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Liu J, Zang C, Yi M, Zhang Y. Clinical Characteristics and Treatment Efficacy for Co-Morbid Insomnia and Sleep Apnea (COMISA): Evidence from Qualitative and Quantitative Analysis. Behav Sleep Med 2024; 22:611-635. [PMID: 38519143 DOI: 10.1080/15402002.2024.2324361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
OBJECTIVES A multitude of physical and mental challenges are being faced in the population with Co-morbid Insomnia and Sleep Apnea (COMISA). Unfortunately, research about clinical characteristics and management of COMISA based on quantitative evidence is lacking. METHOD Standard procedures for literature retrieval, selection and quality assessment, data extraction, analysis, and interpretation were conducted step by step. For studying the sleep characteristics, common complications and widely recognized treatment options for COMISA, Weighted Mean Difference (WMD) and Odds Ratio (OR) were applied to assess the mean and risk differences between compared groups. Outcomes included sleep health parameters and secondary impairments in physical and mental well-being. RESULTS COMISA showed worse sleep quality than OSA only by PSQI (WMD = 3.38 point) and heavier sleep fragmentation (WMD = 11.46 min) than insomnia only. Besides, COMISA patients showed a higher risk for depression (OR [95%CI] = 5.03[2.31, 10.93]) and PTSD (OR [95%CI] = 3.96[1.85, 8.46]) in comparison with OSA alone. Compared to insomnia alone, COMISA patients suffered from more than two times higher risk of cardiovascular diseases, hypertension, and diabetes. In treating COMISA patients, combining CBTI with PAP treatment can enhance the improvement of insomnia severity (ISI, WMD [95%CI] =-3.26[-4.51, -2.00] point) and sleep efficiency (WMD [95%CI] = 6.39[1.97, 10.81] %) compared to PAP alone. CONCLUSIONS Impaired sleep domains in COMISA cover sleep quality and sleep structure. Also, COMISA has a higher risk for cardiometabolic diseases and mental disorders. Combining CBTI with PAP can be a recommended treatment to relieve sleep impairments for COMISA.
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Affiliation(s)
- Jie Liu
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Chenyang Zang
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Minhan Yi
- School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Yuan Zhang
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Arab A, Karimi E, Garaulet M, Scheer FAJL. Dietary patterns and insomnia symptoms: A systematic review and meta-analysis. Sleep Med Rev 2024; 75:101936. [PMID: 38714136 PMCID: PMC11179690 DOI: 10.1016/j.smrv.2024.101936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/18/2024] [Accepted: 03/25/2024] [Indexed: 05/09/2024]
Abstract
We aimed to systematically review and synthesize the available evidence regarding the link between dietary patterns and insomnia symptoms among the general population using observational studies. We reviewed 16,455 references, of which 37 studies met inclusion criteria with a total sample size of 591,223. There was a significant association of the Mediterranean diet (OR: 0.86; 95 % CI, 0.79, 0.93; P < 0.001; I2 = 32.68 %), a high-quality diet (OR: 0.66; 95 % CI, 0.48, 0.90; P = 0.010; I2 = 84.62 %), and an empirically-derived healthy dietary pattern (OR: 0.91; 95 % CI, 0.85, 0.98; P = 0.010; I2 = 57.14 %) with a decreased risk of insomnia symptoms. Moreover, the dietary glycemic index (OR: 1.16; 95 % CI, 1.08, 1.25; P < 0.001; I2 = 0.0 %), the dietary glycemic load (OR: 1.10; 95 % CI, 1.01, 1.20; P = 0.032; I2 = 74.36 %), and an empirically-derived unhealthy dietary pattern (OR: 1.20; 95 % CI, 1.01, 1.42; P = 0.040; I2 = 68.38 %) were linked with a higher risk of insomnia symptoms. Most individual studies were of good quality (NOS) but provided very low certainty of evidence (GRADE). Consistent data reveals that following healthy diets is associated with decreased insomnia symptoms prevalence, while adherence to an unhealthy pattern is associated with an increased prevalence of insomnia symptoms.
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Affiliation(s)
- Arman Arab
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA; Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.
| | - Elham Karimi
- Research Development Center, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Marta Garaulet
- Department of Physiology, Regional Campus of International Excellence, University of Murcia, Murcia, Spain; Biomedical Research Institute of Murcia, IMIB-Arrixaca-UMU, University Clinical Hospital, Murcia, Spain.
| | - Frank A J L Scheer
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA; Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.
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Salinas-Roca B, Sánchez E, Bermúdez-López M, Valdivielso JM, Farràs-Sallés C, Pamplona R, Torres G, Mauricio D, Castro E, Fernández E, Hernández M, Rius F, Lecube A. Association between adherence to the mediterranean diet, physical activity, and sleep apnea-hypopnea syndrome (SAHS) in a middle-aged population with cardiovascular risk: Insights from the ILERVAS cohort. Sleep Med 2024; 116:19-26. [PMID: 38408422 DOI: 10.1016/j.sleep.2024.02.032] [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: 10/30/2023] [Revised: 01/31/2024] [Accepted: 02/19/2024] [Indexed: 02/28/2024]
Abstract
INTRODUCTION Sleep Apnea-Hypopnea Syndrome (SAHS) is a common sleep disorder influenced by factors like age, gender, and obesity. The Mediterranean Diet (MedDiet) and physical activity have shown health benefits in lung diseases, but their effects on SAHS remain underexplored. METHODS In a cross-sectional analysis of 678 middle-aged individuals with low-to-moderate cardiovascular risk from the ILERVAS cohort, we assessed adherence to the MedDiet and physical activity levels using validated tools. Sleep parameters, SAHS severity, and excessive daytime sleepiness were evaluated through non-attended cardiorespiratory polygraphy and the Epworth Sleepiness Scale. Multinomial logistic regression models were employed to assess the relationship between MedDiet adherence, physical activity, and SAHS severity. RESULTS The prevalence of severe, moderate, and mild SAHS was 15.5%, 23.2% and 36.1%, respectively. We found no significant associations between adherence to the MedDiet, physical activity levels, and the presence or severity of SAHS. However, we noted a significant interaction between MedDiet and physical activity with minimum SpO2 values (p = 0.049). Notably, consuming more than one serving of red meat per day was independently associated with a higher risk of moderate SAHS [OR = 2.65 (1.29-5.44), p = 0.008]. CONCLUSION Individually, MedDiet adherence and physical activity did not show independent correlations with SAHS. However, when considered together, a minimal but significant effect on minimum SpO2 was observed. Additionally, red meat consumption was associated with a moderate risk of SAHS. Further research is necessary to comprehend the intricate connections between lifestyle factors and sleep-breathing disorders, with a focus on personalized approaches for high-risk populations.
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Affiliation(s)
- Blanca Salinas-Roca
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida. University of Lleida, Lleida, Spain; Facultat de Ciències de la Salut-Universitat Ramón Llull Blanquerna, Barcelona, Spain
| | - Enric Sánchez
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida. University of Lleida, Lleida, Spain
| | - Marcelino Bermúdez-López
- Vascular and Renal Translational Research Group, IRBLleida. Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), Lleida, Spain; Department of Experimental Medicine, IRBLleida, University of Lleida, Lleida, Spain
| | - José Manuel Valdivielso
- Vascular and Renal Translational Research Group, IRBLleida. Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), Lleida, Spain
| | - Cristina Farràs-Sallés
- Centre d'Atenció Primària Cappont. Gerència Territorial de Lleida, Institut Català de la Salut. Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gorina (IDIAPJGol), Barcelona, Spain
| | - Reinald Pamplona
- Department of Experimental Medicine, IRBLleida, University of Lleida, Lleida, Spain
| | - Gerard Torres
- Respiratory Medicine Department, University Hospital Arnau de Vilanova and Santa María. Group of Translational Research in Respiratory Medicine, IRBLleida. University of Lleida, Lleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Dídac Mauricio
- Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau. Sant Pau Biomedical Research Institute (IIB Sant Pau). Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII). Madrid, Spain
| | - Eva Castro
- Vascular and Renal Translational Research Group, IRBLleida. Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), Lleida, Spain
| | - Elvira Fernández
- Vascular and Renal Translational Research Group, IRBLleida. Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), Lleida, Spain
| | - Marta Hernández
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida. University of Lleida, Lleida, Spain
| | - Ferran Rius
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida. University of Lleida, Lleida, Spain
| | - Albert Lecube
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida. University of Lleida, Lleida, Spain.
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Godos J, Ferri R, Lanza G, Caraci F, Vistorte AOR, Yelamos Torres V, Grosso G, Castellano S. Mediterranean Diet and Sleep Features: A Systematic Review of Current Evidence. Nutrients 2024; 16:282. [PMID: 38257175 PMCID: PMC10821402 DOI: 10.3390/nu16020282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024] Open
Abstract
The prevalence of sleep disorders, characterized by issues with quality, timing, and sleep duration is increasing globally. Among modifiable risk factors, diet quality has been suggested to influence sleep features. The Mediterranean diet is considered a landmark dietary pattern in terms of quality and effects on human health. However, dietary habits characterized by this cultural heritage should also be considered in the context of overall lifestyle behaviors, including sleep habits. This study aimed to systematically revise the literature relating to adherence to the Mediterranean diet and sleep features in observational studies. The systematic review comprised 23 reports describing the relation between adherence to the Mediterranean diet and different sleep features, including sleep quality, sleep duration, daytime sleepiness, and insomnia symptoms. The majority of the included studies were conducted in the Mediterranean basin and reported a significant association between a higher adherence to the Mediterranean diet and a lower likelihood of having poor sleep quality, inadequate sleep duration, excessive daytime sleepiness or symptoms of insomnia. Interestingly, additional studies conducted outside the Mediterranean basin showed a relationship between the adoption of a Mediterranean-type diet and sleep quality, suggesting that biological mechanisms sustaining such an association may exist. In conclusion, current evidence suggests a relationship between adhering to the Mediterranean diet and overall sleep quality and different sleep parameters. The plausible bidirectional association should be further investigated to understand whether the promotion of a healthy diet could be used as a tool to improve sleep quality.
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Affiliation(s)
- Justyna Godos
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy;
| | - Raffaele Ferri
- Sleep Research Centre, Oasi Research Institute-IRCCS, 94018 Troina, Italy;
| | - Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, Italy;
- Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Filippo Caraci
- Department of Drug and Health Sciences, University of Catania, 95125 Catania, Italy;
- Neuropharmacology and Translational Neurosciences Research Unit, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Angel Olider Rojas Vistorte
- Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (A.O.R.V.); (V.Y.T.)
- Universidad Internacional Iberoamericana, Arecibo, PR 00613, USA
- Universidade Internacional do Cuanza, Cuito EN250, Angola
| | - Vanessa Yelamos Torres
- Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (A.O.R.V.); (V.Y.T.)
- Universidad Internacional Iberoamericana, Campeche 24560, Mexico
- Universidad de La Romana, La Romana 22000, Dominican Republic
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy;
- Center for Human Nutrition and Mediterranean Foods (NUTREA), University of Catania, 95123 Catania, Italy
| | - Sabrina Castellano
- Department of Educational Sciences, University of Catania, 95124 Catania, Italy;
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Georgoulis M, Kontogianni MD, Kechribari I, Tenta R, Fragopoulou E, Lamprou K, Perraki E, Vagiakis E, Yiannakouris N. Associations between serum vitamin D status and the cardiometabolic profile of patients with obstructive sleep apnea. Hormones (Athens) 2023; 22:477-490. [PMID: 37322405 PMCID: PMC10449975 DOI: 10.1007/s42000-023-00456-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/26/2023] [Indexed: 06/17/2023]
Abstract
PURPOSE Obstructive sleep apnea (OSA) and the metabolic syndrome (MetS) frequently coexist. Low serum vitamin D has been positively associated with OSA presence and severity; however, data on its link to cardiometabolic features in patients with OSA remain scarce. We aimed to assess serum 25-hydroxyvitamin D [25(OH)D] and explore its association with cardiometabolic parameters in OSA. METHODS This was a cross-sectional study among 262 patients (49 ± 9 years old, 73% men) with polysomnography-diagnosed OSA. Participants were evaluated in terms of anthropometric indices, lifestyle habits, blood pressure, biochemical, plasma inflammatory and urinary oxidative stress markers, and the presence of MetS. Serum 25(OH)D was assessed by chemiluminescence, and vitamin D deficiency (VDD) was defined as 25(OH)D < 20 ng/mL. RESULTS Median (1st, 3rd quartile) serum 25(OH)D levels were 17.7 (13.4, 22.9) ng/mL and 63% of participants had VDD. Serum 25(OH)D correlated negatively with body mass index (BMI), homeostasis model of assessment of insulin resistance (HOMA-IR), total cholesterol, low-density lipoprotein cholesterol, triglycerides, high-sensitivity C-reactive protein (hsCRP), and urinary oxidized guanine species (oxG), and positively with high-density lipoprotein cholesterol (all P < 0.050). In logistic regression analysis, serum 25(OH)D was associated with lower odds of MetS [odds ratio (95% confidence interval): 0.94 (0.90-0.98)], after adjustment for age, sex, season of blood sampling, Mediterranean diet score, physical activity, smoking, apnea-hypopnea index, HOMA-IR, hsCRP, and oxG. In the same multivariate model, VDD was associated with ~ twofold greater odds of MetS [2.39 (1.15, 4.97)]. CONCLUSION VDD is highly prevalent and is associated with a detrimental cardiometabolic profile among patients with OSA.
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Affiliation(s)
- Michael Georgoulis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 70 El. Venizelou Str, 17676, Athens, Greece
| | - Meropi D Kontogianni
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 70 El. Venizelou Str, 17676, Athens, Greece
| | - Ioanna Kechribari
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 70 El. Venizelou Str, 17676, Athens, Greece
| | - Roxane Tenta
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 70 El. Venizelou Str, 17676, Athens, Greece
| | - Elizabeth Fragopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 70 El. Venizelou Str, 17676, Athens, Greece
| | - Kallirroi Lamprou
- Center of Sleep Disorders, Evangelismos General Hospital, 1st Department of Critical Care and Pulmonary Services, Medical School, National and Kapodistrian University of Athens, 10676, Athens, Greece
| | - Eleni Perraki
- Center of Sleep Disorders, Evangelismos General Hospital, 1st Department of Critical Care and Pulmonary Services, Medical School, National and Kapodistrian University of Athens, 10676, Athens, Greece
| | - Emmanouil Vagiakis
- Center of Sleep Disorders, Evangelismos General Hospital, 1st Department of Critical Care and Pulmonary Services, Medical School, National and Kapodistrian University of Athens, 10676, Athens, Greece
| | - Nikos Yiannakouris
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 70 El. Venizelou Str, 17676, Athens, Greece.
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Kechribari I, Kontogianni MD, Fragopoulou E, Tenta R, Georgoulis M, Lamprou K, Vagiakis E, Yiannakouris N. Adherence to a "Western-type" dietary pattern is positively associated with the Apnea-Hypopnea Index in adults with obstructive sleep apnea. Nutr Res 2023; 117:56-65. [PMID: 37480783 DOI: 10.1016/j.nutres.2023.06.006] [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: 04/02/2023] [Revised: 06/24/2023] [Accepted: 06/24/2023] [Indexed: 07/24/2023]
Abstract
Dietary habits have been associated with obstructive sleep apnea (OSA); however, the underlying mechanisms remain unclear. We hypothesized that adherence to dietary patterns may be associated with Apnea-Hypopnea Index (AHI) and OSA severity and that insulin resistance, oxidative stress, and inflammation may act as potential mediators of these associations. This was a cross-sectional study among 269 adult participants with polysomnography-diagnosed moderate-to-severe OSA. Dietary and physical activity habits were assessed through validated questionnaires, and biochemical, inflammatory, and oxidative stress markers were measured for all volunteers. Dietary patterns were identified using principal component analysis, and mediation analyses was also performed. A "Western-type" dietary pattern (characterized by high intakes of full-fat dairy, refined grains, potatoes, red meat, sweets, salty snacks, and soft drinks and low intakes of low-fat dairy and whole grains) was positively associated with AHI. Mediation analyses also revealed that insulin resistance partially explained this association. In multivariable models controlling for age, sex, smoking, socioeconomic status, obesity presence, energy intake, and physical activity level, participants in the highest quartile of adherence to the Western-type dietary pattern had ∼3.5 times higher likelihood of suffering from severe OSA, compared with participants in the lowest quartile of adherence (odds ratio [95% confidence interval]: 3.45 [1.21-9.94], P trend across quartiles: 0.024). After further adjustment for Homeostasis Model of Assessment-Insulin Resistance and high-sensitivity C-reactive protein, this association lost significance. Higher adherence to a less healthy, Western-type dietary pattern is positively associated with AHI and OSA severity, which may partially be mediated through insulin resistance.
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Affiliation(s)
- Ioanna Kechribari
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece.
| | - Meropi D Kontogianni
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Elizabeth Fragopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Roxane Tenta
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Michael Georgoulis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Kallirroi Lamprou
- Center of Sleep Disorders, 1st Department of Critical Care, "Evangelismos" General Hospital, Athens, Greece
| | - Emmanouil Vagiakis
- Center of Sleep Disorders, 1st Department of Critical Care, "Evangelismos" General Hospital, Athens, Greece
| | - Nikos Yiannakouris
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
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Lee S. Association between CLOCK Gene Polymorphisms and Insomnia Risk According to Food Groups: A KoGES Longitudinal Study. Nutrients 2023; 15:2300. [PMID: 37242182 PMCID: PMC10222773 DOI: 10.3390/nu15102300] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
Food intake could mitigate or exacerbate the risk for insomnia associated with the CLOCK gene. This study investigated the associations between the clock circadian regulator (CLOCK) polymorphisms rs12649507 and rs4580704 and the risk of insomnia, as well as its interactions with food groups. Among 1430 adults, new insomnia cases were identified between 2005 and 2012. Single nucleotide polymorphisms were genotyped, and dietary intake was assessed. Next, Cox proportional hazard models were established. The fruit and meat groups significantly mitigated the risk of insomnia associated with rs12649507 among males (pinteraction = 0.006 in a recessive model; p = 0.010 in a dominant model). In contrast, among females the beverage group significantly increased the risk of insomnia (p = 0.041 in a dominant model). As for rs4580704, among males the fruit and meat groups modified the risk of insomnia (p = 0.006 in a recessive model; p = 0.001 in a dominant model). However, among females, the beverage group exacerbated the risk of insomnia associated with rs4580704 (p = 0.004 in a dominant model). In this longitudinal study, we observed a significantly modified insomnia risk associated with the CLOCK gene depending on food groups. Notably, in a general population the risks were modified according to both the fruit and meat intake among 775 males but exacerbated with beverage intake among 655 females.
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Affiliation(s)
- Sunghee Lee
- Department of Food and Nutrition, College of Health Science, Kangwon National University, Samcheok 25949, Republic of Korea
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Verbraecken J. More than sleepiness: prevalence and relevance of nonclassical symptoms of obstructive sleep apnea. Curr Opin Pulm Med 2022; 28:552-558. [PMID: 36101923 PMCID: PMC9553267 DOI: 10.1097/mcp.0000000000000915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to describe the nonclassical symptoms and manifestations occurring in patients with obstructive sleep apnea (OSA), both from a standpoint of prevalence and in terms of clinical relevance. Particular emphasis will be given to nightmares, comorbid insomnia, restless legs syndrome and periodic limb movement disorder, bruxism, morning headache, nocturia, acid reflux, chronic cough and dysphagia. RECENT FINDINGS A review of the recent literature suggests that nonclassical symptoms have a high prevalence, are underestimated, and can interact with quality of life. Although these disturbances may occur together by mere coincidence, they may interact reciprocally. However, the degree of symptoms is not always correlated with OSA severity. SUMMARY OSA is a heterogeneous disease with variable clinical manifestations. This review highlights the need for detailed evaluation of patients with OSA to diagnose other important sleep disorders and clinical manifestations, given their frequent association.
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Affiliation(s)
- Johan Verbraecken
- Department of Pulmonary Medicine and Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital and University of Antwerp, Edegem, Belgium
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9
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Mediterranean Diet on Sleep: A Health Alliance. Nutrients 2022; 14:nu14142998. [PMID: 35889954 PMCID: PMC9318336 DOI: 10.3390/nu14142998] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 07/17/2022] [Accepted: 07/20/2022] [Indexed: 12/19/2022] Open
Abstract
The Mediterranean diet is a plant-based, antioxidant-rich, unsaturated fat dietary pattern that has been consistently associated with lower rates of noncommunicable diseases and total mortality, so that it is considered one of the healthiest dietary patterns. Clinical trials and mechanistic studies have demonstrated that the Mediterranean diet and its peculiar foods and nutrients exert beneficial effects against inflammation, oxidative stress, dysmetabolism, vascular dysfunction, adiposity, senescence, cognitive decline, neurodegeneration, and tumorigenesis, thus preventing age-associated chronic diseases and improving wellbeing and health. Nocturnal sleep is an essential physiological function, whose alteration is associated with health outcomes and chronic diseases. Scientific evidence suggests that diet and sleep are related in a bidirectional relationship, and the understanding of this association is important given their role in disease prevention. In this review, we surveyed the literature concerning the current state of evidence from epidemiological studies on the impact of the Mediterranean diet on nighttime sleep quantity and quality. The available studies indicate that greater adherence to the Mediterranean diet is associated with adequate sleep duration and with several indicators of better sleep quality. Potential mechanisms mediating the effect of the Mediterranean diet and its foods and nutrients on sleep are described, and gap-in-knowledge and new research agenda to corroborate findings are discussed.
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Kechribari I, Kontogianni MD, Georgoulis M, Lamprou K, Vagiakis E, Yiannakouris N. Higher refined cereal grain intake is positively associated with apnoea-hypopnoea index in patients with obstructive sleep apnoea. J Hum Nutr Diet 2021; 35:948-956. [PMID: 34231276 DOI: 10.1111/jhn.12933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/25/2021] [Accepted: 06/29/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Given that obesity is a well-known risk factor for obstructive sleep apnoea (OSA) development, dietary habits may be involved in its pathogenesis. However, little is known about the associations between dietary habits and OSA severity. The present study aimed to investigate possible associations between cereal grain intake and apnoea/hypopnoea indices in OSA patients. METHODS This was a cross-sectional study of 269 patients (21-70 years; 73.2% males) diagnosed with OSA via an attended in-hospital polysomnography. Information on demographics, medical history, anthropometric indices and lifestyle habits were collected at enrolment. Biochemical measurements were performed in all study participants using standard procedures. Cereal grain consumption was evaluated using a validated food frequency questionnaire. Severe OSA was defined as having an apnoea-hypopnoea index ≥30 events h-1 . RESULTS In adjusted analyses, higher intake of refined cereal grains was positively associated with apnoea-hypopnoea index (ptrend = 0.022), after adjusting for age, sex, socio-economic parameters, smoking habits, waist circumference, physical activity level, adequacy of night-time sleep, diet's quality as assessed by a relevant score, insulin resistance and C-reactive protein levels). Multiple logistic regression analysis also showed that energy-adjusted refined grain intake was associated with increased likelihood of severe OSA (odds ratio = 1.56, 95% confidence interval = 1.06-2.30). Νo association between apnoea/hypopnoea indices and non-refined grain intake was observed in this study. CONCLUSIONS The findings show that obstructive sleep apnoea (OSA) is associated with cereal grain intake and suggest that a higher intake of refined cereal grains may be a risk factor for OSA severity.
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Affiliation(s)
- Ioanna Kechribari
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Meropi D Kontogianni
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Michael Georgoulis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Kallirroi Lamprou
- Centre of Sleep Disorders, First Department of Critical Care, 'Evangelismos' General Hospital, Athens, Greece
| | - Emmanouil Vagiakis
- Centre of Sleep Disorders, First Department of Critical Care, 'Evangelismos' General Hospital, Athens, Greece
| | - Nikos Yiannakouris
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
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