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Saidi O, Rochette E, Dambel L, St-Onge MP, Duché P. Chrono-nutrition and sleep: lessons from the temporal feature of eating patterns in human studies - A systematic scoping review. Sleep Med Rev 2024; 76:101953. [PMID: 38788519 DOI: 10.1016/j.smrv.2024.101953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/25/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024]
Abstract
An emerging field of research has revealed a bidirectional relationship between sleep and diet, highlighting the potential role of a healthy diet in improving sleep. However, the impact of chrono-nutrition on sleep remains less explored. Here we conducted a systematic scoping review, considering the multiple dimensions of chrono-nutrition, to describe the extent, range, and nature of the existing literature in this area (PROSPERO: CRD42021274637). There has been a significant increase in the literature exploring this topic over the past six years (almost 67 % of the evolving literature). A breakdown of the included studies was performed according to three major chrono-nutritional dimensions: meal timing [n = 35], irregular eating patterns [n = 84], and frequency of eating occasions [n = 3]. Meal timing included three sub-dimensions: breakfast skipping [n = 13], late eating [n = 16], and earlier vs later meals schedules [n = 6]. Irregular meal patterns included three sub-dimensions: diurnal fasting [n = 65], intermittent fasting [n = 16], and daily meal patterns [n = 3]. Frequency was the least studied dimension (n = 3). We provided a synthetic and illustrative framework underlining important preliminary evidence linking the temporal characteristics of eating patterns to various facets of sleep health. Nonetheless, much work remains to be done to provide chrono-nutrition guidelines to improve sleep health in the general population.
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Affiliation(s)
- Oussama Saidi
- JAP2S Laboratory, Toulon University, F-83041, Toulon, France.
| | - Emmanuelle Rochette
- JAP2S Laboratory, Toulon University, F-83041, Toulon, France; Department of Pediatrics, Clermont-Ferrand University Hospital, F-63000, Clermont-Ferrand, France; Clermont Auvergne University, INSERM, CIC 1405, CRECHE Unit, F-63000, Clermont-Ferrand, France
| | - Lou Dambel
- JAP2S Laboratory, Toulon University, F-83041, Toulon, France
| | - Marie-Pierre St-Onge
- Center of Excellence for Sleep & Circadian Research and Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA, 10032
| | - Pascale Duché
- JAP2S Laboratory, Toulon University, F-83041, Toulon, France
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Cyr M, Artenie DZ, Al Bikaii A, Lee V, Raz A, Olson JA. An evening light intervention reduces fatigue and errors during night shifts: A randomized controlled trial. Sleep Health 2023; 9:373-380. [PMID: 37080863 DOI: 10.1016/j.sleh.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE Shift work causes circadian rhythms to misalign with the demands of the environment, which has been associated with sleep difficulties and cognitive impairments. Although bright light exposure during night shifts can improve circadian alignment, its implementation is often infeasible. Here, we tested whether light exposure in the evening, before the night shift, could improve fatigue, work performance, mood, and sleep. METHODS Fifty-seven healthy nurses who worked full-time rapidly rotating shift schedules completed the study. In a mixed-design randomized controlled trial, participants completed a baseline observation period before following 1 of 2 interventions. The experimental intervention aimed to improve circadian alignment using evening light exposure and morning light avoidance; the control intervention aimed to improve alertness and reduce sleep disturbances by modifying diet. Every morning and evening for 30 days, participants completed measures of fatigue, work-related errors, sleepiness, mood, sleep duration, and sleep quality. RESULTS Compared to the baseline observation period, the experimental intervention reduced errors by 67%, while the control intervention reduced them by only 5%. This reduction was partially mediated by fatigue; experimental participants reported less fatigue on work days than control participants (d = 0.25 [0.10, 0.38]). The experimental group also showed a small improvement in mood. Both groups showed reductions in fatigue (d = 0.29 [0.20, 0.36]) and sleepiness (d = 0.21 [0.12, 0.28]) as well as a small increase in sleep duration. CONCLUSIONS Interventions based on evening light may be a feasible and effective strategy to reduce fatigue and errors in night-shift workers.
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Affiliation(s)
- Mariève Cyr
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Despina Z Artenie
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | | | - Virginia Lee
- McGill University Health Centre, Montreal, QC, Canada
| | - Amir Raz
- Institute for Interdisciplinary Behavioral and Brain Sciences, Chapman University, Irvine, CA, USA
| | - Jay A Olson
- Department of Psychology, McGill University, Montreal, QC, Canada; Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada.
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Moses TE, Gray E, Mischel N, Greenwald MK. Effects of neuromodulation on cognitive and emotional responses to psychosocial stressors in healthy humans. Neurobiol Stress 2023; 22:100515. [PMID: 36691646 PMCID: PMC9860364 DOI: 10.1016/j.ynstr.2023.100515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/19/2022] [Accepted: 01/09/2023] [Indexed: 01/12/2023] Open
Abstract
Physiological and psychological stressors can exert wide-ranging effects on the human brain and behavior. Research has improved understanding of how the sympatho-adreno-medullary (SAM) and hypothalamic-pituitary-adrenocortical (HPA) axes respond to stressors and the differential responses that occur depending on stressor type. Although the physiological function of SAM and HPA responses is to promote survival and safety, exaggerated psychobiological reactivity can occur in psychiatric disorders. Exaggerated reactivity may occur more for certain types of stressors, specifically, psychosocial stressors. Understanding stressor effects and how the body regulates these responses can provide insight into ways that psychobiological reactivity can be modulated. Non-invasive neuromodulation is one way that responding to stressors may be altered; research into these interventions may provide further insights into the brain circuits that modulate stress reactivity. This review focuses on the effects of acute psychosocial stressors and how neuromodulation might be effective in altering stress reactivity. Although considerable research into stress interventions focuses on treating pathology, it is imperative to first understand these mechanisms in non-clinical populations; therefore, this review will emphasize populations with no known pathology and consider how these results may translate to those with psychiatric pathologies.
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Affiliation(s)
| | | | | | - Mark K. Greenwald
- Corresponding author. Department of Psychiatry and Behavioral Neurosciences, Tolan Park Medical Building, 3901 Chrysler Service Drive, Suite 2A, Detroit, MI, 48201, USA.
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Xu J, Chen Y, Gu L, Liu X, Yang J, Li M, Rao K, Dong X, Yang S, Huang B, Jin L, Wang T, Liu J, Wang S, Bai J. Hypothalamic-pituitary-adrenal axis activity and its relationship to the autonomic nervous system in patients with psychogenic erectile dysfunction. Front Endocrinol (Lausanne) 2023; 14:1103621. [PMID: 36936153 PMCID: PMC10020360 DOI: 10.3389/fendo.2023.1103621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 02/14/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Psychological stress and its two stress response systems, the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS), are closely related to psychogenic erectile dysfunction (pED). However, the analyses of perceived stress and stress systems in pED patients need to be more in-depth, especially the interactions between them. METHODS Our study included 75 patients with pEDs and 75 healthy men. The International Index of Erectile Function-5 (IIEF-5) and the 10-item Perceived Stress Scale (PSS-10) were used for assessing the severity of ED and perceived stress. All participants collected saliva samples on three consecutive days at eight specific times with strict reference to the time of morning awakening for measuring cortisol parameters and wore electrocardiography for 24 h to derive heart rate variability (HRV). RESULTS The PSS-10 scores of pED patients were significantly higher than the control group (p<0.001). Although PSS-10 and IIEF-5 scores were negatively correlated in pED patients, there was no statistical significance between them (r=-0.049, p=0.677). Compared with the control group, the HRV parameters of pED patients were significantly increased in LF/HF ratio (p=0.014) but significantly decreased in LF, HF, and pNN50 (p<0.001). However, the two groups had no statistically significant differences in cortisol variables (all p>0.05). The interaction between sympathovagal modulation (HF, rMSSD) and cortisol awakening response (CAR AUCi) explained significantly greater variance in perceived stress than either stress system alone. Higher parasympathetic activity combined with a higher cortisol awakening response was associated with greater perceived stress. CONCLUSION Our results suggested that the interrelation between ANS and HPA axis activity might enhance our comprehension of how stress affected the physical and mental health of pED patients.
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Affiliation(s)
- Jinzhou Xu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yinwei Chen
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Longjie Gu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaming Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jun Yang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Mingchao Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ke Rao
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiyuan Dong
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shulin Yang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Bo Huang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tao Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jihong Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shaogang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jian Bai
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- *Correspondence: Jian Bai,
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Bai J, Gu L, Chen Y, Liu X, Yang J, Li M, Dong X, Yang S, Huang B, Wang T, Jin L, Liu J, Wang S. Evaluation of psychological stress, cortisol awakening response, and heart rate variability in patients with chronic prostatitis/chronic pelvic pain syndrome complicated by lower urinary tract symptoms and erectile dysfunction. Front Psychol 2022; 13:903250. [PMID: 36405196 PMCID: PMC9674019 DOI: 10.3389/fpsyg.2022.903250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 09/28/2022] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Mental stress and imbalance of its two neural stress systems, the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis, are associated with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and erectile dysfunction (ED). However, the comprehensive analyses of psychological stress and stress systems are under-investigated, particularly in CP/CPPS patients complicated by lower urinary tract symptoms (LUTS) and ED. MATERIALS AND METHODS Participants were 95 patients in CP/CPPS+ED group, 290 patients in CP/CPPS group, 124 patients in ED group and 52 healthy men in control group. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), the International Index of Erectile Function-5 (IIEF-5) and the International Prostate Symptom Score (IPSS) were used for assessing the disease severity of CP/CPPS, LUTS and ED. Psychometric self-report questionnaires including the Beck Anxiety Inventory (BAI), Perceived Stress Scale (PSS), Type A Personality Test (TAPT) and Symptom Checklist 90 (SCL-90) were completed for distress from physical symptoms. Twenty-five subjects per group were randomly selected for further investigating the changes of the HPA axis and ANS. Saliva samples were taken on 3 consecutive days at 8 specific times with strict reference to time of morning awakening for evaluation of free cortisol. Heart rate variability (HRV) as marker of the ANS was measured using 24 h electrocardiography, and time-and frequency-domain variables were analyzed. RESULTS The BAI and SCL-90 scores were significantly higher in the CP/CPPS+ED, CP/CPPS and ED groups compared with the control group (p < 0.01). The PSS scores of both groups with ED were significantly higher than the control group (p < 0.01). Compared with the CP/CPPS group, the differences of PSS, SCL-90 and TAPT scores were statistically significant in CP/CPPS+ED patients (p < 0.01). The IPSS scores were shown to have significantly positive correlations with BAI (r = 0.32, p < 0.0001), PSS (r = 0.18, p < 0.01) and SCL-90 (r = 0.19, p < 0.01) in the CP/CPPS patients. However, in all subjects, the IIEF-5 scores were shown to have significantly negative correlations with BAI (r = -0.17,p < 0.001), PSS (r = -0.25,p < 0.0001), SCL-90 (r = -0.20,p < 0.001) and quality of life score in NIH-CPSI (r = -0.14,p = 0.0075). Cortisol awakening response (CAR) parameters and diurnal cortisol levels did not significantly vary between the four groups. Time-dependent parameters of HRV also did not differ significantly across groups. In the frequency domain analysis, low frequency (LF) was significantly lower in ED patients when compared with CP/CPPS+ED patients (p = 0.044) and healthy controls (p = 0.005), high frequency (HF) power was significantly higher in healthy controls compared to patients with ED (p < 0.001), CP/CPPS (p < 0.001) and CP/CPPS+ED (p < 0.001), and the CP/CPPS+ED group had significantly higher LF/HF ratio than the control group (p = 0.001). CONCLUSION CP/CPPS and ED patients score exceedingly high on most psychosocial variables. The symptom scores of LUTS and ED positively correlate with the severity of psychological stress. Our findings also suggest that the ANS sympathovagal imbalance is associated with ED and LUTS in CP/CPPS, whereas HPA axis activity is not.
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Affiliation(s)
- Jian Bai
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Longjie Gu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yinwei Chen
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaming Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Yang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mingchao Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiyuan Dong
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shulin Yang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bo Huang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jihong Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shaogang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Choi Y, Son B, Shin WC, Nam SU, Lee J, Lim J, Kim S, Yang C, Lee H. Association of Dietary Behaviors with Poor Sleep Quality and Increased Risk of Obstructive Sleep Apnea in Korean Military Service Members. Nat Sci Sleep 2022; 14:1737-1751. [PMID: 36187326 PMCID: PMC9521233 DOI: 10.2147/nss.s378564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/13/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Sleep quality among military service members is important for enhancing their capabilities and preventing psychiatric problems. We aimed to explore the association of dietary behaviors with poor sleep quality and increased risk of obstructive sleep apnea (OSA) in military men on active duty. PATIENTS AND METHODS A large-scale multi-site cross-sectional survey was conducted in five units of the Republic of Korea's army. Poor sleep quality and increased risk of OSA were defined using the Pittsburgh sleep quality index (PSQI) and Berlin Questionnaire, respectively. Information on dietary behaviors, including the frequency of skipping breakfast, eating snacks, consuming a night meal, and overeating, were collected. RESULTS From August 2021 to September 2021, 4389 male respondents, mean age (20.8 ± 1.3 years), completed the survey; 2579 (58.8%) were assessed as having poor sleep quality, and 614 (14.0%) increased risk of OSA. After adjusting for lifestyle and occupational covariates, skipping breakfast 1-2 times weekly was associated with an increased likelihood of experiencing poor sleep quality, compared with not skipping breakfast (odds ratio: 1.23 [95% CI 1.02-1.47]). Eating night meals 5-6 times weekly was also associated with poor sleep quality (odds ratio: 5.54 [95% CI 2.49-14.18]). In addition, skipping breakfast daily (odds ratio: 2.28 [95% CI 1.27-4.03]) and eating night meals daily (odds ratio: 2.30 [95% CI 1.21-4.22]) were related to an increased risk of OSA. CONCLUSION Dietary behaviors appear to be related to poor sleep quality and a high risk of OSA. To improve sleep quality, dietary factors could be considered when promoting health programs for military personnel in further research.
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Affiliation(s)
- Yujin Choi
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Byunwoo Son
- Combined Dispensary, 7th Corps, Republic of Korea Army, Icheon, Republic of Korea
| | - Woo-Chul Shin
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea.,Medical Company, 1st Airborne Special Forces Brigade, Republic of Korea Army, Seoul, Republic of Korea
| | - Seong-Uk Nam
- 28th Division, Republic of Korea Army, Yangju-si, Republic of Korea
| | - Jaehong Lee
- Medical Corps, The Capital Defense Command, Seoul, Republic of Korea
| | - Jinwoong Lim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea.,Department of Acupuncture and Moxibustion, Wonkwang University Gwangju Korean Medicine Hospital, Gwangju, Republic of Korea
| | - Sungha Kim
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Changsop Yang
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Hyeonhoon Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.,9th Division, Republic of Korea Army, Goyang, Republic of Korea
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Xu M, Chattopadhyay K, Qian X, Li J, Li X, Sun J, Li L. Association Between Nocturnal Sleep Duration and Obesity Indicators Among People with Type 2 Diabetes: A Cross-Sectional Study in Ningbo, China. Diabetes Metab Syndr Obes 2022; 15:1357-1364. [PMID: 35535215 PMCID: PMC9078341 DOI: 10.2147/dmso.s350347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 04/21/2022] [Indexed: 12/13/2022] Open
Abstract
AIM The study aimed to investigate the association between the nocturnal sleep duration and five obesity indicators, namely, visceral fat area (VFA), subcutaneous fat area (SFA), bodyweight, body mass index (BMI) and waist circumference (WC), among people with type 2 diabetes mellitus (T2DM) in Ningbo, China. METHODS A cross-sectional study was conducted using the National Metabolic Management Centre (MMC) - Ningbo First Hospital data from 1st March 2018 to 28th February 2021. Adults with T2DM were included in the study. Simple and multiple (adjusted for sociodemographic and lifestyle factors and health conditions) linear regression analyses were performed to identify the associations. RESULTS In terms of VFA, SFA, bodyweight, BMI and WC, the eligibility criteria were satisfied by 2771, 2771, 2863, 2863 and 2862 patients, respectively. In the unadjusted model, the shorter nocturnal sleep duration was associated with higher VFA, SFA, bodyweight, BMI and WC. In other words, an hour increase in the nocturnal sleep duration was associated with a decrease of 2.07 cm2 in VFA (regression coefficient = -2.07; 95% CI = -3.25 to -0.88), 2.67 cm2 in SFA (-2.67; -4.55 to -0.78); 0.82 kg in bodyweight (-0.82; -1.2 to -0.43), 0.2 kg/m2 in BMI (-0.2; -0.31 to -0.09) and 0.46 cm in WC (-0.46; -0.76 to -0.16). In the adjusted models, the shorter nocturnal sleep duration was still found to be associated with higher VFA, SFA, bodyweight, BMI and WC (except SFA and WC in models where we further adjusted for health conditions). CONCLUSION The nocturnal sleep duration among people with T2DM in Ningbo, China is negatively associated with visceral and general obesity indicators (VFA, bodyweight and BMI). Thus, there is a need for appropriate interventions to address the issue of sleep deprivation.
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Affiliation(s)
- Miao Xu
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, People’s Republic of China
| | - Kaushik Chattopadhyay
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Xingjun Qian
- Health Management Center, Ningbo First Hospital, Ningbo, People’s Republic of China
| | - Jialin Li
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, People’s Republic of China
| | - Xueyu Li
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, People’s Republic of China
| | - Jing Sun
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Li Li
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, People’s Republic of China
- Correspondence: Li Li, Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, People’s Republic of China, Tel +8613757426626, Email
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