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Catikkas NM, Tunc M, Soysal P. The prevalence of excessive daytime sleepiness and associated factors in older diabetic patients. Aging Clin Exp Res 2023; 35:3205-3214. [PMID: 38064108 DOI: 10.1007/s40520-023-02602-9] [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: 10/06/2023] [Accepted: 10/20/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVES Sleep disorders are a frequent health problem in older patients with diabetes mellitus (DM). There has been no study investigating the factors associated with excessive daytime sleepiness (EDS) in older diabetic patients. We aimed to investigate the prevalence and associated factors of EDS. METHODS We performed a retrospective cross-sectional study in older diabetic patients. The Epworth Sleepiness Scale score of ≥ 11 points indicated EDS. All patients underwent comprehensive geriatric assessment including demographic characteristics, blood pressures, comorbid diseases, cognitive and nutritional states, basic and instrumental daily living activity indexes, lower urinary tract symptoms, and laboratory values. RESULTS Of 227 patients, 73.1% were females, with a mean age of 78.8 ± 6.5. The prevalence of EDS was 19.8%. Patients with EDS were mostly males with dementia and used significantly more medication with more anticholinergic drug burden, falls, urge incontinence, and nocturia (p < 0.05). They had higher SARC-F and lower Barthel index, Lawton-Brodie, Tinetti, MMSE scores, and high-density lipoprotein than the patients without EDS (p < 0.05). After adjusting for age, sex, and dementia, all parameters that were significant in univariate analysis remained associated with EDS, except for falls, and MMSE scores. CONCLUSION The EDS was found in one in five older diabetic patients. There was a significant relationship between EDS and drug use, anticholinergic drug burden, impaired excretory functions, sarcopenia, decreased functional capacity, falls, gait-balance disorder, and cognitive dysfunction. The recognization of EDS and the implementation of interventions may be helpful in the management of geriatric syndromes.
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Affiliation(s)
- Nezahat Muge Catikkas
- Hamidiye Faculty of Medicine, Sancaktepe Prof. Dr. Ilhan Varank Training and, Research Hospital, Department of Internal Medicine, Division of Geriatrics, University of Health Sciences Istanbul, 34785, Sancaktepe, Istanbul, Turkey
| | - Muhammed Tunc
- Faculty of Medicine, Department of Internal Medicine, Bezmialem Vakif University, 34093, Fatih, Istanbul, Turkey
| | - Pinar Soysal
- Faculty of Medicine, Department of Geriatric Medicine, Bezmialem Vakif University, 34093, Fatih, Istanbul, Turkey.
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2
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Zhu R, Yang J, Zhai Z, Zhao H, Jiang F, Sun C, Liu X, Hou J, Dou P, Wang C. The associations between sleep timing and night sleep duration with dyslipidemia in a rural population: The Henan Rural Cohort Study. Chronobiol Int 2023; 40:1261-1269. [PMID: 37781878 DOI: 10.1080/07420528.2023.2262565] [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: 12/28/2022] [Accepted: 09/18/2023] [Indexed: 10/03/2023]
Abstract
Evidence linking sleep timing and night sleep duration to dyslipidemia was limited and inconclusive, especially among low- and middle-income adults. The aims were to evaluate the associations between sleep timing, night sleep duration and dyslipidemia in a rural population. Based on the Henan Rural Cohort Study, a total of 37 164 participants were included. The Pittsburgh Sleep Quality Index was used to collect sleep information. Logistic regression and restrictive cubic splines were conducted to explore the associations. Of the 37 164 enrolled participants, 13881 suffered from dyslipidemia. Compared to the reference groups, people who went to sleep after 23:00 or woke up after 7:30 had higher prevalence of dyslipidemia, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs)were 1.30 (1.20-1.41) and 1.34 (1.19-1.50). The adjusted OR (95%CI) of participants in the Late-sleep/Late-rise category compared to the Early-sleep/Early-rise category was 1.55 (1.08-1.23). Compared to the reference (7~≤8 h), the adjusted OR (95%CI) was 1.11 (1.03-1.20) for longer (>9 h) night sleep duration. Moreover, the combined effects of sleep duration (>9 h) with sleep time (22:00~) (OR = 1.46, 95%CI: 1.16-1.84), sleep duration (>9 h) with wake-up time (≥7:30) (OR = 1.28, 95%CI: 1.08-1.51), and sleep duration (>9 h) with the Late-sleep/Late-rise category (OR = 1.41, 95%CI: 1.14-1.75) increased the prevalence of dyslipidemia. Accordingly, our results indicate that delayed sleep timing and longer night sleep duration had independent and joint effects on higher risks of dyslipidemia in rural population.
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Affiliation(s)
- Ruifang Zhu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jing Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhihan Zhai
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Hongfei Zhao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Feng Jiang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Chunyang Sun
- Department of Preventive Medicine, School of Medicine, Henan University of Chinese Medicine, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ping Dou
- Department of Zhengzhou Center for Disease Control and Prevention, Zhengzhou, Henan, PR China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
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3
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Zhang Y, Zhang T, Xia X, Hu Y, Zhang C, Liu R, Yang Y, Li X, Yue W. The relationship between sleep quality, snoring symptoms, night shift and risk of stroke in Chinese over 40 years old. Front Aging Neurosci 2023; 15:1134187. [PMID: 37082612 PMCID: PMC10110980 DOI: 10.3389/fnagi.2023.1134187] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/21/2023] [Indexed: 04/07/2023] Open
Abstract
ObjectivesTo analyze the relationship between sleep quality, snoring symptoms, night shift and risk of stroke in Chinese population over 40 years old.MethodsBased on the national screening and intervention program for high-risk population of stroke in 2016, 15,016 people completed the study of “the association between sleep and stroke,” 58,696 people completed the snoring questionnaire, and 58,637 people completed the night shift questionnaire.ResultsThe proportion of coronary heart disease, hypertension, hyperlipidemia, diabetes, snoring, atrial fibrillation, stroke and high-risk group of stroke risk rating were higher in the group with poor sleep quality (p < 0.05). The proportion of high blood pressure, hyperlipidemia, diabetes, atrial fibrillation, transient ischemic attack (TIA), or high-risk group of stroke risk rating was higher in snoring group (p < 0.05). The body mass index (BMI), waist circumference, neck circumference, fasting blood glucose, triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL) and homocysteine (Hcy) levels in snoring group were higher than the non-snoring group, and high density lipoprotein (HDL) levels were lower (p < 0.05). People with TIA, high risk for stroke, and high blood pressure were higher in night shift workers than non-night shift workers (p < 0.05). The levels of BMI, fasting blood glucose, 2 h postprandial blood glucose, glycated hemoglobin, TG, TC, LDL, HDL and Hcy in night shift group were lower than the non-night shift group (p < 0.05).ConclusionSleep quality, snoring and night shift might be related to the risk factors of stroke.
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Affiliation(s)
- Yajing Zhang
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Ting Zhang
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Xiaoshuang Xia
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Yahui Hu
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Chao Zhang
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Ran Liu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Yun Yang
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Xin Li
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Wei Yue
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
- *Correspondence: Wei Yue
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Cui H, Xu R, Wan Y, Ling Y, Jiang Y, Wu Y, Guan Y, Zhao Q, Zhao G, Zaid M. Relationship of sleep duration with incident cardiovascular outcomes: a prospective study of 33,883 adults in a general population. BMC Public Health 2023; 23:124. [PMID: 36653782 PMCID: PMC9847128 DOI: 10.1186/s12889-023-15042-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Studies on the effect of sleep duration on cardiovascular health have contradictory findings. Underlying health issues may have led to inconsistent results and warrant consideration. We aim to assess the relationship of night sleep duration with incident cardiovascular disease (CVD) in a general population, taking into consideration underlying chronic diseases. METHODS Data from Shanghai Suburban Adult Cohort and Biobank with a median follow-up of 5.1 years was used, including 33,883 adults aged 20-74 years old. Incident CVD cases were reported and recorded by the Center for Disease Prevention and Control in Songjiang, Shanghai. We used Cox proportional hazard regression models and restricted cubic spline (RCS) analysis to explore the relationship between different sleep groups and sleep duration with incident CVD outcomes, through stratification by gender and age, as well as different health conditions, with adjustments for potential confounders. RESULTS Long sleep duration (> 9 h) compared to > 7 to ≤ 8 h was associated with overall incident CVD in participants aged ≥ 50 years old: HR(95%CI) = 2.07 (1.15, 3.74) for 50-59y and 1.43 (1.04, 1.93) for 60-74y. RCS analysis showed a J-shaped relationship between sleep and CVD risk in those ≥ 50y, which was confirmed only in those with a chronic health condition. Non-linear relationships between sleep and CVD risk factors, such as BMI, blood glucose and glycated haemoglobin, were observed. CONCLUSIONS Long sleep duration is associated with increased risk of CVD in people ≥ 50y. However, CVD risk factors and underlying health conditions such as hypertension, and diabetes, may play a driving role in the relationship.
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Affiliation(s)
- Hui Cui
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032 China
| | - Rong Xu
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032 China
| | - Yiming Wan
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032 China
| | - Yong Ling
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032 China
| | - Yonggen Jiang
- Songjiang District Center for Disease Control and Prevention, Shanghai, 200032 China
| | - Yiling Wu
- Songjiang District Center for Disease Control and Prevention, Shanghai, 200032 China
| | - Ying Guan
- Songjiang District Center for Disease Control and Prevention, Shanghai, 200032 China
| | - Qi Zhao
- grid.8547.e0000 0001 0125 2443Department of Social Medicine, School of Public Health, Fudan University, Shanghai, 200032 China
| | - Genming Zhao
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032 China
| | - Maryam Zaid
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032, China.
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Zhou B, Jiang C, Zhang W, Jin Y, Zhu T, Zhu F, Xu L. Association of sleep duration and napping with stroke mortality in older Chinese: A 14-year prospective cohort study of the Guangzhou Biobank Cohort study. Sleep Med 2023; 101:384-391. [PMID: 36512889 DOI: 10.1016/j.sleep.2022.11.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/13/2022] [Accepted: 11/27/2022] [Indexed: 12/03/2022]
Abstract
STUDY OBJECTIVE Evidence regarding the association of short sleep duration and napping with stroke remains limited and controversial. We examined the association of sleep duration and napping with risk of stroke mortality in an older Chinese cohort. METHODS Sleep duration and daytime napping were assessed by face-to-face interview during 2003-2008. Information of causes of death until April 30, 2021 was collected via record linkage with the Death Registry. Cox regression was used to calculate the hazard ratio (HR) and 95% confidence interval (CI). RESULTS Of 27,254 participants aged average 62.0 (standard deviation = 7.1) years, 818 stroke deaths occurred within 388,798 person-years (mean = 14.3 years) of follow-up. A U-shaped relation between sleep duration and risk of stroke mortality was observed. Participants with short (≤5 h/day) or long sleep duration (≥9 h/day) showed higher risks of total stroke mortality, with adjusted HRs (95% CIs) being 1.27 (1.01-1.59) and 1.37 (1.07-1.75), respectively. However, non-significant association of short or long sleep duration with hemorrhagic or ischemic stroke mortality was found. The associations of short and long sleep duration with total stroke mortality were more pronounced in those with hypertension (P for interaction with hypertension = 0.01), with HRs (95% CIs) being 1.37 (1.04-1.82) and 1.77 (1.33-2.36), respectively. No association between napping and risk of stroke mortality was found. CONCLUSIONS Both short and long sleep duration, but not daytime napping, were associated with higher risk of stroke mortality. Public health messages to encourage good sleep hygiene may be important, especially for people with hypertension.
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Affiliation(s)
- Baijing Zhou
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Chaoqiang Jiang
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
| | - Weisen Zhang
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China.
| | - Yali Jin
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
| | - Tong Zhu
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
| | - Feng Zhu
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
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6
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Association Between Excess Sleep Duration and Risk of Stroke: A Population-Based Study. Can J Neurol Sci 2023; 50:17-22. [PMID: 34670635 DOI: 10.1017/cjn.2021.242] [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: 11/07/2022]
Abstract
BACKGROUND Excess sleep is associated with higher risk of stroke, but whether the risk is modified by age and if it remains elevated after accounting for the competing risk of death is not well understood. METHODS We used nine years of the Canadian Community Health Survey between 2000 to 2016 to obtain self-reported sleep duration and created a cohort of individuals without prior stroke, heart disease, or cancer. We linked to hospital records to determine subsequent admissions or emergency department visits for acute stroke until December 31, 2017. We used Cox proportional hazard models to determine the association between sleep duration and risk of stroke, assessing for modification by age and sex and adjusting for demographic, vascular, and social factors. We obtained cumulative incidence of stroke accounting for the competing risk of death. RESULTS There were 82,795 individuals in our cohort who met inclusion criteria and had self-reported sleep duration, with 1705 stroke events in follow-up. There was an association between excess sleep (≥10 h/night) and risk of stroke in those <70 years (fully adjusted hazard ratio 2.29, 95% CI 1.04-5.06), but not ≥70 years of age, with a similar association after accounting for the competing risk of death. CONCLUSION Sleep duration ≥10 h/night is associated with increased risk of stroke in those <70 years of age. The findings support current guidelines for 7-9 h of sleep per night. Further research is needed to elucidate the relationship between sleep and cerebrovascular disease.
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7
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Yao CA, Chen IL, Chen CY, Torng PL, Su TC. Association between Wakeup Frequency at Night and Atherogenic Dyslipidemia: Evidence for Sex Differences. J Atheroscler Thromb 2023; 30:87-99. [PMID: 35444101 PMCID: PMC9899702 DOI: 10.5551/jat.63254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
AIM This study aimed to determine whether sleep disturbance, defined as the wakeup frequency at night, is associated with atherogenic dyslipidemia and to explore possible sex differences. METHODS A total of 1,368 adults aged 19-70 years were included in the study of lifestyles and atherogenic dyslipidemia at the National Taiwan University Hospital in the period of 2008-2012. They completed a questionnaire regarding lifestyle information and sleep quality, including sleep hour duration, use of sleeping pills, and wakeup frequency during nighttime sleep. The measured lipid profiles included total cholesterol, triglycerides, low- and high-density lipoprotein cholesterol (LDL-C and HDL-C, respectively), non-HDL-C, and small dense LDL-C (sdLDL-C). Multivariate logistic regression was performed to determine habitual interrupted sleep and the odds ratio of atherogenic dyslipidemia following adjustment for conventional risk factors and for sex-based subgroup analysis. RESULTS A wakeup frequency ≥ 3 times per night was independently associated with an increased risk [odds ratio (95% confidence interval)] of dyslipidemia was 1.96 (1.17-3.28), and non-HDL-C ≥ 160 mg/dL was 1.78 (1.09-2.89). A higher wakeup frequency was associated with increased atherogenic dyslipidemia in women than in men. The multivariate adjusted relative risks for non-HDL ≥ 160 mg/dL and cholesterol ≥ 200 mg/dL were 3.05 (1.27-7.34) and 4.01(1.29-12.45) for female individuals with insomnia and those with a wakeup frequency ≥ 2 times per night, respectively. CONCLUSION A higher wakeup frequency was associated with atherogenic dyslipidemia in Taiwanese adults, particularly in women. This study also provided another evidence of increasing cardiovascular diseases in subjects with habitual interrupted sleep.
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Affiliation(s)
- Chien-An Yao
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - I-Ling Chen
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chung-Yen Chen
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan,Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Pao-Ling Torng
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ta-Chen Su
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan,Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan,Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Peila R, Xue X, Feliciano EMC, Allison M, Sturgeon S, Zaslavsky O, Stone KL, Ochs-Balcom HM, Mossavar-Rahmani Y, Crane TE, Aggarwal M, Wassertheil-Smoller S, Rohan TE. Association of sleep duration and insomnia with metabolic syndrome and its components in the Women's Health Initiative. BMC Endocr Disord 2022; 22:228. [PMID: 36104689 PMCID: PMC9476543 DOI: 10.1186/s12902-022-01138-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 08/23/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Epidemiological evidence suggests that inadequate sleep duration and insomnia may be associated with increased risk of metabolic syndrome (MetS). However, longitudinal data with repeated measures of sleep duration and insomnia and of MetS are limited. We examined the association of sleep duration and insomnia with MetS and its components using longitudinal data from the Women's Health Initiative (WHI). METHODS The study included postmenopausal women (ages 50-79 years) diabetes-free at enrollment in the WHI, with baseline data on sleep duration (n = 5,159), insomnia (n = 5,063), MetS, and its components. Repeated measures of self-reported sleep duration and insomnia were available from years 1 or 3 of follow-up and of the MetS components from years 3, 6 and 9. Associations were assessed using logistic regression and generalized estimating equations models, and odds ratios and 95% confidence intervals (CI) adjusted for major risk factors were calculated. RESULTS In cross-sectional analysis, baseline sleep duration ≥ 9 h was positively associated with MetS (OR = 1.51; 95%CI 1.12-2.04), while sleep duration of 8- < 9 h was associated with waist circumference > 88 cm and triglycerides ≥ 150 mg/dL (OR = 1.18; 95%CI 1.01-1.40 and OR = 1.23; 95%CI 1.05-1.46, respectively). Insomnia had a borderline positive association with MetS (OR = 1.14; 95%CI 0.99-1.31), and significant positive associations with waist circumference > 88 cm and glucose ≥ 100 mg/dL (OR = 1.18; 95%CI 1.03-1.34 and OR = 1.17; 95%CI 1.02-1.35, respectively). In the longitudinal analysis, change from restful sleep to insomnia over time was associated with increased odds of developing MetS (OR = 1.40; 95%CI 1.01-1.94), and of a triglyceride level ≥ 150 mg/dL (OR = 1.48; 95%CI 1.08-2.03). CONCLUSIONS Among postmenopausal women in the WHI, sleep duration and insomnia were associated with current and future risk of MetS and some of its components.
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Affiliation(s)
- Rita Peila
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue Belfer, Rm1301A, Bronx, NY, 10461, USA.
| | - Xiaonan Xue
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue Belfer, Rm1301A, Bronx, NY, 10461, USA
| | | | - Matthew Allison
- Division of Preventive Medicine, University of California, San Diego, CA, USA
| | - Susan Sturgeon
- Institute of Applied Life Sciences, University of Massachusetts, Amherst, MA, USA
| | - Oleg Zaslavsky
- Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA
| | - Katie L Stone
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - Heather M Ochs-Balcom
- Department of Epidemiology and Environmental Health, University of Buffalo, Bufallo, NY, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue Belfer, Rm1301A, Bronx, NY, 10461, USA
| | - Tracy E Crane
- Behavioral Measurement and Interventions Cancer Prevention and Control Program, University of Arizona, Tucson, AZ, USA
| | - Monica Aggarwal
- Division of Cardiology, University of Florida, Gainesville, FL, USA
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue Belfer, Rm1301A, Bronx, NY, 10461, USA
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue Belfer, Rm1301A, Bronx, NY, 10461, USA
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9
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Zhao M, Chen T, Huang C, Zhong Q. Association between sleep duration and ideal cardiovascular health in Chinese adults: results from the China health and nutrition survey. Fam Pract 2022; 40:314-321. [PMID: 35994051 DOI: 10.1093/fampra/cmac095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Ideal cardiovascular health (CVH) is related to the future risk of cardiovascular disease. Sleep duration is an important factor influencing health outcomes. The association between sleep duration and CVH is unclear. OBJECTIVES We aimed to explore the associations between sleep duration and CVH among Chinese adults. METHODS This cross-sectional study was based on nationally representative samples from 2009 China Health and Nutrition Survey (CHNS). Sleep duration was categorized as ≤6, 7, 8, and ≥9 h. The CVH scores were evaluated. Generalized linear regressions and restricted cubic splines were used to determine the association between sleep duration and CVH. RESULTS A total of 8,103 Chinese adults with a mean age of 50.29 (14.97) years were included. The mean (SD) CVH score was 3.96 (1.43). Only 36.7% of the participants had ideal CVH. Sleep duration was positively associated with ideal CVH (P-trend < 0.05). When comparing the long sleep duration with the short sleep duration, short sleep duration significantly decreased the mean CVH score, β = -0.24 (95% CI: -0.36, -0.13) and increased the risk of nonideal CVH, OR = 1.38 (95% CI: 1.15, 1.67) by generalized linear regressions. The restricted cubic splines showed CVH did not have a significant nonlinear relationship with sleep duration. The P-value for nonlinear was 0.161. The association of sleep duration with CVH had no obvious threshold. CONCLUSION Short sleep duration was associated with decreased odds of ideal CVH and lower mean CVH score. Confirmation through longitudinal studies is needed.
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Affiliation(s)
- Min Zhao
- Department of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Ting Chen
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Chenglong Huang
- Department of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Qiuan Zhong
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
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10
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Du J, Chen Y, Zhou N, Song Y, Wang W, Hong X. Associations between self-reported sleep duration and abnormal serum lipids in eastern China: a population-based cross-sectional survey. Sleep Med 2022; 95:1-8. [DOI: 10.1016/j.sleep.2022.04.004] [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: 12/06/2021] [Revised: 02/21/2022] [Accepted: 04/06/2022] [Indexed: 11/28/2022]
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11
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Liu L, Yang J, Wang J, Nie M, Wang Z, Guan H, Hu J, Hong F. Relationship Between Sleep Duration and Stroke History in Middle-Aged and Elderly in Guiyang: A Cross-Sectional Survey. Neuropsychiatr Dis Treat 2022; 18:243-252. [PMID: 35185332 PMCID: PMC8848255 DOI: 10.2147/ndt.s340834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/10/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND With over 2 million new cases annually, stroke is associated with the higher amount of disability-adjusted life-years lost than any other disease in China; however, the relationship between sleep time and stroke has not been concluded yet. Aim of this study was to analyze the relationship between sleep duration and stroke history in middle-aged and elderly people in Guiyang, China. METHODS This study was a cross-sectional survey carried out in 40-99-years-old permanent residents of Guiyang. Yunyan, Wudang, and Baiyun districts and Xiuwen County were selected by stratified multilevel sampling for a face-to-face survey. Demographics, history of stroke, and self-reported sleep behavior data were collected, and multivariable logistic regression models were used to gradually adjust possible confounding factors. RESULTS A total of 5065 participants were included, of them 126 (2.5%) had a history of stroke. Short sleep (<7 h) was observed in 11.0%, sufficient sleep (7-9 h) in 69.4%, and long sleep (>9 h) in 19.6%. Sleep duration and stroke prevalence showed a U-shaped distribution. When taking the sleep duration of 7-9 h as a reference, sleep duration >9 h was associated with stroke (all P < 0.05) in the univariable model (OR = 2.68, 95% CI: 1.83-3.93) and in the multivariable models 1 (OR = 2.35, 95% CI: 1.59-3.47), 2 (OR = 2.27, 95% CI: 1.53-3.37), 3 (OR = 2.25, 95% CI: 1.51-3.33), and 4 (OR = 2.11, 95% CI: 1.39-3.19). There were no significant differences between the <7 and 7-9 h groups (P > 0.05). CONCLUSION Thus, long sleep duration (>9 h) is independently associated with history of stroke in middle-aged and elderly people in Guiyang.
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Affiliation(s)
- Li Liu
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou, People's Republic of China
| | - Jingyuan Yang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou, People's Republic of China
| | - Junhua Wang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou, People's Republic of China
| | - Meng Nie
- School of Public Health, Guizhou Medical University, Guiyang, Guizhou, People's Republic of China
| | - Ziyun Wang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou, People's Republic of China
| | - Han Guan
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou, People's Republic of China
| | - Jin Hu
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou, People's Republic of China
| | - Feng Hong
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou, People's Republic of China
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Ren L, Chang L, Kang Y, Zhao Y, Chen F, Pei L. Gender-Specific Association Between Sleep Duration and Body Mass Index in Rural China. Front Endocrinol (Lausanne) 2022; 13:877100. [PMID: 35712236 PMCID: PMC9193222 DOI: 10.3389/fendo.2022.877100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/21/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study aimed at investigating the association of sleep duration with body mass index (BMI) by gender among adult residents in rural Hanzhong of Shaanxi province, Northwest China. METHODS A two-level stratified random cluster sampling method was used to select adult residents between the ages of 18 and 80 years. All information including sociodemographic characteristics and lifestyles was collected by face-to-face interview with a structured questionnaire. According to standard methods, trained staff were responsible for anthropometric measurements using calibrated instruments in an empty room. By gender, both ordinary least square regression (OLS) and quantile regression (QR) were used to analyze the relationship between sleep time and BMI controlling for other confounders. The restricted cubic splines with five knots were further used to express the potentially non-linear association between sleep time and BMI. RESULTS A total of 3,017 eligible participants were included in the study. After controlling for confounding factors including sociodemographic characteristics and lifestyles, OLS regression did not indicate any significant association of sleep duration with BMI among men and women. Among men, it was clear that there is an inverse U-shaped relationship between sleep time and BMI beyond the 66.0th percentile (BMI ≥24). Among women, quantile regression presented a significant U-shaped relationship between BMI and sleep duration. According to the restricted cubic splines, the women who sleep for approximately 9 h had the lowest BMI, and when sleep duration approached approximately 7 h among men, their BMI would be the highest. CONCLUSIONS The U-shaped and inverse U-shaped relationships between sleep duration and BMI were clearly observed for women and men, respectively, in our study. The identification of potentially relevant modifiable risk factors may provide better preventive approaches to obesity.
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Affiliation(s)
- Lin Ren
- Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
- Department of Quality Control, Xi’an Fourth Hospital, Xi’an, China
| | - Li Chang
- The First Department of General Surgery, Shaanxi Province Tumor Hospital, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Yijun Kang
- Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Yaling Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Fangyao Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Leilei Pei
- Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
- *Correspondence: Leilei Pei,
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Tsiptsios D, Leontidou E, Fountoulakis PN, Ouranidis A, Matziridis A, Manolis A, Triantafyllis AS, Tsamakis K, Serdari A, Terzoudi A, Dragioti E, Steiropoulos P, Tripsianis G. Association between sleep insufficiency and dyslipidemia: a cross-sectional study among Greek adults in the primary care setting. Sleep Sci 2022; 15:49-58. [PMID: 35273747 PMCID: PMC8889970 DOI: 10.5935/1984-0063.20200124] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/08/2021] [Indexed: 11/20/2022] Open
Abstract
Objective To investigate the potential association between sleep insufficiency and dyslipidemia (DL) in the primary care setting using self-reported questionnaires. Material and Methods 957 adults aged between 19 and 86 years old from the rural area of Thrace, Greece were enrolled in this cross-sectional study. Multistage stratifed cluster sampling was used and the subjects were classifed into three groups according to sleep duration [short (<6h), normal (6-8h), and long (>8h) sleep duration]. DL was defined by a positive response to the question "Have you ever been told by a doctor or health professional that your blood cholesterol or triglyceride levels were high?", or if they were currently taking antilipidemic agents. Sleep quality, utilizing Epworth sleepiness scale, Athens insomnia scale, Pittsburgh sleep quality index and Berlin questionnaire, was also examined. Results DL prevalence was significantly associated with short sleep duration (aOR=2.18, p<0.001) and insomnia (aOR=1.43, p=0.050), while its relation with poor sleep quality (aOR=1.31, p=0.094) and risk for obstructive sleep apnea (aOR=1.32, p=0.097) were of marginal statistical significance. Concerning insomnia subtypes, DL was significantly associated with difficulties maintaining sleep (aOR=2.99, p<0.001) and early morning awakenings (aOR=1.38, p=0.050), but not difficulties initiating sleep (aOR=1.18, p=0.328). Conclusion This study reveals an association between sleep pathology and DL. Thus, early pharmacological and cognitive or behavioral interventions that improve sleep are deemed necessary in order to decrease DL burden.
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Affiliation(s)
- Dimitrios Tsiptsios
- South Tyneside & Sunderland NHS Foundation Trust, Department of Clinical Neurophysiology - Sunderland - Tyne & Wear - United Kingdom
| | - Eleni Leontidou
- Democritus University of Thrace, Laboratory of Medical Statistics - Alexandroupolis - Thrace - Greece
| | | | - Andreas Ouranidis
- Aristotle University of Thessaloniki, Department of Pharmaceutics - Thessaloniki - Central Macedonia - Greece
| | - Anestis Matziridis
- Democritus University of Thrace, Laboratory of Medical Statistics - Alexandroupolis - Thrace - Greece
| | - Apostolos Manolis
- Democritus University of Thrace, Laboratory of Medical Statistics - Alexandroupolis - Thrace - Greece
| | | | - Konstantinos Tsamakis
- King’s College, Institute of Psychiatry, Psychology and Neuroscience - London - London - United Kingdom
| | - Aspasia Serdari
- Democritus University of Thrace, Department of Child and Adolescent Psychiatry - Alexandroupolis - Thrace - Greece
| | - Aikaterini Terzoudi
- Democritus University of Thrace, Neurology Department - Alexandroupolis - Thrace - Greece
| | - Elena Dragioti
- Linköping University, Department of Health, Medicine and Caring Sciences - Linköping - Linköping - Sweden
| | - Paschalis Steiropoulos
- Democritus University of Thrace, Department of Pneumonology - Alexandroupolis - Thrace - Greece
| | - Gregory Tripsianis
- Democritus University of Thrace, Laboratory of Medical Statistics - Alexandroupolis - Thrace - Greece
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Difficulty of falling asleep and non-high-density lipoprotein cholesterol level among Canadian older adults: a cross-sectional analysis of the Canadian Longitudinal Study for Aging baseline data. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2021; 18:597-608. [PMID: 34527026 PMCID: PMC8390930 DOI: 10.11909/j.issn.1671-5411.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To examine whether difficulty of falling asleep (DoFA) is associated with non-high-density lipoprotein cholesterol (non-HDL-C) level among Canadian older adults. METHODS 26,954 individuals aged 45–85 years from the baseline data of the Canadian Longitudinal Study for Aging were included in this study. DoFA was categorized into five groups by answer to the question “Over the last month, how often did it take you more than 30 min to fall asleep?” Response options are “Never, < 1 time/week, 1−2 times/week, 3−5 times/week, or 6−7 times/week”. Non-HDL-C, the difference of total cholesterol and HDL-C, were categorized into five categories based on these cut-offs (< 2.6 mmol/L, 2.6−3.7 mmol/L, 3.7−4.8 mmol/L, 4.8−5.7 mmol/L, and ≥ 5.7 mmol/L). Ordinal logistic regression (logit link) continuation ratio models were used to estimate the odds of higher non-HDL-C levels for DoFA status. Adjusted means of non-HDL-C by DoFA status were estimated by general linear models. All analyses were sex separately using analytic weights to ensure generalizability. RESULTS The proportions of DoFA in five categories were 41.6%, 25.7%, 13.6%, 9.4%, 9.7% for females and 52.9%, 24.9%, 10.5%, 6.1%, 5.6% for males, respectively. After adjustment of demographical and other covariates (such as depression, comorbidity, sleeping hour, etc.) compared to those who reported never having DoFA, the ORs (95% CIs) of higher levels of non-HDL-C for those whose DoFA status in < 1 time/week, 1−2 times/week, 3−5 times/week, and 6−7 times/week were 1.12 (1.05−1.21), 1.09 (0.99−1.18), 1.20 (1.09−1.33), 1.29 (1.17−1.43) in females and 1.05 (0.98−1.13), 0.95 (0.87−1.05), 1.21 (1.08−1.37), 0.97 (0.85−1.09) in males, respectively. The adjusted means of non-HDL-C among the five DoFA status were 3.68 mmol/L, 3.73 mmol/L, 3.74 mmol/L, 3.82 mmol/L, 3.84 mmol/L for females and 3.54 mmol/L, 3.58 mmol/L, 3.51 mmol/L, 3.69 mmol/L, 3.54 mmol/L for males, respectively. CONCLUSIONS The results of this study have identified a risk association pattern between DoFA status and non-HDL-C levels in females but not in males. Further research is needed to confirm these findings.
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BaHammam AS, Alghannam AF, Aljaloud KS, Aljuraiban GS, AlMarzooqi MA, Dobia AM, Alothman SA, Aljuhani O, Alfawaz RA. Joint consensus statement of the Saudi Public Health Authority on the recommended amount of physical activity, sedentary behavior, and sleep duration for healthy Saudis: Background, methodology, and discussion. Ann Thorac Med 2021; 16:225-238. [PMID: 34484437 PMCID: PMC8388569 DOI: 10.4103/atm.atm_32_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/19/2021] [Indexed: 02/06/2023] Open
Abstract
The Saudi Public Health Authority recently prepared a Consensus Statement regarding how much time a person should spend engaged in physical activity, sedentary behavior, and sleep to promote optimal health across all age groups. This paper describes the background literature, methodology, and modified RAND Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-ADOLOPMENT approach that guided the development process. A Leadership Group and Consensus Panels were formed, and credible existing guidelines were identified. The Panel identified clear criteria to choose the best practice guidelines for the set objectives after evaluation, based on GRADE table evidence, findings table summaries, and draft recommendations. Updating of the selected practice guidelines was performed, and the Consensus Panels separately reviewed the evidence for each behavior and decided to adopt or adapt the selected practice guideline recommendations or create de novo recommendations. Data related to cultural factors that may affect the studied behaviors, such as prayer times, midday napping or "Qailulah," and the holy month of Ramadan, were also reviewed. Two rounds of voting were conducted to reach a consensus for each behavior.
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Affiliation(s)
- Ahmed S. BaHammam
- The University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- National Plan for Science and Technology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah F. Alghannam
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Khalid Saad Aljaloud
- Department of Exercise Physiology, College of Sport Sciences and Physical Activity, King Saud University, Riyadh, Saudi Arabia
| | - Ghadeer S. Aljuraiban
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mezna A. AlMarzooqi
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ali M. Dobia
- Comprehensive Specialized Clinics for the Security Forces in Jazan, General Administration for Medical Services, Ministry of Interior, Riyadh, Saudi Arabia
| | - Shaima A. Alothman
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Osama Aljuhani
- Department of Physical Education, College of Sport Sciences and Physical Activity, King Saud University, Riyadh, Saudi Arabia
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Nie F, Wang Z, Zeng Q, Guan H, Yang J, Luo P, Du L, Wang J, Hong F. Health behaviors and metabolic risk factors are associated with dyslipidemia in ethnic Miao Chinese adults: the China multi-ethnic cohort study. BMC Public Health 2021; 21:851. [PMID: 33941138 PMCID: PMC8091723 DOI: 10.1186/s12889-021-10871-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/19/2021] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Cardiovascular risk factors in Chinese ethnic minority groups are rarely reported. OBJECTIVE To quantify the cardiovascular risk factors in Miao Chinese adults and to examine the association of health behaviors and metabolic risk factors with dyslipidemia. METHODS A cross-sectional analysis was conducted using baseline data from the China Multi-Ethnic Cohort (CMEC) study. A representative sample of 5559 Miao participants aged 30 to 79 years were surveyed and given physical and laboratory exams. The proportion of behavioral and metabolic risk factors were described in ethnic Miao adults. Logistic regression was utilized to evaluate the odds ratio (OR) and 95% confidence interval (CI) of the association between health behaviors and metabolic risk factors with dyslipidemia. RESULTS In Miao Chinese adults, the prevalence of dyslipidemia was 32.8%. After multivariate adjustment, subjects with poor waist-to-hip ratio (WHR), body mass index (BMI), fasting blood glucose (FBG) and blood pressure (BP) were more likely to have higher risk of triglycerides (TG) abnormality, regardless of gender and age. Furthermore, the strongly association was detected between poor WHR and low density lipoprotein cholesterol (LDL-C) abnormality (adjusted OR = 5.24, 95%CI: 2.42-11.34) in the older subgroup (≥ 60 years). Males who current smoking were an independent risk factor only for high density lipoprotein cholesterol (HDL-C) abnormality (adjusted OR = 1.44, 95%CI: 1.05-1.99). However, in the subgroup age, current smoker were at greater risk of high TG and low HDL-C. Males with regular drinking were less likely to be high LDL-C (adjusted OR = 0.51, 95%CI: 0.32-0.81). CONCLUSIONS The present findings indicated that Miao adults with metabolic risk factors were at greater risk of dyslipidemia.
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Affiliation(s)
- Fang Nie
- School of Public Health, The Key Laboratory Of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
- School of Public Health, Guizhou Medical University, Guiyang, 550025, China
| | - Ziyun Wang
- School of Public Health, The Key Laboratory Of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Qibing Zeng
- School of Public Health, The Key Laboratory Of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Han Guan
- School of Public Health, The Key Laboratory Of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Jingyuan Yang
- School of Public Health, The Key Laboratory Of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Peng Luo
- School of Public Health, The Key Laboratory Of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Lunwei Du
- School of Public Health, The Key Laboratory Of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
- School of Public Health, Guizhou Medical University, Guiyang, 550025, China
| | - Junhua Wang
- School of Public Health, The Key Laboratory Of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China.
| | - Feng Hong
- School of Public Health, The Key Laboratory Of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China.
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Wang Y, Chen Q, Liu K, Wang X, Yang H, Zhou N, Ao L, Liu J, Cao J. Sleep behavior is associated with over two-fold decrease of sperm count in a chronotype-specific pattern: path analysis of 667 young men in the MARHCS study. Chronobiol Int 2021; 38:871-882. [PMID: 33715553 DOI: 10.1080/07420528.2021.1896534] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Recent studies have shown that the reduction of sperm count is associated with sleep behaviors, including restricted/excessive sleep duration, late sleep time midpoint, and shift of sleep midpoint time (social jetlag). Chronotype is suggested to regulate sleep behaviors; however, the relationship between chronotype and human sperm count is unknown. The relationship between sleep behaviors and human sperm count, when sleep behaviors as well as chronotype are controlled is also unclear. We performed a path analysis of the data obtained from 667 Chinese men recruited into the MARHCS (Male Reproductive Health in Chongqing College Students) study. Chronotype, sleep duration, sleep time midpoint, and social jetlag were estimated by the Munich Chronotype Questionnaire. Sperm count was measured by computer-aided sperm analysis. The comprehensive relationship between chronotype, all sleep behaviors, and sperm count was tested by path analysis, in which the standardized residual of sperm count was used for adjustment of age, abstinence period, body mass index, tobacco smoking, alcohol drinking, and intake of tea, cola, and coffee. Our major findings are: (1) Chronotype negatively correlated with sleep duration (correlation coefficient (R) = -0.32, P < .001) and positively correlated with sleep midpoint (R = 0.65, P < .001) and social jetlag (R = 0.37, P < .001). (2) Sleep duration (U-shape transformed; R = -0.11, P = .005), sleep midpoint (R = -0.09, P = .021), and social jetlag (R = -0.12, P = .001), respectively, correlated with sperm count in univariate analysis. The relationship between sleep midpoint and sperm count disappeared when social jetlag was controlled. (3) Path analysis showed that chronotype is connected with sperm count through two pathways: via sleep duration (standardized path coefficient = -0.09, 95% CI: -0.17 to -0.01, P = .030) and via social jetlag (standardized path coefficient = -0.09, 95% CI: -0.17 to -0.01, P = .031). For men of earlier, intermediate, and later tertile of chronotype, the sleep-duration-related decrease of sperm count was separately estimated to be 16.3%, 12.8%, and 11.6%, while the social-jetlag-related decrease of sperm count was estimated to be 9.3%, 12.8%, and 19.2%. The total effect of sleep behaviors on sperm count was estimated to be 25.7%, 25.6%, and 30.7%, with an average of 27.4% for men of different chronotypes. The present study showed that men of earlier chronotype were prone to restricted/excessive sleep duration, while men of later chronotype were prone to social jetlag, both of which correlated with reduced sperm count, suggesting that chronotype may modulate the sleep behaviors and exert dual effects on sperm count via different sleep behaviors, leading to a ubiquitous sperm decline. Men of different chronotypes should take care to avoid different types of improper sleep behaviors, so as to prevent such deleterious effect on sperm count.
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Affiliation(s)
- Yimeng Wang
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Qing Chen
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Kun Liu
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xiaogang Wang
- Frontier Defence Medical Service Training Group, Third Military Medical University (Army Medical University), Xinjiang, China
| | - Huan Yang
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Niya Zhou
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Lin Ao
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jinyi Liu
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jia Cao
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China
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Female and male sleep duration in association with the probability of conception in two representative populations of reproductive age in US and China. Sleep Med 2020; 74:9-17. [DOI: 10.1016/j.sleep.2020.05.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Song Q, Liu X, Zhou W, Wu S, Wang X. Night sleep duration and risk of each lipid profile abnormality in a Chinese population: a prospective cohort study. Lipids Health Dis 2020; 19:185. [PMID: 32799877 PMCID: PMC7429803 DOI: 10.1186/s12944-020-01363-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 08/10/2020] [Indexed: 01/28/2023] Open
Abstract
Background To explore the associations between sleep duration and abnormalities in serum lipid levels in a Chinese population. Methods A prospective study was conducted with 34,260 participants from the general Chinese population. Sleep duration was categorized as ≤5, 6, 7, 8 or ≥ 9 h. Each lipid profile abnormality was defined according to the Chinese Guidelines for the Prevention and Treatment of Dyslipidemia in Adults (2016). The Cox proportional hazards model was used to assess the association between sleep duration and dyslipidemia. Results Compared with a 7 h sleep duration, long sleep duration (≥9 h) was significantly associated with low high-density lipoprotein cholesterol (HDL-C) levels (hazard ratio (HR): 1.24; 95% CI: 1.12–1.38). In subgroup analyses, the positive association between long sleep duration and low HDL-C level in men and in the different age groups was more pronounced than the association in women. No significant interactions were observed in the association between sleep duration and each abnormal serum lipid level by sex/age in the study population (P-interaction> 0.05). Conclusions These findings suggest that long sleep duration is associated with low HDL-C level among the Kailuan community population.
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Affiliation(s)
- Qiaofeng Song
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, No.65 Shengli Road, Lunan District, Tangshan, 063000, China
| | - Xiaoxue Liu
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, No.65 Shengli Road, Lunan District, Tangshan, 063000, China
| | - Wenhua Zhou
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, No.65 Shengli Road, Lunan District, Tangshan, 063000, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, 063000, China.
| | - Xizhu Wang
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, No.65 Shengli Road, Lunan District, Tangshan, 063000, China.
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Sleep Duration, Lipid Profile and Insulin Resistance: Potential Role of Lipoprotein(a). Int J Mol Sci 2020; 21:ijms21134680. [PMID: 32630105 PMCID: PMC7369827 DOI: 10.3390/ijms21134680] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/22/2020] [Accepted: 06/28/2020] [Indexed: 11/29/2022] Open
Abstract
Lipoprotein (a) (Lp(a)) is considered a genetic factor for cardiovascular disease playing an important role in atherogenesis and thrombosis, but the evidence about its association with sleep duration is controversial. We evaluated the relation between self-reported sleep duration and Lp(a). Among 1600 participants of the population-based sample, we selected 1427 subjects without previously known cardiovascular events, who answered the questions about their sleep duration; had valid lipid profile results (total cholesterol, low- and high-density lipoproteins, Lp(a), apolipoprotein AI (ApoAI), ApoB, and ApoB/ApoAI); and did not take lipid-lowering drugs (mean age 46 ± 12 years). We performed a structured interview, which included questions about lifestyle, medical history, complaints, and sleep duration (How long have you been sleeping per night during the last month?). Sleep duration was classified as follows: <6 h/night—short, 6–9 h/night—normal, and ≥10 h/night—long. Overall, 73 respondents (5.2%) were short-sleepers and 69 (4.8%) long-sleepers. Males were slightly more prevalent among short-sleepers. The groups matched by age, body mass index, blood pressure, diabetes mellitus, and hypertension rate. Short-sleepers had lower rates of high total cholesterol (≥5.0 mmol/L), lower Lp(a) levels and lower rates of increased Lp(a) ≥0.5 g/L, and higher insulin and insulin resistance (assessed by the homeostatic model assessment for insulin resistance (HOMA-IR)). ApoAI, ApoB, their ratio, and other lab tests were similar in the groups. The multinomial logistic regression demonstrated that only the short sleep duration was independently (odds ratio (OR) 0.29, 95% confidence interval (CI) (0.09–0.91), p = 0.033) associated with Lp(a) (χ2 = 41.58, p = 0.003). Other influencing factors were smoking and HOMA-IR. Such an association was not found for long-sleepers. In conclusion, a short-sleep duration is associated with Lp(a). The latter might mediate the higher insulin resistance and higher cardiometabolic risks in short-sleepers.
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Effects of exercise and dietary interventions on serum metabolites in men with insomnia symptoms: A 6-month randomized controlled trial. SPORTS MEDICINE AND HEALTH SCIENCE 2020; 2:95-101. [PMID: 35784182 PMCID: PMC9219304 DOI: 10.1016/j.smhs.2020.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 02/07/2023] Open
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Silva-Costa A, Rotenberg L, Nobre AA, Chor D, Aquino EM, Melo EC, Barreto SM, Schmidt MI, Griep RH. Sex differences in the association between self-reported sleep duration, insomnia symptoms and cardiometabolic risk factors: cross-sectional findings from Brazilian longitudinal study of adult health. ACTA ACUST UNITED AC 2020; 78:48. [PMID: 32514345 PMCID: PMC7257140 DOI: 10.1186/s13690-020-00429-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 05/13/2020] [Indexed: 12/20/2022]
Abstract
Background The U-shaped associations between sleep durations and cardiometabolic risk factors (glycated hemoglobin levels, obesity, hypertriglyceridemia, hypertension and cholesterol levels) are still inconclusive. Moreover, as sleep is comprised of quantitative and qualitative aspects, exploring both insomnia symptoms and sleep duration are relevant when evaluating the potential effects of sleep problems on health. The aim was to evaluate sex-specific associations between sleep problems and cardiometabolic risk factors. Methods This cross-sectional study used data from wave two of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), including 7491 women and 6232 men. Questionnaires were administered to provide information about socioeconomic conditions, lifestyle, and sleep characteristics. A 12-h fasting blood sample was drawn to measure serum cholesterol, triglycerides, and glycated hemoglobin. Blood pressure, weight and height were also measured using standard equipment. Generalized additive models were used to evaluate the curve shape of the relationship between self-reported sleep duration and the outcomes. Logistic regression was performed to investigate the magnitude of the associations of self-reported sleep duration, insomnia symptoms, and short sleep plus insomnia symptoms with cardiometabolic risk factors. Results For women, self-reported sleep duration and insomnia symptoms (either separately or linked to short sleep duration) were associated with obesity, hypertension and glycated hemoglobin after adjusting for the confounders. The magnitudes of the associations between self-reported short sleep duration plus insomnia symptoms and the outcomes were slightly increased, considering sleep duration or insomnia symptoms separately. For men, both long sleep duration and insomnia symptoms were associated with hypertriglyceridemia after adjusted for the confounders. Conclusion These findings suggest possible sex-specific patterns, since obesity, hypertension and high glycated hemoglobin were associated with self-reported sleep duration and insomnia symptoms in women, but not in men, and reinforce the importance of considering quantitative and qualitative aspects of sleep for the prevention and management of the outcomes.
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Affiliation(s)
- Aline Silva-Costa
- Department of Collective Health, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Lucia Rotenberg
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute - Fiocruz, Rio de Janeiro, Brazil
| | - Aline A Nobre
- Scientific Computing Program, Oswaldo Cruz Foundation - Fiocruz, Rio de Janeiro, Brazil
| | - Dora Chor
- National School of Public Health, Oswaldo Cruz Foundation - ENSP/FIOCRUZ, Brazil, Rio de Janeiro, RJ Brazil
| | - Estela M Aquino
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - Enirtes C Melo
- National School of Public Health, Oswaldo Cruz Foundation - ENSP/FIOCRUZ, Brazil, Rio de Janeiro, RJ Brazil
| | - Sandhi M Barreto
- Postgraduate Program in Public Health and School of Medicine & Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, MG Brazil
| | - Maria Inês Schmidt
- Postgraduate Programme in Epidemiology - School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS Brazil
| | - Rosane H Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute - Fiocruz, Rio de Janeiro, Brazil
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Li J, Zheng D, Loffler KA, Wang X, McEvoy RD, Woodman RJ, Luo Y, Lorenzi-Filho G, Barbe F, Tripathi M, Anderson CS. Sleep duration and risk of cardiovascular events: The SAVE study. Int J Stroke 2020; 15:858-865. [DOI: 10.1177/1747493020904913] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background and aim Controversy exists regarding cardiovascular risk in relation to sleep duration. We determined sleep duration and major recurrent cardiovascular event associations in patients with obstructive sleep apnoea and established cardiovascular disease. Methods Secondary analyses of the international, multicenter, Sleep Apnea Cardiovascular Endpoints trial. Sleep duration was estimated from overnight home oximetry (ApneaLink monitor) used for obstructive sleep apnoea diagnosis. Cox proportional hazards models were used to determine associations of categorized sleep duration (<6 h, 6–8 h (reference), and >8 h) and major cardiovascular outcomes: primary composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and any hospitalization for unstable angina, heart failure, or transient ischemic attack; secondary composite of cardiac and cerebral (stroke/transient ischemic attack) events. Results Oximetry-derived sleep duration estimates were available in 2687 participants (mean 61.2 years, 80.9% males) who experienced a total of 436 cardiovascular events over a mean follow-up of 3.7 years. Compared to the reference category, sleep duration was not associated with risk of the primary composite cardiovascular outcome (adjusted hazard ratio (HR) 1.00, 95% confidence interval 0.76–1.33, and HR 1.22, 95% confidence interval 0.98–1.52, for sleep duration <6 and >8 h, respectively). However, long sleep was associated with increased cerebral events (HR 1.67, 95% confidence interval 1.17–2.39; P = 0.005) and stroke alone (HR 1.79, 95% confidence interval 1.22–2.63; P = 0.003). Conclusions Long sleep duration is associated with an increased risk of stroke but not cardiac events in obstructive sleep apnoea patients with existing cardiovascular disease. Clinical trial registration The trial is registered at ClinicalTrials.gov (NCT00738179).
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Affiliation(s)
- Jingwei Li
- Department of Cardiology, People’s Liberation Army General Hospital, Beijing, China
- Department of Cardiology, Xinqiao Hospital, Third Military Medical University, Chongqing, China
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Danni Zheng
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Kelly A Loffler
- The Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Xia Wang
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - R Doug McEvoy
- The Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Richard J Woodman
- Centre for Biostatistics and Epidemiology, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Yuanming Luo
- The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, Guangzhou, China
| | | | - Ferran Barbe
- Respiratory Department, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Institutde Recerca Biomèdica de Lleida, Madrid, Spain
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Craig S Anderson
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute China, Peking University Health Science Center, Beijing, China
- Neurology Department, Royal Prince Alfred Hospital, Sydney Health Partners, Sydney, Australia
- Heart Health Research Center, Beijing, China
- Center for Clinical Studies, School of Medicine-Clínica Alemana, Instituto de Ciencias e Innovación en Medicina, Universidad del Desarrollo, Santiago, Chile
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Zhou L, Yu K, Yang L, Wang H, Xiao Y, Qiu G, Liu X, Yuan Y, Bai Y, Li X, Yang H, He M, Wang C, Wu T, Zhang X. Sleep duration, midday napping, and sleep quality and incident stroke. Neurology 2019; 94:e345-e356. [DOI: 10.1212/wnl.0000000000008739] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 07/19/2019] [Indexed: 12/28/2022] Open
Abstract
ObjectiveTo investigate the associations of sleep duration, midday napping, sleep quality, and change in sleep duration with risk of incident stroke and stroke subtypes.MethodsAmong 31,750 participants aged 61.7 years on average at baseline from the Dongfeng-Tongji cohort, we used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident stroke.ResultsCompared with sleeping 7 to <8 hours/night, those reporting longer sleep duration (≥9 hours/night) had a greater risk of total stroke (hazard ratio [HR] 1.23; 95% confidence interval [CI] 1.07–1.41), while shorter sleep (<6 hours/night) had no significant effect on stroke risk. The HR (95% CI) of total stroke was 1.25 (1.03–1.53) for midday napping >90 minutes vs 1–30 minutes. The results were similar for ischemic stroke. Compared with good sleep quality, those with poor sleep quality showed a 29%, 28%, and 56% higher risk of total, ischemic, and hemorrhagic stroke, respectively. Moreover, we observed significant joint effects of sleeping ≥9 hours/night and midday napping >90 minutes (HR 1.85; 95% CI 1.28–2.66), and sleeping ≥9 hours/night and poor sleep quality (HR 1.82; 95% CI 1.33–2.48) on risk of total stroke. Furthermore, compared with persistently sleeping 7–9 hours/night, those who persistently slept ≥9 hours/night or switched from 7 to 9 hours to ≥9 hours/night had a higher risk of total stroke.ConclusionsLong sleep duration, long midday napping, and poor sleep quality were independently and jointly associated with higher risks of incident stroke. Persistently long sleep duration or switch from average to long sleep duration increased the risk of stroke.
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Qian YX, Liu JH, Ma QH, Sun HP, Xu Y, Pan CW. Associations of sleep durations and sleep-related parameters with metabolic syndrome among older Chinese adults. Endocrine 2019; 66:240-248. [PMID: 31473919 DOI: 10.1007/s12020-019-02064-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 08/20/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE There is a lack of data on the role of sleep in the development of metabolic syndrome (MetS) in older adults. We aimed to examine the associations of sleep durations at night and other sleep-related parameters with the presence of MetS in older Chinese adults. METHODS Data of 4579 individuals aged 60 years or older from the Weitang Geriatric Disease Study were analyzed. MetS was diagnosed based on the Adult Treatment Panel III (ATP III) criteria. Information regarding sleep durations and other sleep-related parameters was collected by questionnaires. RESULTS Compared with those with daytime napping, individuals without daytime napping were at an increased risk of MetS (odds ratio [OR] = 1.23; 95% confidence interval [CI] = 1.03-1.47). Each hour increase in daytime napping increased the risk of MetS by 33% (OR = 1.33; 95% CI = 1.15-1.52). After adjusting for the effect of age and gender, a J-shaped association between sleep durations at night and the presence of MetS was observed. The risk of MetS was lowest among those who slept 7-8 h at night. Gender-stratified analysis indicated that the J-shaped relationship between sleep durations at night and MetS remained significant in men but not in women. CONCLUSIONS In older Chinese adults, sleep durations at night might have a dual effect on the risk of MetS and this effect was particularly pronounced in men. The results indicated that circadian rhythm might play an important role in the development of MetS in older populations.
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Affiliation(s)
- Yu-Xi Qian
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jing-Hong Liu
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Qing-Hua Ma
- The 3rd People's Hospital of Xiangcheng District, Suzhou, China
| | - Hong-Peng Sun
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yong Xu
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou, China.
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Bridging the Reciprocal Gap between Sleep and Fruit and Vegetable Consumption: A Review of the Evidence, Potential Mechanisms, Implications, and Directions for Future Work. Nutrients 2019; 11:nu11061382. [PMID: 31248175 PMCID: PMC6627504 DOI: 10.3390/nu11061382] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/12/2019] [Accepted: 06/14/2019] [Indexed: 02/06/2023] Open
Abstract
A substantial burden of disease and mortality globally is attributable to both sleep disruption and low intakes of fruit and vegetable (FV) and there is increasing mechanistic and epidemiological evidence to support a reciprocal relationship between the two. This review provides an overview of experimental and observational studies assessing the relations between sleep and FV consumption from 52 human adult studies. Experimental studies are currently limited and show inconsistent results. Observational studies support a non-linear association with adults sleeping the recommended 7–9 hours/day having the highest intakes of FV. The potential mechanisms linking sleep and FV consumption are highlighted. Disrupted sleep influences FV consumption through homeostatic and non-homeostatic mechanisms. Conversely, FV consumption may influence sleep through polyphenol content via several potential pathways. Few human experimental studies have examined the effects of FV items and their polyphenols on sleep and there is a need for more studies to address this. An appreciation of the relationship between sleep and FV consumption may help optimize sleep and FV consumption and may reduce the burden of chronic diseases. This review provides implications for public health and directions for future work.
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Onvani S, Mortazavi Najafabadi M, Haghighatdoost F, Larijani B, Azadbakht L. Short sleep duration is related to kidney-related biomarkers, but not lipid profile and diet quality in diabetic nephropathy patients. INT J VITAM NUTR RES 2019; 88:39-49. [PMID: 31038033 DOI: 10.1024/0300-9831/a000392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Objectives: Diabetic nephropathy may adversely influence on sleep duration. The quality of diet may also be affected by both sleep duration and diabetes nephropathy. Therefore, lower diet quality in short sleepers-diabetic nephropathy patients might be related to higher metabolic abnormalities. In the present study, we investigated if sleep duration is related to diet quality indices and biochemical markers in diabetic nephropathy patients. Method: This cross-sectional study was conducted among 237 diabetic nephropathy patients, randomly selected from patients attending in the Alzahra University Hospital, Isfahan, Iran. Usual dietary intake was assessed using validated food frequency questionnaire. Diet quality indices (including diet diversity score, dietary energy density, mean adequacy ratio, and nutrient adequacy ratio) were calculated based on standard definitions. Sleep duration was estimated using self-reported nocturnal hours of sleep. Results: Short sleepers (5-6 h) had higher blood urea nitrogen and creatinine compared with those who slept more than 7.5 h (20.26 + 0.23 mg/dl vs. 17.61 + 0.30 mg/dl, P < 0.0001, and 1.98 + 0.27 mg/dl vs. 1.90 + 0.24 mg/dl, P = 0.03, respectively). Serum triglyceride levels were positively correlated with sleep duration (P = 0.02). Diet quality indices were not significantly associated with sleep duration. Conclusion: Higher sleep duration is significantly related to lower kidney-related biomarkers in diabetic nephropathy patients. Diet quality indices were not associated with sleep duration in diabetic nephropathy patients. More longitudinal studies are required to evaluate the associations of sleep duration, diet quality and biochemical markers in diabetic nephropathy patients.
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Affiliation(s)
- Shokouh Onvani
- 1 Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,2 Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Fahimeh Haghighatdoost
- 1 Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,2 Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bagher Larijani
- 4 Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Azadbakht
- 1 Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,2 Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.,5 Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medicl Sciences, Tehran, Iran.,6 Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Ren Y, Liu Y, Meng T, Liu W, Qiao Y, Gu Y, Li Y, Liu Y, Yu Y, Cheng Y. Social-biological influences on sleep duration among adult residents of Northeastern China. Health Qual Life Outcomes 2019; 17:47. [PMID: 30876410 PMCID: PMC6419849 DOI: 10.1186/s12955-019-1111-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 02/25/2019] [Indexed: 11/10/2022] Open
Abstract
Background Cold climates traditionally have conferred long sleep duration in the residents in northeast China; however, modern lifestyle reduces sleep duration. In this study, we investigated social-biological factors influencing sleep duration in the adult residents in northeast China. Methods This study was performed using data from the Investigation of Chronic Disease Morbidity Rate and Risk Factors of Adults in Jilin Province, China. Associations between sleep duration and indices of demographic characteristics, health-related behaviors, and disease history in adult residents were analyzed using univariate analysis and multivariate logistic regression analysis. Results The mean sleep duration was 7.24 h. Of the 21,435 participants, approximately 53.4% had short sleep duration (sleep duration per day < 7 h), and 10.5% had long sleep duration (sleep duration per day > 9 h). There were associations between short sleep duration and indices, including age, place of residence, marital status, educational level, alcohol drinking, dietary, obesity, and history of coronary heart disease (CHD) or myocardial infarction (MI). There existed associations of long sleep duration with indices, such as age, place of residence, occupation, educational level, average monthly earnings, and physical exercise. Conclusion Short sleep duration is common among residents in northeast China. Age, place of residence, and educational level are implicated in both short sleep duration and long sleep duration. Short sleep duration inclines to link with the indices (marital status, alcohol drinking, dietary, obesity, and history of CHD or MI). However, long sleep duration is relevant to the indices (occupation, average monthly earnings, and physical exercise).
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Affiliation(s)
- Yaxuan Ren
- Department of Epidemiology and Biostatistics, School of Public Health of Jilin University, Changchun, 130021, China
| | - Yawen Liu
- Department of Epidemiology and Biostatistics, School of Public Health of Jilin University, Changchun, 130021, China
| | - Tingyu Meng
- Department of Epidemiology and Biostatistics, School of Public Health of Jilin University, Changchun, 130021, China
| | - Wenshu Liu
- Department of Epidemiology and Biostatistics, School of Public Health of Jilin University, Changchun, 130021, China
| | - Yichun Qiao
- Department of Epidemiology and Biostatistics, School of Public Health of Jilin University, Changchun, 130021, China
| | - Yulu Gu
- Department of Epidemiology and Biostatistics, School of Public Health of Jilin University, Changchun, 130021, China
| | - Yong Li
- Department of Epidemiology and Biostatistics, School of Public Health of Jilin University, Changchun, 130021, China
| | - Yunkai Liu
- Cardiovascular Center, The First Hospital of Jilin University, Changchun, 130021, China
| | - Yaqin Yu
- Department of Epidemiology and Biostatistics, School of Public Health of Jilin University, Changchun, 130021, China
| | - Yi Cheng
- Cardiovascular Center, The First Hospital of Jilin University, Changchun, 130021, China.
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Longitudinal study of the relationship between sleep duration and hypertension in Chinese adult residents (CHNS 2004-2011). Sleep Med 2019; 58:88-92. [PMID: 31132577 DOI: 10.1016/j.sleep.2019.01.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 01/03/2019] [Accepted: 01/07/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine the associations between sleep duration and hypertension in Chinese adults. METHODS This longitudinal study analyzed 9851 adults who had participated in at least two rounds of the CHNS (China Health and Nutrition Survey) during 2004-2011. Sleep duration was classified into ≤7, 8, and ≥9 h. Age, sex, residence location, education level, smoking, drinking alcohol, drinking tea, drinking coffee, activity level, and body mass index were adjusted as confounders in a generalized linear mixed model. RESULTS The unadjusted analysis showed that compared with a normal sleep duration (8 h), the odds ratios (ORs) for those with short (≤7 h) and long (≥9 h) sleep durations were 1.24 and 1.17, respectively (95% confidence intervals [CIs] = 1.14-1.36 and 1.06-1.29). After adjusting for confounding factors, the effect of a short sleep duration on hypertension was still statistically significant, with an OR of 1.13 (95% CI = 1.04-1.24), while a long sleep duration no longer had a statistically significant effect. CONCLUSIONS A short sleep duration is an independent risk factor for adult hypertension, whereas a long sleep duration is not in Chinese adults. The prevalence of hypertension should be prevented and controlled by improving the sleep status of adults.
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Bos MM, Noordam R, van den Berg R, de Mutsert R, Rosendaal FR, Blauw GJ, Rensen PCN, Biermasz NR, van Heemst D. Associations of sleep duration and quality with serum and hepatic lipids: The Netherlands Epidemiology of Obesity Study. J Sleep Res 2018; 28:e12776. [PMID: 30324729 PMCID: PMC7379241 DOI: 10.1111/jsr.12776] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 08/09/2018] [Accepted: 08/29/2018] [Indexed: 11/26/2022]
Abstract
Short and long sleep duration and poor sleep quality may affect serum and hepatic lipid content, but available evidence is inconsistent. Therefore, we aimed to investigate the associations of sleep duration and quality with serum and hepatic lipid content in a large population‐based cohort of middle‐aged individuals. The present cross‐sectional study was embedded in the Netherlands Epidemiology of Obesity (NEO) study and consisted of 4260 participants (mean age, 55 years; proportion men, 46%) not using lipid‐lowering agents. Self‐reported sleep duration and quality were assessed using the Pittsburgh Sleep Quality Index questionnaire (PSQI). Outcomes of this study were fasting lipid profile (total cholesterol, low‐density lipoprotein [LDL]‐cholesterol, high‐density lipoprotein [HDL]‐cholesterol and triglycerides), postprandial triglyceride (response) levels, and hepatic triglyceride content (HTGC) as measured with magnetic resonance spectroscopy. We performed multivariable linear regression analyses, adjusted for confounders and additionally for measures that link to adiposity (e.g. body mass index [BMI] and sleep apnea). We observed that relative to the group with median sleep duration (≈7.0 hr of sleep), the group with shortest sleep (≈5.0 hr of sleep) had 1.5‐fold higher HTGC (95% confidence interval [CI]: 1.0‐2.2). The group with PSQI score ≥ 10 had a 1.1‐fold (95% CI: 1.0‐1.2) higher serum triglyceride level compared with the group with PSQI ≤ 5. However, these associations disappeared after adjustment for BMI and sleep apnea. Therefore, we concluded that previously observed associations of shorter sleep duration and poorer sleep quality with an adverse lipid profile, may be explained by BMI and sleep apnea, rather than by a direct effect of sleep on the lipid profile.
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Affiliation(s)
- Maxime M Bos
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Raymond Noordam
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Rosa van den Berg
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Frits R Rosendaal
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Gerard Jan Blauw
- Section of Gerontology and Geriatrics, Department of Internal 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
| | - Nienke R Biermasz
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Diana van Heemst
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
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Makarem N, Aggarwal B. Gender Differences in Associations between Insufficient Sleep and Cardiovascular Disease Risk Factors and Endpoints: A Contemporary Review. GENDER AND THE GENOME 2018. [DOI: 10.1089/gg.2017.0001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Nour Makarem
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York
| | - Brooke Aggarwal
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York
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Ding C, Lim LL, Xu L, Kong APS. Sleep and Obesity. J Obes Metab Syndr 2018; 27:4-24. [PMID: 31089536 PMCID: PMC6489488 DOI: 10.7570/jomes.2018.27.1.4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 03/08/2018] [Accepted: 03/09/2018] [Indexed: 12/30/2022] Open
Abstract
Rising global prevalence and incidence of obesity lead to increased cardiovascular-renal complications and cancers. Epidemiological studies reported a worldwide trend towards suboptimal sleep duration and poor sleep quality in parallel with this obesity epidemic. From rodents and human models, it is highly plausible that abnormalities in sleep, both quantity and quality, impact negatively on energy metabolism. While excess dietary intake and physical inactivity are the known drivers of the obesity epidemic, promotion of healthy sleep habits has emerged as a new target to combat obesity. In this light, present review focuses on the existing literature examining the relationship between sleep physiology and energy homeostasis. Notably, sleep dysregulation perturbs the metabolic milieu via alterations in hormones such as leptin and ghrelin, eating behavior, neuroendocrine and autonomic nervous systems. In addition, shift work and trans-meridian air travel may exert a negative influence on the hypothalamic-pituitary-adrenal axis and trigger circadian misalignment, leading to impaired glucose tolerance and increased fat accumulation. Amassing evidence has also suggested that uncoupling of the circadian clock can increase the risk of adverse metabolic health. Given the importance of sleep in maintaining energy homeostasis and that it is potentially modifiable, promoting good sleep hygiene may create new avenues for obesity prevention and treatment.
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Affiliation(s)
- Chenzhao Ding
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Lee Ling Lim
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.,Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Li Xu
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Alice Pik Shan Kong
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
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Deng HB, Tam T, Zee BCY, Chung RYN, Su X, Jin L, Chan TC, Chang LY, Yeoh EK, Lao XQ. Short Sleep Duration Increases Metabolic Impact in Healthy Adults: A Population-Based Cohort Study. Sleep 2018; 40:4004745. [PMID: 28977563 DOI: 10.1093/sleep/zsx130] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Objectives The metabolic impact of inadequate sleep has not been determined in healthy individuals outside laboratories. This study aims to investigate the impact of sleep duration on five metabolic syndrome components in a healthy adult cohort. Methods A total of 162121 adults aged 20-80 years (men 47.4%) of the MJ Health Database, who were not obese and free from major diseases, were recruited and followed up from 1996 to 2014. Sleep duration and insomnia symptoms were assessed by a self-administered questionnaire. Incident cases of five metabolic syndrome components were identified by follow-up medical examinations. Cox proportional hazard ratios (HRs) were calculated for three sleep duration categories "< 6 hours/day (short)," "6-8 hours/day (regular)," and "> 8 hours/day (long)" with adjustment for potential confounding factors. Analyses were stratified by insomnia symptoms to assess whether insomnia symptoms modified the association between sleep duration and metabolic syndrome. Results Compared to regular sleep duration, short sleep significantly (p < .001) increased the risk for central obesity by 12% (adjusted HR 1.12 [1.07-1.17]), for elevated fasting glucose by 6% (adjusted HR 1.06 [1.03-1.09]), for high blood pressure by 8% (adjusted HR 1.08 [1.04-1.13]), for low high-density lipoprotein-cholesterol by 7% (adjusted HR 1.07 [1.03-1.11]), for hypertriglyceridemia by 9% (adjusted HR 1.09 [1.05-1.13]), and for metabolic syndrome by 9% (adjusted HR 1.09 [1.05-1.13]). Long sleep decreased the risk of hypertriglyceridemia (adjusted HR 0.89 [0.84-0.94]) and metabolic syndrome (adjusted HR 0.93 [0.88-0.99]). Insomnia symptoms did not modify the effects of sleep duration. Conclusions Sleep duration may be a significant determinant of metabolic health.
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Affiliation(s)
- Han-Bing Deng
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Tony Tam
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Benny Chung-Ying Zee
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Roger Yat-Nork Chung
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xuefen Su
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Lei Jin
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taiwan
| | - Ly-Yun Chang
- Institute of Sociology, Academia Sinica, Taiwan.,MJ Health Research Foundation, MJ Group, Taiwan
| | - Eng-Kiong Yeoh
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Koo DL, Nam H, Thomas RJ, Yun CH. Sleep Disturbances as a Risk Factor for Stroke. J Stroke 2018; 20:12-32. [PMID: 29402071 PMCID: PMC5836576 DOI: 10.5853/jos.2017.02887] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 01/07/2018] [Accepted: 01/15/2018] [Indexed: 12/30/2022] Open
Abstract
Sleep, a vital process of human being, is carefully orchestrated by the brain and consists of cyclic transitions between rapid eye movement (REM) and non-REM (NREM) sleep. Autonomic tranquility during NREM sleep is characterized by vagal dominance and stable breathing, providing an opportunity for the cardiovascular-neural axis to restore homeostasis, in response to use, distress or fatigue inflicted during wakefulness. Abrupt irregular swings in sympathovagal balance during REM sleep act as phasic loads on the resting cardiovascular system. Any causes of sleep curtailment or fragmentation such as sleep restriction, sleep apnea, insomnia, periodic limb movements during sleep, and shift work, not only impair cardiovascular restoration but also impose a stress on the cardiovascular system. Sleep disturbances have been reported to play a role in the development of stroke and other cardiovascular disorders. This review aims to provide updated information on the role of abnormal sleep in the development of stroke, to discuss the implications of recent research findings, and to help both stroke clinicians and researchers understand the importance of identification and management of sleep pathology for stroke prevention and care.
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Affiliation(s)
- Dae Lim Koo
- Department of Neurology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Hyunwoo Nam
- Department of Neurology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Robert J Thomas
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Chang-Ho Yun
- Department of Neurology, Bundang Clinical Neuroscience Institute, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Ahmed AE, Al-Jahdali F, AlALwan A, Abuabat F, Bin Salih SA, Al-Harbi A, Baharoon S, Khan M, Ali YZ, Al-Jahdali H. Prevalence of sleep duration among Saudi adults. Saudi Med J 2017; 38:276-283. [PMID: 28251223 PMCID: PMC5387904 DOI: 10.15537/smj.2017.3.17101] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: To examine the associations between sleep duration and a variety of demographic and clinical variables in a sample of Saudi adults. Methods: A cross-sectional study among 2,095 participants was conducted at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, between May and October 2014. A questionnaire was administered to collect data related to clinical health outcomes and demographic characteristics. Participants were asked to report their average sleep duration per night in hours. Results: One-third (33.8%) reported short sleep duration of less than 7 hours/night. Short sleep duration was more prevalent in females (37.3% versus 31.4%, p=0.004). The most common medical problems reported were obesity with body mass index of >30 Kg/m2 (39.1%), hypertension (33.9%), diabetes mellitus (20.8%), depression (4.3%), asthma (17.3%), COPD (6.6%), and hyperlipidemia (2.7%). Diabetes mellitus was associated with long sleep of more than 9 hours/night (25.4%, p=0.011) and hypertension (54.2%, p=0.001). The linear regression model tend to reduce their sleep duration by roughly 22 minutes in female gender, 66 minutes in participants with hyperlipidemia, and 70 minutes in participants with poor sleep quality. Conclusions: Short sleep duration per night was prevalent, it affects one in every 3 Saudi adults. Long sleep duration of more than 9 hours was associated with increased comorbid conditions.
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Affiliation(s)
- Anwar E Ahmed
- College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Phua CS, Jayaram L, Wijeratne T. Relationship between Sleep Duration and Risk Factors for Stroke. Front Neurol 2017; 8:392. [PMID: 28848490 PMCID: PMC5550667 DOI: 10.3389/fneur.2017.00392] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 07/24/2017] [Indexed: 12/20/2022] Open
Abstract
Stroke is a leading cause of death and disability worldwide. While various risk factors have been identified, sleep has only been considered a risk factor more recently. Various epidemiologic studies have associated stroke with sleep such as sleep duration, and laboratory and clinical studies have proposed various underlying mechanisms. The pathophysiology is multifactorial, especially considering sleep affects many common risk factors for stroke. This review aims to provide an outline of the effect of sleep duration on common stroke risk factors. Appropriate sleep duration, especially in patients who have stroke risk factors, and increasing awareness and screening for sleep quality may contribute to primary prevention of stroke.
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Affiliation(s)
- Chun Seng Phua
- Department of Medicine, Melbourne Clinical School, University of Melbourne, Melbourne, VIC, Australia.,Department of Neurology, Western Health, St. Albans, VIC, Australia
| | - Lata Jayaram
- Department of Medicine, Melbourne Clinical School, University of Melbourne, Melbourne, VIC, Australia.,Department of Respiratory and Sleep Medicine, Western Health, St. Albans, VIC, Australia
| | - Tissa Wijeratne
- Department of Medicine, Melbourne Clinical School, University of Melbourne, Melbourne, VIC, Australia.,Department of Neurology, Western Health, St. Albans, VIC, Australia.,Department of Medicine, University of Rajarata, Saliyapura, Anuradhapura, Sri Lanka.,Department of Psychology and Counselling, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia
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Chen GC, Liu MM, Chen LH, Xu JY, Hidayat K, Li FR, Qin LQ. Daytime napping and risk of type 2 diabetes: a meta-analysis of prospective studies. Sleep Breath 2017; 22:815-824. [DOI: 10.1007/s11325-017-1528-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/31/2017] [Accepted: 06/05/2017] [Indexed: 01/19/2023]
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LEMKE MK, APOSTOLOPOULOS Y, HEGE A, WIDEMAN L, SÖNMEZ S. Work, sleep, and cholesterol levels of U.S. long-haul truck drivers. INDUSTRIAL HEALTH 2017; 55:149-161. [PMID: 28049935 PMCID: PMC5383412 DOI: 10.2486/indhealth.2016-0127] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 12/26/2016] [Indexed: 06/06/2023]
Abstract
Long-haul truck drivers in the United States experience elevated cardiovascular health risks, possibly due to hypercholesterolemia. The current study has two objectives: 1) to generate a cholesterol profile for U.S. long-haul truck drivers; and 2) to determine the influence of work organization characteristics and sleep quality and duration on cholesterol levels of long-haul truck drivers. Survey and biometric data were collected from 262 long-haul truck drivers. Descriptive analyses were performed for demographic, work organization, sleep, and cholesterol measures. Linear regression and ordinal logistic regression analyses were conducted to examine for possible predictive relationships between demographic, work organization, and sleep variables, and cholesterol outcomes. The majority (66.4%) of drivers had a low HDL (<40 mg/dL), and nearly 42% of drivers had a high-risk total cholesterol to HDL cholesterol ratio. Sleep quality was associated with HDL, LDL, and total cholesterol, and daily work hours were associated with LDL cholesterol. Workday sleep duration was associated with non-HDL cholesterol, and driving experience and sleep quality were associated with cholesterol ratio. Long-haul truck drivers have a high risk cholesterol profile, and sleep quality and work organization factors may induce these cholesterol outcomes. Targeted worksite health promotion programs are needed to curb these atherosclerotic risks.
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Affiliation(s)
- Michael K. LEMKE
- Texas A&M University Complexity & Computational Population Health Group, USA
- Texas A&M University, Department of Health & Kinesiology, USA
| | - Yorghos APOSTOLOPOULOS
- Texas A&M University Complexity & Computational Population Health Group, USA
- Texas A&M University, Department of Health & Kinesiology, USA
| | - Adam HEGE
- Appalachian State University, Department of Health & Exercise Science, USA
| | - Laurie WIDEMAN
- University of North Carolina Greensboro, Department of Kinesiology, USA
| | - Sevil SÖNMEZ
- University of Central Florida, Rosen College of Hospitality Management, USA
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Hu X, Jiang J, Wang H, Zhang L, Dong B, Yang M. Association between sleep duration and sarcopenia among community-dwelling older adults: A cross-sectional study. Medicine (Baltimore) 2017; 96:e6268. [PMID: 28272238 PMCID: PMC5348186 DOI: 10.1097/md.0000000000006268] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Both sleep disorders and sarcopenia are common among older adults. However, little is known about the relationship between these 2 conditions.This study aimed to investigate the possible association between sleep duration and sarcopenia in a population of Chinese community-dwelling older adults.Community-dwelling older adults aged 60 years or older were recruited. Self-reported sleep duration, anthropometric data, gait speed, and handgrip strength were collected by face-to-face interviews. Sarcopenia was defined according to the recommended algorithm of the Asian Working Group for Sarcopenia (AWGS).We included 607 participants aged 70.6 ± 6.6 years (range, 60-90 years) in the analyses. The prevalence of sarcopenia in the whole study population was 18.5%. In women, the prevalence of sarcopenia was significantly higher in the short sleep duration group (< 6 hours) and long sleep duration group (>8 hours) compared with women in the normal sleep duration group (6-8 hours; 27.5%, 22.2% and 13.9%, respectively; P = .014). Similar results were found in men; however, the differences between groups were not statistically significant (18.5%, 20.6%, and 13.0%, respectively; P = .356). After adjustments for the potential confounding factors, older women having short sleep duration (OR: 4.34; 95% CI: 1.74-10.85) or having long sleep duration (OR: 2.50; 95% CI: 1.05-6.99) had greater risk of sarcopenia compared with women having normal sleep duration. With comparison to men with normal sleep duration, the adjusted OR for sarcopenia was 2.12 (0.96-8.39) in the short sleep duration group and 2.25 (0.88-6.87) in the long sleep duration group, respectively.A U-shape relationship between self-reported sleep duration and sarcopenia was identified in a population of Chinese community-dwelling older adults, especially in women.
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Affiliation(s)
- Xiaoyi Hu
- The Center of Gerontology and Geriatrics
| | | | - Haozhong Wang
- The Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lei Zhang
- The Center of Gerontology and Geriatrics
| | | | - Ming Yang
- The Center of Gerontology and Geriatrics
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He Q, Sun H, Wu X, Zhang P, Dai H, Ai C, Shi J. Sleep duration and risk of stroke: a dose-response meta-analysis of prospective cohort studies. Sleep Med 2016; 32:66-74. [PMID: 28366344 DOI: 10.1016/j.sleep.2016.12.012] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 11/17/2016] [Accepted: 12/05/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Suboptimal sleep duration has been considered to increase the risk of stroke incidence. Thus we aimed to conduct a dose-response meta-analysis to examine the association between sleep duration and stroke incidence. METHODS We searched PubMed, Web of science and the Cochrane Library to identify all prospective studies evaluating the association of sleep duration and nonfatal and/or fatal stroke incidence. Then, restricted cubic spline functions and piecewise linear functions were used to evaluate the nonlinear and linear dose-response association between them. RESULTS We included a total of 16 prospective studies enrolling 528,653 participants with 12,193 stroke events. Nonlinear dose-response meta-analysis showed a J-shaped association between sleep duration and total stroke with the lowest risk observed with sleeping for 7 h. Considering people sleeping for 7 h as reference, long sleepers had a higher predicted risk of total stroke than short sleepers [the pooled risk ratios (95% confidence intervals): 4 h: 1.17 (0.99-1.38); 5 h: 1.17 (1.00-1.37); 6 h: 1.10 (1.00-1.21); 8 h: 1.17 (1.07-1.28); 9 h: 1.45 (1.23-1.70); 10 h: 1.64 (1.4-1.92); pnonlinearity<0.001]. Short sleep durations were only significantly associated with nonfatal stroke and with total stroke in the subgroups of structured interview and non-Asian countries. Additionally, we found a slightly decreased risk of ischemic stroke among short sleepers. For piecewise linear trends, compared to 7 h, every 1-h increment of sleep duration led to an increase of 13% [the pooled risk ratios (95% confidence intervals): 1.13 (1.07-1.20); p < 0.001] in risk of total stroke. CONCLUSION Both in nonlinear and piecewise linear dose-response meta-analyses, long sleep duration significantly increased the risk of stroke incidence.
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Affiliation(s)
- Qiao He
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China
| | - Hao Sun
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China
| | - Xiaomei Wu
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China
| | - Peng Zhang
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China
| | - Huixu Dai
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China
| | - Cong Ai
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China
| | - Jingpu Shi
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China.
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Li W, Wang D, Cao S, Yin X, Gong Y, Gan Y, Zhou Y, Lu Z. Sleep duration and risk of stroke events and stroke mortality: A systematic review and meta-analysis of prospective cohort studies. Int J Cardiol 2016; 223:870-876. [DOI: 10.1016/j.ijcard.2016.08.302] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 08/19/2016] [Indexed: 11/27/2022]
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Dinner fat intake and sleep duration and self-reported sleep parameters over five years: Findings from the Jiangsu Nutrition Study of Chinese adults. Nutrition 2016; 32:970-4. [DOI: 10.1016/j.nut.2016.02.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 02/14/2016] [Accepted: 02/15/2016] [Indexed: 10/22/2022]
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Associations between sleep duration and abnormal serum lipid levels: data from the Korean National Health and Nutrition Examination Survey (KNHANES). Sleep Med 2016; 24:119-123. [DOI: 10.1016/j.sleep.2016.05.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 03/18/2016] [Accepted: 05/15/2016] [Indexed: 10/21/2022]
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Chen Q, Yang H, Zhou N, Sun L, Bao H, Tan L, Chen H, Ling X, Zhang G, Huang L, Li L, Ma M, Yang H, Wang X, Zou P, Peng K, Liu T, Cui Z, Ao L, Roenneberg T, Zhou Z, Cao J. Inverse U-shaped Association between Sleep Duration and Semen Quality: Longitudinal Observational Study (MARHCS) in Chongqing, China. Sleep 2016; 39:79-86. [PMID: 26350472 DOI: 10.5665/sleep.5322] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 07/18/2015] [Indexed: 01/02/2023] Open
Abstract
STUDY OBJECTIVES To investigate the association between sleep duration and semen parameters as well as reproductive hormone levels. METHODS We designed a cohort of male college students in Chongqing, China. A total of 796 subjects were recruited in 2013 and 656 (82.4%) were followed up in 2014. Each time, semen and peripheral blood samples were collected for semen quality and reproductive hormone measurement. Sleep duration was estimated by revised Munich Chronotype Questionnaire. In 2014, sleep quality was also measured by Pittsburgh Sleep Quality Index (PSQI). RESULTS There was a substantial inverse U-shaped association between sleep duration and two semen parameters (semen volume and total sperm number), with 7.0-7.5 h/day of sleep showing highest parameters. Either longer or shorter sleep was associated with decreased semen parameters in a dose-response manner (P = 0.002 and 0.001, respectively). Sleeping > 9.0 h was associated with a 21.5% (95% confidence interval 9.2, 32.2) reduction in semen volume and 39.4% (23.3, 52.1) reduction in total sperm number; sleeping ≤ 6.5 h was associated with 4.6% (-10.5, 22.3) and 25.7% (-1.2, 60.1) reduction. Increase of the two parameters was found in those who changed sleep duration toward 7.0-7.5 h/day from 2013 to 2014. The U-shaped association was independent from PSQI and was replicated in another dataset of 1,346 males. No association found between sleep duration and reproductive hormone. CONCLUSIONS Either restricted or excessive sleep may impair semen quality. Further research is needed to validate this finding.
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Affiliation(s)
- Qing Chen
- Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Huan Yang
- Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Niya Zhou
- Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Lei Sun
- Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Huaqiong Bao
- Chongqing Institute of Science and Technology for Population and Family Planning, Chongqing, China
| | - Lu Tan
- Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Hongqiang Chen
- Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Xi Ling
- Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Guowei Zhang
- Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Linping Huang
- Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Lianbing Li
- Chongqing Institute of Science and Technology for Population and Family Planning, Chongqing, China
| | - Mingfu Ma
- Chongqing Institute of Science and Technology for Population and Family Planning, Chongqing, China
| | - Hao Yang
- Chongqing Institute of Science and Technology for Population and Family Planning, Chongqing, China
| | - Xiaogang Wang
- Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Peng Zou
- Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Kaige Peng
- Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Taixiu Liu
- Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Zhihong Cui
- Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Lin Ao
- Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Till Roenneberg
- Centre for Chronobiology, Institute for Medical Psychology, University of Munich, Munich, Germany
| | - Ziyuan Zhou
- Department of Environmental Health, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Jia Cao
- Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
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Sleep duration and quality among different occupations--China national study. PLoS One 2015; 10:e0117700. [PMID: 25782005 PMCID: PMC4363513 DOI: 10.1371/journal.pone.0117700] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 12/30/2014] [Indexed: 11/19/2022] Open
Abstract
Objective To examine the associations between occupation, sleep duration and sleep quality. Methods The data for this study was extracted from data collected from the 2008 Chinese Sub-optimal Health Study. Our study sample consisted of 18,316 Chinese subjects aged 18-65. Occupation and other relevant characteristics to sleep were collected. We used the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality and multiple logistic regression models to examine the association of occupation with shortened sleep duration and poor sleep quality. Results Farmers had the longest sleep duration (mean=8.22 hours) while the civil servants had the shortest sleep duration (mean=7.85 hours). Farmers also had the best sleep quality (mean score=3.74) while professional workers had the worst sleep quality (mean score=4.87). Compared to civil servants, the OR of shortened sleep duration and poor sleep quality for blue collar workers is 1.39 (95%CI: 1.11-1.73) and 1.28 (95%-CI: 1.15-1.42), respectively, after adjusting for age, sex, marital status, education, area, smoking, drinking, pain, and health status. Conclusion sleep duration and quality varied among different Chinese occupation populations. The blue collar workers are more likely to have shortened sleep duration and poor sleep quality.
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Zhan Y, Zhang F, Lu L, Wang J, Sun Y, Ding R, Hu D, Yu J. Prevalence of dyslipidemia and its association with insomnia in a community based population in China. BMC Public Health 2014; 14:1050. [PMID: 25297696 PMCID: PMC4197222 DOI: 10.1186/1471-2458-14-1050] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Accepted: 10/03/2014] [Indexed: 12/16/2022] Open
Abstract
Background Studies of the prevalence of dyslipidemia and its association with insomnia are scarce in China. This study investigated the prevalence of dyslipidemia and its association with insomnia in a community based Chinese population. Methods We conducted a cross-sectional survey in Beijing and recruited 10054 participants aged ≥18 years. The association between self-reported insomnia and dyslipidemia was determined by multiple logistic regression models. Age, gender, education, obesity, body mass index, physical activity, current smoking, current drinking, diabetes, and hypertension were adjusted as confounders. Odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were reported as effect measurements. Results The prevalence of dyslipidemia in those with no insomnia, occasional insomnia, and frequent insomnia were 53.3%, 54.3%, and 54.5% in men and 52.0%, 54.8%, and 61.2% in women. Compared with subjects with no insomnia, the multivariate adjusted ORs and 95% CIs for those with occasional insomnia and frequent insomnia were 1.07(0.86 ~ 1.34) and 1.19(0.89 ~ 1.60) for men, and 1.00(0.86 ~ 1.14) and 1.23(1.03 ~ 1.47) for women. Conclusions These observations indicate that frequent insomnia was associated with a higher prevalence of dyslipidemia in women. This association was not significant in men.
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Affiliation(s)
| | | | | | | | | | | | | | - Jinming Yu
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, P, R, China.
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Complaints of sleep disturbances are associated with cardiovascular disease: results from the Gutenberg Health Study. PLoS One 2014; 9:e104324. [PMID: 25093413 PMCID: PMC4122446 DOI: 10.1371/journal.pone.0104324] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 07/08/2014] [Indexed: 11/19/2022] Open
Abstract
Background Despite their high prevalence, sleep disorders often remain unrecognized and untreated because of barriers to assessment and management. The aims of the present study were to examine associations of complaints of sleep disturbances with cardiovascular disease, related risk factors, and inflammation in the community and to determine the contribution of sleep disturbances to self-perceived physical health. Method The sample consists of n = 10.000 participants, aged 35 to 74 years of a population based community sample in Germany. Cross-sectional associations of complaints of sleep disturbances with cardiovascular risk factors and disease, biomarkers of inflammation, depression, anxiety, and physical health status were analyzed. Results 19% of our sample endorsed clinically significant sleep disturbances. In the unadjusted analyses severity of sleep disturbances increased with female sex, low socioeconomic status, living without a partnership, cardiovascular disease, depression, anxiety, poor physical health, increased levels of C-reactive protein and fibrinogen. After multivariate adjustment robust associations with coronary heart disease, myocardial infarction and dyslipidemia remained. Complaints of sleep disturbances were strong and independent contributors to self-perceived poor physical health beyond depression, anxiety and medical disease burden. Conclusions Given the high prevalence of complaints of sleep disturbances and their strong impact on health status, increased efforts should be undertaken for their identification and treatment.
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