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Sarber KM, Dhanda Patil R. Comorbid Insomnia and Sleep Apnea: Challenges and Treatments. Otolaryngol Clin North Am 2024; 57:385-393. [PMID: 38042666 DOI: 10.1016/j.otc.2023.11.001] [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] [Indexed: 12/04/2023]
Abstract
Insomnia and obstructive sleep apnea (OSA) are 2 of the most prevalent sleep disorders and frequently co-occur. Therapy can be challenging as treatment of 1 disease may worsen the other. Cognitive behavioral therapy for insomnia is the first-line treatment for insomnia and has been shown to improve compliance with positive airway pressure therapy. Other alternatives to OSA treatment may have higher acceptance in those with comorbid insomnia and sleep apnea (COMISA), such as mandibular advancement devices or emerging pharmacotherapies. Surgery, particularly hypoglossal nerve stimulation, appears to be well tolerated and may improve insomnia in those with COMISA. Otolaryngologists must be cognizant of the common presentation of COMISA in patients seeking surgical treatment and utilize a multidisciplinary approach to the treatment of these complex patients.
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Affiliation(s)
- Kathleen M Sarber
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Otolaryngology, Wilford Hall Ambulatory Surgery Center, 1100 Wilford Hall Loop, San Antonio, TX 78236, USA.
| | - Reena Dhanda Patil
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, 3113 Bellevue Avenue, Cincinnati, OH 45219, USA; Department of Otolaryngology-Head and Neck Surgery, Cincinnati Veterans Affairs Medical Center, 3200 Vine Street, Cincinnati, OH 45220, USA
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2
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Wu K, Zhang Z. Knowledge mapping of chronic insomnia: a bibliometric analysis (2000-2023). Sleep Breath 2024:10.1007/s11325-024-03049-6. [PMID: 38730203 DOI: 10.1007/s11325-024-03049-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/21/2024] [Accepted: 04/29/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Recently, significant scientific research breakthroughs have been witnessed in the treatment of chronic insomnia. However, it seems that there is currently no bibliometric analysis of this. Therefore, we hope to comprehensively review and analyze the scholarly system and research focus in the field of chronic insomnia treatment through bibliometric methods. METHODS Between 2000 and 2023, we explored various papers in relation to the treatment of chronic insomnia in the Web of Science Core Collection(WOSCC) database. Subsequently, the collected papers were subjected to bibliometric analysis utilizing CiteSpace, VOSviewer, and the "bibliometric" package in R language. RESULTS With China and the United States(USA) among them, a total of 2937 papers were published across 49 countries. Publications related to the treatment of chronic insomnia were increasing year by year. The Laval University, Washington University, Pittsburgh University, and Stanford University were key research institutions. The journal Sleep was widely popular in the field and was also one of the most cited journals. These papers came from 148 authors, with Morin, Charles M., Roth, Thomas, Espie, Colin A., Harvey, Allison G., and Buysse, Daniel J. publishing the most papers and Morin, cm being co-cited the most. The treatment process of chronic insomnia can be divided into three main stages: drug intervention, diseases related to chronic insomnia, and cognitive behavioral therapy and mental health. Keywords such as "children and adolescents", "novel coronavirus pneumonia" (COVID-19), "mental health" and "heart failure" have become the focus of current research. CONCLUSIONS We carried out a detailed bibliometric review of the development trends and research results of chronic insomnia research through this study for the first time. The information it provides reveals recent research hotspots and cutting-edge issues, providing valuable reference materials for researchers focusing on the treatment of chronic insomnia.
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Affiliation(s)
- Kuilin Wu
- Shandong First Medical University, Shandong, China
| | - Zongwang Zhang
- Department of Anesthesiology, Liaocheng People's Hospital, No. 67, Dongchang West Road, Liaocheng, 252000, Shandong, China.
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3
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Lee Y, Park D, Kim S, Shin C, Suh S. Association of nightmares with cardio-cerebrovascular disease, hypertension and hyperlipidemia in older adults: A population-based cross-sectional study. J Psychosom Res 2024; 182:111669. [PMID: 38788282 DOI: 10.1016/j.jpsychores.2024.111669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 04/04/2024] [Accepted: 04/13/2024] [Indexed: 05/26/2024]
Abstract
OBJECTIVE This cross-sectional study investigated the relationship of nightmares with cardio-cerebrovascular disease (CVD), hypertension and hyperlipidemia which are major preceding diseases of CVD in older adults. METHODS Participants (n = 2824; mean age 63.6 ± 6.6 years, females 49.3%) completed the Disturbing Dream and Nightmare Severity Index (DDNSI), which was used to divide the sample into either the Nightmare or Non-Nightmare group (cut-off score ≥ 10). Demographic information, history of CVD (cerebrovascular disease, myocardial infarction, congestive heart failure, coronary artery disease, and arrhythmia), hypertension, hyperlipidemia, and self-report questionnaires about stress (Perceived Stress Scale), depression (Beck Depression Inventory), sleep quality (Pittsburgh Sleep Quality Index), and insomnia symptoms were also collected. RESULTS Among the sample, 379 participants (13.4%) reported experiencing nightmares more than once a year, and 73 participants (2.6%) were classified as having nightmare disorder based on DDNSI scores (≥10). 11.3% of participants (n = 319) reported having more than one CVD. Approximately half of the participants reported a history of hypertension (52.1%, n = 1471) and hyperlipidemia (47.7%, n = 1346). Logistic regression analysis indicated the Nightmare group was 2.04 times at higher risk for hyperlipidemia (OR = 2.04, 95% CI 1.22-3.40, p = .006) after controlling for covariates compared to the Non-Nightmare group. Although non-significant, there was a trend toward a higher risk of hypertension in the Nightmare group (OR = 1.67, 95% CI 0.99-2.84, p = .056). CONCLUSIONS Results of this study indicate frequent nightmares in older adults may be associated with hyperlipidemia, which are risk factors for CVD. Further studies are needed to explore nightmares' directionality and health consequences in an aging population.
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Affiliation(s)
- Youjin Lee
- Department of Psychology, Sungshin Women's University, Seoul, Republic of Korea
| | - Dasom Park
- Department of Psychology, Sungshin Women's University, Seoul, Republic of Korea
| | - Soriul Kim
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Chol Shin
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea; Biomedical Research Center, Korea University Ansan Hospital, Ansan, Gyeonggi, Republic of Korea.
| | - Sooyeon Suh
- Department of Psychology, Sungshin Women's University, Seoul, Republic of Korea.
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4
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Sarber KM, Patil RD. Comorbid Insomnia and Sleep Apnea: Challenges and Treatments. Otolaryngol Clin North Am 2024:S0030-6665(24)00032-X. [PMID: 38531753 DOI: 10.1016/j.otc.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Insomnia and obstructive sleep apnea (OSA) are 2 of the most prevalent sleep disorders and frequently co-occur. Cognitive behavioral therapy for insomnia is the first line treatment for insomnia and has been shown to improve compliance with positive airway pressure therapy. Other alternatives to OSA treatment may have higher acceptance in those with comorbid insomnia and sleep apnea (COMISA). Surgery, particularly hypoglossal nerve stimulation, appears to be well tolerated and may improve insomnia in those with COMISA. Otolaryngologists must be cognizant of the common presentation of COMISA in patients seeking surgical treatment and utilize a multidisciplinary approach.
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Affiliation(s)
- Kathleen M Sarber
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Otolaryngology, Wilford Hall Ambulatory Surgery Center, 1100 Wilford Hall Loop, San Antonio, TX 78236, USA.
| | - Reena Dhanda Patil
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, OH, USA; Department of Otolaryngology-Head and Neck Surgery, Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, USA
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5
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Joshi AM, Raveendran AV, Arumugam M. Therapeutic role of yoga in hypertension. World J Methodol 2024; 14:90127. [PMID: 38577206 PMCID: PMC10989416 DOI: 10.5662/wjm.v14.i1.90127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/19/2023] [Accepted: 01/16/2024] [Indexed: 03/07/2024] Open
Abstract
Systemic hypertension is an established risk factor for coronary artery disease and cerebrovascular accident and control of blood pressure reduces the risk of a major cardiovascular event. Both non-pharmacological and pharmacological treatment options are available to treat hypertension. Yoga, recently received more attention as a treatment modality for various lifestyle disorders, even though practiced in India since ancient times. In this review, we are analyzing the role of yoga in the treatment of systemic hypertension.
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Affiliation(s)
- Anjali Mangesh Joshi
- Department of Psycho-Oncology, HCG NCHRI Cancer Center, Nagpur 440026, Maharashtra, India
| | - Arkiath Veettil Raveendran
- Department of Internal Medicine, Former Assistant Professor of Medicine, Govt. Medical College, Kozhikode 673010, Kerala, India
| | - Muruganathan Arumugam
- Department of Internal Medicine, Past president API Past Governor American College of Physicians Past President Hypertension Society of India Past Dean Indian College of Physicians, Tirupur 641602, Tamilnadu, India
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Oseni TIA, Udonwa NE, Oku AO, Makinde MT, Archibong F. Association between sleep quality and blood pressure control among hypertensive patients at a rural tertiary hospital in Southern Nigeria: a cross-sectional study. BMJ Open 2024; 14:e079774. [PMID: 38458777 DOI: 10.1136/bmjopen-2023-079774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVES Restorative sleep is critical in preventing hypertension and other chronic diseases. Limited research has explored the relationship between sleep quality and hypertension in Africa. This study investigated the association between sleep quality and blood pressure control among hypertensive patients in Southern Nigeria. DESIGN Cross-sectional study. SETTING A rural tertiary hospital in Southern Nigeria, April to June 2023. PARTICIPANTS 250 systematically selected hypertensive adults. Participants completed a validated semistructured interviewer-administered questionnaire to assess their sleep patterns, including sleep duration, self-reported trouble sleeping and a history of clinical diagnosis of sleep disorders. Sleep patterns were categorised as restorative (healthy) or non-restorative (unhealthy). The blood pressure of respondents was checked and categorised as controlled (<140/90 mm Hg) or uncontrolled (≥140/90 mm Hg). Data were analysed descriptively using SPSS V.24.0 OUTCOME MEASURES: Quality of sleep and blood pressure control. RESULTS Respondents had a mean age of 51.5±10.0 years, with the majority being female (156, 62.4%), married (135, 54.0%) and belonging to the Esan tribe (125, 50.0%). The prevalence of restorative sleep was 36%, while the blood pressure control rate was 23.6%. An association was found between restorative sleep and blood pressure control (adjusted OR =4.38; 95% CI=2.37-8.10; p<0.0001). Respondents aged ≥60 years had 3.5 times higher odds of experiencing non-restorative sleep than those aged ≤40 years (aOR=3.46; 95% CI=1.37-8.74; p=0.009). CONCLUSION The study found an association between poor quality sleep and poor blood pressure control. Incorporating sleep assessments and interventions into comprehensive hypertension management strategies could be explored as a possible approach to improve sleep quality and enhance blood pressure control. TRIAL REGISTRATION NUMBER PACTR202301917477205.
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Affiliation(s)
- Tijani Idris Ahmad Oseni
- Family Medicine, Edo State University Uzairue, Iyamho, Nigeria
- Department of Family Medicine, Edo State University Teaching Hospital Auchi, Auchi, Nigeria
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Tian X, Feng J, Chen S, Zhang Y, Zhang X, Xu Q, Wang P, Wu S, Wang A. Baseline and longitudinal cardiovascular health using Life's Essential 8 metrics with the risk of incident hypertension. Clin Exp Hypertens 2023; 45:2271190. [PMID: 37983187 DOI: 10.1080/10641963.2023.2271190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/10/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE The quantification of cardiovascular health (CVH) was updated by the American Heart Association recently by using the "Life's Essential 8" (LE8) score. We aimed to investigate the associations of baseline and longitudinal CVH status measured by the new LE8 score (except for blood pressure) with the risk of hypertension. METHODS A total of 52 990 participants with complete data on LE8 metrics and without hypertension were enrolled from the Kailuan study, Tangshan, China. The associations of incident hypertension with the overall baseline, time-updated, and time-varying CVH score (ranging 0 [lowest] to 100 [highest]), and each component of LE8, were assessed by Cox regressions. RESULTS During a median follow-up of 10.73 years 28 380 cases of incident hypertension were identified. The risk of hypertension attenuated with increased CVH score (Ptrend < 0.0001), the hazard ratios (HRs) in high CVH versus low CVH group was 0.54 (95% confidence interval [CI], 0.51-0.57) for baseline CVH, 0.47 (95% CI, 0.45-0.50) for time-updated CVH, and 0.59 (95% CI, 0.55-0.63) for time-varying CVH. The predictive value of CVH in predicting hypertension improved by using LE8 than using Life's Simple 7 metrics. Among LE8 components, body mass index score was the strongest risk factor for hypertension. Subgroup analyses showed that the benefit of a higher CVH score on hypertension was more prominent in young adults and in women (Pinteraction < 0.05). CONCLUSIONS A higher CVH score assessed by new LE8 is associated with a lower risk of subsequent hypertension, especially young adults and women.
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Affiliation(s)
- Xue Tian
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jingxuan Feng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Yijun Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaoli Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Qin Xu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Penglian Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
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Ji CY, Yang LR. Perioperative nursing care for hip arthroplasty patients with concomitant hypertension: A minireview. World J Clin Cases 2023; 11:8440-8446. [PMID: 38188203 PMCID: PMC10768512 DOI: 10.12998/wjcc.v11.i36.8440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/18/2023] [Accepted: 12/08/2023] [Indexed: 12/22/2023] Open
Abstract
Hip replacement (HA) is mainly indicated for the elderly, who generally suffer from various underlying diseases such as hypertension. This article provides a review of the key points of perioperative nursing care for patients with hypertension undergoing HA. It analyzes the key points of care during the perioperative period (preoperative, intraoperative, and postoperative) and proposes directions for the development of perioperative nursing care for HA. The prognosis for patients can be improved through the modification of traditional medical approaches and the application of new technologies and concepts.
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Affiliation(s)
- Chang-Yue Ji
- Department of Orthopedic Sports Medicine Joint Surgery, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Li-Ru Yang
- Department of Cardiovascular Medicine, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
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Nuryunarsih D, Herawati L, Badi'ah A, Donsu JDT, Okatiranti. Predicting Changes in Systolic and Diastolic Blood Pressure of Hypertensive Patients in Indonesia Using Machine Learning. Curr Hypertens Rep 2023; 25:377-383. [PMID: 37642805 PMCID: PMC10598158 DOI: 10.1007/s11906-023-01261-5] [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] [Accepted: 08/04/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE OF REVIEW This retrospective study investigated factors that influence the occurrence of decreased systolic and diastolic blood pressure including sociodemographic and economic factors, hypertension duration, cigarette consumption, alcohol consumption, duration of smoking, type of cigarettes, exercise, salt consumption, sleeping pills consumption, insomnia, and diabetes. These factors were applied to predict the reality of systolic and diastolic decrease using the machine learning algorithm Naïve Bayes, artificial neural network, logistic regression, and decision tree. RECENT FINDINGS The increase in blood pressure, both systolic and diastolic, is very harmful to the health because uncontrolled high systolic and diastolic blood pressure can cause various diseases such as congestive heart failure, kidney failure, and cardiovascular disease. There have been many studies examining the factors that influence the occurrence of hypertension, but few studies have used machine learning to predict hypertension. The machine learning models performed well and can be used for predicting whether a person with hypertension with certain characteristics will experience a decrease in their systolic or diastolic blood pressure after treatment with antihypertensive drugs.
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Affiliation(s)
- Desy Nuryunarsih
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Rd, Glasgow, G4 0BA, UK.
| | - Lucky Herawati
- Environmental Health Department, Health Polytechnic, Ministry of Health, Yogyakarta, Indonesia
| | - Atik Badi'ah
- Nursing Department, Health Polytechnic, Ministry of Health, Yogyakarta, Indonesia
| | | | - Okatiranti
- Nursing Department, University of Nottingham, Nottingham, UK
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Rocha RB, Bomtempo FF, Nager GB, Cenci GI, Telles JPM. Dual orexin receptor antagonists for the treatment of insomnia: systematic review and network meta-analysis. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:475-483. [PMID: 37257468 DOI: 10.1055/s-0043-1768667] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Several randomized clinical trials (RCTs) have shown that dual orexin receptor antagonists (DORAs) are effective in the treatment of chronic insomnia. However, the superiority of one particular DORA over the others remains unclear. OBJECTIVE To perform a network meta-analysis to evaluate the efficacy of different DORAs in patients with chronic insomnia. METHODS The Medline, Embase, and Cochrane Central databases were searched for RCTs that compared DORA with placebo in patients ≥ 18 years of age with a diagnosis of insomnia disorder. We pooled outcomes for wake time after sleep onset (WASO), latency to persistent sleep (LPS), total sleep time (TST), and adverse events (AEs). RESULTS We included 10 RCTs with 7,806 patients, 4,849 of whom received DORAs as the intervention. Overall, we found that DORAs were associated with the improvement of all analyzed efficacy outcomes. Concerning TST, an apparent dose-dependent pattern was noticed, with higher doses relating to a longer TST. Lemborexant 10mg provided the largest reduction in WASO (at month 1) in minutes (standardized mean difference [SMD] = -25.40; 95% confidence interval [95%CI] = -40.02--10.78), followed by suvorexant 20/15mg (SMD = -25.29; 95%CI = -36.42--14.15), which also appeared to provide the largest decrease in long-term WASO (SMD = -23.70; 95%CI = -35.89--11.51). The most frequent AEs were somnolence, nasopharyngitis, and headache, with rates of up to 14.8%. CONCLUSION Our results suggest that DORAs are associated with greater efficacy when compared with placebo in the treatment of insomnia, a complex 24-hour sleep disorder. Additionally, dosing might play an important role in the management of chronic insomnia.
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Affiliation(s)
| | | | - Gabriela Borges Nager
- Universidade Federal do Estado do Rio de Janeiro, Faculdade de Medicina, Rio de Janeiro RJ, Brazil
| | | | - João Paulo Mota Telles
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil
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Hou X, Hu J, Wang E, Wang J, Song Z, Hu J, Shi J, Zhang C. Self-Reported Sleep Disturbance is an Independent Predictor of All-Cause Mortality and Respiratory Disease Mortality in US Adults: A Population-Based Prospective Cohort Study. Int J Public Health 2023; 68:1605538. [PMID: 36865999 PMCID: PMC9971003 DOI: 10.3389/ijph.2023.1605538] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 01/20/2023] [Indexed: 02/16/2023] Open
Abstract
Objective: Self-reported sleep disturbance is common but its association with mortality has rarely been investigated. Methods: This prospective cohort analysis included 41,257 participants enrolled in the National Health and Nutrition Examination Survey from 2005 to 2018. Self-reported sleep disturbance in the present study refers to the patients who have ever consulted doctors or other professionals for trouble sleeping. Univariate and multivariate survey-weighted Cox proportional hazards models were used to evaluate the association of self-reported sleep disturbance with all-cause and disease-specific mortality. Results: Approximately 27.0% of US adults were estimated to have self-reported sleep disturbance. After adjusting for all sociodemographic variables, health behavioral factors, and common comorbidities, participants with self-reported sleep disturbance tend to have higher all-cause mortality risk with a hazard ratio (HR) of 1.17 (95% CI, 1.04-1.32) and chronic lower respiratory disease mortality risk (HR, 1.88; 95% CI, 1.26-2.80), but not cardiovascular disease mortality risk (HR, 1.19; 95% CI, 0.96-1.46) and cancer mortality risk (HR, 1.10; 95% CI, 0.90-1.35). Conclusion: Self-reported sleep disturbance could be associated with higher mortality in adults, and may need to be paid more attention in public health management.
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Affiliation(s)
- Xinran Hou
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jiajia Hu
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - E Wang
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jian Wang
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Zongbin Song
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jie Hu
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jian Shi
- Department of Anesthesiology, Changsha Yamei Plastic Surgery Hospital, Changsha, China
| | - Chengliang Zhang
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China,Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, Changsha, China,*Correspondence: Chengliang Zhang,
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12
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Lin L, Huang J, Liu Z, Chen P, Huang C. Associations of siesta and total sleep duration with hypertension or cardiovascular diseases in middle-aged and older adults. Clin Cardiol 2022; 46:159-170. [PMID: 36510696 PMCID: PMC9933105 DOI: 10.1002/clc.23954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/09/2022] [Accepted: 11/14/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Whether the ratio of siesta duration in the total sleep duration was associated with the occurrence of hypertension or cardiovascular diseases (CVDs) was unclear. HYPOTHESIS To explore the associations of siesta, and siesta ratio with hypertension or CVDs in middle-aged and older adults. METHODS This cohort study collected the data of 9247 middle-aged and older adults. The associations of siesta, and siesta ratio with hypertension were analyzed in 7619 participants while the associations of siesta, and siesta ratio with CVDs were analyzed in 8685 participants via univariate and multivariate logistic regression analysis. RESULTS Total sleep duration < 6 h (odd ratio [OR] = 1.168, 95% confidence interval [CI]: 1.023-1.335) and siesta ratios ≥ 0.4 (OR = 1.712, 95% CI: 1.129-2.594) were associated with increased risk of hypertension in middle-aged and older adults. Siesta ratio ≥ 0.4 was linked with higher risk of hypertension in males aged ≥ 60 years and total sleep duration < 6 h was correlated with elevated risk of hypertension in males < 60 years. The risk of CVDs was elevated in people with siesta duration < 0.5 h (OR = 2.053, 95% CI: 1.323-3.185). In females ≥60 years, the sleep duration at night < 6 h was associated with increased risk of CVDs. In females < 60 years, increased risk was observed in those with siesta duration < 0.5 h and sleep duration at night < 6 h. CONCLUSION Short sleep duration or high siesta ratio were associated with higher risk of hypertension. Short siesta duration, sleep duration at night or total sleep duration were correlated with an elevated risk of CVDs.
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Affiliation(s)
- Ling Lin
- Department of Emergency NursingFujian Medical University Union HospitalFuzhouChina
| | - Jingyi Huang
- Department of Emergency NursingFujian Medical University Union HospitalFuzhouChina
| | - Zixuan Liu
- Department of Emergency NursingFujian Medical University Union HospitalFuzhouChina
| | - Pengfei Chen
- Department of Emergency NursingFujian Medical University Union HospitalFuzhouChina
| | - Canyan Huang
- Department of Emergency NursingFujian Medical University Union HospitalFuzhouChina
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13
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Amisaki R, Kato M, Fujiyama M, Matsuda E, Hattori Y, Hirai M, Yanagihara K, Kinugasa Y, Yamamoto K. Difficulty initiating sleep in patients with heart failure: Impact of left atrial pressure. J Cardiol 2022; 80:365-372. [PMID: 35725947 DOI: 10.1016/j.jjcc.2022.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 05/26/2022] [Accepted: 06/03/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND Patients with heart failure (HF) often complain of sleep discomfort. Previous reports described that difficulty initiating sleep increased the cardiovascular risk in the general population. However, the association between difficulty initiating sleep and cardiac function in patients with HF remains unclear. This study aimed to investigate the associations between difficulty initiating sleep and clinical characteristics and cardiac function in patients with HF. METHODS Eighty-seven patients with HF who underwent overnight polysomnography for suspected sleep-disordered breathing were included. Patients were divided into two groups of the longer sleep latency (SL) group (SL ≥14 min, n = 44) and the shorter SL group (SL <14 min, n = 43). The median value of SL was defined as the time from lights-off to falling asleep. We compared the patients' characteristics, laboratory data, and polysomnographic and echocardiographic indices between the two groups. RESULTS The patients' median age was 67 years, and 85.1 % were men. There was lower beta blocker use [25 (56.8 %) vs. 34 (79.1 %), p = 0.046] and a higher peak mitral early filling velocity to mitral annular velocity ratio (E/e') [16.5 (14.2-21.7) vs. 13.7 (10.9-16.2), p = 0.005] in the longer SL group than in the shorter SL group. In multivariate logistic analysis, E/e' (odds ratio: 1.10, 95 % confidence interval: 1.01 to 1.19; p = 0.032) and systolic blood pressure before sleeping (odds ratio: 1.05, 95 % confidence interval: 1.00 to 1.10; p = 0.033) were significantly associated with a longer SL in patients with HF. CONCLUSIONS Increased left atrial pressure suggested by increased E/e' and increased systolic blood pressure before sleeping is independently associated with difficulty initiating sleep in patients with HF. Management of these hemodynamic imbalances is required to improve difficulty initiating sleep in patients with HF.
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Affiliation(s)
- Ryosuke Amisaki
- Department of Multidisciplinary Internal Medicine, Division of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Masahiko Kato
- Division of School of Health Science, Department of Pathobiological Science and Technology, Faculty of Medicine, Tottori University, Yonago, Japan.
| | - Misato Fujiyama
- Division of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Eriko Matsuda
- Division of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yuiko Hattori
- Division of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Masayuki Hirai
- Department of Multidisciplinary Internal Medicine, Division of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Kiyotaka Yanagihara
- Department of Multidisciplinary Internal Medicine, Division of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yoshiharu Kinugasa
- Department of Multidisciplinary Internal Medicine, Division of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Kazuhiro Yamamoto
- Department of Multidisciplinary Internal Medicine, Division of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Yonago, Japan
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Poza JJ, Pujol M, Ortega-Albás JJ, Romero O. Melatonin in sleep disorders. Neurologia 2022; 37:575-585. [PMID: 30466801 DOI: 10.1016/j.nrl.2018.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 08/06/2018] [Accepted: 08/18/2018] [Indexed: 12/19/2022] Open
Abstract
Melatonin is the main hormone involved in the control of the sleep-wake cycle. It is easily synthesisable and can be administered orally, which has led to interest in its use as a treatment for insomnia. Moreover, as production of the hormone decreases with age, in inverse correlation with the frequency of poor sleep quality, it has been suggested that melatonin deficit is at least partly responsible for sleep disorders. Treating this age-related deficit would therefore appear to be a natural way of restoring sleep quality, which is lost as patients age. However, despite the undeniable theoretical appeal of this approach to insomnia, little scientific evidence is available that supports any benefit of this substitutive therapy. Furthermore, the most suitable dose ranges and pharmaceutical preparations for melatonin administration are yet to be clearly defined. This review addresses the physiology of melatonin, the different pharmaceutical preparations, and data on its clinical usefulness.
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Affiliation(s)
- J J Poza
- Servicio de Neurología, Hospital Universitario Donostia, San Sebastián, España.
| | - M Pujol
- Unidad Multidisciplinar de Sueño, Hospital Universitario de Santa María, Lleida, España
| | - J J Ortega-Albás
- Unidad de Sueño, Hospital General Universitario de Castellón, Castellón, España
| | - O Romero
- Unidad Multidisciplinar de Sueño, Hospital Universitario Vall d́Hebron, Barcelona, España
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Siddiqui M, Moore T, Long DM, Burkholder GA, Willig A, Wyatt C, Heath S, Muntner P, Overton ET. Risk Factors for Incident Hypertension Within 1 Year of Initiating Antiretroviral Therapy Among People with HIV. AIDS Res Hum Retroviruses 2022; 38:735-742. [PMID: 35778856 PMCID: PMC9514597 DOI: 10.1089/aid.2021.0213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Hypertension (HTN) is a common comorbidity among people with HIV and associated with an increased risk for atherosclerotic cardiovascular disease and chronic kidney disease. The relationship of antiretroviral therapy (ART) initiation to incident HTN remains a clinical question. We determined HTN incidence at 48 weeks of follow-up among ART-naive participants without HTN and not taking antihypertensive medications at ART initiation through randomized clinical trials through the AIDS Clinical Trial Group between 1999 and 2011. We assessed the association of baseline characteristics, including randomized ART agents with HTN incidence at 48 weeks using Poisson regression models. Incident HTN was defined as blood pressure ≥130/80 mmHg, or use of antihypertensive medication. Among 2,614 participants, mean age was 37 ± 10 years, 79% male sex, and 36% African American race. After 48 weeks, 839 participants (32%) developed HTN. Receiving a non-nucleoside reverse transcriptase inhibitor (NNRTI) was associated with an increased relative risk (RR) of incident HTN, while the risk was lower for protease inhibitor use. Stavudine and efavirenz were associated with an increased RR of developing HTN, while tenofovir disoproxil fumarate, darunavir/ritonavir, and atazanavir/ritonavir were associated with a decreased risk of developing HTN. Additionally, older age, higher body mass index (BMI), and having hepatitis C were associated with an increased risk for developing HTN, while women and participants with a higher baseline CD4 count were at a decreased risk of developing HTN at 48 weeks. One third of these ART naive participants developed HTN after ART initiation. NNRTIs, notably efavirenz, and stavudine were associated with an increased risk of HTN. Additional factors associated with HTN included traditional factors like older age and higher BMI, and advanced HIV disease (lower CD4 count). (Clinicaltrials.gov: NCT00001137).
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Affiliation(s)
- Mohammed Siddiqui
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - T.J. Moore
- Health HIV, Washington, District of Columbia, USA
| | - Dustin M. Long
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Greer A. Burkholder
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Amanda Willig
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Christina Wyatt
- Department of Medicine, Duke University, Durham, North Carolina, USA
| | - Sonya Heath
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Paul Muntner
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Edgar Turner Overton
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Liu H, Yang L, Wan C, Li Z, Yan G, Han Y, Sun H, Wang X. Exploring potential mechanism of ciwujia tablets for insomnia by UPLC-Q-TOF-MS/MS, network pharmacology, and experimental validation. Front Pharmacol 2022; 13:990996. [PMID: 36110515 PMCID: PMC9468710 DOI: 10.3389/fphar.2022.990996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/08/2022] [Indexed: 11/24/2022] Open
Abstract
Insomnia, whether chronic or intermittent, is a common central nervous system disease. Ciwujia Tablet (CWT) is a well-known traditional Chinese medicine (TCM) made from the extract of Eleutherococcus senticosus (Rupr. & Maxim.) Maxim. This medication is commonly used for treating insomnia in China, but the lack of in-depth research focused on the chemical ingredients of CWT creates a gap in knowledge regarding its effective constituents against insomnia. Considering that the therapeutic material basis, targets, and pathways related to this drug have not been fully investigated by scholars in the field, the focus of this study is on identifying the chemical ingredients or structural characteristics of CWT by the UPLC-Q-TOF-MS/MS technique. Besides, concepts of network pharmacology were also used to investigate the targets and pathways of CWT. An insomnia rat model was established by intraperitoneal injection of p-chlorophenylalanine, and the results were verified through various experiments. A total of 46 ingredients were identified in CWT, such as eleutheroside B, eleutheroside E, isofraxidin, and chlorogenic acid. Among them, 17 ingredients with good solubility, favorable gastrointestinal absorption, and high bioavailability were selected for network pharmacological analysis. It was concluded that CWT participated in the regulation of neurotransmitter levels, modulation of ion transport, neurotransmitter receptor activity, synaptic transmission, dopaminergic transmission and other essential processes. Results from the animal experiments showed that CWT can increase the content of inhibitory neurotransmitters 5-HT and GABA in the brain, reduce the synthesis of excitatory escalating transmitters DA and NE, shorten the sleep latency and prolong the sleep duration of insomnia rats. Furthermore, CWT could significantly alleviate the symptoms of insomnia in model rats. Identifying the chemical ingredients of CWT in this experiment is of great significance for exploring its potential curative effects, which provides a solid basis for further understanding the therapeutic value of this medication.
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Affiliation(s)
- Hongda Liu
- National Chinmedomics Research Center, National TCM Key Laboratory of Serum Pharmacochemistry, Metabolomics Laboratory, Department of Pharmaceutical Analysis, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Le Yang
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunlei Wan
- National Chinmedomics Research Center, National TCM Key Laboratory of Serum Pharmacochemistry, Metabolomics Laboratory, Department of Pharmaceutical Analysis, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Zhineng Li
- National Chinmedomics Research Center, National TCM Key Laboratory of Serum Pharmacochemistry, Metabolomics Laboratory, Department of Pharmaceutical Analysis, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Guangli Yan
- National Chinmedomics Research Center, National TCM Key Laboratory of Serum Pharmacochemistry, Metabolomics Laboratory, Department of Pharmaceutical Analysis, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Ying Han
- National Chinmedomics Research Center, National TCM Key Laboratory of Serum Pharmacochemistry, Metabolomics Laboratory, Department of Pharmaceutical Analysis, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Hui Sun
- National Chinmedomics Research Center, National TCM Key Laboratory of Serum Pharmacochemistry, Metabolomics Laboratory, Department of Pharmaceutical Analysis, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xijun Wang
- National Chinmedomics Research Center, National TCM Key Laboratory of Serum Pharmacochemistry, Metabolomics Laboratory, Department of Pharmaceutical Analysis, Heilongjiang University of Chinese Medicine, Harbin, China
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macau SAR, China
- *Correspondence: Xijun Wang,
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Self-reported sleep-disordered breathing and insomnia in association with hypertension: a community-based study in Eastern China. Blood Press Monit 2022; 27:320-326. [PMID: 35866504 DOI: 10.1097/mbp.0000000000000609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We aimed to explore the associations of self-reported sleep-disordered breathing (SDB) and insomnia with hypertension based on a community-based survey among adults in Suzhou, Eastern China. METHODS The Suzhou Food Consumption and Health Survey was conducted from 2018 to 2019. A multistage random sampling method was used to recruit potential participants. Associations of SDB and insomnia with hypertension were examined by multivariable logistic regression models with adjustment for covariates. In addition, sensitivity analysis was used to reinforce our findings. RESULTS A total of 2728 participants were included in the final analysis. SDB (OR, 1.83; 95% CI, 1.44-2.34; P < 0.001) and insomnia (OR, 1.31; 95% CI, 1.04-1.65; P < 0.001) were significantly associated with prevalent hypertension after multivariable adjustments. In the subgroup analysis by age groups and sex, the association between SDB and hypertension persisted in all groups, whereas the association between insomnia and hypertension remained significant in males and different age groups. In addition, SDB was positively correlated with DBP. Notably, participants with comorbid SDB and insomnia had the highest risk for hypertension (OR, 1.95; 95% CI, 1.40-2.72; P < 0.001). CONCLUSION Both SDB and insomnia were associated with the prevalence of hypertension among the Chinese adults, whereas the comorbid conditions conveyed the highest risk for hypertension. Our findings provide a new insight for the potential pathogenesis of hypertension and a prevention strategy of hypertension among community adults.
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18
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Sidani S, Fox MT, Butler JI, Maimets IK. Development of a multi-component intervention to promote sleep in older persons with dementia transitioning from hospital to home. Int J Older People Nurs 2022; 17:e12463. [PMID: 35362239 DOI: 10.1111/opn.12463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 10/18/2021] [Accepted: 02/03/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hospitalised older persons with dementia are commonly discharged with intensified sleep disturbances. These disturbances can impede the recovery process. Nurses are well-positioned to assist persons with dementia and their family caregivers in managing sleep disturbances during the transition from hospital to home. OBJECTIVES To describe the development of a multi-component intervention to promote sleep. METHODS We applied three stages of the intervention mapping method to develop a non-pharmacological, multi-component sleep intervention. The first stage involved a review of the literature to generate an understanding of the determinants of sleep disturbances experienced by persons with dementia in hospital and home settings. The second stage consisted of a literature review to identify therapies for managing commonly reported determinants of sleep disturbances. The third stage entailed delineation of the intervention components. RESULTS The most common determinants of sleep disturbances experienced by persons with dementia in hospital and home settings were: physiological changes associated with ageing, sleep environments non-conducive to sleep, limited exposure to light and engagement in physical activity, stress and sleep-related beliefs and behaviours. Therapies found effective included: light therapy, physical activity therapy, sleep hygiene, and stimulus control therapy. These therapies were integrated into a multi-component sleep intervention to be provided using the teach-back technique, during and following hospitalisation. DISCUSSION Consistent with the principles of patient engagement, the multi-component sleep intervention will be evaluated for its acceptability and feasibility. IMPLICATIONS FOR PRACTICE The intervention has potentials to improve sleep during the transition from hospital to home.
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Affiliation(s)
- Souraya Sidani
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
| | - Mary T Fox
- School of Nursing, York University, Toronto, Ontario, Canada.,York University Centre for Aging Research and Education, Toronto, Ontario, Canada
| | - Jeffrey I Butler
- School of Nursing, York University, Toronto, Ontario, Canada.,York University Centre for Aging Research and Education, Toronto, Ontario, Canada
| | - Ilo-Katryn Maimets
- Steacie Science and Engineering Library, York University, Toronto, Ontario, Canada
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19
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Zhang W, Liu Y, Yu J, Li D, Jia Y, Zhang Q, Gao Y, Wan Z, Wei W. Exercise improves sleep quality in older adults: a protocol for a systematic review and meta-analysis. BMJ Open 2022; 12:e047555. [PMID: 35105610 PMCID: PMC8804655 DOI: 10.1136/bmjopen-2020-047555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Sleep disturbance is a common problem among the elderly and is associated with physical and mental health. Exercise has been reported as an alternative therapeutic strategy for people with sleep disturbances. However, this topic has not been systematically reviewed for older adults. This study was conducted to provide a protocol to systematically evaluate the effects of exercise on sleep quality in the elderly. METHODS AND ANALYSIS An electronic search of the PubMed, Embase and Cochrane Library databases will be performed with no language restrictions, and data extraction will be performed by two independent reviewers. The reviewers will discuss and resolve any differences, and a third reviewer will be consulted in cases of uncertainty. Randomised controlled trials will be selected. The primary outcome will be an objective measurement of sleep quality (eg, polysomnography). The secondary outcomes will be self-reported sleep quality (using the Pittsburgh Sleep Quality Index scale), and adverse events (such as falls and fractures). RevMan V.5.3.5 and Stata V.16.0 software will be used for meta-analysis. If the heterogeneity tests show slight or no statistical heterogeneity, the fixed effects model will be used; in other cases, the random effect model will be used for data synthesis. ETHICS AND DISSEMINATION The protocol does not require ethical approval. The findings will be disseminated in peer-reviewed publications and journals. PROSPERO REGISTRATION NUMBER CRD42021287980.
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Affiliation(s)
- Wei Zhang
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- School of Nursing, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Institute of Disaster Medicine, Sichuan University, Chengdu, People's Republic of China
- Nursing Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
| | - Yi Liu
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- School of Nursing, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Institute of Disaster Medicine, Sichuan University, Chengdu, People's Republic of China
- Nursing Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
| | - Jing Yu
- School of Nursing, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Institute of Disaster Medicine, Sichuan University, Chengdu, People's Republic of China
- Nursing Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
| | - Dongze Li
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yu Jia
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Qin Zhang
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- School of Nursing, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Institute of Disaster Medicine, Sichuan University, Chengdu, People's Republic of China
- Nursing Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
| | - Yongli Gao
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- School of Nursing, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Institute of Disaster Medicine, Sichuan University, Chengdu, People's Republic of China
- Nursing Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
| | - Zhi Wan
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Wei Wei
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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O’Brien LM. Sleep in Pregnancy. Respir Med 2022. [DOI: 10.1007/978-3-030-93739-3_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Considering Psychosocial Factors When Investigating Blood Pressure in Patients with Short Sleep Duration: A Propensity Score Matched Analysis. Int J Hypertens 2021; 2021:7028942. [PMID: 34888099 PMCID: PMC8651353 DOI: 10.1155/2021/7028942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/16/2021] [Accepted: 11/23/2021] [Indexed: 11/30/2022] Open
Abstract
Few studies have considered psychosocial characteristics when investigating the associations between sleep duration and blood pressure (BP). In this study, we took propensity score matching (PSM) to adjust for psychosocial characteristics when comparing BP between individuals with short sleep duration and those with normal sleep duration. A total of 429 participants were included. 72 participants with sleep duration ≤6 h and 65 participants with sleep duration >6 h were matched after PSM. We compared office BP, 24-hour BP, and prevalence of hypertension in the populations before and after PSM, respectively. In the unmatched population, participants with sleep duration ≤6 h were observed with higher office diastolic BP (DBP) and 24-h systolic BP (SBP)/DBP (all P < 0.05). In the matched populations, the differences between the two groups (sleep duration ≤6 h vs. sleep duration >6 h) in office DBP (88.4 ± 10.9 vs. 82.5 ± 11.1 mm Hg; P=0.002), 24-h SBP (134.7 ± 12.0 vs. 129.3 ± 11.6 mm Hg; P=0.009), and 24-h DBP (83.4 ± 9.9 vs. 78.1 ± 10.1 mm Hg; P=0.002) become more significant. Participants with sleep duration ≤6 h only show higher prevalence of hypertension based on 24-h BP data, while analysis after PSM further revealed that these with sleep duration ≤6 h presented about 20% higher prevalence of elevated BP up to office diagnosed hypertension threshold. Therefore, psychosocial characteristics accompanied with short sleep duration should be fully valued in individuals at risks for elevated BP. This trial is registered with NCT03866226.
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Dong YJ, Jiang NH, Zhan LH, Teng X, Fang X, Lin MQ, Xie ZY, Luo R, Li LZ, Li B, Zhang BB, Lv GY, Chen SH. Soporific effect of modified Suanzaoren Decoction on mice models of insomnia by regulating Orexin-A and HPA axis homeostasis. Biomed Pharmacother 2021; 143:112141. [PMID: 34509822 DOI: 10.1016/j.biopha.2021.112141] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/26/2021] [Accepted: 08/31/2021] [Indexed: 12/12/2022] Open
Abstract
AIM Modified Suanzaoren Decoction (MSZRD) is obtained by improving Suanzaoren Decoction (SZRT), a traditional Chinese herbal prescription that has been used to treat insomnia for more than thousands of years. Our previous study showed that MSZRD can improve the gastrointestinal discomfort related insomnia by regulating Orexin-A. This study is the first study to evaluate the effects and possible mechanisms of MSZRD in mice with insomnia caused by p-chlorophenylalanine (PCPA) combined with multifactor random stimulation. METHODS After 14 days of multifactor stimulation to ICR mice, a PCPA suspension (30 mg/mL) was injected intraperitoneally for two consecutive days to establish an insomnia model. Three different doses of MSZRD (3.6, 7.2, and 14.4 g/kg/day) were given to ICR mice for 24 days. The food intake and back temperature were measured, and behavioral tests and pentobarbital sodium-induced sleep tests were conducted. The levels of Orexin-A, corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and adrenocortical hormones (CORT) in the serum and 5-hydroxytryptamine (5-HT), dopamine (DA), and norepinephrine (NE) in hypothalamus were measured using enzyme-linked immunosorbent assay (ELISA) kits. The levels of γ-aminobutyric acid (GABA) and glutamic acid (Glu) were measured by high-performance liquid chromatography (HPLC). The expression of 5HT1A receptor (5-HTRIA) and orexin receptor 2 antibody (OX2R) was measured by Western blot (WB) and immunohistochemical staining (ICH). Hematoxylin and eosin (H&E) staining and Nissl staining were used to assess the histological changes in hypothalamus tissue. RESULTS Of note, MSZRD can shorten the sleep latency of insomnia mice (P < 0.05, 0.01), prolonged the sleep duration of mice (P < 0.05, 0.01), and improve the circadian rhythm disorder relative to placebo-treated animals. Furthermore, MSZRD effectively increased the content of 5-HT and 5-HTR1A protein in the hypothalamus of insomnia mice (P < 0.05, 0.01), while downregulated the content of DA and NE (P < 0.05, 0.01). Importantly, serum GABA concentration was increased by treatment with MSZRD (P < 0.05), as reflected by a decreased Glu/GABA ratio (P < 0.05). Moreover, MSZRD decreased the levels of CORT, ACTH, and CRH related hormones in HPA axis (P < 0.05, 0.01). At the same time, MSZRD significantly downregulated the serum Orexin-A content in insomnia mice (P < 0.05), as well as hypothalamic OX2R expression (P < 0.05). In addition, MSZRD also improved the histopathological changes in hypothalamus in insomnia mice. CONCLUSION MSZRD has sleep-improvement effect in mice model of insomnia. The mechanism may be that regulating the expression of Orexin-A affects the homeostasis of HPA axis and the release of related neurotransmitters in mice with insomnia.
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Affiliation(s)
- Ying-Jie Dong
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, No. 18, Chaowang Road, Xiacheng District, Hangzhou, Zhejiang 310014, China
| | - Ning-Hua Jiang
- The Second Affiliated Hospital of Jiaxing University, No. 1518, Huancheng North Road, Nanhu District, Jaxing, Zhejiang 314001, China
| | - Liang-Hui Zhan
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, No. 18, Chaowang Road, Xiacheng District, Hangzhou, Zhejiang 310014, China
| | - Xi Teng
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, No. 18, Chaowang Road, Xiacheng District, Hangzhou, Zhejiang 310014, China
| | - Xi Fang
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, No. 18, Chaowang Road, Xiacheng District, Hangzhou, Zhejiang 310014, China
| | - Min-Qiu Lin
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, No. 18, Chaowang Road, Xiacheng District, Hangzhou, Zhejiang 310014, China
| | - Zhi-Yi Xie
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, No. 18, Chaowang Road, Xiacheng District, Hangzhou, Zhejiang 310014, China
| | - Rong Luo
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, No. 18, Chaowang Road, Xiacheng District, Hangzhou, Zhejiang 310014, China
| | - Lin-Zi Li
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, No. 18, Chaowang Road, Xiacheng District, Hangzhou, Zhejiang 310014, China
| | - Bo Li
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, No. 18, Chaowang Road, Xiacheng District, Hangzhou, Zhejiang 310014, China
| | - Bei-Bei Zhang
- Center for Food Evaluation, State Administrition for Market Regulation, No. 188 Western Road of South Fourth Ring Road, Fengtai District, Beijing 100070, China.
| | - Gui-Yuan Lv
- College of Pharmaceutical Science, Zhejiang Chinese Medical University, No. 548, Binwen Road, Binjiang District, Hangzhou, Zhejiang 310053, China.
| | - Su-Hong Chen
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, No. 18, Chaowang Road, Xiacheng District, Hangzhou, Zhejiang 310014, China.
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Li C, Shang S. Relationship between Sleep and Hypertension: Findings from the NHANES (2007-2014). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157867. [PMID: 34360157 PMCID: PMC8345503 DOI: 10.3390/ijerph18157867] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/17/2021] [Accepted: 07/21/2021] [Indexed: 11/24/2022]
Abstract
Background: To evaluate the association of sleep factors (sleep duration, self-reported trouble sleeping, diagnosed sleep disorder) and combined sleep behaviors with the risk of hypertension. Methods: We analyzed 12,166 adults aged 30–79 years who participated in the 2007–2014 National Health and Nutrition Examination Survey. Sleep duration, self-reported trouble sleeping and sleep disorders were collected using a standardized questionnaire. We included three sleep factors (sleep duration, self-reported trouble sleeping and sleep disorder) to generate an overall sleep score, ranging from 0 to 3. We then defined the sleep pattern as “healthy sleep pattern” (overall sleep score = 3), “intermediate sleep pattern” (overall sleep score = 2), and “poor sleep pattern” (0 ≤ overall sleep score ≤ 1) based on the overall sleep score. The definition of hypertension was based on self-reported antihypertensive medication use or biological measurement (systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg). We used weighted logistic regression models to investigate the associations between sleep and hypertension. Results: The overall prevalence of hypertension was 37.8%. A short sleep duration (OR = 1.20, 95% CI: 1.08 to 1.33, p = 0.001), self-reported trouble sleeping (OR = 1.45, 95% CI: 1.28 to 1.65, p < 0.001) and sleep disorder (OR = 1.33, 95% CI: 1.07 to 1.66, p = 0.012) were related to the risk of hypertension. Poor sleep patterns were closely correlated with the risk of hypertension (OR = 1.90, 95% CI: 1.62 to 2.24). Conclusions: Participants with poor sleep patterns were associated with an increased risk for hypertension.
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Ahnaou A, Drinkenburg WHIM. Sleep, neuronal hyperexcitability, inflammation and neurodegeneration: Does early chronic short sleep trigger and is it the key to overcoming Alzheimer's disease? Neurosci Biobehav Rev 2021; 129:157-179. [PMID: 34214513 DOI: 10.1016/j.neubiorev.2021.06.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 05/13/2021] [Accepted: 06/25/2021] [Indexed: 01/13/2023]
Abstract
Evidence links neuroinflammation to Alzheimer's disease (AD); however, its exact contribution to the onset and progression of the disease is poorly understood. Symptoms of AD can be seen as the tip of an iceberg, consisting of a neuropathological build-up in the brain of extracellular amyloid-β (Aβ) plaques and intraneuronal hyperphosphorylated aggregates of Tau (pTau), which are thought to stem from an imbalance between its production and clearance resulting in loss of synaptic health and dysfunctional cortical connectivity. The glymphatic drainage system, which is particularly active during sleep, plays a key role in the clearance of proteinopathies. Poor sleep can cause hyperexcitability and promote Aβ and tau pathology leading to systemic inflammation. The early neuronal hyperexcitability of γ-aminobutyric acid (GABA)-ergic inhibitory interneurons and impaired inhibitory control of cortical pyramidal neurons lie at the crossroads of excitatory/inhibitory imbalance and inflammation. We outline, with a prospective framework, a possible vicious spiral linking early chronic short sleep, neuronal hyperexcitability, inflammation and neurodegeneration. Understanding the early predictors of AD, through an integrative approach, may hold promise for reducing attrition in the late stages of neuroprotective drug development.
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Affiliation(s)
- A Ahnaou
- Dept. of Neuroscience Discovery, Janssen Research & Development, A Division of Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse, B-2340, Belgium.
| | - W H I M Drinkenburg
- Dept. of Neuroscience Discovery, Janssen Research & Development, A Division of Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse, B-2340, Belgium
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Yu H, Luo J, Chen K, Pollitt KJG, Liew Z. Solid fuels use for cooking and sleep health in adults aged 45 years and older in China. Sci Rep 2021; 11:13304. [PMID: 34172775 PMCID: PMC8233310 DOI: 10.1038/s41598-021-92452-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/04/2021] [Indexed: 12/04/2022] Open
Abstract
Outdoor air pollution has been linked to poor sleep health, but limited studies have investigated the relationship between solid cooking fuels and sleep health in adults. Therefore, we analyzed data from the China Health and Retirement Survey (CHARLS), a national survey of about 17,000 residents aged over 45. Participants were restricted to those who participated in CHARLS 2011, 2013 and 2015 (n = 8,668). Sleep health was indicated by self-reported average sleep hours at night and the numbers of unrested days/week in CHARLS 2015. We analyzed cooking fuel types reported and assessed the duration of solid fuels usage as consistent (indicated use in all three surveys or 6 + years) or inconsistent use (indicated use in one or two surveys or 1-4 years). We found consistent use of solid fuels was associated with a shorter sleep duration (OR = 1.17 95% CI 1.01, 1.35 for ≤ 6 h vs. 7-9 h/day) and higher frequencies of feeling unrested (OR = 1.32 95% CI 1.12, 1.55 for ≥ 5 days/week vs. none) compared with cleaner fuels use. The associations for inconsistent solid fuels use and sleep health were in the similar direction but smaller in magnitude. Further research is needed to confirm our findings and evaluate the exposure impact of specific fuel types to inform intervention strategies.
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Affiliation(s)
- Haiqing Yu
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06510, USA
| | - Jiajun Luo
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06510, USA
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06510, USA
| | - Krystal J Godri Pollitt
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06510, USA
- Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06510, USA.
- Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT, 06510, USA.
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Zhou F, Liu Z, Guo Y, Xu H. Association of short sleep with risk of periodontal disease: A meta-analysis and Mendelian randomization study. J Clin Periodontol 2021; 48:1076-1084. [PMID: 34109656 DOI: 10.1111/jcpe.13483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 04/22/2021] [Accepted: 04/27/2021] [Indexed: 12/27/2022]
Abstract
AIM The aim of this meta-analysis and Mendelian randomization (MR) study was to assess the association between short sleep and periodontal disease, including tooth loss and periodontitis. MATERIALS AND METHODS The meta-analysis of relevant studies was conducted to assess the association between short sleep and periodontal disease. MR analyses were conducted with the inverse-variance-weighted (IVW) method, weighted median method, MR-Egger method, and MR-Robust Adjusted Profile Score (RAPS) method to assess the causal effect of short sleep on tooth loss and periodontitis. RESULTS Seven cross-sectional studies involving 40,196 individuals were included in the meta-analysis. The association between short sleep and periodontal disease was not statistically significant (odds ratios (OR) =1.13, 95% confidence interval (CI): 0.99, 1.28; p = 0.076). In the MR analysis, we did not observe statistically significant causal associations of genetically determined short sleep with tooth loss (β: -0.056; 95% CI: -0.181 to 0.068; p = 0.376) and periodontitis (β: -0.112; 95% CI: -0.340 to 0.117; p = 0.339). CONCLUSIONS Short sleep is not associated with the risk of periodontal disease according to current evidence. Future studies need to pay attention to the measurement of sleep duration, the choice of statistical models, and other domains of sleep health.
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Affiliation(s)
- Feixiang Zhou
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zongyan Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yicong Guo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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Trends in the prescription of drugs used for insomnia: an open-cohort study in Australian general practice, 2011-2018. Br J Gen Pract 2021; 71:e877-e886. [PMID: 33950853 PMCID: PMC8366783 DOI: 10.3399/bjgp.2021.0054] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/19/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Despite an increase in the prevalence of sleep problems, few studies have investigated changes in the prescribing of drugs that are often used to manage insomnia. AIM To explore changes in the pattern of benzodiazepine (BZD), Z-drug (zolpidem, zopiclone), and non-BZD prescriptions. DESIGN AND SETTING Open-cohort study comprising 1 773 525 patients (55 903 294 consultations) who attended one of 404 Australian general practices at least three times in two consecutive years between 2011 and 2018. METHOD Data were extracted from MedicineInsight, a database of 662 general practices in Australia. Prescription rates per 1000 consultations, the proportion of repeat prescriptions above recommendations, and the proportion of prescriptions for patients with a recent (within 2 years) recorded diagnosis of insomnia were analysed using adjusted regression models. RESULTS Rates of BZD, Z-drug, and non-BZD prescriptions were 56.6, 4.4, and 15.5 per 1000 consultations in 2011 and 41.8, 3.5, and 21.5 per 1000 consultations in 2018, respectively. Over the whole study period, temazepam represented 25.3% of the prescriptions and diazepam 21.9%. All BZD and zolpidem prescriptions declined over the whole study period (annual change varying from -1.4% to -10.8%), but non-BZD and zopiclone prescriptions increased in the same period (annual change 5.0% to 22.6%). Repeat prescriptions that exceeded recommended levels remained at <10% for all medications, except melatonin (64.5%), zolpidem (63.3%), zopiclone (31.4%), and alprazolam (13.3%). In 2018, >50% of Z-drug and melatonin prescriptions were for patients with insomnia. There was an annual increase of 0.8-5.9% in the proportion of prescriptions associated with a recently recorded diagnosis of insomnia. CONCLUSION Overall, BZD prescriptions in Australia declined between 2011 and 2018. However, the prescription of some of these drugs increased for patients with a recently recorded diagnosis of insomnia. This is concerning because of the potential adverse effects of these medications and the risk of dependence.
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Yang F, Zhang Y, Qiu R, Tao N. Association of sleep duration and sleep quality with hypertension in oil workers in Xinjiang. PeerJ 2021; 9:e11318. [PMID: 33987006 PMCID: PMC8101473 DOI: 10.7717/peerj.11318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 03/30/2021] [Indexed: 11/20/2022] Open
Abstract
Objective The aim of this study is to explore sleep status and hypertension among oil workers in Xinjiang, China. It may provide new ideas and basis for the precise prevention and treatment of hypertension in occupational population. Methods Sleep status and hypertension were investigated in 3,040 workers by a multi-stage cluster sampling method in six oil field bases in Karamay City, Xinjiang. The Pittsburgh Sleep Quality Index was used to evaluate the sleep status of workers. Logistic regression was used to analyze the relationship between sleep duration and sleep quality, and hypertension. Stratified analysis was also performed. Results Our results show: 1. Insufficient sleep duration (OR = 1.51, 95% CI [1.19–1.90]) and poor sleep quality (OR = 1.78, 95% CI [1.33–2.38] were positively associated with hypertension. 2. Stratified analysis indicated insufficient sleep duration was associated with increased risk of hypertension in females (OR = 1.54, 95% CI [1.16–2.04]) than males (OR = 1.49, 95% CI [1.00–2.23]), and the risk of hypertension in the group <30 years old (OR = 9.03, 95% CI [2.32–35.15]) was higher than that in the group of 30–45 years old (OR = 1.59, 95% CI [1.14–2.20]). However, in the group > 45 years old, sleeping > 8 h was associated with increased risk of hypertension (OR = 3.36, 95% CI [1.42–7.91]). Oil workers doing shift work had a higher risk of hypertension (OR = 1.55, 95% CI [1.16–2.07]) to no shift work (OR = 1.48, 95% CI [1.02–2.15]). The risk of hypertension in the group with < 10 years of service (OR = 4.08, 95% CI [1.92–8.83]) was higher than that in the group with length of service of 10–20 years (OR = 2.79, 95% CI [1.59–4.86]). Poor sleep quality was associated with risk for hypertension in females (OR = 1.78, 95% CI [1.26–2.49]), those doing shift work (OR = 1.70, 95% CI [1.17–2.47]), those with length of service of > 20 years (OR = 1.64, 95% CI [1.18–2.27]). The risk of hypertension in the group 30–45 years old is higher than that in the group > 45 years old (OR30–45 years old = 1.71, 95% CI [1.10–2.66]; OR > 45 years old = 1.60, 95% CI [1.09–2.34]). Conclusion Insufficient sleep duration and poor sleep quality are the potential factors affecting hypertension in Xinjiang oil workers.
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Affiliation(s)
- Fen Yang
- School of Public Health, Xinjiang Medical University, Xinjiang, China
| | - Yuanyue Zhang
- School of Public Health, Xinjiang Medical University, Xinjiang, China
| | - Ruiying Qiu
- School of Public Health, Xinjiang Medical University, Xinjiang, China
| | - Ning Tao
- School of Public Health, Xinjiang Medical University, Xinjiang, China.,Clinical Postdoctoral Mobile Station, Xinjiang Medical University, Xinjiang, China
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García-Marín LM, Campos AI, Martin NG, Cuéllar-Partida G, Rentería ME. Inference of causal relationships between sleep-related traits and 1,527 phenotypes using genetic data. Sleep 2021; 44:5893494. [PMID: 32805044 DOI: 10.1093/sleep/zsaa154] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/30/2020] [Indexed: 12/20/2022] Open
Abstract
STUDY OBJECTIVE Sleep is essential for both physical and mental health, and there is a growing interest in understanding how different factors shape individual variation in sleep duration, quality and patterns, or confer risk for sleep disorders. The present study aimed to identify novel inferred causal relationships between sleep-related traits and other phenotypes, using a genetics-driven hypothesis-free approach not requiring longitudinal data. METHODS We used summary-level statistics from genome-wide association studies and the latent causal variable (LCV) method to screen the phenome and infer causal relationships between seven sleep-related traits (insomnia, daytime dozing, easiness of getting up in the morning, snoring, sleep duration, napping, and morningness) and 1,527 other phenotypes. RESULTS We identify 84 inferred causal relationships. Among other findings, connective tissue disorders increase insomnia risk and reduce sleep duration; depression-related traits increase insomnia and daytime dozing; insomnia, napping, and snoring are affected by obesity and cardiometabolic traits and diseases; and working with asbestos, thinner, or glues may increase insomnia risk, possibly through an increased risk of respiratory disease or socio-economic related factors. CONCLUSION Overall, our results indicate that changes in sleep variables are predominantly the consequence, rather than the cause, of other underlying phenotypes and diseases. These insights could inform the design of future epidemiological and interventional studies in sleep medicine and research.
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Affiliation(s)
- Luis M García-Marín
- Genetic Epidemiology Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Adrián I Campos
- Genetic Epidemiology Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Nicholas G Martin
- Genetic Epidemiology Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Gabriel Cuéllar-Partida
- Genetic Epidemiology Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Miguel E Rentería
- Genetic Epidemiology Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Global Brain Health Institute, University of California, San Francisco, CA, USA
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Associations between fecal short-chain fatty acids and sleep continuity in older adults with insomnia symptoms. Sci Rep 2021; 11:4052. [PMID: 33603001 PMCID: PMC7893161 DOI: 10.1038/s41598-021-83389-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 02/02/2021] [Indexed: 12/18/2022] Open
Abstract
Insomnia is a disorder characterized by difficulty falling asleep and poor sleep continuity and is associated with increased risks for physical and cognitive decline. Insomnia with short sleep duration is considered the most biologically severe phenotype of the disorder. Evidence suggests that short-chain fatty acids (SCFAs), the main byproducts of fiber fermentation in the gut, may affect sleep via gut–brain communications. This study explores associations between SCFAs and sleep continuity and compares SCFA concentrations in short vs. normal sleep insomnia phenotypes in older adults. Fifty-nine participants with insomnia symptoms (≥ 65 years), completed 2 weeks of objective sleep monitoring (actigraphy), and were divided into short and normal sleep duration phenotypes via cluster analysis. Sleep measures included total sleep time (TST), sleep onset latency (SOL), sleep efficiency (SE), and wake after sleep onset (WASO). Stool samples were collected and fecal SCFA concentrations were determined by gas-chromatography-mass-spectrometry (GCMS). Higher concentrations of acetate, butyrate, and propionate, and total SCFAs, were associated with lower SE and longer SOL after controlling for Body Mass Index (BMI). Concentrations were higher in the short sleep duration phenotype. Age, BMI, TST, and SOL explained 40.7% of the variance in total SCFAs. Findings contribute to understanding pathways along the gut–brain axis and may lead to the use of SCFAs as biomarkers of insomnia phenotypes.
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Jeon B, Luyster FS, Callan JA, Chasens ER. Depressive Symptoms in Comorbid Obstructive Sleep Apnea and Insomnia: An Integrative Review. West J Nurs Res 2021:193945921989656. [PMID: 33533324 PMCID: PMC8329133 DOI: 10.1177/0193945921989656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The purpose of this integrative review was to synthesize evidence concerning the relationship between comorbid obstructive sleep apnea and insomnia (OSA+I), and depressive symptoms. OSA and insomnia are common sleep disorders, recently comorbid OSA+I has been recognized as prevalent in adults. Although each sleep disorder increases the risk and severity of depressive symptoms, the effect of comorbid OSA+I on depressive symptoms remains unclear. A systematic search of PubMed, CINAHL, and PsycINFO identified 15 data-based studies. All the studies were observational with either a cross-sectional (n = 14) or a case-control design (n = 1). Study quality was assessed. Most of the studies (n = 14) indicated that comorbid OSA+I had an additive role on depressive symptoms. Insomnia appeared to have a more important role than OSA in increasing the severity of depressive symptoms in persons with comorbid OSA+I.
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Affiliation(s)
- Bomin Jeon
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Faith S Luyster
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Judith A Callan
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eileen R Chasens
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
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Li X, Sotres-Alvarez D, Gallo LC, Ramos AR, Aviles-Santa L, Perreira KM, Isasi CR, Zee PC, Savin KL, Schneiderman N, Wassertheil-Smoller S, Sofer T, Daviglus M, Redline S. Associations of Sleep-disordered Breathing and Insomnia with Incident Hypertension and Diabetes. The Hispanic Community Health Study/Study of Latinos. Am J Respir Crit Care Med 2021; 203:356-365. [PMID: 32758008 PMCID: PMC7874314 DOI: 10.1164/rccm.201912-2330oc] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Rationale: Sleep disorders are associated with hypertension and diabetes, which are primary risk factors for cardiovascular diseases and mortality. It is important to understand these associations in Hispanic/Latino individuals, in whom cardiovascular death is the leading cause of mortality.Objectives: To investigate the prospective associations of sleep-disordered breathing (SDB) and insomnia with incident hypertension and diabetes among U.S. Hispanic/Latino people over 6 years of follow-up and to assess potential sex differences in these associations.Methods: Data from 11,623 Hispanic/Latino participants in the Hispanic Community Health Study/Study of Latinos (visit 1, 2008-2011; visit 2, 2014-2017) were analyzed using survey logistic regression models, adjusting for potential confounders.Measurements and Main Results: SDB (apnea-hypopnea index of 5 or more) and insomnia (Women's Health Initiative Insomnia Rating Scale of 9 or more) were measured at baseline. Incident hypertension (stage 2 or greater) and diabetes were defined according to national guidelines. In the target population, 52.6% were women, with a mean age of 41.1 ± 14.9 years at baseline. SDB was associated with 1.54 higher adjusted odds of incident hypertension (95% confidence interval [CI], 1.18-2.00) and 1.33 higher odds of incident diabetes (95% CI, 1.05-1.67) compared with no SDB. Insomnia was associated with incident hypertension (odds ratio, 1.37; 95% CI, 1.11-1.69) but not with diabetes. The association between insomnia and incident hypertension was stronger among men than among women.Conclusions: SDB was associated with incident hypertension and diabetes. Insomnia was associated with incident hypertension. These findings support the importance of sleep disorders as modifiable targets for disease prevention and reduction.
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Affiliation(s)
- Xiaoyu Li
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | | | - Linda C. Gallo
- Department of Social Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Alberto R. Ramos
- Department of Psychology, San Diego State University, San Diego, California
| | | | - Krista M. Perreira
- National Institute on Minority Health and Health Disparities, NIH, Bethesda, Maryland
| | - Carmen R. Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, New York
| | | | - Kimberly L. Savin
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Neil Schneiderman
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California, San Diego, California
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, New York
| | - Tamar Sofer
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Martha Daviglus
- Department of Psychology, University of Miami, Coral Gables, Florida; and,Department of Medicine, Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts
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The association of insomnia disorder characterised by objective short sleep duration with hypertension, diabetes and body mass index: A systematic review and meta-analysis. Sleep Med Rev 2021; 59:101456. [PMID: 33640704 DOI: 10.1016/j.smrv.2021.101456] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 12/07/2020] [Accepted: 01/04/2021] [Indexed: 01/26/2023]
Abstract
Insomnia disorder with objective short sleep duration (less than 6 h of objective sleep or sleep efficiency less than 85%) has been considered as a biologically severe subtype of insomnia associated with a higher risk of cardiometabolic disease morbidity. This systematic review and meta-analysis firstly compared insomnia disorder with objective short and normal sleep duration, and subsequently, objective short sleep duration with and without insomnia disorder, and their associations with hypertension, type 2 diabetes and body mass index. A systematic search of five databases yielded 2345 non-duplicated articles, of which 11 individual studies were used for the qualitative review and 10 individual studies for the meta-analysis. The sample size varied from 30 to 4994 participants. A higher risk of hypertension (RR 1.54, 95% CI: [1.30; 1.82] p < 0.0001) and type 2 diabetes (RR 1.63 [1.37; 1.94], p < 0.0001) was associated with insomnia disorder with objective short sleep compared to normal sleep duration, but not for body mass index. Comparisons between insomnia disorder with objective short sleep and objective short sleep without insomnia disorder showed no significant differences. However, the majority of these studies were cross-sectional, and there is a need for more cohort study data.
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Poza J, Pujol M, Ortega-Albás J, Romero O. Melatonin in sleep disorders. NEUROLOGÍA (ENGLISH EDITION) 2020; 37:575-585. [DOI: 10.1016/j.nrleng.2018.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 08/18/2018] [Indexed: 12/18/2022] Open
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Yuan J, Wang H, Chen J, Lei Y, Wan Z, Zhao Y, Han Z, Liu D, Wang P, Luo F, Wang Y, Cao Y. Effect of low frequency repetitive magnetic stimulation at Shenmen (HT7) on sleep quality in patients with chronic insomnia. Medicine (Baltimore) 2020; 99:e21292. [PMID: 32791711 PMCID: PMC7387057 DOI: 10.1097/md.0000000000021292] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Insomnia is a common, recurrent, and tenacious sleep problem, especially the chronic insomnia. Repetitive transcranial magnetic stimulation (rTMS) at right dorsolateral prefrontal cortex (r-DLPFC) is used in chronic insomnia, and repetitive magnetic stimulation (rMS) at Shenmen (HT7) acupoint may be an alternative approach. However, the efficacy and mechanism of rMS at HT7 acupoint for chronic insomnia has not been confirmed. METHODS/DESIGN This is a 3-armed randomized positive-controlled noninferiority clinical trial. We will allocate 45 subjects aged between 18 and 65 years old, diagnosed with initial chronic insomnia over 3 months to 3 groups randomly in a ratio of 1:1:1. Patients in the experimental group will be treated with rMS at HT7 acupoint while the others in the control group will be treated with rTMS at r-DLPFC or waiting treatment. All will be given rMS at HT7 or rTMS at r-DLPFC or no treatment for 10 days, and then received 20-day follow-up. Patients will be evaluated with the insomnia severity index and Pittsburgh sleep quality index for sleep state, Beck Depression Inventory-2nd edition scores for the depression state, Beck anxiety inventory scores for the anxiety state, and Montreal Cognitive Assessment scores for the cognition state before and the 10th day of treatment, 30th day of follow-up; study on mechanisms of rMS will be revealed through the resting motor threshold diversity of the motor cortex before and the 10th day of treatment, 30th day of follow-up. Baseline characteristics of patients will be summarized by groups and compared with Chi-squared for categorical variables, and analysis of variance or Kruskal-Wallis test for the continuous variables. Primary and secondary outcomes according to the measurement times are applicable to univariate repetitive measurement deviation analysis or analysis of variance, or Kruskal-Wallis test. CONCLUSION The present study is designed to preliminarily investigate short-term efficacy and mechanism of rMS at HT7 acupoint therapy on chronic insomnia, also to explore the correlation between motor cortex excitability and chronic insomnia. With this research, we are looking forward to find out an appropriate alternative and easy therapy for chronic insomnia individuals compared with rTMS at r-DLPFC. TRIAL REGISTRATION The trial was registered on Chinese Clinical Trial Registry (http://www.chictr.org.cn/index.aspx) with the ID ChiCTR1900026844 on October 24, 2019.
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Affiliation(s)
- Jie Yuan
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu
- Department of Encephalopathy, Shaanxi Provincial Hospital of Traditional Chinese Medicine
- Syndrome and Treatment Research Office For Insomnia With Yin Yang Sequential Treatment, Shaanxi Administration of Traditional Chinese Medicine
| | - Hui Wang
- Department of Geriatrics, Xi’an Hospital of Traditional Chinese Medicine, Xi’an, China
| | - Jie Chen
- Department of Encephalopathy, Shaanxi Provincial Hospital of Traditional Chinese Medicine
- Syndrome and Treatment Research Office For Insomnia With Yin Yang Sequential Treatment, Shaanxi Administration of Traditional Chinese Medicine
| | - Yaling Lei
- Department of Encephalopathy, Shaanxi Provincial Hospital of Traditional Chinese Medicine
- Syndrome and Treatment Research Office For Insomnia With Yin Yang Sequential Treatment, Shaanxi Administration of Traditional Chinese Medicine
| | - Zhaoxin Wan
- Department of Encephalopathy, Shaanxi Provincial Hospital of Traditional Chinese Medicine
| | - Yuan Zhao
- Department of Encephalopathy, Shaanxi Provincial Hospital of Traditional Chinese Medicine
- Syndrome and Treatment Research Office For Insomnia With Yin Yang Sequential Treatment, Shaanxi Administration of Traditional Chinese Medicine
| | - Zucheng Han
- Department of Encephalopathy, Shaanxi Provincial Hospital of Traditional Chinese Medicine
- Syndrome and Treatment Research Office For Insomnia With Yin Yang Sequential Treatment, Shaanxi Administration of Traditional Chinese Medicine
| | - Dongling Liu
- Department of Encephalopathy, Shaanxi Provincial Hospital of Traditional Chinese Medicine
- Syndrome and Treatment Research Office For Insomnia With Yin Yang Sequential Treatment, Shaanxi Administration of Traditional Chinese Medicine
| | - Pei Wang
- Department of Encephalopathy, Shaanxi Provincial Hospital of Traditional Chinese Medicine
- Syndrome and Treatment Research Office For Insomnia With Yin Yang Sequential Treatment, Shaanxi Administration of Traditional Chinese Medicine
| | - Fan Luo
- Department of Encephalopathy, Shaanxi Provincial Hospital of Traditional Chinese Medicine
- Syndrome and Treatment Research Office For Insomnia With Yin Yang Sequential Treatment, Shaanxi Administration of Traditional Chinese Medicine
| | - Yuan Wang
- Department of Encephalopathy, Shaanxi Provincial Hospital of Traditional Chinese Medicine
- Syndrome and Treatment Research Office For Insomnia With Yin Yang Sequential Treatment, Shaanxi Administration of Traditional Chinese Medicine
| | - Yue Cao
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu
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Auricular Acupressure in Patients with Hypertension and Insomnia: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:7279486. [PMID: 32655667 PMCID: PMC7317612 DOI: 10.1155/2020/7279486] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 05/18/2020] [Accepted: 05/28/2020] [Indexed: 11/17/2022]
Abstract
Objective The efficacy of auricular acupressure in patients with hypertension and insomnia is controversial. This systematic review aims to explore the effectiveness of auricular acupressure in reducing blood pressure and improving sleep in this population. Methods We conducted an extensive database search in Cochrane Central Register of Controlled Trials, PubMed, Ovid LWW, Web of Science, Chinese Biomedical Literature Database, China Knowledge Resource Integrated Database, Wanfang Data, and China Science and Technology Journal Database on randomized controlled trials published from inception to November 2019 that compared auricular acupressure with a control or comparison group on blood pressure control and sleep improvement. Two reviewers independently conducted data screening and extraction. Study quality was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analyses were performed on blood pressure, Pittsburgh Sleep Quality Index (PSQI), the efficacy rate of diagnostic and therapeutic criteria for traditional Chinese medicine syndromes (DTCTCMS), and the efficacy rate of guidelines for traditional Chinese medicine (new drug) clinical research (GTCMCR) by Revman 5.3.0. Results A total of 18 randomized controlled trials with 1685 patients were identified. Compared with a control or comparison group, pooled meta-analyses showed that auricular acupressure significantly improved systolic blood pressure (MD = −15.05, 95% CI (−18.49, −11.61), P < 0.00001), diastolic blood pressure (MD = −8.41, 95% CI (−11.33, −5.48), P < 0.00001), PSQI (MD = −2.37, 95% CI (−4.64, −0.10), P=0.04), the efficacy rate of DTCTCMS (RR = 1.63, 95% CI (1.16, 2.28), P=0.004), and the efficacy rate of GTCMCR (RR = 1.25, 95% CI (1.12, 1.38)). Conclusions The results demonstrated a favorable effect of auricular acupressure to reduce blood pressure and improve sleep in patients with hypertension and insomnia. Further studies to better understand the acupoints and intervention times of auricular acupressure are warranted.
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Gorokhova S, Fietze I, Glos M, Penzel T, Buniatyan M, Atkov O. On the use of actigraphy in clinical evaluation of diurnal blood pressure profile. SOMNOLOGIE 2020. [DOI: 10.1007/s11818-020-00250-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AbstractA disturbed diurnal blood pressure profile is one of the most important risk factors of cardiovascular diseases. This review analyzes the use of simultaneous diurnal ambulatory blood pressure monitoring (ABPM) and motion activity monitoring (actigraphy) to obtain additional information for correct interpretation of ABPM results in clinically significant decision-making. The article considers practical aspects of actigraphy in expert ABPM for clock-independent calculation of the parameters of nighttime and daytime blood pressure (BP); detection of BP changes during sleep; connection with respiratory disturbances during sleep, motion activity, and body position; and sleep deprivation in shift workers. Original illustrations of simultaneous ABPM and actigraphy are provided.
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Doyle CY, Ruiz JM, Taylor DJ, Smyth JW, Flores M, Dietch J, Ahn C, Allison M, Smith TW, Uchino BN. Associations Between Objective Sleep and Ambulatory Blood Pressure in a Community Sample. Psychosom Med 2020; 81:545-556. [PMID: 31083055 PMCID: PMC6607429 DOI: 10.1097/psy.0000000000000711] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Epidemiologic data increasingly support sleep as a determinant of cardiovascular disease risk. Fewer studies have investigated the mechanisms underlying this relationship using objective sleep assessment approaches. Therefore, the aim of this study was to examine associations between daily blood pressure (BP) and both objectively assessed sleep duration and efficiency. METHODS A diverse community sample of 300 men and women aged 21 to 70 years, enrolled in the North Texas Heart Study, participated in the study. Actigraphy-assessed sleep was monitored for two consecutive nights with ambulatory BP sampled randomly within 45-minute blocks on the first and second day as well as the second night. RESULTS Overall, sleep duration results paralleled those of sleep efficiency. Individuals with lower sleep efficiency had higher daytime systolic (B = -0.35, SE = 0.11, p = .0018, R = 0.26) but not diastolic BP (B = -0.043, SE = 0.068, p = .52, R = 0.17) and higher nighttime BP (systolic: B = -0.37, SE = 0.10, p < .001, R = .15; diastolic: B = -0.20, SE = 0.059, p < .001, R = .14). Moreover, lower sleep efficiency on one night was associated with higher systolic (B = -0.51, SE = 0.11, p < .001, R = 0.23) and diastolic BP (B = -0.17, SE = 0.065, p = .012, R = .16) the following day. When 'asleep' BP was taken into account instead of nighttime BP, the associations between sleep and BP disappeared. When both sleep duration and efficiency were assessed together, sleep efficiency was associated with daytime systolic BP, whereas sleep duration was associated with nighttime BP. CONCLUSIONS Lower sleep duration and efficiency are associated with higher daytime systolic BP and higher nighttime BP when assessed separately. When assessed together, sleep duration and efficiency diverge in their associations with BP at different times of day. These results warrant further investigation of these possible pathways to disease.
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Affiliation(s)
| | | | | | | | | | | | - Chul Ahn
- University of Texas Southwestern Medical Center
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Liao LZ, Li WD, Liu Y, Li JP, Zhuang XD, Liao XX. Causal assessment of sleep on coronary heart disease. Sleep Med 2020; 67:232-236. [DOI: 10.1016/j.sleep.2019.08.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 06/19/2019] [Accepted: 08/05/2019] [Indexed: 12/23/2022]
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Lee PF, Ho CC, Yeh DP, Hung CT, Chang YC, Liu CC, Tseng CY, Hsieh XY. Cross-Sectional Associations of Physical Fitness Performance Level and Sleep Duration among Older Adults: Results from the National Physical Fitness Survey in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020388. [PMID: 31936056 PMCID: PMC7013682 DOI: 10.3390/ijerph17020388] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 01/03/2020] [Accepted: 01/04/2020] [Indexed: 12/14/2022]
Abstract
Research on relationships between physical fitness and sleep duration among older adults is scarce, especially in Taiwanese representative samples of elderly people who undergo physical fitness measurements. This study aimed to determine the associations between physical fitness and short and long sleep durations among older adults in Taiwan. We conducted a cross-sectional study and reviewed data derived from the National Physical Fitness Survey in Taiwan. A total of 24,125 Taiwanese adults aged 65 years and older participated in this study between October 2014 and March 2015. Each individual's sleep duration was recorded with a standard questionnaire method. Sleep duration data were stratified into short (≤5 h), normal (6-7 h), and long (≥8 h) sleep duration groups. Physical fitness was assessed by five components: aerobic endurance (2 min step test), muscle strength and endurance (30 s arm curl and 30 s chair stand tests), flexibility (back scratch and chair sit-and-reach tests), body composition (body mass index (BMI) and waist-to-hip ratio (WHR)), and balance (one-leg stance with eye open and 8-foot up-and-go tests). To understand whether a dose-response relationship exists between physical fitness and short or long sleep duration, we analyzed four levels of performance on the basis of quartiles of physical fitness measurements by using logistic regression. The first quartile of physical fitness performance was the baseline level. The odds ratio (OR) for short sleep duration for the third quartile of BMI was 0.8031 times (95% CI, 0.7119-0.9061) lower than the baseline. For the fourth quartile of BMI, the OR was 0.8660 times (95% CI, 0.7653-0.9800) lower than the baseline. The adjusted OR for long sleep duration significantly decreased in the second, third, and fourth quartiles of the 30 s chair stand, back scratch, chair sit-and-reach test, one-leg stance with one eye open, and BMI. The adjusted OR was increased in the third and fourth quartiles of the 8-foot up-and-go and WHR. The results of the current study suggest that physical fitness performance may influence sleep duration as an associated factor, and the relationship is much stronger for long sleep duration than for short sleep duration.
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Affiliation(s)
- Po-Fu Lee
- Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei City 111, Taiwan;
- Department of Physical Education, Fu Jen Catholic University, New Taipei City 242, Taiwan; (D.-P.Y.); (Y.-C.C.); (C.-Y.T.); (X.-Y.H.)
| | - Chien-Chang Ho
- Department of Physical Education, Fu Jen Catholic University, New Taipei City 242, Taiwan; (D.-P.Y.); (Y.-C.C.); (C.-Y.T.); (X.-Y.H.)
- Research and Development Center for Physical Education, Health and Information Technology, College of Education, Fu Jen Catholic University, New Taipei City 242, Taiwan
- Correspondence: ; Tel.: +886-2-2905-3386; Fax: +886-2-2905-2380
| | - Ding-Peng Yeh
- Department of Physical Education, Fu Jen Catholic University, New Taipei City 242, Taiwan; (D.-P.Y.); (Y.-C.C.); (C.-Y.T.); (X.-Y.H.)
- College of Humanities and Social Sciences, Taipei Medical University, Taipei City 110, Taiwan
| | - Chang-Tsen Hung
- Department of Health and Leisure Management, Yuanpei University of Medical Technology, Hsinchu City 300, Taiwan;
| | - Yun-Chi Chang
- Department of Physical Education, Fu Jen Catholic University, New Taipei City 242, Taiwan; (D.-P.Y.); (Y.-C.C.); (C.-Y.T.); (X.-Y.H.)
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei City 112, Taiwan
| | - Chia-Chen Liu
- Department of Physical Education, National Taichung University of Education, Taichung City 403, Taiwan;
| | - Ching-Yu Tseng
- Department of Physical Education, Fu Jen Catholic University, New Taipei City 242, Taiwan; (D.-P.Y.); (Y.-C.C.); (C.-Y.T.); (X.-Y.H.)
- Research and Development Center for Physical Education, Health and Information Technology, College of Education, Fu Jen Catholic University, New Taipei City 242, Taiwan
| | - Xin-Yu Hsieh
- Department of Physical Education, Fu Jen Catholic University, New Taipei City 242, Taiwan; (D.-P.Y.); (Y.-C.C.); (C.-Y.T.); (X.-Y.H.)
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Wu W, Wang W, Gu Y, Xie Y, Liu X, Chen X, Zhang Y, Tan X. Sleep quality, sleep duration, and their association with hypertension prevalence among low-income oldest-old in a rural area of China: A population-based study. J Psychosom Res 2019; 127:109848. [PMID: 31670193 DOI: 10.1016/j.jpsychores.2019.109848] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/29/2019] [Accepted: 10/02/2019] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The relationship among sleep quality, sleep duration and hypertension prevalence is controversial in different age groups and genders. This study aimed to investigate sleep quality, sleep duration and their association with hypertension prevalence among low-income oldest-old in a rural area of China. METHODS A cross-sectional survey was conducted in a representative sample of 1066 adults aged 80-99 years in 2017. Logistic regression analysis was performed. RESULTS Among males, sleep durations of <6 h and 6-<7 h were significantly associated with hypertension prevalence, with odds ratios (ORs) of 3.15 (95% confidence interval (CI) 1.37 to 7.23) and 2.38 (95% CI 1.22 to 4.63), respectively. Among females, only the sleep duration of <6 h was associated with increased OR of hypertension of 3.49 (95% CI 1.50 to 8.09). Poor sleep quality was associated with hypertension for both genders (ORmen 1.67, 95% CI 1.12 to 2.49; ORwomen 1.91, 95% CI 1.29 to 2.82). For women, a combination of poor sleep quality and any group of sleep duration, except for 7-<8 h, was associated with higher hypertension prevalence. For men, only the combination of poor sleep quality and short sleep duration (<7 h) was associated with high hypertension prevalence. CONCLUSION Short sleep duration and poor sleep quality are associated with hypertension prevalence of oldest-old. The prevention of hypertension in older adults should be investigated from the perspective of sleep improvement.
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Affiliation(s)
- Wenwen Wu
- School of Health Sciences, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China; School of Public Health and Management, Hubei University of Medicine, No.30, Renmin South Road, Shiyan 442000, Hubei Province, China
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, 117597, Singapore
| | - Yaohua Gu
- School of Health Sciences, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Yaofei Xie
- School of Health Sciences, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Xiangxiang Liu
- School of Health Sciences, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Xuyu Chen
- School of Health Sciences, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Yuting Zhang
- School of Health Sciences, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Xiaodong Tan
- School of Health Sciences, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China.
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Dong Y, Yang FM. Insomnia symptoms predict both future hypertension and depression. Prev Med 2019; 123:41-47. [PMID: 30742871 DOI: 10.1016/j.ypmed.2019.02.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 01/24/2019] [Accepted: 02/06/2019] [Indexed: 11/28/2022]
Abstract
The prevalence of hypertension and depression is high in older populations. Moreover, their comorbidity may significantly increase morbidity and mortality. However, the risk factors contributing to both health conditions are not well understood. Older individuals are prone to insomnia; thus we hypothesized that having more insomnia symptoms increases risk for incident hypertension and depression over time. The sample consisted of a longitudinal population-based study of community-dwelling older individuals, from the 2008-2016 waves of the Health and Retirement Study, sampled across the United States. A total of 18,123 subjects, aged 50+, were stratified into three age groups, ages 50-60, 61-74, and 75 and older years. Subjects were excluded for reporting baseline hypertension or depression at the first wave 2008. Center for Epidemiologic Studies-Depression (CES-D) score ≥ 4 was the cutoff for elevated depressive symptomatology. Subjective insomnia symptoms were evaluated. Cox proportional hazards regression revealed that SBP (1.02[1.01, 1.02]) and more insomnia symptoms (1.11[1.01, 1.21]) were significant predictors of hypertension for all age groups. For depression, only insomnia symptoms were significant predictors (9.91[6.37, 15.41]). Kaplan-Meier curves revealed that 9.2% of the overall cohort had both hypertension and depression within 8 years and more insomnia symptoms predicted greater incidences of both conditions (p-values <0.001). In this older prospective cohort, insomnia symptoms are consistent predictors of future hypertension and depression in all age groups, who were not hypertensive and depressed at baseline. Insomnia may contribute to the etiology and comorbidity of hypertension and depression in older individuals.
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Affiliation(s)
- Yutong Dong
- School of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Frances Margaret Yang
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA.
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Makarem N, Shechter A, Carnethon MR, Mullington JM, Hall MH, Abdalla M. Sleep Duration and Blood Pressure: Recent Advances and Future Directions. Curr Hypertens Rep 2019; 21:33. [PMID: 30953237 DOI: 10.1007/s11906-019-0938-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW This review discusses the recent literature on subjectively and objectively assessed sleep duration in relation to hypertension risk and out-of-clinic blood pressure (BP) measures and highlights critical areas for future research. RECENT FINDINGS Sleep duration, particularly short sleep, may influence BP through disturbed autonomic balance, hormonal imbalances, increased adiposity and metabolic dysfunction, and disrupted circadian rhythms. Observational studies indicate that short and long sleep are associated with hypertension risk, reduced nocturnal dipping, and elevated morning BP, but evidence is stronger for short sleep. Experimental sleep restriction increases BP, while sleep extension may lower BP in prehypertensive individuals. Women and racial/ethnic minorities are more prone to the detrimental effects of short sleep on BP. Additional studies are warranted to clarify the association of objectively assessed sleep with BP level and diurnal pattern and to determine the sex- and race-specific effects of sleep restriction and extension on BP.
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Affiliation(s)
- Nour Makarem
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, 51 Audubon Avenue, 5th floor, Suite 501, New York, NY, 10032, USA
| | - Ari Shechter
- Department of Medicine, Division of Cardiology, Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, 622 West 168th Street, PH 9-321, New York, NY, 10032, USA
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Janet M Mullington
- Department of Neurology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Marwah Abdalla
- Department of Medicine, Division of Cardiology, Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, 622 West 168th Street, PH 9-321, New York, NY, 10032, USA.
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Stavropoulos K, Imprialos KP, Doumas M, Karagiannis A, Papademetriou V. Insomnia and hypertension: A misty landscape. J Clin Hypertens (Greenwich) 2019; 21:835-837. [DOI: 10.1111/jch.13519] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Konstantinos Stavropoulos
- Second Propedeutic Department of Internal Medicine Aristotle University of Thessaloniki Thessaloniki Greece
- Veterans Affairs Medical Center Georgetown University Washington District of Columbia
| | - Konstantinos P. Imprialos
- Second Propedeutic Department of Internal Medicine Aristotle University of Thessaloniki Thessaloniki Greece
| | - Michael Doumas
- Second Propedeutic Department of Internal Medicine Aristotle University of Thessaloniki Thessaloniki Greece
- Veterans Affairs Medical Center George Washington University Washington District of Columbia
| | - Asterios Karagiannis
- Second Propedeutic Department of Internal Medicine Aristotle University of Thessaloniki Thessaloniki Greece
| | - Vasilios Papademetriou
- Veterans Affairs Medical Center Georgetown University Washington District of Columbia
- Faculty of Medicine Aristotle University of Thessaloniki Thessaloniki Greece
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45
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Fernandez-Mendoza J. What should we tell our worried patients with insomnia about blood pressure? Sleep Med Rev 2018; 41:1-2. [PMID: 30097172 DOI: 10.1016/j.smrv.2018.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 07/02/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Julio Fernandez-Mendoza
- Sleep Research & Treatment Center, Penn State College of Medicine, Penn State Health Milton S. Hershey Medical Center, 500 University Dr. H073, Hershey, PA, 17033, USA.
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46
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Khassawneh BY, Bathgate CJ, Tsai SC, Edinger JD. Neurocognitive performance in insomnia disorder: The impact of hyperarousal and short sleep duration. J Sleep Res 2018; 27:e12747. [PMID: 30069961 DOI: 10.1111/jsr.12747] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/04/2018] [Accepted: 07/06/2018] [Indexed: 12/27/2022]
Abstract
Given the recent evidence on the association between hyperarousal in insomnia disorder and neurocognitive deficits, we aimed to examine the effect of short sleep duration on neurocognitive reaction time tests in insomnia disorder sufferers. We recruited subjects with insomnia disorder (n = 35, mean age = 40.6 years) who scored ≥29 on a Hyperarousal Scale, and a group of controls (n = 54, mean age = 31.5 years) who had no sleep disorders and scored <26 on the Hyperarousal Scale. Participants completed two in-home polysomnograms and four daytime trials of neurocognitive tests, including simple reaction time, choice reaction time, big circle-little circle, rapid visual information processing, attention switching task, and spatial working memory tests. Total sleep time divided study cohorts into subgroups of short (total sleep time <6 hr) and normal (total sleep time ≥6 hr) sleepers. ANCOVA showed a significant interaction between participant type (insomnia disorder versus controls) and sleep duration (short versus normal) for spatial working memory-latency (p = 0.020) and spatial working memory-errors (p = 0.025). The short-sleeping insomnia disorder group had longer spatial working memory-latencies and more spatial working memory-errors than did normal-sleeping controls. Regardless of sleep duration, those with insomnia disorder had more attentional deficits with longer attention switching task-latency (p = 0.011) and more attention switching task-incorrect trials (p = 0.015) than the control group. Normal-sleepers only had longer attention switching task-latency than short-sleepers (p = 0.004). A phenotype of insomnia disorder with hyperarousal and short sleep duration is associated with daytime cognitive deficits in complex attentional and spatial working memory tasks.
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Affiliation(s)
- Basheer Y Khassawneh
- Jordan University of Science and Technology, Irbid, Jordan.,National Jewish Health, Denver, Colorado
| | | | | | - Jack D Edinger
- National Jewish Health, Denver, Colorado.,Duke University Medical Center, Durham, North Carolina
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