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D'agata MN, Hoopes EK, Keiser T, Patterson F, Szymanski KM, Matias AA, Brewer BC, Witman MA. Device-estimated sleep metrics do not mediate the relation between race and blood pressure dipping in young black and white women. J Clin Hypertens (Greenwich) 2024; 26:850-860. [PMID: 38923277 PMCID: PMC11232447 DOI: 10.1111/jch.14856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/01/2024] [Accepted: 05/17/2024] [Indexed: 06/28/2024]
Abstract
Short, disturbed, and irregular sleep may contribute to blunted nocturnal blood pressure (BP) dipping, a predictor of cardiovascular disease. Black women (BLW) demonstrate less BP dipping and poorer sleep health than White women (WHW). However, it remains unclear whether device-estimated sleep health metrics mediate the relation between race and BP dipping in young women. We hypothesized that the relation between race and BP dipping would be partly mediated by sleep health metrics of sleep duration, sleep efficiency, and sleep regularity. Participants (20 BLW, 17 WHW) were 18-29 years old, normotensive, nonobese, and without evidence of sleep disorders. Systolic and diastolic BP dipping were derived from 24-h ambulatory BP monitoring. Habitual sleep duration and sleep efficiency were estimated via 14 days of wrist actigraphy. Sleep duration regularity was calculated as the standard deviation (SD) of nightly sleep duration (SDSD). Sleep timing regularity metrics were calculated as the SD of sleep onset and sleep midpoint (SMSD). Mediation analysis tested the mediating effect of each sleep metric on the relation between race and BP dipping. BLW experienced less systolic (P = .02) and diastolic (P = .01) BP dipping. Sleep duration (P = .14) was not different between groups. BLW had lower sleep efficiency (P < .01) and higher SDSD (P = .02), sleep onset SD (P < .01) and SMSD (P = .01). No sleep metrics mediated the relation between race and BP dipping (all indirect effects P > .38). In conclusion, mediation pathways of sleep health metrics do not explain racial differences in nocturnal BP dipping between young BLW and WHW.
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Affiliation(s)
- Michele N. D'agata
- Department of Kinesiology and Applied PhysiologyCollege of Health SciencesUniversity of DelawareNewarkDelawareUSA
| | - Elissa K. Hoopes
- Department of Health Behavior and Nutrition SciencesCollege of Health SciencesUniversity of DelawareNewarkDelawareUSA
| | - Thomas Keiser
- Department of Health Behavior and Nutrition SciencesCollege of Health SciencesUniversity of DelawareNewarkDelawareUSA
| | - Freda Patterson
- Department of Health Behavior and Nutrition SciencesCollege of Health SciencesUniversity of DelawareNewarkDelawareUSA
| | - Krista M. Szymanski
- Department of Kinesiology and Applied PhysiologyCollege of Health SciencesUniversity of DelawareNewarkDelawareUSA
| | - Alexs A. Matias
- Department of Kinesiology and Applied PhysiologyCollege of Health SciencesUniversity of DelawareNewarkDelawareUSA
| | - Benjamin C. Brewer
- Department of EpidemiologyCollege of Health SciencesUniversity of DelawareNewarkDelawareUSA
| | - Melissa A. Witman
- Department of Kinesiology and Applied PhysiologyCollege of Health SciencesUniversity of DelawareNewarkDelawareUSA
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2
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Kogon AJ, Maqsood AM, LoGuidice J, Amaral S, Meyers K, Mitchell JA. Sleep Duration and Blood Pressure in Youth Referred for Elevated Blood Pressure Evaluation. Pediatrics 2024; 154:e2023062940. [PMID: 38887814 DOI: 10.1542/peds.2023-062940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 04/15/2024] [Accepted: 04/18/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVES Sleep promotion is not specifically recommended as a target for hypertension management. We examined associations of sleep duration and timing with blood pressure parameters in patients referred to pediatric nephrology clinic for elevated blood pressure evaluation. METHODS This is a retrospective study of initial ambulatory blood pressure monitoring data and self-report sleep data collected from patients referred to nephrology clinic for the evaluation of elevated blood pressure. Linear and logistic regression modeling determined associations between sleep exposures (duration and timing) and continuous and dichotomous blood pressure outcomes, respectively, adjusted for age, sex, body mass index, and weekday versus weekend status. RESULTS The study sample included 539 patients with mean age 14.6 years and 56% meeting hypertension criteria. Sleep duration averaged 9.1 hours per night. Average timing of sleep onset and offset were 11:06 pm and 8:18 am, respectively. Longer sleep duration was associated with better daytime blood pressure parameters (eg, every extra hour of sleep duration was associated with a reduced odds of wake hypertension [odds ratio, 0.88; 95% CI, 0.79-0.99]). Later sleep onset was associated with worse daytime blood pressure parameters (eg, each additional hour of later sleep onset was associated with higher wake systolic blood pressure index [mean wake blood pressure/95th percentile]) (β = 0.07; 95% CI, 0.02-0.13). Associations were consistent across sex, age, body mass index, and weekday status. CONCLUSIONS Longer sleep duration and earlier sleep onset were associated with lower blood pressure. This suggests that sleep optimization may be an important target for intervention in hypertension management.
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Affiliation(s)
- Amy J Kogon
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Anam M Maqsood
- Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jill LoGuidice
- Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Sandra Amaral
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kevin Meyers
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jonathan A Mitchell
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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3
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Springall De Pablo M, Lauderdale DS. Associations of actigraph sleep characteristics with blood pressure among older adults. Sleep Health 2024:S2352-7218(24)00067-6. [PMID: 38906803 DOI: 10.1016/j.sleh.2024.04.002] [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: 12/18/2023] [Revised: 03/29/2024] [Accepted: 04/12/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVES Many studies have examined links between sleep and blood pressure, with mixed findings, mostly using self-reported sleep data and cross-sectional designs. We examined whether actigraph-estimated sleep characteristics are associated with concurrent blood pressure or 5-year blood pressure change in a national cohort of older adults (National Social Life, Health and Aging Project), and whether these associations differ by hypertension medication use. METHODS Subjects were 669 older adults (62-90years), 471 with 5-year follow-up data. Sleep characteristics were duration (linear plus quadratic terms); sleep percentage; and categorical onset, midpoint, and waking times. Multivariable linear models adjusted for age, race, gender, obesity, smoking, daytime napping, and hypertension medication use. Interactions between sleep characteristics and hypertension medication were tested among the 401 subjects with consistent hypertension medication status over time. RESULTS We found U-shaped cross-sectional and longitudinal relationships between duration and blood pressure, with shorter and longer sleep times associated with higher blood pressure. Later onset times were cross-sectionally associated with higher systolic blood pressure, while earlier onset times were longitudinally associated with systolic blood pressure increase. Midpoint, wake time, and sleep percentage were not significantly associated with blood pressure. Significant interaction terms suggested hypertension medications attenuated associations of sleep onset and wake time with diastolic blood pressure. CONCLUSIONS These results with actigraph-estimated parameters confirm some, but not all, associations reported from research based on self-reported sleep data. Our findings are consistent with recommended intermediate sleep durations for cardiovascular health and suggest hypertension medication may attenuate some associations between sleep timing and blood pressure.
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Affiliation(s)
| | - Diane S Lauderdale
- University of Chicago Department of Public Health Sciences, Chicago, Illinois, USA
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Tincher IM, Rojas DA, Abukhadra S, DeForge CE, Yuan M, Thomas SJ, Flanary K, Shimbo D, Makarem N, Chang BP, Agarwal S. Disruptions in Sleep Health and Independent Associations with Psychological Distress in Close Family Members of Cardiac Arrest Survivors: A Prospective Study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.18.24309137. [PMID: 38946971 PMCID: PMC11213050 DOI: 10.1101/2024.06.18.24309137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Background While recent guidelines have noted the deleterious effects of poor sleep on cardiovascular health, the upstream impact of cardiac arrest-induced psychological distress on sleep health metrics among families of cardiac arrest survivors remains unknown. Methods Sleep health of close family members of consecutive cardiac arrest patients admitted at an academic center (8/16/2021 - 6/28/2023) was self-reported on the Pittsburgh Sleep Quality Index (PSQI) scale. The baseline PSQI administered during hospitalization was cued to sleep in the month before cardiac arrest. It was then repeated one month after cardiac arrest, along with the Patient Health Questionnaire-8 (PHQ-8) to assess depression severity. Multivariable linear regressions estimated the associations of one-month total PHQ-8 scores with changes in global PSQI scores between baseline and one month with higher scores indicating deteriorations. A prioritization exercise of potential interventions categorized into family's information and well-being needs to alleviate psychological distress was conducted at one month. Results In our sample of 102 close family members (mean age 52±15 years, 70% female, 21% Black, 33% Hispanic), mean global PSQI scores showed a significant decline between baseline and one month after cardiac arrest (6.2±3.8 vs. 7.4±4.1; p<0.01). This deterioration was notable for sleep quality, duration, and daytime dysfunction components. Higher PHQ-8 scores were significantly associated with higher change in PSQI scores, after adjusting for family members' age, sex, race/ethnicity, and patient's discharge disposition [β=0.4 (95% C.I 0.24, 0.48); p<0.01]. Most (n=72, 76%) prioritized interventions supporting information over well-being needs to reduce psychological distress after cardiac arrest. Conclusions There was a significant decline in sleep health among close family members of cardiac arrest survivors in the acute phase following the event. Psychological distress was associated with this sleep disruption. Further investigation into their temporal associations is needed to develop targeted interventions to support families during this period of uncertainty. WHAT IS KNOWN Sleep health has been identified as a key element in maintaining cardiovascular health.Close family members of critically ill patients experience suboptimal sleep health and psychological distress may contribute to it. WHAT THE STUDY ADDS It is breaking new ground in understanding the sleep health dynamics of close family members of cardiac arrest survivors, a critical but often overlooked group of caregivers.The study highlights significant associations between psychological distress and poor sleep that further deteriorates within the first month after a loved one's cardiac arrest.Families of cardiac arrest survivors expressed a high priority for information-based interventions to help alleviate psychological distress during the initial month following the cardiac event emphasizing the need for targeted, accessible, resources to address their psychological and potentially sleep-related challenges.
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5
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Nurrobi YAS, Winston K, Damara I, Rahman AL, Falakhi MF, Aristya MP, Toaha AF, Larasaty IN. The Effect of Sleep Duration on Hypertension Risk in an Adult Asian Population: A Systematic Review and Meta-Analysis. Cureus 2024; 16:e61508. [PMID: 38957247 PMCID: PMC11218897 DOI: 10.7759/cureus.61508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2024] [Indexed: 07/04/2024] Open
Abstract
Sleep duration has been proposed as a potential and important modifiable risk factor, yet its precise relationship with hypertension among Asian adults remains unclear. This meta-analysis aims to elucidate the impact of short sleep duration on hypertension risk within the adult Asian population. A systematic search of databases, including PubMed, Scopus, and ScienceDirect, was conducted to identify relevant studies published up to January 4, 2024. Eligible studies comprised observational cohort studies and cross-sectional studies that compared short sleep duration to normal sleep duration in relation to hypertension risk among Asian adults. The definitions for short and normal sleep durations were derived from the respective studies. The random effects model was utilized to pool effect estimates, and all statistical analyses were conducted using Review Manager 5.4 software (RevMan) (Cochrane Collaboration, Oxford, UK). Results from a systematic search obtained seven studies assessing sleep duration and hypertension risk in Asian populations. Based on a meta-analysis of six studies, short sleep duration is associated with a higher hypertension risk when compared to normal sleep duration (OR: 1.36; 95% CI: 1.13-1.64; p: 0.0010; I2: 75%). Subgroup analysis based on sex showed that the association is evident across males (OR: 1.12; 95% CI: 1.01-1.25; p: 0.03; I2: 64%) and females (OR: 1.22; 95% CI: 1.10-1.35; p: 0.0003; I2: 82%). In conclusion, based on the analyzed studies, short sleep duration is associated with a higher mild risk of hypertension, irrespective of sex. Thus, short sleep duration can be a modifiable risk factor that can be prevented to reduce the risk of hypertension. By incorporating sleep hygiene practices and promoting healthy sleep habits, significant improvement in cardiovascular health can be made, especially in hypertension risk at a population level. Further studies on the effect of sleep duration in different age populations should be conducted to confirm the impact of short sleep duration.
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Affiliation(s)
- Yusuf Aji S Nurrobi
- Cardiology, Pertamina Hospital, Balikpapan, IDN
- Cardiology, Faculty of Medicine, Universitas Airlangga, Surabaya, IDN
| | - Kevin Winston
- Hospital Medicine, Bhakti Medicare Hospital, Cicurug, IDN
| | - Ivan Damara
- Research, Oxford University Clinical Research Unit Indonesia, Jakarta, IDN
| | - Andi L Rahman
- General Medicine, Hasri Ainun Habibie Regional Hospital, Parepare, IDN
| | - Moh F Falakhi
- General Medicine, Muhammadiyah Gresik Hospital, Gresik, IDN
| | - Meutia P Aristya
- General Medicine, Metropolitan Medical Centre Hospital, Jakarta, IDN
| | - Ahmad F Toaha
- General Medicine, Labuang Baji Hospital, Makassar, IDN
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6
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Nagarajan P, Winkler TW, Bentley AR, Miller CL, Kraja AT, Schwander K, Lee S, Wang W, Brown MR, Morrison JL, Giri A, O’Connell JR, Bartz TM, de las Fuentes L, Gudmundsdottir V, Guo X, Harris SE, Huang Z, Kals M, Kho M, Lefevre C, Luan J, Lyytikäinen LP, Mangino M, Milaneschi Y, Palmer ND, Rao V, Rauramaa R, Shen B, Stadler S, Sun Q, Tang J, Thériault S, van der Graaf A, van der Most PJ, Wang Y, Weiss S, Westerman KE, Yang Q, Yasuharu T, Zhao W, Zhu W, Altschul D, Ansari MAY, Anugu P, Argoty-Pantoja AD, Arzt M, Aschard H, Attia JR, Bazzanno L, Breyer MA, Brody JA, Cade BE, Chen HH, Ida Chen YD, Chen Z, de Vries PS, Dimitrov LM, Do A, Du J, Dupont CT, Edwards TL, Evans MK, Faquih T, Felix SB, Fisher-Hoch SP, Floyd JS, Graff M, Gu C, Gu D, Hairston KG, Hanley AJ, Heid IM, Heikkinen S, Highland HM, Hood MM, Kähönen M, Karvonen-Gutierrez CA, Kawaguchi T, Kazuya S, Kelly TN, Komulainen P, Levy D, Lin HJ, Liu PY, Marques-Vidal P, McCormick JB, Mei H, Meigs JB, Menni C, Nam K, Nolte IM, Pacheco NL, Petty LE, Polikowsky HG, Province MA, Psaty BM, Raffield LM, Raitakari OT, Rich SS, Riha RL, Risch L, Risch M, Ruiz-Narvaez EA, Scott RJ, Sitlani CM, Smith JA, Sofer T, Teder-Laving M, Völker U, Vollenweider P, Wang G, van Dijk KW, Wilson OD, Xia R, Yao J, Young KL, Zhang R, Zhu X, Below JE, Böger CA, Conen D, Cox SR, Dörr M, Feitosa MF, Fox ER, Franceschini N, Gharib SA, Gudnason V, Harlow SD, He J, Holliday EG, Kutalik Z, Lakka TA, Lawlor DA, Lee S, Lehtimäki T, Li C, Liu CT, Mägi R, Matsuda F, Morrison AC, Penninx BWJH, Peyser PA, Rotter JI, Snieder H, Spector TD, Wagenknecht LE, Wareham NJ, Zonderman AB, North KE, Fornage M, Hung AM, Manning AK, Gauderman J, Chen H, Munroe PB, Rao DC, van Heemst D, Redline S, Noordam R, Wang H. A Large-Scale Genome-Wide Study of Gene-Sleep Duration Interactions for Blood Pressure in 811,405 Individuals from Diverse Populations. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.03.07.24303870. [PMID: 38496537 PMCID: PMC10942520 DOI: 10.1101/2024.03.07.24303870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Although both short and long sleep duration are associated with elevated hypertension risk, our understanding of their interplay with biological pathways governing blood pressure remains limited. To address this, we carried out genome-wide cross-population gene-by-short-sleep and long-sleep duration interaction analyses for three blood pressure traits (systolic, diastolic, and pulse pressure) in 811,405 individuals from diverse population groups. We discover 22 novel gene-sleep duration interaction loci for blood pressure, mapped to genes involved in neurological, thyroidal, bone metabolism, and hematopoietic pathways. Non-overlap between short sleep (12) and long sleep (10) interactions underscores the plausibility of distinct influences of both sleep duration extremes in cardiovascular health. With several of our loci reflecting specificity towards population background or sex, our discovery sheds light on the importance of embracing granularity when addressing heterogeneity entangled in gene-environment interactions, and in therapeutic design approaches for blood pressure management.
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Affiliation(s)
- Pavithra Nagarajan
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Thomas W Winkler
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | - Amy R Bentley
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, US National Institutes of Health, Bethesda, MD, USA
| | - Clint L Miller
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesvil le, VA, USA
- Department of Biochemistry and Molecular Genetics, University of Virginia, Charlottesville ,VA, USA
| | - Aldi T Kraja
- University of Mississippi Medical Center, Jackson, MS, USA
| | - Karen Schwander
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Songmi Lee
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA
| | - Wenyi Wang
- Department of Human Genetics, Leiden University Medical Center, Leiden, Netherlands
| | - Michael R Brown
- Human Genetics Center, Department of Epidemiology, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - John L Morrison
- Division of Biostatistics, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Ayush Giri
- Division of Quantitative Sciences, Department of Obstetrics & Gynecology, Vanderbilt University Medical Center, Nashville, TN, USA
- Biomedical Laboratory Research and Development, Tennessee Valley Healthcare System (626), Department of Veterans Affairs/ Nashville, TN, USA
| | - Jeffrey R O’Connell
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Lisa de las Fuentes
- Cardiovascular Division, Department of Medicine, Washington University School of Medicine in St. Louis, MO, USA
- Center for Biostatistics and Data Science, Institute for Informatics, Data Science, and Biostatistics, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA
| | - Valborg Gudmundsdottir
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, Department of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Sarah E Harris
- Department of Psychology, The University of Edinburgh, Edinburgh, UK
| | - Zhijie Huang
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, US
| | - Mart Kals
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Minjung Kho
- Graduate School of Data Science, Seoul National University, Seoul, South Korea
| | - Christophe Lefevre
- Department of Data Sciences, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Jian’an Luan
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Leo-Pekka Lyytikäinen
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
- Finnish Cardiovascular Research Center - Tampere, Department of Clinical Chemistry, Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Massimo Mangino
- Department of Twin Research, King’s College London, London, UK
- National Heart & Lung Institute, Cardiovascular Genomics and Precision Medicine, Imperial College London, London, UK
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam UMC/Vrije universiteit, Amsterdam, Netherlands
- GGZ inGeest, Amsterdam, Netherlands
| | - Nicholette D Palmer
- Department of Biochemistry, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Varun Rao
- Division of Nephrology, Department of Medicine, University of Illinois Chicago, Chicago, USA
| | - Rainer Rauramaa
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Botong Shen
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Stefan Stadler
- Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
| | - Quan Sun
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jingxian Tang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Sébastien Thériault
- Department of Molecular Biology, Medical Biochemistry and Pathology, Université Laval, Quebec City, Qc, Canada
| | - Adriaan van der Graaf
- Statistical Genetics Group, Department of Computational Biology, University of Lausanne, Lausanne, Switzerland
| | - Peter J van der Most
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Yujie Wang
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stefan Weiss
- Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
| | - Kenneth E Westerman
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Qian Yang
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Tabara Yasuharu
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Wei Zhao
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Wanying Zhu
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Drew Altschul
- Department of Psychology, The University of Edinburgh, Edinburgh, UK
| | - Md Abu Yusuf Ansari
- Department of Data Science, University of Mississippi Medical Center, Jackson, MS, USA
| | - Pramod Anugu
- Jackson Heart Study, University of Mississippi Medical Center, Jackson, MS, USA
| | - Anna D Argoty-Pantoja
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Michael Arzt
- Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
| | - Hugues Aschard
- Department of Computational Biology, F-75015 Paris, France Institut Pasteur, Université Paris Cité, Paris, France
- Department of Epidemiology, Harvard TH School of Public Health, Boston, MA, USA
| | - John R Attia
- School of Medicine and Public Health, College of Health Medicine and Wellbeing, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Lydia Bazzanno
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, US
| | - Max A Breyer
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jennifer A Brody
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Brian E Cade
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Hung-hsin Chen
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yii-Der Ida Chen
- The Institute for Translational Genomics and Population Sciences, Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Zekai Chen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Paul S de Vries
- Human Genetics Center, Department of Epidemiology, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Latchezar M Dimitrov
- Department of Biochemistry, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Anh Do
- Center for Biostatistics and Data Science, Institute for Informatics, Data Science, and Biostatistics, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA
| | - Jiawen Du
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Charles T Dupont
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Todd L Edwards
- Biomedical Laboratory Research and Development, Tennessee Valley Healthcare System (626), Department of Veterans Affairs/ Nashville, TN, USA
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, US A
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Tariq Faquih
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Stephan B Felix
- DZHK (German Center for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
- Cardiology, Pneumology, Infectious Diseases, Intensive Care Medicine, Department of Internal Medicine B, Un iversity Medicine Greifswald, Greifswald, Germany
| | - Susan P Fisher-Hoch
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Brownsville, TX, USA
| | - James S Floyd
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Mariaelisa Graff
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Charles Gu
- Center for Biostatistics and Data Science, Institute for Informatics, Data Science, and Biostatistics, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA
| | - Dongfeng Gu
- Shenzhen Key Laboratory of Cardiovascular Health and Precision Medicine, Southern University of Science an d Technology, Shenzhen, China
| | - Kristen G Hairston
- Department of Endocrinology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Anthony J Hanley
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Iris M Heid
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | - Sami Heikkinen
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Kuopio
| | - Heather M Highland
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michelle M Hood
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Mika Kähönen
- Finnish Cardiovascular Research Center - Tampere, Department of Clinical Chemistry, Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere, Finland
- Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland
| | | | - Takahisa Kawaguchi
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Setoh Kazuya
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Tanika N Kelly
- Division of Nephrology, Department of Medicine, University of Illinois Chicago, Chicago, USA
| | | | - Daniel Levy
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
- Framingham Heart Study, Framingham, MA, USA
| | - Henry J Lin
- The Institute for Translational Genomics and Population Sciences, Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Peter Y Liu
- The Institute for Translational Genomics and Population Sciences, Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Joseph B McCormick
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Brownsville, TX, USA
| | - Hao Mei
- Department of Data Science, University of Mississippi Medical Center, Jackson, MS, USA
| | - James B Meigs
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Cristina Menni
- Department of Twin Research, King’s College London, London, UK
| | - Kisung Nam
- Graduate School of Data Science, Seoul National University, Seoul, South Korea
| | - Ilja M Nolte
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Natasha L Pacheco
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Lauren E Petty
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hannah G Polikowsky
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael A Province
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Laura M Raffield
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
| | - Olli T Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, and Department of Clinical Physiology and Nuclear Medicine, University of Turku, and Turku University Hospital, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Renata L Riha
- Department of Sleep Medicine, The University of Edinburgh, Edinburgh, UK
| | - Lorenz Risch
- Faculty of Medical Sciences , Institute for Laboratory Medicine, Private University in the Principality of Liecht enstein, Vaduz, Liechtenstein
- Center of Laboratory Medicine, Institute of Clinical Chemistry, University of Bern and Inselspital, Bern, Switze rland
| | - Martin Risch
- Central Laboratory, Cantonal Hospital Graubünden, Chur, Switzerland
- Medical Laboratory, Dr. Risch Anstalt, Vaduz, Liechtenstein
| | | | - Rodney J Scott
- School of Biomedical Sciences and Pharmacy, College of Health Medicine and Wellbeing, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Colleen M Sitlani
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Jennifer A Smith
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Tamar Sofer
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- CardioVascular Institute (CVI), Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Maris Teder-Laving
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Uwe Völker
- Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Guanchao Wang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ko Willems van Dijk
- Department of Human Genetics, Leiden University Medical Center, Leiden, Netherlands
- Department of Internal Medicine, Division of Endocrinology, Leiden, Netherlands
| | - Otis D Wilson
- Biomedical Laboratory Research and Development, Tennessee Valley Healthcare System (626), Department of Veterans Affairs/ Nashville, TN, USA
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rui Xia
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA
| | - Jie Yao
- The Institute for Translational Genomics and Population Sciences, Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Kristin L Young
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ruiyuan Zhang
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, US
| | - Xiaofeng Zhu
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jennifer E Below
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Carsten A Böger
- Department of Nephrology, University Hospital Regensburg, Regensburg, Germany
- Department of Nephrology and Rheumatology, Kliniken Südostbayern, Traunstein, Germany
- KfH Kidney Centre Traunstein, Traunstein, Germany
| | - David Conen
- Population Health Research Institute, Medicine, McMaster University, Hamilton, On, Canada
| | - Simon R Cox
- Department of Psychology, The University of Edinburgh, Edinburgh, UK
| | - Marcus Dörr
- DZHK (German Center for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
- Cardiology, Pneumology, Infectious Diseases, Intensive Care Medicine, Department of Internal Medicine B, Un iversity Medicine Greifswald, Greifswald, Germany
| | - Mary F Feitosa
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Ervin R Fox
- Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Nora Franceschini
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sina A Gharib
- Pulmonary, Critical Care and Sleep Medicine, Medicine, University of Washington, Seattle, WA, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, Department of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Sioban D Harlow
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, US
- Tulane University Translational Sciences Institute, New Orleans, LA , USA
| | - Elizabeth G Holliday
- School of Medicine and Public Health, College of Health Medicine and Wellbeing, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Zoltan Kutalik
- Statistical Genetics Group, Department of Computational Biology, University of Lausanne, Lausanne, Switzerland
- Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Timo A Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Kuopio
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Seunggeun Lee
- Graduate School of Data Science, Seoul National University, Seoul, South Korea
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
- Finnish Cardiovascular Research Center - Tampere, Department of Clinical Chemistry, Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Changwei Li
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, US
| | - Ching-Ti Liu
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Reedik Mägi
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Alanna C Morrison
- Human Genetics Center, Department of Epidemiology, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Brenda WJH Penninx
- Department of Psychiatry, Amsterdam UMC/Vrije universiteit, Amsterdam, Netherlands
- GGZ inGeest, Amsterdam, Netherlands
| | - Patricia A Peyser
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Jerome I Rotter
- The Institute for Translational Genomics and Population Sciences, Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Tim D Spector
- Department of Twin Research, King’s College London, London, UK
| | - Lynne E Wagenknecht
- Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | | | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Kari E North
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA
- Human Genetics Center, Department of Epidemiology, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | | | - Adriana M Hung
- Biomedical Laboratory Research and Development, Tennessee Valley Healthcare System (626), Department of Veterans Affairs/ Nashville, TN, USA
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Alisa K Manning
- Clinical and Translational Epidemiology Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Metabolism Program, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - James Gauderman
- Division of Biostatistics, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Han Chen
- Human Genetics Center, Department of Epidemiology, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
- Center for Precision Health, McWilliams School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Patricia B Munroe
- Clinical Pharmacology and Precision Medicine, Queen Mary University of London, London, UK
| | - Dabeeru C Rao
- Center for Biostatistics and Data Science, Institute for Informatics, Data Science, and Biostatistics, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA
| | - Diana van Heemst
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Lei den, Netherlands
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Raymond Noordam
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Lei den, Netherlands
| | - Heming Wang
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
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Tahsin CT, Anselmo M, Lee E, Stokes W, Fonkoue IT, Vanden Noven ML, Carter JR, Keller-Ross ML. Sleep disturbance and sympathetic neural reactivity in postmenopausal females. Am J Physiol Heart Circ Physiol 2024; 326:H752-H759. [PMID: 38214902 PMCID: PMC11221801 DOI: 10.1152/ajpheart.00724.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/02/2024] [Accepted: 01/09/2024] [Indexed: 01/13/2024]
Abstract
Sleep disturbance, one of the most common menopausal symptoms, contributes to autonomic dysfunction and is linked to hypertension and cardiovascular risk. Longitudinal studies suggest that hyperreactivity of blood pressure (BP) to a stressor can predict the future development of hypertension. It remains unknown if postmenopausal females who experience sleep disturbance (SDG) demonstrate greater hemodynamic and sympathetic neural hyperreactivity to a stressor. We hypothesized that postmenopausal females with reported sleep disturbance would exhibit increased hemodynamic and sympathetic reactivity to a stressor compared with postmenopausal females without sleep disturbance (non-SDG). Fifty-five postmenopausal females (age, 62 ± 4 yr old; SDG, n = 36; non-SDG; n = 19) completed two study visits. The Menopause-Specific Quality of Life Questionnaire (MENQOL) was used to assess the presence of sleep disturbance (MENQOL sleep scale, ≥2 units). Beat-to-beat BP (finger plethysmography), heart rate (HR; electrocardiogram), and muscle sympathetic nerve activity (MSNA; microneurography; SDG, n = 25; non-SDG, n = 15) were continuously measured during a 10-min baseline and 2-min stressor (cold pressor test; CPT) in both groups. Menopause age and body mass index were similar between groups (P > 0.05). There were no differences between resting BP, HR, or MSNA (P > 0.05). HR and BP reactivity were not different between SDG and non-SDG (P > 0.05). In contrast, MSNA reactivity had a more rapid increase in the first 30 s of the CPT in the SDG (burst incidence, Δ10.2 ± 14.8 bursts/100 hb) compared with the non-SDG (burst incidence, Δ4.0 ± 14.8 bursts/100 hb, time × group, P = 0.011). Our results demonstrate a more rapid sympathetic neural reactivity to a CPT in postmenopausal females with perceived sleep disturbance, a finding that aligns with and advances recent evidence that sleep disturbance is associated with sympathetic neural hyperactivity in postmenopausal females.NEW & NOTEWORTHY This is the first study to demonstrate that muscle sympathetic nerve activity (MSNA) to a cold pressor test is augmented in postmenopausal females with perceived sleep disturbance. The more rapid increase in MSNA reactivity during the cold pressor test in the sleep disturbance group was present despite similar increases in the perceived pain levels between groups. Baseline MSNA burst incidence and burst frequency, as well as blood pressure and heart rate, were similar between the sleep disturbance and nonsleep disturbance groups.
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Affiliation(s)
- Chowdhury Tasnova Tahsin
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
| | - Miguel Anselmo
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
| | - Emma Lee
- Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
| | - William Stokes
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
| | - Ida T Fonkoue
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
- Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
| | - Marnie L Vanden Noven
- Department of Exercise Science, Belmont University, Nashville, Tennessee, United States
| | - Jason R Carter
- Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, United States
| | - Manda L Keller-Ross
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
- Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
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Saha A, Muhammad T, Mandal B, Govil D, Ali W. Moderating role of functional/ mobility limitations in the association between sleep problems and hypertension among middle-aged and older adults in India. Prev Med Rep 2024; 38:102589. [PMID: 38283958 PMCID: PMC10820285 DOI: 10.1016/j.pmedr.2024.102589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 12/29/2023] [Accepted: 01/02/2024] [Indexed: 01/30/2024] Open
Abstract
Hypertension has become a global health concern and is recognized as an important modifiable risk factor for cardiovascular diseases (CVDs). There are very limited studies in India and worldwide focused on sleep problems, activities of daily living (ADL), instrumental ADL (IADL) and mobility limitations, and their discrete and combined effects on hypertension. Therefore, this study examined whether sleep problems are associated with hypertension, and whether the association is more pronounced among middle-aged and older adults with functional/mobility limitations. This study used data from the Longitudinal Ageing Study in India (LASI) wave 1, 2017-18, with a total sample of 59,951 adults aged 45 years and above. Log-binomial regression, and interaction terms were used to assess the relationship between sleep problems and hypertension, and the moderating effect of functional/mobility limitations. Respondents with sleep problems had a 29 % higher prevalence of hypertension [PR (prevalence ratio): 1.29; CI (confidence interval): 1.20-1.39]. Those with ADL and IADL limitations had 20 % [PR: 1.20; CI: 1.09-1.32] and 9 % [PR: 1.09; CI: 1.00-1.18] greater prevalence of hypertension. Interaction analysis revealed that individuals with ADL, IADL, and mobility limitations had 58 %, 52 %, and 45 % higher prevalence of hypertension, respectively, and was especially pronounced among women. Our findings highlight that improved sleep can reduce the prevalence of hypertension in middle-aged and older adults. Individuals with functional/mobility limitations may need additional care and support from their family members or the community, which could lower the prevalence of elevated blood pressure due to their sleep problems.
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Affiliation(s)
- Amiya Saha
- Department of Family & Generations, International Institute for Population Sciences, Mumbai 400088, India
| | - T Muhammad
- Postdoctoral Scholar, Center for Healthy Aging, The Pennsylvania State University, PA 16802, USA
| | - Bittu Mandal
- School of Humanities and Social Sciences, Indian Institute of Technology, Indore 453552, India
| | - Dipti Govil
- Department of Family & Generations, International Institute for Population Sciences, Mumbai 400088, India
| | - Waad Ali
- Department of Geography, Sultan Qaboos University, Muscat 123, Oman
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Lima LCBDA, Aquino SLS, da Cunha ATO, Peixoto TDN, Lima SCVC, Sena-Evangelista KCM, Lima JG, Pedrosa LFC. Associations between Components of Metabolic Syndrome and Demographic, Nutritional, and Lifestyle Factors. J Nutr Metab 2024; 2024:8821212. [PMID: 38282753 PMCID: PMC10817810 DOI: 10.1155/2024/8821212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/18/2023] [Accepted: 12/29/2023] [Indexed: 01/30/2024] Open
Abstract
Objectives To evaluate the associations between individuals with and without changes in components of metabolic syndrome (MetS) and demographic, nutritional, and lifestyle factors. Methods A cross-sectional study was conducted with 224 individuals followed-up at a public hospital in Northeast Brazil. We used National Cholesterol Education Program-Adult Treatment Panel III (NCEP) criteria to diagnose MetS. We assessed components of MetS as dependent variables, while sex, age, food consumption, smoking, alcohol intake, physical activity, anthropometric parameters, and sleep hours were independent variables. Results Comparing individuals with and without changes in components of MetS, the logistic regression models revealed that female sex was predictive of increased waist circumference and low HDL-c levels while advanced age was predictive of increased blood pressure and blood glucose levels. BMI emerged as a predictor for waist circumference and a protective factor for triglyceride levels. In addition, potassium intake, physical activity, and sleep duration were protective against decreased HDL-c, elevated triglyceride, and elevated blood pressure levels, respectively. Conclusion This study demonstrated that sex, age, BMI, dietary potassium intake, physical activity, and hours of sleep are factors to be targeted in public health actions for prevention and treatment of MetS.
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Affiliation(s)
| | - Séphora Louyse Silva Aquino
- Postgraduate Program in Health Sciences, Federal University of Rio Grande do Norte, Av. Cordeiro de Farias s/n, Natal 59012-570, RN, Brazil
| | - Aline Tuane Oliveira da Cunha
- Collaborative Researcher in Postgraduate Program in Nutrition, Federal University of Rio Grande do Norte, Av. Salgado Filho, 3000-Lagoa Nova, Natal 59078970, Brazil
| | - Talita do Nascimento Peixoto
- Postgraduate Program in Health Sciences, Federal University of Rio Grande do Norte, Av. Cordeiro de Farias s/n, Natal 59012-570, RN, Brazil
| | - Severina Carla Vieira Cunha Lima
- Postgraduate Program in Nutrition, Federal University of Rio Grande do Norte, Av. Salgado Filho, 3000-Lagoa Nova, Natal 59078970, RN, Brazil
- Department of Nutrition, Federal University of Rio Grande do Norte, Av. Salgado Filho, 3000-Lagoa Nova, Natal, RN 59078-970, Brazil
| | - Karine Cavalcanti Maurício Sena-Evangelista
- Postgraduate Program in Nutrition, Federal University of Rio Grande do Norte, Av. Salgado Filho, 3000-Lagoa Nova, Natal 59078970, RN, Brazil
- Department of Nutrition, Federal University of Rio Grande do Norte, Av. Salgado Filho, 3000-Lagoa Nova, Natal, RN 59078-970, Brazil
| | - Josivan Gomes Lima
- Department of Clinical Medicine, Endocrine Unit, Federal University of Rio Grande do Norte, Av. Nilo Peçanha 620, Petrópolis, Natal, RN 59010-180, Brazil
| | - Lucia Fátima Campos Pedrosa
- Postgraduate Program in Nutrition, Federal University of Rio Grande do Norte, Av. Salgado Filho, 3000-Lagoa Nova, Natal 59078970, RN, Brazil
- Postgraduate Program in Health Sciences, Federal University of Rio Grande do Norte, Av. Cordeiro de Farias s/n, Natal 59012-570, RN, Brazil
- Department of Nutrition, Federal University of Rio Grande do Norte, Av. Salgado Filho, 3000-Lagoa Nova, Natal, RN 59078-970, Brazil
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Chandra Shekhar H, Joshua L, Thomas JV. Standardized Extract of Valeriana officinalis Improves Overall Sleep Quality in Human Subjects with Sleep Complaints: A Randomized, Double-Blind, Placebo-Controlled, Clinical Study. Adv Ther 2024; 41:246-261. [PMID: 37899385 PMCID: PMC10796483 DOI: 10.1007/s12325-023-02708-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/03/2023] [Indexed: 10/31/2023]
Abstract
INTRODUCTION Sleep deficit or poor sleep leads to ill-health, whereas sleep deprivation for longer periods of time increases the risk of developing adverse conditions associated with poor quality of life, and high socioeconomic impact. The treatments for sleep disturbances include melatonin and over-the-counter medicines like diphenhydramine and doxylamine, all of which have negative side effects. Valerian (Valeriana officinalis L.) is a traditional herb and the most preferred alternate sleep solution to manage sleep complaints. METHODS Eighty adult subjects with sleep complaints were randomized in 1:1 ratio to receive either V. officinalis extract (VE) or placebo for 8 weeks in a double-blind, placebo-controlled, parallel, clinical study. Primary efficacy endpoints included the Pittsburgh Sleep Quality Index (PSQI) and sleep latency using wrist actigraphy (WA), as well as a number of secondary endpoints, including sleep parameters such as actual sleep time and sleep efficiency using WA, the Epworth Sleepiness Scale (ESS), the Beck Anxiety Inventory (BAI), the Visual Analogue Scale (VAS) for the feeling of waking up refreshed, and a tertiary endpoint of sleep parameters using polysomnography (PSG) in a subset of 20 subjects per group. Safety parameters included physical examination, vital sign measurements, hematology, and clinical chemistry tests. Adverse events and serious adverse events were monitored throughout the study period. RESULTS Seventy-two subjects (35 and 37 subjects in the placebo and VE groups, respectively) completed the study and were included in the efficacy assessments. On Days 14, 28, and 56, the PSQI Total Score in the VE group decreased significantly (p < 0.05) compared to the placebo group. Further, the VE group showed significant improvements (p < 0.05) in sleep latency and actual sleep time on Days 3, 14, 28, and 56, and sleep efficiency on Days 14, 28, and 56, as evaluated by WA. There was a decrease (p < 0.05) in anxiety (BAI) on Days 14, 28, and 56, daytime drowsiness (ESS) on Days 28 and 56, and an increased feeling of waking up refreshed (VAS) on Days 28 and 56 compared to placebo. PSG results carried out in subset of subjects revealed significant improvements (p < 0.05) in total sleep time, sleep latency, and sleep efficiency on Day 56 in the VE group compared to the placebo group. No safety concerns were observed throughout the study. CONCLUSION VE supplementation significantly improved various subjective and objective parameters of sleep in young subjects with mild insomnia symptoms, such as overall sleep quality, sleep latency, sleep efficiency, and total sleep time. We also observed decreased anxiety and daytime sleepiness, and improved feeling of being refreshed after waking up with VE supplementation. VE was found to be safe and well tolerated throughout the study. TRIAL REGISTRATION Clinical Trials Registry of India: CTRI/2022/05/042818.
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Affiliation(s)
- Harshith Chandra Shekhar
- BGS Global Institute of Medical Sciences, No. 67, BGS Health and Education City, Uttarahalli Road, Kengeri, Bengaluru, 560060, Karnataka, India
| | - Lincy Joshua
- Leads Clinical Research and Bio Services Pvt. Ltd., No. 9, 1st Floor Mythri Legacy, Kalyan Nagar, Chelekere Main Road, Bengaluru, 560043, Karnataka, India
| | - Jestin V Thomas
- Leads Clinical Research and Bio Services Pvt. Ltd., No. 9, 1st Floor Mythri Legacy, Kalyan Nagar, Chelekere Main Road, Bengaluru, 560043, Karnataka, India.
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Reichenberger DA, Ness KM, Strayer SM, Mathew GM, Schade MM, Buxton OM, Chang AM. Recovery Sleep After Sleep Restriction Is Insufficient to Return Elevated Daytime Heart Rate and Systolic Blood Pressure to Baseline Levels. Psychosom Med 2023; 85:744-751. [PMID: 37363991 PMCID: PMC10543608 DOI: 10.1097/psy.0000000000001229] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
OBJECTIVE Sleep restriction alters daytime cardiac activity, including elevating heart rate (HR) and blood pressure (BP). There is minimal research on the cumulative effects of sleep loss and the response after subsequent recovery sleep on HR and BP. This study examined patterns of HR and BP across baseline, sleep restriction, and recovery conditions using multiple daytime cardiac measurements. METHODS Participants (15 healthy men, mean [standard deviation] = 22.3 [2.8] years) completed an 11-day inpatient protocol with three nights of 10 hours/night baseline sleep opportunity, five sleep restriction nights (5-hour/night sleep opportunity), and two recovery nights (10-hour/night sleep opportunity). Resting HR and BP were measured every 2 hours during wake. Multilevel models with random effects for individuals examined daytime HR and BP across study conditions and days into the study. RESULTS Mean daytime HR was 1.2 (0.5) beats/min lower during sleep restriction compared with baseline ( p < .001). During recovery, HR was 5.5 (1.0) beats/min higher ( p < .001), and systolic BP (SBP) was 2.9 (1.1) mm Hg higher ( p = .009). When accounting for days into the study (irrespective of condition) and measurement timing across the day, HR increased by 7.6 beats/min and SBP increased by 3.4 mm Hg across the study period ( p < .001). CONCLUSIONS Our findings suggest that daytime HR and SBP increase after successive nights of sleep restriction, even after accounting for measurement time of day. HR and SBP did not recover to baseline levels after two recovery nights of sleep, suggesting that longer recovery sleep may be necessary to recover from multiple, consecutive nights of moderate sleep restriction.
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Affiliation(s)
| | - Kelly M. Ness
- Department of Medicine, Division of Metabolism, Endocrinology, and Nutrition, University of Washington
| | | | - Gina Marie Mathew
- Program in Public Health; Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, United States
| | | | - Orfeu M. Buxton
- Department of Biobehavioral Health, Pennsylvania State University
| | - Anne-Marie Chang
- Department of Biobehavioral Health, Pennsylvania State University
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Zhang H, Zhang X, Yao X, Wang Q. Exploring factors related to heart attack complicated with hypertension using a Bayesian network model: a study based on the China Health and Retirement Longitudinal Study. Front Public Health 2023; 11:1259718. [PMID: 37780426 PMCID: PMC10534983 DOI: 10.3389/fpubh.2023.1259718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
Objectives While Bayesian networks (BNs) represents a good approach to discussing factors related to many diseases, little attention has been poured into heart attack combined with hypertension (HAH) using BNs. This study aimed to explore the complex network relationships between HAH and its related factors, and to achieve the Bayesian reasoning for HAH, thereby, offering a scientific reference for the prevention and treatment of HAH. Methods The data was downloaded from the Online Open Database of CHARLS 2018, a population-based longitudinal survey. In this study, we included 16 variables from data on demographic background, health status and functioning, and lifestyle. First, Elastic Net was first used to make a feature selection for highly-related variables for HAH, which were then included into BN model construction. The structural learning of BNs was achieved using Tabu algorithm and the parameter learning was conducted using maximum likelihood estimation. Results Among 19,752 individuals (9,313 men and 10,439 women) aged 64.73 ± 10.32 years, Among 19,752 individuals (9,313 men and 10,439 women), there are 8,370 ones without HAH (42.4%) and 11,382 ones with HAH (57.6%). What's more, after feature selection using Elastic Net, Physical activity, Residence, Internet access, Asset, Marital status, Sleep duration, Social activity, Educational levels, Alcohol consumption, Nap, BADL, IADL, Self report on health, and age were included into BN model establishment. BNs were constructed with 15 nodes and 25 directed edges. The results showed that age, sleep duration, physical activity and self-report on health are directly associated with HAH. Besides, educational levels and IADL could indirectly connect to HAH through physical activity; IADL and BADL could indirectly connect to HAH through Self report on health. Conclusion BNs could graphically reveal the complex network relationship between HAH and its related factors. Besides, BNs allows for risk reasoning for HAH through Bayesian reasoning, which is more consistent with clinical practice and thus holds some application prospects.
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Affiliation(s)
- Haifen Zhang
- Department of General Practice, Shanxi Provincial People’s Hospital, The Fifth Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Xiaotong Zhang
- Department of Respiratory and Critical Care Medicine, Shanxi Provincial People’s Hospital, The Fifth Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Xiaodong Yao
- Department of General Practice, Shanxi Provincial People’s Hospital, The Fifth Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Qiang Wang
- Department of Infectious Disease, Shanxi Provincial People’s Hospital, The Fifth Clinical Medical College of Shanxi Medical University, Taiyuan, China
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Al Haddad N, Costanian C, Zibara V, Bilen Y, Kilani H, Tohme F, Bahous SA. The association between sleep disturbances and blood pressure variability: a review of the literature. J Clin Sleep Med 2023; 19:1533-1544. [PMID: 37078190 PMCID: PMC10394351 DOI: 10.5664/jcsm.10566] [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: 08/05/2022] [Revised: 03/19/2023] [Accepted: 03/21/2023] [Indexed: 04/21/2023]
Abstract
STUDY OBJECTIVES Sleep disturbances are an underrecognized public health issue that results in various adverse outcomes and disturbed quality of life. Blood pressure variability (BPV) is an emerging entity in assessing cardiovascular disease risk and accumulating evidence suggests that BPV is closely associated with end-organ damage. This review aims to explore the association between sleep disturbances and BPV. METHODS A comprehensive systematic literature search was conducted electronically using Web of Science, Ovid MEDLINE, , and SCOPUS. The electronic search was restricted to relevant English-language studies published between 1985 and August 2020. Most studies were prospective cohorts in design. After applying eligibility criteria, 29 articles were included for synthesis. RESULTS This review shows that sleep disturbances are linked to short-term, midterm, and long-term BPV. Restless legs syndrome, shift work, insomnia, short sleep, long sleep, obstructive sleep apnea, and sleep deprivation were all positively associated with systolic blood pressure or diastolic blood pressure fluctuations. CONCLUSIONS Given the prognostic implications of BPV and sleep disturbances on cardiovascular mortality, recognizing and treating both disorders is essential. More research is needed to examine the impact of sleep disorder treatment on BPV and cardiovascular mortality. CITATION Al Haddad N, Costanian C, Zibara V, et al. The association between sleep disturbances and blood pressure variability: a review of the literature. J Clin Sleep Med. 2023;19(8):1533-1544.
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Affiliation(s)
- Nadia Al Haddad
- Lebanese American University School of Medicine, Byblos, Lebanon
| | | | - Victor Zibara
- Department of Internal Medicine, Lebanese American University Medical Center—Rizk Hospital, Beirut, Lebanon
| | - Yara Bilen
- Department of Internal Medicine, Lebanese American University Medical Center—Rizk Hospital, Beirut, Lebanon
| | - Hala Kilani
- Department of Internal Medicine, Lebanese American University Medical Center—Rizk Hospital, Beirut, Lebanon
| | - Fadi Tohme
- Department of Internal Medicine, Lebanese American University Medical Center—Rizk Hospital, Beirut, Lebanon
| | - Sola Aoun Bahous
- Lebanese American University School of Medicine, Byblos, Lebanon
- Department of Internal Medicine, Lebanese American University Medical Center—Rizk Hospital, Beirut, Lebanon
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Bridges J, Shishavan HH, Salmon A, Metersky M, Kim I. Exploring the Potential of Pulse Transit Time as a Biomarker for Sleep Efficiency through a Comparison Analysis with Heart Rate and Heart Rate Variability. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23115112. [PMID: 37299839 DOI: 10.3390/s23115112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/17/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
The relationship between sleep dynamics and blood pressure (BP) changes is well established. Moreover, sleep efficiency and wakefulness during sleep (WASO) events have a significant impact on BP dipping. Despite this knowledge, there is limited research on the measurement of sleep dynamics and continuous blood pressure (CBP). This study aims to explore the relationship between sleep efficiency and cardiovascular function indicators such as pulse transit time (PTT), as a biomarker of CBP, and heart rate variability (HRV), measured using wearable sensors. The results of the study conducted on 20 participants at the UConn Health Sleep Disorders Center suggest a strong linear relationship between sleep efficiency and changes in PTT (r2 = 0.8515) and HRV during sleep (r2 = 5886). The findings of this study contribute to our understanding of the relationship between sleep dynamics, CBP, and cardiovascular health.
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Affiliation(s)
- Jenna Bridges
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Hossein Hamidi Shishavan
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Adrian Salmon
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Connecticut Health, Farmington, CT 06030, USA
| | - Mark Metersky
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Connecticut Health, Farmington, CT 06030, USA
| | - Insoo Kim
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
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15
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Dai J, Wu HY, Jiang XD, Tang YJ, Tang HK, Meng L, Huang N, Gao JY, Li J, Baker JS, Zheng CJ, Yang YD. Association between napping and 24-hour blood pressure variability among university students: A pilot study. Front Pediatr 2023; 11:1062300. [PMID: 36937964 PMCID: PMC10018217 DOI: 10.3389/fped.2023.1062300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 02/10/2023] [Indexed: 03/06/2023] Open
Abstract
Background Blood pressure variability (BPV) has been reported to be a predictor of cardiovascular and some cognitive diseases. However, the association between napping and BPV remains unknown. This study aimed to explore the association between napping and BPV. Materials and methods A cross-sectional study including 105 university students was conducted. Participants' 24 h ambulatory blood pressure monitoring (24 h ABPM) were measured, and napping behaviors were investigated. BPV were measured by the 24 h ABPM, included standard deviation (SD), coefficient of variation (CV), and average real variability (ARV). Results Among the participants, 61.9% reported daytime napping. We found that nap duration was significantly associated with daytime CV of diastolic blood pressure (DBP) (r = 0.250, P = 0.010), nighttime CV of systolic blood pressure (SBP) (r = 0.217, P = 0.026), 24 h WCV of DBP (r = 0.238, P = 0.014), 24 h ARV of SBP (r = 0.246, P = 0.011) and 24 h ARV of DBP (r = 0.291, P = 0.003). Compared with the no napping group, 24 h WCV of DBP, daytime CV of DBP, and daytime SD of DBP were significantly higher in participants with napping duration >60 min. With multiple regression analysis we found that nap duration was an independent predictor for 24 h ARV of SBP (β = 0.859, 95% CI, 0.101-1.616, P = 0.027) and 24 h ARV of DBP (β = 0.674, 95% CI, 0.173-1.175, P = 0.009). Conclusions Napping durations are associated with BPV among university students. Especially those with napping durations >60 min had a significantly higher BPV than those non-nappers.
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Affiliation(s)
- Jie Dai
- Department of Child and Adolescent Health, School of Medicine, Hunan Normal University, Changsha, China
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Hua-ying Wu
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Xiao-dong Jiang
- Department of Child and Adolescent Health, School of Medicine, Hunan Normal University, Changsha, China
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Yong-jie Tang
- Department of Child and Adolescent Health, School of Medicine, Hunan Normal University, Changsha, China
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Hao-Kai Tang
- Department of Child and Adolescent Health, School of Medicine, Hunan Normal University, Changsha, China
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Li Meng
- Department of Child and Adolescent Health, School of Medicine, Hunan Normal University, Changsha, China
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Na Huang
- Department of Child and Adolescent Health, School of Medicine, Hunan Normal University, Changsha, China
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Jing-yu Gao
- Department of Child and Adolescent Health, School of Medicine, Hunan Normal University, Changsha, China
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Jian Li
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China
| | - Chan-Juan Zheng
- Department of Child and Adolescent Health, School of Medicine, Hunan Normal University, Changsha, China
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
- Correspondence: Yi-De Yang Chan-Juan Zheng
| | - Yi-De Yang
- Department of Child and Adolescent Health, School of Medicine, Hunan Normal University, Changsha, China
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
- Correspondence: Yi-De Yang Chan-Juan Zheng
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Yoshida Y, Yajima Y, Fujikura Y, Zhuang H, Higo-Yamamoto S, Toyoda A, Oishi K. Identification of salivary microRNA profiles in male mouse model of chronic sleep disorder. Stress 2023; 26:21-28. [PMID: 36522611 DOI: 10.1080/10253890.2022.2156783] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Chronic sleep disorders (CSD) comprise a potential risk factor for metabolic and cardiovascular diseases, obesity and stroke. Thus, the identification of biomarkers for CSD is an important step in the early prevention of metabolic dysfunctions induced by sleep dysfunction. Diagnostic saliva samples can be easily and noninvasively collected. Thus, we aimed to identify whole microRNA (miRNA) profiles of saliva in control and psychophysiologically stressed CSD mouse models and compare them at Zeitgeber time (ZT) 0 (lights on) and ZT12 (lights off). The findings of two-way ANOVA revealed that the expression of 342 and 109 salivary miRNAs was affected by CSD and the time of day, respectively. Interactions were found in 122 miRNAs among which, we identified 197 (ZT0) and 62 (ZT12) upregulated, and 40 (ZT0) and seven (ZT12) downregulated miRNAs in CSD mice. We showed that miR-30c-5p, which is elevated in the plasma of patients with hypersomnia, was upregulated in the saliva of CSD mice collected at ZT0. The miRNAs, miR-10a-5p, miR-146b-5p, miR-150-5p, and miR-25-3p are upregulated in the serum of humans with poor sleep quality, and these were also upregulated in the saliva of CSD mice collected at ZT0. The miRNAs miR-30c, miR146b-5p, miR150, and miR-25-5p are associated with cardiovascular diseases, and we found that plasma concentrations of brain natriuretic peptides were significantly increased in CSD mice. The present findings showed that salivary miRNA profiles could serve as useful biomarkers for predicting CSD.
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Affiliation(s)
- Yuta Yoshida
- Department of Food and Life Sciences, College of Agriculture, Ibaraki University, Ami, Japan
| | - Yuhei Yajima
- Department of Food and Life Sciences, College of Agriculture, Ibaraki University, Ami, Japan
- United Graduate School of Agricultural Science, Tokyo University of Agriculture and Technology, Fuchu-City, Japan
| | - Yuri Fujikura
- Healthy Food Science Research Group, Cellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
| | - Haotong Zhuang
- Healthy Food Science Research Group, Cellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa, Japan
| | - Sayaka Higo-Yamamoto
- Healthy Food Science Research Group, Cellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
| | - Atsushi Toyoda
- Department of Food and Life Sciences, College of Agriculture, Ibaraki University, Ami, Japan
- United Graduate School of Agricultural Science, Tokyo University of Agriculture and Technology, Fuchu-City, Japan
| | - Katsutaka Oishi
- Healthy Food Science Research Group, Cellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa, Japan
- Department of Applied Biological Science, Graduate School of Science and Technology, Tokyo University of Science, Noda, Japan
- School of Integrative and Global Majors, University of Tsukuba, Tsukuba, Japan
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17
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Li C, Shang S, Liang W. Sleep and risk of hypertension in general American adults: the National Health and Nutrition Examination Surveys (2015-2018). J Hypertens 2023; 41:63-73. [PMID: 36129105 DOI: 10.1097/hjh.0000000000003299] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The purpose of research is to investigate the associations of sleep factors separately and jointly with risk of hypertension. METHODS The National Health and Nutrition Examination Surveys (NHANES) is a nationally representative survey. Participants aged over 20 years with complete and credible data from the NHANES 2015-2016 and 2017-2018 waves were included. Hypertension was assessed based on self-report medical diagnoses, or antihypertensive medication use, or systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg. Sleep information (sleep duration, trouble sleeping, daytime sleepiness, self-reported snoring and sleep-related breathing issue) was obtained from household interview. RESULTS Of 7426 participants, the mean (standard deviation) age was 48.0 (17.3) years, 3845 (51.8%) were females. The prevalence of hypertension was 32.8%, and lower in those with 7-9 h sleep, no trouble sleeping, no excessive daytime sleepiness, no snoring or sleep apnea symptoms, decreased as the quantity of healthy sleep factors increased. The self-reported short sleep (odds ratio [OR]: 1.25, 95% confidence interval [CI]: 1.02-1.54, P = 0.032), trouble sleeping (OR: 1.53, 95% CI: 1.20 to 1.95, P = 0.001), excessive daytime sleepiness (OR: 1.17, 95% CI: 1.01-1.35, P = 0.041) and sleep apnea symptoms (OR: 1.33, 95% CI: 1.10-1.61, P = 0.004) were associated with 25%, 53%, 17% and 33% increased risk of hypertension, respectively. Participants with a poor sleep pattern was associated with higher hypertension risk (OR: 2.47, 95% CI: 1.90-3.22, P < 0.001). CONCLUSION Sleep behaviors were cross-sectionally associated with a considerably higher hypertension risk.
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Affiliation(s)
- Chunnan Li
- Vanke School of Public Health
- Institute for Healthy China, Tsinghua University
- School of Nursing, Peking University, Haidian District, Beijing, China
| | - Shaomei Shang
- School of Nursing, Peking University, Haidian District, Beijing, China
| | - Wannian Liang
- Vanke School of Public Health
- Institute for Healthy China, Tsinghua University
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18
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Knapik JJ, Caldwell JA, Steelman RA, Trone DW, Farina EK, Lieberman HR. Short sleep duration is associated with a wide variety of medical conditions among United States military service members. Sleep Med 2023; 101:283-295. [PMID: 36470164 DOI: 10.1016/j.sleep.2022.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This cross-sectional study investigated self-reported sleep duration and its association with a comprehensive range of clinically-diagnosed medical condition categories (CDMCs), as well as the relationship between short sleep duration (≤6 h) and demographic/lifestyle factors, among United States military service members (SMs). METHODS A stratified random sample of SMs (n = 20,819) completed an online questionnaire on usual daily hours of sleep and demographic/lifestyle characteristics. CDMCs for a six-month period prior to questionnaire completion were obtained from a comprehensive military electronic medical surveillance system and grouped into 33 CDMCs covering both broad and specific medical conditions. Prevalence of CDMCs was compared among three sleep duration categories (≤4, 5-6 and ≥7 h). RESULTS SMs reported a mean ± standard deviation of 6.3 ± 1.4 h of sleep per day. After adjustment for demographic/lifestyle characteristics, shorter sleep duration was associated with higher odds of a medical condition in 25 of 33 CDMCs, with most (n = 20) demonstrating a dose-response relationship. The five CDMCs with the largest differences between ≤4 vs ≥ 7 h sleep were: diseases of the nervous system (odds ratio [OR] = 2.9, 95% confidence interval [95%CI] = 2.4-3.4), mental/behavioral diseases (OR = 2.7, 95%CI = 2.3-3.2), diseases of the musculoskeletal system (OR = 1.9, 95%CI = 1.6-2.1), diseases of the circulatory system (OR = 1.7, 95%CI = 1.3-2.2), and diseases of the digestive system (OR = 1.6, 95%CI = 1.2-2.0). Six hours of sleep or less was independently associated with older age, less formal education, race, Hispanic ethnicity, higher body mass index, smoking, and military service branch. CONCLUSIONS In this young, physically active population, reporting shorter sleep duration was associated with a higher risk of multiple CDMCs.
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Affiliation(s)
- Joseph J Knapik
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA.
| | - John A Caldwell
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA; Laulima Government Solutions, 5301 Buckystown Pike, STE 460, Frederick, MD, 21704, USA
| | - Ryan A Steelman
- U.S. Army Public Health Center, 8252 Blackhawk Rd, Aberdeen Proving Ground, MD, 21010, USA
| | - Daniel W Trone
- Naval Health Research Center, Building 329, Ryne Rd, San Diego, CA, 92152, USA
| | - Emily K Farina
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
| | - Harris R Lieberman
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
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Forshaw PE, Correia ATL, Roden LC, Lambert EV, Rae DE. Sleep characteristics associated with nocturnal blood pressure nondipping in healthy individuals: a systematic review. Blood Press Monit 2022; 27:357-370. [PMID: 36094364 DOI: 10.1097/mbp.0000000000000619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The current literature investigating nocturnal blood pressure (BP) nondipping has largely focused on clinical populations, however, conditions such as hypertension, obstructive sleep apnoea and insomnia are recognized confounding factors for BP dipping. The exact mechanisms responsible for BP nondipping remain unclear, therefore, there is a need to investigate BP nondipping in healthy individuals to better understand the underlying mechanisms. This review identifies sleep characteristics that may contribute to BP nondipping in healthy individuals. It is anticipated that an understanding of the sleep characteristics that contribute to BP nondipping may inform future sleep-related behavioral interventions to ultimately reducing the burden of cardiovascular disease. METHODS The PubMed, Scopus and Web of Science databases were searched for relevant, English language, peer-reviewed publications (from inception to March 2022). The search identified 550 studies. After duplicates were removed, the titles and abstracts of the remaining 306 studies were screened. Of these, 250 studies were excluded leaving 56 studies to test for eligibility. Thirty-nine studies were excluded such that 17 studies fully met the inclusion criteria for the review. RESULTS Findings from this review indicate that short sleep duration, more sleep fragmentation, less sleep depth and increased variability in sleep timing may be associated with BP nondipping in healthy individuals. CONCLUSION While there is no evidence-based approach for the treatment of nocturnal BP nondipping, it seems promising that addressing one's sleep health may be an important starting point to reduce the prevalence of BP nondipping and perhaps the progression to cardiovascular disease.
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Affiliation(s)
- Philippa Eileen Forshaw
- Health through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Arron Taylor Lund Correia
- Health through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Laura Catherine Roden
- Health through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Centre for Sport, Exercise and Life Sciences, School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, United Kingdom
| | - Estelle Victoria Lambert
- Health through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Dale Elizabeth Rae
- Health through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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An Y, Li X, Ouyang F, Xiao S. Association between nocturnal sleep duration and the risk of hyperuricemia among Chinese government employees: A cross-sectional study. Front Public Health 2022; 10:1055778. [PMID: 36504942 PMCID: PMC9727396 DOI: 10.3389/fpubh.2022.1055778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/07/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives Evidence has shown that nocturnal sleep duration is associated with the risk of hyperuricemia, yet the findings are inconsistent. Thus, we aimed at exploring the association between nocturnal sleep duration and the risk of hyperuricemia in Chinese government employees. Methods A total of 10,321 government employees aged 20-60 years were collected from the Cohort Study on Chronic Diseases among Government Employees in Hunan Province, China. Sleep duration was self-reported. And serum uric acid levels >420 μmol/L in men and >360 μmol/L in women were considered hyperuricemia. The association between nocturnal sleep duration and hyperuricemia risk was examined utilizing multivariate logistic regression models. To further examine the connection between nocturnal sleep duration and serum uric acid levels, multiple linear regression analyses were utilized. Results The prevalence of hyperuricemia was 17.2%. The results of logistic regression demonstrated that, in contrast to participants whose sleep duration was 7-8 h, those who slept for <7 h had an elevated risk of hyperuricemia (OR = 1.343, 95%CI: 1.126, 1.601). Further stratified analysis revealed that this association was still observed in those without obesity (OR = 1.365; 95%CI: 1.127, 1.655), hypertension (OR = 1.290, 95%CI: 1.054, 1.578), or diabetes mellitus (OR = 1.361, 95%CI: 1.136, 1.631). Multiple linear regression showed that shorter sleep duration (< 7 h) was positively correlated with serum uric acid levels. In comparison to individuals who slept for 7-8 h, those with sleep duration of fewer than 7 h had serum uric acid levels that were 7.231 μmol/L (95% CI: 2.875, 11.588) higher. Conclusion Short nocturnal sleep duration (< 7 h) was associated with a higher risk of hyperuricemia, especially in participants without obesity, hypertension, or diabetes mellitus. Besides, short nocturnal sleep duration was related to greater uric acid levels.
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Pirojsakul K, Aekplakorn W, Siwarom S, Paksi W, Kessomboon P, Neelapaichit N, Chariyalertsak S, Assanangkornchai S, Taneepanichskul S. Sleep duration and risk of high blood pressure in Thai adolescents: the Thai National Health Examination Survey V, 2014 (NHES-V). BMC Public Health 2022; 22:1983. [PMID: 36309648 PMCID: PMC9617401 DOI: 10.1186/s12889-022-14430-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/23/2022] [Indexed: 11/10/2022] Open
Abstract
Background Sleep duration has been proposed to be associated with high blood pressure. However, nationwide studies regarding this association in adolescents remain limited. This study aimed to explore the national prevalence of high blood pressure among Thai adolescents and to determine the association between sleep duration and high blood pressure. Methods Data from adolescents aged 10–19 years from the Thai National Health and Examination Survey V were included. We collected demographic data (including age and gender), height, weight, waist circumference, blood pressure, fasting blood chemistries and sleep duration data. Sleep durations were categorized as short, normal or long for each age group based on the United States National Sleep Foundation’s recommendations. High blood pressure was diagnosed using the 2017 guidelines of the American Academy of Pediatrics. Factors associated with high blood pressure were analyzed using multivariate logistic regression. Results A total of 3505 adolescents (1785 female) were included. The prevalence of high blood pressure was 9.4% (95% CI 8.5–10.4%). The high blood pressure group had higher BMI z-score, LDL-C, triglyceride and lower HDL-C than the normotensive group. In the multivariate analysis, BMI z-score, LDL-C and HDL-C were independently associated with high blood pressure. However, there was no association between sleep duration and high blood pressure. Conclusions High blood pressure risk was increased in adolescents with high BMI z-score. Neither short nor long sleep duration was associated with an increased risk of high blood pressure. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14430-z.
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22
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Wei R, Duan X, Guo L. Effects of sleep deprivation on coronary heart disease. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY 2022; 26:297-305. [PMID: 36039730 PMCID: PMC9437362 DOI: 10.4196/kjpp.2022.26.5.297] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/06/2022] [Accepted: 06/10/2022] [Indexed: 11/30/2022]
Abstract
The presence of artificial light enables humans to be active 24 h a day. Many people across the globe live in a social culture that encourages staying up late to meet the demands of various activities, such as work and school. Sleep deprivation (SD) is a severe health problem in modern society. Meanwhile, as with cardiometabolic disease, there was an obvious tendency that coronary heart disease (CHD) to become a global epidemic chronic disease. Specifically, SD can significantly increase the morbidity and mortality of CHD. However, the underlying mechanisms responsible for the effects of SD on CHD are multilayered and complex. Inflammatory response, lipid metabolism, oxidative stress, and endothelial function all contribute to cardiovascular lesions. In this review, the effects of SD on CHD development are summarized, and SD-related pathogenesis of coronary artery lesions is discussed. In general, early assessment of SD played a vital role in preventing the harmful consequences of CHD.
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Affiliation(s)
- Ran Wei
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Peking University Fifth School of Clinical Medicine, Beijing, China
| | - Xiaoye Duan
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Lixin Guo
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Peking University Fifth School of Clinical Medicine, Beijing, China
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23
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Makarem N, Alcantara C, Musick S, Quesada O, Sears DD, Chen Z, Tehranifar P. Multidimensional Sleep Health Is Associated with Cardiovascular Disease Prevalence and Cardiometabolic Health in US Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710749. [PMID: 36078471 PMCID: PMC9518578 DOI: 10.3390/ijerph191710749] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 06/01/2023]
Abstract
Individual sleep dimensions have been linked to cardiovascular disease (CVD) risk and cardiometabolic health (CMH), but sleep health is multifaceted. We investigated associations of a multidimensional sleep health (MDSH) score, enabling the assessment of sleep health gradients, with CVD and CMH. Participants were 4555 adults aged ≥20 years from the 2017-2018 National Health and Nutrition Examination Survey. A MDSH score, capturing poor, moderate, and ideal sleep was computed from self-reported sleep duration, sleep regularity, difficulty falling asleep, symptoms of sleep disorders, and daytime sleepiness. Survey-weighted multivariable linear and logistic models examined associations of MDSH with CVD and CMH. Ideal and moderate vs. poor MDSH were related to lower odds of hypertension (62% and 41%), obesity (73% and 56%), and central adiposity (68% and 55%), respectively; a statistically significant linear trend was observed across gradients of MDSH (p-trend < 0.001). Ideal vs. moderate/poor MDSH was associated with 32% and 40% lower odds of prevalent CVD and type 2 diabetes, respectively. More favorable MDSH was associated with lower blood pressure, BMI, waist circumference, and fasting glucose. In sex-stratified analyses, ideal vs. moderate/poor MDSH was associated with lower CVD odds and blood pressure in women only. The MDSH framework may be more than just the sum of its parts and could better capture information regarding CVD risk.
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Affiliation(s)
- Nour Makarem
- Department of Epidemiology, Mailman School of Public Heath, Columbia University Irving Medical Center, New York, NY 10032, USA
| | | | - Sydney Musick
- Department of Epidemiology, Mailman School of Public Heath, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Odayme Quesada
- Women’s Heart Center, The Christ Hospital Heart and Vascular Institute, Cincinnati, OH 45219, USA
| | - Dorothy D. Sears
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
- Department of Medicine, University of California San Diego, San Diego, CA 92093, USA
- Center for Circadian Biology, University of California San Diego, San Diego, CA 92093, USA
| | - Ziyu Chen
- Department of Epidemiology, Mailman School of Public Heath, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Parisa Tehranifar
- Department of Epidemiology, Mailman School of Public Heath, Columbia University Irving Medical Center, New York, NY 10032, USA
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24
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Lloyd-Jones DM, Allen NB, Anderson CAM, Black T, Brewer LC, Foraker RE, Grandner MA, Lavretsky H, Perak AM, Sharma G, Rosamond W. Life's Essential 8: Updating and Enhancing the American Heart Association's Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association. Circulation 2022; 146:e18-e43. [PMID: 35766027 PMCID: PMC10503546 DOI: 10.1161/cir.0000000000001078] [Citation(s) in RCA: 613] [Impact Index Per Article: 306.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In 2010, the American Heart Association defined a novel construct of cardiovascular health to promote a paradigm shift from a focus solely on disease treatment to one inclusive of positive health promotion and preservation across the life course in populations and individuals. Extensive subsequent evidence has provided insights into strengths and limitations of the original approach to defining and quantifying cardiovascular health. In response, the American Heart Association convened a writing group to recommend enhancements and updates. The definition and quantification of each of the original metrics (Life's Simple 7) were evaluated for responsiveness to interindividual variation and intraindividual change. New metrics were considered, and the age spectrum was expanded to include the entire life course. The foundational contexts of social determinants of health and psychological health were addressed as crucial factors in optimizing and preserving cardiovascular health. This presidential advisory introduces an enhanced approach to assessing cardiovascular health: Life's Essential 8. The components of Life's Essential 8 include diet (updated), physical activity, nicotine exposure (updated), sleep health (new), body mass index, blood lipids (updated), blood glucose (updated), and blood pressure. Each metric has a new scoring algorithm ranging from 0 to 100 points, allowing generation of a new composite cardiovascular health score (the unweighted average of all components) that also varies from 0 to 100 points. Methods for implementing cardiovascular health assessment and longitudinal monitoring are discussed, as are potential data sources and tools to promote widespread adoption in policy, public health, clinical, institutional, and community settings.
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25
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Abdalla M, Muntner P. Reply to 'Sleep duration and sleep blood pressure: the Nagahama Study'. J Hypertens 2022; 40:1625-1627. [PMID: 35881454 PMCID: PMC9333260 DOI: 10.1097/hjh.0000000000003161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Marwah Abdalla
- Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Paul Muntner
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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26
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Betson JR, Kirkcaldie MTK, Zosky GR, Ross RM. Transition to shift work: Sleep patterns, activity levels, and physiological health of early-career paramedics. Sleep Health 2022; 8:514-520. [PMID: 35907709 DOI: 10.1016/j.sleh.2022.06.001] [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: 09/23/2021] [Revised: 04/28/2022] [Accepted: 06/02/2022] [Indexed: 10/16/2022]
Abstract
The physiological impact of transitioning from full-time study to work in occupations that involve high-stress environments and shift work may plausibly impact sleep patterns and quality. There are limited studies focusing on the transition to shift work in graduate paramedics. This study aimed to assess early metabolic markers of health, activity, and sleep quality during the first 5 months of rostered shift work in a cohort of 28 graduate paramedics. Participants were tested for 4-week blocks before starting shift work (baseline), and during their first and fifth month of shift work. In each block, sleep and activity levels were monitored 24 h/day (workdays and nonworking days) using a wrist-worn actigraph. During shift work, the number of sleep episodes increased by 16.7% (p = .02) and self-reporting of poor sleep quality increased by 35.4% (p = .05); however, overall sleep quantity and sleep efficiency did not differ. Sleep metrics recorded during nonwork days were not different to baseline with exception of reduced sleep duration recorded the night before returning to work (5.99 ± 1.66 hours Month 1; 5.72 ± 1.06 hours Month 5). Sedentary behavior increased by 4.8% across the study, attributable to a significant decline in light exercise (p = .05). No changes were recorded in vigorous physical activity, average steps recorded per day, fasting blood glucose levels, systolic and diastolic blood pressure, weight, or waist circumference. These results warrant further large-scale and longitudinal studies to gauge any physiological implications for ongoing paramedic health.
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Affiliation(s)
- Jason R Betson
- College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia; Faculty of Health, Australian Catholic University, Melbourne, Victoria, Australia; Ambulance Victoria, Melbourne, Australia.
| | | | - Graeme R Zosky
- College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Renee M Ross
- College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
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27
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Chang X, Chen X, Ji JS, Luo G, Chen X, Sun Q, Zhang N, Guo Y, Pei P, Li L, Chen Z, Wu X. Association between sleep duration and hypertension in southwest China: a population-based cross-sectional study. BMJ Open 2022; 12:e052193. [PMID: 35760551 PMCID: PMC9237882 DOI: 10.1136/bmjopen-2021-052193] [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: 11/16/2022] Open
Abstract
OBJECTIVE Hypertension is a major risk factor and cause of many non-communicable diseases in China. While there have been studies on various diet and lifestyle risk factors, we do not know whether sleep duration has an association to blood pressure in southwest China. This predictor is useful in low-resource rural settings. We examined the association between sleep duration and hypertension in southwest China. DESIGN Population-based cross-sectional study. SETTING This study was part of the baseline survey of a large ongoing prospective cohort study, the China Kadoorie Biobank. Participants were enrolled in 15 townships of Pengzhou city in Sichuan province during 2004-2008. PARTICIPANTS 55 687 participants aged 30-79 years were included. Sleep duration was assessed by a self-reported questionnaire. MAIN OUTCOME MEASURES Hypertension was defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg, or prior physician-diagnosed hypertension in hospitals at the township (community) level or above. RESULTS The prevalence of hypertension was 25.17%. The percentages of subjects with sleep durations of <6, 6, 7, 8 and ≥9 hours were 17.20%, 16.14%, 20.04%, 31.95% and 14.67%, respectively. In multivariable-adjusted analyses, the increased ORs of having hypertension were across those who reported ≥9 hours of sleep (men: 1.16, 95% CI 1.04 to 1.30; women: 1.19, 95% CI 1.08 to 1.32; general population: 1.17, 95% CI 1.08 to 1.26). The odds of hypertension was relatively flat until around 6.81 hours of sleep duration and then started to increase rapidly afterwards in subjects and a J-shaped pattern was observed. There was a U-shaped relationship between sleep duration and hypertension in females. CONCLUSION Long sleep duration was significantly associated with hypertension and a J-shaped pattern was observed among rural adults in southwest China, independent of potential confounders. However, this association was not obvious between short sleep duration and hypertension.
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Affiliation(s)
- Xiaoyu Chang
- Department of Chronic and Non-communicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Xiaofang Chen
- Department of Epidemiology and Statistics, Chengdu Medical College, Chengdu, Sichuan, China
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Guojin Luo
- Pengzhou Center for Disease Control and Prevention, Pengzhou, Sichuan, China
| | - Xiaofang Chen
- Pengzhou Center for Disease Control and Prevention, Pengzhou, Sichuan, China
| | - Qiang Sun
- Pengzhou Center for Disease Control and Prevention, Pengzhou, Sichuan, China
| | - Ningmei Zhang
- Department of Chronic and Non-communicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Pei Pei
- Chinese Academy of Medical Sciences, Beijing, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Center for Public Health and Epidemic Preparedness and Response, Peking University, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit (CTSU) and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Xianping Wu
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
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28
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Chen JW, Huang HK, Fang YT, Lin YT, Li SZ, Chen BW, Lo YC, Chen PC, Wang CF, Chen YY. A Data-Driven Model with Feedback Calibration Embedded Blood Pressure Estimator Using Reflective Photoplethysmography. SENSORS 2022; 22:s22051873. [PMID: 35271020 PMCID: PMC8914760 DOI: 10.3390/s22051873] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/07/2022] [Accepted: 02/25/2022] [Indexed: 12/05/2022]
Abstract
Ambulatory blood pressure (BP) monitoring (ABPM) is vital for screening cardiovascular activity. The American College of Cardiology/American Heart Association guideline for the prevention, detection, evaluation, and management of BP in adults recommends measuring BP outside the office setting using daytime ABPM. The recommendation to use night–day BP measurements to confirm hypertension is consistent with the recommendation of several other guidelines. In recent studies, ABPM was used to measure BP at regular intervals, and it reduces the effect of the environment on BP. Out-of-office measurements are highly recommended by almost all hypertension organizations. However, traditional ABPM devices based on the oscillometric technique usually interrupt sleep. For all-day ABPM purposes, a photoplethysmography (PPG)-based wrist-type device has been developed as a convenient tool. This optical, noninvasive device estimates BP using morphological characteristics from PPG waveforms. As measurement can be affected by multiple variables, calibration is necessary to ensure that the calculated BP values are accurate. However, few studies focused on adaptive calibration. A novel adaptive calibration model, which is data-driven and embedded in a wearable device, was proposed. The features from a 15 s PPG waveform and personal information were input for estimation of BP values and our data-driven calibration model. The model had a feedback calibration process using the exponential Gaussian process regression method to calibrate BP values and avoid inter- and intra-subject variability, ensuring accuracy in long-term ABPM. The estimation error of BP (ΔBP = actual BP—estimated BP) of systolic BP was −0.1776 ± 4.7361 mmHg; ≤15 mmHg, 99.225%, and of diastolic BP was −0.3846 ± 6.3688 mmHg; ≤15 mmHg, 98.191%. The success rate was improved, and the results corresponded to the Association for the Advancement of Medical Instrumentation standard and British Hypertension Society Grading criteria for medical regulation. Using machine learning with a feedback calibration model could be used to assess ABPM for clinical purposes.
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Affiliation(s)
- Jia-Wei Chen
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan; (J.-W.C.); (Y.-T.F.); (S.-Z.L.); (B.-W.C.)
| | - Hsin-Kai Huang
- Department of Cardiology, Ten-Chan General Hospital (Chung Li), Taoyuan 32043, Taiwan;
| | - Yu-Ting Fang
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan; (J.-W.C.); (Y.-T.F.); (S.-Z.L.); (B.-W.C.)
- Food and Drug Administration, Ministry of Health and Welfare, Taipei 11561, Taiwan
| | - Yen-Ting Lin
- Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 33004, Taiwan;
| | - Shih-Zhang Li
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan; (J.-W.C.); (Y.-T.F.); (S.-Z.L.); (B.-W.C.)
| | - Bo-Wei Chen
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan; (J.-W.C.); (Y.-T.F.); (S.-Z.L.); (B.-W.C.)
| | - Yu-Chun Lo
- The Ph.D. Program for Neural Regenerative Medicine, Taipei Medical University, Taipei 11031, Taiwan;
| | - Po-Chuan Chen
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA;
| | - Ching-Fu Wang
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan; (J.-W.C.); (Y.-T.F.); (S.-Z.L.); (B.-W.C.)
- Biomedical Engineering Research and Development Center, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
- Correspondence: (C.-F.W.); (Y.-Y.C.)
| | - You-Yin Chen
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan; (J.-W.C.); (Y.-T.F.); (S.-Z.L.); (B.-W.C.)
- The Ph.D. Program for Neural Regenerative Medicine, Taipei Medical University, Taipei 11031, Taiwan;
- Correspondence: (C.-F.W.); (Y.-Y.C.)
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29
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Association between Sleep Duration and Hypertension among Adults in Southwest China. Glob Heart 2022; 17:10. [PMID: 35342697 PMCID: PMC8877812 DOI: 10.5334/gh.1100] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/26/2022] [Indexed: 11/20/2022] Open
Abstract
Objective: This study aimed to evaluate the association between sleep duration and hypertension among adults in southwest China. Methods: Baseline variables were collected from a representative sample of 20,053 adults aged 23–98 years in southwest China who received physical examinations from January 2019 to December 2020. All participants were categorized into either a hypertension group or a non-hypertension group. Sleep duration was classified as short (<6 h/day), normal (6–8 h/day),or long (>8 h/day). Baseline variables were compared between individuals with and without hypertension by rank-sum tests for two independent samples or χ2 tests for nonparametric data. Multivariate logistic regression analysis was performed to evaluate the association between sleep duration and hypertension. Results: The overall incidence of hypertension was 51.2%. Unadjusted analysis showed that the risk of hypertension was higher in individuals with short (<6h/day) or long (>8h/day) sleep durations compared with those with a normal (6–8 h/day) sleep duration. The risk of hypertension was significantly increased by 30.1% in participants with a long (>8h/day) sleep duration compared with those with a normal (6–8h/day) sleep duration (OR = 1.301, P < 0.010, 95%CI = 1.149–1.475). The risk of hypertension was also increased by 1.1% in participants with a short (<6h/day) sleep duration compared with participants with a normal (6–8h/day) sleep duration, but the difference was not significant (OR = 1.011, P = 0.849, 95%CI = 0.905–1.129). After fully adjusting for confounding factors (model 4), the risk of hypertension was increased significantly (by 25%) in individuals with a short (<6h/day) sleep duration (OR = 1.25, P = 0.02, 95%CI = 1.036–1.508) but not in those with a long (>8h/day) sleep duration (17.5% increase) compared with participants with a normal (6–8h/day) sleep duration (OR = 1.175, P = 0.144, 95%CI = 0.946–1.460). Conclusion: The results of this study indicate that a short (<6h/day) sleep duration is related to an increased risk of hypertension, suggesting that sleep helps to protect against hypertension.
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30
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Gonzales JU, Clark C, Anderson T. Effect of five nights of sleep extension on peripheral vascular function: a randomized crossover investigation into long sleep duration. Sleep Med 2022; 90:145-152. [PMID: 35180478 PMCID: PMC8923941 DOI: 10.1016/j.sleep.2022.01.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/17/2021] [Accepted: 01/24/2022] [Indexed: 02/04/2023]
Abstract
Long sleep duration, defined as ≥9 h, is associated with increased cardiovascular mortality. We sought to determine the effect of sleep extension on peripheral vascular health. Twelve middle-aged adults were randomly assigned to spend five nights with 8 h (control) or 10+ hours time in bed (TIB) in a crossover fashion. Sleep was assessed using wrist actigraphy. Peak reactive hyperemia in the forearm was measured using venous-occlusion plethysmography as an index of microvascular vasodilation. Nighttime and morning blood pressure was recorded along with pulse wave velocity (arterial stiffness). Average sleep duration was 7.1 ± 0.3 and 9.3 ± 0.3 h for 8 and 10+ hours TIB (P < 0.001), respectfully. On average, sleep was extended by 127 ± 29 min with nine participants reaching average sleep durations >9 h. Extended sleep did not change nighttime or morning blood pressure, or pulse wave velocity (all P > 0.05). In contrast, peak forearm vascular conductance (FVC, 0.27 ± 0.08 vs. 0.23 ± 0.07 ml/100 ml/min/mmHg, P = 0.02) and total excess blood flow (28 ± 9 vs. 24 ± 11 ml/100 ml, P < 0.01) were increased following sleep extension. The change in FVC and total excess blood flow were inversely correlated with the change in wake after sleep onset and TIB (both r = -0.62, P < 0.05), but not with sleep duration. These results demonstrate that extended time in bed accompanied by long sleep durations does not impair peripheral vascular function, but rather, may increase microvasculature vasodilatory capacity in midlife adults.
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Affiliation(s)
- Joaquin U. Gonzales
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, United States of America
| | - Cayla Clark
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, United States of America
| | - Todd Anderson
- Department of Environmental Toxicology, Texas Tech University, Lubbock, Texas, United States of America
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31
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Exploring the Associations between Single-Child Status and Childhood High Blood Pressure and the Mediation Effect of Lifestyle Behaviors. Nutrients 2022; 14:nu14030500. [PMID: 35276857 PMCID: PMC8839388 DOI: 10.3390/nu14030500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/16/2022] [Accepted: 01/18/2022] [Indexed: 02/07/2023] Open
Abstract
Background: This study aimed to assess the association between single-child status and childhood high blood pressure (HBP) and to explore the role of lifestyle behaviors in this relationship. Methods: This study used data from a cross-sectional survey of 50,691 children aged 7~18 years in China. Linear and logistic regression models were used to assess the relationship between single-child status and HBP, and interactions between single-child status and lifestyle behaviors were also evaluated. Mediation analysis was conducted to detect the mediation effect of lifestyle behaviors. Results: Of the participants enrolled, 67.2% were single children and 49.4% were girls. Non-single children were associated with a greater risk of HBP, especially in girls (OR = 1.11, 95%CI: 1.03~1.19). Meat consumption and sedentary behavior mediated 58.9% of the association between single-child status and HBP (p < 0.01). When stratified by sleeping duration, non-single girls of insufficient sleep and hypersomnia showed a higher risk of HBP (p < 0.05) than single-child peers, but not in those with adequate sleep. Conclusion: Findings suggest that non-single children had an increased risk of HBP, and keeping healthy lifestyle behaviors could help to mitigate the adverse impact in non-single children.
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32
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Becker KN, Gifford CS, Qaqish H, Alexander C, Ren G, Caras A, Miller WK, Schroeder JL. A Population-Based Study of Patients with Sleep-Wake Disorders Undergoing Elective Instrumented Spinal Surgery. World Neurosurg 2022; 160:e335-e343. [PMID: 35032715 DOI: 10.1016/j.wneu.2022.01.008] [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: 11/15/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sleep-wake disorders are associated with multisystemic pathologies, but the clinical risk that such disorders carry for spinal surgery patients is not well understood. This population-based study comprehensively evaluates the significance of sleep-related risk factors on instrumented spinal surgery outcomes. METHODS National Inpatient Sample data for hospitalizations of patients undergoing elective instrumented spine surgery between 2008 and 2014 was analyzed using national estimates. Cohorts were defined as those admissions with or without a coexisting sleep-wake disorder diagnosis identified by ICD-9 codes. Postoperative complications, mortality rate, length of stay, discharge status, and total cost of admission were compared between groups using bivariate and multivariate analyses. RESULTS A coexisting sleep-wake disorder existed in 234,640 (10.8%) of 2,171,167 instrumented spinal surgery hospitalizations. Multivariate binary logistic regression accounting for these variables confirmed that a sleep-wake disorder is a significant risk factor for postoperative complication (OR 1.160, 95% CI 1.140-1.179, p<0.0001), length of stay above the 75th percentile (OR 1.303, 95% CI 1.288-1.320, p<0.0001), non-routine discharge (OR 1.147, 95% CI 1.131-1.163, p<0.0001), and death (OR 1.533, 95% CI 1.131-2.078, p<0.01), but not for total charges above the 75th percentile (OR 0.975, 95% CI 0.962-0.989, p<0.001). CONCLUSIONS Sleep-wake disorders confer increased risk of morbidity and mortality in elective instrumented spine surgery. Understanding the specific contributions of sleep-wake disorders to postoperative morbidity and mortality can help physicians implement prophylactic measures to reduce complications and improve postoperative patient recovery.
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Affiliation(s)
- Kathryn N Becker
- Division of Neurosurgery, Department of Surgery, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA.
| | - Connor S Gifford
- Division of Neurosurgery, Department of Surgery, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA
| | - Hanan Qaqish
- Division of Neurosurgery, Department of Surgery, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA
| | - Christopher Alexander
- Division of Neurosurgery, Department of Surgery, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA
| | - Gang Ren
- Division of Neurosurgery, Department of Surgery, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA
| | - Andrew Caras
- Department of Neurosurgery, Virginia Commonwealth University, Richmond, VA, USA
| | - William K Miller
- Department of Neurosurgery, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
| | - Jason L Schroeder
- Division of Neurosurgery, Department of Surgery, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA; ProMedica Physicians Neurosurgery, Toledo, OH, USA
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33
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Night shift work and the risk of metabolic syndrome: Findings from an 8-year hospital cohort. PLoS One 2021; 16:e0261349. [PMID: 34898652 PMCID: PMC8668137 DOI: 10.1371/journal.pone.0261349] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/30/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives Studies concerning the risk of metabolic syndrome associated with night work have shown inconsistent findings, due to imprecise working time data and cross-sectional design. We used register-based daily working time data to examine the risk of incident metabolic syndrome associated with night shift work. Methods Working time data collected between 2010 and 2018 of 5775 Taiwanese hospital workers were used to identify night shift workers and to calculate the number of night shifts. Metabolic syndrome was identified by annual occupational health examination results, which were linked to the working time data. Logistic regression models and generalized estimating equations were used to examine the association between night shift work and metabolic syndrome and the 5 components of metabolic syndrome. Results Night shift work is associated with a higher risk of developing metabolic syndrome (adjusted OR = 1.36, 95% CI = 1.04 to 1.78) and high waist circumference (adjusted OR = 1.27, 95% CI = 1.07 to 1.78) compared to day work. Among night shift workers, increased number of night shifts was associated with high blood pressure (adjusted OR = 1.15, 95% CI = 1.01 to 1.31). Conclusions Night shift work is associated with metabolic risk factors. Long-term effects of circadian rhythm disruption on metabolic disturbances needs to be further studied.
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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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The association of actigraphy-assessed sleep duration with sleep blood pressure, nocturnal hypertension, and nondipping blood pressure: the coronary artery risk development in young adults (CARDIA) study. J Hypertens 2021; 39:2478-2487. [PMID: 34738991 DOI: 10.1097/hjh.0000000000002956] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Nocturnal hypertension and nondipping systolic blood pressure (SBP) are associated with increased cardiovascular disease (CVD) risk. Short and long sleep duration (SSD and LSD) are also associated with increased CVD risk and may be risk factors for nocturnal hypertension and nondipping SBP. We examined the association between SSD and LSD with sleep BP, nocturnal hypertension, and nondipping SBP among 647 white and African American Coronary Artery Risk Development in Young Adults (CARDIA) study participants who completed 24-h ambulatory BP monitoring, wrist actigraphy, and sleep diaries in 2015-2016. METHODS The times when participants were asleep and awake were determined from actigraphy complemented by sleep diaries. Nocturnal hypertension was defined as sleep BP ≥120/70 mmHg and nondipping SBP as mean sleep-to-awake SBP ratio >0.90. Sleep duration was categorized as SSD (<6 h), normal sleep duration (NSD: 6-8.9 h), and LSD (≥9 h). RESULTS The prevalence of SSD and LSD were 13.9 and 21.1%, respectively. Compared to participants with NSD, participants with LSD had higher mean sleep SBP (2.1 mmHg, 95% confidence interval [CI] 0.2, 4.1 mmHg) and diastolic BP (1.7 mmHg, 95% CI 0.5, 3.0 mmHg). Participants with LSD had a higher prevalence of nocturnal hypertension (prevalence ratio [PR]: 1.26, 95% CI 1.03-1.54) and nondipping SBP (PR 1.33, 95% CI 1.03-1.72) compared to participants with NSD. There was no evidence of an association between SSD and sleep SBP or DBP, nocturnal hypertension, or nondipping SBP. CONCLUSIONS These findings suggest that LSD may be associated with nocturnal hypertension and nondipping SBP.
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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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Gamboa Madeira S, Fernandes C, Paiva T, Santos Moreira C, Caldeira D. The Impact of Different Types of Shift Work on Blood Pressure and Hypertension: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136738. [PMID: 34201492 PMCID: PMC8269039 DOI: 10.3390/ijerph18136738] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 11/16/2022]
Abstract
Shift work (SW) encompasses 20% of the European workforce. Moreover, high blood pressure (BP) remains a leading cause of death globally. This review aimed to synthesize the magnitude of the potential impact of SW on systolic blood pressure (SBP), diastolic blood pressure (DBP) and hypertension (HTN). MEDLINE, EMBASE and CENTRAL databases were searched for epidemiological studies evaluating BP and/or HTN diagnosis among shift workers, compared with day workers. Random-effects meta-analyses were performed and the results were expressed as pooled mean differences or odds ratios and 95% confidence intervals (95% CI). The Newcastle-Ottawa Scale was used to assess the risk of bias. Forty-five studies were included, involving 117,252 workers. We found a significant increase in both SBD and DBP among permanent night workers (2.52 mmHg, 95% CI 0.75-4.29 and 1.76 mmHg, 95% CI 0.41-3.12, respectively). For rotational shift workers, both with and without night work, we found a significant increase but only for SBP (0.65 mmHg, 95% CI 0.07-1.22 and 1.28 mmHg, 95% CI 0.18-2.39, respectively). No differences were found for HTN. Our findings suggest that SW is associated with an increase of BP, mainly for permanent night workers and for SBP. This is of special interest given the large number of susceptible workers exposed over time.
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Affiliation(s)
- Sara Gamboa Madeira
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-026 Lisbon, Portugal
- Family Health Unit Mactamã, Administração Regional de Saúde de Lisboa e Vale do Tejo, 2745-862 Lisbon, Portugal
- Correspondence:
| | - Carina Fernandes
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, 1600-560 Lisbon, Portugal;
- Neurology Department, Hospital das Forças Armadas, 1649-020 Lisbon, Portugal
| | - Teresa Paiva
- Sleep Medicine Center (CENC), 1070-068 Lisbon, Portugal;
- Comprehensive Health Research Center (CHRC), Nova Medical School, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal
| | - Carlos Santos Moreira
- Medicine Clinic I, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal;
| | - Daniel Caldeira
- Cardiology Department, Hospital de Santa Maria/Santa Maria University Hospital—Centro Hospitalar Universitário Lisboa Norte (CHULN), 1649-028 Lisbon, Portugal;
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
- Centro Cardiovascular da Universidade de Lisboa (CCUL), CAML, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
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Çoner A, Akbay E, Akıncı S, Özyıldız G, Gençtoy G, Müderrisoğlu H. Determinants of reverse dipping blood pressure in normotensive, non-diabetic population with an office measurement below 130/85mmHg. Clin Exp Hypertens 2021; 43:647-652. [PMID: 34151642 DOI: 10.1080/10641963.2021.1925685] [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: 10/21/2022]
Abstract
Objective: The role of dipping blood pressure pattern in normotensives is unclear. The study aims to search the circadian blood pressure rhythm and the clinical determinants related to reverse dipping pattern in a strictly selected, normotensive population.Methods: The study population was divided into three groups depending on the nocturnal dipping pattern as dipping, non-dipping, and reverse dipping. Basal clinical characteristics, anthropometric measurements, and spot urine samples from the first-morning void were collected. Clinical determinants related to the presence of reverse dipping pattern were tested by the Multiple Binary Logistic Regression analysis.Results: A total of 233 participants were involved in the study population (median age 45 years [40-50]). Dipping pattern was detected in 55.4%, non-dipping pattern in 33.0%, and reverse dipping pattern in 11.6% of the study population. There was no difference between the groups in terms of basal clinical features. Albumin-to-creatinine ratio (ACR) (p < .001) and hs-CRP levels (p = .006) were also statistically significant across the groups. ACR (HR: 1.195, 95% CI: 1.067-1.338, p = .002) and hs-CRP (HR: 2.438, 95% CI: 1.023-5.808, p = .044) were found to be related to the presence of reverse dipping blood pressure pattern.Conclusions: The absence of nocturnal physiological dipping is seen at a remarkable rate in the normotensive Turkish population. ACR and hs-CRP are the clinical determinants related to the presence of reverse dipping blood pressure pattern.
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Affiliation(s)
- Ali Çoner
- Department of Cardiology, Baskent University Hospital Alanya Application and Research Center, Alanya/Antalya, Turkey
| | - Ertan Akbay
- Department of Cardiology, Baskent University Hospital Alanya Application and Research Center, Alanya/Antalya, Turkey
| | - Sinan Akıncı
- Department of Cardiology, Baskent University Hospital Alanya Application and Research Center, Alanya/Antalya, Turkey
| | - Gökhan Özyıldız
- Department of Cardiology, Recep Tayyip Erdogan University Training and Research Hospital, Rize, Turkey
| | - Gültekin Gençtoy
- Department of Nephrology, Baskent University Hospital Alanya Application and Research Center, Alanya/Antalya, Turkey
| | - Haldun Müderrisoğlu
- Department of Cardiology, Baskent University Faculty of Medicine, Ankara, Turkey
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Makarem N, Zuraikat FM, Scaccia SE, RoyChoudhury A, St-Onge MP. Sustained Mild Sleep Restriction Increases Blood Pressure in Women: An Update From the American Heart Association Go Red for Women Strategically Focused Research Network. Hypertension 2021; 77:e50-e52. [PMID: 33775114 DOI: 10.1161/hypertensionaha.120.16370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Nour Makarem
- Department of Epidemiology, Mailman School of Public Health (N.M.), Columbia University Irving Medical Center, New York.,Sleep Center of Excellence (N.M., F.M.Z., S.E.S., M.-P.S.-O.), Columbia University Irving Medical Center, New York
| | - Faris M Zuraikat
- Sleep Center of Excellence (N.M., F.M.Z., S.E.S., M.-P.S.-O.), Columbia University Irving Medical Center, New York.,Department of Medicine (F.M.Z., S.E.S., M.-P.S.-O.), Columbia University Irving Medical Center, New York
| | - Samantha E Scaccia
- Sleep Center of Excellence (N.M., F.M.Z., S.E.S., M.-P.S.-O.), Columbia University Irving Medical Center, New York.,Department of Medicine (F.M.Z., S.E.S., M.-P.S.-O.), Columbia University Irving Medical Center, New York
| | - Arindam RoyChoudhury
- Division of Biostatistics, Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.R.)
| | - Marie-Pierre St-Onge
- Sleep Center of Excellence (N.M., F.M.Z., S.E.S., M.-P.S.-O.), Columbia University Irving Medical Center, New York.,Department of Medicine (F.M.Z., S.E.S., M.-P.S.-O.), Columbia University Irving Medical Center, New York
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40
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Paixão-Dias VM. Objective short sleep duration and its effect on 24-hour blood pressure. Int J Cardiol Hypertens 2021; 8:100073. [PMID: 33884366 PMCID: PMC7803048 DOI: 10.1016/j.ijchy.2020.100073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 12/04/2020] [Indexed: 11/29/2022] Open
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Makarem N, Alcántara C, Williams N, Bello NA, Abdalla M. Effect of Sleep Disturbances on Blood Pressure. Hypertension 2021; 77:1036-1046. [PMID: 33611935 DOI: 10.1161/hypertensionaha.120.14479] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This review summarizes recent literature addressing the association of short sleep duration, shift work, and obstructive sleep apnea with hypertension risk, blood pressure (BP) levels, and 24-hour ambulatory BP. Observational studies demonstrate that subjectively assessed short sleep increases hypertension risk, though conflicting results are observed in studies of objectively assessed short sleep. Intervention studies demonstrate that mild and severe sleep restriction are associated with higher BP. Rotating and night shift work are associated with hypertension as shift work may exacerbate the detrimental impact of short sleep on BP. Further, studies demonstrate that shift work may increase nighttime BP and reduce BP control in patients with hypertension. Finally, moderate to severe obstructive sleep apnea is associated with hypertension, particularly resistant hypertension. Obstructive sleep apnea is also associated with abnormal 24-hour ambulatory BP profiles, including higher daytime and nighttime BP, nondipping BP, and a higher morning surge. Continuous positive airway pressure treatment may lower BP and improve BP dipping. In conclusion, efforts should be made to educate patients and health care providers about the importance of identifying and treating sleep disturbances for hypertension prevention and management. Empirically supported sleep health interventions represent a critical next step to advance this research area and establish causality.
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Affiliation(s)
- Nour Makarem
- From the Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY (N.M.)
| | | | - Natasha Williams
- Department of Population Health, Center for Healthful Behavior Change, New York University Grossman School of Medicine (N.W.)
| | - Natalie A Bello
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, NY (N.A.B., M.A.)
| | - Marwah Abdalla
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, NY (N.A.B., M.A.)
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DelRosso LM, Chan J, Ruth C, Powell WT, Arp M, Hanevold C, Ferri R. Ambulatory blood pressure monitoring in children undergoing polysomnography. J Sleep Res 2021; 30:e13280. [PMID: 33535275 DOI: 10.1111/jsr.13280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 12/18/2020] [Accepted: 12/29/2020] [Indexed: 01/06/2023]
Abstract
Ambulatory blood pressure monitoring (ABPM) is recommended for the diagnosis of hypertension in children at high risk, such as children with obesity or obstructive sleep apnea (OSA). Nocturnal hypertension is highly predictive of cardiovascular outcomes. ABPM allows for early detection of nocturnal hypertension in children. Although OSA is the most common sleep disorder associated with hypertension, studies have also shown an increase in cardiovascular risk in adult patients with other sleep disorders; therefore, there is an imperative need to provide early diagnosis in children at high risk. In the present study, we evaluated the feasibility of using ABPM during polysomnography (PSG) in children referred for sleep disordered breathing to the Seattle Children's Hospital Sleep Disorders Center. A total of 41 children aged 7-18 years were included in this study. The ABPM monitor was worn for a mean (SD) of 10.2 (1.5) hr. No significant changes were seen in PSG parameters when ABPM was co-performed with PSG, including sleep efficiency and arousals. In total, 12 of the 41 patients were identified as having nocturnal hypertension. Our study is important in that it shows that concomitant use of ABPM during PSG can aid in the early identification of nocturnal hypertension in this population.
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Affiliation(s)
- Lourdes M DelRosso
- Seattle Children's Hospital, Seattle, WA, USA.,University of Washington, Seattle, WA, USA
| | - Jeremy Chan
- Seattle Children's Hospital, Seattle, WA, USA.,University of Washington, Seattle, WA, USA
| | - Chris Ruth
- Seattle Children's Hospital, Seattle, WA, USA
| | - Weston T Powell
- Seattle Children's Hospital, Seattle, WA, USA.,University of Washington, Seattle, WA, USA
| | | | - Coral Hanevold
- Seattle Children's Hospital, Seattle, WA, USA.,University of Washington, Seattle, WA, USA
| | - Raffaele Ferri
- Sleep Research Centre, Oasi Research Institute - IRCCS, Troina, Italy
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Huang L, Long Z, Lyu J, Chen Y, Li R, Wang Y, Li S. The Associations of Trajectory of Sleep Duration and Inflammation with Hypertension: A Longitudinal Study in China. Nat Sci Sleep 2021; 13:1797-1806. [PMID: 34675727 PMCID: PMC8517638 DOI: 10.2147/nss.s329038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/22/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Existing evidence suggested that sleep duration may be involved in hypertension; however, the conclusions were still controversial. This study aimed to examine the association of longitudinal trajectory of sleep duration with hypertension and to explore the role of the inflammation in such associations. METHODS A total of 3178 subjects over 30 years of age without hypertension were enrolled in 2004, and they were followed until 2009. Self-reported sleep duration was recorded, and inflammation was measured by highly sensitive C reactive protein (hs-CRP). Log-binomial regression models were applied to examine the association of sleep duration trajectory and inflammation with the risk of hypertension. The mediating effect of elevated hs-CRP was examined by the bootstrap and the process software. RESULTS The prevalence of persistent short (≤7 hours/day), normal (8-9 hours/day), and long (>9 hours/day) sleep duration over 5 years were 9.1%, 37.7%, and 2.3%, respectively. The incidence of hypertension was 26.6% during the follow-up period. Compared with those who persistently slept 8-9 hours/day from baseline to follow-up, those who persistently slept ≤7 hours/day, persistently slept ≥10 hours/day, and those whose sleep duration changed have higher risks of hypertension by 1.375-fold (95% CI: 1.121, 1.686), 1.557-fold (95% CI: 1.171, 2.069) and 1.299-fold (95% CI: 1.135, 1.487), respectively. In addition, persistently slept ≤7 hours/day was found to be associated with higher risk of inflammation (RR: 1.285, 95% CI: 1.008, 1.638). The mediation analysis did not find significant mediating effect of elevated CRP on the association between sleep duration trajectory and hypertension. CONCLUSION Experiencing both a short or long sleep duration, especially for a long time, could lead to higher risk of hypertension. Persistent exposure to short sleep duration was also associated with inflammation. However, the higher risk of hypertension caused by persistent short sleep duration does not seem to be directly mediated through inflammation.
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Affiliation(s)
- Lili Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Zichong Long
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jiajun Lyu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Yiting Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Rong Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Yanlin Wang
- Prenatal Diagnosis Department, International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Shenghui Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,MOE - Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
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Baek SJ, Ban HJ, Park SM, Lee B, Choi Y, Baek Y, Lee S, Cha S. Circulating microRNAs as Potential Diagnostic Biomarkers for Poor Sleep Quality. Nat Sci Sleep 2021; 13:1001-1012. [PMID: 34234603 PMCID: PMC8254567 DOI: 10.2147/nss.s311541] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 05/21/2021] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Persistent poor sleep quality leads to impaired cognitive performance and an inability to perform daily activities. Biomarker-assisted diagnosis is important for the early treatment of poor sleep quality; however, diagnostic biomarkers for poor sleep quality remain unidentified. Circulating microRNAs (miRNAs) have been reported to be linked to the pathogenesis of poor sleep quality, indicating their possible role in sleep problem diagnosis. The present study aimed to identify potential miRNA biomarkers for poor sleep quality. PATIENTS AND METHODS Differentially expressed serum miRNAs in patients with poor sleep quality and healthy controls (n=20) were analyzed via small RNA sequencing. Two-step quantitative RT-PCR in the two independent populations and receiver operating characteristic (ROC) analyses were used to validate the identified miRNAs. In silico analysis was then used to identify the target genes. RESULTS Of the 59 circulating miRNAs identified via differential analysis, six were validated for differential expression by quantitative RT-PCR (n=60). Two of these six miRNAs, miR-4433b-3p and miR-619-5p, were reconfirmed in the second validation with an independent validation cohort (n=59). ROC analyses (n=40) revealed the probability of the two miRNAs as potential biomarkers with areas under the ROC curve (AUCs) of 0.81 and 0.70, respectively. The combined AUC was 0.86, which was much higher than that of each miRNA. Using in silico target gene analysis, the target genes of the two miRNAs were identified to be associated with the regulation of the circadian rhythm and inflammatory pathways. CONCLUSION Our results revealed that miR-619-5p and miR-4433b-3p could be developed as potential diagnostic biomarkers for poor sleep quality. The combination of both miRNAs may be more effective than the use of the individual miRNA for sleep problem diagnosis.
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Affiliation(s)
- Su-Jin Baek
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Hyo-Jeong Ban
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Sang-Min Park
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Boyoung Lee
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Yoorae Choi
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Younghwa Baek
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Siwoo Lee
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Seongwon Cha
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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45
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Affiliation(s)
- Ripu D. Jindal
- Birmingham VA Medical Center, University of Alabama at Birmingham, Birmingham, Alabama
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46
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Abdalla M, Schwartz JE, Cornelius T, Chang BP, Alcántara C, Shechter A. Objective short sleep duration and 24-hour blood pressure. Int J Cardiol Hypertens 2020; 7:100062. [PMID: 33447783 PMCID: PMC7803013 DOI: 10.1016/j.ijchy.2020.100062] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/16/2020] [Accepted: 10/23/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Short sleep duration is a contributor to cardiovascular disease (CVD) events and mortality. Short sleep duration is associated with an increased risk of high clinic blood pressure (BP). BP measured outside the clinic using 24-h ambulatory blood pressure monitoring (ABPM) is a better predictor of an individual's CVD risk. We examined the association between objectively-assessed sleep duration and 24-h ambulatory blood pressure (ABP). METHODS A total of 893 working adults underwent sleep and ABPM. Participants were fitted with an ABPM device, and measures were taken at 28-30 min intervals. Objective sleep duration, and times of wakefulness and sleep during the 24-h ABPM period were derived from wrist-worn actigraphy. Linear regression, adjusted for age, sex, race/ethnicity, body mass index, smoking status, and diabetes were conducted on the relationship between sleep duration and the ABP measures. RESULTS Mean age of participants (final n = 729, 59.5% female, 11.9% Hispanic) was 45.2 ± 10.4 y. Mean actigraphy-derived sleep duration was 6.8 ± 1.2 h. Sleep duration <6 h was associated with a 1.73 mmHg higher 24-h systolic BP (p = 0.031) and 2.17 mmHg higher 24-h diastolic BP (p < 0.001). Shorter sleep duration was not associated with mean awake or asleep systolic BP (p = 0.89 and p = 0.92) or mean awake or asleep diastolic BP (p = 0.30 and p = 0.74). CONCLUSIONS To our knowledge, this is the largest study conducted which assessed sleep duration objectively while measuring 24-h ABP. Shorter sleep duration is associated with higher 24-h BP and potentially cardiovascular risk.
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Affiliation(s)
- Marwah Abdalla
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Joseph E. Schwartz
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, NY, USA
| | - Talea Cornelius
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Bernard P. Chang
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | | | - Ari Shechter
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
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DelRosso LM, Mogavero MP, Ferri R. Effect of Sleep Disorders on Blood Pressure and Hypertension in Children. Curr Hypertens Rep 2020; 22:88. [PMID: 32893326 DOI: 10.1007/s11906-020-01100-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW In this review, we aim to discuss the pathophysiologic basis of hypertension in sleep disorders and the current evidence in the medical literature linking sleep disorders and hypertension in children. RECENT FINDINGS The medical literature in adults is clear about the contribution of sleep disorders, poor sleep quality, and sleep deprivation to hypertension and increased cardiovascular risk. The literature on cardiovascular consequences of sleep disorders in children is not as robust, but there is some evidence of early cardiovascular changes in children with sleep deprivation and obstructive sleep apnea. Children with obstructive sleep apnea have increased sympathetic activation during sleep, blunted dipping, or elevated systolic or diastolic pressures. Although the literature on other sleep disorders such as narcolepsy and restless legs syndrome is scarce, there is evidence in adults and some recent supportive data in children.
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Affiliation(s)
- Lourdes M DelRosso
- Pediatric Pulmonary and Sleep Medicine, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA.
| | - Maria Paola Mogavero
- Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia, Via Salvatore Maugeri 4, 27100, Pavia, Italy
| | - Raffaele Ferri
- Sleep Research Centre, Oasi Research Institute-IRCCS, Via C. Ruggero 73, 94018, Troina, Italy
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Winkler MR, Telke S, Ahonen EQ, Crane MM, Mason SM, Neumark-Sztainer D. Constrained choices: Combined influences of work, social circumstances, and social location on time-dependent health behaviors. SSM Popul Health 2020; 11:100562. [PMID: 32195314 PMCID: PMC7078433 DOI: 10.1016/j.ssmph.2020.100562] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/28/2020] [Accepted: 02/29/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Physical activity and sleep are two time-dependent behaviors with important health implications. The amount of time people have to engage in these behaviors may vary based on their everyday work, social circumstances (e.g., parenthood), and social location (e.g., gender). AIMS The current study aimed to explore the ways work, social circumstances, and social locations combine that lead to heterogeneity in the time-dependent health behaviors of physical activity and time spent in bed (i.e., sleep) among a young adult population. We drew upon two conceptual frameworks-Constrained Choices and an intersectionality perspective-and examined multiple work characteristics (e.g., number of jobs), social circumstances (e.g., household income), and social locations (e.g., U.S. nativity) relevant to young adulthood. METHODS 2015-2016 data from a Minneapolis-St. Paul, U.S. cohort of 1830 young adults (25-36 years) were analyzed using conditional inference tree (CIT)-a data-driven approach which identifies population sub-groups that differ in their outcome values as well as in the interacting factors that predict outcome differences. Sensitivity analyses to evaluate CIT robustness were also performed. RESULTS CITs revealed four relevant sub-groups for physical activity (sub-group averages ranged = 2.9-4.9 h per week), with working mothers achieving the least activity, and six relevant sub-groups for time in bed (range = 7.8-8.7 h per day), with full-time working men obtaining the least. In both models, parent status and employment status/hours were found to consistently differentiate behavior among women but not men. CONCLUSION According to these data, time to engage in physical activity and time in bed was constrained by particular everyday contexts (work and parent status) and the extent to which these contexts mattered also depended on gender. If replicated in other studies, results suggest equitable strategies are necessary to assist all parents and workers in engaging in these time-dependent health behaviors for long-term health.
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Affiliation(s)
- Megan R. Winkler
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Susan Telke
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Emily Q. Ahonen
- Department of Social and Behavioral Sciences, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA
| | - Melissa M. Crane
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Susan M. Mason
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Hudec M, Dankova P, Solc R, Bettazova N, Cerna M. Epigenetic Regulation of Circadian Rhythm and Its Possible Role in Diabetes Mellitus. Int J Mol Sci 2020; 21:E3005. [PMID: 32344535 PMCID: PMC7215839 DOI: 10.3390/ijms21083005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/14/2020] [Accepted: 04/21/2020] [Indexed: 12/11/2022] Open
Abstract
This review aims to summarize the knowledge about the relationship between circadian rhythms and their influence on the development of type 2 diabetes mellitus (T2DM) and metabolic syndrome. Circadian rhythms are controlled by internal molecular feedback loops that synchronize the organism with the external environment. These loops are affected by genetic and epigenetic factors. Genetic factors include polymorphisms and mutations of circadian genes. The expression of circadian genes is regulated by epigenetic mechanisms that change from prenatal development to old age. Epigenetic modifications are influenced by the external environment. Most of these modifications are affected by our own life style. Irregular circadian rhythm and low quality of sleep have been shown to increase the risk of developing T2DM and other metabolic disorders. Here, we attempt to provide a wide description of mutual relationships between epigenetic regulation, circadian rhythm, aging process and highlight new evidences that show possible therapeutic advance in the field of chrono-medicine which will be more important in the upcoming years.
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Affiliation(s)
- Michael Hudec
- Department of Medical Genetics, Third Faculty of Medicine, Charles University; Ruská 87, 100 00 Prague, Czech Republic; (N.B.); (M.C.)
| | - Pavlina Dankova
- Department of Anthropology and Human Genetics, Faculty of Science, Charles University; Viničná 7, 128 00 Prague, Czech Republic; (P.D.); (R.S.)
| | - Roman Solc
- Department of Anthropology and Human Genetics, Faculty of Science, Charles University; Viničná 7, 128 00 Prague, Czech Republic; (P.D.); (R.S.)
| | - Nardjas Bettazova
- Department of Medical Genetics, Third Faculty of Medicine, Charles University; Ruská 87, 100 00 Prague, Czech Republic; (N.B.); (M.C.)
| | - Marie Cerna
- Department of Medical Genetics, Third Faculty of Medicine, Charles University; Ruská 87, 100 00 Prague, Czech Republic; (N.B.); (M.C.)
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Abstract
PURPOSE OF REVIEW In this review, we summarize recent epidemiological data (2014-2019) that examine the association of sleep variability with blood pressure (BP), discuss potential underlying mechanisms, and highlight future research directions. RECENT FINDINGS Higher standard deviations of sleep duration and sleep-onset timing were not related to BP. However, a higher Sleep Regularity Index score was associated with lower odds of hypertension. Studies on social jetlag, a prevalent form of sleep variability, reported null associations. In contrast, lower interdaily stability in circadian rest-activity rhythms, a measure of invariability in sleep-wake cycles between days and synchronization to light and dark cycles, was associated with higher BP and greater hypertension odds, particularly among non-shift workers. Sleep variability is consistently associated with risk factors for hypertension. Evidence on sleep variability and BP is limited and varies depending on the measure used to characterize day-to-day variability in sleep. Studies that identify and utilize a standard definition of sleep variability, incorporate a 24-h ambulatory BP monitoring, and ensure coinciding timing of sleep and BP measurements are necessary to disentangle these relationships.
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