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Wang B, Zhang H, Sun Y, Tan X, Zhang J, Wang N, Lu Y. Association of sleep patterns and cardiovascular disease risk is modified by glucose tolerance status. Diabetes Metab Res Rev 2023; 39:e3642. [PMID: 37009685 DOI: 10.1002/dmrr.3642] [Citation(s) in RCA: 1] [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: 12/16/2022] [Revised: 03/06/2023] [Accepted: 03/21/2023] [Indexed: 04/04/2023]
Abstract
AIMS To investigate whether the association between sleep patterns and cardiovascular disease (CVD) risk differs according to glucose tolerance status. MATERIALS AND METHODS This prospective study included 358,805 participants initially free of CVD from the UK Biobank. We created a sleep score based on five sleep factors (sleep duration, chronotype, insomnia, snoring, and daytime sleepiness) with one point for each unhealthy factor. Cox proportional hazards models were used to examine the association between sleep and incident CVD, including coronary heart disease (CHD) and stroke, according to normal glucose tolerance (NGT), prediabetes, and diabetes. RESULTS During a median follow-up of 12.4 years, 29,663 incident CVD events were documented. There was a significant interaction between sleep score and glucose tolerance status on CVD (P for interaction = 0.002). Each 1 point increment in sleep score was associated with a 7% (95% confidence interval 6%-9%), 11% (8%-14%), and 13% (9%-17%) higher risk of CVD among participants with NGT, prediabetes, and diabetes, respectively. Similar interaction patterns were observed for CHD and stroke. Among the individual sleep factors, sleep duration and insomnia significantly interacted with glucose tolerance status on CVD outcomes (all P for interaction <0.05). All five unhealthy sleep factors accounted for 14.2% (8.7%-19.8%), 19.5% (7.4%-31.0%), and 25.1% (9.7%-39.3%) of incident CVD cases among participants with NGT, prediabetes, and diabetes, respectively. CONCLUSIONS The CVD risk associated with a poor sleep pattern was exacerbated across glucose intolerance status. Our findings emphasise the importance of integrating sleep management into a lifestyle modification programme, particularly in people with prediabetes or diabetes.
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Affiliation(s)
- Bin Wang
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haojie Zhang
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Sun
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao Tan
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, China
| | - Jihui Zhang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ningjian Wang
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingli Lu
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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2
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Gangitano E, Martinez-Sanchez N, Bellini MI, Urciuoli I, Monterisi S, Mariani S, Ray D, Gnessi L. Weight Loss and Sleep, Current Evidence in Animal Models and Humans. Nutrients 2023; 15:3431. [PMID: 37571368 PMCID: PMC10420950 DOI: 10.3390/nu15153431] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
Sleep is a vital process essential for survival. The trend of reduction in the time dedicated to sleep has increased in industrialized countries, together with the dramatic increase in the prevalence of obesity and diabetes. Short sleep may increase the risk of obesity, diabetes and cardiovascular disease, and on the other hand, obesity is associated with sleep disorders, such as obstructive apnea disease, insomnia and excessive daytime sleepiness. Sleep and metabolic disorders are linked; therefore, identifying the physiological and molecular pathways involved in sleep regulation and metabolic homeostasis can play a major role in ameliorating the metabolic health of the individual. Approaches aimed at reducing body weight could provide benefits for both cardiometabolic risk and sleep quality, which indirectly, in turn, may determine an amelioration of the cardiometabolic phenotype of individuals. We revised the literature on weight loss and sleep, focusing on the mechanisms and the molecules that may subtend this relationship in humans as in animal models.
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Affiliation(s)
- Elena Gangitano
- OCDEM Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford OX3 7LE, UK
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Noelia Martinez-Sanchez
- OCDEM Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford OX3 7LE, UK
| | | | - Irene Urciuoli
- Department of Surgery, Sapienza University of Rome, 00161 Rome, Italy
| | - Stefania Monterisi
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford OX1 3PT, UK
| | - Stefania Mariani
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - David Ray
- OCDEM Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford OX3 7LE, UK
| | - Lucio Gnessi
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
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3
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Guo X, Qin Z, Meng C, Lv J, Hu Y, Fei J, Liang L, Li J, Yuan T, Mei S, Tong Q. Investigation of the Sleep Quality Among Hospitalized Cardiovascular Patients Using Regression Models and Qualitative Comparative Analysis. Clin Nurs Res 2023; 32:580-588. [PMID: 36633212 DOI: 10.1177/10547738221148150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
This study aimed to explore the relationships between modifiable and non-modifiable factors that influence sleep quality in hospitalized patients with cardiovascular disease in China. This study design was cross-sectional and descriptive. This study involved a convenience sample of 242 patients hospitalized for cardiovascular issues. Hierarchical regression model and qualitative comparative analysis model were performed. Regression revealed that age and depression both had statistically significant effects on sleep quality. The combination of conditions with strongest predictive effect on sleep quality was male of younger age, high level of depression, high level of anxiety, and low level of social support. Other combinations with predictive power on sleep quality are as follows: (1) younger male patients (aged 47-63 years) with high level of anxiety, high level of social support, and low level of depression; (2) older male patients (aged 63-79 years) with high level of depression, high level of social support, and low levels of anxiety; and (3) older male patients with high level of anxiety and low level of social support. Nurses may promote primary and secondary prevention of cardiovascular health prior to hospitalization, through routine screening for depressive and anxious symptoms and assessment of the patient's social support network. It is unknown whether these findings are unique to hospitalized patients. Therefore, future work should assess the fit of the model to other more diverse groups of hospitalized patients.
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Affiliation(s)
- Xinmeng Guo
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Zeying Qin
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Cuicui Meng
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Jianping Lv
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Yueyang Hu
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Junsong Fei
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Leilei Liang
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Jingyang Li
- First Hospital, Jilin University, Changchun, Jilin Province, China
| | - Tongshuang Yuan
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Songli Mei
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Qian Tong
- First Hospital, Jilin University, Changchun, Jilin Province, China
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4
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Tian M, Ma H, Shen J, Hu T, Cui H, Huangfu N. Causal association between sleep traits and the risk of coronary artery disease in patients with diabetes. Front Cardiovasc Med 2023; 10:1132281. [PMID: 36937914 PMCID: PMC10020648 DOI: 10.3389/fcvm.2023.1132281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 02/16/2023] [Indexed: 03/06/2023] Open
Abstract
Background and aims The association between sleep traits and coronary artery disease (CAD) in patients with diabetes has been reported in previous observational studies. However, whether these potential relationships are causal remains unclear. We aim to assess the causal relationship between sleep traits and CAD in diabetic. Methods Genetic instrumental variables associated with five sleep-related traits (insomnia, sleep duration, ease of getting up, morningness and snoring) were extracted from corresponding genome-wide association studies (GWAS). The associations of genetic variants with CAD were based on 15,666 individuals with diabetes (3,968 CAD cases and 11,696 controls). The primary analysis was derived using the inverse variance weighting method. Further sensitivity analysis was conducted to confirm the robustness and consistency of the main results. Results Genetic liability to insomnia was significantly related to the increased risk of CAD in individuals with diabetes [odds ratio (OR): 1.163; 95% CI: 1.072-1.254; p = 0.001]. Suggestive evidence was found for the borderline associations between both sleep duration (OR: 0.629; 95% CI: 0.380-1.042, p = 0.072) and snoring (OR: 1.010, 95% CI: 1.000-1.020, p = 0.050) with CAD risk. However, no consistent evidence was found for the association between ease of getting up and morningness with the risk of CAD in diabetic. Similar results can be verified in most sensitivity analyses. Conclusions We provide consistent evidence for the causal effect of insomnia on the increased risk of CAD in individuals with diabetes. The management of sleep health should be emphasized to prevent CAD in diabetic patients.
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Affiliation(s)
- Mengyun Tian
- School of Medicine, Ningbo University, Ningbo, China
| | - Hongchuang Ma
- Department of Cardiology, Ningbo First Hospital, Ningbo, China
- Department of Cardiology, Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, Ningbo, China
- Clinical Medicine Research Centre for Cardiovascular Disease of Ningbo, Ningbo, China
| | - Jiaxi Shen
- Department of Cardiology, Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, Ningbo, China
- Clinical Medicine Research Centre for Cardiovascular Disease of Ningbo, Ningbo, China
| | - Teng Hu
- School of Medicine, Ningbo University, Ningbo, China
| | - Hanbin Cui
- Department of Cardiology, Ningbo First Hospital, Ningbo, China
- Department of Cardiology, Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, Ningbo, China
- Clinical Medicine Research Centre for Cardiovascular Disease of Ningbo, Ningbo, China
| | - Ning Huangfu
- Department of Cardiology, Ningbo First Hospital, Ningbo, China
- Department of Cardiology, Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, Ningbo, China
- Clinical Medicine Research Centre for Cardiovascular Disease of Ningbo, Ningbo, China
- Correspondence: Ning Huangfu
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5
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Pak VM, Paul S, Swieboda D, Balthazar MS, Wharton W. Sleep duration and biomarkers of inflammation in African American and white participants with a parental history of Alzheimer's disease. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12332. [PMID: 36177446 PMCID: PMC9473642 DOI: 10.1002/trc2.12332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/24/2022] [Accepted: 06/01/2022] [Indexed: 01/13/2023]
Abstract
Introduction African Americans (AA)s have worse inflammation, worse sleep, and a greater incidence of Alzheimer's disease (AD) compared to whites; however, no studies have examined associations between biomarkers, sleep, and cognition, and differences by race. Methods Seventy-six cognitively normal, middle aged (45-65 years) adults with a parental history of AD were included in this study. Associations between biomarkers (tumor necrosis factor-α [TNF-α], interleukin-10 [IL-10], intercellular adhesion molecule-1 [ICAM-1],, and C-reactive protein [CRP]) and self-reported sleep or cognition measures, were assessed. Results Average sleep duration was significantly lower for AA versus whites (average[SD]) in hours: 6.02(1.18) versus 7.23(0.91), P = .000004). We found a statistically significant association between plasma IL-10 and sleep duration (Spearman's ρ = 0.26, P = .04) and CSF ICAM-1 and sleep quality (Spearman's ρ = 0.30, P = .03). Discussion Longer sleep duration is positively associated with plasma IL-10 levels irrespective of race. Sleep quality was positively associated with CSF ICAM-1 only in African Americans.
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Affiliation(s)
| | | | | | - Monique S. Balthazar
- School of NursingEmory UniversityAtlantaGeorgiaUSA,Byrdine F. Lewis College of Nursing and Health ProfessionsGeorgia State UniversityAtlantaGeorgiaUSA
| | - Whitney Wharton
- School of NursingEmory UniversityAtlantaGeorgiaUSA,Cognitive Neurology DepartmentEmory UniversityAtlantaGeorgiaUSA
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Yang XH, Zhang BL, Cheng Y, Fu SK, Jin HM. Association of the Coexistence of Somnipathy and Diabetes With the Risks of Cardiovascular Disease Events, Stroke, and All‐Cause Mortality: A Systematic Review and Meta‐analysis. J Am Heart Assoc 2022; 11:e024783. [PMID: 35861844 PMCID: PMC9707815 DOI: 10.1161/jaha.121.024783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background
Somnipathy and diabetes are independently associated with an increased risk of cardiovascular disease (CVD). However, whether a combination of both conditions is associated with a higher risk of CVD events remains uncertain. Therefore, the aim of this meta‐analysis was to clarify this association.
Methods and Results
We searched MEDLINE, Web of Science, EMBASE,
ClinicalTrials.gov
, and the Cochrane Central Register for Controlled Trials. We included randomized controlled trials, nonrandomized trials, and prospective observational cohort studies that assessed the combined effect of diabetes and comorbid somnipathy on CVD risk and mortality for at least 1 year. Outcomes included CVD, coronary heart disease, stroke, and all‐cause mortality. Twelve studies involving 582 267 participants were included in the meta‐analysis. Patients with somnipathy and comorbid diabetes exhibited increased risks of CVD, coronary heart disease, stroke, and all‐cause mortality (risk ratio [RR], 1.27 [95% CI, 1.12–1.45],
P
<0.0001; RR, 1.40 [95% CI, 1.21–1.62],
P
<0.0001; RR, 1.28 [95% CI, 1.08–1.52],
P
=0.004, and RR, 1.56 [95% CI, 1.26–1.94],
P
<0.0001, respectively).
Conclusions
The coexistence of somnipathy and diabetes is associated with higher risks of CVD, coronary heart disease, stroke, and mortality than somnipathy or diabetes alone. Resolving sleep problems in patients with diabetes may reduce the risks of CVD, stroke, and mortality.
Registration Information
https://www.crd.york.ac.uk/prospero/
. Identifier: PROSPERO CRD42021274566.
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Affiliation(s)
- Xiu Hong Yang
- Division of Nephrology, Shanghai Pudong Hospital Fudan University Pudong Medical Center Shanghai China
| | - Bao Long Zhang
- The Institutes of Biomedical Sciences (IBS) Fudan University Shanghai China
| | - Yun Cheng
- Division of Nephrology, Shanghai Pudong Hospital Fudan University Pudong Medical Center Shanghai China
| | - Shun Kun Fu
- Division of Nephrology, Shanghai Pudong Hospital Fudan University Pudong Medical Center Shanghai China
| | - Hui Min Jin
- Division of Nephrology, Shanghai Pudong Hospital Fudan University Pudong Medical Center Shanghai China
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7
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Sleep in Paralympic athletes and its relationship with injuries and illnesses. Phys Ther Sport 2022; 56:24-31. [DOI: 10.1016/j.ptsp.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 11/22/2022]
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8
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Pak VM, Russell K, Shi Z, Zhang Q, Cox J, Uppal K, Yu T, Hertzberg V, Liu K, Ioachimescu OC, Collop N, Bliwise DL, Kutner NG, Rogers A, Dunbar SB. Sphinganine is associated with 24-h MAP in the non-sleepy with OSA. Metabolomics 2022; 18:23. [PMID: 35391564 DOI: 10.1007/s11306-021-01860-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 12/07/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Excessive daytime sleepiness is a debilitating symptom of obstructive sleep apnea (OSA) linked to cardiovascular disease, and metabolomic mechanisms underlying this relationship remain unknown. We examine whether metabolites from inflammatory and oxidative stress-related pathways that were identified in our prior work could be involved in connecting the two phenomena. METHODS This study included 57 sleepy (Epworth Sleepiness Scale (ESS) ≥ 10) and 37 non-sleepy (ESS < 10) participants newly diagnosed and untreated for OSA that completed an overnight in-lab or at home sleep study who were recruited from the Emory Mechanisms of Sleepiness Symptoms Study (EMOSS). Differences in fasting blood samples of metabolites were explored in participants with sleepiness versus those without and multiple linear regression models were utilized to examine the association between metabolites and mean arterial pressure (MAP). RESULTS The 24-h MAP was higher in sleepy 92.8 mmHg (8.4) as compared to non-sleepy 88.8 mmHg (8.1) individuals (P = 0.03). Although targeted metabolites were not significantly associated with MAP, when we stratified by sleepiness group, we found that sphinganine is significantly associated with MAP (Estimate = 8.7, SE = 3.7, P = 0.045) in non-sleepy patients when controlling for age, BMI, smoking status, and apnea-hypopnea index (AHI). CONCLUSION This is the first study to evaluate the relationship of inflammation and oxidative stress related metabolites in sleepy versus non-sleepy participants with newly diagnosed OSA and their association with 24-h MAP. Our study suggests that Sphinganine is associated with 24 hour MAP in the non-sleepy participants with OSA.
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Affiliation(s)
- Victoria M Pak
- School of Nursing, Emory University, 1520 Clifton Road, 243, Atlanta, GA, 30322, USA.
- Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Katherine Russell
- School of Nursing, Emory University, 1520 Clifton Road, 243, Atlanta, GA, 30322, USA
| | - Zhenzhen Shi
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Gangarosa Department of Environmental Health, Atlanta, GA, 30322, USA
| | - Qiang Zhang
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Gangarosa Department of Environmental Health, Atlanta, GA, 30322, USA
| | - John Cox
- School of Nursing, Emory University, 1520 Clifton Road, 243, Atlanta, GA, 30322, USA
| | - Karan Uppal
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Tianwei Yu
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Shenzhen Research Institute of Big Data, and School of Data Science, The Chinese University of Hong Kong, Shenzhen, 518172, China
| | - Vicki Hertzberg
- School of Nursing, Emory University, 1520 Clifton Road, 243, Atlanta, GA, 30322, USA
| | - Ken Liu
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Octavian C Ioachimescu
- School of Medicine, Emory University, Atlanta, GA, USA
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University - School of Medicine, Atlanta, GA, 30322, USA
- Sleep Medicine Section, Atlanta VA Healthcare System, Atlanta, GA, 30322, USA
| | - Nancy Collop
- School of Medicine, Emory University, Atlanta, GA, USA
| | | | - Nancy G Kutner
- Gangarosa Department of Environmental Health, Atlanta, GA, 30322, USA
| | - Ann Rogers
- School of Nursing, Emory University, 1520 Clifton Road, 243, Atlanta, GA, 30322, USA
| | - Sandra B Dunbar
- School of Nursing, Emory University, 1520 Clifton Road, 243, Atlanta, GA, 30322, USA
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Li J, Yin J, Luo Y, Ma T, He L, Xie H, Li J, Zhang G, Cheng X, Bai Y. Association of healthy sleep pattern with the risk of cardiovascular disease and all-cause mortality among people with diabetes: A prospective cohort study. Diabetes Res Clin Pract 2022; 186:109822. [PMID: 35271877 DOI: 10.1016/j.diabres.2022.109822] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 01/08/2023]
Abstract
AIMS This study aimed to assess the association of healthy sleep pattern with the risk of cardiovascular disease and all-cause mortality among people with diabetes. METHODS Our study included 12,770 individuals from the UK Biobank at baseline. Sleep patterns were defined by a combination of five sleep behaviors (chronotype, sleep duration, snoring, insomnia, and excessive daytime sleepiness). The competing risk models were used to estimate the relationship between sleep patterns and CVD (including coronary heart disease [CHD] and stroke) in individuals with diabetes. To examine the association between sleep patterns and all-cause mortality risk, we utilized the flexible parametric Royston-Parmar proportion-hazard models. RESULTS We recorded 2627 CVD events, which includes 1999 CHD and 903 S events, and 1576 all-cause mortality events. Compared to those with poor sleep pattern, individuals having healthy sleep pattern have a 24% lower CVD risk (p < 0.001), a 26% lower CHD risk (p = 0.001), a 25% lower stroke risk (p = 0.036), and a 21% lower all-cause mortality risk (p = 0.020). CONCLUSIONS Adherence to healthy sleep pattern has been significantly related to cardiovascular disease and all-cause mortality risk reduction among people with diabetes.
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Affiliation(s)
- Jing Li
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Jinghua Yin
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Yi Luo
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Tianqi Ma
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Lingfang He
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Hejian Xie
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Jinchen Li
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China; Department of Geriatric Medicine, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Guogang Zhang
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha 410008, China; Department of Cardiovascular Medicine, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Xunjie Cheng
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China.
| | - Yongping Bai
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China.
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10
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Wang L, Sun M, Guo Y, Yan S, Li X, Wang X, Hu W, Yang Y, Li J, Li B. The Role of Dietary Inflammatory Index on the Association Between Sleep Quality and Long-Term Cardiovascular Risk: A Mediation Analysis Based on NHANES (2005-2008). Nat Sci Sleep 2022; 14:483-492. [PMID: 35330783 PMCID: PMC8939873 DOI: 10.2147/nss.s357848] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/10/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE People with poor sleep quality have higher risk of cardiovascular disease (CVD), and one potential mechanism of CVD is chronic inflammation. The aim of this study was to investigate the role of dietary inflammation in the relationship between sleep quality and CVD risk. METHODS This study involved 5594 participants from the National Health and Nutrition Examination Survey (NHANES) in 2005-2008. Sleep quality, dietary inflammation, and 10-year CVD risk were evaluated via the Pittsburgh Sleep Quality Index (PSQI), the Energy-adjusted Dietary Inflammatory Index (E-DII), and the Framingham Risk Score (FRS), respectively. We used generalized additive model (GAM) and mediation analysis to investigate the relationship among sleep quality, 10-year CVD risk, and E-DII. RESULTS PSQI had a non-linear relationship with 10-year CVD risk (P < 0.001). Meanwhile, among the participants with poor sleep quality, PSQI was positively associated with increased 10-year CVD risk (P < 0.001) and E-DII (P < 0.001). Furthermore, the association between sleep quality and CVD risk was partially mediated by E-DII, and the mediated proportion was 14.6%, and the mediating effect of E-DII varied in different gender and age groups. However, in the subjects with good sleep quality, the association among PSQI, E-DII, and 10-year CVD risk was not existed. CONCLUSION Ten-year CVD risk could be reduced by controlling the intake of inflammatory food, especially for whom with sleep disorders. In general, the reduction of inflammatory diet could weaken the effect of sleep disorders on the CVD risk.
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Affiliation(s)
- Ling Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
| | - Mengzi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
| | - Yinpei Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
| | - Shoumeng Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
| | - Xiaotong Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
| | - Xuhan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
| | - Wenyu Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
| | - Yixue Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
| | - Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
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Pak VM, Maislin DG, Keenan BT, Townsend RR, Benediktsdottir B, Dunbar SB, Pack AI, Gislason T, Kuna ST. Changes in sleepiness and 24-h blood pressure following 4 months of CPAP treatment are not mediated by ICAM-1. Sleep Breath 2021; 25:1495-1502. [PMID: 33404963 PMCID: PMC9951106 DOI: 10.1007/s11325-020-02257-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/09/2020] [Accepted: 11/18/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Continuous positive airway pressure (CPAP) therapy reduces circulating intercellular adhesion molecule 1 (ICAM-1) in adults with obstructive sleep apnea (OSA). ICAM-1 levels may affect the daytime sleepiness and elevated blood pressure associated with OSA. We evaluated the association of changes from baseline in ICAM-1 with changes of objective and subjective measures of sleepiness, as well as 24-h ambulatory blood pressure monitoring (ABPM) measures, following 4 months of CPAP treatment. METHODS The study sample included adults with newly diagnosed OSA. Plasma ICAM-1, 24-h ABPM, Epworth Sleepiness Scale (ESS), and psychomotor vigilance task (PVT) were obtained at baseline and following adequate CPAP treatment. The associations between changes in natural log ICAM-1 and changes in the number of lapses on PVT, ESS score, and 24-h mean arterial blood pressure (MAP) were assessed using multivariate regression models, controlling for a priori baseline covariates of age, sex, BMI, race, site, smoking status, physical activity, anti-hypertensive medications, AHI, and daily hours of CPAP use. RESULTS Among 140 adults (83% men), mean (± SD) body mass index (BMI) was 31.5 ± 4.2 kg/m2, and apnea-hyopnea index (AHI) was 36.8 ± 15.3 events/h. Sleepiness measures, although not ICAM-1 or ABPM measures, improved significantly following CPAP treatment. We observed no statistically significant associations between the change in ICAM-1 and changes in sleepiness, MAP, or other ABPM measures. CONCLUSION Changes in ICAM-1 levels were not related to changes in sleepiness or ABPM following CPAP treatment of adults with OSA. Future work should explore whether or not other biomarkers may have a role in mediating these treatment outcomes in adults with OSA.
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Affiliation(s)
- Victoria M. Pak
- School of Nursing, Emory University, 1520 Clifton Road, 243, Atlanta, GA 30322, USA
| | - David G. Maislin
- Division of Sleep Medicine, Department of Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Brendan T. Keenan
- Division of Sleep Medicine, Department of Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Raymond R. Townsend
- Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Bryndis Benediktsdottir
- Department of SleepMedicine,Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Sandra B. Dunbar
- School of Nursing, Emory University, 1520 Clifton Road, 243, Atlanta, GA 30322, USA
| | - Allan I. Pack
- Division of Sleep Medicine, Department of Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Thorarinn Gislason
- Department of SleepMedicine,Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Samuel T. Kuna
- Division of Sleep Medicine, Department of Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA,Sleep Medicine Section, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
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12
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Wang W, Meng H, Liu Y, Yin W, Li Z, Wan M, Zou L, Zhang D. Effects of sleep duration and sleep quality in early pregnancy and their interaction on gestational diabetes mellitus. Sleep Breath 2021; 26:489-496. [PMID: 33929688 DOI: 10.1007/s11325-021-02391-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 04/06/2021] [Accepted: 04/23/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To examine the association of sleep duration and quality in early pregnancy with gestational diabetes mellitus (GDM), and explore their interaction effect on GDM. METHODS Participants from 2 hospitals were enrolled in this case-control study between April 2018 and November 2020. Sleep duration and quality were measured using the Pittsburg Sleep Quality Index (PSQI). RESULTS A total of 1300 participants (396 GDM and 904 controls) were included. After adjusting for potential confounders, higher global PSQI scores or poor sleep quality were associated with GDM with odds ratios of 1.13 (95% CI 1.07, 1.19, p < 0.001) and 1.75 (95% CI 1.29, 2.38, p < 0.001), respectively; sleep duration < 7 h, 9-9.9 h and ≥ 10 h were all associated with increased GDM with odds ratios of 4.28 (95% CI 2.51, 7.31, p < 0.001), 1.69 (95% CI 1.20, 2.39, p = 0.003), and 4.42 (95% CI 3.01, 6.50, p < 0.001), respectively. In the stratified analysis based on sleep duration, the effect of poor sleep quality on GDM in the < 7 h group (OR 5.47, 95% CI 2.57, 11.64, p < 0.001) was much stronger than that in the 7-8.9 h group (OR 1.24, 95% CI 0.81, 1.91, p = 0.327), and the p value of the interaction was 0.011. CONCLUSIONS Poor sleep quality and short or long sleep duration in early pregnancy were all associated with GDM, and an interaction effect between short sleep duration and poor sleep quality on GDM was noted.
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Affiliation(s)
- Weiye Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, 38 Dengzhou Road, Qingdao, Shandong, 266021, People's Republic of China
- Department of Public Health and Preventive Medicine, School of Medicine, Jinggangshan University, 28 Xueyuan Road, Ji'an, Jiangxi, 343009, People's Republic of China
| | - Haozhe Meng
- Department of Biomedical Engineering, School of Mechanical and Electrical Engineering, Jinggangshan University, 28 Xueyuan Road, Ji'an, Jiangxi, 343009, People's Republic of China
| | - Yiwa Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinggangshan University, 28 Xueyuan Road, Ji'an, Jiangxi, 343009, People's Republic of China
| | - Wei Yin
- Department of Public Health and Preventive Medicine, School of Medicine, Jinggangshan University, 28 Xueyuan Road, Ji'an, Jiangxi, 343009, People's Republic of China
| | - Zetong Li
- Department of Public Health and Preventive Medicine, School of Medicine, Jinggangshan University, 28 Xueyuan Road, Ji'an, Jiangxi, 343009, People's Republic of China
| | - Mengting Wan
- Department of Public Health and Preventive Medicine, School of Medicine, Jinggangshan University, 28 Xueyuan Road, Ji'an, Jiangxi, 343009, People's Republic of China
| | - Linbing Zou
- Department of Obstetrics, Anhui Women and Children Health Hospital, 15 Yimin Road, Hefei, Anhui, 230001, People's Republic of China
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, 38 Dengzhou Road, Qingdao, Shandong, 266021, People's Republic of China.
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13
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Dzierzewski JM, Donovan EK, Kay DB, Sannes TS, Bradbrook KE. Sleep Inconsistency and Markers of Inflammation. Front Neurol 2020; 11:1042. [PMID: 33041983 PMCID: PMC7525126 DOI: 10.3389/fneur.2020.01042] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/10/2020] [Indexed: 12/12/2022] Open
Abstract
Objective: Poor sleep is associated with higher levels of inflammatory biomarkers. Conventionally, higher average time awake, lower average time asleep, and lower sleep efficiency define poor sleep. Recent research suggests that, in addition to average sleep, sleep inconsistency is an important indicator of sleep dysfunction. The current study sought to extend our knowledge of the relationship between sleep and inflammation through an examination of sleep inconsistency and inflammatory biomarkers. Methods: Secondary analyses of the Survey of Midlife in the United States (MIDUS) sleep study were conducted. Five hundred thirty-three individuals completed nightly sleep diaries, actigraphy, and underwent a blood draw for the inflammatory biomarkers C-reactive protein, interleukin-6, and fibrinogen. Sleep inconsistency was derived from 7 consecutive nights of assessment and was operationalized as nightly fluctuations in the following variables: terminal wakefulness, number of awakenings, time in bed, sleep onset latency, and wake after sleep onset. Structural equation modeling was used to examine the influence of a latent average sleep and a latent sleep inconsistency variable on a latent inflammation variable. Models were subsequently adjusted for age, sex, BMI, health, and medication. Stratified models by sex were also analyzed. Results: The average sleep model would not converge. The sleep inconsistency model fit the data well. A significant positive association between the latent factors sleep inconsistency and inflammation was observed (β = 10.18, SE = 4.40, p = 0.021), suggesting inconsistent sleep is associated with higher levels of inflammatory biomarkers. When stratified by sex, the association between the latent sleep inconsistency factor and inflammation was significant for women (β = 1.93, SE = 0.82, p = 0.018), but not men (β = 0.20, SE = 0.35, p = 0.566). The association between sleep inconsistency and inflammation weakened following multivariate adjustment (β = 6.23, SE = 3.71, p = 0.093). Conclusions: Inconsistent sleep may be an associated feature of inflammatory dysfunction, especially in women. Future studies should build upon this preliminary work and examine these associations longitudinally and through treatment trials.
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Affiliation(s)
- Joseph M. Dzierzewski
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Emily K. Donovan
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Daniel B. Kay
- Department of Psychology, Brigham Young University, Provo, UT, United States
| | - Timothy S. Sannes
- Division of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Keighly E. Bradbrook
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, United States
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14
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Choi Y, Choi JW. Association of sleep disturbance with risk of cardiovascular disease and all-cause mortality in patients with new-onset type 2 diabetes: data from the Korean NHIS-HEALS. Cardiovasc Diabetol 2020; 19:61. [PMID: 32404104 PMCID: PMC7222449 DOI: 10.1186/s12933-020-01032-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 05/05/2020] [Indexed: 02/08/2023] Open
Abstract
Background Sleep disturbance has been significantly associated with the incidence of cardiovascular disease (CVD) in the general population. However, despite the common prevalence of sleep disturbance in patients with type 2 diabetes, its relationship with the risk of CVD remains unclear. Here, we have examined the association of sleep disturbance with the incidence of all CVD and all-cause mortality in patients with newly-diagnosed type 2 diabetes. Methods We used the Korean National Health Insurance Service–Health Screening Cohort data and included 36,058 patients with new-onset type 2 diabetes aged ≥ 40 years between 2004 and 2007, along with follow-up examinations to 2013. We used the ICD-10 code to measure sleep disturbance as a primary diagnosis and the multivariable Cox proportional hazards regression models to estimate the adjusted hazard ratio (AHR) and 95% confidence interval (CI) of all CVD, coronary heart disease (CHD), stroke, and all-cause mortality. Results We identified 6897 cases of all CVD (CHD, n = 4138; stroke, n = 2759) and 2890 events of all-cause mortality during a mean follow-up period of 7.0 years. Sleep disturbance was associated with an increased risk of All CVD (AHR, 1.24; 95% CI, 1.06–1.46), CHD events (AHR, 1.24; 95% CI, 1.00–1.53), and all-cause mortality (AHR, 1.47; 95% CI, 1.15–1.87) in patients with new-onset type 2 diabetes. Furthermore, women (AHR, 1.33; 95% CI, 1.06–1.67) and middle-aged adults (AHR, 1.29; 95% CI, 1.02–1.64) with sleep disturbance had a significantly increased risk of CVD than those without; contrarily, men (AHR, 1.45; 95% CI, 1.09–1.95) and older adults (AHR, 1.51; 95% CI, 1.15–1.99) with sleep disturbance were associated with a significantly increased risk of all-cause mortality than those without. Conclusions Our findings suggest that sleep disturbance is significantly associated with an increased risk of CVD and all-cause mortality in patients with new-onset type 2 diabetes.
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Affiliation(s)
- Young Choi
- Department of Health Care Management, Catholic University of Pusan, 57 Oryundae-ro, Geumjeong-gu, Busan, South Korea
| | - Jae Woo Choi
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, 162-1 Songdo-Dong, Yeonsu-Gu, Incheon, South Korea.
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15
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Koopman ADM, Beulens JW, Dijkstra T, Pouwer F, Bremmer MA, van Straten A, Rutters F. Prevalence of Insomnia (Symptoms) in T2D and Association With Metabolic Parameters and Glycemic Control: Meta-Analysis. J Clin Endocrinol Metab 2020; 105:5585878. [PMID: 31603475 PMCID: PMC7110921 DOI: 10.1210/clinem/dgz065] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 10/23/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We aimed to determine the prevalence of insomnia and insomnia symptoms and its association with metabolic parameters and glycemic control in people with type 2 diabetes (T2D) in a systematic review and meta-analysis. DATA SOURCES A systematic literature search was conducted in PubMed/Embase until March 2018. STUDY SELECTION Included studies described prevalence of insomnia or insomnia symptoms and/or its association with metabolic parameters or glycemic control in adults with T2D. DATA EXTRACTION Data extraction was performed independently by 2 reviewers, on a standardized, prepiloted form. An adaptation of Quality Assessment Tool for Quantitative Studies was used to assess the methodological quality of the included studies. DATA SYNTHESIS When possible, results were meta-analyzed using random-effects analysis and rated using Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS A total of 11 329 titles/abstracts were screened and 224 were read full text in duplicate, of which 78 studies were included. The pooled prevalence of insomnia (symptoms) in people with T2D was 39% (95% confidence interval, 34-44) with I2 statistic of 100% (P < 0.00001), with a very low GRADE of evidence. Sensitivity analyses identified no clear sources of heterogeneity. Meta-analyses showed that in people with T2D, insomnia (symptoms) were associated with higher hemoglobin A1c levels (mean difference, 0.23% [0.1-0.4]) and higher fasting glucose levels (mean difference, 0.40 mmol/L [0.2-0.7]), with a low GRADE of evidence. The relative low methodological quality and high heterogeneity of the studies included in this meta-analysis complicate the interpretation of our results. CONCLUSIONS The prevalence of insomnia (symptoms) is 39% (95% confidence interval, 34-44) in the T2D population and may be associated with deleterious glycemic control.
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Affiliation(s)
- Anitra D M Koopman
- Amsterdam UMC, location VUmc, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, HV Amsterdam, the Netherlands
- Correspondence and Reprint Requests: Femke Rutters, Amsterdam UMC, location VUmc, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands, De Boelelaan 1089a, 1081 HV Amsterdam, the Netherlands. E-mail:
| | - Joline W Beulens
- Amsterdam UMC, location VUmc, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, HV Amsterdam, the Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, GA Utrecht, the Netherlands
| | - Tine Dijkstra
- Amsterdam UMC, location VUmc, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, HV Amsterdam, the Netherlands
| | - Frans Pouwer
- University of Southern Denmark, Department of Psychology, Odense, Denmark
- Deakin University, School of Psychology, Geelong, Australia
- STENO Diabetes Center Odense, Odense, Denmark
| | - Marijke A Bremmer
- Amsterdam UMC, location VUmc, Department of Psychiatry, Amsterdam Public Health Research Institute, HV Amsterdam, the Netherlands
| | - Annemieke van Straten
- Faculty of Behavioural and Movement Sciences & Amsterdam Public Health Research Institute, Vrije Universiteit, HV Amsterdam, the Netherlands
| | - Femke Rutters
- Amsterdam UMC, location VUmc, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, HV Amsterdam, the Netherlands
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16
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D'Antono B, Bouchard V. Impaired sleep quality is associated with concurrent elevations in inflammatory markers: are post-menopausal women at greater risk? Biol Sex Differ 2019; 10:34. [PMID: 31287027 PMCID: PMC6615113 DOI: 10.1186/s13293-019-0250-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 06/30/2019] [Indexed: 12/30/2022] Open
Abstract
Abstract Background Chronic inflammation and impaired sleep increase the risk for cardiovascular disease. Menopausal women may be particularly at risk as a result of impaired sleep. The objective of the current investigation was to assess the relationship between poor sleep and C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and myeloperoxidase (MPO) in healthy non- and postmenopausal women and men. Methods A fasting blood draw was obtained from 122 healthy men and women (31 were postmenopausal). Higher scores on the Pittsburgh Sleep Quality Index (PSQI) were used to define poor sleep. Given the sample size and healthy nature of the sample, hierarchical linear regression analyses were performed on a composite inflammatory score involving CRP, IL-6, and TNF-α. Sex/menopausal group and PSQI were entered as predictors, and the interaction of the group by PSQI was entered stepwise. Analyses on MPO were performed separately. Results Sleep quality was associated with higher inflammatory activity (β = 0.272, P = 0.003), which remained significant (P = 0.046) after controlling for age, waist circumference, exercise times per week, and depressive symptoms. While in the same direction, sleep quality was not significantly associated with MPO. Dichotomizing sleep quality led to similar results. Conclusion Impaired sleep quality is independently associated with greater inflammation in healthy adult men and women. Despite an overall less favorable metabolic and inflammatory profile in postmenopausal women, impaired sleep did not emerge as differentially related to inflammatory activity in this group.
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Affiliation(s)
- Bianca D'Antono
- Research Center, Montreal Heart Institute, 5000 Belanger Street, Montreal, Quebec, H1T 1C8, Canada. .,Psychology Department, Université de Montréal, Montreal, Quebec, Canada.
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17
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Dillon EL, Sheffield-Moore M, Durham WJ, Ploutz-Snyder LL, Ryder JW, Danesi CP, Randolph KM, Gilkison CR, Urban RJ. Efficacy of Testosterone plus NASA Exercise Countermeasures during Head-Down Bed Rest. Med Sci Sports Exerc 2019; 50:1929-1939. [PMID: 29924745 DOI: 10.1249/mss.0000000000001616] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Prolonged confinement to head-down bed rest (HDBR) results in musculoskeletal losses similar to those observed during long-duration space flight. Exercise countermeasures by themselves have not completely prevented the deleterious losses in muscle mass or function in HDBR or space flight. PURPOSE The objective was to investigate the safety and efficacy of intermittent, low-dose testosterone treatment in conjunction with NASA exercise (SPRINT) countermeasures during 70 d of 6° HDBR. METHODS Healthy men (35 ± 8 yr) were randomized into one of three groups that remained inactive (CON) or performed exercise 6 d·wk in addition to receiving either placebo (PEX) or testosterone treatment (TEX, 100 mg·wk). Testosterone/placebo injections were administered once a week for 2 wk, followed by 2 wk off and so on, during HDBR. RESULTS Total, leg, and trunk lean body mass (LBM) consistently decreased in CON, increased in TEX, and had little or no changes in PEX. Total, leg, and trunk fat mass consistently increased in CON and PEX and decreased in TEX. Leg strength decreased in CON, whereas PEX and TEX were protected against loss in strength. Changes in leg LBM correlated positively with changes in leg muscle strength. CONCLUSIONS Addition of a testosterone countermeasure enhanced the preventative actions of exercise against body composition changes during long-term HDBR in healthy eugonadal men. This is the first report to demonstrate that cycled, low-dose testosterone treatment increases LBM under conditions of strict exercise control. These results are clinically relevant to the development of safe and effective therapies against muscle atrophy during long-term bed rest, aging, and disease where loss of muscle mass and strength is a risk. The potential space flight applications of such countermeasure combinations deserve further investigations.
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Affiliation(s)
- E Lichar Dillon
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX
| | | | - William J Durham
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX
| | | | | | - Christopher P Danesi
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX
| | - Kathleen M Randolph
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX
| | - Charles R Gilkison
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX
| | - Randall J Urban
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX
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18
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Uchino BN, Scott E, Kent de Grey RG, Hogan J, Trettevik R, Cronan S, Smith TW, Bosch JA. Sleep Quality and Inflammation in Married Heterosexual Couples: an Actor-Partner Analysis. Int J Behav Med 2019; 26:247-254. [DOI: 10.1007/s12529-018-09763-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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19
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Wang M, Wei J, Yang X, Ni P, Wang Y, Zhao L, Deng W, Guo W, Wang Q, Li T, Ma X. The level of IL-6 was associated with sleep disturbances in patients with major depressive disorder. Neuropsychiatr Dis Treat 2019; 15:1695-1700. [PMID: 31417262 PMCID: PMC6602297 DOI: 10.2147/ndt.s202329] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 05/06/2019] [Indexed: 02/05/2023] Open
Abstract
Purpose: Major depression disorder (MDD) was associated with inflammatory processes, but association results of inflammatory syndrome and MDD were inconsistent. To provide more evidence, we measured the plasma levels of IL-1β, IL-6, interferon (INT)-α2, INT-γ, and tumor necrosis factor (TNF)-α in patients having MDD and explored correlations between the five proinflammatory cytokines and specific depressive symptoms. Patients and methods: Plasma concentrations of IL-1β, IL-6, INT-α2, INT-γ, and TNF-α were measured using ELISA for 44 MDD patients and 54 healthy controls. Patients with MDD were assessed on the 17-item Hamilton Depression Rating Scale (HAMD-17), and a total score and five syndrome scores were acquired. Results: IL-6 levels in depressed patients were significantly elevated than in healthy controls, but no significant differences were observed in the levels of INF-α2, INF-γ, IL-1β, or TNF-α. In addition, correlation analysis revealed that sleep disturbances positively correlated with IL-6. Although there was no significant difference between the two groups in the levels of INF-α2, a significant positive correlation between IFN-α2 and retardation was observed. Conclusion: Elevated IL-6 levels were observed in MDD patients and IL-6 may correlate with sleep disturbances.
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Affiliation(s)
- Min Wang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, People's Republic of China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Jinxue Wei
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, People's Republic of China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Xiao Yang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, People's Republic of China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Peiyan Ni
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, People's Republic of China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Yingcheng Wang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, People's Republic of China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Liansheng Zhao
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, People's Republic of China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Wei Deng
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, People's Republic of China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Wanjun Guo
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, People's Republic of China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Qiang Wang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, People's Republic of China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Tao Li
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, People's Republic of China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Xiaohong Ma
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, People's Republic of China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China
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20
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MUSA NA, MOY FM, WONG LP. Prevalence and factors associated with poor sleep quality among secondary school teachers in a developing country. INDUSTRIAL HEALTH 2018; 56:407-418. [PMID: 29848899 PMCID: PMC6172183 DOI: 10.2486/indhealth.2018-0052] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 05/24/2018] [Indexed: 06/01/2023]
Abstract
This study aimed to determine the prevalence and factors associated with poor sleep quality among secondary school teachers in the state of Selangor, Malaysia. This was a cross sectional study, conducted in two phases. Phase I tested the reliability of the Pittsburgh Sleep Quality Index in the Malay language (M-PSQI), whereas Phase II determined the prevalence and factors associated with poor sleep quality where a total of 1,871 secondary school teachers were studied. Participants were recruited using multistage sampling. Self-administered questionnaire was used to collect data on socio-demographic and teaching characteristics, comorbidities and characteristics of sleep. The M-PSQI was used to measure sleep quality. The Depression Anxiety Stress Scale-21 was used to measure mental health status. Results showed that the M-PSQI had a good internal consistency and moderate reliability. The prevalence of poor sleep quality was 61 (95% CI: 54-67)%. Total teaching hours/day, depression and stress were significantly associated with poor sleep quality in the univariate analysis, while only stress (OR 1.04; 95% CI 1.02-1.05%) remained significant in the multivariate analyses. In conclusion, stress level of the secondary school teachers should be reduced to improve sleep quality.
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Affiliation(s)
- Nor Asma MUSA
- Julius Centre University of Malaya, Department of Social and
Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Foong Ming MOY
- Julius Centre University of Malaya, Department of Social and
Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Li Ping WONG
- Julius Centre University of Malaya, Department of Social and
Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia
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21
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Lao XQ, Liu X, Deng HB, Chan TC, Ho KF, Wang F, Vermeulen R, Tam T, Wong MCS, Tse LA, Chang LY, Yeoh EK. Sleep Quality, Sleep Duration, and the Risk of Coronary Heart Disease: A Prospective Cohort Study With 60,586 Adults. J Clin Sleep Med 2018; 14:109-117. [PMID: 29198294 DOI: 10.5664/jcsm.6894] [Citation(s) in RCA: 142] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 09/14/2017] [Indexed: 12/21/2022]
Abstract
STUDY OBJECTIVES There is limited information on the relationship between risk of cardiovascular disease and the joint effects of sleep quality and sleep duration, especially from large, prospective, cohort studies. This study is to prospectively investigate the joint effects of sleep quality and sleep duration on the development of coronary heart disease. METHODS This study examined 60,586 adults aged 40 years or older. A self-administered questionnaire was used to collect information on sleep quality and sleep duration as well as a wide range of potential confounders. Events of coronary heart disease were self-reported in subsequent medical examinations. Two types of Sleep Score (multiplicative and additive) were constructed to reflect the participants' sleep profiles, considering both sleep quality and sleep duration. The Cox regression model was used to estimate the hazard ratio (HR) and the 95% confidence interval (CI). RESULTS A total of 2,740 participants (4.5%) reported new events of coronary heart disease at follow-up. For sleep duration, participants in the group of < 6 h/d was significantly associated with an increased risk of coronary heart disease (HR: 1.13, 95% CI: 1.04-1.23). However, the association in the participants with long sleep duration (> 8 h/d) did not reach statistical significance (HR: 1.11, 95% CI: 0.98-1.26). For sleep quality, both dreamy sleep (HR: 1.21, 95% CI: 1.10-1.32) and difficult to fall asleep/use of sleeping pills or drugs (HR: 1.40, 95% CI: 1.25-1.56) were associated with an increased risk of the disease. Participants in the lowest quartile of multiplicative Sleep Score (HR: 1.31, 95% CI: 1.16-1.47) and of additive sleep score (HR: 1.31, 95% CI: 1.16-1.47) were associated with increased risk of coronary heart disease compared with those in the highest quartile. CONCLUSIONS Both short sleep duration and poor sleep quality are associated with the risk of coronary heart disease. The association for long sleep duration does not reach statistical significance. Lower Sleep Score (poorer sleep profile) increases the risk of coronary heart disease, suggesting the importance of considering sleep duration and sleep quality together when developing strategies to improve sleep for cardiovascular disease prevention.
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Affiliation(s)
- Xiang Qian Lao
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xudong Liu
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.,School of Public Health, Yat-sen University, Guangzhou, China
| | - Han-Bing Deng
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taiwan
| | - Kin Fai Ho
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Feng Wang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, The Netherlands
| | - Tony Tam
- Department of Sociology, the Chinese University of Hong Kong, Hong Kong
| | - Martin C S Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - L A Tse
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ly-Yun Chang
- Institute of Sociology, Academia Sinica, Taiwan.,MJ Health Research Foundation, MJ Group, Taiwan
| | - Eng-Kiong Yeoh
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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Center of Biomedical Research Excellence in Cardiovascular Health. Dela J Public Health 2017; 3:4-10. [PMID: 34466904 PMCID: PMC8352516 DOI: 10.32481/djph.2017.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Gbadoe KM, Berdouzi N, Aguiñano AAA, Ndiaye NC, Visvikis-Siest S. Cardiovascular diseases-related GNB3 C825T polymorphism has a significant sex-specific effect on serum soluble E-selectin levels. JOURNAL OF INFLAMMATION-LONDON 2016; 13:39. [PMID: 27990099 PMCID: PMC5148858 DOI: 10.1186/s12950-016-0146-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 12/02/2016] [Indexed: 12/20/2022]
Abstract
Background The C825T polymorphism (rs5443) of the Guanine Nucleotide-Binding protein subunit β3 (GNB3) gene has been associated with obesity, essential hypertension, atherosclerosis, coronary diseases, and cerebrovascular events, but with some sex-specific effects. Its association with inflammatory mediators such as cell adhesion molecules has not been studied, although they are heavily involved in cardiovascular diseases’ (CVDs) processes. The aim of our study was then to investigate a possible sex-specific effect of the GNB3 C825T polymorphism on serum soluble cell adhesion molecules such as E, P and L-selectins (sE, sP and sL-selectins). Results Participants were from the STANISLAS Family Study and were free of chronic disease as CVDs or cancer. We included in total 771 subjects aged 6 to 58 years (391 males (50.71%) and 380 females (49.29%)). No significant association of rs5443 was observed in the whole population with serum sE, sP and sL-selectins after adjusting for age, sex, body mass index, systolic blood pressure, anti-inflammatory drugs and hormonal drugs consumption. A significant interaction of rs5443 was observed with sex for sE-selectin (p < 0.001), but not for sP and sL-selectins. After adjusting for covariables, the T allele was significantly associated with an additive increase effect on serum sE-selectin levels in males (β = 5.03 ± 2.18; p = 0.020), while a significant additive decrease effect was observed in females (β =−4.46 ± 2.06; p = 0.030). These associations stayed significant after correction for multiple tests (p = 0.045 in males and in females). The additive phenotypic variance was 21.54% in males versus 1.91% in females. Conclusions In our Caucasian population, the GNB3 C825T polymorphism showed a significant sex-specific effect on serum sE-selectin levels, with a disadvantage for males, as increased sE-selectin levels has been associated with CVDs outcomes. The T allele has been previously associated with the same CVDs as increased sE-selectin, but more often in males. The link we observed between this polymorphism and E-selectin is then consistent with previous findings, and helps to better understand the deleterious effect of the GNB3 825 T allele on CVDs outcomes in males. We revealed in this study an important pathway through which the GNB3 gene induces CVDs’ outcomes.
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Affiliation(s)
- Kokoè Mélinda Gbadoe
- UMR INSERM U1122; IGE-PCV "Interaction Gène-Environnement en Physiopathologie CardioVasculaire", Faculté de Pharmacie, Université de Lorraine, Nancy, F-54000 France
| | - Nazha Berdouzi
- UMR INSERM U1122; IGE-PCV "Interaction Gène-Environnement en Physiopathologie CardioVasculaire", Faculté de Pharmacie, Université de Lorraine, Nancy, F-54000 France
| | - Alex-Ander Aldasoro Aguiñano
- UMR INSERM U1122; IGE-PCV "Interaction Gène-Environnement en Physiopathologie CardioVasculaire", Faculté de Pharmacie, Université de Lorraine, Nancy, F-54000 France
| | - Ndeye Coumba Ndiaye
- UMR INSERM U1122; IGE-PCV "Interaction Gène-Environnement en Physiopathologie CardioVasculaire", Faculté de Pharmacie, Université de Lorraine, Nancy, F-54000 France
| | - Sophie Visvikis-Siest
- UMR INSERM U1122; IGE-PCV "Interaction Gène-Environnement en Physiopathologie CardioVasculaire", Faculté de Pharmacie, Université de Lorraine, Nancy, F-54000 France
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Meng LL, Liu Y, Geng RN, Tang YZ, Li DQ. Association of diabetic vascular complications with poor sleep complaints. Diabetol Metab Syndr 2016; 8:80. [PMID: 27980688 PMCID: PMC5146879 DOI: 10.1186/s13098-016-0195-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 11/29/2016] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Literatures reported that poor sleep complaints were associated with a great deal of health outcomes. However, there are few studies on the association of poor sleep complaints with diabetic vascular complications. METHODS Aiming on the association, a cross-sectional survey was conducted among 1220 diabetic patients in this study. Poor sleep complaints were composed of difficulty falling asleep, early final awakening, short sleep and long sleep. The diabetic vascular complications involved in the study were diagnosed according to the Standards of Medical Care in Diabetes (ADA 2016). RESULTS Our findings indicated that short sleep remained independently associated with diabetic kidney disease (DKD) (OR > 1, P < 0.05) after the adjustments; long sleep independently associated with diabetic retinopathy (DR) (OR > 1, P < 0.05); early final awakening and short sleep independently associated with cardiovascular disease (OR > 1, P < 0.05); short sleep independently associated with peripheral arterial disease (OR > 1, P < 0.05); there was no association between poor sleep complaints and neuropathy (P > 0.05). CONCLUSIONS The study suggests that the poor sleep complaints were distinguishably associated with diabetic vascular complications. Clinicians should take poor sleep complaints into account in diabetes treatment.
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Affiliation(s)
- Ling-Ling Meng
- Key Laboratory of Hormones and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Diseases, Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tongan Road 66, Heping District, Tianjin, 300070 China
- Third Division of Endocrinology Department, Hebei Cangzhou Central Hospital, Xinhua West Road 16, Yunhe District, Cangzhou, 061000 Hebei China
| | - Ying Liu
- Key Laboratory of Hormones and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Diseases, Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tongan Road 66, Heping District, Tianjin, 300070 China
| | - Rui-Na Geng
- Key Laboratory of Hormones and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Diseases, Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tongan Road 66, Heping District, Tianjin, 300070 China
| | - Yun-Zhao Tang
- Key Laboratory of Hormones and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Diseases, Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tongan Road 66, Heping District, Tianjin, 300070 China
| | - Dai-Qing Li
- Key Laboratory of Hormones and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Diseases, Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tongan Road 66, Heping District, Tianjin, 300070 China
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Blood-Brain Barrier Disruption Induced by Chronic Sleep Loss: Low-Grade Inflammation May Be the Link. J Immunol Res 2016; 2016:4576012. [PMID: 27738642 PMCID: PMC5050358 DOI: 10.1155/2016/4576012] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 08/14/2016] [Accepted: 08/24/2016] [Indexed: 12/16/2022] Open
Abstract
Sleep is a vital phenomenon related to immunomodulation at the central and peripheral level. Sleep deficient in duration and/or quality is a common problem in the modern society and is considered a risk factor to develop neurodegenerative diseases. Sleep loss in rodents induces blood-brain barrier disruption and the underlying mechanism is still unknown. Several reports indicate that sleep loss induces a systemic low-grade inflammation characterized by the release of several molecules, such as cytokines, chemokines, and acute-phase proteins; all of them may promote changes in cellular components of the blood-brain barrier, particularly on brain endothelial cells. In the present review we discuss the role of inflammatory mediators that increase during sleep loss and their association with general disturbances in peripheral endothelium and epithelium and how those inflammatory mediators may alter the blood-brain barrier. Finally, this manuscript proposes a hypothetical mechanism by which sleep loss may induce blood-brain barrier disruption, emphasizing the regulatory effect of inflammatory molecules on tight junction proteins.
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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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Sonik RA. Massachusetts Inpatient Medicaid Cost Response to Increased Supplemental Nutrition Assistance Program Benefits. Am J Public Health 2016; 106:443-8. [PMID: 26794167 PMCID: PMC4880217 DOI: 10.2105/ajph.2015.302990] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate the impact of an increase in Supplemental Nutrition Assistance Program (SNAP) benefits on Medicaid costs and use in Massachusetts. METHODS Using single and multigroup interrupted time series models, I examined the effect of an April 2009 increase in SNAP benefits on inpatient Medicaid cost and use patterns. I analyzed monthly Medicaid discharge data from 2006 to 2012 collected by the Massachusetts Center for Health Information and Analysis. RESULTS Inpatient costs for the overall Massachusetts Medicaid population grew by 0.55 percentage points per month (P < .001) before the SNAP increase. After the increase, cost growth fell by 73% to 0.15 percentage points per month (-0.40; P = .003). Compared with the overall Medicaid population, cost growth for people with the selected chronic illnesses was significantly greater before the SNAP increase, as was the decline in growth afterward. Reduced hospital admissions after the SNAP increase drove the cost declines. CONCLUSIONS Medicaid cost growth fell in Massachusetts after SNAP benefits increased, especially for people with chronic illnesses with high sensitivity to food insecurity.
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Affiliation(s)
- Rajan Anthony Sonik
- Rajan Anthony Sonik is with the Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, Waltham, MA
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