151
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Grumbach P, Opel N, Martin S, Meinert S, Leehr EJ, Redlich R, Enneking V, Goltermann J, Baune BT, Dannlowski U, Repple J. Sleep duration is associated with white matter microstructure and cognitive performance in healthy adults. Hum Brain Mapp 2020; 41:4397-4405. [PMID: 32648625 PMCID: PMC7502839 DOI: 10.1002/hbm.25132] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 01/01/2023] Open
Abstract
Reduced sleep duration and sleep deprivation have been associated with cognitive impairment as well as decreased white matter integrity as reported by experimental studies. However, it is largely unknown whether differences in sleep duration and sleep quality might affect microstructural white matter and cognition. Therefore, the present study aims to examine the cross-sectional relationship between sleep duration, sleep quality, and cognitive performance in a naturalistic study design, by focusing on the association with white matter integrity in a large sample of healthy, young adults. To address this, 1,065 participants, taken from the publicly available sample of the Human Connectome Project, underwent diffusion tensor imaging. Moreover, broad cognitive performance measures (NIH Cognition Toolbox) and sleep duration and quality (Pittsburgh Sleep Quality Index) were assessed. The results revealed a significant positive association between sleep duration and overall cognitive performance. Shorter sleep duration significantly correlated with fractional anisotropy (FA) reductions in the left superior longitudinal fasciculus (SLF). In turn, FA in this tract was related to measures of cognitive performance and was shown to significantly mediate the association of sleep duration and cognition. For cognition only, associations shift to a negative association of sleep duration and cognition for participants sleeping more than 8 hr a day. Investigations into subjective sleep quality showed no such associations. The present study showed that real-world differences in sleep duration, but not subjective sleep quality are related to cognitive performance measures and white matter integrity in the SLF in healthy, young adults.
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Affiliation(s)
| | - Nils Opel
- Department of PsychiatryUniversity of MünsterMünsterGermany
| | - Stella Martin
- Department of EconomicsUniversity of MünsterMünsterGermany
| | | | | | - Ronny Redlich
- Department of PsychiatryUniversity of MünsterMünsterGermany
| | | | | | - Bernhard T. Baune
- Department of PsychiatryUniversity of MünsterMünsterGermany
- Department of PsychiatryMelbourne Medical School, The University of MelbourneMelbourneVictoriaAustralia
- The Florey Institute of Neuroscience and Mental HealthThe University of MelbourneParkvilleVictoriaAustralia
| | - Udo Dannlowski
- Department of PsychiatryUniversity of MünsterMünsterGermany
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152
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Penner CG, Gerardy B, Ryan R, Williams M. The Odds Ratio Product (An Objective Sleep Depth Measure): Normal Values, Repeatability, and Change With CPAP in Patients With OSA. J Clin Sleep Med 2020; 15:1155-1163. [PMID: 31482838 DOI: 10.5664/jcsm.7812] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The Odds Ratio Product (ORP) is an objective measure of sleep depth using the relationships of the powers of different electroencephalogram (EEG) frequencies in a single index. The range of the ORP is 0 (deeply asleep) to 2.5 (fully awake). This investigation seeks to elucidate normal values of non-rapid eye movement ORP (ORPNR) in healthy individuals, repeatability of the measure, and the change in ORPNR following continuous positive airway pressure (CPAP) treatment. METHODS Healthy individuals underwent a home sleep apnea test (HSAT) with EEG followed 1 week later by EEG alone. Another cohort with OSA underwent baseline HSAT with EEG followed by a second EEG study approximately 4 weeks into treatment with CPAP. RESULTS Thirty-eight healthy individuals completed the protocol (mean age of 34.9 ± 7.4 years, Epworth Sleepiness Scale score 3.6 ± 2.4, Insomnia Severity Index score 2.0 ± 1.6 and Functional Outcomes of Sleep Questionnaire - shorter version score 19 ± 1.2). The mean ORPNR for all nights was 0.52 ± 0.13. The difference between the first night and the second night was 0.024 ± 0.17 (not significant). The intraclass correlation coefficient was 0.525, suggesting only moderate agreement between the first and second nights. The normal value for ORPNR in healthy individuals is ≤ 0.78 units using two standard deviations as the cutoff. Forty participants completed the OSA protocol (mean age 49 ± 11 years, body mass index 35 ± 6 kg/m², apnea-hypopnea index 33.5 ± 28.4 events/h). The mean pre-CPAP ORPNR was 0.69 ± 0.24 and the mean post-CPAP ORPNR was 0.57 ± 0.22 (P = .02). CONCLUSIONS The ORPNR proves to have significant variability from night to night in healthy individuals. ORPNR objectively improves following CPAP treatment, providing further evidence that it measures sleep depth. CITATION Penner CG, Gerardy B, Ryan R, Williams M. The odds ratio product (an objective sleep depth measure): normal values, repeatability, and change with CPAP in patients with OSA. J Clin Sleep Med. 2019;15(8):1155-1163.
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Affiliation(s)
- Charles Gerhard Penner
- University of Manitoba, Winnipeg, Canada; Cerebra Health Inc., Winnipeg, Canada; RANA Respiratory Care Group, Brandon, Manitoba
| | | | - Rob Ryan
- RANA Respiratory Care Group, Brandon, Manitoba
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153
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Sieverdes JC, Treiber FA, Kline CE, Mueller M, Brunner-Jackson B, Sox L, Cain M, Swem M, Diaz V, Chandler J. Ethnicity Differences in Sleep Changes Among Prehypertensive Adults Using a Smartphone Meditation App: Dose-Response Trial. JMIR Form Res 2020; 4:e20501. [PMID: 33021484 PMCID: PMC7576537 DOI: 10.2196/20501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/22/2020] [Accepted: 07/26/2020] [Indexed: 01/13/2023] Open
Abstract
Background African Americans (AAs) experience greater sleep quality problems than non-Hispanic Whites (NHWs). Meditation may aid in addressing this disparity, although the dosage levels needed to achieve such benefits have not been adequately studied. Smartphone apps present a novel modality for delivering, monitoring, and measuring adherence to meditation protocols. Objective This 6-month dose-response feasibility trial investigated the effects of a breathing awareness meditation (BAM) app, Tension Tamer, on the secondary outcomes of self-reported and actigraphy measures of sleep quality and the modulating effects of ethnicity of AAs and NHWs. Methods A total of 64 prehypertensive adults (systolic blood pressure <139 mm Hg; 31 AAs and 33 NHWs) were randomized into 3 different Tension Tamer dosage conditions (5,10, or 15 min twice daily). Sleep quality was assessed at baseline and at 1, 3, and 6 months using the Pittsburgh Sleep Quality Index (PSQI) and 1-week bouts of continuous wrist actigraphy monitoring. The study was conducted between August 2014 and October 2016 (IRB #Pro00020894). Results At baseline, PSQI and actigraphy data indicated that AAs had shorter sleep duration, greater sleep disturbance, poorer efficiency, and worse quality of sleep (range P=.03 to P<.001). Longitudinal generalized linear mixed modeling revealed a dose effect modulated by ethnicity (P=.01). Multimethod assessment showed a consistent pattern of NHWs exhibiting the most favorable responses to the 5-min dose; they reported greater improvements in sleep efficiency and quality as well as the PSQI global value than with the 10-min and 15-min doses (range P=.04 to P<.001). Actigraphy findings revealed a consistent, but not statistically significant, pattern in the 5-min group, showing lower fragmentation, longer sleep duration, and higher efficiency than the other 2 dosage conditions. Among AAs, actigraphy indicated lower sleep fragmentation with the 5-min dose compared with the 10-min and 15-min doses (P=.03 and P<.001, respectively). The 10-min dose showed longer sleep duration than the 5-min and 15-min doses (P=.02 and P<.001, respectively). The 5-min dose also exhibited significantly longer average sleep than the 15-min dose (P=.03). Conclusions These findings indicate the need for further study of the potential modulating influence of ethnicity on the impact of BAM on sleep indices and user-centered exploration to ascertain the potential merits of refining the Tension Tamer app with attention to cultural tailoring among AAs and NHWs with pre-existing sleep complaints.
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Affiliation(s)
- John C Sieverdes
- College of Charleston, Health and Human Performance, Charleston, SC, United States
| | - Frank A Treiber
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States.,College of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Christopher E Kline
- Department of Health & Physical Activity, University of Pittsburgh, Pittsburgh, PA, United States
| | - Martina Mueller
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
| | - Brenda Brunner-Jackson
- College of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Luke Sox
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
| | - Mercedes Cain
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
| | - Maria Swem
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
| | - Vanessa Diaz
- College of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Jessica Chandler
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
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154
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Hirata RP, Dala Pola DC, Schneider LP, Bertoche MP, Furlanetto KC, Hernandes NA, Mesas AE, Pitta F. Tossing and turning: association of sleep quantity-quality with physical activity in COPD. ERJ Open Res 2020; 6:00370-2020. [PMID: 33447609 PMCID: PMC7792763 DOI: 10.1183/23120541.00370-2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/05/2020] [Indexed: 11/13/2022] Open
Abstract
The association between characteristics of sleep and physical activity in daily life (PADL) has not yet been investigated in depth in subjects with COPD. This study evaluated whether time spent per day in physical activity (PA) and sedentary behaviour are associated with sleep quantity and quality in this population. Sleep and PADL were objectively assessed by an activity monitor for 7 days and analysed on a minute-by-minute basis. Subjects also underwent spirometry and 6-min walking test (6MWT). Fifty-five subjects with moderate-to-severe COPD (28 male, 67±8 years) were studied. Subjects with total time in bed (TIB) per night ≥9 h had higher wake-after-sleep onset than TIB 7-9 h and TIB ≤7 h (195 (147-218) versus 117 (75-167) and 106 (84-156) min) and more fragmented sleep than TIB ≤7 h (8.2 (6.7-14.3) versus 6.3 (5.6-6.9) sleeping bouts; p<0.05 for all). Subjects with TIB ≥9 h also spent more time per day in sedentary behaviour and less time per day in PA of light and moderate-to-vigorous intensity than those with TIB 7-9 h and ≤7 h. In multiple linear regression, TIB ≥9 h was the only significant predictor of physical inactivity (β=-3.3 (-5.1, -1.6), p≤0.0001), accounting for 20% of its variation. Sleep fragmentation was frequent and more pronounced in physically inactive than active patients (7.5 (6.3-9.6) versus 6.4 (5.5-7.3) sleeping bouts; p=0.027). In summary, subjects with COPD with TIB ≥9 h·night-1 have more fragmented sleep, are more sedentary and less physically active than those with <9 h·night-1, independently of the awake time. Sleep quality is frequently poor and even worse in patients classified as physically inactive.
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Affiliation(s)
- Raquel Pastrello Hirata
- Laboratory of Research in Respiratory Physiotherapy, Dept of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil
| | - Daniele Caroline Dala Pola
- Laboratory of Research in Respiratory Physiotherapy, Dept of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil
| | - Lorena Paltanin Schneider
- Laboratory of Research in Respiratory Physiotherapy, Dept of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil
| | - Mariana Pereira Bertoche
- Laboratory of Research in Respiratory Physiotherapy, Dept of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil
| | - Karina Couto Furlanetto
- Laboratory of Research in Respiratory Physiotherapy, Dept of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil
- Research Center in Health Sciences, University of Northern Paraná (UNOPAR), Londrina, Brazil
| | - Nidia Aparecida Hernandes
- Laboratory of Research in Respiratory Physiotherapy, Dept of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil
| | - Arthur Eumann Mesas
- Postgraduate Program in Public Health, UEL, Londrina, Brazil
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Fabio Pitta
- Laboratory of Research in Respiratory Physiotherapy, Dept of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil
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155
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Eke R, Li T, Bond K, Ho A, Graves L. Viewing Trends and Users’ Perceptions of the Effect of Sleep-Aiding Music on YouTube: Quantification and Thematic Content Analysis. J Med Internet Res 2020; 22:e15697. [PMID: 32831182 PMCID: PMC7477671 DOI: 10.2196/15697] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 12/30/2019] [Accepted: 05/13/2020] [Indexed: 11/13/2022] Open
Abstract
Background
Sleep plays an essential role in the psychological and physiological functioning of humans. A report from the Centers for Disease Control and Prevention (CDC) found that sleep duration was significantly reduced among US adults in 2012 compared to 1985. Studies have described a significant association between listening to soothing music and an improvement in sleep quality and sleep duration. YouTube is a platform where users can access sleep-aiding music videos. No literature exists pertaining to the use of sleep-aiding music on YouTube.
Objective
This study aimed to examine the patterns of viewing sleep-aiding music videos on YouTube. We also performed a content analysis of the comments left on sleep-aiding music video posts, to describe the perception of users regarding the effects of these music videos on their sleep quality.
Methods
We searched for sleep-aiding music videos published on YouTube between January 1, 2012, and December 31, 2017. We sorted videos by view number (highest to lowest) and used a targeted sampling approach to select eligible videos for qualitative content analysis. To perform the content analysis, we imported comments into a mixed-method analytical software. We summarized variables including total views, likes, dislikes, play duration, and age of published music videos. All descriptive statistics were completed with SAS statistical software.
Results
We found a total of 238 sleep-aiding music videos on YouTube that met the inclusion criteria. The total view count was 1,467,747,018 and the total playtime was 84,252 minutes. The median play length was 186 minutes (IQR 122 to 480 minutes) and the like to dislike ratio was approximately 9 to 1. In total, 135 (56.7%) videos had over 1 million views, and 124 (52.1%) of the published sleep-aiding music videos had stayed active for 1 to 2 years. Overall, 4023 comments were extracted from 20 selected sleep-aiding music videos. Five overarching themes emerged in the reviewed comments, including viewers experiencing a sleep problem, perspective on the positive impact of the sleep-aiding music videos, no effect of the sleep-aiding music videos, time to initiation of sleep or sleep duration, and location of viewers. The overall κ statistic for the codes was 0.87 (range 0.85-0.96).
Conclusions
This is the first study to examine the patterns of viewing sleep-aiding music videos on YouTube. We observed a substantial increase in the number of people using sleep-aiding music videos, with a wide variation in viewer location. This study supports the hypothesis that listening to soothing music has a positive impact on sleep habits.
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Affiliation(s)
- Ransome Eke
- Department of Health Science, University of Alabama, Tuscaloosa, AL, United States
| | - Tong Li
- Western Michigan University School of Medicine, Kalamazoo, MI, United States
| | - Kiersten Bond
- Department of Health Science, University of Alabama, Tuscaloosa, AL, United States
| | - Arlene Ho
- Western Michigan University School of Medicine, Kalamazoo, MI, United States
| | - Lisa Graves
- Western Michigan University School of Medicine, Kalamazoo, MI, United States
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156
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Harjumaa M, Absetz P, Ermes M, Mattila E, Männikkö R, Tilles-Tirkkonen T, Lintu N, Schwab U, Umer A, Leppänen J, Pihlajamäki J. Internet-Based Lifestyle Intervention to Prevent Type 2 Diabetes Through Healthy Habits: Design and 6-Month Usage Results of Randomized Controlled Trial. JMIR Diabetes 2020; 5:e15219. [PMID: 32779571 PMCID: PMC7448183 DOI: 10.2196/15219] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 11/29/2019] [Accepted: 02/29/2020] [Indexed: 12/14/2022] Open
Abstract
Background Type 2 diabetes can be prevented through lifestyle changes, but sustainable and scalable lifestyle interventions are still lacking. Habit-based approaches offer an opportunity to induce long-term behavior changes. Objective The purposes of this study were to describe an internet-based lifestyle intervention for people at risk for type 2 diabetes targeted to support formation of healthy habits and explore its user engagement during the first 6 months of a randomized controlled trial (RCT). Methods The app provides an online store that offers more than 400 simple and contextualized habit-forming behavioral suggestions triggered by daily life activities. Users can browse, inspect, and select them; report their performances; and reflect on their own activities. Users can also get reminders, information on other users’ activities, and information on the prevention of type 2 diabetes. An unblended parallel RCT was carried out to evaluate the effectiveness of the app in comparison with routine care. User engagement is reported for the first 6 months of the trial based on the use log data of the participants, who were 18- to 70-year-old community-dwelling adults at an increased risk of type 2 diabetes. Results Of 3271 participants recruited online, 2909 were eligible to participate in the RCT. Participants were randomized using a computerized randomization system to the control group (n=971), internet-based intervention (digital, n=967), and internet-based intervention with face-to-face group coaching (F2F+digital, n=971). Mean age of control group participants was 55.0 years, digital group 55.2 years, and F2F+digital 55.2 years. The majority of participants were female, 81.1% (787/971) in the control group, 78.3% (757/967) in the digital group, and 80.7% (784/971) in the F2F+digital group. Of the participants allocated to the digital and F2F+digital groups, 99.53% (1929/1938) logged in to the app at least once, 98.55% (1901/1938) selected at least one habit, and 95.13% (1835/1938) reported at least one habit performance. The app was mostly used on a weekly basis. During the first 6 months, the number of active users on a weekly level varied from 93.05% (1795/1929) on week 1 to 51.79% (999/1929) on week 26. The daily use activity was not as high. The digital and F2F+digital groups used the app on a median of 23.0 and 24.5 days and for 79.4 and 85.1 minutes total duration, respectively. A total of 1,089,555 habit performances were reported during the first 6 months. There were no significant differences in the use metrics between the groups with regard to cumulative use metrics. Conclusions Results demonstrate that internet-based lifestyle interventions can be delivered to large groups including community-dwelling middle-aged and older adults, many with limited experience in digital app use, without additional user training. This intermediate analysis of use behavior showed relatively good engagement, with the percentage of active weekly users remaining over 50% at 6 months. However, we do not yet know if the weekly engagement was enough to change the lifestyles of the participants. Trial Registration ClinicalTrials.gov NCT03156478; https://clinicaltrials.gov/ct2/show/NCT03156478
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Affiliation(s)
- Marja Harjumaa
- VTT Technical Research Centre of Finland Ltd, Espoo, Finland
| | - Pilvikki Absetz
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Miikka Ermes
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Elina Mattila
- VTT Technical Research Centre of Finland Ltd, Espoo, Finland
| | - Reija Männikkö
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Endocrinology and Clinical Nutrition, Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Tanja Tilles-Tirkkonen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Niina Lintu
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Endocrinology and Clinical Nutrition, Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Adil Umer
- VTT Technical Research Centre of Finland Ltd, Espoo, Finland
| | - Juha Leppänen
- VTT Technical Research Centre of Finland Ltd, Espoo, Finland
| | - Jussi Pihlajamäki
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Endocrinology and Clinical Nutrition, Department of Medicine, Kuopio University Hospital, Kuopio, Finland
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157
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Malhotra RK. Evaluating the Sleepy and Sleepless Patient. ACTA ACUST UNITED AC 2020; 26:871-889. [PMID: 32756226 DOI: 10.1212/con.0000000000000880] [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: 11/15/2022]
Abstract
PURPOSE OF REVIEW This article explains the clinical approach to patients presenting with sleepiness or sleeplessness in a neurologic practice setting. Addressing the patient's sleep symptoms may help improve symptoms of their other underlying primarily neurologic disorder. RECENT FINDINGS New diagnostic modalities at home such as home sleep apnea testing have improved access and diagnosis of sleep apnea. Consumer health tracking devices have also helped patients focus on their sleep duration and quality, prompting them to bring their concerns to their neurologist. SUMMARY Like many neurologic disorders, a detailed history and physical examination are critical in the evaluation of patients with sleepiness or sleeplessness. Patients who have neurologic disorders are more likely to have poor-quality sleep. Questions about the patient's sleep schedule or screening patients for common sleep disorders such as sleep apnea and restless legs syndrome (RLS) are useful to add to a typical neurologic evaluation to better recognize sleep disorders in this population. Polysomnography, home sleep apnea testing, multiple sleep latency tests, and actigraphy can be used with the available history and examination to determine the proper diagnosis and management plan for these patients.
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158
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Huyett P, Siegel N, Bhattacharyya N. Prevalence of Sleep Disorders and Association With Mortality: Results From the NHANES 2009-2010. Laryngoscope 2020; 131:686-689. [PMID: 32681735 DOI: 10.1002/lary.28900] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To determine the prevalence of sleep disorders in the United States and the association between sleep disorders and all-cause mortality. METHODS A cross-sectional analysis of the 2009 to 2010 National Health and Nutrition Examination Survey (NHANES) and 2015 National Death Index (NDI) was performed. The 2009 to 2010 NHANES national household survey for adults ≥ 18 years was examined for the prevalence of sleep disorders as well as standard demographics and the presence of comorbidities (coronary artery disease [CAD], stroke, and emphysema). This dataset was linked to the 2015 NDI to associate the presence of sleep disorders with 5-year all-cause mortality. RESULTS The study sample had a mean age of 46.1 years old, was 48.3% male, and had an average body mass index (BMI) of 28.7 (28.4-28.9). 7.1% (6.5%-7.7%) of adults reported being diagnosed with a sleep disorder, which represents an estimated 15.9 million (13.2-18.6) patients. The estimated mortality rate for those having a sleep disorder was 9.3% (7.2%-11.9%) compared to 5.2% (4.5%-5.9%) without a sleep disorder (odds ratio 1.89, P = <.001). After adjusting for age, sex, BMI, CAD, stroke, and emphysema, having a sleep disorder remained a significant predictor of increased mortality (hazard ratio, 1.5 [1.02-2.18], P = .042). CONCLUSION This study reports a high prevalence of self-reported but physician-diagnosed sleep disorders; however, this likely represents an underestimate. Given the association with all-cause mortality, there is a need for increased recognition of undiagnosed sleep disorders within the United States. LEVEL OF EVIDENCE 2b Laryngoscope, 131:686-689, 2021.
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Affiliation(s)
- Phillip Huyett
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, U.S.A
| | - Noah Siegel
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, U.S.A
| | - Neil Bhattacharyya
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, U.S.A
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159
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Qin DD, Feng SF, Zhang FY, Wang N, Sun WJ, Zhou Y, Xiong TF, Xu XL, Yang XT, Zhang X, Zhu X, Hu XT, Xiong L, Liu Y, Chen YC. Potential use of actigraphy to measure sleep in monkeys: comparison with behavioral analysis from videography. Zool Res 2020; 41:437-443. [PMID: 32400976 PMCID: PMC7340525 DOI: 10.24272/j.issn.2095-8137.2020.056] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 05/13/2020] [Indexed: 02/05/2023] Open
Abstract
Sleep is indispensable for human health, with sleep disorders initiating a cascade of negative consequences. As our closest phylogenetic relatives, non-human primates (NHPs) are invaluable for comparative sleep studies and exhibit tremendous potential for improving our understanding of human sleep and related disorders. Previous work on measuring sleep in NHPs has mostly used electroencephalography or videography. In this study, simultaneous videography and actigraphy were applied to observe sleep patterns in 10 cynomolgus monkeys ( Macaca fascicularis) over seven nights (12 h per night). The durations of wake, transitional sleep, and relaxed sleep were scored by analysis of animal behaviors from videography and actigraphy data, using the same behavioral criteria for each state, with findings then compared. Here, results indicated that actigraphy constituted a reliable approach for scoring the state of sleep in monkeys and showed a significant correlation with that scored by videography. Epoch-by-epoch analysis further indicated that actigraphy was more suitable for scoring the state of relaxed sleep, correctly identifying 97.57% of relaxed sleep in comparison with video analysis. Only 34 epochs (0.13%) and 611 epochs (2.30%) were differently interpreted as wake and transitional sleep compared with videography analysis. The present study validated the behavioral criteria and actigraphy methodology for scoring sleep, which can be considered as a useful and a complementary technique to electroencephalography and/or videography analysis for sleep studies in NHPs.
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Affiliation(s)
- Dong-Dong Qin
- Yunnan Key Laboratory of Primate Biomedicine Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, Yunnan 650500, China
- Yunnan University of Chinese Medicine, Kunming, Yunnan 650500, China
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan 650223, China
| | - Shu-Fei Feng
- Yunnan Key Laboratory of Primate Biomedicine Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, Yunnan 650500, China
| | - Fei-Yu Zhang
- Yunnan University of Chinese Medicine, Kunming, Yunnan 650500, China
| | - Na Wang
- Yunnan University of Chinese Medicine, Kunming, Yunnan 650500, China
| | - Wen-Jie Sun
- Yunnan Key Laboratory of Primate Biomedicine Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, Yunnan 650500, China
| | - Yin Zhou
- Yunnan Key Laboratory of Primate Biomedicine Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, Yunnan 650500, China
| | - Teng-Fang Xiong
- Yunnan University of Chinese Medicine, Kunming, Yunnan 650500, China
| | - Xian-Lai Xu
- Yunnan University of Chinese Medicine, Kunming, Yunnan 650500, China
| | - Xiao-Ting Yang
- Yunnan University of Chinese Medicine, Kunming, Yunnan 650500, China
| | - Xiang Zhang
- Yunnan University of Chinese Medicine, Kunming, Yunnan 650500, China
| | - Xue Zhu
- Yunnan University of Chinese Medicine, Kunming, Yunnan 650500, China
| | - Xin-Tian Hu
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan 650223, China
| | - Lei Xiong
- Yunnan University of Chinese Medicine, Kunming, Yunnan 650500, China
| | - Yun Liu
- Department of Rehabilitation, Kunming Children's Hospital, Kunming, Yunnan, 650034, China. E-mail:
| | - Yong-Chang Chen
- Yunnan Key Laboratory of Primate Biomedicine Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, Yunnan 650500, China. E-mail:
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Gupta S, Bhardwaj A, Nadda A, Gill A, Mittal A, Gupta S. A comparative study of sleep quality in different phases of the medical course: A study from Haryana (North India). J Family Med Prim Care 2020; 9:2006-2010. [PMID: 32670956 PMCID: PMC7346907 DOI: 10.4103/jfmpc.jfmpc_1137_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 12/21/2019] [Accepted: 02/12/2020] [Indexed: 11/04/2022] Open
Abstract
Background: Inadequate sleep quality is a crucial problem in today's hectic lifestyle. Sleep is known to facilitate cognitive skills, aid memory, and is important for physical, emotional and intellectual health. Objectives: To determine the sleep quality of the medical undergraduate students and to explore differences in various phases of medical curriculum. Material and Methods: Sleep quality was assessed in 400 medical students in various phases of the medical course using the Pittsburgh Sleep Quality Index (PSQI). Chi square test was used for comparisons of the all seven components of PSQI and sleep quality for different study year, whereas ANOVA was used for comparison of the components and global score. Results: Of the total, 25.3% of the participants classified their sleep quality as either very or fairly bad, and 31.1% reported taking more than 30 min to fall asleep. The average hours slept per night was 7.1 ± 1.21. Of the total, 8.4% of the participants reported using sleep medication at least once a week. Subjective sleep quality and sleep duration were found to be significantly different among the four groups. Conclusion: Poor subjective sleep quality was high for students in all class years of the undergraduate medical course. The comparison across the various phases of the course showed that first years reported worse sleep quality than did those in other class years.
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Affiliation(s)
- Shilpi Gupta
- Department of Community Medicine, Maharishi Markandeshwar Institute of Medical Sciences and Research, Maharishi Markandeshwar (Deemed to be University), Mullana (Ambala), Haryana, India
| | - Anu Bhardwaj
- Department of Community Medicine, Maharishi Markandeshwar Institute of Medical Sciences and Research, Maharishi Markandeshwar (Deemed to be University), Mullana (Ambala), Haryana, India
| | - Anuradha Nadda
- Department of Community Medicine, Gian Sagar Medical College and Hospital, Jhansla, Punjab, India
| | - Angad Gill
- Department of Community Medicine, Maharishi Markandeshwar Institute of Medical Sciences and Research, Maharishi Markandeshwar (Deemed to be University), Mullana (Ambala), Haryana, India
| | - Anshu Mittal
- Department of Community Medicine, Maharishi Markandeshwar Institute of Medical Sciences and Research, Maharishi Markandeshwar (Deemed to be University), Mullana (Ambala), Haryana, India
| | - Sachin Gupta
- Department of Community Medicine, Maharishi Markandeshwar Institute of Medical Sciences and Research, Maharishi Markandeshwar (Deemed to be University), Mullana (Ambala), Haryana, India
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Carneiro-Barrera A, Amaro-Gahete FJ, Acosta FM, Ruiz JR. Body Composition Impact on Sleep in Young Adults: The Mediating Role of Sedentariness, Physical Activity, and Diet. J Clin Med 2020; 9:jcm9051560. [PMID: 32455844 PMCID: PMC7290677 DOI: 10.3390/jcm9051560] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 12/12/2022] Open
Abstract
Obesity and sleep disturbances are both related to endocrine and metabolic alterations, cardiovascular disease, and impaired daytime functioning and mood. However, the bidirectional relationship between these conditions and the underlying mechanisms still remain unclear. This study aimed to investigate the potential association of anthropometric and body composition parameters with sleep in young adults, considering the mediating role of sedentariness, physical activity, and diet. A total of 187 adults aged 18–25 (35.29% men) participated in the study. Body mass index (BMI), waist–hip ratio, and waist–height ratio were calculated, and a dual-energy X-ray absorptiometry scanner was used to assess body composition. Sedentary time and physical activity, as well as sleep duration and quality, were objectively and subjectively measured using accelerometry and the Pittsburgh Sleep Quality Index. An inverse association was found between BMI and total sleep time (β = −0.165, p = 0.029). Waist–hip ratio and lean mass index were also negatively associated with total sleep time (β = −0.222, p = 0.007, and β = −0.219, p = 0.004) and sleep efficiency (β = −0.174, p = 0.037, and β = −0.188, p = 0.013). Sedentary time moderated by sex explained the association of BMI with total sleep time such that a high BMI was related to higher sedentariness in men which, in turn, was significantly associated with shorter sleep duration. Sedentary time is, therefore, a link/risk factor mediating the association of high BMI with short sleep duration in healthy young men.
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Affiliation(s)
- Almudena Carneiro-Barrera
- Sleep and Health Promotion Laboratory, Mind, Brain and Behaviour Research Centre (CIMCYC), University of Granada, 18011 Granada, Spain
- Correspondence:
| | - Francisco J. Amaro-Gahete
- EFFECTS-262 Research Group, Department of Medical Physiology, School of Medicine, University of Granada, 18071 Granada, Spain;
- Department of Health, Camilo José Cela University, 28692 Madrid, Spain
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain; (F.M.A.); (J.R.R.)
| | - Francisco M. Acosta
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain; (F.M.A.); (J.R.R.)
| | - Jonatan R. Ruiz
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain; (F.M.A.); (J.R.R.)
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Gupta G, Shellhaas RA. Losing Sleep: Considering Caregivers of Children with Rare Epilepsy Syndromes. THE JOURNAL OF PEDIATRICS: X 2020; 2:100022. [PMID: 37332627 PMCID: PMC10236555 DOI: 10.1016/j.ympdx.2020.100022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Gita Gupta
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
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Stec M, Arbour MW. Wellness and Disease Self-Management Mobile Health Apps Evaluated by the Mobile Application Rating Scale. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.yfpn.2020.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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165
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Tanikawa Y, Kimachi M, Ishikawa M, Hisada T, Fukuhara S, Yamamoto Y. Association between work schedules and motivation for lifestyle change in workers with overweight or obesity: a cross-sectional study in Japan. BMJ Open 2020; 10:e033000. [PMID: 32354776 PMCID: PMC7213847 DOI: 10.1136/bmjopen-2019-033000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To investigate the association between work schedules and motivation for behavioural change of lifestyle, based on the transtheoretical model (TTM) in workers with overweight or obesity. DESIGN A cross-sectional observational study. SETTING A healthcare examination centre in Japan. PARTICIPANTS Between April 2014 and March 2016, we recruited 9243 participants who underwent healthcare examination and met the inclusion criteria, namely, age 20-65 years, body mass index (BMI) ≥25 kg/m2 and full-time workers. EXPOSURE Night and shift (night/shift) workers were compared with daytime workers in terms of motivation for behavioural change. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was action and maintenance stages of change (SOC) for lifestyle in TTM. In a subgroup analysis, we investigated interactions between characteristics, including age, sex, BMI, current smoking, alcohol habits, hours of sleep and working hours. RESULTS Overall, 1390 participants (15.0%) were night/shift workers; night/shift workers were younger (median age (IQR): 46 (40-54) vs 43 (37-52) years) and the proportion of men was lesser (75.4 vs 60.9%) compared with daytime workers. The numbers of daytime and night/shift workers in the action and maintenance SOC were 2113 (26.9%) and 309 (22.2%), respectively. Compared with daytime workers, night/shift workers were less likely to demonstrate action and maintenance SOC (adjusted OR (AOR): 0.85, 95% CI: 0.74 to 0.98). In a subgroup analysis that included only those with long working hours (≥10 hours/day), results revealed a strong inverse association between night/shift work and action and maintenance SOC (AOR: 0.65, 95% CI: 0.48 to 0.86). A significant interaction was observed between long working hours and night/shift work (P for interaction=0.04). CONCLUSIONS In workers with overweight or obesity, a night/shift work schedule was associated with a lower motivation for behavioural change in lifestyle, and the association was strengthened in those with long working hours.
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Affiliation(s)
- Yukihiro Tanikawa
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Miho Kimachi
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Minoru Ishikawa
- Health Examination Centre, Urasoe General Hospital, Urasoe, Japan
| | | | - Shunichi Fukuhara
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University, Kyoto, Japan
- Centre for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan
- Shirakawa STAR for General Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
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166
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Barger LK, Sullivan JP, Blackwell T, O'Brien CS, St Hilaire MA, Rahman SA, Phillips AJK, Qadri S, Wright KP, Segar JL, McGuire JK, Vitiello MV, de la Iglesia HO, Poynter SE, Yu PL, Zee P, Sanderson AL, Halbower AC, Lockley SW, Landrigan CP, Stone KL, Czeisler CA. Effects on resident work hours, sleep duration, and work experience in a randomized order safety trial evaluating resident-physician schedules (ROSTERS). Sleep 2020; 42:5489525. [PMID: 31106381 DOI: 10.1093/sleep/zsz110] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 03/12/2019] [Indexed: 11/12/2022] Open
Abstract
STUDY OBJECTIVES We compared resident physician work hours and sleep in a multicenter clustered-randomized crossover clinical trial that randomized resident physicians to an Extended Duration Work Roster (EDWR) with extended-duration (≥24 hr) shifts or a Rapidly Cycling Work Roster (RCWR), in which scheduled shift lengths were limited to 16 or fewer consecutive hours. METHODS Three hundred two resident physicians were enrolled and completed 370 1 month pediatric intensive care unit rotations in six US academic medical centers. Sleep was objectively estimated with wrist-worn actigraphs. Work hours and subjective sleep data were collected via daily electronic diary. RESULTS Resident physicians worked fewer total hours per week during the RCWR compared with the EDWR (61.9 ± 4.8 versus 68.4 ± 7.4, respectively; p < 0.0001). During the RCWR, 73% of work hours occurred within shifts of ≤16 consecutive hours. In contrast, during the EDWR, 38% of work hours occurred on shifts of ≤16 consecutive hours. Resident physicians obtained significantly more sleep per week on the RCWR (52.9 ± 6.0 hr) compared with the EDWR (49.1 ± 5.8 hr, p < 0.0001). The percentage of 24 hr intervals with less than 4 hr of actigraphically measured sleep was 9% on the RCWR and 25% on the EDWR (p < 0.0001). CONCLUSIONS RCWRs were effective in reducing weekly work hours and the occurrence of >16 consecutive hour shifts, and improving sleep duration of resident physicians. Although inclusion of the six operational healthcare sites increases the generalizability of these findings, there was heterogeneity in schedule implementation. Additional research is needed to optimize scheduling practices allowing for sufficient sleep prior to all work shifts.Clinical Trial: Multicenter Clinical Trial of Limiting Resident Work Hours on ICU Patient Safety (ROSTERS), https://clinicaltrials.gov/ct2/show/NCT02134847.
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Affiliation(s)
- Laura K Barger
- Department of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Jason P Sullivan
- Department of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | - Terri Blackwell
- California Pacific Medical Center Research Institute, San Francisco, CA
| | - Conor S O'Brien
- Department of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | - Melissa A St Hilaire
- Department of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Shadab A Rahman
- Department of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Andrew J K Phillips
- Department of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA.,Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton VIC, Australia
| | - Salim Qadri
- Department of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | - Kenneth P Wright
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Jeffrey L Segar
- University of Iowa Stead Family Children's Hospital, Iowa City, IA
| | | | | | | | - Sue E Poynter
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH
| | - Pearl L Yu
- University of Virginia Children's Hospital, Charlottesville, VA
| | - Phyllis Zee
- Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL.,Center for Circadian and Sleep Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Amy L Sanderson
- Division of Critical Care Medicine, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA
| | - Ann C Halbower
- Children's Hospital Colorado Anschutz Medical Campus, Aurora, CO
| | - Steven W Lockley
- Department of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Christopher P Landrigan
- Department of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA.,Division of General Pediatrics, Department of Pediatrics, Boston Children Hospital, Boston, MA
| | - Katie L Stone
- California Pacific Medical Center Research Institute, San Francisco, CA
| | - Charles A Czeisler
- Department of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
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Gangemi AJ, Satti A, Zantah M, Blair R, Brewer B, Ma G, Grandner MA, Davey A, Criner GJ, Patterson F. Sleep Duration and Efficiency Associated With Better Functional Exercise Capacity in Black Smokers at Risk for COPD. Chest 2020; 158:1680-1688. [PMID: 32333930 DOI: 10.1016/j.chest.2020.03.070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 02/18/2020] [Accepted: 03/18/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Black smokers have earlier development of lung disease as well as poorer sleep health than whites. RESEARCH QUESTION In a sample of black smokers, to what extent does sleep health modify the association between smoking level and functional exercise capacity? DESIGN AND METHODS Cross-sectional data from 209 black smokers (≥ 1 cigarette in last month), aged 40 to 65 years with no evidence of sleep-disordered breathing (apnea-hypopnea index < 15) or severe COPD (FEV1 > 50%), were used for the current study. Self-reported smoking rate, objectively measured sleep efficiency (SE), total sleep time (TST), and the 6-min walk test (6MWT) for functional exercise capacity were the key assessments. RESULTS The mean age was 54.8 years (SD, 5.96), and mean cigarettes smoked per day (cpd) was 8.71 (SD, 6.78). Mean SE was 69.9% (SD, 12.3%), and mean TST was 307.99 min (SD 92.2). In adjusted linear regression models of the 6MWT (meters), TST (slope estimate, -0.14; P = .14) and SE (slope estimate, -1.0; P = .19) were negatively associated with 6MWT. The smoking rate × SE interaction was highly significant (slope estimate, 0.18; P = .007) such that in individuals who smoked ≥ 10 cpd, every additional percentage of SE garnered an additional distance of 0.83 to 6.62 m. Similarly, the smoking rate × TST interaction was significant (slope estimate, 0.019; P = .03) such that in smokers who smoked ≥ 10 cpd, every additional minute of TST garnered an additional distance of 0.04 to 0.60 m. INTERPRETATION Higher SE and, to a lesser extent, longer TST, in black adults who smoke ≥ 10 cpd is associated with better 6MWT performance. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov; No.: NCT03534076; URL: www.clinicaltrials.gov.
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Affiliation(s)
- Andrew J Gangemi
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University Hospital, Philadelphia, PA
| | - Aditi Satti
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University Hospital, Philadelphia, PA
| | - Massa Zantah
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University Hospital, Philadelphia, PA
| | - Rachel Blair
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University Hospital, Philadelphia, PA
| | - Benjamin Brewer
- College of Health Sciences, University of Delaware, Newark, DE
| | - Grace Ma
- Health Disparities and Center for Asian Health, Department of Clinical Sciences, Lewis Katz School of Medicine at Temple University Hospital, Philadelphia, PA
| | | | - Adam Davey
- College of Health Sciences, University of Delaware, Newark, DE
| | - Gerard J Criner
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University Hospital, Philadelphia, PA
| | - Freda Patterson
- College of Health Sciences, University of Delaware, Newark, DE.
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Sleep duration and timing in obsessive-compulsive disorder (OCD): evidence for circadian phase delay. Sleep Med 2020; 72:111-117. [PMID: 32575000 DOI: 10.1016/j.sleep.2020.03.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/04/2020] [Accepted: 03/17/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To investigate potential delays in endogenous melatonin in individuals with obsessive-compulsive disorder (OCD). METHODS First, data are presented for 15 individuals with OCD and matched healthy controls. Next, nine additional participants with OCD who did not have matched controls were added, resulting in a sample of 24 individuals with OCD. All participants were assessed for sleep and circadian rhythm disturbance. Dim light melatonin onset (DLMO) was derived from salivary melatonin and was used in conjunction with sleep diaries, interview measures, and questionnaires. A subset of the OCD group (n = 16) also used actigraphy. RESULTS In sum, 42% percent (10/24) of the patients with OCD met the criteria for delayed sleep-wake phase disorder (DSWPD) in comparison to 0% in the control sample. DLMO was significantly later in individuals with OCD compared to controls. DLMO and bedtime were not significantly associated with the severity of obsessive-compulsive symptoms or negative affect. CONCLUSIONS Replication of the findings presented herein, particularly the DLMO results, is warranted. Further, there are now three studies showing that nearly ½ of individuals with OCD meet criteria for a DSWPD. Future studies can explore the mechanisms underlying these connections and the implications of this comorbidity. These findings may increase our understanding of OCD and inform future interventions.
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169
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Binks H, E. Vincent G, Gupta C, Irwin C, Khalesi S. Effects of Diet on Sleep: A Narrative Review. Nutrients 2020; 12:nu12040936. [PMID: 32230944 PMCID: PMC7230229 DOI: 10.3390/nu12040936] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/02/2020] [Accepted: 03/25/2020] [Indexed: 01/13/2023] Open
Abstract
Many processes are involved in sleep regulation, including the ingestion of nutrients, suggesting a link between diet and sleep. Aside from studies investigating the effects of tryptophan, previous research on sleep and diet has primarily focused on the effects of sleep deprivation or sleep restriction on diet. Furthermore, previous reviews have included subjects with clinically diagnosed sleep-related disorders. The current narrative review aimed to clarify findings on sleep-promoting foods and outline the effects of diet on sleep in otherwise healthy adults. A search was undertaken in August 2019 from the Cochrane, MEDLINE (PubMed), and CINAHL databases using the population, intervention, control, outcome (PICO) method. Eligible studies were classified based on emerging themes and reviewed using narrative synthesis. Four themes emerged: tryptophan consumption and tryptophan depletion, dietary supplements, food items, and macronutrients. High carbohydrate diets, and foods containing tryptophan, melatonin, and phytonutrients (e.g., cherries), were linked to improved sleep outcomes. The authors posit that these effects may be due in part to dietary influences on serotonin and melatonin activity.
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Affiliation(s)
- Hannah Binks
- Central Queensland University, School of Health, Medical and Applied Sciences, Melbourne 3000, Victoria, Australia;
| | - Grace E. Vincent
- Central Queensland University, Appleton Institute, Adelaide 5034, South Australia, Australia; (G.E.V.); (C.G.)
| | - Charlotte Gupta
- Central Queensland University, Appleton Institute, Adelaide 5034, South Australia, Australia; (G.E.V.); (C.G.)
| | - Christopher Irwin
- Griffith University, School of Allied Health Sciences, Menzies Health Institute Queensland, Gold Coast 4222, Queensland, Australia;
| | - Saman Khalesi
- Central Queensland University, School of Health, Medical and Applied Sciences and Appleton Institute, Brisbane 4000, Queensland, Australia
- Correspondence: ; Tel.: +61-7-3023-4153
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Kim SY, Oh KS, Shin DW, Lim WJ, Jeon SW, Kim EJ, Cho SJ, Shin YC. The association of physical activity and sleep duration with incident anxiety symptoms: A cohort study of 134,957 Korean adults. J Affect Disord 2020; 265:305-313. [PMID: 32090754 DOI: 10.1016/j.jad.2020.01.072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 01/14/2020] [Accepted: 01/17/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Maintaining adequate levels of sleep and physical activity (PA) as self-help for the prevention of new-onset anxiety symptoms is becoming more important. METHODS A cohort study was performed with 134,957 adults, free of anxiety symptoms at baseline who underwent at least two comprehensive health screening examinations between 2012 and 2017. At baseline, the amount of PA was measured using the International Physical Activity Questionnaire-Short Form and sleep duration per day was assessed using a self-report questionnaire. The study's end point was new-onset anxiety symptoms, defined as a Beck Anxiety Inventory score of ≥19. RESULTS During 361,969 person-years of follow-up, 5086 participants developed case-level anxiety. Compared with a reference (0-600 METs-min/wk), a U-shaped relationship was observed between PA and case-level anxiety. The most beneficial levels of PA for reducing incident anxiety symptoms were higher in men than women (men: 1800-3000 METs-min/wk HR, 0.88 [95% CI, 0.78-0.81], 3000-6000 METs-min/wk HR, 0.81 [95% CI, 0.70-0.93]; women: 600-1,200 METs-min/wk HR, 0.86 [95% CI, 0.76-0.98]). In comparison with a reference (<6 h), the relationship between sleep duration and case-level anxiety also had a U-shaped pattern. The optimal sleep duration for decreasing the onset of case-level anxiety was 7-8 h, regardless of sex (men: HR, 0.75 [95% CI, 0.63-0.90]; women; HR, 0.61 [95% CI, 0.54-0.70]). LIMITATIONS PA, sleep duration, and anxiety symptoms were measured using self-report questionnaires. CONCLUSIONS The results of this study revealed the appropriate levels of PA and total sleep time for reducing incident anxiety symptoms.
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Affiliation(s)
- Sun-Young Kim
- Department of Psychiatry, Ewha Woman's University Seoul Hospital, Ewha Woman's University College of Medicine, 29 Saemunan-ro, Seoul, Republic of Korea
| | - Kang-Seob Oh
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong-Won Shin
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Weon-Jeong Lim
- Department of Psychiatry, Ewha Woman's University Seoul Hospital, Ewha Woman's University College of Medicine, 29 Saemunan-ro, Seoul, Republic of Korea
| | - Sang-Won Jeon
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Workplace Mental Health Institute, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Eun-Jin Kim
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Workplace Mental Health Institute, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Sung Joon Cho
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Workplace Mental Health Institute, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Young-Chul Shin
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Workplace Mental Health Institute, Kangbuk Samsung Hospital, Seoul, Republic of Korea.
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Abstract
PURPOSE OF REVIEW Sleep is an essential component of human health, and suboptimal sleep duration has been associated with increased cardiovascular morbidity and mortality. This review summarizes physiological and pathological effects of sleep duration on the cardiovascular system. RECENT FINDINGS Both decreased and increased duration of sleep lead to increased cardiovascular mortality and has a U-shaped curve. Sleep apnea is an independent risk factor for atherosclerosis and hypertension, and its treatment with continuous positive airway pressure (CPAP) results in increased survival. Estimated sleep duration of 6-8 h is associated with decreased mortality and major cardiovascular events and should be addressed by clinicians during routine visits.
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172
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Kim SY, Lee MH, Lim WJ, Kim SI, Lee YJ. Associations of 25-Hydroxyvitamin D Levels and Arthritis with Sleep Duration: The Korean National Health and Nutrition Examination Survey 2008-2014. Nat Sci Sleep 2020; 12:883-894. [PMID: 33177906 PMCID: PMC7650027 DOI: 10.2147/nss.s275464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/02/2020] [Indexed: 01/23/2023] Open
Abstract
PURPOSE The mean sleep duration of Koreans is 7 hours 49 minutes, which is the lowest among Organization for Economic Cooperation and Development countries. Although vitamin D deficiency and arthritis are considered modifiable factors influencing restorative sleep, mean vitamin D levels are low (17.33 ng/mL) and arthritis is prevalent among Koreans. This study investigated whether vitamin D deficiency and arthritis increase the risk of short sleep duration. PATIENTS AND METHODS The current study used data from the Korean National Health and Nutrition Examination Survey (KNHANES) for 46,405 Korean adults. Vitamin D levels were measured using a radioimmunoassay kit. Sleep duration and arthritis history were assessed using a self-reported questionnaire. Sleep duration was categorized as optimal (7 to <9 hours/day), short (<7 hours/day), and long (≥9 hours/day). Vitamin D levels were grouped as vitamin D sufficiency (≥20 ng/mL), insufficiency (10-19.99 ng/mL), and deficiency (<10 ng/mL). Multiple imputation was used to compensate for missing data. Multinomial logistic regression was used to examine the associations of vitamin D and arthritis status with sleep duration. The regressions were adjusted for covariates, and each model was adjusted for vitamin D and arthritis. RESULTS Among these participants, 23,078 (49.73%) and 3518 (7.58%) had short and long sleep duration, respectively; 26,724 (57.59%) and 4349 (9.37%) exhibited vitamin D insufficiency and deficiency, respectively; and 4709 (10.15%) were arthritis patients. Compared with vitamin D sufficiency, vitamin D insufficiency and deficiency were associated with short sleep duration (vitamin D insufficiency group: OR = 1.07, 95% CI = 1.01-1.13; vitamin D deficiency group: OR = 1.13, 95% CI = 1.03-1.24). The presence of arthritis was associated with short sleep duration (OR = 1.14, 95% CI = 1.06-1.22) compared with its absence. The interaction between vitamin D deficiency and the presence of arthritis was significantly associated with short sleep duration. However, long sleep duration was not significantly associated with vitamin D levels or arthritis status. CONCLUSION Low vitamin D levels and the presence of arthritis were associated with an increased risk of short sleep duration. Additionally, there was a positive interaction effect between vitamin D deficiency and arthritis on short sleep duration.
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Affiliation(s)
- Sun-Young Kim
- Department of Psychiatry, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Mi Hyun Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul University College of Medicine, Seoul, Republic of Korea
| | - Weon-Jeong Lim
- Department of Psychiatry, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Soo In Kim
- Department of Psychiatry, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Yu Jin Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul University College of Medicine, Seoul, Republic of Korea
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Wallace ML, Lee S, Hall MH, Stone KL, Langsetmo L, Redline S, Schousboe JT, Ensrud K, LeBlanc ES, Buysse DJ. Heightened sleep propensity: a novel and high-risk sleep health phenotype in older adults. Sleep Health 2019; 5:630-638. [PMID: 31678177 PMCID: PMC6993140 DOI: 10.1016/j.sleh.2019.08.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 07/12/2019] [Accepted: 08/01/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To reveal sleep health phenotypes in older adults and examine their associations with time to 5-year all-cause and cardiovascular mortality. DESIGN Prospective longitudinal cohorts. SETTING The Study of Osteoporotic Fractures and Outcomes of Sleep Disorders in Older Men Study. PARTICIPANTS N = 1722 men and women aged ≥65 years matched 1:1 on sociodemographic and clinical measures. MEASUREMENTS Self-reported habitual sleep health characteristics (satisfaction, daytime sleepiness, timing, efficiency, and duration) measured at an initial visit and longitudinal follow-up for mortality. RESULTS Latent class analysis revealed 3 sleep health phenotypes: (1) heightened sleep propensity (HSP; medium to long duration, high sleepiness, high efficiency/satisfaction; n = 322), (2) average sleep (AS; medium duration, average efficiency, high satisfaction, low sleepiness; n = 1,109), and (3) insomnia with short sleep (ISS; short to medium duration, low efficiency/satisfaction, moderate sleepiness; n = 291). Phenotype predicted time to all-cause mortality (χ2 = 9.4, P = .01), with HSP conferring greater risk than AS (hazard ratio [95% confidence interval] = 1.48 [1.15-1.92]) or ISS (1.52 [1.07-2.17]), despite ISS reporting the poorest mental and physical health. Although sex did not formally moderate the relationship between phenotype and mortality, subgroup analyses indicated that these findings were driven primarily by women. Phenotype did not predict cardiovascular mortality. CONCLUSIONS These analyses support the utility of examining multidimensional sleep health profiles by suggesting that the combination of long sleep, high efficiency/satisfaction, and daytime sleepiness-previously identified as independent risk factors-may be components of a single high-risk sleep phenotype, HSP. Further investigation of sex differences and the mechanisms underlying mortality risk associated with HSP is warranted.
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Affiliation(s)
- M L Wallace
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara St, Pittsburgh, PA, 15213, USA; Department of Biostatistics, University of Pittsburgh, 130 De Soto St, Pittsburgh, PA, 15261, USA.
| | - S Lee
- School of Aging Studies, College of Behavioral and Community Sciences, University of South Florida, 4202 E Fowler Ave, Tampa, FL 33620, USA
| | - M H Hall
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
| | - K L Stone
- California Pacific Medical Center Research Institute, Mission Hall, Second Floor, 550 16th St, San Francisco, CA 94158, USA
| | - L Langsetmo
- Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd St, Suite 300, Minneapolis, MN, 55454, USA
| | - S Redline
- Departments of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - J T Schousboe
- Park Nicollet Clinic and Health Partners Institute, HealthPartners Inc, 3311 Old Shakopee Road, Bloomington, MN 55425, USA
| | - K Ensrud
- Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd St, Suite 300, Minneapolis, MN, 55454, USA; Department of Medicine, University of Minnesota, 401 E River Pkwy, VCRC Suite 131, Minneapolis, MN 55455, USA
| | - E S LeBlanc
- Kaiser Permanente Center for Health Research NW, 3800 N Interstate Ave, Portland, OR 97227-1098, USA
| | - D J Buysse
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
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174
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Patterns of Change in Employment Status and Their Association with Self-Rated Health, Perceived Daily Stress, and Sleep among Young Adults in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224491. [PMID: 31739599 PMCID: PMC6887718 DOI: 10.3390/ijerph16224491] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/08/2019] [Accepted: 11/12/2019] [Indexed: 11/17/2022]
Abstract
We identified distinct trajectories of temporal changes in employment status and investigated their association with self-rated health, perceived stress, and sleep. Data pertaining to 1228 respondents (age: 17–31 years) were extracted from the Korea Youth Panel (YP2007) survey (3rd–9th wave) datasets. Participants were either paid employees (permanent or precarious) or currently unemployed but seeking a job at baseline. Latent class growth analyses were employed to extract different classes based on the annual change in employment status (permanent/precarious/unemployed). Logistic regression analyses were performed using extracted classes as predictor variables and health-related variables at the final time-point as outcome variables. Five trajectories of employment status change were identified: stability sustained; gradually deteriorated; swiftly alleviated; gradually alleviated; instability sustained. Compared with the stability sustained group, the gradually deteriorated and gradually alleviated groups showed higher odds of perceived stress. The gradually deteriorated, instability sustained, and gradually alleviated groups showed significantly higher odds of shorter sleep than the stabilized group. We highlight the adverse health effects of prolonged unstable employment and the need for interventions to mitigate these effects.
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175
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Facco FL, Parker CB, Hunter S, Reid KJ, Zee PP, Silver RM, Pien G, Chung JH, Louis JM, Haas DM, Nhan-Chang CL, Simhan HN, Parry S, Wapner RJ, Saade GR, Mercer BM, Bickus M, Reddy UM, Grobman WA. Later sleep timing is associated with an increased risk of preterm birth in nulliparous women. Am J Obstet Gynecol MFM 2019; 1:100040. [PMID: 33345835 PMCID: PMC7757682 DOI: 10.1016/j.ajogmf.2019.100040] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/06/2019] [Accepted: 08/26/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although uterine contractions have a diurnal periodicity and increase in frequency during hours of darkness, data on the relationship between sleep duration and sleep timing patterns and preterm birth are limited. OBJECTIVE We sought to examine the relationship of self-reported sleep duration and timing in pregnancy with preterm birth. STUDY DESIGN In the prospective Nulliparous Pregnancy Outcome Study: Monitoring Mothers-to-be cohort, women completed a survey of sleep patterns at 6-13 weeks gestation (visit 1) and again at 22-29 weeks gestation (visit 3). Additionally, at 16-21 weeks gestation (visit 2), a subgroup completed a weeklong actigraphy recording of their sleep. Weekly averages of self-reported sleep duration and sleep midpoint were calculated. A priori, sleep duration of <7 hours was defined as "short," and sleep midpoint after 5 am was defined as "late." The relationships among these sleep characteristics and all preterm birth and spontaneous preterm birth at <37 weeks gestation were examined in univariate analyses. Multivariable logistic regressions that controlled for age and body mass index alone (model 1) and with additional covariates (race, smoking, insurance, and employment schedule) following a backward elimination process (model 2) were performed. RESULTS Of the 10,038 women who were enrolled, sleep survey data were available on 7524 women at visit 1 and 7668 women at visit 3. The rate of short sleep duration was 17.1% at visit 1 and 20.7% at visit 3. The proportion with a late sleep midpoint was 11.6% at visit 1 and 12.2% at visit 3. There was no significant relationship between self-reported short sleep and preterm birth across all visits. However, self-reported late sleep midpoint (>5 am) was associated with preterm birth . Women with a late sleep midpoint (>5 am) in early pregnancy had a preterm birth rate of 9.5%, compared with 6.9% for women with sleep midpoint ≤5 am (P=.005). Similarly, women with a late sleep midpoint had a higher rate of spontaneous preterm birth (6.2% vs 4.4%; P=.019). Comparable results were observed for women with a late sleep midpoint at visit 3 (all preterm birth 8.9% vs 6.6%; P=.009; spontaneous preterm birth 5.9% vs 4.3%; P=.023). All adjusted analyses on self-reported sleep midpoint (models 1 and 2) maintained statistical significance (P<.05), except for visit 1, model 2 for spontaneous preterm birth (P=.07). The visit 2 objective data from the smaller subgroup (n=782) demonstrated similar trends in preterm birth rates by sleep midpoint status. CONCLUSION Self-reported late sleep midpoint in both early and late pregnancy, but not short sleep duration, is associated with an increased rate of preterm birth.
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Affiliation(s)
- Francesca L Facco
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA.
| | | | | | - Kathryn J Reid
- Department of Neurology, Northwestern University, Chicago, IL
| | - Phyllis P Zee
- Department of Neurology, Northwestern University, Chicago, IL
| | - Robert M Silver
- Department of Obstetrics and Gynecology, University of Utah and Intermountain Healthcare, Salt Lake City, UT
| | - Grace Pien
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD
| | - Judith H Chung
- Department of Obstetrics and Gynecology, University of California, Irvine, Irvine, CA
| | - Judette M Louis
- University of South Florida Morsani College of Medicine, Tampa FL
| | - David M Haas
- Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, IN
| | | | - Hyagriv N Simhan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Samuel Parry
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA
| | - Ronald J Wapner
- Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, IN
| | - George R Saade
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, University of Texas, Galveston, TX
| | - Brian M Mercer
- Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, OH
| | - Melissa Bickus
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Uma M Reddy
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - William A Grobman
- Department of Obstetrics, Gynecology-Maternal Fetal Medicine & Preventive Medicine, Northwestern University, Chicago, IL
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176
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Mashaqi S, Gozal D. The impact of obstructive sleep apnea and PAP therapy on all-cause and cardiovascular mortality based on age and gender - a literature review. Respir Investig 2019; 58:7-20. [PMID: 31631059 DOI: 10.1016/j.resinv.2019.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/28/2019] [Accepted: 08/20/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is a common sleep disorder which negatively impacts different body systems, especially the cardiovascular system. The correlation between sleep related breathing disorders and cardiovascular diseases has been well studied. However, the impact of OSA on cardiovascular related mortality and the role of positive airway pressure therapy in decreasing mortality is unclear. We reviewed studies investigating the impact of OSA on all-cause and cardiovascular related mortality in both genders, and in different age groups. METHODS A literature search (PubMed) using two phrases "obstructive sleep apnea and co-morbidities in males and females" and "obstructive sleep apnea and co-morbidities by age" yielded a total of 214 articles. Nineteen articles met the inclusion criteria. RESULTS The studies reviewed showed conflicting results. Some showed that OSA increases all cause and cardiovascular related mortality predominantly in the middle-aged group (40-65) followed by a plateau or a reduction in mortality. Other studies showed a positive linear correlation between OSA and mortality up to the age of 80. The same controversy was noted for gender; some studies did not observe an increase in mortality in females with OSA, while others observed a trend for an increase in mortality in females. CONCLUSION There is a debate in the literature regarding the impact of OSA on all-cause and cardiovascular mortality in both genders and in different age groups. However, the variation in results might be related to different study designs and significant epidemiological prevalence of OSA in males and females.
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Affiliation(s)
- Saif Mashaqi
- Department of Sleep Medicine, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA.
| | - David Gozal
- Department of Child Health and the Child Health Research Institute, University of Missouri School of Medicine, Columbia, MO, USA
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177
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Oviedo-Caro MÁ, Bueno-Antequera J, Munguía-Izquierdo D. Associations of 24-hours activity composition with adiposity and cardiorespiratory fitness: The PregnActive project. Scand J Med Sci Sports 2019; 30:295-302. [PMID: 31593623 DOI: 10.1111/sms.13566] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 09/17/2019] [Accepted: 09/30/2019] [Indexed: 01/20/2023]
Abstract
AIM This study examined the associations of activity behaviors composition (sleep, sedentary time, light and moderate-to-vigorous physical activity) with adiposity and cardiorespiratory fitness, and how isotemporal reallocations of time between activity behaviors are associated with differences in adiposity and cardiorespiratory fitness. METHODS A cross-sectional study was conducted in 130 women during midpregnancy. Activity behaviors, conceptualized as a 24-hours composition, were objectively assessed by multi-sensor monitors. Skinfold thickness, fat mass index, and body mass index were calculated as indicators of adiposity. Cardiorespiratory fitness was assessed using a 6-minute walk test. Log-ratio multiple linear regression models and compositional isotemporal substitutions were used to analyze the associations and estimated differences in outcomes. RESULTS The activity composition was significantly associated with adiposity indicators (all P < .001) and cardiorespiratory fitness (P values from .025 to <.001) during midpregnancy. The isotemporal substitutions were asymmetrical, showing the highest estimated differences in adiposity (8.7%, 0.80 kg/m2 , for fat mass index; 6.0%, 2.65 mm, for the sum of skinfold thickness; and 3.8%, 1.02 kg/m2 , for body mass index) and cardiorespiratory fitness (3.0%, 1.00 mL/kg min) when 30 minutes of moderate-to-vigorous physical activity was reallocated by sedentary time. CONCLUSION The activity composition was associated with adiposity and the cardiorespiratory fitness levels during midpregnancy, with moderate-to-vigorous physical activity being the leading activity behavior. The most unfavorable differences in adiposity and cardiorespiratory fitness were found when moderate-to-vigorous physical activity was replaced by another behavior, mainly sedentary time, reinforcing the importance of at least maintaining moderate-to-vigorous physical activity during pregnancy.
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Affiliation(s)
- Miguel Ángel Oviedo-Caro
- Department of Sports and Computer Science, Faculty of Sports Sciences, Physical Performance & Sports Research Center, Section of Physical Education and Sports, University Pablo de Olavide, Seville, Spain.,Research Group in Development MovimientoHumano, Universidad de Zaragoza, Seville, Spain
| | - Javier Bueno-Antequera
- Department of Sports and Computer Science, Faculty of Sports Sciences, Physical Performance & Sports Research Center, Section of Physical Education and Sports, University Pablo de Olavide, Seville, Spain.,Research Group in Development MovimientoHumano, Universidad de Zaragoza, Seville, Spain
| | - Diego Munguía-Izquierdo
- Department of Sports and Computer Science, Faculty of Sports Sciences, Physical Performance & Sports Research Center, Section of Physical Education and Sports, University Pablo de Olavide, Seville, Spain.,Research Group in Development MovimientoHumano, Universidad de Zaragoza, Seville, Spain.,Biomedical Research Networking Center on Frailty and Healthy Aging, Madrid, Spain
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178
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Chaiard J, Deeluea J, Suksatit B, Songkham W, Inta N, Stone TE. Sleep disturbances and related factors among nurses. Nurs Health Sci 2019; 21:470-478. [PMID: 31317652 DOI: 10.1111/nhs.12626] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Indexed: 11/30/2022]
Abstract
The aim of this study was to describe patterns and potential risk factors for sleep disturbances, including that of sleep apnea, among Thai registered nurses. A descriptive, cross-sectional design was implemented. A sample of 233 registered nurses was recruited from 10 nursing departments from a tertiary hospital. Participants completed a one-time, self-report questionnaire and a 1 week-long sleep diary. Descriptive and logistic regression statistics were used for the analysis. Approximately 76% of nurses slept less than 7 h, 12.3% had difficulty initiating sleep, and 5% had difficulty maintaining sleep. Short sleep duration was prevalent, and night shift work schedules that exceeded 10 episodes/month were perceived as contributing to difficulties with initiating sleep. After excluding males from the analysis, the risk for depression related to short sleep duration becomes statistically significant. Organizational policies for registered nurses' shift work should include effective management of night shift assignments, as well as interventional strategies and policy directions, to promote sleep quality and mental health to ensure nurse well-being and patient safety.
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Affiliation(s)
- Jindarat Chaiard
- Medical Nursing Department, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
| | - Jirawan Deeluea
- Obstetrics and Gynecology Nursing Department, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
| | - Benjamas Suksatit
- Medical Nursing Department, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
| | - Wanpen Songkham
- Public Health Nursing, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
| | - Nonglak Inta
- Nursing Research Unit, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand
| | - Teresa E Stone
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
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179
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Meira E Cruz M, Lukic N, Wojczynska A, Steiger B, Guimarães AS, Ettlin DA. Insomnia in Patients Seeking Care at an Orofacial Pain Unit. Front Neurol 2019; 10:542. [PMID: 31191436 PMCID: PMC6546892 DOI: 10.3389/fneur.2019.00542] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/07/2019] [Indexed: 01/08/2023] Open
Abstract
Introduction: Orofacial pain and dysfunction include a broad range of disturbances among which pain and insomnia are some of the most common complaints. Sleep strengthens physiological and psychological resilience and is an absolute requirement for health. Insomnia is a common symptom or sleep disorder, yet data on its prevalence is sparse. Here we extracted data from the insomnia severity index which was part of the web-based interdisciplinary symptom evaluation (WISE) tool given to a large sample of patients seeking care at an orofacial pain unit for analyzing insomnia prevalence in this clinical population. Material and methods: Anonymized data were available from 952 patients who consulted the Orofacial Pain Unit at the Center of Dental Medicine, University of Zurich, Zurich, Switzerland between January 2017 and December 2018. Prevalence data for insomnia stratified by gender and 10 age groups (decades) were calculated. The distribution of four insomnia severity grades was determined, also stratified by age and gender. Results: 952 patients (290 men: 30.5%) with a mean age of 44.8 ± 17.4 years completed a WISE. Three hundred and fifty-two (37.0%) patients with a mean age of 45.8 ± 16.7 years positively responded to a screening question for insomnia and/or hypersomnia. Insomnia was severe in women from the 2nd to 8th decade, ranging from 4.3% (3rd decade) to 14.5% (6th decade), and moderately severe from the 2nd to 9th decade, ranging from 18.8% (6th decade) to 27.8% (2nd decade). In men, severe insomnia was present from the 3rd to 7th decade, ranging from 2.3% (7th decade) to 4.4% (4th decade) and moderately severe insomnia from the 3rd to 7th decade, ranging from 4.6% (7th decade) to 12.2% (5th decade). Conclusions: This is the first study reporting on insomnia in a large sample of patients seeking care at an orofacial pain unit. One in three patients reported some form of sleep disturbances, which for almost half of them was moderate to severe insomnia. The gender ratio was almost equal throughout adulthood, yet younger and older women were more frequently affected and experienced higher insomnia severity than men.
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Affiliation(s)
- Miguel Meira E Cruz
- Sleep Unit, Cardiovascular Center, School of Medicine, University of Lisbon, Lisbon, Portugal
| | - Nenad Lukic
- Interdisciplinary Orofacial Pain Unit, Faculty of Medicine, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Aleksandra Wojczynska
- Interdisciplinary Orofacial Pain Unit, Faculty of Medicine, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Beat Steiger
- Interdisciplinary Orofacial Pain Unit, Faculty of Medicine, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Antonio Sérgio Guimarães
- Laboratório Experimental de Dor, Faculdade de Medicina e Odontologia, São Leopoldo Mandic, São Paulo, Brazil
| | - Dominik A Ettlin
- Interdisciplinary Orofacial Pain Unit, Faculty of Medicine, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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180
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Redeker NS, Caruso CC, Hashmi SD, Mullington JM, Grandner M, Morgenthaler TI. Workplace Interventions to Promote Sleep Health and an Alert, Healthy Workforce. J Clin Sleep Med 2019; 15:649-657. [PMID: 30952228 DOI: 10.5664/jcsm.7734] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 03/07/2019] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The purpose of this review is to synthesize the published literature that addresses employer-initiated interventions to improve the sleep of workers and in turn improve health, productivity, absenteeism, and other outcomes that have been associated with sleep disorders or sleep deficiency. METHODS We conducted a systematic search and a selective narrative review of publications in PubMed from 1966 to December 2017. We extracted study characteristics, including the workers' professions, workplace settings and shift work, and workplace interventions focused on worker sleep. Because of the high degree of heterogeneity in design and outcomes, we conducted a narrative review. RESULTS We identified 219 publications. After restriction to publications with studies of workplace interventions that evaluated the outcomes of sleep duration or quality, we focused on 47 articles. An additional 13 articles were accepted in the pearling process. Most studies employed non-randomized or controlled pretest and posttest designs and self-reported measures of sleep. The most common workplace interventions were educational programs stressing sleep hygiene or fatigue management. Other interventions included timed napping before or after work, urging increased daytime activity levels, modifying workplace environmental characteristics such as lighting, and screening, and referral for sleep disorders treatment. Overall, most reports indicated that employer efforts to encourage improved sleep hygiene and healthier habits result in improvements in sleep duration, sleep quality, and self-reported sleepiness complaints. CONCLUSIONS These studies suggest employer-sponsored efforts can improve sleep and sleep-related outcomes. The existing evidence, although weak, suggests efforts by employers to encourage better sleep habits and general fitness result in self-reported improvements in sleep-related outcomes, and may be associated with reduced absenteeism and better overall quality of life. Candidate workplace strategies to promote sleep health are provided.
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Affiliation(s)
| | - Claire C Caruso
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio
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181
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Crain TL, Hammer LB, Bodner T, Olson R, Kossek EE, Moen P, Buxton OM. Sustaining sleep: Results from the randomized controlled work, family, and health study. J Occup Health Psychol 2019; 24:180-197. [PMID: 29809024 PMCID: PMC6261705 DOI: 10.1037/ocp0000122] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although calls for intervention designs are numerous within the organizational literature and increasing efforts are being made to conduct rigorous randomized controlled trials, existing studies have rarely evaluated the long-term sustainability of workplace health intervention outcomes, or mechanisms of this process. This is especially the case with regard to objective and subjective sleep outcomes. We hypothesized that a work-family intervention would increase both self-reported and objective actigraphic measures of sleep quantity and sleep quality at 6 and 18 months post-baseline in a sample of information technology workers from a U.S. Fortune 500 company. Significant intervention effects were found on objective actigraphic total sleep time and self-reported sleep insufficiency at the 6- and 18-month follow-up, with no significant decay occurring over time. However, no significant intervention effects were found for objective actigraphic wake after sleep onset or self-reported insomnia symptoms. A significant indirect effect was found for the effect of the intervention on objective actigraphic total sleep time through the proximal intervention target of 6-month control over work schedule and subsequent more distal 12-month family time adequacy. These results highlight the value of long-term occupational health intervention research, while also highlighting the utility of this work-family intervention with respect to some aspects of sleep. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Tori L Crain
- Department of Psychology, Colorado State University
| | - Leslie B Hammer
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University
| | - Todd Bodner
- Department of Psychology, Portland State University
| | - Ryan Olson
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University
| | | | - Phyllis Moen
- Department of Sociology, University of Minnesota
| | - Orfeu M Buxton
- Department of Biobehavioral Health, The Pennsylvania State University
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Herring SJ, Yu D, Spaeth A, Pien G, Darden N, Riis V, Bersani V, Wallen J, Davey A, Foster GD. Influence of Sleep Duration on Postpartum Weight Change in Black and Hispanic Women. Obesity (Silver Spring) 2019; 27:295-303. [PMID: 30597751 PMCID: PMC6345591 DOI: 10.1002/oby.22364] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 10/14/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The primary purpose of this study was to examine associations of objectively measured sleep duration with weight changes in black and Hispanic mothers over the first postpartum year. METHODS Data were from 159 mothers (69% black, 32% Hispanic). Nocturnal sleep duration was assessed using wrist actigraphy at 6 weeks and 5 months post partum, examined as a continuous variable and in categories (< 7 vs. ≥ 7 hours/night, consistent with American Academy of Sleep Medicine recommendations). Body weights were abstracted from medical records in pregnancy and measured at 6 weeks, 5 months, and 12 months post partum. Outcomes included early postpartum (6 weeks to 5 months) and late postpartum (5 to 12 months) weight changes. RESULTS The majority of participants slept < 7 hours/night at 6 weeks (75%) and 5 months (63%) post partum. Early postpartum weight change did not differ by 6-week sleep duration category. By contrast, adjusted average late postpartum weight gain (SE) was 1.8 (0.7) kg higher in participants sleeping < 7 hours/night at 5 months post partum compared with those sleeping ≥ 7 hours/night (P = 0.02). Results did not show statistically significant associations of continuous measures of sleep duration, nor of measures of sleep quality, with postpartum weight changes. CONCLUSIONS Sleeping < 7 hours/night was associated with late postpartum weight gain in minority mothers.
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Affiliation(s)
- Sharon J. Herring
- Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
- Department of Clinical Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Daohai Yu
- Department of Clinical Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Andrea Spaeth
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA
| | - Grace Pien
- Department of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD
| | - Niesha Darden
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA
- Department of Clinical Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Valerie Riis
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA
| | - Veronica Bersani
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA
- Department of Clinical Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Jessica Wallen
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA
- Department of Clinical Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Adam Davey
- College of Health Sciences, University of Delaware, Newark, DE
| | - Gary D. Foster
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA
- Weight Watchers International, New York, NY
- Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Facco FL, Parker CB, Hunter S, Reid KJ, Zee PC, Silver RM, Haas DM, Chung JH, Pien GW, Nhan-Chang CL, Simhan HN, Parry S, Wapner RJ, Saade GR, Mercer BM, Torres C, Knight J, Reddy UM, Grobman WA. Association of Adverse Pregnancy Outcomes With Self-Reported Measures of Sleep Duration and Timing in Women Who Are Nulliparous. J Clin Sleep Med 2018; 14:2047-2056. [PMID: 30518449 DOI: 10.5664/jcsm.7534] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 08/31/2018] [Indexed: 12/21/2022]
Abstract
STUDY OBJECTIVES To examine the relationship of self-reported sleep during pregnancy with adverse pregnancy outcomes. A secondary objective was to describe the concordance between self-reported and objectively assessed sleep during pregnancy. METHODS In this prospective cohort, women completed a survey of sleep patterns at 6 to 13 weeks' gestation (visit 1) and again at 22 to 29 weeks' gestation (visit 3). Additionally, at 16 to 21 weeks (visit 2), a subgroup completed a week-long sleep diary coincident with an actigraphy recording. Weekly averages of self-reported sleep duration and sleep midpoint were calculated. A priori, sleep duration < 7 hours was defined as "short," and sleep midpoint after 5:00 AM was defined as "late." The relationship of these sleep abnormalities with hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) was determined. RESULTS Of the 10,038 women enrolled, sleep survey data were available for 7,524 women at visit 1 and 7,668 women at visit 3. A total of 752 women also provided ≥ 5 days of sleep diary data coincident with actigraphy at visit 2. We did not observe any consistent relationship between self-reported short sleep and HDP or GDM. There was an association between self-reported late sleep midpoint and GDM (visit 1 adjusted odds ratio 1.67, 95% confidence interval 1.17, 2.38; visit 2 adjusted odds ratio 1.73, 95% confidence interval 1.23, 2.43). At visit 2, 77.1% of participants had concordance between their diary and actigraphy for short sleep duration, whereas 94.3% were concordant for sleep midpoint. CONCLUSIONS Self-reported sleep midpoint, which is more accurate than self-reported sleep duration, is associated with the risk of GDM. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov, Title: Pregnancy as a Window to Future Cardiovascular Health: Adverse Pregnancy Outcomes as Predictors of Increased Risk Factors for Cardiovascular Disease, Identifier: NCT02231398, URL: https://clinicaltrials.gov/ct2/show/NCT02231398.
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Affiliation(s)
- Francesca L Facco
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Shannon Hunter
- RTI International, Research Triangle Park, North Carolina
| | - Kathryn J Reid
- Department of Neurology, Northwestern University, Chicago, Illinois
| | - Phyllis C Zee
- Department of Neurology, Northwestern University, Chicago, Illinois
| | - Robert M Silver
- Department of Obstetrics and Gynecology, University of Utah and Intermountain Healthcare, Salt Lake City, Utah
| | - David M Haas
- Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, Indiana
| | - Judith H Chung
- Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California
| | - Grace W Pien
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Chia-Ling Nhan-Chang
- Department of Obstetrics and Gynecology, Columbia University, New York, New York
| | - Hyagriv N Simhan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Samuel Parry
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ronald J Wapner
- Department of Obstetrics and Gynecology, Columbia University, New York, New York
| | - George R Saade
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, University of Texas, Galveston, Texas
| | - Brian M Mercer
- Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, Ohio
| | - Caroline Torres
- Department of Obstetrics and Gynecology, Columbia University, New York, New York
| | - Jordan Knight
- Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, Indiana
| | - Uma M Reddy
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - William A Grobman
- Department of Obstetrics and Gynecology Medicine, Northwestern University, Chicago, Illinois
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184
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Wise LA, Rothman KJ, Wesselink AK, Mikkelsen EM, Sorensen HT, McKinnon CJ, Hatch EE. Male sleep duration and fecundability in a North American preconception cohort study. Fertil Steril 2018; 109:453-459. [PMID: 29566862 DOI: 10.1016/j.fertnstert.2017.11.037] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/06/2017] [Accepted: 11/28/2017] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To evaluate prospectively the association between male sleep duration and fecundability. DESIGN Pregnancy Online Study (PRESTO), a Web-based prospective cohort study of North American couples enrolled during the preconception period (2013-2017). SETTING Not applicable. PATIENT(S) Male participants were aged ≥21 years; female participants were aged 21-45 years. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) At enrollment, men reported their average nightly sleep duration in the previous month. Pregnancy status was updated on female follow-up questionnaires every 8 weeks for up to 12 months or until conception. Analyses were restricted to 1,176 couples who had been attempting to conceive for up to six cycles at enrollment. Proportional probabilities regression models were used to estimate fecundability ratios (FRs) and 95% confidence intervals (CIs), adjusting for potential confounders. RESULT(S) Relative to 8 hours per night of sleep, multivariable-adjusted FRs for <6, 6, 7, and ≥9 hours per night of sleep were 0.62 (95% CI 0.45-0.87), 1.06 (95% CI 0.87-1.30), 0.97 (95% CI 0.81-1.17), and 0.73 (95% CI 0.46-1.15), respectively. The association between short sleep duration (<6 hours per night) and fecundability was similar among men not working nights or rotating shifts (FR 0.60, 95% CI 0.41-0.88) and among men without a history of infertility (FR 0.62, 95% CI 0.44-0.87) and was stronger among fathers (FR 0.46, 95% CI 0.28-0.76). CONCLUSION(S) Short sleep duration in men was associated with reduced fecundability. Because male factor accounts for 50% of couple infertility, identifying modifiable determinants of infertility could provide alternatives to expensive fertility workups and treatments.
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Affiliation(s)
- Lauren Anne Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts.
| | - Kenneth Jay Rothman
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts; RTI International, Research Triangle Park, North Carolina
| | - Amelia Kent Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | | | | | - Craig James McKinnon
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Elizabeth Elliott Hatch
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
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185
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Chang VC, Chaput JP, Roberts KC, Jayaraman G, Do MT. Factors associated with sleep duration across life stages: results from the Canadian Health Measures Survey. Health Promot Chronic Dis Prev Can 2018; 38:404-418. [PMID: 30430815 PMCID: PMC6262981 DOI: 10.24095/hpcdp.38.11.02] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Sleep is essential for both physical and mental well-being. This study investigated sociodemographic, lifestyle/behavioural, environmental, psychosocial and health factors associated with sleep duration among Canadians at different life stages. METHODS We analyzed nationally representative data from 12 174 Canadians aged 3-79 years in the Canadian Health Measures Survey (2009-2013). Respondents were grouped into five life stages by age in years: preschoolers (3-4), children (5-13), youth (14-17), adults (18-64) and older adults (65-79). Sleep duration was classified into three categories (recommended, short and long) according to established guidelines. Logistic regression models were used to identify life stage-specific correlates of short and long sleep. RESULTS The proportion of Canadians getting the recommended amount of sleep decreased with age, from 81% of preschoolers to 53% of older adults. Statistically significant factors associated with short sleep included being non-White and having low household income among preschoolers; being non-White and living in a lone-parent household among children; and second-hand smoke exposure among youth. Boys with a learning disability or an attention-deficit/hyperactivity disorder and sedentary male youth had significantly higher odds of short sleep. Among adults and older adults, both chronic stress and arthritis were associated with short sleep. Conversely, mood disorder and poor/fair self-perceived general health in adults and weak sense of community belonging in adults and older men were associated with long sleep. CONCLUSION Our population-based study identified a wide range of factors associated with short and long sleep at different life stages. This may have implications for interventions aimed at promoting healthy sleep duration.
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Affiliation(s)
- Vicky C Chang
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | | | | | - Minh T Do
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
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186
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Shattuck NL, Matsangas P, Saitzyk A. Improving Work and Rest Patterns of Military Personnel in Operational Settings with Frequent Unplanned Events. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/1541931218621175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Members of the military get inadequate sleep due to a variety of reasons. Reduced manning, extended work hours, shiftwork schedules that result in circadian misalignment – all of these factors contribute to the sleep debt and degraded alertness observed in much of the military population. The issue of watchstanding schedules, performance, and alertness is of critical importance to the US military and is the focus of the current study. Based on a sample of active duty military members (N=75), this study had two goals. First, to conduct a field-based monitoring of the sleep and performance of military personnel while performing their duties. Second, to create and validate optimal recommendations based on the results of this empirical study. Participants wore actigraphs over a two-week period, completed daily activity logs, and took three-minute reaction time tests before and after standing watch on their regular schedules. Participants worked on a 2-day on/2-day off schedule, either in 3-section 8-hour shifts, or 2-section 12-hour shifts. Although there were no significant differences in the sleep amounts between the two schedules, results showed that participants on 8-hr shifts had fewer errors and less variable reaction time performance than those working 12-hr shifts. The 8-hr group reported better sleep quality, too. Our results suggest that the 8-hour schedule is better than the 12-hour schedule in terms of sleep and performance but may be more difficult to be applied. This study clearly shows the difficulty of implementing a specific watchstanding schedule in operational environments overloaded with unplanned, and irregular operational duties.
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187
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Grandner MA. The Cost of Sleep Lost: Implications for Health, Performance, and the Bottom Line. Am J Health Promot 2018; 32:1629-1634. [PMID: 30099900 PMCID: PMC6530553 DOI: 10.1177/0890117118790621a] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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188
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Park SK, Jung JY, Oh CM, McIntyre RS, Lee JH. Association Between Sleep Duration, Quality and Body Mass Index in the Korean Population. J Clin Sleep Med 2018; 14:1353-1360. [PMID: 30092896 DOI: 10.5664/jcsm.7272] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 04/12/2018] [Indexed: 12/12/2022]
Abstract
STUDY OBJECTIVES Mounting evidence indicates that sleep disturbance contributes to the increased risk for cardiometabolic diseases. Obesity and underweight are also closely linked to cardiometabolic risk. Thus, the objective of this study was to examine the association between sleep duration, quality, and body mass index (BMI) categories. METHODS Using data from a cohort of 107,718 Korean individuals (63,421 men and 44,297 women), we conducted cross-sectional analysis with sex subgroup analysis. Sleep duration was classified into 3 groups-short (< 7 hours), normal (7-9 hours) and long sleep (> 9 hours)-and Pittsburgh Sleep Quality Index (PSQI) score was used to divide sleep quality into 2 groups-poor (PSQI > 5) and good sleep (PSQI ≤ 5). Compared to normal sleep and good sleep quality, adjusted odds ratios of short and long sleep and poor sleep for BMI categories were calculated. BMI categories included underweight (BMI < 18.5 kg/m2), overweight (BMI 23 to < 25 kg/m2), obesity (BMI 25 to < 30 kg/m2) and severe obesity (BMI ≥ 30 kg/m2). RESULTS Short sleep duration had the dose-dependent relationship with obesity categories from overweight to severe obesity, and inverse relationship with underweight (adjusted odds ratios [95% confidence intervals] for underweight, overweight, obesity, and severe obesity versus normal weight; 0.88 [0.82-0.94], 1.15 [1.11-1.20], 1.31 [1.26-1.37], 1.70 [1.54-1.85]). Poor sleep quality was significantly associated with severe obesity in male subgroup (1.16 [1.05-1.27]) and with obesity (1.18 [1.10-1.25]) and severe obesity in female subgroup (1.66 [1.40-1.98]). CONCLUSIONS Short sleep duration and poor sleep quality was more positively associated with obesity across BMI than underweight.
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Affiliation(s)
- Sung Keun Park
- Center for Cohort Study, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ju Young Jung
- Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of medicine, Seoul, Korea
| | - Chang-Mo Oh
- Departments of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Ontario, Canada.,Department of Pharmacology, University of Toronto, Ontario, Canada
| | - Jae-Hon Lee
- Korea University Research and Business Foundation, Seoul, Korea
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189
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Using optimal combined moderators to define heterogeneity in neural responses to randomized conditions: Application to the effect of sleep loss on fear learning. Neuroimage 2018; 181:718-727. [PMID: 30041060 DOI: 10.1016/j.neuroimage.2018.07.051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 07/18/2018] [Accepted: 07/21/2018] [Indexed: 12/24/2022] Open
Abstract
Comparing the neural outcomes of two randomized experimental groups is a primary aim of many functional neuroimaging studies. However, between-group effects can be obscured by heterogeneity in neural responses. Optimal Combined Moderator (OCM) approaches have previously been used to clarify heterogeneity in clinical outcomes following treatment randomization. We show that OCMs can also be used to clarify heterogeneity in the effect of a randomized experimental condition on neural responses. In 78 healthy adults aged 18-30 from the Effects of Dose-Dependent Sleep Disruption on Fear and Reward (SFeRe) study, we used demographic, clinical, genetic, and polysomnographic characteristics to develop OCMs for the effect of a randomized sleep restriction (SR) versus normal sleep (NS) condition on blood-oxygen-level dependent responses in the right amygdala (RAmyg) and subgenual anterior cingulate cortex (sgACC) during fear conditioning (FC) and extinction (FE) paradigms. The OCM for the RAmyg during FE was strongest [r (95% CI) = 0.52 (0.42, 0.68)], withstood cross-validation, and divided the sample into two subgroups with opposing experimental effects. Among N = 48 participants ("SR < NS"), those with SR exhibited less RAmyg activation during FE than those with NS [d (95%CI) = -1.10 (-1.86, -0.77)]. Among the remaining N = 30 participants ("SR > NS"), those with SR exhibited greater RAmyg activation during FE following SR than those with NS [d (95%CI) = 0.87 (0.37,1.78)]. SR > NS participants were more likely to be female, white, l/l genotype carriers, and have a psychiatric history. They had less sleep (overall and in REM), lower REM density, and lower spindle activity (12-16 Hz). Applying OCMs to randomized studies with neural outcomes can clarify neural heterogeneity and jumpstart mechanistic research; with further validation they also offer promise for personalized brain-based treatments and interventions.
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190
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Fox EC, Wang K, Aquino M, Grandner MA, Xie D, Branas CC, Gooneratne NS. Sleep debt at the community level: impact of age, sex, race/ethnicity and health. Sleep Health 2018; 4:317-324. [PMID: 30031523 DOI: 10.1016/j.sleh.2018.05.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/15/2018] [Accepted: 05/29/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Insufficient sleep has become recognized as a pervasive problem in modern society. Sleep debt is a novel measure of sleep adequacy that may be useful in describing those at risk for inadequate sleep. Our objective was to investigate factors that may be associated with sleep debt at the population level, as well as build upon previous data that showed that minority groups may be more likely to have sleep debt. DESIGN A cross-sectional population phone survey included questions regarding amount of sleep required and amount of sleep achieved. Sleep debt was calculated by subtracting sleep achieved from sleep required. SETTING This study was designed by the Philadelphia Health Management Corporation and conducted over landlines and cell phones. PARTICIPANTS The Random Digit Dialing method was used to randomly choose 8,752 adults older than 18 years from several counties in and around Philadelphia to answer questions about sleep. MEASUREMENTS Logistic regression was performed to test associations between sleep debt and various sociodemographic factors in different population subgroups to identify those at risk for sub-optimal sleep duration. RESULTS Sleep debt was seen to decrease with age, a novel finding that is in contrast with literature suggesting that older adults have poor sleep. Greater sleep debt was also associated with female gender, Hispanic/Latino ethnicity, <40 years of age, self-reported poor health, and increased stress. CONCLUSIONS Although older adults may sleep less as they age, they may also require less sleep to feel rested, resulting in less sleep debt. This and other demographic factors, such as female gender and Hispanic/Latino ethnicity, can be used to identify those at higher risk of inadequate sleep and potentially manage their sleep debt.
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Affiliation(s)
- Elliott C Fox
- Division of Geriatric Medicine and the Center for Sleep and Circadian Neurobiology, University of Pennsylvania Perelman School of Medicine; Frank H. Netter MD School of Medicine, Quinnipiac University.
| | - Kairuo Wang
- Division of Geriatric Medicine and the Center for Sleep and Circadian Neurobiology, University of Pennsylvania Perelman School of Medicine
| | - Melissa Aquino
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai
| | - Michael A Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona
| | - Dawei Xie
- Department of Epidemiology, University of Pennsylvania Perelman School of Medicine
| | - Charles C Branas
- Department of Epidemiology, Columbia University Mailman School of Public Health
| | - Nalaka S Gooneratne
- Division of Geriatric Medicine and the Center for Sleep and Circadian Neurobiology, University of Pennsylvania Perelman School of Medicine
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191
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Beverly CM, Naughton MJ, Pennell ML, Foraker RE, Young G, Hale L, Feliciano EMC, Pan K, Crane TE, Danhauer SC, Paskett ED. Change in longitudinal trends in sleep quality and duration following breast cancer diagnosis: results from the Women's Health Initiative. NPJ Breast Cancer 2018; 4:15. [PMID: 29978034 PMCID: PMC6026122 DOI: 10.1038/s41523-018-0065-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 05/15/2018] [Accepted: 05/17/2018] [Indexed: 11/16/2022] Open
Abstract
Breast cancer survivors frequently report sleep problems, but little research has studied sleep patterns longitudinally. We examined trends in sleep quality and duration up to 15 years before and 20 years after a diagnosis of breast cancer, over time among postmenopausal women participating in the Women's Health Initiative (WHI). We included 12,098 participants who developed invasive breast cancer after study enrollment. A linear mixed-effects model was used to determine whether the time trend in sleep quality, as measured by the WHI Insomnia Rating Scale (WHIIRS), a measure of perceived insomnia symptoms from the past 4 weeks, changed following a cancer diagnosis. To examine sleep duration, we fit a logistic regression model with random effects for both short (<6 h) and long (≥9 h) sleep. In addition, we studied the association between depressive symptoms and changes in WHIIRS and sleep duration. There was a significantly slower increase in the trend of WHIIRS after diagnosis (β = 0.06; p = 0.03), but there were non-significant increases in the trend of the probability of short or long sleep after diagnosis. The probability of depressive symptoms significantly decreased, though the decrease was more pronounced after diagnosis (p < 0.01). Trends in WHIIRS worsened at a relatively slower rate following diagnosis and lower depression rates may explain the slower worsening in WHIIRS. Our findings suggest that over a long period of time, breast cancer diagnosis does not adversely affect sleep quality and duration in postmenopausal women compared to sleep pre-diagnosis, yet both sleep quality and duration continue to worsen over time.
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Affiliation(s)
- Chloe M. Beverly
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH 43210 USA
| | - Michelle J. Naughton
- Division of Population Sciences, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210 USA
| | - Michael L. Pennell
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210 USA
| | - Randi E. Foraker
- Institute for Informatics, School of Medicine, Washington University in St. Louis, St. Louis, MO 63108 USA
| | - Gregory Young
- Center for Biostatistics, The Ohio State University, Columbus, OH 43210 USA
| | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, NY 11794 USA
| | | | - Kathy Pan
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, University of California, Los Angeles, Torrance, CA 90509 USA
| | - Tracy E. Crane
- College of Nursing, University of Arizona Cancer Center, University of Arizona, Tucson, AZ 85724 USA
| | - Suzanne C. Danhauer
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157 USA
| | - Electra D. Paskett
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210 USA
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Sung SA, Hyun YY, Lee KB, Park HC, Chung W, Kim YH, Kim YS, Park SK, Oh KH, Ahn C. Sleep Duration and Health-Related Quality of Life in Predialysis CKD. Clin J Am Soc Nephrol 2018; 13:858-865. [PMID: 29724791 PMCID: PMC5989677 DOI: 10.2215/cjn.11351017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 03/07/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Sleep duration has been associated with cardiometabolic risk and mortality. The health-related quality of life represents a patient's comprehensive perception of health and is accepted as a health outcome. We examined the relationship between sleep duration and health-related quality of life in predialysis CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In this cross-sectional study, data from 1910 adults with CKD enrolled in the Korean Cohort Study for Outcome in Patients with CKD were analyzed. Health-related quality of life was assessed with the physical component summary and mental component summary of the Short Form-36 Health Survey. Low health-related quality of life was defined as a Short Form-36 Health Survey score >1 SD below the mean. Using a generalized additive model and multivariable logistic regression analysis, the relationship between self-reported sleep duration and health-related quality of life was examined. RESULTS Seven-hour sleepers showed the highest health-related quality of life. We found an inverted U-shaped relationship between sleep duration and health-related quality of life as analyzed by a generalized additive model. In multivariable logistic analysis, short sleepers (≤5 h/d) had lower health-related quality of life (odds ratio, 3.23; 95% confidence interval, 1.86 to 5.60 for the physical component summary; odds ratio, 2.37; 95% confidence interval, 1.43 to 3.94 for the mental component summary), and long sleepers (≥9 h/d) had lower health-related quality of life (odds ratio, 2.80; 95% confidence interval, 1.55 to 5.03 for the physical component summary; odds ratio, 2.08; 95% confidence interval, 1.20 to 3.60 for the mental component summary) compared with 7-hour sleepers. Sleep duration had a significant U-shaped association with low health-related quality of life. CONCLUSIONS These findings suggest that short or long sleep duration is independently associated with low health-related quality of life in adults with CKD.
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Affiliation(s)
- Su-Ah Sung
- Department of Internal Medicine, Eulji General Hospital, Seoul, Korea
| | - Young Youl Hyun
- Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyu Beck Lee
- Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hayne Cho Park
- Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea
| | - Wookyung Chung
- Department of Internal Medicine, Gil Hospital, Gachon University, Incheon, Korea
| | - Yeong Hoon Kim
- Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Yong-Soo Kim
- Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sue Kyung Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea; and
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Curie Ahn
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Bertisch SM, Pollock BD, Mittleman MA, Buysse DJ, Bazzano LA, Gottlieb DJ, Redline S. Insomnia with objective short sleep duration and risk of incident cardiovascular disease and all-cause mortality: Sleep Heart Health Study. Sleep 2018; 41:4924334. [PMID: 29522193 PMCID: PMC5995202 DOI: 10.1093/sleep/zsy047] [Citation(s) in RCA: 227] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 12/29/2017] [Indexed: 01/22/2023] Open
Abstract
Study Objectives To quantify the association between insomnia or poor sleep with objective short sleep duration and incident cardiovascular disease (CVD) and mortality in the general population. Methods We conducted a time-to-event analysis of Sleep Heart Health Study data. Questionnaires and at-home polysomnography (PSG) were performed between 1994 and 1998. Participants were followed for a median of 11.4 years (Q1-Q3, 8.8-12.4 years) until death or last contact. The primary exposure was insomnia or poor sleep with short sleep defined as follows: difficulty falling asleep, difficulty returning to sleep, early morning awakenings, or sleeping pill use, 16-30 nights per month; and total sleep of <6 hr on PSG. We used proportional hazard models to estimate the association between insomnia or poor sleep with short sleep and CVD, as well as all-cause mortality. Results Among 4994 participants (mean age: 64.0 ± 11.1 years), 14.1 per cent reported insomnia or poor sleep, of which 50.3 per cent slept <6 hr. Among 4437 CVD-free participants at baseline, we observed 818 incident CVD events. After propensity adjustment, there was a 29 per cent higher risk of incident CVD in the insomnia or poor sleep with short sleep group compared with the reference group (HR: 1.29, 95% CI: 1.00, 1.66), but neither the insomnia or poor sleep only nor short sleep only groups were associated with higher incident CVD. Insomnia or poor sleep with objective short sleep was not associated with all-cause mortality (HR: 1.07, 95% CI: 0.86, 1.33). Conclusions Insomnia or poor sleep with PSG-short sleep was associated with higher risk of incident CVD. Future studies should evaluate the impact of interventions to improve insomnia with PSG-short sleep on CVD.
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Affiliation(s)
- Suzanne M Bertisch
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Benjamin D Pollock
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
- Department of Epidemiology, Center for Clinical Effectiveness, Baylor Scott & White Health, Dallas, TX
- Robbins Institute for Health Policy and Leadership, Baylor University, Waco, TX
| | - Murray A Mittleman
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Lydia A Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Daniel J Gottlieb
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
- VA Boston Healthcare System, Boston, MA
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA
| | - Susan Redline
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA
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194
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Zhou B, Ma Y, Wei F, Zhang L, Chen X, Peng S, Xiong F, Peng X, NiZam B, Zou Y, Huang K. Association of active/passive smoking and urinary 1-hydroxypyrene with poor sleep quality: A cross-sectional survey among Chinese male enterprise workers. Tob Induc Dis 2018; 16:23. [PMID: 31516423 PMCID: PMC6659545 DOI: 10.18332/tid/90004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 04/17/2018] [Accepted: 04/17/2018] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Tobacco use has been implicated as an important factor for poor sleep quality. However, in most studies, the sleep quality of smokers was only assessed though a self-reported questionnaire, without measuring any internal biomarkers that reflect the levels of tobacco exposure. We examined the association of active and passive smoking with sleep quality, assessed smoking exposure using urinary 1-hydroxypyrene (1-HOP) as an internal biomarker, and further explored the relationship between 1-HOP and sleep quality. METHODS A cross-sectional survey was conducted in Liuzhou city, Guangxi, China. A total of 1787 male enterprise workers were enrolled. The smoking attribute data were collected by self-reported questionnaire, and individual sleep quality was evaluated through the Pittsburgh Sleep Quality Index (PSQI). The concentration of urinary 1-HOP was measured by high-performance liquid chromatography. RESULTS Compared with non-smoking, active smoking and passive smoking were significantly associated with long sleep latency (odds ratio, OR=1.84, 95% confidence interval, CI=1.28–2.64; 1.45, 1.00–2.11, respectively), short sleep duration (OR=2.72, 95% CI=1.45–5.09; 1.94, 1.01–3.71, respectively), daytime dysfunction (OR=1.54, 95% CI=1.10–2.17; 1.44, 1.02–2.03, respectively), and overall poor sleep quality with PSQI total score >5 (OR=1.41, 95% CI=1.05–1.88; 1.34, 1.00–1.79, respectively). Compared with non-smokers, active smokers had higher urinary 1-OHP concentrations that were significant (p=0.004), while passive smokers had no significant difference in urinary 1-OHP concentration (p=0.344). The high concentration group was significantly associated with daytime dysfunction and overall poor sleep quality with PSQI total score >5 (OR = 1.73, 95% CI=1.06–2.81; 1.76, 1.18–2.63, respectively). CONCLUSIONS Both active smoking and passive smoking are risk factors for poor sleep quality among Chinese male enterprise workers. Active smokers had significantly higher levels of urinary 1-OHP than non-smokers, and high concentration of 1-OHP was associated with daytime dysfunction and overall poor sleep quality.
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Affiliation(s)
- Bo Zhou
- Research Center for Regenerative Medicine, Guangxi Medical University, Nanning, China
| | - Yifei Ma
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, China.,AIDS Prevention and Control Institute, Liuzhou Center for Disease Control and Prevention, Liuzhou, China
| | - Fu Wei
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Li'e Zhang
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Xiaohong Chen
- Department of Physical Examination, Guangxi Institute of Occupational Disease Prevention and Treatment, Nanning, China
| | - Suwan Peng
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Feng Xiong
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Xiaowu Peng
- Center for Environmental Health Research, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, China
| | - Bushra NiZam
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Yunfeng Zou
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Kaiyong Huang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
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Chaiard J, Deeluea J, Suksatit B, Songkham W, Inta N. Short sleep duration among Thai nurses: Influences on fatigue, daytime sleepiness, and occupational errors. J Occup Health 2018; 60:348-355. [PMID: 29743391 PMCID: PMC6176030 DOI: 10.1539/joh.2017-0258-oa] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES This study was conducted to: 1) describe sleep duration, fatigue, daytime sleepiness, and occupational errors among Thai nurses and 2) explore the influence of sleep duration on fatigue, daytime sleepiness, and occupational errors. METHODS A cross-sectional design was implemented. A convenience sample of 233 full-time nurses with at least one year of work experience was recruited to participate in the study. Data were collected using self-reported questionnaires and 1-week sleep diaries. Descriptive and logistic regression statistics were performed using SPSS software. RESULTS The mean total sleep time was 6.2 hours. Of the total participants, 75.9% (n=167) experienced short sleep duration, 38.2% (n=84) experienced fatigue, and 49.5% (n=109) experienced excessive daytime sleepiness. Occupational errors were reported by 11.7% (n=25). Medication errors, incorrectly performed procedures, and needle stick injuries were reported by 6.5% (n=13), 5.6% (n=12), and 4.7% (n=10), respectively, of participants performing the associated activities. The "Short Sleep Duration" group experienced more fatigue (p=.044) and excessive daytime sleepiness (p=.001) compared with the "Adequate Sleep Duration" group. Although occupational errors were more common in the "Short Sleep Duration" group, the difference between the two groups did not reach the level of statistical significance. Multivariable logistic regression analysis found that short sleep duration was a statistically significant risk factor for excessive daytime sleepiness (OR=2.47, 95% CI=1.18-5.19). CONCLUSIONS The majority of registered nurses experience short sleep duration. Short sleep duration increased the risk of excessive daytime sleepiness but not fatigue or occupational errors. Adequate night-time sleep is paramount for preventing daytime sleepiness and achieving optimal work performance.
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Affiliation(s)
| | | | | | | | - Nonglak Inta
- Nursing Research Unit, Maharaj Nakorn Chiang Mai Hospital
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196
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Abstract
PURPOSE OF REVIEW Sleep plays many roles in maintenance of cardiovascular health. This review summarizes the literature across several areas of sleep and sleep disorders in relation to cardiometabolic disease risk factors. RECENT FINDINGS Insufficient sleep duration is prevalent in the population and is associated with weight gain and obesity, inflammation, cardiovascular disease, diabetes, and mortality. Insomnia is also highly present and represents an important risk factor for cardiovascular disease, especially when accompanied by short sleep duration. Sleep apnea is a well-characterized risk factor for cardiometabolic disease and cardiovascular mortality. Other issues are relevant as well. For example, sleep disorders in pediatric populations may convey cardiovascular risks. Also, sleep may play an important role in cardiovascular health disparities. SUMMARY Sleep and sleep disorders are implicated in cardiometabolic disease risk. This review addresses these and other issues, concluding with recommendations for research and clinical practice.
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197
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Brazeau AS, Meltzer SJ, Pace R, Garfield N, Godbout A, Meissner L, Rahme E, Da Costa D, Dasgupta K. Health behaviour changes in partners of women with recent gestational diabetes: a phase IIa trial. BMC Public Health 2018; 18:575. [PMID: 29716559 PMCID: PMC5930949 DOI: 10.1186/s12889-018-5490-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 04/20/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND We recently demonstrated that a gestational diabetes history in mothers is associated with higher postpartum incident diabetes not only in mothers but also in fathers. In the present study, we examined changes in health behaviours and cardiometabolic profiles in both mothers and partners who participated in a diabetes prevention program within 5 years of a gestational diabetes pregnancy. METHODS Couples were enrolled into a 13-week program that included 5 half-day group sessions and web/telephone-based support between sessions. It was designed in consultation with patients and previously studied in mothers. We computed mean changes from baseline (95% CI) for physical activity, eating, and sleep measures, and cardiometabolic parameters (fasting and 2-h post glucose load plasma glucose, BMI, blood pressure) in both partners and mothers. RESULTS Among 59 couples enrolled, 45 partners (76%) and 47 mothers (80%) completed final evaluations. Baseline cardiometabolic measures averaged within normal limits. Similar to mothers, partners increased physical activity (+ 1645 steps/day, 95%CI 730, 2561; accelerometer assessed moderate-to-vigorous physical activity + 36.4 min/week, 95% CI 1.4, 71.4) and sleep duration (+ 0.5 h/night, 95% CI 0.1, 0.9) and reduced the sodium-to-potassium ratio of food intake (- 0.09 95% CI -0.19, - 0.001). No conclusive changes were observed in glucose measures or insulin resistance; in analyses combining mothers and partners, systolic blood pressure decreased (- 2.7 mmHg, 95% CI -4.4, - 1.0). CONCLUSIONS Partners and mothers demonstrated improved physical activity, sleep, and dietary quality. Baseline cardiometabolic profiles averaged at normal values and there were no changes in glucose or insulin resistance; some blood pressure impact was observed. While strategies need to be developed to attract participants at higher cardiometabolic risk, this study demonstrates that partners of women within 5 years of a gestational diabetes diagnosis can be recruited and do achieve health behaviour change. TRIAL REGISTRATION ClinicalTrials.gov: NCT02343354 (date of registration: January 22, 2015).
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Affiliation(s)
| | - Sara J Meltzer
- Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Romina Pace
- Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Natasha Garfield
- Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Ariane Godbout
- Division of Endocrinology, Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Canada
| | | | - Elham Rahme
- Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Deborah Da Costa
- Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Kaberi Dasgupta
- Department of Medicine, McGill University, Montréal, Québec, Canada.
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Short Sleep Duration Is Associated With Abnormal Serum Aminotransferase Activities and Nonalcoholic Fatty Liver Disease. Clin Gastroenterol Hepatol 2018; 16:588-590. [PMID: 28882688 DOI: 10.1016/j.cgh.2017.08.049] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 08/29/2017] [Accepted: 08/29/2017] [Indexed: 02/07/2023]
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199
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Wynchank D, ten Have M, Bijlenga D, Penninx BW, Beekman AT, Lamers F, de Graaf R, Kooij JS. The Association Between Insomnia and Sleep Duration in Adults With Attention-Deficit Hyperactivity Disorder: Results From a General Population Study. J Clin Sleep Med 2018; 14:349-357. [PMID: 29458702 PMCID: PMC5837836 DOI: 10.5664/jcsm.6976] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 09/28/2017] [Accepted: 11/17/2017] [Indexed: 02/07/2023]
Abstract
STUDY OBJECTIVES Insomnia and short or long sleep duration are important comorbid conditions in adults with attention-deficit hyperactivity disorder (ADHD), but reports of the association vary. In a general population study, we evaluated the relationship between ADHD symptom severity, insomnia symptoms, and sleep duration in adults. METHODS Data were from the third wave of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2; n = 4,618). ADHD symptom severity and symptom dimensions (hyperactivity and inattention) were assessed using the Adult ADHD Self-Report Scale screener. Self-reported insomnia symptoms (Insomnia Rating Scale; IRS) were defined as clinically relevant if IRS ≥ 9. Self-reported short sleep duration was defined as ≤ 6 hours, and long sleep duration as ≥ 10 hours. RESULTS Within the group with clinically relevant ADHD symptoms, 43% reported significant insomnia symptoms (odds ratio [OR] = 2.66, 95% confidence interval [CI] 1.74-4.07); 41% short sleep duration (relative risk ratio [RRR] = 1.94, 95% CI 1.31-2.85) and 6% long sleep (RRR = 5.87, 95% CI 1.97-17.45). Increased inattention symptoms were associated with IRS ≥ 9, short and long sleep duration in fully adjusted models (OR = 1.10, 95% CI 1.06-1.14; RRR = 1.06, 95% CI 1.02-1.09; RRR = 1.16, 95% CI 1.05-1.28, respectively). Increased hyperactivity symptoms were associated with IRS ≥ 9 (OR = 1.17, 95% CI 1.11-1.23) and short sleep duration (RRR = 1.12, 95% CI 1.05-1.19). CONCLUSIONS Both clinically significant ADHD symptoms and inattention and hyperactivity symptom dimensions were consistently associated with insomnia symptoms and altered sleep duration. These associations confirm that sleep disturbances should be assessed and given appropriate clinical attention in adults with ADHD.
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Affiliation(s)
- Dora Wynchank
- PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands
| | - Margreet ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Denise Bijlenga
- PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands
| | - Brenda W. Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Aartjan T. Beekman
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Femke Lamers
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - J.J. Sandra Kooij
- PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
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Zhou H, Wang K, Zhou X, Ruan S, Gan S, Cheng S, Lu Y. Prevalence and Gender-Specific Influencing Factors of Hypertension among Chinese Adults: A Cross-Sectional Survey Study in Nanchang, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E382. [PMID: 29473870 PMCID: PMC5858451 DOI: 10.3390/ijerph15020382] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 02/09/2018] [Accepted: 02/20/2018] [Indexed: 01/23/2023]
Abstract
Hypertension has become the leading cause of death worldwide; data on hypertension among Nanchang adults are sparse. The aim of this study was to investigate the prevalence and gender-specific influencing factors of hypertension in adults in Nanchang, China. A cross-sectional survey was conducted with a representative sample of 2722 Chinese residents aged 18 years and above between May and September 2016, with a response rate of 92.4% (2516/2722). A stratified cluster sampling method was adopted in this study. Data on prevalence and influencing factors were obtained from a standard questionnaire and physical measurements. Univariate and multivariate logistic regressions were performed to analyze the influencing factors. The age-standardized prevalence was 19.8% (18.2-21.3) (male: 19.5% (18.0-21.1); female, 20.01% (18.5-21.6)). Factors positively associated with hypertension prevalence were past smoking, diabetes mellitus (DM), and overweight and obesity in both genders. Abdominal obesity and family history of cardiovascular diseases (CVD) were risk factors only in males; sleeping time and consumption of fresh vegetables and fruits were related to the prevalence of hypertension only in females. These findings will form the baseline information for the development of more effective approaches to enhance current prevention and control management of hypertension.
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Affiliation(s)
- Hui Zhou
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, Jiangxi 330006, China.
| | - Kai Wang
- School of Medicine, Nanchang University, Nanchang, Jiangxi 330006, China.
| | - Xiaojun Zhou
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, Jiangxi 330006, China.
| | - Shiying Ruan
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, Jiangxi 330006, China.
| | - Shaohui Gan
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, Jiangxi 330006, China.
| | - Siyuan Cheng
- Department of Public Health Sciences, University of Hawaii at Mānoa, Honolulu, HI 96822, USA.
| | - Yuanan Lu
- Department of Public Health Sciences, University of Hawaii at Mānoa, Honolulu, HI 96822, USA.
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