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Liu H, Wu Y, Zhu H, Wang P, Chen T, Xia A, Zhao Z, He D, Chen X, Xu J, Ji L. Association between napping and type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2024; 15:1294638. [PMID: 38590820 PMCID: PMC10999583 DOI: 10.3389/fendo.2024.1294638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/12/2024] [Indexed: 04/10/2024] Open
Abstract
As the incidence of type 2 diabetes mellitus (T2DM) is increasing rapidly and its consequences are severe, effective intervention and prevention, including sleep-related interventions, are urgently needed. As a component of sleep architecture, naps, alone or in combination with nocturnal sleep, may influence the onset and progression of T2DM. Overall, napping is associated with an increased risk of T2DM in women, especially in postmenopausal White women. Our study showed that napping >30 minutes (min) increased the risk of T2DM by 8-21%. In addition, non-optimal nighttime sleep increases T2DM risk, and this effect combines with the effect of napping. For nondiabetic patients, napping >30 min could increase the risks of high HbA1c levels and impaired fasting glucose (IFG), which would increase the risk of developing T2DM later on. For diabetic patients, prolonged napping may further impair glycemic control and increase the risk of developing diabetic complications (e.g., diabetic nephropathy) in the distant future. The following three mechanisms are suggested as interpretations for the association between napping and T2DM. First, napping >30 min increases the levels of important inflammatory factors, including interleukin 6 and C-reactive protein, elevating the risks of inflammation, associated adiposity and T2DM. Second, the interaction between postmenopausal hormonal changes and napping further increases insulin resistance. Third, prolonged napping may also affect melatonin secretion by interfering with nighttime sleep, leading to circadian rhythm disruption and further increasing the risk of T2DM. This review summarizes the existing evidence on the effect of napping on T2DM and provides detailed information for future T2DM intervention and prevention strategies that address napping.
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Affiliation(s)
- Hongyi Liu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Yingxin Wu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Hui Zhu
- Department of Internal Medicine, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Penghao Wang
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Tao Chen
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Anyu Xia
- Department of Clinical Medicine, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Zhijia Zhao
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Da He
- Department of Obstetrics and Gynecology, Yinzhou District Maternal and Child Health Care Institute, Ningbo, Zhejiang, China
| | - Xiang Chen
- Department of Obstetrics and Gynecology, Yinzhou District Maternal and Child Health Care Institute, Ningbo, Zhejiang, China
| | - Jin Xu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
- Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Ningbo University, Ningbo, China
| | - Lindan Ji
- Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Ningbo University, Ningbo, China
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
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Lee DY, Jung I, Park SY, Yu JH, Seo JA, Kim KJ, Kim NH, Yoo HJ, Kim SG, Choi KM, Baik SH, Kim NH. Attention to Innate Circadian Rhythm and the Impact of Its Disruption on Diabetes. Diabetes Metab J 2024; 48:37-52. [PMID: 38173377 PMCID: PMC10850272 DOI: 10.4093/dmj.2023.0193] [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: 06/21/2023] [Accepted: 10/16/2023] [Indexed: 01/05/2024] Open
Abstract
Novel strategies are required to reduce the risk of developing diabetes and/or clinical outcomes and complications of diabetes. In this regard, the role of the circadian system may be a potential candidate for the prevention of diabetes. We reviewed evidence from animal, clinical, and epidemiological studies linking the circadian system to various aspects of the pathophysiology and clinical outcomes of diabetes. The circadian clock governs genetic, metabolic, hormonal, and behavioral signals in anticipation of cyclic 24-hour events through interactions between a "central clock" in the suprachiasmatic nucleus and "peripheral clocks" in the whole body. Currently, circadian rhythmicity in humans can be subjectively or objectively assessed by measuring melatonin and glucocorticoid levels, core body temperature, peripheral blood, oral mucosa, hair follicles, rest-activity cycles, sleep diaries, and circadian chronotypes. In this review, we summarized various circadian misalignments, such as altered light-dark, sleep-wake, rest-activity, fasting-feeding, shift work, evening chronotype, and social jetlag, as well as mutations in clock genes that could contribute to the development of diabetes and poor glycemic status in patients with diabetes. Targeting critical components of the circadian system could deliver potential candidates for the treatment and prevention of type 2 diabetes mellitus in the future.
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Affiliation(s)
- Da Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Inha Jung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - So Young Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji Hee Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji A Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyeong Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Korea
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Wang C, Liu Y, Chen X, Zhu J, Wu Q, Chen H, Liao H, Lin J, Wang Z, Zheng Z, Chen R. Meta-analysis of correlation between sleep duration and gender difference in adults with type 2 diabetes. Sleep Breath 2023; 27:2325-2332. [PMID: 37160494 DOI: 10.1007/s11325-023-02841-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/19/2023] [Accepted: 04/24/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To explore the correlation between sleep duration and type II diabetes in adults. METHOD Computer databases searches were carried out through October 1, 2022, including PubMed, Cochrane Library, Embase, and Web of Science. Relevant literature was collected, and the Newcastle-Ottawa Scale (NOS) and extracted data were used to exclude studies and evaluate quality on the basis of inclusion and exclusion criteria. Meta-analysis was conducted using RevMan 5.4.1 software with random/fixed effects models. RESULTS A total of 5 studies with 74,226 subjects (31,611 in the male study group, 42,615 in the female study group) were included. The meta-analysis revealed that women with long sleep duration (LSD) have a higher risk for developing type II diabetes than men, OR = 0.70; 95% CI 0.59-0.84, Z = 4.00 and P < 0.001. Men with short sleep duration (SSD) tended to have a higher risk in developing type II diabetes than women though the difference between men and women did not reach statistical significance, OR = 1.09, 95% CI 0.73-1.62, Z = 0.42 and P = 0.68. Further subgroup analysis by regional populations suggested that men in Europe and America with SSD had a higher risk of type II diabetes OR = 1.52, 95% CI 1.04-2.21, Z = 2.18 and P = 0.03. CONCLUSION Women with LSD may have a higher risk for type II diabetes, and men in Europe and America with SSD may have a higher risk for type II diabetes than men of other regions.
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Affiliation(s)
- Chaoyu Wang
- Taishan Hospital of Traditional Chinese Medicine, Jiangmen, China
| | - Yanhong Liu
- Taishan Hospital of Traditional Chinese Medicine, Jiangmen, China
| | - Xiaojuan Chen
- Medical College of Jiaying University, Meizhou, China
| | - Jinru Zhu
- The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524003, Guangdong, China
| | - Qinglan Wu
- Central People's Hospital of Zhanjiang, Zhanjiang, China
| | - Huimin Chen
- The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524003, Guangdong, China
| | - Huizhao Liao
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Junyan Lin
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhiwei Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhenzhen Zheng
- The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524003, Guangdong, China.
| | - Riken Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
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Nyhuis CC, Fernandez-Mendoza J. Insomnia nosology: a systematic review and critical appraisal of historical diagnostic categories and current phenotypes. J Sleep Res 2023; 32:e13910. [PMID: 37122153 DOI: 10.1111/jsr.13910] [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: 03/27/2023] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 05/02/2023]
Abstract
Insomnia nosology has significantly evolved since the Diagnostic and Statistical Manual (DSM)-III-R first distinguished between 'primary' and 'secondary' insomnia. Prior International Classification of Sleep Disorders (ICSD) nosology 'split' diagnostic phenotypes to address insomnia's heterogeneity and the DSM nosology 'lumped' them into primary insomnia, while both systems assumed causality for insomnia secondary to health conditions. In this systematic review, we discuss the historical phenotypes in prior insomnia nosology, present findings for currently proposed insomnia phenotypes based on more robust approaches, and critically appraise the most relevant ones. Electronic databases PsychINFO, PubMED, Web of Science, and references of eligible articles, were accessed to find diagnostic manuals, literature on insomnia phenotypes, including systematic reviews or meta-analysis, and assessments of the reliability or validity of insomnia diagnoses, identifying 184 articles. The data show that previous insomnia diagnoses lacked reliability and validity, leading current DSM-5-TR and ICSD-3 nosology to 'lump' phenotypes into a single diagnosis comorbid with health conditions. However, at least two new, robust insomnia phenotyping approaches were identified. One approach is multidimensional-multimethod and provides evidence for self-reported insomnia with objective short versus normal sleep duration linked to clinically relevant outcomes, while the other is multidimensional and provides evidence for two to five clusters (phenotypes) based on self-reported trait, state, and/or life-history data. Some approaches still need replication to better support whether their findings identify true phenotypes or simply different patterns of symptomatology. Regardless, these phenotyping efforts aim at improving insomnia nosology both as a classification system and as a mechanism to guide treatment.
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Affiliation(s)
- Casandra C Nyhuis
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Julio Fernandez-Mendoza
- Sleep Research and Treatment Center, Department of Psychiatry and Behavioral Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
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Sun X, Tan J, Chen Y, Liu Y, Dong GH, Yang BY, Li N, Wang L, Li S, Chen G, Guo Y. The association between long-term exposure to outdoor artificial light at night and poor sleep quality among Chinese veterans: A multi-city study. Int J Hyg Environ Health 2023; 252:114218. [PMID: 37429120 DOI: 10.1016/j.ijheh.2023.114218] [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: 01/03/2023] [Revised: 06/26/2023] [Accepted: 07/01/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND A handful of previous studies have reported the association between exposure to outdoor artificial light at night (ALAN) and sleep problems. However, evidence for such association is limited in low- and middle-income countries. This study aimed to examine the association between outdoor ALAN exposure and sleep quality in veterans across different regions of China. METHODS Within the network of the Chinese Veteran Clinical Research Platform, we selected 7258 participants from 277 veteran communities in 18 cities across China during December 2009 and December 2011, using a multi-stage stratified cluster sampling strategy. Face-to-face interviews with the participants were conducted by trained investigators. We used the Pittsburgh Sleep Quality Index (PSQI) to assess participants' sleep quality. We defined poor sleep quality as a PSQI global score >7. The 3-year average exposure to outdoor ALAN prior to the baseline interview was calculated using satellite imagery data, according to participants' geolocation information. The association of ALAN exposure with sleep quality was examined using the mixed-effects logistic regression models with natural cubic splines. RESULTS The exposure-response curve for sleep quality associated with ALAN exposure was nonlinear, with a threshold value of 49.20 nW/cm2/sr for the 3-year average exposure to outdoor ALAN prior to the baseline interview. Higher ALAN exposure above the threshold was associated with increased risk of poor sleep quality. After adjusting for potential confounders, the odds ratios (and 95%CI, 95% confidence intervals) were 1.15 (0.97, 1.36) and 1.45 (1.17, 1.78) at the 75th and 95th percentiles of ALAN against the threshold. The association of ALAN exposure with poor sleep quality was more pronounced in veterans with depression than those without. Higher OR of poor sleep quality at the 75th percentile of ALAN against the threshold was observed in veterans with depression than those without [2.09 (1.16, 3.76) vs. 1.09 (0.92, 1.30)]. CONCLUSIONS Long-term exposure to outdoor ALAN was associated with higher risk of poor sleep quality in Chinese veterans. Effective outdoor ALAN management may help to reduce the burden of sleep disorders in Chinese veterans.
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Affiliation(s)
- Xinyi Sun
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Jiping Tan
- Geriatric Neurology Department of the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100039, China
| | - Yan Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Guang-Hui Dong
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Bo-Yi Yang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Nan Li
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, 100191, China
| | - Luning Wang
- Geriatric Neurology Department of the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100039, China
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
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Lee DY, Jung I, Park SY, Yu JH, Seo JA, Kim KJ, Kim NH, Yoo HJ, Kim SG, Choi KM, Baik SH, Lee SK, Shin C, Kim NH. Sleep Duration and the Risk of Type 2 Diabetes: A Community-Based Cohort Study with a 16-Year Follow-up. Endocrinol Metab (Seoul) 2023; 38:146-155. [PMID: 36740966 PMCID: PMC10008656 DOI: 10.3803/enm.2022.1582] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/18/2023] [Indexed: 02/07/2023] Open
Abstract
BACKGRUOUND We aimed to investigate the moderating effects of obesity, age, and sex on the association between sleep duration and the development of diabetes in Asians. METHODS We analyzed data from a cohort of the Korean Genome and Epidemiology Study conducted from 2001 to 2020. After excluding shift workers and those with diabetes at baseline, 7,407 participants were stratified into three groups according to sleep duration: ≤5 hours/night, >5 to 7 hours/night (reference), and >7 hours/night. The Cox proportional hazards analyses were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident type 2 diabetes mellitus (T2DM). Subgroup analyses were performed according to obesity, age, and sex. RESULTS During 16 years of follow-up, 2,024 cases of T2DM were identified. Individuals who slept ≤5 h/night had a higher risk of incident diabetes than the reference group (HR, 1.17; 95% CI, 1.02 to 1.33). The subgroup analysis observed a valid interaction with sleep duration only for obesity. A higher risk of T2DM was observed in the ≤5 hours/night group in non-obese individuals, men, and those aged <60 years, and in the >7 hours/night group in obese individuals (HRs were 1.34 [95% CI, 1.11 to 1.61], 1.22 [95% CI, 1 to 1.49], and 1.18 [95% CI, 1.01 to 1.39], respectively). CONCLUSION This study confirmed the effect of sleep deprivation on the risk of T2DM throughout the 16-year follow-up period. This impact was confined to non-obese or young individuals and men. We observed a significant interaction between sleep duration and obesity.
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Affiliation(s)
- Da Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Inha Jung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - So Young Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji Hee Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji A Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyeong Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Seung Ku Lee
- Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, Korea
| | - Chol Shin
- Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, Korea
- Corresponding authors: Nan Hee Kim. Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan 15355, Korea Tel: +82-31-412-4274, Fax: +82-31-412-6770, E-mail:
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Korea
- Corresponding authors: Nan Hee Kim. Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan 15355, Korea Tel: +82-31-412-4274, Fax: +82-31-412-6770, E-mail:
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Quadra MR, Santos LPD, Schäfer AA, Meller FDO. [Influence of sleep and chrononutrition on hypertension and diabetes: a population-based study]. CAD SAUDE PUBLICA 2022; 38:e00291021. [PMID: 35894369 DOI: 10.1590/0102-311xpt291021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 05/09/2022] [Indexed: 11/21/2022] Open
Abstract
The objective is to evaluate the influence of sleep and chrononutrition on hypertension and diabetes in the adult population (18 years or older) in a municipality in Southern Brazil. This is a population-based cross-sectional study, developed in Criciúma, State of Santa Catarina, in 2019. The exposure variables were sleep duration and quality, and two of the main aspects of chrononutrition, the number of daily meals and the presence of breakfast. The outcomes studied were diabetes mellitus and systemic arterial hypertension. Crude and adjusted Poisson regression with robust variance was used to evaluate the associations between exposures and outcomes. For all analyses, the effect of the sample design was considered, and the significance level adopted was 5%. In total, 820 patients were evaluated. The prevalence of diabetes and hypertension was of 19.9% and 44.1%, respectively. Individuals with worse sleep quality had a higher prevalence of 33% for diabetes and 17% for hypertension, compared to those with good quality of sleep. Those who had four or more meals per day had a 16% lower prevalence of hypertension, when compared to those who had less than four meals. We concluded that the quality of sleep and the number of daily meals, a feeding behavior related to chrononutrition, were related to hypertension and diabetes. These results highlight the importance of public health actions that address new strategies for coping with these diseases focused on sleep quality and chrononutrition.
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Yao QY, Yuan XQ, Liu C, Du YY, Yao YC, Wu LJ, Jiang HH, Deng TR, Guo N, Deng YL, Zeng Q, Li YF. OUP accepted manuscript. Hum Reprod 2022; 37:1297-1310. [PMID: 35259255 DOI: 10.1093/humrep/deac040] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 02/09/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Qing-Yun Yao
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Xiao-Qiong Yuan
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Chong Liu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yao-Yao Du
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yang-Cheng Yao
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Lin-Jing Wu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Hua-Hua Jiang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Tao-Ran Deng
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Na Guo
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yan-Ling Deng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Qiang Zeng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yu-Feng Li
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
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Association of sleep duration with risk of type 2 diabetes mellitus in a rural Chinese population: a nested case-control study. Sleep Breath 2021; 26:2025-2033. [PMID: 34839464 DOI: 10.1007/s11325-021-02535-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/07/2021] [Accepted: 11/22/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To investigate the association of sleep duration with type 2 diabetes mellitus (T2DM) in a rural Chinese population. METHODS A 1:1 matched nested case-control study was performed based on a cohort that had been established in rural communities in Henan Province, China. T2DM patients and healthy controls (550 pairs) were included in this study. RESULTS Abnormal sleep duration significantly increased the risk of T2DM with an approximate U-shaped association (sleep duration ≤ 6 h, OR = 1.742, 95% CI = 1.007-3.011, P = 0.047; sleep duration 8-9 h, OR = 1.462, 95% CI = 1.038-2.060, P = 0.030) compared with participants with a night sleep duration of 7-8 h, after adjusting for multiple confounders. When stratified by gender, only women were sensitive to shorter sleep duration (OR = 2.483, 95% CI = 1.149-5.366, P = 0.021). Abnormal sleep duration (too short or too long) had adverse effects on homeostasis model assessment (HOMA) and blood metabolites, and the effect was more noticeable in people with longer sleep durations. CONCLUSION In a rural Chinese population, both too short and too long sleep duration increased the risk of T2DM. Especially women with less sleep duration have a higher risk of T2DM. Abnormal sleep also affects the HOMA index and metabolites; the relationship between HOMA-IR, total cholesterol, and LDL-Cholesterol with sleep duration was U-shaped, while fasting plasma glucose, body mass index, waist circumference, and triglyceride levels increased significantly only with longer sleep duration.
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Andreasson A, Axelsson J, Bosch JA, Balter LJ. Poor sleep quality is associated with worse self-rated health in long sleep duration but not short sleep duration. Sleep Med 2021; 88:262-266. [PMID: 34801824 DOI: 10.1016/j.sleep.2021.10.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/26/2021] [Accepted: 10/22/2021] [Indexed: 10/19/2022]
Abstract
Unhealthy sleep duration, either short or long, is associated with worse health and central subjective dimensions of sleep and health such as fatigue. It has been argued that the link between sleep duration and health may depend on the quality of the slept hours, and on its functional impact (ie, fatigue). The present study therefore assessed whether the relationship between last night's sleep duration and general self-rated health (SRH) differs as a function of sleep quality, and secondly, whether current fatigue and sleep quality are factors linking sleep duration and SRH. The present cross-sectional dataset involved 1304 individuals (57% female, Mage = 28.8, range 18-79). Participants completed surveys for general SRH, previous night's sleep duration and sleep quality, and current fatigue. Results showed the expected inverted U-shaped (ie, quadratic) relation between last night's sleep duration and SRH and a linear relation between last night's sleep quality and SRH. However, long sleep duration was only associated with poorer SRH in individuals who also reported poor sleep quality. Further, the quadratic relationship between sleep duration and SRH was partially mediated by fatigue and sleep quality. The results of this multi-study analysis suggest that SRH is particularly poor in those who slept both long and with poor quality the night before, while good sleep quality may protect those with a long sleep duration from poor SRH. Thus, last night's long sleep does not seem to be associated with poor subjective health unless it is coupled with poor sleep quality. Furthermore, fatigue and sleep quality are potential pathways linking short and long sleep duration with SRH. Different dimensions of sleep interact in their association with health, and future research will benefit from an integrative approach.
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Affiliation(s)
- Anna Andreasson
- Stress Research Institute, Psychology Department, Stockholm University, Stockholm, Sweden; Department of Medicine Solna, Division of Clinical Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Psychology, Macquarie University, NSW, Australia
| | - John Axelsson
- Stress Research Institute, Psychology Department, Stockholm University, Stockholm, Sweden; Department of Clinical Neuroscience, Division of Psychology, Stockholm, Karolinska Institutet, Stockholm, Sweden
| | - Jos A Bosch
- Clinical Psychology, Psychology Department, University of Amsterdam, Amsterdam, the Netherlands
| | - Leonie Jt Balter
- Stress Research Institute, Psychology Department, Stockholm University, Stockholm, Sweden; Department of Clinical Neuroscience, Division of Psychology, Stockholm, Karolinska Institutet, Stockholm, Sweden.
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Bayrak M, Çadirci K. Quality of Sleep in Elderly Patients with Diabetes Mellitus from Turkey: A Cross-Sectional Observational Study. Exp Aging Res 2021; 48:373-386. [PMID: 34635033 DOI: 10.1080/0361073x.2021.1989929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Elderly patients frequently experience poor sleep quality. We aimed to determine its prevalence and risk factors in diabetic elderly patients from Turkey. METHODS An observational cross-sectional study of 220 diabetic elderly patients with a mean age of 70.4 ± 5.9 was conducted between June 2019 and December 2019. Pittsburgh Sleep Quality Index (PSQI) questionnaire was used. Patients were divided based on sleep quality into poor (PSQI> 5) and good (PSQI≤ 5) sleep quality groups. Geriatric Depression Scale, Beck Anxiety Inventory, and Hendrich II Fall Risk Model were adopted. The prevalence of poor sleep quality and risk factors were evaluated. RESULTS Prevalence of poor sleep quality was 58.6%. Poor sleepers were significantly older, were more likely to be divorced, had more comorbidities, and used more medicines (ps<0.05). Longer duration of diabetes, higher incidence of hypoglycemic events, and diabetic complications were significantly associated with poor sleep quality (ps<0.05). Poor sleepers had higher levels of blood glucose and HbA1c levels (ps<0.05). PSQI was significantly correlated with age, HbA1c, duration of diabetes, higher depression, anxiety, and falling risk (ps<0.05). Severe depression, anxiety, and higher falling risk were independent risk factors. CONCLUSION Most patients experienced poor sleep quality. It was associated with a longer duration of diabetes, chronic diabetes-related complications, and higher HbA1c levels. Severe depression, anxiety, and higher falling risk were risk factors for poor sleep quality.
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Affiliation(s)
- Muharrem Bayrak
- Department of Internal Medicine, Health Sciences University, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Kenan Çadirci
- Department of Internal Medicine, Health Sciences University, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
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12
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Yang Y, Zhao LH, Li DD, Xu F, Wang XH, Lu CF, Wang CH, Yu C, Zhang XL, Ning LY, Wang XQ, Su JB, Wang LH. Association of sleep quality with glycemic variability assessed by flash glucose monitoring in patients with type 2 diabetes. Diabetol Metab Syndr 2021; 13:102. [PMID: 34556157 PMCID: PMC8461905 DOI: 10.1186/s13098-021-00720-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/13/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Deterioration of sleep quality has been reported to contribute to the incidence of diabetes and may be responsible for glycemic status in diabetes. The present study explored the relationship between sleep quality and glycemic variability in patients with type 2 diabetes (T2D). METHODS We recruited 111 patients with T2D for this cross-sectional study. Each patient underwent flash glucose monitoring for 14 days to obtain glycemic variability parameters, such as standard deviation of glucose (SD), coefficient of variation of glucose (CV), mean amplitude of glycemic excursions (MAGE), mean of daily differences (MODD), and time in glucose range of 3.9-10 mmol/L (TIR3.9-10). After 14 days of flash glucose monitoring, each patient received a questionnaire on the Pittsburgh Sleep Quality Index (PSQI) to evaluate subjective sleep quality. HbA1c was also collected to assess average glucose. RESULTS HbA1c was comparable among the subgroups of PSQI score tertiles. Across ascending tertiles of PSQI scores, SD, CV and MAGE were increased, while TIR3.9-10 was decreased (p for trend < 0.05), but not MODD (p for trend = 0.090). Moreover, PSQI scores were positively correlated with SD, CV, MODD and MAGE (r = 0.322, 0.361, 0.308 and 0.354, respectively, p < 0.001) and were inversely correlated with TIR3.9-10 (r = - 0.386, p < 0.001). After adjusting for other relevant data by multivariate linear regression analyses, PSQI scores were independently responsible for SD (β = 0.251, t = 2.112, p = 0.041), CV (β = 0.286, t = 2.207, p = 0.033), MAGE (β = 0.323, t = 2.489, p = 0.018), and TIR3.9-10 (β = - 0.401, t = - 3.930, p < 0.001) but not for MODD (β = 0.188, t = 1.374, p = 0.177). CONCLUSIONS Increased glycemic variability assessed by flash glucose monitoring was closely associated with poor subjective sleep quality evaluated by the PSQI in patients with T2D.
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Affiliation(s)
- Yang Yang
- Department of Nursing, Affiliated Hospital 2 of Nantong University, and First People’s Hospital of Nantong City, No. 6 Haierxiang North Road, Nantong, 226001 China
| | - Li-hua Zhao
- Department of Endocrinology, Affiliated Hospital 2 of Nantong University, and First People’s Hospital of Nantong City, No. 6 Haierxiang North Road, Nantong, 226001 China
| | - Dan-dan Li
- Department of Nursing, Affiliated Hospital 2 of Nantong University, and First People’s Hospital of Nantong City, No. 6 Haierxiang North Road, Nantong, 226001 China
| | - Feng Xu
- Department of Endocrinology, Affiliated Hospital 2 of Nantong University, and First People’s Hospital of Nantong City, No. 6 Haierxiang North Road, Nantong, 226001 China
| | - Xiao-hua Wang
- Department of Endocrinology, Affiliated Hospital 2 of Nantong University, and First People’s Hospital of Nantong City, No. 6 Haierxiang North Road, Nantong, 226001 China
| | - Chun-feng Lu
- Department of Endocrinology, Affiliated Hospital 2 of Nantong University, and First People’s Hospital of Nantong City, No. 6 Haierxiang North Road, Nantong, 226001 China
| | - Chun-hua Wang
- Department of Endocrinology, Affiliated Hospital 2 of Nantong University, and First People’s Hospital of Nantong City, No. 6 Haierxiang North Road, Nantong, 226001 China
| | - Chao Yu
- Department of Clinical Laboratory, Affiliated Hospital 2 of Nantong University, and First People’s Hospital of Nantong City, No. 6 Haierxiang North Road, Nantong, 226001 China
| | - Xiu-lin Zhang
- Department of Clinical Laboratory, Affiliated Hospital 2 of Nantong University, and First People’s Hospital of Nantong City, No. 6 Haierxiang North Road, Nantong, 226001 China
| | - Li-yan Ning
- Department of Administration, Affiliated Hospital 2 of Nantong University, and First People’s Hospital of Nantong City, No.6 Haierxiang North Road, Nantong, 226001 China
| | - Xue-qin Wang
- Department of Endocrinology, Affiliated Hospital 2 of Nantong University, and First People’s Hospital of Nantong City, No. 6 Haierxiang North Road, Nantong, 226001 China
| | - Jian-bin Su
- Department of Endocrinology, Affiliated Hospital 2 of Nantong University, and First People’s Hospital of Nantong City, No. 6 Haierxiang North Road, Nantong, 226001 China
| | - Li-hua Wang
- Department of Nursing, Affiliated Hospital 2 of Nantong University, and First People’s Hospital of Nantong City, No. 6 Haierxiang North Road, Nantong, 226001 China
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Mosavat M, Mirsanjari M, Arabiat D, Smyth A, Whitehead L. The Role of Sleep Curtailment on Leptin Levels in Obesity and Diabetes Mellitus. Obes Facts 2021; 14:214-221. [PMID: 33756469 PMCID: PMC8138234 DOI: 10.1159/000514095] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 12/23/2020] [Indexed: 12/15/2022] Open
Abstract
Emerging evidence has identified sleep as a significant, but modifiable, risk factor for metabolic syndrome, diabetes, and obesity. Leptin, an adipocyte-derived peptide and a regulator of food intake and energy expenditure, has been shown to be associated with a short sleep duration in the pathophysiology of obesity and consequently type 2 diabetes. This review focuses on the current evidence indicating the effects of a short sleep duration on the regulation of leptin concentration in association with obesity and diabetes mellitus. In summary, the evidence suggests that sleep deprivation, by affecting leptin regulation, may lead to obesity and consequently development of type 2 diabetes through increased appetite and food intake. However, findings on the role of leptin in diabetes due to sleep deprivation are contradictory, and further studies with larger sample sizes are needed to confirm previous findings.
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Affiliation(s)
- Maryam Mosavat
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Washington, Australia,
| | - Mitra Mirsanjari
- Mazandaran University of Medical Sciences, Emam Khomeini Hospital, Mazandaran, Iran
| | - Diana Arabiat
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Washington, Australia
- Maternal and Child Nursing Department, The University of Jordan, Amman, Jordan
| | - Aisling Smyth
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Washington, Australia
| | - Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Washington, Australia
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14
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Khorasani ZM, Ravan VR, Hejazi S. Evaluation of the Prevalence of Sleep Disorder Among Patients with Type 2 Diabetes Mellitus Referring to Ghaem Hospital from 2016 to 2017. Curr Diabetes Rev 2021; 17:214-221. [PMID: 32459608 DOI: 10.2174/1573399816666200527140340] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Diabetes is the most common metabolic disease in primary health care. The prevalence and severity of diabetes can be influenced through lifestyle modification. This study was aimed to identify the prevalence of sleep disorders as a modifiable lifestyle factor among diabetic patients. MATERIALS AND METHODS This cross-sectional study was conducted on 190 patients with type 2 diabetes mellitus who referred to the Internal Medicine Clinic of the Ghaem Hospital, Mashhad, Iran from 2016 to 2017. A demographic questionnaire and the Pittsburgh Sleep Quality Assessment questionnaire (with sleep disorder defined as scores higher than 5) was filled for each subject. Blood tests including haemoglobin A1 C (Hb A1C), fasting blood sugar (FBS) and 2 hour post prandial glucose as well as the assessment of blood pressure and body mass index (BMI) were performed for all patients. Data were analysed using the statistical package for social sciences (SPSS) version 16. RESULTS Age of the patients (with male to female ratio being 71/119s) was 56.31 ± 7.37 years. BMI of more than 25 kg/m2was observed in 145 (76.3%) of patients. Mean Pittsburgh Sleep Quality Assessment score was 7.48 ± 4.11. Fifty-one (26.8%) patients were good sleepers and 139 (73.2%) were poor sleepers. There was a significant relationship between sleep disorder and age (p=0.019) and female gender (p=0.017), but no other variables which included level of education, occupation, HbA1 C, FBS, 2-hour post prandial glucose, systolic and diastolic blood pressure. CONCLUSION Sleep disorders are common among type 2 diabetic patients especially women. It is recommended that sleep disorders should be screened in diabetic patients. Treatment and prevention of sleep disorders through sleep hygiene education including recommendation to have normal nocturnal sleep should be focused by practitioners in type 2 diabetic patients, especially women. Appropriate measures should be taken to manage sleep disorders by weight control in this population.
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Affiliation(s)
- Zahra M Khorasani
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahid R Ravan
- Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sepideh Hejazi
- Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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15
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Lu H, Yang Q, Tian F, Lyu Y, He H, Xin X, Zheng X. A Meta-Analysis of a Cohort Study on the Association between Sleep Duration and Type 2 Diabetes Mellitus. J Diabetes Res 2021; 2021:8861038. [PMID: 33834077 PMCID: PMC8012145 DOI: 10.1155/2021/8861038] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/26/2021] [Accepted: 03/04/2021] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To study the association between sleep duration and the incidence of type 2 diabetes mellitus (T2DM) and to provide a theoretical basis for the prevention of T2DM through a meta-analysis. METHODS PubMed, Web of Science, Scopus, Embase, Cochrane Library, ProQuest, CNKI, Wanfang, VIP, and SINOMED were searched from their inception until May 2020. All cohort studies on the relationship between sleep duration and T2DM in adults were included. According to the inclusion and exclusion criteria, two authors independently assessed the literature and extracted the data. Metaregression and publication bias were evaluated, and sensitivity and meta-analyses were conducted with RevMan 5.3. RESULTS A total of 17 studies were collected, involving 737002 adults. The incidence of T2DM was 4.73% in short sleep duration (SSD) (t ≤ 6 h), 4.39% in normal sleep duration (NSD) (6 h < t < 9 h), and 4.99% in long sleep duration (LSD) (t ≥ 9 h). The meta-analysis demonstrated that SSD increased the risk of T2DM compared with NSD (RR = 1.22, 95% CI: 1.15-1.29, P < 0.001), LSD increased the risk of T2DM compared with NSD (RR = 1.26, 95% CI: 1.15-1.39, P < 0.001), and the risk of T2DM has no significant difference between SSD and LSD (RR = 0.97, 95% CI: 0.89-1.05, P = 0.41). The sensitivity of each study was robust and the publication bias was weak. CONCLUSION SSD or LSD can increase the risk of T2DM.
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Affiliation(s)
- Huapeng Lu
- Department of Hepatobiliary and Pancreas Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Qinling Yang
- Department of Hepatobiliary and Pancreas Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Fang Tian
- School of Nursing, Yan'an University, Yan'an, Shaanxi 710061, China
| | - Yi Lyu
- Department of Hepatobiliary and Pancreas Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Hairong He
- Department of Clinical Research Center, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xia Xin
- Department of Nursing, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Xuemei Zheng
- Department of Nursing, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
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Birhanu TT, Hassen Salih M, Abate HK. Sleep Quality and Associated Factors Among Diabetes Mellitus Patients in a Follow-Up Clinic at the University of Gondar Comprehensive Specialized Hospital in Gondar, Northwest Ethiopia: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2020; 13:4859-4868. [PMID: 33328747 PMCID: PMC7734063 DOI: 10.2147/dmso.s285080] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 11/26/2020] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Diabetic mellitus has a negative impact on the quality of sleep. It is one of the leading public health conditions which can result in poor sleep quality. Poor sleep quality is an unreported and unrecognized problem which can affect the prognosis of diabetes patients. OBJECTIVE The aim of this study is to assess the prevalence of poor sleep quality and its associated factors among patients with diabetes mellitus attending follow-up clinics at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2019. METHODS An institution-based cross-sectional study was conducted among 430 diabetes mellitus patients at the University of Gondar Comprehensive Specialized Hospital from February 1, 2020 to March 28, 2020. A systematic random sampling method was used to reach the study subjects. An interviewer-administered questionnaire was used for data collection. Pittsburgh sleep quality index was used for assessing sleep quality. To explain study variables, frequency tables and percentages were used. A binary logistic regression was conducted to see the relation between dependent and independent variables. RESULTS A total of 430 diabetes mellitus patients participated in the study with a response rate of 100%. The overall prevalence of poor sleep quality was 47.2%. Drinking alcohol (AOR = 2.45, 95% CI: 1.28-4.69), smokers (AOR = 6.26, 95% CI: 2.04-19.21), comorbidity (AOR = 1.80, 95% CI: 1.10-2.96), BMI ≥ 30 (AOR = 4.87, 95% CI: 1.07-22.09), having type 2 diabetes mellitus (AOR = 2.16, 95% CI: 1.04-4.50), poor glycemic control (AOR = 2.61, 95% CI: 1.81-4.81) and having depression (AOR = 9.95, 95% CI: 4.85-20.38) were associated with poor sleep quality. CONCLUSION In this study, nearly half of the patients had poor sleep quality. Drinking alcohol, smoking, comorbidities, higher BMI, type 2 diabetes mellitus, poor glycemic control and having depression were factors in poor sleep quality. Creating awareness of the need for weight reduction, minimizing alcohol intake, cessation of smoking, and improving sleep hygiene for DM patients would be effective management for improving poor sleep quality.
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Affiliation(s)
| | - Mohamed Hassen Salih
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Hailemichael Kindie Abate
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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17
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Hur MH, Lee MK, Seong K, Hong JH. Deterioration of Sleep Quality According to Glycemic Status. Diabetes Metab J 2020; 44:679-686. [PMID: 32431108 PMCID: PMC7643591 DOI: 10.4093/dmj.2019.0125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 08/20/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a progressive disease with multiple complications. The present study aimed to determine the effects of glycemic status on sleep quality in individuals with T2DM, prediabetes, and normal glucose tolerance (NGT). METHODS A total of 90 participants were categorized into three groups, T2DM (n=30), prediabetes (n=30), and NGT (n=30). Objective sleep quality was measured with the actigraph wrist-worn device over 3 nights and subjective sleep quality was evaluated with a questionnaire. RESULTS The duration of diabetes in the T2DM group was 2.23 years and the glycosylated hemoglobin (HbA1c) levels in the T2DM, prediabetes, and NGT groups were 7.83%, 5.80%, and 5.31%, respectively. Sleep efficiency decreased across the T2DM, prediabetes, and NGT groups (86.25%, 87.99%, and 90.22%, respectively; P=0.047). Additionally, HbA1c levels revealed a significant negative correlation with sleep efficiency (r=-0.348, P=0.001). The sleep quality questionnaire results were similar among the three groups. CONCLUSION Although the participants in the present study were not necessarily conscious of their sleep disturbances, deterioration in sleep quality progressed according to glycemic status.
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Affiliation(s)
| | | | - Kayeon Seong
- Eulji University College of Nursing, Daejeon, Korea
| | - Jun Hwa Hong
- Division of Endocrinology, Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
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18
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Lifestyle clusters related to type 2 diabetes and diabetes risk in a multi-ethnic population: The HELIUS study. Prev Med 2020; 137:106141. [PMID: 32454057 DOI: 10.1016/j.ypmed.2020.106141] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 12/12/2022]
Abstract
Little is known about how health-related behaviours cluster across different populations and how lifestyle clusters are associated with type 2 diabetes (T2D) risk. We investigated lifestyle clusters and their association with T2D in a multi-ethnic population. 4396 Dutch, 2850 South-Asian Surinamese, 3814 African Surinamese, 2034 Ghanaian, 3328 Turkish, and 3661 Moroccan origin participants of the HELIUS study were included (2011-2015). K-medoids cluster analyses were used to identify lifestyle clusters. Logistic and cox regression analyses were performed to investigate the association of clusters with prevalent and incident T2D, respectively. Pooled analysis revealed three clusters: a 'healthy', 'somewhat healthy', and 'unhealthy' cluster. Most ethnic groups were unequally distributed: Dutch participants were mostly present in the 'healthy' cluster, Turkish and Moroccan participants in the 'somewhat healthy' cluster, while the Surinamese and Ghanaian participants were equally distributed across clusters. When stratified for ethnicity, analysis revealed three clusters per ethnic group. While the 'healthy' and 'somewhat healthy' clusters were similar to those of the pooled analysis, we observed considerable differences in the ethnic-specific 'unhealthy' clusters. Fruit consumption (3-4 days/week) was the only behaviour that was consistent across all ethnic-specific 'unhealthy' clusters. The pooled 'unhealthy' cluster was positively associated with prediabetes (OR: 1.34, 95%CI 1.21-1.48) and incident T2D (OR: 1.23, 95%CI 0.89-1.69), and negatively associated with prevalent T2D (OR: 0.80, 95%CI 0.69-0.93). Results were similar for most, but not all, ethnic-specific clusters. This illustrates that targeting multiple behaviours is relevant in prevention of T2D but that ethnic differences in lifestyle clusters should be taken into account.
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19
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Seow LSE, Tan XW, Chong SA, Vaingankar JA, Abdin E, Shafie S, Chua BY, Heng D, Subramaniam M. Independent and combined associations of sleep duration and sleep quality with common physical and mental disorders: Results from a multi-ethnic population-based study. PLoS One 2020; 15:e0235816. [PMID: 32673344 PMCID: PMC7365445 DOI: 10.1371/journal.pone.0235816] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 06/23/2020] [Indexed: 12/11/2022] Open
Abstract
Sleep duration and sleep quality are often linked to increased risk of mortality and morbidity. However, national representative data on both sleep duration and sleep quality and their relationship with chronic health problems are rarely available from the same source. This current study aimed to examine the independent and combined associations of sleep duration and sleep quality with physical and mental disorders, using data from the Singapore Mental Health Study 2016. 6,126 residents aged ≥18years participated in this epidemiological, cross-sectional survey. Sleep measures were assessed using the Pittsburg Sleep Quality Index while lifetime or 12-month medical and psychiatric diagnoses were established using the Composite International Diagnostic Interview 3.0. Both short sleep (<6hrs compared to 7-8hrs) and poor sleep were found to be independently associated with chronic pain, obsessive compulsive disorder and any mental disorder while poor sleep was additionally associated with major depressive disorder, bipolar disorder, generalized anxiety disorder and any physical disorder, when adjusted for confounders. Poor sleep combined with short sleep (≤6hrs/day vs 7-8hrs/day) was associated with the highest number of comorbidities among other sleep combinations. Sleep duration and sleep quality, when adjusted for each other, remained independently associated with both physical and mental disorders. Affective disorders may be more closely related to poor sleep quality compared to abnormal sleep duration. Our findings suggest sleep quality to be a more important indicator for psychological and overall health compared to sleep duration.
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Affiliation(s)
| | - Xiao Wei Tan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Boon Yiang Chua
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Derrick Heng
- Ministry of Health of Singapore, Singapore, Singapore
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20
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Jiang J, Li Y, Mao Z, Wang F, Huo W, Liu R, Zhang H, Tian Z, Liu X, Zhang X, Tu R, Qian X, Liu X, Luo Z, Bie R, Wang C. Abnormal night sleep duration and poor sleep quality are independently and combinedly associated with elevated depressive symptoms in Chinese rural adults: Henan Rural Cohort. Sleep Med 2020; 70:71-78. [DOI: 10.1016/j.sleep.2019.10.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 08/29/2019] [Accepted: 10/17/2019] [Indexed: 01/08/2023]
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21
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Yan B, Zhao B, Fan Y, Yang J, Zhu F, Chen Y, Ma X. The association between sleep efficiency and diabetes mellitus in community-dwelling individuals with or without sleep-disordered breathing. J Diabetes 2020; 12:215-223. [PMID: 31503406 DOI: 10.1111/1753-0407.12987] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 08/26/2019] [Accepted: 09/08/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Sleeping habits have been reported to be associated with diabetes mellitus. This study aimed to explore the relationship of sleep efficiency with diabetes mellitus in individuals with or without sleep-disordered breathing based on polysomnography records. METHODS We enrolled participants from the Sleep Heart Health Study. Objective indicators of sleep characteristics including sleep efficiency, sleep latency, slow-wave sleep, wake after sleep onset, and total arousal index were monitored via in-home polysomnography. Sleep efficiency was divided into grade 1 (≥85%), grade 2 (80%-84.9%), and grade 3 (<80%). Multivariate logistic regression models were utilized to investigate the association between sleep quality and diabetes mellitus. RESULTS The present study comprised 4737 participants with a mean age of 63.6 ± 11.0 years. The prevalence of diabetes mellitus was higher in those with grade 3 sleep efficiency than that in those with grade 1 and grade 2 sleep efficiency in participants with (10.9% vs 8.5% vs 8.3%, respectively; P =.134) or without (9.5% vs 5.6% vs 3.5%, respectively; P <.001) sleep-disordered breathing. After adjusting for potential confounding factors, sleep efficiency <80% was associated with the prevalence of diabetes mellitus only in participants without sleep-disordered breathing (odds ratio, 1.894; 95% confidence interval, 1.187-3.022, P =.007). CONCLUSION Poor sleep efficiency is associated with diabetes mellitus in those without sleep-disordered breathing. Therefore, the relationship between sleep efficiency and diabetes mellitus is worth further investigation.
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Affiliation(s)
- Bin Yan
- Department of Clinical Research Centre, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Binbin Zhao
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yajuan Fan
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jian Yang
- Department of Clinical Research Centre, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Feng Zhu
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yunchun Chen
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiancang Ma
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Center of Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Althakafi KA, Alrashed AA, Aljammaz KI, Abdulwahab IJ, Hamza R, Hamad AF, Alhejaili KS. Prevalence of short sleep duration and effect of co-morbid medical conditions - A cross-sectional study in Saudi Arabia. J Family Med Prim Care 2019; 8:3334-3339. [PMID: 31742164 PMCID: PMC6857418 DOI: 10.4103/jfmpc.jfmpc_660_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 08/22/2019] [Accepted: 09/03/2019] [Indexed: 12/17/2022] Open
Abstract
Background: Sleep is crucial to human's health and essential for a person's wellbeing. It is involved in multiple physiological mechanisms, such as metabolism, appetite regulation, immune and hormone function, and cardiovascular systems. The National Sleep Foundation recommends 7–9 h of sleep each night for adults. Short (<7 h) and long (<9 h) sleep duration has been reported to be associated with increased risk of morbidity and mortality. Aim: 1) To assess the prevalence of short sleep durations among Saudi adult population. 2) To examine comorbid medical condition's association with short sleep duration. Methods: A nation-wide quantitative cross-sectional study using an online self-administered constructed questionnaire during the period from August to October 2018 was conducted. The questionnaire included demographic characters, such as age, gender, education level, height, and weight. As well as some of the participants’ habits such as consuming coffee and/or tea, smoking status, and other habits known to be associated with shorter sleep hours. The questionnaire also included self-reported duration of sleep and history of diagnosed medical illnesses. Results: The study included 805 adult Saudi participants with ages ranging from 15- to 60-year old and mean age of 21.8 ± 10.7-year old. About 63% of the participants were females. It was established that almost half 49.6% of the participants sleep for <7 h daily, and 39.3% of them sleep for 7–9 h. Conclusion: About half of Saudi adults do not get enough hours of sleep. Especially, people who are married, above 30-year old, students or tea drinkers (P < 0.05): furthermore, people with medical comorbidities such as anxiety, depression, and insomnia had a higher association with short sleep duration. Last, sleep deprivation adversely affects the physical wellbeing and quality of life of participants, demonstrated in bad mood, somnolence, and tiredness during the day time.
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Affiliation(s)
- Kholoud A Althakafi
- College of Medicine, King Saud Bin Abdulaziz for Health Sciences, Jeddah, Saudi Arabia
| | | | | | | | - Raghad Hamza
- College of Medicine, Taif University, Taif, Saudi Arabia
| | - Asalah F Hamad
- College of Medicine, Ibn Sina National College, Jeddah, Saudi Arabia
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Serum 25-hydroxyvitamin D3 levels and poor sleep quality in a Japanese population: the DOSANCO Health Study. Sleep Med 2019; 57:135-140. [DOI: 10.1016/j.sleep.2019.01.046] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/30/2018] [Accepted: 01/08/2019] [Indexed: 12/18/2022]
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24
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Wang F, Chow IHI, Li L, Li XH, Ng CH, Ungvari GS, Wang AH, Jia FJ, Zhang Y, Xiang YT. Sleep duration and patterns in Chinese patients with diabetes: A meta-analysis of comparative studies and epidemiological surveys. Perspect Psychiatr Care 2019; 55:344-353. [PMID: 30693541 DOI: 10.1111/ppc.12353] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/10/2018] [Accepted: 01/06/2019] [Indexed: 02/05/2023] Open
Abstract
PURPOSE A meta-analysis on sleep duration and patterns in patients with diabetes in China. DESIGN AND METHODS Two investigators independently carried out a systematic literature search in both international and Chinese databases. FINDINGS A total of 47 studies with 98 911 patients were included. The pooled mean sleep duration was 7.15 hours/day in patients with diabetes and 7.49 hours/day in healthy controls. The estimated percentage of short sleep duration of less than 6 hours/day was 23.0% in patients with diabetes and 12.3% in healthy controls, while the proportion of short sleep duration of less than 7 hours/day was 38.0% in patients with diabetes and 14.1% in healthy controls. PRACTICE IMPLICATIONS Short sleep duration was common in Chinese patients with diabetes.
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Affiliation(s)
- Fei Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China.,Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Ines H I Chow
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Lu Li
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Xiao-Hong Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Gabor S Ungvari
- University of Notre Dame Australia / Graylands Hospital, Perth, Australia.,Division of Psychiatry, Medical School, University of Western Australia, Perth, Australia
| | - Ai-Hong Wang
- Department of Endocrinology, the 306 Hospital of PLA, Beijing, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Ye Zhang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
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25
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Zhang H, Li Y, Mao Z, Liu M, Huo W, Liu R, Liu X, Tu R, Yang K, Qian X, Jiang J, Zhang X, Tian Z, Bie R, Wang C. A dose-response association of night sleep duration with hypertension in a Chinese rural population: the Henan Rural Cohort Study. ACTA ACUST UNITED AC 2018; 12:867-879.e3. [PMID: 30425019 DOI: 10.1016/j.jash.2018.10.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 10/09/2018] [Accepted: 10/13/2018] [Indexed: 01/22/2023]
Abstract
The purpose of the study was to determine if there was a relationship between night sleep duration and hypertension, and to evaluate as to whether blood lipid levels played a role in this relationship. A total of 37,317 participants aged 18-79 years were included in this study. Night sleep duration was classified as <5, 5-, 6-, 7-, 8-, 9-, and ≥10 hours. Logistic regression and restricted cubic spline analysis was carried out to evaluate the association of sleep duration with hypertension. Compared with reference sleep duration (7 hours), in males, the multivariate odds ratios (ORs) (95% confidence interval [95% CI]) of the groups with longest sleep duration (≥10 hours) and shortest sleep duration (<5 hours) for hypertension was 1.52 (1.25-1.84) and 1.07 (0.80-1.44), respectively. Similarly, the longest sleep duration was associated with diagnosed hypertension (1.21, 1.00-1.45) in females. The OR for an indirect effect of sleep duration through low-density lipoprotein cholesterol (LDL-C) on hypertension was 1.085 (95% CI 1.038-1.137). Overall, a 3.5% possibility of hypertension being associated with sleep duration was attributable to LDL-C. In summary, a relationship between sleep duration and hypertension was observed in this rural population. LDL-C appeared to partially mediate the effect of sleep duration on hypertension in males.
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Affiliation(s)
- Haiqing Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yuqian Li
- Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Min Liu
- Department of Hypertension, Henan Provincial People's Hospital, Zhengzhou, Henan, PR China
| | - Wenqian Huo
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ruihua Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Runqi Tu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Kaili Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xinling Qian
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jingjing Jiang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xia Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhongyan Tian
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ronghai Bie
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
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Li G, Feng D, Wang Y, Fu J, Han L, Li L, Grant SFA, Li M, Li M, Gao S. Loss of Cardio-Protective Effects at the CDH13 Locus Due to Gene-Sleep Interaction: The BCAMS Study. EBioMedicine 2018; 32:164-171. [PMID: 29903569 PMCID: PMC6020797 DOI: 10.1016/j.ebiom.2018.05.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 05/21/2018] [Accepted: 05/29/2018] [Indexed: 12/17/2022] Open
Abstract
Left ventricular mass index (LVMI) provides a metric for cardiovascular disease risk. We aimed to assess the association of adiponectin-related genetic variants resulting from GWAS in East Asians (loci in/near CDH13, ADIPOQ, WDR11FGF, CMIP and PEPD) with LVMI, and to examine whether sleep duration modified these genetic associations in youth. The 559 subjects aged 15–28 years were recruited from the Beijing Child and Adolescent Metabolic Syndrome study. Among the six loci, CDH13 rs4783244 was significantly correlated with adiponectin levels (p = 8.07 × 10−7). The adiponectin-rising allele in rs4783244 locus was significantly associated with decreased LVMI (p = 6.99 × 10−4) after adjusting for classical cardiovascular risk factors, and further for adiponectin levels, while no significant association was found between the other loci and LVMI. Moreover, we observed a significant interaction effect between rs4783244 and sleep duration (p = .005) for LVMI; the genetic association was more evident in long sleep duration while lost in short sleep duration. Similar interaction was found in the subgroup analysis using longitudinal data (p = .025 for interaction). In this young Chinese population, CDH13 rs4783244 represents a key locus for cardiac structure, and confers stronger cardio-protection in longer sleep duration when contrasted with short sleep duration. CDH13 rs4783244 represents a key locus for cardiac structure. The effect of CDH13 rs4783244 on reduced left ventricular mass index is significantly modified by sleep duration. Short sleep may contribute to the loss of CDH13 locus-mediated cardio-protective effects.
We analyzed the associations of five adiponectin-associated genetic variants with left-ventricular mass index (LVMI), a cardiovascular risk factor, in a population of 559 youth. We found a significant protective association of CDH13 rs4783244 with decreased LVMI, independent of adiponectin and other conventional risk factors. Sleep duration has previously been described as a risk factor for increased LVMI in this population, therefore, we assessed modification of this association in CDH13 by sleep duration, and found that short sleep attenuated the cardio-protective effect of this SNP. Our study provides important insights into pathologic mechanisms and prevention strategies for early risk of cardiovascular disease.
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Affiliation(s)
- Ge Li
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China
| | - Dan Feng
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100043, China
| | - Yonghui Wang
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100043, China
| | - Junling Fu
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China
| | - Lanwen Han
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100043, China
| | - Lujiao Li
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China
| | - Struan F A Grant
- Division of Endocrinology, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania; Philadelphia, PA 19104, USA; Division of Human Genetics, The Children's Hospital of Philadelphia Research Institute, Philadelphia, PA 19104, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Mingyao Li
- Departments of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ming Li
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China.
| | - Shan Gao
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100043, China.
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27
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Guerrero-Zúñiga S, Gaona-Pineda EB, Cuevas-Nasu L, Torre-Bouscoulet L, Reyes-Zúñiga M, Shamah-Levy T, Perez-Padilla R. Prevalencia de síntomas de sueño y riesgo de apnea obstructiva del sueño en México. ACTA ACUST UNITED AC 2018; 60:347-355. [DOI: 10.21149/9280] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 03/08/2018] [Indexed: 11/06/2022]
Abstract
Objetivo. Estimar la prevalencia nacional de síntomas asociados con el sueño (SAS) en México, y su distribución por región, localidad y sexo. Material y métodos. Estudio transversal con muestreo probabilístico, representativo a nivel nacional en adultos mayores de 20 años. Se aplicó un cuestionario sobre duración de sueño, insomnio, uso de hipnóticos y riesgo de síndrome de apnea obstructiva del sueño (SAOS). Resultados. Los SAS más frecuentes fueron ronquido (48.5%) y dificultad para dormir (36.9%). Se identificó riesgo elevado de SAOS en 27.3% de los adultos, y se incrementa por índice de masa corporal (RM=1.1), edad (RM=1.03) y habitar zona urbana (RM=1.37). Se reportó insomnio en 18.8% de los participantes, que predomina en mujeres (RM=1.88). La duración promedio de sueño fue de 7.6 ± 3 horas; 28.4% de los adultos duermen <7 horas/ noche. Conclusiones. Existe una elevada prevalencia de SAS. Uno de cada cuatro adultos mexicanos tiene elevada probabilidad de padecer SAOS. La detección y tratamiento de SAS pudieran minimizar los efectos deletéreos en la salud.
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Ding C, Lim LL, Xu L, Kong APS. Sleep and Obesity. J Obes Metab Syndr 2018; 27:4-24. [PMID: 31089536 PMCID: PMC6489488 DOI: 10.7570/jomes.2018.27.1.4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 03/08/2018] [Accepted: 03/09/2018] [Indexed: 12/30/2022] Open
Abstract
Rising global prevalence and incidence of obesity lead to increased cardiovascular-renal complications and cancers. Epidemiological studies reported a worldwide trend towards suboptimal sleep duration and poor sleep quality in parallel with this obesity epidemic. From rodents and human models, it is highly plausible that abnormalities in sleep, both quantity and quality, impact negatively on energy metabolism. While excess dietary intake and physical inactivity are the known drivers of the obesity epidemic, promotion of healthy sleep habits has emerged as a new target to combat obesity. In this light, present review focuses on the existing literature examining the relationship between sleep physiology and energy homeostasis. Notably, sleep dysregulation perturbs the metabolic milieu via alterations in hormones such as leptin and ghrelin, eating behavior, neuroendocrine and autonomic nervous systems. In addition, shift work and trans-meridian air travel may exert a negative influence on the hypothalamic-pituitary-adrenal axis and trigger circadian misalignment, leading to impaired glucose tolerance and increased fat accumulation. Amassing evidence has also suggested that uncoupling of the circadian clock can increase the risk of adverse metabolic health. Given the importance of sleep in maintaining energy homeostasis and that it is potentially modifiable, promoting good sleep hygiene may create new avenues for obesity prevention and treatment.
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Affiliation(s)
- Chenzhao Ding
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Lee Ling Lim
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.,Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Li Xu
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Alice Pik Shan Kong
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
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Vézina-Im LA, Nicklas TA, Baranowski T. Associations Among Sleep, Body Mass Index, Waist Circumference, and Risk of Type 2 Diabetes Among U.S. Childbearing-Age Women: National Health and Nutrition Examination Survey. J Womens Health (Larchmt) 2018; 27:1400-1407. [PMID: 29583069 DOI: 10.1089/jwh.2017.6534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Women of childbearing age (18-44 years) present an important group for understanding sleep, but few studies have focused on this population. No study has investigated the associations among sleep, overweight/obesity, and risk of type 2 diabetes among childbearing-age women in the National Health and Nutrition Examination Survey (NHANES). METHODS Data were from NHANES, 2005-2008. The study population consisted of 18-44 year old women. Pregnant women and those diagnosed with sleep disorders were excluded. Sleep duration and quality were self-reported. Body mass index (BMI), waist circumference (WC) measurements, and a 2-hour 75 g oral glucose tolerance test (OGTT) were performed by trained NHANES staff. An unadjusted linear regression analysis; a second adjusted for demographics only (partially adjusted model); and a third adjusted for demographics and variables associated with overweight/obesity and diabetes (fully adjusted model) were computed to assess associations among sleep duration/quality and BMI, WC, and 2-hour OGTT. RESULTS Total sample consisted of 2388 childbearing-age women. Only sleep duration was significantly associated with BMI and WC in the unadjusted and partially adjusted models, but was no longer significant in the fully adjusted model. Neither sleep duration nor quality was significantly associated with 2-hour OGTT in any of the models. CONCLUSIONS Targeting sleep duration and sleep quality alone would not likely contribute to significantly lower BMI, WC, or risk of type 2 diabetes in US childbearing-age women. Additional studies, especially longitudinal ones using objective measures of sleep, are needed to confirm these findings.
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Affiliation(s)
- Lydi-Anne Vézina-Im
- Children's Nutrition Research Center, Baylor College of Medicine , Houston, Texas
| | - Theresa A Nicklas
- Children's Nutrition Research Center, Baylor College of Medicine , Houston, Texas
| | - Tom Baranowski
- Children's Nutrition Research Center, Baylor College of Medicine , Houston, Texas
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Retondario A, Fernandes R, Rockenbach G, Alves MDA, Bricarello LP, Trindade EBSDM, Vasconcelos FDAGD. Selenium intake and metabolic syndrome: A systematic review. Clin Nutr 2018. [PMID: 29530547 DOI: 10.1016/j.clnu.2018.02.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Metabolic syndrome is a multi-causal disease. Its treatment includes lifestyle changes with a focus on weight loss. This systematic review assessed the association between Selenium intake and metabolic syndrome. METHODS Data were collected mainly from four databases: PubMed, CENTRAL (Cochrane), Scopus and Web of Knowledge. Keywords related to metabolic syndrome, selenium, as well as metabolic syndrome features were searched. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. A systematic review protocol was registered at PROSPERO (n. 42016046321). Two reviewers independently screened 2957 abstracts. Six studies were included to perform data extraction with standardized spreadsheets. The risk of bias was assessed by using specific tools according to the design of the relevant studies. An assessment was carried out based on the appropriateness of the study reports accordingly to STROBE and the CONSORT-based checklist for each study design. RESULTS Three studies found no association between Selenium intake and metabolic syndrome; two of them found an inverse association; and one study found a direct association between Selenium intake and metabolic syndrome. One study also showed an inverse association between Selenium intake and the prevalence of high waist circumference, high diastolic blood pressure, and hyperglycaemia in women. CONCLUSIONS Overall, based on the argumentation and results of this study, it is possible to conclude that Selenium intake and metabolic syndrome are not clearly associated in adults and elderly.
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Affiliation(s)
- Anabelle Retondario
- Federal University of Santa Catarina (UFSC, Portuguese Acronym for Universidade Federal de Santa Catarina), Postgraduate Program in Nutrition, CAPES [Coordenação de Aperfeiçoamento de Pessoal de Nível Superior] Scholarship, Florianópolis, Santa Catarina, Brazil.
| | - Ricardo Fernandes
- Federal University of Santa Catarina (UFSC, Portuguese Acronym for Universidade Federal de Santa Catarina), Postgraduate Program in Nutrition, CAPES [Coordenação de Aperfeiçoamento de Pessoal de Nível Superior] Scholarship, Florianópolis, Santa Catarina, Brazil
| | - Gabriele Rockenbach
- Federal University of Santa Catarina (UFSC), Nutrition Department, Florianópolis, Santa Catarina, Brazil
| | - Mariane de Almeida Alves
- Federal University of Santa Catarina (UFSC), Postgraduate Program in Nutrition, FAPESC [Fundação de Amparo à Pesquisa e Inovação do Estado de Santa Catarina] Scholarship, Florianópolis, Santa Catarina, Brazil
| | - Liliana Paula Bricarello
- Federal University of Santa Catarina (UFSC, Portuguese Acronym for Universidade Federal de Santa Catarina), Postgraduate Program in Nutrition, CAPES [Coordenação de Aperfeiçoamento de Pessoal de Nível Superior] Scholarship, Florianópolis, Santa Catarina, Brazil
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Ahmed AE, Al-Jahdali F, AlALwan A, Abuabat F, Bin Salih SA, Al-Harbi A, Baharoon S, Khan M, Ali YZ, Al-Jahdali H. Prevalence of sleep duration among Saudi adults. Saudi Med J 2017; 38:276-283. [PMID: 28251223 PMCID: PMC5387904 DOI: 10.15537/smj.2017.3.17101] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: To examine the associations between sleep duration and a variety of demographic and clinical variables in a sample of Saudi adults. Methods: A cross-sectional study among 2,095 participants was conducted at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, between May and October 2014. A questionnaire was administered to collect data related to clinical health outcomes and demographic characteristics. Participants were asked to report their average sleep duration per night in hours. Results: One-third (33.8%) reported short sleep duration of less than 7 hours/night. Short sleep duration was more prevalent in females (37.3% versus 31.4%, p=0.004). The most common medical problems reported were obesity with body mass index of >30 Kg/m2 (39.1%), hypertension (33.9%), diabetes mellitus (20.8%), depression (4.3%), asthma (17.3%), COPD (6.6%), and hyperlipidemia (2.7%). Diabetes mellitus was associated with long sleep of more than 9 hours/night (25.4%, p=0.011) and hypertension (54.2%, p=0.001). The linear regression model tend to reduce their sleep duration by roughly 22 minutes in female gender, 66 minutes in participants with hyperlipidemia, and 70 minutes in participants with poor sleep quality. Conclusions: Short sleep duration per night was prevalent, it affects one in every 3 Saudi adults. Long sleep duration of more than 9 hours was associated with increased comorbid conditions.
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Affiliation(s)
- Anwar E Ahmed
- College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Nakajima K, Suwa K, Toyama K. Age-dependent changes in the association between sleep duration and impaired glucose metabolism. World J Diabetes 2017; 8:397-406. [PMID: 28861177 PMCID: PMC5561039 DOI: 10.4239/wjd.v8.i8.397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 03/03/2017] [Accepted: 03/16/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To investigate whether the association between sleep duration and impaired glucose metabolism varies among younger and older populations. METHODS We reviewed data of self-reported habitual sleep duration per night, HbA1c levels, and clinically relevant factors in a cross-sectional checkup database of 75472 Japanese from the general population aged 20-79 years (51695 men and 23777 women). Associations of prediabetes (HbA1c ≥ 5.7% and/or diabetic pharmacotherapy) or diabetes (HbA1c ≥ 6.5% and/or diabetic pharmacotherapy) with short and long sleep durations compared with a reference sleep duration (7 h) were investigated by multivariate logistic regression analysis. We controlled for potential relevant confounders, including age, sex, and work duration per day according to younger and older subjects. RESULTS As age advanced, sleep duration became longer and this increase in the 40s and 50s was two times greater in men than in women. This finding was accompanied by a deterioration in HbA1c levels. In subjects aged younger than 40 years (n = 32929), HbA1c levels were inversely and linearly correlated with sleep duration in both sexes. However, in subjects aged 40 years or older (n = 42543), HbA1c levels showed a non-linear relationship against sleep duration with a nadir at 7 h. Multivariate logistic regression analysis showed that in younger subjects, short durations of sleep (≤ 5 h and 6 h) were positively associated with prediabetes (both P < 0.001), but a long duration of sleep (≥ 8 h) was inversely associated with prediabetes (P < 0.001). These associations remained significant after adjustment for relevant confounders, including age, sex, and work duration per day (ORs = 1.20, 95%CI: 1.05-1.37, P < 0.001; ORs = 1.12, 95%CI: 1.02-1.24, P < 0.05; and ORs = 0.84, 95%CI: 0.72-0.99, P < 0.05, respectively). In contrast, in older subjects, besides an association of prediabetes with a short duration of sleep (≤ 5 h) (ORs = 1.12, 95%CI: 1.03-1.21, P < 0.01), diabetes was significantly associated with a long duration of sleep (≥ 8 h) (ORs = 1.11, 95%CI: 1.02-1.25, P < 0.05). CONCLUSION A short sleep duration may be associated with prediabetes throughout life. However, the association between a long sleep duration and glucose metabolism can change with aging.
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Vézina-Im LA, Moreno JP, Nicklas TA, Baranowski T. Behavioral interventions to promote adequate sleep among women: protocol for a systematic review and meta-analysis. Syst Rev 2017; 6:95. [PMID: 28490370 PMCID: PMC5425988 DOI: 10.1186/s13643-017-0490-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 05/02/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Short and poor sleep have been associated with adverse health outcomes in adults, such as overweight/obesity and type 2 diabetes, especially among women. Women therefore represent an important target for interventions aimed at improving sleep and such interventions have been advocated to enhance maternal, fetal, and infant health. This systematic review will assess the efficacy or effectiveness of behavioral interventions aimed at promoting adequate sleep among women. The primary outcomes will be changes in sleep duration and/or sleep quality from baseline to post-intervention and to the last available follow-up measured either through self-reports or objectively. Secondary outcomes will be assessing the behavior change techniques that are responsible for the changes in sleep duration and quality among women. METHODS Behavioral interventions that are non-pharmacological and target either sleep directly or sleep hygiene behaviors will be included. Randomized controlled trials, quasi-experimental, and one-group pre-post studies will be included, but treated separately in the analyses, given that a limited number of studies on the topic of sleep is expected. MEDLINE/PubMed, PsycINFO, CINAHL, EMBASE, and Proquest Dissertations and Theses will be investigated. There will be no restriction on the year of publication of the articles, but we will include only the ones written in English or French. Two authors will independently assess articles for eligibility and will extract data using a standardized data extraction form that will have been previously pilot-tested. The quality of the studies will be assessed using the Effective Public Health Practice Project tool for quantitative study designs. The intervention procedures will be classified according to the latest validated taxonomy of behavior change techniques. If there is a sufficient number of studies (k > 5), a meta-analysis of the results will be performed with a random-effect model. If the heterogeneity is high (I 2 ≥ 75%), it will be investigated through sensitivity analyses and meta-regression. DISCUSSION This review will provide valuable information to those interested in promoting adequate sleep among women and, hopefully, encourage additional research in this important field to promote maternal, fetal, and infant health. SYSTEMATIC REVIEW REGISTRATION The study protocol was registered in PROSPERO in October 2016 (CRD42016049538).
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Affiliation(s)
- Lydi-Anne Vézina-Im
- Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, USA, 77030.
| | - Jennette Palcic Moreno
- Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, USA, 77030
| | - Theresa A Nicklas
- Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, USA, 77030
| | - Tom Baranowski
- Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, USA, 77030
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He Q, Sun H, Wu X, Zhang P, Dai H, Ai C, Shi J. Sleep duration and risk of stroke: a dose-response meta-analysis of prospective cohort studies. Sleep Med 2016; 32:66-74. [PMID: 28366344 DOI: 10.1016/j.sleep.2016.12.012] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 11/17/2016] [Accepted: 12/05/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Suboptimal sleep duration has been considered to increase the risk of stroke incidence. Thus we aimed to conduct a dose-response meta-analysis to examine the association between sleep duration and stroke incidence. METHODS We searched PubMed, Web of science and the Cochrane Library to identify all prospective studies evaluating the association of sleep duration and nonfatal and/or fatal stroke incidence. Then, restricted cubic spline functions and piecewise linear functions were used to evaluate the nonlinear and linear dose-response association between them. RESULTS We included a total of 16 prospective studies enrolling 528,653 participants with 12,193 stroke events. Nonlinear dose-response meta-analysis showed a J-shaped association between sleep duration and total stroke with the lowest risk observed with sleeping for 7 h. Considering people sleeping for 7 h as reference, long sleepers had a higher predicted risk of total stroke than short sleepers [the pooled risk ratios (95% confidence intervals): 4 h: 1.17 (0.99-1.38); 5 h: 1.17 (1.00-1.37); 6 h: 1.10 (1.00-1.21); 8 h: 1.17 (1.07-1.28); 9 h: 1.45 (1.23-1.70); 10 h: 1.64 (1.4-1.92); pnonlinearity<0.001]. Short sleep durations were only significantly associated with nonfatal stroke and with total stroke in the subgroups of structured interview and non-Asian countries. Additionally, we found a slightly decreased risk of ischemic stroke among short sleepers. For piecewise linear trends, compared to 7 h, every 1-h increment of sleep duration led to an increase of 13% [the pooled risk ratios (95% confidence intervals): 1.13 (1.07-1.20); p < 0.001] in risk of total stroke. CONCLUSION Both in nonlinear and piecewise linear dose-response meta-analyses, long sleep duration significantly increased the risk of stroke incidence.
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Affiliation(s)
- Qiao He
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China
| | - Hao Sun
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China
| | - Xiaomei Wu
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China
| | - Peng Zhang
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China
| | - Huixu Dai
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China
| | - Cong Ai
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China
| | - Jingpu Shi
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China.
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Fatima Y, Doi SAR, Najman JM, Mamun AA. Exploring Gender Difference in Sleep Quality of Young Adults: Findings from a Large Population Study. Clin Med Res 2016; 14:138-144. [PMID: 28188139 PMCID: PMC5302457 DOI: 10.3121/cmr.2016.1338] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/15/2016] [Accepted: 11/15/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To explore if gender difference in sleep quality is due to higher prevalence of depression in females, and whether socio-demographic and lifestyle factors have a differential effect on sleep quality in males and females. METHODS Youth self-reports and the Pittsburgh Sleep Quality Index were used to assess sleep quality and associated risk factors. Logistic regression analyses were used to analyze the association between various risk factors and poor sleep quality. RESULTS Reports from 3,778 young adults (20.6±0.86 years) indicate a higher prevalence of poor sleep quality in females than males (65.1% vs. 49.8%). It seems that gender difference in poor sleep is independent of depression, socio-demographics, and lifestyle factors, since the higher odds of poor sleep quality in females was robust to adjust for depression, socio-demographics, and lifestyle factors (OR: 1.53, 95% CI: 1.23-1.90). Lifestyle factors (eg, smoking) (OR 1.91; 95% CI 1.05-3.46) were associated with sleep quality in only males. CONCLUSION Our findings indicate that female vulnerability to poor sleep quality should be explored beyond psycho-social disparities. Perhaps, exploring if the female predisposition to poor sleep quality originates at the biological level could lead to the answer.
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Affiliation(s)
- Yaqoot Fatima
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
- Mount Isa Centre for Rural and Remote Health, James Cook University, Queensland, Australia
| | - Suhail A R Doi
- Research School of Population Health, Australian National University, Canberra, ACT, Australia
- School of Agricultural, Computing, and Environmental Sciences, Universtity of Southern Queensland, Toowoomba, Australia
- College of Medicine, Qatar University, Doha, Qatar
| | - Jake M Najman
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
- School of Social Science, University of Queensland, Brisbane, Queensland, Australia
| | - Abdullah Al Mamun
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
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Al-Abri MA, Jaju D, Al-Sinani S, Al-Mamari A, Albarwani S, Al-Resadi K, Bayoumi R, Hassan M, Al-Hashmi K. Habitual Sleep Deprivation is Associated with
Type 2 Diabetes: A Case-Control Study. Oman Med J 2016; 31:399-403. [PMID: 27974953 DOI: 10.5001/omj.2016.81] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES It is suggested that a minimum of eight hours of sleep per night is needed for metabolism to work normally. The aim of the study was to determine the association of habitual sleep deprivation and type 2 diabetes mellitus (T2DM). METHODS We conducted a case-control study comparing patients with T2DM with age and sex matched healthy controls. Standard sleep questionnaires (the Berlin and Epworth Sleepiness Scale) and a weekly diary were used by patients to self-report habitual sleep. RESULTS A total of 172 diabetics and 188 healthy controls were enrolled in the study. There was a significant difference between T2DM and healthy controls in nocturnal sleep duration (p = 0.033). There was a significant association between nocturnal sleep duration of fewer than six hours and T2DM (χ2 = 14.0; p = 0.0001). There was no significant difference in daytime sleepiness and daytime naps between the T2DM and control groups (p = 0.452; p = 0.581, respectively). CONCLUSIONS A nocturnal sleep duration < 6 hours is associated with T2DM.
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Affiliation(s)
- Mohammed A Al-Abri
- Department of Clinical Physiology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Deepali Jaju
- Department of Clinical Physiology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Sawsan Al-Sinani
- Department of Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman
| | - Ali Al-Mamari
- Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | - Sulayma Albarwani
- Department of Clinical Physiology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Khalid Al-Resadi
- Department of Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman
| | - Riyadh Bayoumi
- Department of Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman
| | - Mohammed Hassan
- Department of Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman
| | - Khamis Al-Hashmi
- Department of Clinical Physiology, Sultan Qaboos University Hospital, Muscat, Oman
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Bermúdez-Millán A, Pérez-Escamilla R, Segura-Pérez S, Damio G, Chhabra J, Osborn CY, Wagner J. Psychological Distress Mediates the Association between Food Insecurity and Suboptimal Sleep Quality in Latinos with Type 2 Diabetes Mellitus. J Nutr 2016; 146:2051-2057. [PMID: 27489004 PMCID: PMC5037870 DOI: 10.3945/jn.116.231365] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 06/27/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Evidence increasingly indicates that poor sleep quality is a major public health concern. Household food insecurity (HFI) disproportionately affects Latinos and is a novel risk factor for poor sleep quality. Psychological distress may be a potential mechanism through which HFI affects sleep quality. Sleep, food insecurity, and distress are linked to type 2 diabetes mellitus. OBJECTIVES We examined the relations between HFI, psychological distress, and sleep quality and tested whether psychological distress mediates the relation between HFI and sleep in people with diabetes mellitus. METHODS Latinos with type 2 diabetes mellitus (n = 121) who completed baseline assessments for the CALMS-D (Community Health Workers Assisting Latinos Manage Stress and Diabetes) stress management intervention trial completed the US Household Food Security Survey, and measures of depressive symptoms [Personal Health Questionnaire Depression Scale (PHQ-8)], anxiety symptoms [Patient-Reported Outcomes Measurement Information System (PROMIS)-short], diabetes distress [Problem Areas in Diabetes Questionnaire (PAID-5)], and sleep quality [Pittsburgh Sleep Quality Index (PSQI)]. Psychological distress was operationalized with the PHQ-8, PROMIS-short, and PAID-5 scales. We used unadjusted and adjusted indirect effect tests with bias-corrected bootstrapped 95% CIs on 10,000 samples to test both relations between variables and potential mediation. RESULTS Mean age was 61 y, 74% were women, and 67% were food insecure. Experiencing HFI was associated with both greater psychological distress and worse sleep quality (P < 0.05). Depressive symptoms (adjusted R2: 2.22, 95% CI: 1.27, 3.42), anxiety symptoms (adjusted R2: 1.70, 95% CI: 0.87, 2.85), and diabetes mellitus distress (adjusted R2: 0.60, 95% CI: 0.11, 1.32) each mediated the relation between HFI and worse sleep quality with and without adjustment for age, education, income, marital status, and employment status. CONCLUSIONS Household food insecurity is a common and potent household stressor that is associated with suboptimal sleep quality through psychological distress. Efforts to improve food security and decrease psychological distress may yield improved sleep in this high-risk population. The CALMS-D stress management trial was registered at clinicaltrials.gov as NCT01578096.
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Affiliation(s)
- Angela Bermúdez-Millán
- Division of Behavioral Sciences and Community Health, School of Dental Medicine, University of Connecticut Health, Farmington, CT;
| | | | | | | | - Jyoti Chhabra
- Research Program, Hartford Hospital, Hartford, CT; and
| | - Chandra Y Osborn
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Julie Wagner
- Division of Behavioral Sciences and Community Health, School of Dental Medicine, University of Connecticut Health, Farmington, CT
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Basnet S, Merikanto I, Lahti T, Männistö S, Laatikainen T, Vartiainen E, Partonen T. Associations of common chronic non-communicable diseases and medical conditions with sleep-related problems in a population-based health examination study. Sleep Sci 2016; 9:249-254. [PMID: 28123670 PMCID: PMC5241609 DOI: 10.1016/j.slsci.2016.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 10/18/2016] [Accepted: 11/14/2016] [Indexed: 12/31/2022] Open
Abstract
A cross-sectional population-based survey, the National FINRISK 2012 Study, designed to monitor chronic diseases and their risk factors in Finland. A random sample of 10,000 adults aged 25-74 years, and of them, 64% (n=6424) participated the study. Participants subjectively reported the total durations for sleep and naps (n=6238), sleep quality (n=5878), bedtimes and wake-up times separately for working days and weekends yielding the amount of sleep debt (n=5878), and the seasonal variation in sleep duration (n=4852). The participants were asked whether they were diagnosed or treated for common chronic diseases in the past 12 months. Logistic regression models were adopted to analysis and adjusted for a range of covariates as potential confounding factors. Total sleep duration and nap duration prolonged in depression and other mental disorder (p<.001 for all). Seasonal variation in sleep duration was associated with depression (p=.014), hypertension (p=.018) and angina pectoris (p=.024). Participants with gallstones, cardiac insufficiency, depression, or degenerative arthritis had poor sleep quality (odds ratios of 1.6-6.3, p=.001 or less for each). Those with degenerative arthritis had sleep debt less (p<.05) and those with angina pectoris more (p<.05) than individuals without these medical conditions. Depression is significantly associated with sleep problems, albeit no sleep debt. Cardiovascular diseases, degenerative arthritis, and gallstones had significant associations with one or more sleep problems. There is therefore a need for more successful management of sleep problems in chronic diseases to improve the quality of life, to reduce treatment relapses, and to increase health and longevity in a population.
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Affiliation(s)
- Syaron Basnet
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
- Faculty of Medicine, Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ilona Merikanto
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
- Department of Psychology, University of Helsinki, Helsinki, Finland
| | - Tuuli Lahti
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
- Faculty of Medicine, Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Satu Männistö
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Tiina Laatikainen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Hospital District of North Karelia, Joensuu, Finland
| | - Erkki Vartiainen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Timo Partonen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
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Lecube A, Sánchez E, Gómez-Peralta F, Abreu C, Valls J, Mestre O, Romero O, Martínez MD, Sampol G, Ciudin A, Hernández C, Simó R. Global Assessment of the Impact of Type 2 Diabetes on Sleep through Specific Questionnaires. A Case-Control Study. PLoS One 2016; 11:e0157579. [PMID: 27315083 PMCID: PMC4912108 DOI: 10.1371/journal.pone.0157579] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 06/01/2016] [Indexed: 12/12/2022] Open
Abstract
Abstract Type 2 diabetes (T2D) is an independent risk factor for sleep breathing disorders. However, it is unknown whether T2D affects daily somnolence and quality of sleep independently of the impairment of polysomnographic parameters. Material and Methods A case-control study including 413 patients with T2D and 413 non-diabetic subjects, matched by age, gender, BMI, and waist and neck circumferences. A polysomnography was performed and daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS). In addition, 135 subjects with T2D and 45 controls matched by the same previous parameters were also evaluated through the Pittsburgh Sleep Quality Index (PSQI) to calculate sleep quality. Results Daytime sleepiness was higher in T2D than in control subjects (p = 0.003), with 23.9% of subjects presenting an excessive daytime sleepiness (ESS>10). Patients with fasting plasma glucose (FPG ≥13.1 mmol/l) were identified as the group with a higher risk associated with an ESS>10 (OR 3.9, 95% CI 1.8–7.9, p = 0.0003). A stepwise regression analyses showed that the presence of T2D, baseline glucose levels and gender but not polysomnographic parameters (i.e apnea-hyoapnea index or sleeping time spent with oxigen saturation lower than 90%) independently predicted the ESS score. In addition, subjects with T2D showed higher sleep disturbances [PSQI: 7.0 (1.0–18.0) vs. 4 (0.0–12.0), p<0.001]. Conclusion The presence of T2D and high levels of FPG are independent risk factors for daytime sleepiness and adversely affect sleep quality. Prospective studies addressed to demonstrate whether glycemia optimization could improve the sleep quality in T2D patients seem warranted.
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Affiliation(s)
- Albert Lecube
- Endocrinology and Nutrition Department, Hospital Universitari Arnau de Vilanova, Biomedical Research Institute of Lleida (IRBLLEIDA), Universitat de Lleida, Av Rovira Roure 80, 25198, Lleida, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Diabetes and Metabolism Research Unit, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Pg Vall d’Hebron 119-129, 08035, Barcelona, Spain
- * E-mail:
| | - Enric Sánchez
- Endocrinology and Nutrition Department, Hospital Universitari Arnau de Vilanova, Biomedical Research Institute of Lleida (IRBLLEIDA), Universitat de Lleida, Av Rovira Roure 80, 25198, Lleida, Spain
| | - Fernando Gómez-Peralta
- Endocrinology and Nutrition Unit, Segovia General Hospital, C/Miguel Servet s/n, 40002, Segovia, Spain
| | - Cristina Abreu
- Endocrinology and Nutrition Unit, Segovia General Hospital, C/Miguel Servet s/n, 40002, Segovia, Spain
| | - Joan Valls
- Biostatistics and Epidemiology Unit, Biomedical Research Institute of Lleida (IRBLLEIDA), Av Rovira Roure 80, 25198, Lleida, Spain
| | - Olga Mestre
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Diabetes and Metabolism Research Unit, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Pg Vall d’Hebron 119-129, 08035, Barcelona, Spain
| | - Odile Romero
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Sleep Unit, Neurophysiology Department, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Pg Vall d’Hebron 119-129, 08035, Barcelona, Spain
| | - María Dolores Martínez
- Endocrinology and Nutrition Department, Hospital Universitari Arnau de Vilanova, Biomedical Research Institute of Lleida (IRBLLEIDA), Universitat de Lleida, Av Rovira Roure 80, 25198, Lleida, Spain
| | - Gabriel Sampol
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Sleep Unit, Pneumology Department, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Pg Vall d’Hebron 119-129, 08035, Barcelona, Spain
| | - Andreea Ciudin
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Diabetes and Metabolism Research Unit, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Pg Vall d’Hebron 119-129, 08035, Barcelona, Spain
| | - Cristina Hernández
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Diabetes and Metabolism Research Unit, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Pg Vall d’Hebron 119-129, 08035, Barcelona, Spain
| | - Rafael Simó
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Diabetes and Metabolism Research Unit, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Pg Vall d’Hebron 119-129, 08035, Barcelona, Spain
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Upala S, Sanguankeo A, Congrete S, Romphothong K. Sleep duration and insulin resistance in individuals without diabetes mellitus: A systematic review and meta-analysis. Diabetes Res Clin Pract 2015; 109:e11-2. [PMID: 26163439 DOI: 10.1016/j.diabres.2015.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Accepted: 06/19/2015] [Indexed: 11/15/2022]
Affiliation(s)
- Sikarin Upala
- Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, NY, USA; Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Anawin Sanguankeo
- Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, NY, USA; Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| | - Soontharee Congrete
- Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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