PMCID: PMC10335309 DOI: 10.2147/nss.s416084] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023] Open
Abstract
Purpose As one of the most rapidly aging countries in the world, the elderly population is expected to reach over 400 million in China by 2032. Many studies have suggested a positive association between sleep duration and adverse health events among elderly individuals. This study aimed to investigate the sleep conditions of Chinese elderly individuals between 2005 and 2018. Patients and methods Data for 53,013 elderly individuals were taken from five cycles of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) during 2005-2018. Sex- and age-specific means and 95% confidence intervals (95% CIs) were used to estimate sleep duration trends. Changes in sleep patterns were explored during this period. The prevalence of short and long sleep durations was assessed and age-standardized by the 2010 census. Finally, self-reported sleep quality was used to determine sleep conditions from another perspective among elderly individuals. Results The mean sleep duration decreased from 7.87 (95% CI: 7.83-7.91) to 7.29 (95% CI: 7.25-7.33) hours between 2005 and 2018. Changes in sleep duration patterns were found during the study period. The proportion of the elderly population who slept ≤6 hours increased and that of those who slept ≥9 hours decreased noticeably over the past 13 years. The age-standardized prevalence of short sleep duration increased from 32.7% (95% CI: 32.7-32.9%) to 38.4% (95% CI: 38.3-38.5%). A significant decrease was observed in the prevalence of long sleep duration. Conclusion Sleep conditions are gradually shifting toward a shorter sleep duration and poorer sleep quality among Chinese elderly individuals.
Collapse
Affiliation(s)
- Xing-Bing Pan
- Performance Appraisal Office, Children’s Hospital of Hebei Province, Shijiazhuang, People’s Republic of China
| | - Hong-Xia Wang
- Department of Obstetrics and Gynecology, The Fourth Hospital of Hebei Medical University/The Tumour Hospital of Hebei Province, Shijiazhuang, People’s Republic of China
| | - Ya-Jing Cao
- Institutes for Non-Communicable Chronic Diseases Control and Prevention, Hebei Provincial Centre for Disease Control and Prevention, Shijiazhuang, People’s Republic of China
| | - Yan-Yu Liu
- Cancer Institute, The Fourth Hospital of Hebei Medical University/The Tumour Hospital of Hebei Province, Shijiazhuang, People’s Republic of China
| |
Collapse
|
48
|
Amiri S. Sleep Duration, Sleep Quality, and Insomnia in Association With Self-Rated Health: A Systematic Review and Meta-Analysis. SLEEP MEDICINE RESEARCH 2023; 14:66-79. [DOI: 10.17241/smr.2023.01732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 06/06/2023] [Indexed: 08/28/2023] Open
Abstract
Background and Objective This study undertook a systematic review and meta-analysis of the relationship between sleep duration, sleep quality, and insomnia in association with self-rated health.Methods Studies that had examined the relationship between sleep duration, sleep quality, and insomnia with self-rated health were eligible. PubMed and Scopus were the two main databases for searching for studies related to this meta-analysis. The Google Scholar database as a source of gray literature was also searched by hand. This search was from the beginning of the formation of databases until the end of January 2022, and the search language was limited to articles published in English. The Effective Public Health Practice Project Quality Assessment Tool was used to assess the quality of studies. For this meta-analysis, odds ratio and 95% confidence interval were extracted or calculated. The pool of studies was processed by the random effects method.Results Twenty-six studies were included in this meta-analysis. Sleep duration of ≤ 8 hours per day (h/d) (odds ratio = 1.58 and 95% confidence interval = [1.41–1.77]) and sleep duration of > 8 h/d (odds ratio = 1.32 and 95% confidence interval = [1.17–1.50]) are associated with poor self-rated health. Poor sleep quality and insomnia are associated with poor self-rated health. Conclusions Sleep problems have a negative effect on self-rated health, and therefore, effective interventions can help improve sleep.
Collapse
|
49
|
Griggs S, Irani E, Strohl KP, Al-Kindi S, Rajagopalan S, Crawford SL, Margevicius S, Hickman RL. Sleep health dimensions are associated with next-day symptoms in young adults with type 1 diabetes. Sleep Health 2023; 9:339-345. [PMID: 36567195 PMCID: PMC10287843 DOI: 10.1016/j.sleh.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/06/2022] [Accepted: 11/07/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE We investigated intra-individual reciprocal associations between sleep health dimensions (individual and composite) and symptoms among young adults with type 1 diabetes (T1D). DESIGN AND MEASUREMENTS Cross-lagged multilevel models were used to analyze electronic diary-reported sleep and symptom patterns over 7 days at waketime in 42 young adults with T1D. Sleep health dimensions included regularity, satisfaction, alertness, timing, efficiency (percentage of time spent asleep), and duration (total sleep time) and symptoms included mood, fatigue, and pain. Covariates included biological sex and age. SETTING AND PARTICIPANTS We recruited young adults (mean age 21.5 ± 2.1 years, HbA1c 6.8%, 85% female, 10% gender minority) with T1D for at least 6 months and no other major medical or psychiatric comorbidity from social media platforms, the College Diabetes Network, and ResearchMatch. RESULTS On days with a better sleep health composite, participants reported lower next-day symptoms (higher mood, lower fatigue, and lower pain) and on days when participants reported lower symptoms, participants reported better sleep health (as a composite). Several individual sleep health dimensions led to lower next-day symptoms (eg, higher satisfaction, alertness, and efficiency and higher mood); however, symptoms were no longer predictive of next-day sleep when controlling for prior day sleep. CONCLUSIONS Optimal sleep health is an antecedent of fewer next day symptoms. Sleep health dimensions likely have positive additive effects on lower symptoms as some of the individual sleep health dimensions were not significantly associated with some symptoms among young adults with T1D.
Collapse
Affiliation(s)
- Stephanie Griggs
- Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, Ohio, USA.
| | - Elliane Irani
- Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, Ohio, USA
| | - Kingman P Strohl
- Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA
| | - Sadeer Al-Kindi
- Center for Vascular Metabolic Disease, School of Medicine, Cleveland, Ohio, USA; Cardiovascular Research Institute, Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA
| | - Sanjay Rajagopalan
- Cardiovascular Research Institute, Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA
| | - Sybil L Crawford
- UMass Chan Medical School, Tan Chingfen Graduate School of Nursing, Worcester, Massachusetts, USA
| | - Seunghee Margevicius
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Case Comprehensive Cancer Center, School of Medicine, Cleveland, Ohio, USA
| | - Ronald L Hickman
- Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, Ohio, USA
| |
Collapse
|
50
|
Choi MY, Malspeis S, Sparks JA, Cui J, Yoshida K, Costenbader KH. Association of Sleep Deprivation and the Risk of Developing Systemic Lupus Erythematosus Among Women. Arthritis Care Res (Hoboken) 2023; 75:1206-1212. [PMID: 36094865 PMCID: PMC10008454 DOI: 10.1002/acr.25017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/14/2022] [Accepted: 09/08/2022] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Sleep deprivation has been associated with risk of autoimmune diseases. Using the Nurses' Health Study (NHS) (1986-2016) and NHSII (1989-2017) cohorts, we aimed in the present study to investigate whether sleep deprivation was associated with risk of developing systemic lupus erythematosus (SLE). METHODS Average sleep duration in a 24-hour period was reported in the NHS (1986-2014) and NHSII (1989-2009). Lifestyle, exposure, and medical information was collected on biennial questionnaires. Adjusted Cox regression analyses modeled associations between cumulative average sleep duration (categorical variables) and incident SLE. Interactions between sleep duration and shiftwork, bodily pain (using the Short Form 36 [SF-36] questionnaire), and depression were examined. RESULTS We included 186,072 women with 187 incident SLE cases during 4,246,094 person-years of follow-up. Chronic low sleep duration (≤5 hours/night versus reference >7-8 hours) was associated with increased SLE risk (adjusted hazard ratio [HRadj ] 2.47 [95% confidence interval (95% CI) 1.29, 4.75]), which persisted after the analysis was lagged (4 years; HRadj 3.14 [95% CI 1.57, 6.29]) and adjusted for shiftwork, bodily pain, and depression (HRadj 2.13 [95% CI 1.11, 4.10]). We detected additive interactions between low sleep duration and high bodily pain (SF-36 score <75) with an attributable proportion (AP) of 64% (95% CI 40%, 87%) and an HR for SLE of 2.97 (95% CI 1.86, 4.75) for those with both risk factors compared to those with neither. Similarly, there was an interaction between low sleep duration and depression, with an AP of 68% (95% CI 49%, 88%) and an HR for SLE of 2.82 (95% CI 1.64, 4.85). CONCLUSION Chronic low sleep duration was associated with higher SLE risk, with stronger effects among those with bodily pain and depression, highlighting the potential role of adequate sleep in disease prevention.
Collapse
Affiliation(s)
- May Y Choi
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, and University of Calgary, Calgary, Alberta, Canada
| | - Susan Malspeis
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jeffrey A Sparks
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jing Cui
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Kazuki Yoshida
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Karen H Costenbader
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| |
Collapse
|