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Bruni O, Breda M, Nobili L, Fietze I, Capdevila ORS, Gronfier C. European expert guidance on management of sleep onset insomnia and melatonin use in typically developing children. Eur J Pediatr 2024; 183:2955-2964. [PMID: 38625388 PMCID: PMC11192690 DOI: 10.1007/s00431-024-05556-w] [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: 01/10/2024] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/17/2024]
Abstract
Sleeping problems are prevalent among children and adolescents, often leading to frequent consultations with pediatricians. While cognitive-behavioral therapy has shown effectiveness, especially in the short term, there is a lack of globally endorsed guidelines for the use of pharmaceuticals or over-the-counter remedies in managing sleep onset insomnia. An expert panel of pediatric sleep specialists and chronobiologists met in October 2023 to develop practical recommendations for pediatricians on the management of sleep onset insomnia in typically developing children. When sleep onset insomnia is present in otherwise healthy children, the management should follow a stepwise approach. Practical sleep hygiene indications and adaptive bedtime routine, followed by behavioral therapies, must be the first step. When these measures are not effective, low-dose melatonin, administered 30-60 min before bedtime, might be helpful in children over 2 years old. Melatonin use should be monitored by pediatricians to evaluate the efficacy as well as the presence of adverse effects. Conclusion: Low-dose melatonin is a useful strategy for managing sleep onset insomnia in healthy children who have not improved or have responded insufficiently to sleep hygiene and behavioral interventions.
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Affiliation(s)
- Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy.
| | - Maria Breda
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Lino Nobili
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy
- Child Neurology and Psychiatry, Istituto G. Gaslini, Genoa, Italy
| | - Ingo Fietze
- Interdisciplinary Center of Sleep Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Medicine, Southwest Medical University Affiliated Zigong Hospital, Zigong, Sichuan, China
| | - Oscar Ramon Sans Capdevila
- Sleep Unit at the Sant Joan de Déu Children's Hospital in Barcelona, Barcelona, Spain
- International University of Catalonia (UIC), Barcelona, Spain
| | - Claude Gronfier
- Lyon Neuroscience Research Center (CRNL), Neurocampus, Waking Team, Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France
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Even C, Magzal F, Shochat T, Haimov I, Agmon M, Tamir S. Microbiota Metabolite Profiles and Dietary Intake in Older Individuals with Insomnia of Short vs. Normal Sleep Duration. Biomolecules 2024; 14:419. [PMID: 38672436 PMCID: PMC11047947 DOI: 10.3390/biom14040419] [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: 02/19/2024] [Revised: 03/23/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Recent evidence suggests that the gut microbiota plays a role in insomnia pathogenesis. This study compared the dietary habits and microbiota metabolites of older adults with insomnia of short vs. normal sleep duration (ISSD and INSD, respectively). Data collection included sleep assessment through actigraphy, dietary analysis using the Food Frequency Questionnaire, and metabolomic profiling of stool samples. The results show that ISSD individuals had higher body mass index and a greater prevalence of hypertension. Significant dietary differences were observed, with the normal sleep group consuming more kilocalories per day and specific aromatic amino acids (AAAs) phenylalanine and tyrosine and branch-chain amino acid (BCAA) valine per protein content than the short sleep group. Moreover, metabolomic analysis identified elevated levels of the eight microbiota metabolites, benzophenone, pyrogallol, 5-aminopental, butyl acrylate, kojic acid, deoxycholic acid (DCA), trans-anethole, and 5-carboxyvanillic acid, in the short compared to the normal sleep group. The study contributes to the understanding of the potential role of dietary and microbial factors in insomnia, particularly in the context of sleep duration, and opens avenues for targeted dietary interventions and gut microbiota modulation as potential therapeutic approaches for treating insomnia.
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Affiliation(s)
- Carmel Even
- Nutritional Science Department, Tel Hai College, Upper Galilee, Kiryat Shmona 1220800, Israel (S.T.)
| | - Faiga Magzal
- Nutritional Science Department, Tel Hai College, Upper Galilee, Kiryat Shmona 1220800, Israel (S.T.)
- Laboratory of Human Health and Nutrition Sciences, MIGAL-Galilee Research Institute, Kiryat Shmona 11016, Israel
| | - Tamar Shochat
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa 3103301, Israel; (T.S.)
| | - Iris Haimov
- Department of Psychology and the Center for Psychobiological Research, The Max Stern Yezreel Valley College, Affula 19300, Israel;
| | - Maayan Agmon
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa 3103301, Israel; (T.S.)
| | - Snait Tamir
- Nutritional Science Department, Tel Hai College, Upper Galilee, Kiryat Shmona 1220800, Israel (S.T.)
- Laboratory of Human Health and Nutrition Sciences, MIGAL-Galilee Research Institute, Kiryat Shmona 11016, Israel
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Rogers EM, Banks NF, Jenkins NDM. The effects of sleep disruption on metabolism, hunger, and satiety, and the influence of psychosocial stress and exercise: A narrative review. Diabetes Metab Res Rev 2024; 40:e3667. [PMID: 37269143 DOI: 10.1002/dmrr.3667] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 04/27/2023] [Accepted: 05/18/2023] [Indexed: 06/04/2023]
Abstract
Sleep deficiency is a ubiquitous phenomenon among Americans. In fact, in the United States, ∼78% of teens and 35% of adults currently get less sleep than recommended for their age-group, and the quality of sleep appears to be getting worse for many. The consequences of sleep disruption manifest in a myriad of ways, including insulin resistance and disrupted nutrient metabolism, dysregulation of hunger and satiety, and potentially increased body weight and adiposity. Consequently, inadequate sleep is related to an increased risk of various cardiometabolic diseases, including obesity, diabetes, and heart disease. Exercise has the potential to be an effective therapeutic to counteract the deleterious effects of sleep disruption listed above, whereas chronic psychosocial stress may causally promote sleep disruption and cardiometabolic risk. Here, we provide a narrative review of the current evidence on the consequences of short sleep duration and poor sleep quality on substrate metabolism, circulating appetite hormones, hunger and satiety, and weight gain. Secondly, we provide a brief overview of chronic psychosocial stress and its impact on sleep and metabolic health. Finally, we summarise the current evidence regarding the ability of exercise to counteract the adverse metabolic health effects of sleep disruption. Throughout the review, we highlight areas where additional interrogation and future exploration are necessary.
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Affiliation(s)
- Emily M Rogers
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, The University of Iowa, Iowa City, Iowa, USA
| | - Nile F Banks
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, The University of Iowa, Iowa City, Iowa, USA
| | - Nathaniel D M Jenkins
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, The University of Iowa, Iowa City, Iowa, USA
- Abboud Cardiovascular Research Center, The University of Iowa, Iowa City, Iowa, USA
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Ma Q, Liu T, Li Y, Xu H, Xiao Q, Yao Q. The Association Between Sleep Duration and Sleep-Related Gene Methylation with Osteoporosis in Chinese Postmenopausal Women. Rejuvenation Res 2023; 26:221-228. [PMID: 37786334 DOI: 10.1089/rej.2023.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023] Open
Abstract
This study aims to investigate the association between sleep duration and osteoporosis. In addition, sleep-related gene methylation was also detected in this study and we explored its relationship with osteoporosis. The epidemiological investigation section of this study was designed as a retrospective cross-sectional study. We gathered 148 postmenopausal women from two communities and used questionnaires to collect data of sleep duration and other sleep patterns. Biochemical variables were tested, and bone mineral density was measured by dual-energy X-ray absorptiometry. In addition, sleep-related gene (PER2 and PER3) methylation was tested, and the association with osteoporosis was further studied. Twenty-nine of the 148 participants (aged from 65 to 86 years) who suffered from osteoporosis were tested for osteopenia. A significant difference was observed in the association between sleep duration and osteoporosis; the p-value was 0.013. In addition, in our study, we found that short sleep duration (<7 hours) may increase the risk of osteoporosis compared with longer sleep duration. Moreover, sleep-related genes such as PER2 and PER3 and their CpG island methylation were tested, and there was no significant difference between PER2 and PER3 CpG island methylation and osteoporosis. Short sleep duration may increase the risk of osteoporosis. However, the association between sleep-related gene methylation and osteoporosis was not found.
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Affiliation(s)
- Qianqian Ma
- Geriatric Department, The First Affiliated Hospital of Ningbo University, Ningbo, People's Republic of China
| | - Ting Liu
- Geriatric Department, The First Affiliated Hospital of Ningbo University, Ningbo, People's Republic of China
| | - Ying Li
- Geriatric Department, The First Affiliated Hospital of Ningbo University, Ningbo, People's Republic of China
| | - Hongyu Xu
- Geriatric Department, The First Affiliated Hospital of Ningbo University, Ningbo, People's Republic of China
| | - Qianqian Xiao
- Geriatric Department, The First Affiliated Hospital of Ningbo University, Ningbo, People's Republic of China
| | - Qi Yao
- Geriatric Department, The First Affiliated Hospital of Ningbo University, Ningbo, People's Republic of China
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Cao J, Qiu W, Lin Y, Liu T, Dou Z, Chen Z. Appropriate sleep duration modifying the association of insulin resistance and hepatic steatosis is varied in different status of metabolic disturbances among adults from the United States, NHANES 2017-March 2020. Prev Med Rep 2023; 36:102406. [PMID: 37744738 PMCID: PMC10511803 DOI: 10.1016/j.pmedr.2023.102406] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/20/2023] [Accepted: 09/07/2023] [Indexed: 09/26/2023] Open
Abstract
Steatosis is the hepatic manifestation of metabolic syndrome (MetS) and its developing is closely associated with insulin resistance. Shortened sleep has adverse effects on hepatic steatosis and the underlying mechanism remains unknown. We conceived to evaluate whether sleep duration was a lifestyle factor modifying the association between insulin resistance and hepatic steatosis and whether it was varied in different status of metabolic disturbances. We performed a cross-sectional analysis on 2264 adults of United States representing a population of 138,319,512 with MetS or pre-MetS from National Health and Nutrition Examination Survey (NHANES) 2017-March 2020. Participants underwent hepatic transient elastography and laboratory tests. The sleep duration was obtained from interviews. Results showed that insulin resistance was significantly associated with hepatic steatosis among participants with metabolic disturbances (OR = 1.85, 95% CI: 1.30-2.65). Significant moderation of sleep duration on the association between insulin resistance and hepatic steatosis was observed when sleep duration was dichotomized by 6.5- (P = 0.042) or 9.5-hour (P = 0.031). The risk of hepatic steatosis associated with insulin resistance was increased when sleep duration was ≤ 6.5 h and > 9.5 h. Furthermore, the moderation effect of 6.5-hour sleeping was only significant among participants with pre-MetS while that of 9.5-hour sleeping was only significant among participants with MetS. In conclusion, insufficient or excessive sleep increased the risk of hepatic steatosis associated with insulin resistance. Appropriate sleep duration was advocated and varied in different status of metabolic disturbances. Ensuring adequate sleep should be highlighted before MetS occurs and excessive sleep should be prevented for participants with MetS.
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Affiliation(s)
- Junyan Cao
- Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, China
| | - Weihong Qiu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, China
| | - Yuwei Lin
- Peking University Clinical Research Institute, Peking University, China
| | - Tianyu Liu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, China
| | - Zulin Dou
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, China
| | - Zhaocong Chen
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, China
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Park GR, Kim J. The gendered health consequences of persistent exposure to short sleep duration during adolescence. J Adolesc 2023; 95:1311-1320. [PMID: 37308460 DOI: 10.1002/jad.12203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 06/01/2023] [Accepted: 06/03/2023] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Despite evidence that sleep duration is associated with adolescent health, there remain several gaps in the literature. Little is known about: (1) the extent to which persistent exposure to short sleep duration is associated with adolescent health and (2) whether this association varies by gender. METHODS Using six waves of longitudinal data from the 2011-2016 Korean Children and Youth Panel Survey (N = 6147), this study examined whether persistent exposure to short sleep duration is related to two adolescent health outcomes (overweight status and self-rated health). Fixed effects models were estimated to account for individual-level heterogeneity. RESULTS Short sleep duration was associated with being overweight and self-rated health in different ways for boys and girls. Gender-stratified analysis suggests that, for girls, the risk of being overweight increased for 5 years in a row as short sleep duration persisted. Prolonged short sleep duration also resulted in a continued decline in girls' self-rated health. For boys, persistent exposure to short sleep duration predicted a lower likelihood of being overweight up to the fourth year, but then began to recover. No association between persistent exposure to short sleep duration and self-rated health was observed for boys. CONCLUSION Persistent exposure to short sleep duration was found to be more harmful to the health of girls than boys. Promoting longer sleep duration during adolescence may be an effective intervention to improve adolescent health, especially for girls.
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Affiliation(s)
- Gum-Ryeong Park
- Department of Health, Aging, & Society, McMaster University, Hamilton, Ontario, Canada
| | - Jinho Kim
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Beunders VAA, Koopman-Verhoeff ME, Vermeulen MJ, Jansen PW, Luik AI, Derks IPM, Reiss IKM, Joosten KFM, Jaddoe VWV. Sleep, 24-hour activity rhythms, and cardiometabolic risk factors in school-age children. J Clin Sleep Med 2023; 19:1219-1229. [PMID: 36866620 PMCID: PMC10315610 DOI: 10.5664/jcsm.10544] [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: 12/02/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/04/2023]
Abstract
STUDY OBJECTIVES Disturbed sleep and 24-hour activity rhythms are linked to adverse cardiometabolic profiles in adults and adolescents, and these associations may originate in early life. We aimed to study associations of sleep and 24-hour rhythms with cardiometabolic risk factors in school-age children. METHODS This cross-sectional population-based study comprised 894 children aged 8-11 years from the Generation R Study. Sleep (duration, efficiency, number of awakenings, and time awake after sleep onset) and 24-hour activity rhythms (social jet lag, interdaily stability, and intradaily variability) were assessed using triaxial wrist actigraphy for 9 consecutive nights. Cardiometabolic risk factors included adiposity (body mass index Z-score, fat mass index using dual-energy X-ray absorptiometry, and visceral fat mass and liver fat fraction using magnetic resonance imaging), blood pressure, and blood markers (glucose, insulin, and lipids). We adjusted for season, age, sociodemographics, and lifestyle factors. RESULTS Each increase in interquartile range of nightly awakenings (2 times) was associated with -0.12 standard deviation (95% confidence interval: -0.21, -0.04) lower body mass index and 0.15 mmol/L (0.10, 0.21) higher glucose. Among boys, an increase in interquartile range of intradaily variability (0.12) was associated with higher fat mass index (+0.07 kg/m2; 95% confidence interval: 0.03, 0.11) and visceral FM (+0.08 g; 95% confidence interval: 0.02, 0.15). We observed no associations with blood pressure or clustering of cardiometabolic risk factors. CONCLUSIONS Already at school age, greater fragmentation of the 24-hour activity rhythm is associated with general and organ adiposity. In contrast, more nightly awakenings were associated with lower body mass index. Future research should bring clarity to these disparate observations in order to create potential targets for obesity prevention programs. CITATION Beunders VAA, Koopman-Verhoeff ME, Vermeulen MJ, et al. Sleep, 24-hour activity rhythms, and cardiometabolic risk factors in school-age children. J Clin Sleep Med. 2023;19(7):1219-1229.
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Affiliation(s)
- Victoria A. A. Beunders
- Department of Pediatrics, Division of Neonatology, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M. Elisabeth Koopman-Verhoeff
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Institute of Education and Child Studies, Leiden University, Leiden, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marijn J. Vermeulen
- Department of Pediatrics, Division of Neonatology, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Pauline W. Jansen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Annemarie I. Luik
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ivonne P. M. Derks
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Irwin K. M. Reiss
- Department of Pediatrics, Division of Neonatology, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Koen F. M. Joosten
- Department of Pediatrics, Intensive Care Unit, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Vincent W. V. Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Jang JH, Kim W, Moon JS, Roh E, Kang JG, Lee SJ, Ihm SH, Huh JH. Association between Sleep Duration and Incident Diabetes Mellitus in Healthy Subjects: A 14-Year Longitudinal Cohort Study. J Clin Med 2023; 12:jcm12082899. [PMID: 37109236 PMCID: PMC10143022 DOI: 10.3390/jcm12082899] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/15/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND This study aimed to investigate whether sleep duration and/or quality are associated with incident diabetes mellitus (DM). METHODS A total of 8816 of 10,030 healthy participants were enrolled in a prospective cohort study. Sleep duration and quality questionnaires were completed. Sleep quality was assessed using the Epworth Sleepiness Scale (ESS), which measures excessive daytime sleepiness in individuals. RESULTS During the 14-year follow-up period, 18% (1630/8816) were diagnosed with DM. A U-shaped relationship was observed between sleep duration and incident DM, with the highest risk observed when sleep duration was ≥10 h/day (hazard ratios (HR) 1.65 [1.25-2.17]). This group exhibited decreased insulin glycogenic index, a marker of insulin secretory function, during the study period. Among study participants who slept less than 10 h/day, the risk of incident DM increased when the ESS score was >10. CONCLUSIONS We found that the association between sleep duration and incident DM was U-shaped; both short (≤5 h) and long (≥10 h) sleep durations were associated with an increased risk for the occurrence of incident DM. When sleep duration was 10 h or longer per day, there was a tendency to develop DM due to decreased insulin secretory function.
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Affiliation(s)
- Jin Ha Jang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
| | - Wonjin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gangnam CHA Medical Center, CHA University School of Medicine, Seoul 06135, Republic of Korea
| | - Jin Sil Moon
- Department of Biostatistics, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - Eun Roh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
| | - Jun Goo Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
| | - Seong Jin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
| | - Sung-Hee Ihm
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
| | - Ji Hye Huh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
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Jansen EC, Burgess HJ, Chervin RD, Dolinoy D, Téllez-Rojo MM, Cantoral A, Olascoaga-Torres L, Lee J, Dunietz GL, O’Brien LM, Peterson KE. Sleep duration and timing are prospectively linked with insulin resistance during late adolescence. Obesity (Silver Spring) 2023; 31:912-922. [PMID: 36847394 PMCID: PMC10033442 DOI: 10.1002/oby.23680] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 03/01/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate whether short sleep duration or later sleep timing is a risk factor for insulin resistance (IR) in late adolescence. METHODS Mexico City adolescents enrolled in a longitudinal birth cohort (ELEMENT) took part in two study visits during peri-puberty that occurred approximately 2 years apart. IR was assessed with serum glucose and insulin. Four groups were defined using puberty-specific cut points: no IR over the follow-up period, transition from normal to IR, transition from IR to normal, and IR at both time points. Baseline sleep assessments were measured with 7-day wrist actigraphy. Multinomial logistic regression models were used to evaluate associations between sleep duration and timing with homeostatic model assessment of insulin resistance categories, adjusting for age, sex, and baseline pubertal status. RESULTS Adolescents who were ≥ 1 hour below the sleep duration recommendations-for-age were 2.74 times more likely to develop IR (95% CI: 1.0-7.4). Similarly, adolescents who were in the latest category of sleep midpoint (>4:33 a.m.) were more likely than those with earliest midpoints (1 a.m.-3 a.m.) to develop IR (odds ratio = 2.63, 95% CI: 1.0-6.7). Changes in adiposity over follow-up did not mediate sleep and IR. CONCLUSIONS Insufficient sleep duration and late sleep timing were associated with development of IR over a 2-year period in late adolescence.
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Affiliation(s)
- Erica C. Jansen
- Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, MI
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | | | - Ronald D. Chervin
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Dana Dolinoy
- Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, MI
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Martha María Téllez-Rojo
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Libni Olascoaga-Torres
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Joyce Lee
- Department of Pediatrics, University of Michigan, Ann Arbor, MI
| | - Galit Levi Dunietz
- Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, MI
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Louise M. O’Brien
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Karen E. Peterson
- Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, MI
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI
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Alves JM, Chow T, Nguyen-Rodriguez S, Angelo B, Defendis A, Luo S, Smith A, Yunker AG, Xiang AH, Page KA. Associations Between Sleep and Metabolic Outcomes in Preadolescent Children. J Endocr Soc 2022; 6:bvac137. [PMID: 36249413 PMCID: PMC9557847 DOI: 10.1210/jendso/bvac137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Indexed: 01/29/2023] Open
Abstract
Context Growing evidence suggests an important role for sleep for the metabolic health of children. Objective We aimed to determine how sleep is related to insulin sensitivity, insulin secretion, beta-cell function, and adiposity (BMI z-scores, body fat %, waist to height ratio) using objectively measured sleep and oral glucose tolerance test (OGTT)-derived measures. Methods Sixty-two children aged 7-11 years, born at Kaiser Permanente Southern California, wore wrist accelerometers for 7 days to objectively measure sleep, completed an OGTT, and had anthropometric measures (height [cm], weight [kg], waist [cm], body fat [%]) collected. Using linear regression, associations between Matsuda insulin sensitivity index (ISI), insulinogenic index (IGI), disposition index (DI), BMI z-score, waist to height ratio, and body fat % with sleep parameters [total sleep time (TST; min), sleep efficiency (SE; %), time in bed (TIB; min), wake after sleep onset (WASO; min), and sleep latency (SL; min)] were assessed. Body fat % was tested as a mediator of the relationship between TST and ISI. Results Longer TST was associated with better insulin sensitivity (P = 0.02), but not after adjusting for body fat %. Sleep parameters were not associated with IGI or DI. Longer TST was associated with lower % body fat (P = 0.01) and lower waist-to-height-ratios (P = 0.05). Body fat % explained 62% (P = 0.01) of the relationship between TST and ISI. Longer TIB was associated with lower adiposity measures (P < 0.05). There were no associations between SE, WASO, or SL and metabolic outcomes. Conclusion Objectively measured sleep duration was associated with lower adiposity, and the relationship between sleep duration and ISI appeared partly through adiposity levels in preadolescent children. Longer sleep duration may be important for metabolic health.
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Affiliation(s)
- Jasmin Marie Alves
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
| | - Ting Chow
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, 91101 CA, USA
| | - Selena Nguyen-Rodriguez
- Department of Health Science, California State University Long Beach, Long Beach, 90840-4902 CA, USA
| | - Brendan Angelo
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
| | - Alexis Defendis
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
| | - Shan Luo
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Department of Psychology, University of Southern California, Los Angeles, 90089 CA, USA
- Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles, Los Angeles, 90027 CA, USA
| | - Alexandro Smith
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
| | - Alexandra Grace Yunker
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, 02115 MA, USA
| | - Anny H Xiang
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, 91101 CA, USA
| | - Kathleen Alanna Page
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
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11
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Monzon AD, Patton SR, Koren D. Childhood diabetes and sleep. Pediatr Pulmonol 2022; 57:1835-1850. [PMID: 34506691 DOI: 10.1002/ppul.25651] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/18/2021] [Accepted: 08/26/2021] [Indexed: 12/18/2022]
Abstract
Sleep modulates glucose metabolism, both in healthy states and in disease. Alterations in sleep duration (insufficient and excessive) and obstructive sleep apnea may have reciprocal ties with obesity, insulin resistance and Type 2 diabetes, as demonstrated by emerging evidence in children and adolescents. Type 1 diabetes is also associated with sleep disturbances due to the influence of wide glycemic fluctuations upon sleep architecture, the need to treat nocturnal hypoglycemia, and the need for glucose monitoring and insulin delivery technologies. In this article, we provide an extensive and critical review on published pediatric literature regarding these topics, reviewing both epidemiologic and qualitative data, and provide an overview of the pathophysiology linking sleep with disorders of glucose homeostasis.
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Affiliation(s)
- Alexandra D Monzon
- Department of Psychology and Applied Behavioral Science, Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas, USA
| | - Susana R Patton
- Department of Biomedical Research, Center for Healthcare Delivery Science, Nemours Children's Health System, Jacksonville, Florida, USA
| | - Dorit Koren
- Department of Pediatrics, Pediatric Endocrinology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
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12
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The Association of Sleep Duration with Breakfast Patterns and Snack Behaviors among Chinese Children Aged 6 to 17 Years: Chinese National Nutrition and Health Surveillance 2010–2012. Nutrients 2022; 14:nu14112247. [PMID: 35684046 PMCID: PMC9182912 DOI: 10.3390/nu14112247] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/25/2022] [Accepted: 05/25/2022] [Indexed: 02/06/2023] Open
Abstract
A significant increase in the prevalence of short sleep among children has been observed. Short sleep may be associated with unhealthy breakfast and snacking behaviors. The purpose of the current study was to explore the associations of short sleep with breakfast and snacking behaviors among children. Data were obtained from the 2010–2012 China National Nutrition and Health Surveillance (CNNHS). A total of 5254 children aged 6 to 17 years were included. Sleep duration was classified into three categories: moderate sleep, slightly short sleep, and severely short sleep. Breakfast behaviors included skipping breakfast, food diversity, intake of energy and macronutrients, and their proportion of daily total intake. Snack behaviors included snack consumption rate/frequency, types, intake of energy and macronutrients, and proportion of daily total intake. Multiple linear regression and multivariate logistic regression were used for analysis, with models adjusted for the potential effects of gender, age, region, and family income level. The bootstrapping method was used to calculate the 95% confidence intervals of the model statistics. Results showed that slightly short sleep (OR = 1.15, 95%CI: 1.00, 1.33)) and severely short sleep (OR = 1.36, 95%CI: 1.04, 1.77) was related to higher rates of skipping breakfast compared to moderate sleep. Severely short sleep was associated with higher energy (β = 28.44, 95%CI: 31.97, 44.70), carbohydrate (β = 6.62, 95%CI: 8.29, 8.84) and protein (β = 1.17, 95%CI: 1.44, 1.70) intake at breakfast and breakfast accounted for a higher proportion of total daily energy (β = 1.39, 95%CI: 1.48, 2.52), protein (β = 2.26, 95%CI: 3.16, 5.84) and carbohydrate (β = 0.83, 95%CI: 0.07, 3.41). Severely short sleep was associated with higher energy (β = 27.4, 95%CI: 18.64, 69.41), protein (β = 0.8, 95%CI: 0.48, 2.40), and fat (β = 1.40, 95%CI: 1.21, 3.16) intake at snacks and snacks accounted for a higher proportion of total daily protein intake (β = 1.23, 95%CI: 0.71, 3.58) and fat intake (β = 2.74, 95%CI: 3.13, 6.09). Slightly short sleep was associated with higher energy (β = 7.28, 95%CI: 0.15, 28.13) and carbohydrate (β = 1.67, 95%CI: 0.86, 5.73) intake at snacks and snacks accounted for a higher proportion of total daily carbohydrate intake. Children with severely short sleep were more likely to choose sugar-sweetened beverages (SSBs) as snacks (16.5%) and intake them more frequently, at a daily consumption of 204.7 g and 26.7 g per night. Overall, short sleep was associated with unhealthy breakfast patterns and snack behaviors among children. Children with short sleep had higher intake of energy and macronutrients at breakfast and snacks compared with those with moderate sleep. Promoting adequate sleep among children may have a positive effect on developing healthy eating behaviors.
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13
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Xu Y, Su S, McCall WV, Isales C, Snieder H, Wang X. Rest-activity circadian rhythm and impaired glucose tolerance in adults: an analysis of NHANES 2011-2014. BMJ Open Diabetes Res Care 2022; 10:e002632. [PMID: 35241430 PMCID: PMC8895931 DOI: 10.1136/bmjdrc-2021-002632] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/09/2022] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Circadian rhythm disturbance occurs in type 2 diabetes, yet it is unknown whether it also exists in the prediagnostic phase of the disease. Thus, we examined the association of rest-activity circadian rhythm with 2-hour glucose levels and the risk of impaired glucose tolerance (IGT) in a nationally representative sample of adults without diabetes using a cross-sectional design. RESEARCH DESIGN AND METHODS We analyzed data from 2760 adults without diabetes (age ≥20) with at least 4 days of validated accelerometer recordings and a valid oral glucose tolerance test from the National Health and Nutrition Examination Survey 2011-2014. Non-parametric rest-activity circadian rhythm parameters were derived from the accelerometer recordings. RESULTS In the models adjusting for multiple covariates, a one-quantile increase in relative amplitude (ie, increased circadian rhythmicity) was associated with 2.66 mg/dL decrease in 2-hour glucose level (95% CI -3.94 to -1.38, p<0.001) and a decreased odds of IGT (OR 0.75, 95% CI 0.63 to 0.89, p=0.002). A one-quantile increase in intradaily variability (ie, increased rhythm fragmentation) was associated with 3.01 mg/dL increase in 2-hour glucose level (95% CI 1.52 to 4.49, p=0.001) and an increased odds of IGT (OR 1.37, 95% CI 1.19 to 1.58, p<0.001). CONCLUSIONS Circadian disruption is significantly associated with impaired glucose homeostasis in a general population of adults without diabetes. The association of circadian rhythm abnormalities with indicators of the pre-diabetic state suggests that circadian dysfunction may contribute to early disease pathogenesis.
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Affiliation(s)
- Yanyan Xu
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Shaoyong Su
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - William V McCall
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Carlos Isales
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, Groningen, The Netherlands
| | - Xiaoling Wang
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
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14
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Causal Roles of Sleep Duration in Osteoporosis and Cardiometabolic Diseases: A Mendelian Randomization Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6819644. [PMID: 36277903 PMCID: PMC9586149 DOI: 10.1155/2022/6819644] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/01/2022] [Accepted: 09/22/2022] [Indexed: 11/17/2022]
Abstract
Sleep duration suggests some association with osteoporosis and cardiometabolic diseases, but it is unknown if these associations are causal or confounded. In this two-sample Mendelian randomization (MR) study, we included the largest genome-wide association studies (GWASs) associated with sleep duration and the outcome measures of osteoporosis and cardiometabolic diseases. Finally, 25 single nucleotide polymorphisms (SNPs) associated with short sleep duration and 7 SNPs associated with long sleep duration obtained the genome-wide significance (P < 5 × 10-8) and were used as instrumental variables. Genetic predisposition to short sleep duration was strongly associated with increased risk of coronary artery disease (beta-estimate: 0.199, 95% confidence interval CI: 0.081 to 0.317, standard error SE:0.060, P value = 0.001) and heart failure (beta-estimate: 0.145, 95% CI: 0.025 to 0.264, SE:0.061, P value = 0.017), which were both confirmed by the sensitivity analyses. Both short and long sleep duration may reduce the estimated bone mineral density (eBMD, beta-estimate: -0.086, 95% CI: -0.141 to -0.031, SE:0.028, P value = 0.002 for short sleep duration; beta-estimate: -0.080, 95% CI: -0.120 to -0.041, SE:0.020, P value < 0.0001 for long sleep duration). There was limited evidence of associations between sleep duration and fracture, type 2 diabetes, atrial fibrillation, fasting glucose, fasting insulin, or HbA1c. This study provides robust evidence that short sleep duration is causally associated with high risk of coronary artery disease and heart failure and suggests that short sleep duration should be avoided to prevent these two cardiovascular diseases. Short and long sleep duration show some MR association with reduced eBMD, which indicates that both short and long sleep duration may be prevented to reduce the incidence of osteoporosis.
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15
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Soltero EG, Navabi N, Vander Wyst KB, Hernandez E, Castro FG, Ayers SL, Mendez J, Shaibi GQ. Examining 24-Hour Activity and Sleep Behaviors and Related Determinants in Latino Adolescents and Young Adults With Obesity. HEALTH EDUCATION & BEHAVIOR 2021; 49:291-303. [PMID: 34791905 DOI: 10.1177/10901981211054789] [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: 11/17/2022]
Abstract
Background. Few studies have examined 24-hour activity and sleep behaviors and their contribution to type 2 diabetes (T2D) in Latino adolescents and young adults with obesity. Aim. This study included quantitative data on T2D risk and 24-hour activity and sleep behaviors and qualitative data on individual, social, and environmental behavioral determinants. Method. A 7 day, 24-hour, wrist-worn accelerometer protocol assessed moderate-to-vigorous physical activity (PA), sedentary behaviors (SB), sleep, and sleep regularity, in adolescents (N = 38; 12-16 years) and young adults (N = 22; 18-22 years). T2D-related outcomes included adiposity (BMI, BF%, waist circumference), fasting, and 2-hour glucose. A subsample of participants (N = 16 adolescents, N = 15 young adults) completed interviews to identify behavioral determinants. Results. High levels of PA were observed among adolescents (M = 103.8 ± 67.5 minutes/day) and young adults (M = 96.8 ± 78.8 minutes/day) as well as high levels of SB across both age groups (≥10 hours/day). Sleep regularity was negatively associated with adiposity (all ps < .05) in both age groups as well as fasting and 2-hour glucose in young adults (all ps < .05). Social support was associated with PA in both age groups as well as SB in younger youth. Auditory noises, lights, and safety inhibited sleep in both age groups. Conclusion. PA is critical for disease reduction, yet reducing SB and improving sleep are also important targets for reducing T2D risk in Hispanic adolescents and young adults. Future health promotion and disease prevention strategies should leverage qualitative findings regarding behavioral determinants.
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Affiliation(s)
- Erica G Soltero
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Neeku Navabi
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, AZ, USA
| | | | - Edith Hernandez
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Felipe G Castro
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, AZ, USA
| | - Stephanie L Ayers
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, AZ, USA
| | | | - Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, AZ, USA
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16
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Clark ELM, Gulley LD, Prince MA, Casamassima M, Sanchez N, Jimenez V, Johnson SA, Miller RL, Conte I, Kaar JL, Simon SL, Melby C, Lucas-Thompson RG, Shomaker LB. The role of mindfulness in associations among depression symptoms, sleep duration, and insulin resistance in adolescents. J Behav Med 2021; 44:694-703. [PMID: 33884531 DOI: 10.1007/s10865-021-00225-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 04/10/2021] [Indexed: 12/14/2022]
Abstract
Sleep difficulties may be one explanatory factor in the association between depression and insulin resistance; yet, explicit tests of this hypothesis are lacking. We determined if there was an indirect effect of depression symptoms on insulin resistance through sleep duration in adolescents at risk for excess weight gain. We also investigated whether dispositional mindfulness moderated the interconnections among depression, sleep, and insulin resistance. Ninety adolescents (14.2 ± 1.6y; 50% female) at risk for excess weight gain (body mass index [BMI, kg/m2] z score 1.6 ± 0.6) participated in the cross-sectional, baseline phase of a health behaviors study. Depression was assessed with the Center for Epidemiologic Studies-Depression Scale, sleep duration with the Sleep Habits Survey, and mindfulness with the Mindful Attention and Awareness Scale. Homeostatic model assessment of insulin resistance was determined from fasting insulin and glucose. The product-of-coefficients method was used to test the indirect effect of depression on insulin resistance through sleep duration, accounting for age, sex, BMIz, puberty, and socioeconomic status (SES). Dispositional mindfulness was tested as a moderator of the associations among depression, sleep, and insulin resistance. There was a significant indirect effect of depression on insulin resistance through sleep duration, controlling for age, sex, BMIz, puberty, and SES, 95%CI [0.001, 0.05]. Dispositional mindfulness moderated the association between sleep duration and insulin resistance, such that lower sleep duration related to greater insulin resistance only among adolescents with lower mindfulness (p < .001). Short sleep may be one explanatory factor in the depression-insulin resistance connection in adolescents at risk for excess weight gain. Adolescents with poorer mindfulness and short sleep are at highest risk for insulin resistance, whereas higher mindfulness may be protective.
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Affiliation(s)
- Emma L M Clark
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523-1570, US
| | - Lauren D Gulley
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523-1570, US
- Department of Pediatrics, University of Colorado Anschutz Medical Campus/Children's Hospital Colorado, Aurora, US
| | - Mark A Prince
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523-1570, US
- Department of Psychology, Colorado State University, Fort Collins, US
| | | | - Natalia Sanchez
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523-1570, US
| | - Virginia Jimenez
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523-1570, US
| | - Sarah A Johnson
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, US
| | - Reagan L Miller
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523-1570, US
| | - Isabella Conte
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523-1570, US
| | - Jill L Kaar
- Department of Pediatrics, University of Colorado Anschutz Medical Campus/Children's Hospital Colorado, Aurora, US
- Colorado School of Public Health, Fort Collins, US
| | | | - Christopher Melby
- Colorado School of Public Health, Fort Collins, US
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, US
| | - Rachel G Lucas-Thompson
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523-1570, US
- Department of Pediatrics, University of Colorado Anschutz Medical Campus/Children's Hospital Colorado, Aurora, US
| | - Lauren B Shomaker
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523-1570, US.
- Department of Pediatrics, University of Colorado Anschutz Medical Campus/Children's Hospital Colorado, Aurora, US.
- Colorado School of Public Health, Fort Collins, US.
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17
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Zou Y, He MJ, Su DT, Huang LC, Fang YQ, Zhang RH. The Current Status of Insufficient Sleep Duration and Its Influencing Factors Among Children and Adolescents: A Household Based Cross-Sectional Study in Zhejiang Province, China. J Pediatr Nurs 2021; 60:e1-e5. [PMID: 33741220 DOI: 10.1016/j.pedn.2021.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE Insufficient sleep duration is common among children and adolescents worldwide, and the decline of sleep duration during the recent years is troubling. This study aimed to learn the status of insufficient sleep duration and to explore its influencing factors among children and adolescents in Zhejiang Province, China. DESIGN AND METHODS A stratified sampling technique was employed in the present cross-sectional study. Demographic characteristics, sports time as well as sedentary behavior were investigated. RESULTS A greater proportion of children than adolescents reported insufficient sleep duration (36.4% versus 19.2%, p = 0.001). For children, insufficient sleep duration was associated with age (OR = 1.290, 95%CI: 1.069-1.557), watching movies or TV shows with smartphones after school (OR = 3.098, 95%CI: 1.293-7.420), surf the internet after school (OR = 0.113, 95%CI: 0.013-0.969), walk to school (OR = 0.289, 95%CI: 0.105-0.793). For adolescents, insufficient sleep duration was associated with watch TV after school (OR = 0.379, 95%CI: 0.148-0.970), watching movies or TV shows with smartphones after school (OR = 4.744, 95%CI: 1.799-12.507), do homework after school (OR = 0.265, 95%CI: 0.086-0.813). CONCLUSIONS An unhealthy sedentary screen lifestyle profile may have influence on insufficient sleep duration. Urgent actions are needed to improve sleep duration among children and adolescents.
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Affiliation(s)
- Yan Zou
- Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Meng-Jie He
- Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Dan-Ting Su
- Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Li-Chun Huang
- Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Yue-Qiang Fang
- Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Rong-Hua Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, China.
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18
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Gabbs MH, Dart AB, Woo MR, Pinto T, Wicklow BA. Poor sleep, increased stress, and metabolic co-morbidity in adolescents and youth with type 2 diabetes. Can J Diabetes 2021; 46:142-149. [DOI: 10.1016/j.jcjd.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 04/15/2021] [Accepted: 07/29/2021] [Indexed: 10/20/2022]
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Chen P, Baylin A, Lee J, Dunietz GL, Cantoral A, Tellez Rojo MM, Peterson KE, Jansen EC. The Association Between Sleep Duration and Sleep Timing and Insulin Resistance Among Adolescents in Mexico City. J Adolesc Health 2021; 69:57-63. [PMID: 33221190 PMCID: PMC8244572 DOI: 10.1016/j.jadohealth.2020.10.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/04/2020] [Accepted: 10/05/2020] [Indexed: 01/06/2023]
Abstract
PURPOSE Emerging evidence suggests that short sleep duration and delayed sleep timing may be independently related to insulin resistance (IR), although findings are mixed. Our aim was to investigate associations between sleep duration and timing with insulin resistance among adolescents. METHODS The analytic sample included 384 Mexican adolescents from a birth cohort study who took part in a follow-up study beginning in 2015. Insulin and glucose were measured in fasting serum, and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was calculated (marker of insulin resistance; [insulin x glucose]/22.5). Sleep duration and midpoint were measured by actigraphy for 7 days after the visit and for analysis were separated by weekdays and weekends. In full and sex-stratified regression analysis, sleep duration and midpoint were exposures, and the log HOMA-IR was the outcome, adjusting for age. RESULTS The mean age of the sample was 13.8 ± 1.93 with 51% female. Shorter sleep duration on weekdays was associated with higher log HOMA-IR (β = -.049, 95% confidence interval [CI] -.097 to -.0009). Later midpoints on weekdays and the weekend were independently associated with higher log HOMA-IR (β = .0408, 95% CI -.0049 to .087, and β = .0486, 95% CI .0042 to .093, respectively). Girls showed stronger associations than boys for both sleep duration and timing with HOMA-IR. CONCLUSIONS Sleep duration and sleep timing were independently associated with insulin resistance, and associations were more pronounced among girls.
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Affiliation(s)
- Peiyu Chen
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Ana Baylin
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Joyce Lee
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan
| | - Galit Levi Dunietz
- Department of Neurology, Division of Sleep Medicine, Michigan Medicine, Ann Arbor, Michigan
| | - Alejandra Cantoral
- CONACYT, National Institute of Public Health, Cuernavaca, Mexico,Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Martha Maria Tellez Rojo
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Karen E. Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan,Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Erica C. Jansen
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
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Corrêa MM, Borges MADS, Oliveira ERAD. Sleep duration and overweight: is there a relationship in adolescence? REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210031. [PMID: 34076093 DOI: 10.1590/1980-549720210031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 03/08/2021] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the association between sleep duration and excess weight in Brazilian adolescents. METHODS This is a cross-sectional study conducted with 65,837 adolescents, aged 12 to 17 years, enrolled in the Study of Cardiovascular Risks in Adolescents (ERICA). Sleep duration was assessed by means of a questionnaire focusing on weekday and weekend hours of sleep. Nutritional status was assessed based on body mass index, and participants were classified according to age and gender. The statistical analysis was performed with the Stata 13 software, using the survey command. Poisson regression was used to determine the association of excess weight with sleep duration categories. RESULTS A decline in sleep duration was associated with advancing age. The prevalence of short and long-term sleep among adolescents was 17.9 and 3.6%, respectively, while overweight was diagnosed in 25.5% of the sample. Adolescents who reported having short sleep had 10% (PR = 1.10; 95%CI 1.06 - 1.15) more overweight, while those who reported sleeping more than 11 hours had approximately 12% (PR = 0.88; 95%CI 0.78 - 0.99) less excess weight. CONCLUSION Our findings reinforce the assumption that insufficient sleep poses health risks, and encouraging regular and sufficient sleep may be a cost-effective intervention for the prevention of overweight in adolescence.
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Affiliation(s)
- Márcia Mara Corrêa
- Graduate Program in Collective Health, Universidade Federal do Espírito Santo - Vitória (ES), Brazil.,Universitary Hospital Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo - Vitória (ES), Brazil
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21
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Dumuid D, Wake M, Burgner D, Tremblay MS, Okely AD, Edwards B, Dwyer T, Olds T. Balancing time use for children's fitness and adiposity: Evidence to inform 24-hour guidelines for sleep, sedentary time and physical activity. PLoS One 2021; 16:e0245501. [PMID: 33465128 PMCID: PMC7815105 DOI: 10.1371/journal.pone.0245501] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 01/04/2021] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Daily time spent on one activity cannot change without compensatory changes in others, which themselves may impact on health outcomes. Optimal daily activity combinations may differ across outcomes. We estimated optimal daily activity durations for the highest fitness and lowest adiposity. METHODS Cross-sectional Child Health CheckPoint data (1182 11-12-year-olds; 51% boys) from the population-based Longitudinal Study of Australian Children were used. Daily activity composition (sleep, sedentary time, light physical activity [LPA], moderate-to-vigorous physical activity [MVPA]) was from 8-day, 24-hour accelerometry. We created composite outcomes for fitness (VO2max; standing long jump) and adiposity (waist-to-height ratio; body mass index; fat-to-fat-free log-ratio). Adjusted compositional models regressed activity log-ratios against each outcome. Best activity compositions (optimal time-use zones) were plotted in quaternary tetrahedrons; the overall optimal time-use composition was the center of the overlapping area. RESULTS Time-use composition was associated with fitness and adiposity (all measures p<0.001). Optimal time use differed for fitness and adiposity. While both maximized MVPA and minimized sedentary time, optimal fitness days had higher LPA (3.4 h) and shorter sleep (8.25 h), but optimal adiposity days had lower LPA (1.0 h) and longer sleep (10.9 h). Balancing both outcomes, the overall optimal time-use composition was (mean [range]): 10.2 [9.5; 10.5] h sleep, 9.9 [8.8; 11.2] h sedentary time, 2.4 [1.8; 3.2] h LPA and 1.5 [1.5; 1.5] h MVPA. CONCLUSION Optimal time use for children's fitness and adiposity involves trade-offs. To best balance both outcomes, estimated activity durations for sleep and LPA align with, but for MVPA exceed, 24-h guidelines.
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Affiliation(s)
- Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - David Burgner
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Mark S. Tremblay
- Children’s Hospital of Eastern Ontario Research Institute and Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Anthony D. Okely
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Ben Edwards
- Centre for Social Research and Methods, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Terence Dwyer
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Oxford Martin School, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Timothy Olds
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
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22
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Abstract
PURPOSE OF REVIEW This paper presents a review of the current literature in support of a model explaining the relationships between sleep health and risk for type 2 diabetes in adolescents. RECENT FINDINGS Short sleep duration is associated with risk of developing obesity in youth. Sleep restriction increases energy expenditure, but also increases hunger, appetite, and food intake, causing positive energy balance, impacting appetite-regulating hormones, and leading to increased eating late at night. Insufficient sleep may lead to reduced physical activity and greater sedentary behaviors. In addition, short sleep duration is associated with reduced insulin sensitivity. The cumulative negative consequences of insufficient sleep increase risk for type 2 diabetes. Applications to clinical care, public policy, and future research are discussed. Insufficient sleep in adolescence increases risk for type 2 diabetes directly through impact on insulin sensitivity and indirectly through increased dietary intake, sedentary activity, and weight gain.
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Affiliation(s)
- Stacey L. Simon
- grid.430503.10000 0001 0703 675XUniversity of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Janine Higgins
- grid.430503.10000 0001 0703 675XUniversity of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Edward Melanson
- grid.430503.10000 0001 0703 675XUniversity of Colorado Anschutz Medical Campus, Aurora, CO USA
- Eastern Colorado Veterans Affairs Geriatric Research, Education, and Clinical Center, Denver, CO USA
| | - Kenneth P. Wright
- grid.430503.10000 0001 0703 675XUniversity of Colorado Anschutz Medical Campus, Aurora, CO USA
- grid.266190.a0000000096214564University of Colorado Boulder, Boulder, CO USA
| | - Kristen J. Nadeau
- grid.430503.10000 0001 0703 675XUniversity of Colorado Anschutz Medical Campus, Aurora, CO USA
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Arora A, Pell D, van Sluijs EMF, Winpenny EM. How do associations between sleep duration and metabolic health differ with age in the UK general population? PLoS One 2020; 15:e0242852. [PMID: 33227026 PMCID: PMC7682906 DOI: 10.1371/journal.pone.0242852] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 11/11/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Despite a growing body of evidence suggesting that short sleep duration may be linked to adverse metabolic outcomes, how these associations differ between age groups remains unclear. We use eight years of data from the UK National Diet and Nutritional Survey (NDNS) (2008-2016) to analyse cross-sectional relationships between sleep duration and metabolic risk in participants aged 11-70 years. METHODS Participants (n = 2008) who provided both metabolic risk and sleep duration data were included. Self-reported sleep duration was standardised by age, to account for differences in age-related sleep requirements. A standardised metabolic risk score was constructed, comprising: waist circumference, blood pressure, serum triglycerides, serum high-density lipoprotein cholesterol, and fasting plasma glucose. Regression models were constructed across four age groups from adolescents to older adults. RESULTS Overall, decreased sleep duration (hrs) was associated with an increased metabolic risk (standard deviations) with significant quadratic (B:0.028 [95%CI: 0.007, 0.050]) and linear (B:-0.061 [95%CI: -0.111, -0.011]) sleep duration coefficients. When separated by age group, stronger associations were seen among mid-aged adults (36-50y) (quadratic coefficient: 0.038 [95%CI: 0.002, 0.074]) compared to other age groups (e.g. adolescents (11-18y), quadratic coefficient: -0.009 [95%CI: -0.042, 0.025]). An increased difference between weekend and weekday sleep was only associated with increased metabolic risk in adults aged 51-70 years (B:0.18 [95%CI: 0.005, 0.348]). CONCLUSIONS Our results indicate that sleep duration is linked to adverse metabolic risk and suggest heterogeneity between age groups. Longitudinal studies with larger sample sizes are required to explore long-term effects of abnormal sleep and potential remedial benefits.
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Affiliation(s)
- Anmol Arora
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - David Pell
- Centre for Diet and Activity Research (CEDAR) & MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Esther M. F. van Sluijs
- Centre for Diet and Activity Research (CEDAR) & MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Eleanor M. Winpenny
- Centre for Diet and Activity Research (CEDAR) & MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
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24
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Hansen LS, Pedersen MRL, Tarp J, Bugge A, Wedderkopp N, Møller NC. Weekly variation in markers of cardiometabolic health - the possible effect of weekend behavior - a cross-sectional study. BMC Cardiovasc Disord 2020; 20:405. [PMID: 32894053 PMCID: PMC7487626 DOI: 10.1186/s12872-020-01692-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/30/2020] [Indexed: 12/16/2022] Open
Abstract
Background Adolescents’ health-related behavior varies from weekday to weekend. Only few studies, however, have examined to which degree such variation will affect markers of cardiometabolic health. Therefore, the primary aim of this study is to examine if markers of cardiometabolic health differ between different days of the week in adolescents. Methods This cross-sectional school-based study included up to 581 participants, 11–17 years old. Markers of metabolic health were insulin, glucose, triglyceride, HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C) and blood pressure. Linear mixed regression modelling was used to examine the cardiometabolic profile across weekdays. Results Significant declining trends were observed across the week in adolescents’ levels of cardiometabolic health markers. Lower levels of insulin (16.1%), glucose (2.6%) and triglyceride (24.7%) were observed on Fridays compared to Mondays (p ≤ 0.006). Gradual improvement in measurement profiles across weekdays was less apparent for HDL-C, LDL-C, systolic blood pressure and diastolic blood pressure (P ≥ 0.06). Analyses stratified by sex suggested a more noticeable pattern of gradual improvement across weekdays in boys than in girls. Conclusion Significantly lower levels of insulin, glucose and triglyceride were observed in adolescents on Fridays compared to Mondays. However, when sex specific analyses were performed significant profile variations were only observed across the week in boys. More research is needed to better understand which behavioral factors in particular seem to influence weekly variation in markers of cardiometabolic health - especially since such variation potentially will have an impact on how assessments of markers of cardiometabolic health optimally should be planned, standardized and carried out, both in research and in medical practice.
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Affiliation(s)
- Louise Sølund Hansen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Marlene Rosager Lund Pedersen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Jakob Tarp
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Anna Bugge
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy Faculty of Health, University College Copenhagen, Copenhagen, Denmark
| | - Niels Wedderkopp
- Orthopedic dep. Hospital of South West Denmark, Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
| | - Niels Christian Møller
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
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25
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Jansen EC, Dolinoy DC, O'Brien LM, Peterson KE, Chervin RD, Banker M, Téllez-Rojo MM, Cantoral A, Mercado-Garcia A, Sanchez B, Goodrich JM. Sleep duration and fragmentation in relation to leukocyte DNA methylation in adolescents. Sleep 2020; 42:5513437. [PMID: 31181146 PMCID: PMC7255500 DOI: 10.1093/sleep/zsz121] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/27/2019] [Indexed: 12/14/2022] Open
Abstract
STUDY OBJECTIVES Sleep deprivation and low sleep quality are widespread among adolescents, and associate with obesity risk. Plausible mediators include diet and physical activity. Another potential interrelated pathway, as yet unexplored in adolescents, could involve epigenetic modification of metabolism genes. METHODS In a cohort of 351 Mexico City adolescents (47% male; mean [SD] age = 14 [2] years), 7-day actigraphy was used to assess average sleep duration, sleep fragmentation, and movement index. DNA isolated from blood leukocytes was bisulfite-converted, amplified, and pyrosequenced at four candidate regions. Linear mixed models evaluated sex-stratified associations between sleep characteristics (split into quartiles [Q]) and DNA methylation of each region, adjusted for potential confounders. RESULTS Mean sleep duration was 8.5 [0.8] hours for boys and 8.7 [1] hours for girls. There were sex-specific associations between sleep duration and LINE-1 (long interspersed nuclear element) methylation. Boys with longer sleep duration (Q4) had lower LINE-1 methylation than boys in the 3rd quartile reference category, while girls with both longer and shorter sleep duration had higher LINE-1 methylation compared to Q3. Longer sleep duration was associated with higher H19 methylation among girls (comparing highest to third quartile, -0.9% [-2.2, 0.5]; p, trend = 0.047). Sleep fragmentation was inversely associated with peroxisome proliferator-activated receptor alpha (PPARA) methylation among girls (comparing highest to lowest fragmentation quartile, 0.9% [0.1 to 1.8]). Girls also showed an inverse association between sleep fragmentation and hydroxysteroid (11-beta) dehydrogenase 2 (HSD11B2; Q4 to Q1, 0.6% [-1.2%, 0%]). CONCLUSIONS Sleep duration and fragmentation in adolescents show sex-specific associations with leukocyte DNA methylation patterns of metabolism genes.
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Affiliation(s)
- Erica C Jansen
- Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, MI.,Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Dana C Dolinoy
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI.,Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Louise M O'Brien
- Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, MI.,Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Ronald D Chervin
- Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, MI
| | - Margaret Banker
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI
| | - Martha María Téllez-Rojo
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Adriana Mercado-Garcia
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Brisa Sanchez
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA
| | - Jaclyn M Goodrich
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI
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26
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Associations between sleep duration and insulin resistance in European children and adolescents considering the mediating role of abdominal obesity. PLoS One 2020; 15:e0235049. [PMID: 32603369 PMCID: PMC7326225 DOI: 10.1371/journal.pone.0235049] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 06/05/2020] [Indexed: 02/06/2023] Open
Abstract
Background Short sleep duration has been suggested to lead to insulin resistance both directly by altering glucose metabolism and indirectly through obesity. This study aims to investigate associations between nocturnal sleep duration and insulin resistance considering abdominal obesity as a mediator. Methods We analysed data of 3 900 children aged 2–15 years participating in the second (2009/10) and third (2013/14) examination wave of the European IDEFICS/I.Family study (hereafter referred to as baseline and follow-up). Information on nocturnal sleep duration was collected by questionnaires and age-standardised (SLEEP z-score). The homeostasis model assessment (HOMA) was calculated from fasting insulin and fasting glucose obtained from blood samples; waist circumference (WAIST) was measured with an inelastic tape. HOMA and WAIST were used as indicators for insulin resistance and abdominal obesity, respectively, and transformed to age- and sex-specific z-scores. Cross-sectional and longitudinal associations between SLEEP z-score and HOMA z-score were investigated based on a path model considering WAIST z-score as a mediator adjusting for relevant confounders. Results Cross-sectionally, baseline SLEEP z-score was negatively associated with baseline WAIST z-score (unstandardised effect estimate -0.120, 95% confidence interval [-0.167; -0.073]). We observed no direct effect of baseline SLEEP z-score on baseline HOMA z-score but a negative indirect effect through baseline WAIST z-score (-0.042 [-0.058; -0.025]). Longitudinally, there was no direct effect of baseline SLEEP z-score on HOMA z-score at follow-up but a negative indirect effect through both baseline WAIST z-score and WAIST z-score at follow-up (-0.028 [-0.040; -0.016]). Conclusions Our results do not support the hypothesis of an association between short sleep duration and insulin resistance independent of abdominal obesity. However, longer sleep duration may exert short and long term beneficial effects on insulin resistance through its beneficial effects on abdominal obesity.
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27
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Toyoura M, Miike T, Tajima S, Matsuzawa S, Konishi Y. Inadequate sleep as a contributor to impaired glucose tolerance: A cross-sectional study in children, adolescents, and young adults with circadian rhythm sleep-wake disorder. Pediatr Diabetes 2020; 21:557-564. [PMID: 32134542 DOI: 10.1111/pedi.13003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 01/19/2020] [Accepted: 03/01/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Sleep deprivation and circadian disruption are associated with decreased insulin sensitivity and hyperglycemia. It is uncertain whether circadian sleep-wake disorder (CRSWD), which relates to both the homeostatic sleep system and the circadian timing system, affects glycemic regulation and insulin secretion. We aimed to examine the associations among sleep duration, sleep architecture or circadian rhythm of the sleep-wake cycle, and glucose metabolism in children, adolescents, and young adults with CRSWD. METHODS This cross-sectional observational study of 124 patients with CRSWD took place at Hyogo Children's Sleep and Development Medical Research Center in Hyogo, Japan. The patients underwent a 3-hour oral glucose tolerance test, anthropometric measurements, sleep-log analyses, and polysomnography. Analysis of covariance models were used to assess the association between sleep architecture or circadian rhythm of sleep-wake cycle and glucose/insulin homeostasis, adjusted for confounding variables such as age, gender, standardized body mass index, and sleep apnea index. RESULTS Impaired glucose tolerance was detected in 25.8% of all patients with CRSWD. After adjustment for confounding variables, we found a negative association between total sleep time (TST) and the 2-hour plasma glucose level. Stage N1 (%TST) was also a significant predictor of 3-hour glucose level. However, we did not detect an association between circadian rhythm of the sleep-wake cycle and glucose/insulin measures. CONCLUSIONS Decreased sleep duration and increased stage N1 (%TST) were associated with hyperglycemia in patients with CRSWD. Further research should elucidate how circadian misalignment in patients with CRSWD is associated with glucose and insulin homeostasis.
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Affiliation(s)
- Makiko Toyoura
- Department of Pediatrics, Hyogo Children's Sleep and Development Medical Research Center, Kobe, Japan
| | - Teruhisa Miike
- Department of Pediatrics, Hyogo Children's Sleep and Development Medical Research Center, Kobe, Japan
| | - Seiki Tajima
- Department of Pediatrics, Hyogo Children's Sleep and Development Medical Research Center, Kobe, Japan
| | | | - Yukuo Konishi
- Department of Pediatrics, Hyogo Children's Sleep and Development Medical Research Center, Kobe, Japan
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Rosinger AY, Chang AM, Buxton OM, Li J, Wu S, Gao X. Short sleep duration is associated with inadequate hydration: cross-cultural evidence from US and Chinese adults. Sleep 2020; 42:5155420. [PMID: 30395316 DOI: 10.1093/sleep/zsy210] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Indexed: 01/11/2023] Open
Abstract
Study Objectives Short and long sleep durations are linked to reduced kidney function, but little research has examined how sleep is associated with hydration status. Our aim was to assess the relationship between sleep duration and urinary hydration biomarkers among adults in a cross-cultural context. Methods Three samples of adults aged ≥20 years were analyzed: 2007-2008 National Health and Nutrition Examination Survey (NHANES; n = 4680), 2009-2012 NHANES (n = 9559), and 2012 cross-sectional wave of the Chinese Kailuan Study (n = 11903), excluding pregnant women and adults with failing kidneys. We estimated multiple linear regression models between self-reported usual night-time sleep duration (<6, 6, 7, 8 (reference), and ≥9 hr/day) and urine specific gravity (Usg) and urine osmolality (Uosm) as continuous variables and logistic regression models dichotomized as inadequate hydration (>1.020 g/mL; >831 mOsm/kg). In primary analyses, we estimated models excluding diabetes and diuretic medications for healthier subpopulations (NHANES, n = 11353; Kailuan, n = 8766). Results In the healthier NHANES subset, 6 hr was associated with significantly higher Usg and odds of inadequate hydration (adjusted OR: 1.59, 95% CI: 1.25, 2.03) compared with 8 hr. Regression results were mixed using Uosm, but in the same direction as Usg. Among Chinese adults, short sleep duration (<6 and 6 hr) was associated with Usg and higher likelihood of inadequate hydration (6 hr adjusted OR: 1.42, 95% CI: 1.26, 1.60). No consistent association was found with sleeping ≥9 hr. Conclusions Short sleep duration was associated with higher odds of inadequate hydration in US and Chinese adults relative to sleeping 8 hr.
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Affiliation(s)
- Asher Y Rosinger
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA.,Department of Anthropology, Pennsylvania State University, State College, PA
| | - Anne-Marie Chang
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA
| | - Orfeu M Buxton
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA.,Division of Sleep Medicine, Harvard Medical School, Harvard University, Cambridge, MA
| | - Junjuan Li
- Department of Nephrology, Kailuan General Hospital, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Xiang Gao
- Department of Nutrition, Pennsylvania State University, State College, PA
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Differences in Lifestyle Behaviours of Students between Inner Urban and Peri-urban High Schools: A Cross-Sectional Study in Chongqing, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072282. [PMID: 32231112 PMCID: PMC7177544 DOI: 10.3390/ijerph17072282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 12/15/2022]
Abstract
Background: Lifestyle behaviours of students from schools in different socioeconomic areas may be different. Few studies have investigated such topics in China. This study aimed to explore the differences in lifestyle behaviours between inner urban high school students (IUHSSs) and peri-urban high school students (PUHSSs). Methods: A cross-sectional survey based on a self-report questionnaire was administered among 1560 high school students (726 from inner urban high schools and 834 from peri-urban high schools) in Chongqing, China. Physical activity, sleep time, screen time and dietary behaviours were assessed according to a series of recommendations of Chinese guidelines. Results: No significant difference was found in meeting the recommendation for daily physical activity between IUHSSs and PUHSSs (7.6% vs. 6.8%, p > 0.05). PUHSSs were more likely to meet the recommendations of weekdays’ sleep time (14.9% vs. 5.4%, p < 0.001), weekdays’ and weekends’ screen time (85.4% vs. 76.7%, p < 0.001; 21.1% vs. 14.3%, p < 0.001), and had higher proportion of high-score group of dietary behaviours (58.6% vs. 36.4%, p < 0.001) than those of IUHSSs. IUHSSs were more likely to meet the recommendation of weekends’ sleep time (75.6% vs. 67.9%, p < 0.001) than that of PUHSSs. Conclusions: A low proportion met the recommendations of physical activity, weekdays’ sleep time and weekends’ screen time among high school students in Chongqing, China. Lifestyle behaviours may differ between inner urban and peri-urban high school students. Additional support or targeted health education should be provided by high schools to improve the lifestyle behaviours of students, especially in inner urban districts.
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30
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The relationship between subjective happiness and sleep problems in Japanese adolescents. Sleep Med 2020; 69:120-126. [PMID: 32062038 DOI: 10.1016/j.sleep.2020.01.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/30/2019] [Accepted: 01/05/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Low sleep quality in adolescents is an important public health concern, as it relates to both their current and future physical and mental health. Furthermore, subjective happiness is also often regarded as a major life goal. Although Japan is an economically powerful country, the reported levels of subjective happiness among Japanese adolescents is low. Thus, this study aims to examine the relationship between subjective happiness and sleep problems in Japanese adolescents. METHODS We conducted a nationally representative cross-sectional study of adolescents enrolled in junior and senior high schools in Japan. We used a questionnaire to determine the prevalence of sleep problems (eg, insomnia, short sleep duration (SSD) and poor sleep quality) and to evaluate the participants' reported levels of subjective happiness. Multivariable logistic regression analyses were used to examine the associations between subjective happiness and sleep problems. Adjusted variables were basic demographic characteristics (eg, gender and school grade), lifestyle behaviors, and mental health status. RESULTS Data from 64,329 students were analyzed (age range 12-18 years, mean age 15.7 years, 53.9% male). The results indicated that reported levels of subjective happiness were strongly associated with the prevalence of sleep problems. Linear relationships can be observed between sleep problems and subjective happiness scores. The multivariable logistic regression analysis showed that dose-response association of subjective happiness score was observed with all three sleep problems. CONCLUSIONS Due to these findings, we recommend that policy makers and school officials educate adolescents on the importance of both subjective happiness and good sleep hygiene.
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31
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Otsuka Y, Kaneita Y, Itani O, Tokiya M. A school-based sleep hygiene education program for adolescents in Japan: a large-scale comparative intervention study. Sleep Biol Rhythms 2019. [DOI: 10.1007/s41105-019-00240-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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32
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Duraccio KM, Krietsch KN, Chardon ML, Van Dyk TR, Beebe DW. Poor sleep and adolescent obesity risk: a narrative review of potential mechanisms. ADOLESCENT HEALTH MEDICINE AND THERAPEUTICS 2019; 10:117-130. [PMID: 31572040 PMCID: PMC6749827 DOI: 10.2147/ahmt.s219594] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 08/17/2019] [Indexed: 12/12/2022]
Abstract
Poor sleep is related to increased obesity risk in adolescents, though the mechanisms of this relationship are unclear. This paper presents a conceptual framework of the various pathways that have been proposed to drive this relationship. In this framework, increased food reward, emotional reactivity, decreased inhibitory control, metabolic disturbances, poorer dietary quality, and disrupted meal timings may increase the likelihood of increasing overall energy intake. This paper further notes how poor sleep increases sedentary behavior and screen time, which likely limits overall energy expenditure. The model posits that these mechanisms result in an imbalance of energy intake and expenditure following poor sleep, intensifying the overall risk for obesity. Increases in food reward processes, decreases in insulin sensitivity, disrupted meal timing, and increases in sedentary behavior seem to be the most compelling mechanisms linking poor sleep with increased obesity risk in adolescents. Future directions and clinical implications of this framework are discussed.
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Affiliation(s)
- Kara M Duraccio
- Cincinnati Children's Hospital Center, Behavioral Medicine and Clinical Psychology Department, Cincinnati, OH, USA
| | - Kendra N Krietsch
- Cincinnati Children's Hospital Center, Behavioral Medicine and Clinical Psychology Department, Cincinnati, OH, USA
| | - Marie L Chardon
- Cincinnati Children's Hospital Center, Behavioral Medicine and Clinical Psychology Department, Cincinnati, OH, USA
| | - Tori R Van Dyk
- Loma Linda University, Department of Psychology, Loma Linda, CA, USA
| | - Dean W Beebe
- Cincinnati Children's Hospital Center, Behavioral Medicine and Clinical Psychology Department, Cincinnati, OH, USA.,University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, OH, USA
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Meltzer LJ, Beebe DW, Jump S, Flewelling K, Sundström D, White M, Zeitlin PL, Strand MJ. Impact of sleep opportunity on asthma outcomes in adolescents. Sleep Med 2019; 65:134-141. [PMID: 31751908 DOI: 10.1016/j.sleep.2019.07.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 07/11/2019] [Accepted: 07/13/2019] [Indexed: 12/28/2022]
Abstract
RATIONALE Insufficient sleep is associated with a number of negative health outcomes; as most adolescents obtain <7 h of sleep per night, it is important to understand how sleep impacts asthma among adolescents. OBJECTIVES To examine the impact of sleep opportunity on asthma in adolescents. METHODS In this study, 54 adolescents with asthma (12-17 years, 69% female, 65% Caucasian) participated in a randomized, cross-over sleep manipulation trial, including a sleep stabilization week, five nights of a "Short" sleep opportunity (time in bed: 6.5 h/night), and five nights of a "Long" sleep opportunity (time in bed: 9.5 h/night). Wake times were consistent across all three study weeks. Primary outcomes were lung function (daily peak expiratory flow rate, weekly spirometry) and functional asthma outcomes (daily asthma symptoms, Asthma Control Questionnaire, PROMIS Asthma Impact Scale). Markers of inflammation were also explored. MEASUREMENTS AND MAIN RESULTS Compared to the Long sleep week, during the Short sleep week, morning FEV1 was lower (p = 0.006), while asthma symptoms and albuterol use was higher (p < 0.05), and asthma showed a trend towards greater negative impact on daily life (p = 0.07). No differences were found for weekly measures of lung function or inflammation. CONCLUSIONS An insufficient sleep opportunity negatively impacts objective and subjective daily symptoms of asthma in adolescents, as well as health related quality of life. As most adolescents are significantly sleep deprived, it is important to target sleep health in the treatment of asthma.
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Affiliation(s)
| | - Dean W Beebe
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, USA
| | | | | | - D Sundström
- Department of Pediatrics, National Jewish Health, USA
| | - Michael White
- Department of Pediatrics, National Jewish Health, USA
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The Association between Habitual Sleep Duration and Sleep Quality with Glycemic Traits: Assessment by Cross-Sectional and Mendelian Randomization Analyses. J Clin Med 2019; 8:jcm8050682. [PMID: 31096629 PMCID: PMC6572144 DOI: 10.3390/jcm8050682] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/03/2019] [Accepted: 05/13/2019] [Indexed: 12/28/2022] Open
Abstract
Evidence on whether habitual sleep duration and sleep quality are associated with increased insulin resistance is inconsistent. Here, we investigated the associations between different measures of habitual sleep with glycemic traits through cross-sectional and Mendelian randomization (MR) analyses. We assessed the associations of sleep duration and sleep quality with glycemic traits using multivariable linear regression models adjusted for potential confounders in 4672 middle-aged (45–65 years; 48% men) nondiabetic participants of the Netherlands Epidemiology of Obesity (NEO) study. Genetic variants for total, short, and long sleep duration were used as instrumental variables in MR analyses using summary-level data of glycemic traits in nondiabetic individuals (MAGIC; n = 58,074). In cross-sectional analyses, shortest sleepers (median 5.0 h of sleep per night) had 14.5% (95% confidence interval (CI): 2.0; 28.6%) higher fasting insulin level and 16.3% (95% CI: 2.7; 31.7%) higher HOMA-β. Bad sleep quality was associated with higher insulin resistance (e.g., 14.3% (95% CI: 4.7; 24.9%) higher HOMA-IR). All these associations disappeared after adjustment for BMI and the risk of sleep apnea. MR analyses did not indicate a causal association between total, short or long sleep duration and glycemic traits. Therefore, our used measures of habitual sleep duration and sleep quality are unlikely to directly associate with insulin resistance.
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Roche J, Isacco L, Perret F, Dumoulin G, Gillet V, Mougin F. Beneficial effects of a lifestyle intervention program on C-reactive protein: impact of cardiorespiratory fitness in obese adolescents with sleep disturbances. Am J Physiol Regul Integr Comp Physiol 2019; 316:R376-R386. [PMID: 30789791 DOI: 10.1152/ajpregu.00309.2018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The objectives of this study were to assess the relationship between inflammation and obstructive sleep apnea (OSA) and determine whether the lifestyle program's effects on inflammatory markers are associated with changes in anthropometric parameters, cardiorespiratory fitness, sleep duration, and OSA severity in severely obese adolescents. Participants were aged 14.6 (SD 1.2) yr, with a body mass index (BMI) of 40.2 (SD 6.5) kg/m2. Sleep, anthropometric parameters, glucose metabolism, inflammatory profile, and cardiorespiratory fitness [V̇o2peak relative to body weight (V̇o2peakBW) and fat-free mass (V̇o2peakFFM)] were assessed at admission and at the end of a 9-mo lifestyle intervention program (LIP). Associations between C-reactive protein (CRP) concentrations and BMI, sex, oxygen desaturation index (ODI), sleep fragmentation, total sleep time (TST), and V̇o2peak were assessed via ANCOVA. Twenty-three subjects completed the study. OSA subjects ( n = 13) exhibited higher CRP concentrations and a trend for higher BMI than non-OSA subjects ( P = 0.09) at admission. After intervention, OSA was normalized in six subjects, and CRP significantly decreased in the OSA group and in the whole population. In both groups, leptin levels significantly decreased, whereas adiponectin concentrations increased. At admission, BMI adjusted for sex, arousal index, ODI, TST, and V̇o2peakBW was associated with CRP levels (adjusted r2 = 0.32, P < 0.05). The decrease in CRP concentrations postintervention was associated with enhanced V̇o2peakFFM adjusted for sex, weight loss, and changed sleep parameters (adjusted r2 = 0.75, P < 0.05). Despite higher amounts of CRP in OSA subjects, obesity severity outweighs the proinflammatory effects of OSA, short sleep duration, and low cardiorespiratory fitness. However, enhanced cardiorespiratory fitness is associated with the decrease of inflammation after controlling for the same parameters.
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Affiliation(s)
- Johanna Roche
- Research unit EA3920, Prognostic Markers and Regulatory Factors of Cardiovascular Diseases and Exercise Performance, Health, Innovation platform, University of Bourgogne Franche-Comté , Besançon , France.,Sports Science Faculty, University of Bourgogne Franche-Comté , Besançon , France.,Sleep Medicine Center, Ellipse, Franois, France
| | - Laurie Isacco
- Research unit EA3920, Prognostic Markers and Regulatory Factors of Cardiovascular Diseases and Exercise Performance, Health, Innovation platform, University of Bourgogne Franche-Comté , Besançon , France.,Sports Science Faculty, University of Bourgogne Franche-Comté , Besançon , France
| | - Frédéric Perret
- UGECAM Bourgogne Franche-Comté, Specialized residential institution, La Beline, Salins les Bains, France
| | - Gilles Dumoulin
- Research unit EA3920, Prognostic Markers and Regulatory Factors of Cardiovascular Diseases and Exercise Performance, Health, Innovation platform, University of Bourgogne Franche-Comté , Besançon , France.,University Hospital of Besançon, Department of Endocrine and Metabolic Biochemistry , Besançon , France
| | | | - Fabienne Mougin
- Research unit EA3920, Prognostic Markers and Regulatory Factors of Cardiovascular Diseases and Exercise Performance, Health, Innovation platform, University of Bourgogne Franche-Comté , Besançon , France.,Sports Science Faculty, University of Bourgogne Franche-Comté , Besançon , France
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Simon SL, Behn CD, Cree-Green M, Kaar JL, Pyle L, Hawkins SMM, Rahat H, Garcia-Reyes Y, Wright KP, Nadeau KJ. Too Late and Not Enough: School Year Sleep Duration, Timing, and Circadian Misalignment Are Associated with Reduced Insulin Sensitivity in Adolescents with Overweight/Obesity. J Pediatr 2019; 205:257-264.e1. [PMID: 30497764 PMCID: PMC6357957 DOI: 10.1016/j.jpeds.2018.10.027] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 09/04/2018] [Accepted: 10/11/2018] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To examine the relationship between insulin resistance (IR) and sleep/circadian health in overweight/obese adolescents. We hypothesized that insufficient and delayed sleep would be associated with IR in this population. STUDY DESIGN Thirty-one adolescents (mean age, 16.0 ± 1.4 years; 77% female) with body mass index ≥90th percentile for age/sex were recruited from outpatient clinics at a children's hospital. Participants underwent 1 week of objective home sleep monitoring with wrist actigraphy during the academic year. A 3-hour oral glucose tolerance test was conducted, followed by in-laboratory salivary dim-light melatonin sampling every 30-60 minutes from 5 p.m. to noon the next day. Regression analyses between sleep and circadian variables with IR were examined. RESULTS Longer sleep time and time in bed on weekends and weekdays and earlier weekday bedtime were significantly associated with better insulin sensitivity. Participants who obtained less than the median duration of sleep per night (6.6 hours) had evidence of IR with compensatory insulin secretion compared with those obtaining ≥6.6 hours of sleep. A wider phase angle between bedtime and melatonin onset, indicating a later circadian timing of sleep onset, was significantly associated with IR. CONCLUSIONS Short sleep duration, later weekday bedtime, and later circadian timing of sleep were associated with IR in a cohort of adolescents with overweight/obesity during the school year. Further research is needed to better understand the physiology underlying these observations and to evaluate the impact of improved sleep and circadian health on metabolic health in this at-risk population.
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Affiliation(s)
- Stacey L Simon
- Division of Pulmonary Medicine, Department of Pediatrics, University of Colorado Anschutz Medical Campus & Children's Hospital Colorado, Aurora, CO.
| | - Cecilia Diniz Behn
- Department of Applied Mathematics and Statistics, Colorado School of Mines, Golden, CO; Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO
| | - Melanie Cree-Green
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Jill L Kaar
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO
| | - Stephen M M Hawkins
- Division of Pulmonary Medicine, Department of Pediatrics, University of Colorado Anschutz Medical Campus & Children's Hospital Colorado, Aurora, CO
| | - Haseeb Rahat
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO
| | - Yesenia Garcia-Reyes
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO
| | - Kenneth P Wright
- Sleep & Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO; Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Kristen J Nadeau
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO
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Mantua J, Simonelli G. Sleep duration and cognition: is there an ideal amount? Sleep 2019; 42:5288680. [DOI: 10.1093/sleep/zsz010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 01/07/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Guido Simonelli
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD
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Arslanian S, Bacha F, Grey M, Marcus MD, White NH, Zeitler P. Evaluation and Management of Youth-Onset Type 2 Diabetes: A Position Statement by the American Diabetes Association. Diabetes Care 2018; 41:2648-2668. [PMID: 30425094 PMCID: PMC7732108 DOI: 10.2337/dci18-0052] [Citation(s) in RCA: 202] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Silva Arslanian
- Division of Pediatric Endocrinology, Metabolism, and Diabetes Mellitus, University of Pittsburgh, Pittsburgh, PA
- Center for Pediatric Research in Obesity and Metabolism, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Fida Bacha
- Children's Nutrition Research Center, Texas Children's Hospital and Baylor College of Medicine, Houston, TX
| | - Margaret Grey
- Yale School of Nursing, New Haven, CT
- Yale School of Medicine, New Haven, CT
| | | | - Neil H White
- Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Philip Zeitler
- Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, CO
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van Dijk D, Balkau B, Segrestin B, Gottsäter M, Gabriel R, Hatunic M, Mari A, Dekker JM, Rutters F. Associations between sleep duration and sleep debt with insulin sensitivity and insulin secretion in the EGIR-RISC Study. DIABETES & METABOLISM 2018; 45:375-381. [PMID: 30439506 DOI: 10.1016/j.diabet.2018.11.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 10/26/2018] [Accepted: 11/01/2018] [Indexed: 12/30/2022]
Abstract
AIM Extremes in sleep duration play an important role in the development of type 2 diabetes. We examined the associations between sleep duration and sleep debt with estimates of insulin sensitivity and insulin secretion. METHODS Data were derived from the European multi-centre EGIR-RISC study. Sleep duration and sleep debt were derived from a sleep questionnaire asking about sleeping time during the week and during the weekend. Insulin sensitivity and insulin secretion were estimated from a 2-hour Oral Glucose Tolerance Test, with samples every 30 minutes. Associations between sleep duration and sleep debt with insulin sensitivity and insulin secretion, were analysed by multiple linear regression models corrected for possible confounders. RESULTS Sleep data were available in 1002 participants, 46% men, mean age 48 ± 8 years, who had an average sleep duration of 7 ± 1 hours [range 3-14] and an average sleep debt (absolute difference hours sleep weekend days minus weekdays) of 1 ± 1 hour [range 0-8]. With regard to insulin sensitivity, we observed an inverted U-shaped association between sleep duration and the Stumvoll MCR in (mL/kg/min), with a corrected β (95% CI) of 2.05 (0.8; 3.3) and for the quadratic term -0.2 (-0.3; -0.1). Similarly, a U-shaped association between sleep duration and log HOMA-IR in (µU/mL), with a corrected βs of -0.83 (-1.4; -0.24) and 0.06 (0.02; 0.10) for the quadratic term. Confounders showed an attenuating effect on the associations, while BMI mediated 60 to 91% of the association between sleep duration and insulin sensitivity. No significant associations were observed between sleep duration with insulin secretion or between sleep debt with either insulin sensitivity or insulin secretion. CONCLUSIONS Short and long sleep duration are associated with a lower insulin sensitivity, suggesting that sleep plays an important role in insulin resistance and may provide the link with development of type 2 diabetes.
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Affiliation(s)
- D van Dijk
- Department Epidemiology and Biostatistics, Amsterdam University Medical Centres, Amsterdam, Netherlands; Amsterdam Public Health Institute, Amsterdam, the Netherlands
| | - B Balkau
- Centre for Research in Epidemiology and Population Health (CESP), University Paris-Saclay, Université Paris Sud, UVSQ, UMRS 1018, 92300 Villejuif, France
| | - B Segrestin
- Department of Nutrition, CRNH-RA, Lyon 1 University, Hospices civils de Lyon, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - M Gottsäter
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
| | - R Gabriel
- Instituto de Investigación Princesa IP, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - M Hatunic
- Endocrinology Department, Mater Misericordiae University Hospital, Dublin, Ireland
| | - A Mari
- Institute of Neuroscience, National Research Council, Padua, Italy
| | - J M Dekker
- Department Epidemiology and Biostatistics, Amsterdam University Medical Centres, Amsterdam, Netherlands; Amsterdam Public Health Institute, Amsterdam, the Netherlands
| | - F Rutters
- Department Epidemiology and Biostatistics, Amsterdam University Medical Centres, Amsterdam, Netherlands; Amsterdam Public Health Institute, Amsterdam, the Netherlands.
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Simon SL, Vigers T, Campbell K, Pyle L, Branscomb R, Nadeau KJ, Chan CL. Reduced insulin sensitivity is correlated with impaired sleep in adolescents with cystic fibrosis. Pediatr Diabetes 2018; 19:1183-1190. [PMID: 30022572 PMCID: PMC6175609 DOI: 10.1111/pedi.12727] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 05/01/2018] [Accepted: 07/02/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Prevalence of cystic fibrosis-related diabetes (CFRD) rises sharply in adolescence/young-adulthood and is associated with increased morbidity/mortality. Sleep may be a modifiable risk factor for diabetes but its relationship with metabolic function has not been fully examined in youth with CF. The aim of the study was to examine the relationship between objectively measured sleep and glucose metabolism in youth with CF. METHODS Adolescents (43 with CF and 11 healthy controls) completed 1-week of concurrent home continuous glucose monitoring (CGM) and actigraphy. Fasting labs and an oral glucose tolerance test were obtained. T-tests and analysis of variance (ANOVA) were used to test differences between actigraphy outcomes in CF participants and controls. Spearman's rank correlation coefficients were used to test for correlations between actigraphy, CGM, and insulin sensitivity (IS) measures. RESULTS All participants averaged insufficient sleep (mean = 7.5 hours per night) compared to the 8 to 10 hours recommended for this age group. CF participants had poorer sleep by actigraphy measures than healthy controls. Higher minimum daytime glucoses on CGM correlated with shorter total sleep time (TST) and worse sleep efficiency (SE). Reduced IS in CF participants with dysglycemia was correlated with shorter TST, longer sleep latency, more wake after sleep onset, and poorer SE. CONCLUSIONS Poor sleep appears to correlate with higher blood glucose and lower IS in CF adolescents with dysglycemia. Further research is needed to better understand the mechanisms and directionality behind this relationship.
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Affiliation(s)
- Stacey L. Simon
- Division of Pulmonary Medicine, Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045 USA
| | - Tim Vigers
- Division of Endocrinology, Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045 USA
| | - Kristen Campbell
- Division of Biostatistics, Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045 USA
| | - Laura Pyle
- Division of Biostatistics, Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045 USA
| | - Rachael Branscomb
- Division of Endocrinology, Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045 USA
| | - Kristen J. Nadeau
- Division of Endocrinology, Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045 USA
| | - Christine L. Chan
- Division of Endocrinology, Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045 USA
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Rechenberg K, Grey M, Sadler L. "Anxiety and Type 1 diabetes are like cousins": The experience of anxiety symptoms in youth with Type 1 diabetes. Res Nurs Health 2018; 41:544-554. [PMID: 30375003 DOI: 10.1002/nur.21913] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 08/09/2018] [Indexed: 01/09/2023]
Abstract
Type 1 diabetes (T1D) is one of the most common chronic health conditions in youth in the United States, and its incidence is rising worldwide. Youth with T1D are at a high risk of psychological comorbidity, for example, anxiety, depression, and eating disorders. Psychological comorbidities, especially anxiety symptoms, have been correlated with poorer diabetes outcomes, but anxiety symptoms have not been well studied in these youth. The primary aim of this study was to describe the experience of anxiety symptoms in youth with T1D, especially as those symptoms relate to diabetes self-management tasks. We used a qualitative descriptive approach, consisting of an in-depth, semi-structured interview comprising 10 open-ended questions with follow-up probes. The analysis was guided by the principles of thematic analysis. Demographic data, Hemoglobin A1c levels, and the State-Trait Anxiety Inventory for Children survey data were also collected and analyzed. We identified four themes and seven sub-themes. Participants (n = 29, ages 10-16, 55% female) reported that T1D was an extra layer of responsibility that took time away from their ability to participate fully in other aspects of their lives. Some participants were able to integrate diabetes management into their lives, while others were not. Some participants were dependent on parents and the school nurse for diabetes management. Participants described two types of anxiety symptoms, general and diabetes-specific, and they noted that their experience of anxiety was associated with poor quality sleep, general lifestyle factors, and diabetes.
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Affiliation(s)
| | - Margaret Grey
- Yale University School of Nursing, West Haven, Connecticut
| | - Lois Sadler
- Yale University School of Nursing, West Haven, Connecticut
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Association between unhealthy dietary behaviors and sleep disturbances among Japanese adolescents: a nationwide representative survey. Sleep Biol Rhythms 2018. [DOI: 10.1007/s41105-018-0193-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Dekker SA, Noordam R, Biermasz NR, de Roos A, Lamb HJ, Rosendaal FR, Rensen PCN, van Heemst D, de Mutsert R. Habitual Sleep Measures are Associated with Overall Body Fat, and not Specifically with Visceral Fat, in Men and Women. Obesity (Silver Spring) 2018; 26:1651-1658. [PMID: 30277027 DOI: 10.1002/oby.22289] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/03/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This study aimed to investigate the associations of sleep duration and sleep quality with visceral adipose tissue (VAT) in middle-aged individuals. METHODS In this cross-sectional analysis of baseline measurements of the Netherlands Epidemiology of Obesity (NEO) study, participants underwent anthropometry and completed the Pittsburgh Sleep Quality Index (PSQI) for assessing short sleep duration (as sex-specific age-adjusted percentiles) and poor quality (PSQI > 5). VAT was assessed by magnetic resonance imaging in a random subgroup. We performed linear regression analyses to examine associations of short sleep and poor sleep with measures of body fat, adjusted for confounding, including total body fat in models with VAT. RESULTS A total of 5,094 participants (52% women; mean age of 56 [SD 6] years), 1,947 of whom had VAT measurements, were analyzed. The difference in VAT between poor sleep (PSQI > 5) and good sleep (PSQI ≤ 5) was 7.2cm2 (95% CI: 1.2-13.8) in women and 16.1cm2 (95% CI: 6.2-26.0) in men. These differences attenuated toward the null after the adjustment for total body fat. Similar patterns of associations were observed for short sleep (lowest 10% compared with median 60%). CONCLUSIONS Our results suggest that measures of sleep are not specifically associated with a higher amount of VAT.
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Affiliation(s)
- Sigrid A Dekker
- Department of Internal Medicine, Section Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Raymond Noordam
- Department of Internal Medicine, Section Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Nienke R Biermasz
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Albert de Roos
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Patrick C N Rensen
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Diana van Heemst
- Department of Internal Medicine, Section Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
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Seo YG, Choi MK, Kang JH, Lee HJ, Jang HB, Park SI, Ju YS, Park KH. Cardiovascular disease risk factor clustering in children and adolescents: a prospective cohort study. Arch Dis Child 2018; 103:968-973. [PMID: 29650509 DOI: 10.1136/archdischild-2017-313226] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 03/09/2018] [Accepted: 03/25/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The early identification of predictors related to cardiovascular disease risk factor clustering (CVD-RFC) can help prevent chronic disease. We aimed to identify the risk factors for CVD-RFC in adolescents. METHODS A prospective longitudinal cohort study design was used to obtain data included in these analyses from school-aged children who participated in the Korean Child-Adolescent Study 2008-2014. A total of 1309 children aged 6-15 years were enrolled. We compared the participants based on the presence or absence of CVD-RFC and examined the cumulative incidence of CVD-RFC. RESULTS Of the total 1309 children, 410 (31.32%) had CVD-RFC in adolescence. A higher average household income ≥3 million Korean Republic won (KRW)/month (3-5 million KRW/month: HR 0.75 (95% CI 0.58 to 0.97); ≥5 million KRW/month: HR 0.58 (95% CI 0.44 to 0.77)) was associated with a lower CVD-RFC incidence, while the presence of parental CVD history (HR 1.28 (95% CI 1.04 to 1.57)), overweight or obesity (HR 3.83 (95% CI 3.05 to 4.80)) and shorter sleep duration of 8-9 hour/day (HR 1.80 (95% CI 1.05 to 3.07)) and <8 hour/day (HR 1.93 (95% CI 1.11 to 3.34)) had higher CVD-RFC incidences. CONCLUSIONS Obesity in childhood, short sleep duration and parental factors such as low socioeconomic status and parental history of CVD are significant risk factors for the development of CVD-RFC in adolescents. Efforts to create awareness regarding sufficient sleep duration in children via intervention programmes targeting cardiometabolic health in children and special attention to lifestyle modifications and socioeconomic components of the family should be considered.
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Affiliation(s)
- Young-Gyun Seo
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Min-Kyu Choi
- Department of Family Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Jae-Heon Kang
- Department of Family Medicine, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Republic of Korea
| | - Hye-Ja Lee
- Center for Biomedical Sciences, Korea National Institute of Health, Cheongju, Republic of Korea
| | - Han Byul Jang
- Center for Biomedical Sciences, Korea National Institute of Health, Cheongju, Republic of Korea
| | - Sang Ick Park
- Center for Biomedical Sciences, Korea National Institute of Health, Cheongju, Republic of Korea
| | - Young Soo Ju
- Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Kyung Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
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Wang D, Ruan W, Peng Y, Li W. Sleep duration and the risk of osteoporosis among middle-aged and elderly adults: a dose-response meta-analysis. Osteoporos Int 2018; 29:1689-1695. [PMID: 29574520 DOI: 10.1007/s00198-018-4487-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 03/12/2018] [Indexed: 12/31/2022]
Abstract
It remains unclear how many hours of sleep are associated with the lowest risk of osteoporosis. This meta-analysis was performed to assess the dose-response relationship between sleep duration and risk of osteoporosis. PubMed and Web of Science were searched from inception to December 3, 2017, supplemented by manual searches of the bibliographies of retrieved articles. Data were pooled using fixed- and random-effects models. Restricted cubic spline analysis with four knots was used to model the sleep duration and osteoporosis association. Four cross-sectional studies with eight records were eligible for inclusion in the meta-analysis. A U-shaped dose-response relationship was observed between sleep duration and risk of osteoporosis, with the lowest risk observed at a sleep duration category of 8-9 h per day. Compared with 8-h sleep duration per day, the pooled odds ratio for osteoporosis were 1.03 (95% CI 1.01-1.06) for each 1-h reduction among individuals with shorter sleep duration and 1.01 (95% CI 1.00-1.02) for each 1-h increment among individuals with longer sleep duration. Our dose-response meta-analysis shows a U-shaped relationship between sleep duration and risk of osteoporosis, with the lowest osteoporosis risk at about 8 h per day of sleep duration. Both short and long sleep duration is associated with a significantly increased risk of osteoporosis in the middle-aged and elderly adults, appropriate sleep duration could help for delay or prevention of osteoporosis.
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Affiliation(s)
- D Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
- Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan, Hubei, 430030, People's Republic of China
| | - W Ruan
- Department of Clinical Medicine, Xi'an Medical University, Xi'an, Shanxi, 710000, People's Republic of China
| | - Y Peng
- Department of Emergency, Wuhan Center for Diseases Prevention and Control, Wuhan, Hubei, 430015, People's Republic of China
| | - W Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, Hubei, 430030, People's Republic of China.
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Cespedes Feliciano EM, Quante M, Rifas-Shiman SL, Redline S, Oken E, Taveras EM. Objective Sleep Characteristics and Cardiometabolic Health in Young Adolescents. Pediatrics 2018; 142:peds.2017-4085. [PMID: 29907703 PMCID: PMC6260972 DOI: 10.1542/peds.2017-4085] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/10/2018] [Indexed: 12/22/2022] Open
Abstract
UNLABELLED : media-1vid110.1542/5778442247001PEDS-VA_2017-4085Video Abstract BACKGROUND AND OBJECTIVES: Shorter sleep duration is associated with childhood obesity. Few studies measure sleep quantity and quality objectively or examine cardiometabolic biomarkers other than obesity. METHODS This cross-sectional study of 829 adolescents derived sleep duration, efficiency and moderate-to-vigorous physical activity from >5 days of wrist actigraphy recording for >10 hours/day. The main outcome was a metabolic risk score (mean of 5 sex-specific z-scores for waist circumference, systolic blood pressure, high-density lipoprotein cholesterol scaled inversely, and log-transformed triglycerides and homeostatic model assessment of insulin resistance), for which higher scores indicate greater metabolic risk. Secondary outcomes included score components and dual-energy radiograph absorptiometry fat mass. We measured socioeconomic status, race and/or ethnicity, pubertal status, and obesity-related behaviors (television-viewing and fast food and sugar-sweetened beverage consumption) using questionnaires. RESULTS The sample was 51.5% girls; mean (SD) age 13.2 (0.9) years, median (interquartile range) sleep duration was 441.1 (54.8) minutes per day and sleep efficiency was 84.0% (6.3). Longer sleep duration was associated with lower metabolic risk scores (-0.11 points; 95% CI: -0.19 to -0.02, per interquartile range). Associations with sleep efficiency were similar and persisted after adjustment for BMI z score and physical activity, television-viewing, and diet quality. Longer sleep duration and greater sleep efficiency were also favorably associated with waist circumference, systolic blood pressure, high-density lipoprotein cholesterol, and fat mass. CONCLUSIONS Longer sleep duration and higher sleep efficiency were associated with a more favorable cardiometabolic profile in early adolescence, independent of other obesity-related behaviors. These results support the need to assess the role of sleep quantity and quality interventions as strategies for improving cardiovascular risk profiles of adolescents.
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Affiliation(s)
| | - Mirja Quante
- Division of Sleep and Circadian Disorders, Department
of Medicine, Brigham and Women’s Hospital and Beth Israel Deaconess
Medical Center,,Department of Neonatology, University of
Tübingen, Tübingen, Germany; and
| | - Sheryl L. Rifas-Shiman
- Division of Chronic Disease Research Across the
Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care
Institute, Harvard Medical School, and
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Department
of Medicine, Brigham and Women’s Hospital and Beth Israel Deaconess
Medical Center
| | - Emily Oken
- Division of Chronic Disease Research Across the
Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care
Institute, Harvard Medical School, and
| | - Elsie M. Taveras
- Department of Nutrition, Harvard T. H. Chan School of
Public Health, Harvard University, Boston, Massachusetts;,Division of General Academic Pediatrics,
Massachusetts General Hospital for Children, Boston, Massachusetts
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Guedes LG, Abreu GDA, Bloch KV. Self-reported nocturnal sleep duration and glycosylated hemoglobin A in the Study of Cardiovascular Risks in Adolescents (ERICA). Sleep Med 2018; 47:60-65. [PMID: 29758395 DOI: 10.1016/j.sleep.2018.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 03/06/2018] [Accepted: 03/12/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE At present, epidemiologic studies regarding the relationship between sleep duration and glucose metabolism in adolescents are scarce. The objective was to investigate the association between self-reported nocturnal sleep duration and glycosylated hemoglobin A in 12- to 17-year-old Brazilian adolescents. PATIENTS/METHODS A school-based multicenter cross-sectional study was carried out in private and public schools from 273 municipalities with more than 100,000 inhabitants. The final sample comprised 24,923 adolescents. A self-administered questionnaire was used. Blood tests included glucose, insulin, glycosylated hemoglobin A and serum lipids. Age, sex, skin color, school type, body mass index (BMI), physical activity, and Brazilian regions were studied as possible effect modifiers and/or confounders using linear regression. RESULTS A significant positive association was found between more than 12 h of nocturnal sleep and glycosylated hemoglobin A in two Brazilian regions: Southeast and South, even after adjustment for age, sex, skin color, and BMI (coefficients of 0.142 and 0.339, respectively). No association was found with nocturnal sleep duration <7 h. CONCLUSION Notably, a significant positive relationship was found between more than 12 h of nocturnal sleep duration and glycosylated hemoglobin A in two Brazilian regions. The specific pubertal sleep curtailment can be a compensatory mechanism for dealing with the insulin resistance during adolescence. Those that escape from this regulatory strategy and sleep longer than the adequate duration, break down this balance and tend to damage their glucose metabolism. To our knowledge, this is the first large scale study, of the association between sleep duration and glucose metabolism in adolescents.
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Affiliation(s)
- Luciane Gaspar Guedes
- Instituto de Puericultura e Pediatria Martagão Gesteira/Universidade Federal do Rio de Janeiro, Brazil.
| | | | - Katia Vergetti Bloch
- Instituto de Estudos em Saúde Coletiva/Universidade Federal do Rio de Janeiro, Brazil
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Troxel WM, Tucker JS, Ewing B, Miles JN, D’Amico EJ. Sleepy Teens and Energy Drink Use: Results From an Ethnically Diverse Sample of Youth. Behav Sleep Med 2018; 16:223-234. [PMID: 27322869 PMCID: PMC5173439 DOI: 10.1080/15402002.2016.1188390] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study examines the association between use of energy drinks or products (EP), EP expectancies, and the association between EP use and sleep in a racially and ethnically diverse sample (N = 2,485) of adolescents. Prevalence of EP use was approximately 18%, with no statistically significant racial or ethnic differences in prevalence. There were significant racial and ethnic differences in EP expectancies; Hispanic and Multiracial or Other groups endorsed less positive expectancies than Whites and Asians. EP use was significantly associated with later weekend bedtimes, shorter weekend total sleep time (TST), a smaller weekend-weekday difference in TST, and more trouble sleeping, even after adjusting for covariates. There were no significant race or ethnicity interactions between EP use and sleep. EP use is an independent correlate of sleep problems in adolescents across racial or ethnic groups.
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Forrest CB, Meltzer LJ, Marcus CL, de la Motte A, Kratchman A, Buysse DJ, Pilkonis PA, Becker BD, Bevans KB. Development and validation of the PROMIS Pediatric Sleep Disturbance and Sleep-Related Impairment item banks. Sleep 2018; 41:4931870. [DOI: 10.1093/sleep/zsy054] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Christopher B Forrest
- Project Performance Site: Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Lisa J Meltzer
- Department of Pediatrics, National Jewish Health, Denver, CO
| | - Carole L Marcus
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Anna de la Motte
- Project Performance Site: Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Amy Kratchman
- Project Performance Site: Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Paul A Pilkonis
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Brandon D Becker
- Project Performance Site: Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, PA
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Lucas-de la Cruz L, Martín-Espinosa N, Cavero-Redondo I, González-García A, Díez-Fernández A, Martínez-Vizcaíno V, Notario-Pacheco B. Sleep patterns and cardiometabolic risk in schoolchildren from Cuenca, Spain. PLoS One 2018; 13:e0191637. [PMID: 29360869 PMCID: PMC5779683 DOI: 10.1371/journal.pone.0191637] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 01/07/2018] [Indexed: 12/11/2022] Open
Abstract
Sleep seems to have a significant influence on the metabolic syndrome (MetS). However, results in this association are still inconsistent in children. The aim of this study was to examine the influence of sleep characteristics in the MetS (index and factors) in Spanish children. Cross-sectional study including a sample of 210 children aged 8-to-11-years belonging to 20 schools from the province of Cuenca, Spain was conducted. Cardiometabolic risk and actigraphy sleep patterns were determined and analysed using correlation coefficients, ANCOVA models and a propensity score derivation model. Overall, children in the lower time in bed category and those who went to bed later (> 23:15h) showed worse values in the cardiometabolic profile and risk index. Differences were observed when the total time in bed was below 9h 15mins. Our study shows that short sleep duration could be a risk factor for cardiometabolic risk in children, and bedtime may independently influence this risk. In addition, our data suggests that children’s sleep hygiene should be incorporated in parenting educational programs.
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Affiliation(s)
- Lidia Lucas-de la Cruz
- Universidad de Castilla-La Mancha, Faculty of Nursing, Cuenca, Spain
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | | | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Faculty of Nursing, Cuenca, Spain
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- * E-mail:
| | - Alberto González-García
- Universidad de Castilla-La Mancha, Faculty of Nursing, Cuenca, Spain
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Ana Díez-Fernández
- Universidad de Castilla-La Mancha, Faculty of Nursing, Cuenca, Spain
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Blanca Notario-Pacheco
- Universidad de Castilla-La Mancha, Faculty of Nursing, Cuenca, Spain
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
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