Sleep quality as predictor of BMI in non-depressed caregivers of people with dementia

The relationship between burden and caregiver's sleep disturbances in dementia: a systematic review

Caregivers of people living with dementia (PLwD) have a high burden degree that leads to health issues, including sleep.

Objective

This study aimed to analyze the impacts of the caregiving burden on caregiver's sleep disturbances.

Methods

This systematic review involved a qualitative analysis of publications on Web of Science and Pubmed/Medline databases published between February 2018 and August 2022.

Results

A total of 27 studies were identified and analyzed. Caregiver's sleep presents impairments in sleep latency, sleep fragmentation, sleep duration, subjective sleep quality, daytime dysfunction, and insomnia. Caregiver's distress and depressive symptoms have a dual relationship with sleep problems.

Conclusion

Sleep disturbances presented by caregivers are correlated with higher burden levels and lead to more vulnerability to psychiatric symptoms and health issues.

Correlation Between Symptoms of Depression and Obesity in Caregivers of Patients With Chronic Illness: A Gender Difference Analysis

This study involved gender-stratified analysis and total-sample analysis to assess the extent to which symptoms of depression correlate with the body mass index (BMI) of a population of 112 people responsible for caring for others diagnosed with a chronic illness. The majority of the participants (caregivers) of this study were female (57.1%). All participants were recruited from an urban medical city hospital. The Patient Health Questionnaire-9 (PHQ-9) was employed to assess the extent to which caregivers exhibited symptoms of depression, and BMI was calculated by the researcher using the subject's height and weight. Regressions were executed on the entire dataset spanning male and female participants to generate insights into demographic factors, after which the PHQ-9 was administered. After taking into account the possible confounding factors, the findings of the regression showed that there was a significant correlation between the BMI and PHQ-9 scores (β = .25, P = .042). The correlation between BMI and PHQ-9 persisted among females (β = .37, P = .023). Furthermore, there is a noteworthy correlation among the participants who were morbidly obese (BMI > 30 kg/m2). The correlation between BMI and PHQ-9 caregivers of patients with chronic illness remained after taking demographic factors into account. These findings could be utilized to enhance the outcomes for caregivers of patients with chronic illness. They may be particularly pertinent for caregivers who are experiencing depression or are overweight.

Sleep Quality Reports From Family Caregivers and Matched Non-caregiving Controls in a Population-Based Study

The stress of family caregiving may affect many health-related variables, including sleep. We evaluated differences in self-reported sleep quality between incident caregivers and matched non-caregiving controls from a national population-based study. Caregivers and controls were identified in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study and matched on seven different demographic and health history factors. Caregivers reported significantly longer sleep onset latency than controls, before and after adjusting for covariates (ps < .05). No differences were found on measures of total sleep time or sleep efficiency. Among caregivers only, employed persons reported less total sleep time and number of care hours was a significant predictor of total sleep time. Dementia caregivers did not differ from other caregivers. This is one of the few population-based studies of sleep quality in family caregivers. Additional research is needed to examine whether sleep disturbance contributes to greater health problems among caregivers.

Association of sleep, screen time and physical activity with overweight and obesity in Mexico

PURPOSE

Approximately 70% of adults in Mexico are overweight or obese. Unhealthy lifestyle behaviors are also prevalent. We examined the association of three lifestyle behaviors with body mass index (BMI) categories in adults from Mexico.

METHODS

We used publicly available data from the ENSANUT 2016 survey (n = 6419). BMI was used to categorize participants. Differences in sleep duration, suffering from symptoms of insomnia, TV watching time, time in front of any screen, vigorous physical activity (yes vs no), moderate physical activity (> 30 min/day-yes vs. no) and walking (> 60 min/day-yes vs. no) were compared across BMI groups using adjusted linear and logistic regression analyses.

RESULTS

Thirty-nine percent of participants were overweight and 37% obese. Time in front of TV, in front of any screen, sleep duration and physical activity were significantly associated with overweight and obesity. Compared to normal weight participants, participants in the obese II category spend on average 0.60 h/day (95% CI 0.36-0.84, p = 0.001) and participants in the obese III category 0.54 h/day (95% CI 0.19-0.89, p < 0.001) more in front of any screen; participants in the obese II category reported 0.55 h/day less sleep (95% CI - 0.67 to - 0.43, p < 0.001); participants in the obese III category were less likely to engage in vigorous activity (OR = 0.60, 95% CI 0.43-0.84, p ≤ 0.003), or walking (OR = 0.65, 95% CI 0.49-0.88, p = 0.005).

CONCLUSION

Screen time, sleeping hours, and physical activity were associated with overweight and obesity. However, these associations were not consistent across all BMI categories. Assuming established causal connections, overweight individuals and individuals with obesity would benefit from reduced screen time and engaging in moderate/vigorous physical activity.

LEVEL OF EVIDENCE

Level III: observational case-control analytic study.

Self-reported Sleep Quality and Bone Outcomes in Older Adults: Findings from the Hertfordshire Cohort Study

Sleep duration may be associated with risk of osteoporosis, with suggestions that too little or indeed too much sleep may be detrimental to bone health. In this study, we considered whether perceived sleep quality is also associated with bone health in older adults. We explored this association in a cohort of 443 older community-dwelling UK adults. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI); poor sleep quality was defined as > 5 on this score system. Bone density, shape and microarchitecture were assessed using dual energy X-ray absorptiometry (DXA), peripheral quantitative computed tomography (pQCT) and high-resolution pQCT (HRpQCT). Thirty-seven percent of men and 43% of women had a PSQI score greater than 5, indicative of poor perceived sleep. We found that quality of sleep was associated with altered bone microarchitecture. In men, poor sleep quality was associated with lower radial trabecular (4% slice, p < 0.04) and cortical (66% slice, p = 0.02) bone mineral density, as well as decreased tibial cortical density (p < 0.02) and increased porosity (p < 0.04), but increased size of the tibia (p < 0.04). In women, poor perceived sleep quality was associated with thinner (p < 0.03) and less dense (p < 0.04) cortices of the radius, but greater tibial trabecular number (p < 0.02) and lower separation (p < 0.04). Relationships with DXA parameters were non-significant after adjustment for confounders. Taking sleep medications was associated with decreased tibial size (38% and 66% slices) and strength in women (all p < 0.05), but not in men. Perceived sleep quality was associated with altered bone density and microarchitecture in older adults, and these differences varied according to biological sex and site. Further work is indicated to investigate possible mechanisms underlying these observations.

Sleep duration and body mass index: moderating effect of self-perceived stress and age. Results of a cross-sectional population-based study

PURPOSE

The objective of this analysis was to assess whether the association between sleep duration and BMI and between sleep duration and waist circumference is moderated by age and self-perceived stress.

METHODS

We analyzed data from 2034 participants enrolled in 2014 in the cross-sectional study Obesity in Romania Study-study of the prevalence of obesity and related risk factors in Romanian general population (ORO study).

RESULTS

Interaction between sleep duration, self-perceived stress and age, with BMI as dependent variable, was statistically significant after adjustment for demographic and lifestyle factors (p value for interaction 0.003). In participants without self-perceived stress, a linear negative association between sleep duration and BMI was observed only in those 18-39 years old (p = 0.049), with BMI decreasing in parallel with increased sleep duration. In participants with self-perceived stress, a U-shaped relationship was observed between BMI and sleep duration in those 40-64 years old, with higher BMI in those sleeping ≤ 6 h and ≥ 9 h/night compared to those sleeping > 6 and < 9 h/night (p = 0.002 and 0.005). Those ≥ 65 years old with self-perceived stress sleeping ≥ 9 h/night had a significantly higher BMI compared to those in other sleep duration categories (p = 0.041 vs. those sleeping ≤ 6 h/night and p = 0.013 vs. to those sleeping > 6 and < 9 h/night). No interaction between age, self-perceived stress and sleep duration, with waist circumference as dependent variable was observed.

CONCLUSIONS

In our sample, the association between sleep duration and BMI was moderated by self-perceived stress and age.

Impact of obesity on central processing time rather than overall reaction time in young adult men

BACKGROUND AND PURPOSE

The association between weight status with simple cognitive tasks such as reaction time (RT) may not be observed in young people as cognitive functioning development has reached its peak. In the present study, we aimed to examine the association between overall and central adiposity with overall and central processing of RT in a sample of young adult men with different weight status from Ardabil, Iran.

METHODS

Eighty-six young males between June-July 2018 completed RT tests as well as premotor time (PMT) using surface electromyography changes in isometric contraction response to an audio stimulus.

RESULTS

No significant associations were observed between RT and PMT and different body mass index categories (underweight, normal weight, overweight and obese), as well as fat mass and fat to skeletal muscle mass ratio quartiles (Q). However, participants with greater waist to height ratio (WHtR) had longer PMT (but not RT) than their peers with lower WHtR (Q3 than Q2 and Q1 groups; p < 0.05, d = 1.23). Participants in the skeletal muscle mass quartile Q2 tended to have longer RT than participants in Q3 in an adjusted comparison model (p = 0.05, d = 0.72).

CONCLUSIONS

Although the association between weight status and RT might be elusive in young adults, our results show that higher central adiposity is negatively associated with PMT in young adults. Longitudinal studies are needed to explore the changes in obesity indexes and process speed in longer terms.

LEVEL OF EVIDENCE

Level I, experimental study.