Associations between poor sleep quality and different measures of obesity

Association between waist circumference and sleep disorder in the elderly: Based on the NHANES 2005-2018

The existing data do not consistently support the link between elderly adults' waist circumferences and sleep disorders. This study aimed to evaluate whether waist circumference was connected with sleep disorder in the elderly. This cross-sectional study utilized data from the 2005-2018 National Health and Nutrition Examination Survey (NHANES) regarding waist circumference, sleep disorders, and confounding factors. Included in the study were participants older than 60 who completed sleep questionnaires and waist circumference measurements. Using a multivariate logistic regression model and subgroup analyses, the relationship between waist circumference and sleep disorder was evaluated. To explore the non-linear relationship, restricted cubic spline (RCS) with three knots coupled with a logistic regression model to assess the dose-response relationship between waist circumference (continuous variables) and sleep disorder. A total of 2,545 (Weighted 14,682,916.3) elderly participants with complete information were included in the analysis and 312 (Weighted 1,777,137.8) subjects met the definition of sleep disorder. Compared with participants without sleep disorder, those with sleep disorder had a higher waist circumference (100.80 cm vs. 108.96 cm, P< 0.001). The results of the multivariable adjusted logistic regression model suggested that those in quartiles 4 (≥ 75th percentile) for their waist circumference had higher odds of sleep disorder [adjusted odds ratio (AOR) = 2.75, 95% confidence interval (CI) = 1.66-4.54, P < 0.001] compared with those in quartile 1. The RCS result showed that the OR of sleep disorder and waist circumference displayed a linear relationship (P <0.001, Non-linear P = 0.642). Age and gender subgroup analysis revealed comparable relationships between waist circumference and sleep disorder among elderly individuals. Waist circumference was associated with sleep disorders in the elderly. There was a dose-response relationship between waist circumference and the likelihood of sleep disorder. Those with a larger waist circumference were more likely to have a sleep disorder than those with a smaller waist circumference.

Predicting long-term sleep deprivation using wearable sensors and health surveys

Sufficient sleep is essential for individual well-being. Inadequate sleep has been shown to have significant negative impacts on our attention, cognition, and mood. The measurement of sleep from in-bed physiological signals has progressed to where commercial devices already incorporate this functionality. However, the prediction of sleep duration from previous awake activity is less studied. Previous studies have used daily exercise summaries, actigraph data, and pedometer data to predict sleep during individual nights. Building upon these, this article demonstrates how to predict a person's long-term average sleep length over the course of 30 days from Fitbit-recorded physical activity data alongside self-report surveys. Recursive Feature Elimination with Random Forest (RFE-RF) is used to extract the feature sets used by the machine learning models, and sex differences in the feature sets and performances of different machine learning models are then examined. The feature selection process demonstrates that previous sleep patterns and physical exercise are the most relevant kind of features for predicting sleep. Personality and depression metrics were also found to be relevant. When attempting to classify individuals as being long-term sleep-deprived, good performance was achieved across both the male, female, and combined data sets, with the highest-performing model achieving an AUC of 0.9762. The best-performing regression model for predicting the average nightly sleep time achieved an R-squared of 0.6861, with other models achieving similar results. When attempting to predict if a person who previously was obtaining sufficient sleep would become sleep-deprived, the best-performing model obtained an AUC of 0.9448.

The Use of Nonmonetary Outcomes in Health-Related Delay Discounting Research: Review and Recommendations

Delay discounting (DD) refers to the tendency to devalue an outcome as a function of its delay. Most contemporary human DD research uses hypothetical money to assess individual rates of DD. However, nonmonetary outcomes such as food, substances of misuse, and sexual outcomes have been used as well, and have advantages because of their connections to health. This article reviews the literature on the use of nonmonetary outcomes of food, drugs, and sexual outcomes in relation to health and reinforcer pathologies such as substance use disorders, obesity, and sexual risk behaviors, respectively, and makes a case for their use in discounting research. First, food, substances, and sex may be more ecologically valid outcomes than money in terms of their connections to health problems and reinforcer pathologies. Second, consistent trends in commodity-specific (i.e., domain) effects, in which nonmonetary outcomes are discounted more steeply than money, enhance variation in discounting values. Third, commodity-specific changes in discounting with treatments designed to change health choices are described. Finally, methodological trends such as test-retest reliability, magnitude effects, the use of hypothetical versus real outcomes, and age-related effects are discussed in relation to the three outcome types and compared to trends with monetary discounting. Limitations that center around individual preferences, nonsystematic data, and deprivation are discussed. We argue that researchers can enhance their DD research, especially those related to health problems and reinforcer pathologies, with the use of nonmonetary outcomes. Recommendations for future directions of research are delineated.

Gender-specific link between sleep quality and body composition components: a cross-sectional study on the elderly

Sleep duration has been associated with overweight/obesity. Since sleep quality and body composition alter during aging, we conducted this study to determine if sleep quality is linked to body composition components in elderly people. This is a cross-sectional study conducted on 305 Iranian community-dwelling elderly aged ≥ 65 years. Sleep quality and body composition components were evaluated using Pittsburgh sleep quality index and bioelectric impedance analysis, respectively. The association of sleep quality and body composition components was examined using linear regression analysis. The prevalence of poor sleep quality and overweight/obesity was 48.9% and 54.4% in men and 77.0% and 79.3% in women, respectively. Women had significantly higher scores in most PSQI items than men, indicating their worse sleep quality compared to men. Women also had significantly higher body mass index (BMI), body fat percentage, and visceral adipose tissue and lower skeletal muscle and fat-free mass percentages than men. In the adjusted regression model, men showed positive associations between the third tertile of poor sleep quality and BMI (B = 1.35; 95% CI 0.08-2.61) and waist circumference (B = 4.14; 95% CI 0.39-7.89), but they did not demonstrate an association between sleep quality and body composition components. In the adjusted regression model for women, there were positive associations for BMI (B = 1.21; 95% CI 0.34-2.07), waist circumference (B = 2.95; 95% CI 0.99-4.91), body fat percentage (B = 2.75; 95% CI 1.06-4.45), and visceral adipose tissue (B = 7.80; 95% CI 1.73-13.87); also there were negative associations for skeletal muscle (B =  - 1.40; 95% CI - 2.39 - - 0.41) and fat-free mass (B =  - 2.76; 95% CI - 4.46 - -1.07) percentages. Except for waist circumference, other variables differed between men and women (P < 0.001). Weight management, prevention of muscle wasting, and improvement of sleep quality should be considered in a consortium when designing healthcare strategies for the elderly.

Fitness age outperforms body mass index in differentiating aging patterns and health risk profiles of healthy adults aged 51-80 years

Physical fitness has been extensively shown to strongly associate with general health status and major health risks. Here we tested the ability of a novel estimate of fitness age (FitAge) to differentiate aging trajectories.This study aimed at (1) testing the ability of FitAge to differentiate aging patterns among decelerated, normal, and accelerated agers in selected health domains, (2) estimating the risk for developing major health issues depending on the aging trajectory, and (3) comparing FitAge to body mass index (BMI) categorization in differentiating healthy from unhealthy aging patterns.A total of 176 volunteers participated in this cross-sectional study. Participants underwent clinical screening and a comprehensive assessment of body composition, nutritional and health-related status, cognitive functioning, and haematochemical analyses with routine tests, oxidative stress, and inflammation markers. Scores for major health risks were also computed.FitAge outperformed BMI in estimating major health risk scores and was able to differentiate decelerated from normal and accelerated agers for health risk profile and several physiological domains. Body composition, immune system activation, and inflammation markers emerged as those variables flagging the largest differences between decelerated and accelerated aging patterns.The novel estimate of biological aging can accurately differentiate both in women and men decelerated from accelerated agers in almost all the domains scrutinized. Overall, decelerated aging is linked to positively oriented features which associate with reduced risk of developing major health issues.The present findings have potential relevance and practical implications to identify individuals at higher risk of accelerated aging according to their FitAge estimated via simple and cost-effective motor tests.

Effects of non-invasive ventilation on sleep in chronic hypercapnic respiratory failure

Chronic respiratory disease can exacerbate the normal physiological changes in ventilation observed in healthy individuals during sleep, leading to sleep-disordered breathing, nocturnal hypoventilation, sleep disruption and chronic respiratory failure. Therefore, patients with obesity, slowly and rapidly progressive neuromuscular disease and chronic obstructive airways disease report poor sleep quality. Non-invasive ventilation (NIV) is a complex intervention used to treat sleep-disordered breathing and nocturnal hypoventilation with overnight physiological studies demonstrating improvement in sleep-disordered breathing and nocturnal hypoventilation, and clinical trials demonstrating improved outcomes for patients. However, the impact on subjective and objective sleep quality is dependent on the tools used to measure sleep quality and the patient population. As home NIV becomes more commonly used, there is a need to conduct studies focused on sleep quality, and the relationship between sleep quality and health-related quality of life, in all patient groups, in order to allow the clinician to provide clear patient-centred information.

Individual and dual trajectories of insomnia symptoms and body mass index before and after retirement and their associations with changes in subjective cognitive functioning

BACKGROUND

We examined individual and dual trajectories of insomnia symptoms and body mass index (BMI) before and after retirement, and their associations with changes in subjective cognitive functioning after retirement.

METHODS

We used the Helsinki Health Study's (n = 2360, 79% women, aged 40-60 at baseline, Finland) repeated surveys to identify the developmental patterns of insomnia symptoms and BMI (2000-2017) and changes in subjective cognitive functioning (2017-2022). We analysed the data using latent group-based dual trajectory modelling and logistic regression analysis.

RESULTS

Three latent groups were identified for insomnia symptoms (stable low, decreasing and increasing symptoms) and BMI (stable healthy weight, stable overweight and stable obesity). Insomnia symptoms were associated with declining subjective cognitive functioning and largely explained the effects in the dual models.

CONCLUSION

The association between dual trajectories of insomnia symptoms and BMI with subjective cognitive decline is dominated by insomnia symptoms.

Mechanisms of improved body composition among perimenopausal women practicing Meditative Movement: a proposed biobehavioral model

OBJECTIVES

Weight gain and unfavorable body composition are prevalent among midlife/older women throughout menopause. These shifts may negatively impact health, well-being, and longevity. Efforts to attenuate weight and body composition changes are traditionally driven by manipulation of diet and/or exercise; however, sustained results are limited, possibly because the full spectrum of biobehavioral systems is not addressed by diet and exercise alone. We propose a biobehavioral model detailing mechanisms of body composition decline among perimenopausal women and the associated components of Meditative Movement (ie, tai chi, qigong, yoga) that address each of these factors.

METHODS

Based on our previous work and extensive review of the literature, we developed a multifactorial and multidimensional biobehavioral model including factors that most directly relate to body composition among perimenopausal women: 1) psychological (ie, stress and mood, mindfulness and self-compassion, body awareness), 2) behavioral (ie, sleep, physical activity, eating behaviors), and 3) physiological (ie, cortisol, estrogen). Relationships between each factor, Meditative Movement practice components, and predicted effects on body composition were explored in detail.

RESULTS

Our model describes select psychological, behavioral, and physiological factors, and potential mechanistic pathways of Meditative Movement practice driving improved changes in body composition and weight outcomes for perimenopausal women.

CONCLUSIONS

The proposed model details a novel, evidence-supported means to reduce the risk of deleterious shifts in body composition throughout perimenopause and menopause thereafter. We suggest that these changes may occur directly and/or indirectly through psychological, behavioral, and physiological mechanisms that facilitate the desired changes in body composition.

Neighbourhood crime and obesity: Longitudinal evidence from Australia

RATIONALE

Obesity remains a significant public health concern globally with over one billion adults projected to be obese by 2025. To better understand the drivers of obesity and to inform policy, it is important to explore the factors that influence obesity.

OBJECTIVES

The objective of this paper to examine if the crime rates in the neighbourhood or local area in which a person lives influences their likelihood of being obese. Thus, we seek to contribute to the literature on the determinants of obesity by asking the question: what is the effect of neighbourhood (i.e., postcode) crime on obesity? We also examine the pathways through which neighbourhood crime influences obesity with a focus on the role of social capital, physical activity and sleep quality.

METHODS

Using 14 waves of longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA) survey merged with official police statistics on crime rates at the postcode level, we apply identification strategies that address endogeneity arising from endogenous sorting and omitted variable bias.

RESULTS

We find that an increase in neighbourhood crime rates is associated with an increase in body mass index (BMI) and the likelihood of being obese. Exploring the pathways through which neighbourhood crime influences obesity, we find that social capital and physical activity are important channels, while sleep quality is not. The evidence also suggests that the effects of violent crime are more pronounced compared to property crime.

CONCLUSION

Our findings suggest that targeting crime, and in particular violent crime, which seems to be driving the findings, is a core mechanism for reducing BMI and maintaining healthy body weight. The mediating role of physical activity and social capital also suggest that public policy can specifically target these areas by providing interventions that promote social capital and physical activity even amidst high crime rates.

Sex differences in the associations of sleep-wake characteristics and rest-activity circadian rhythm with specific obesity types among Hong Kong community-dwelling older adults

BACKGROUND

Sex differences exist in sleep characteristics, circadian rhythm and body composition but the evidence on their associations with obesity risk remains unclear. We aimed to examine sex differences in the associations of sleep-wake cycle and rest-activity circadian rhythm with specific obesity types among aged Chinese population.

METHODS

This report pooled data from 2 population-based surveys conducted during 4/2018-9/2018 and 7/2019-9/2020. All participants wore actigraphy on wrists for 7 days to measure their objective sleep patterns and rest-activity circadian rhythm. We measured participants' anthropometric data, and obtained their body weight, body fat percentage(fat%), visceral fat rating, muscle mass by calibrated bioelectrical impedance analysis device. Hand-grip strength was assessed by Jamar Hydraulic hand dynamometer. Multinomial logistic regression was performed to assess the odds ratio(OR) and 95% confidence intervals(95%CI).

RESULTS

We recruited 206 male and 134 female older adults with complete actigraphy data, with obesity prevalence of 36.9% and 31.3%, respectively. Male participants who had delayed sleep-wake cycle(i.e.,sleep-onset-time and wake-up time) was associated with higher risk of obesity(late sleep-onset-time:OR=5.28, 95%CI=2.00-13.94), and the results remained consistent for different types of obesity. Males with late M10(i.e., most active 10-hours) onset had higher adipose outcomes with an adjusted OR of 2.92(fat%:95%CI=1.10-7.71; visceral fat:95%CI=1.12-7.61). Among female participants, those with lower relative amplitude were associated with higher BMI and lower hand-grip strength.

CONCLUSIONS

This study revealed that circadian rhythm fragmentation was associated with obesity and muscle loss. Promoting good sleep quality and maintaining robust circadian rhythm and physical activity can prevent poor muscle strength among older adults.

A Series of Remote Melatonin Supplement Interventions for Poor Sleep: Protocol for a Feasibility Pilot Study for a Series of Personalized (N-of-1) Trials

BACKGROUND

Poor sleep, defined as short-duration or poor-quality sleep, is a frequently reported condition with many deleterious effects including poorer cognitive functioning, increased accidents, and poorer health. Melatonin has been shown to be an efficacious treatment to manage symptoms of poor sleep. However, the treatment effects of melatonin on sleep can vary greatly between participants. Personalized, or N-of-1, trial designs represent a method for identifying the best treatment for individual participants. Although using N-of-1 trials of melatonin to treat poor sleep is possible, the feasibility, acceptability, and effectiveness of N-of-1 trials using melatonin are unknown. Using the National Institutes of Health Stage Model for Behavioral Intervention Development, a stage IB (intervention refinement, modification, and adaptation and pilot testing) design appeared to be needed to address these feasibility questions.

OBJECTIVE

This trial series evaluates the feasibility, acceptability, and effectiveness of a series of personalized interventions for remote delivery of melatonin dose (3 and 0.5 mg) versus placebo supplements for self-reported poor sleep among 60 participants. The goal of this study is to provide valuable information about implementing remote N-of-1 randomized controlled trials to improve poor sleep.

METHODS

Participants will complete a 2-week baseline followed by six 2-week alternating intervention periods of 3 mg of melatonin, 0.5 mg of melatonin, and placebo. Participants will be randomly assigned to 2 intervention orders. The feasibility and acceptability of the personalized trial approach will be determined with participants' ratings of usability and satisfaction with the remote, personalized intervention delivery system. The effectiveness of the intervention will be measured using participants' self-reported sleep quality and duration and Fitbit tracker-measured sleep duration and efficiency. Additional measures will include ecological momentary assessment measures of fatigue, stress, pain, mood, concentration, and confidence as well as measures of participant adherence to the intervention, use of the Fitbit tracker, and survey data collection.

RESULTS

As of the submission of this protocol, recruitment for this National Institutes of Health stage IB personalized trial series is approximately 78.3% complete (47/60). We expect recruitment and data collection to be finalized by June 2023.

CONCLUSIONS

Evaluating the feasibility, acceptability, and effectiveness of a series of personalized interventions of melatonin will address the longer term aim of this program of research-is integrating N-of-1 trials useful patient care? The personalized trial series results will be published in a peer-reviewed journal and will follow the CONSORT (Consolidated Standards of Reporting Trials) extension for N-of-1 trials (CENT 2015) reporting guidelines. This trial series was approved by the Northwell Health institutional review board.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05349188; https://www.clinicaltrials.gov/study/NCT05349188.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/45313.

What Value of Sixth Month Excess Weight Loss (Postsleeve Gastrectomy) Is Necessary for Better Sleep Quality?

BACKGROUND

Obesity, caused by caloric intake over output, is a global health problem. The relationship between sleep and obesity is discussed in the literature. Little is known about the compliance of sleep quality and patients' weight loss. This study aimed to review how sleep quality is affected by bariatric surgery, assess whether compliance with sleep quality can be predicted after bariatric surgery, and establish its correlation with excess weight loss.

METHODS

A cross-sectional study was conducted for patients undergoing bariatric surgery (laparoscopic sleeve gastrectomy). Sleep quality was assessed with the Pittsburgh sleep quality index (PSQI) scale preoperatively and in the sixth postoperative month. A PSQI global score above 5 indicated poor sleep quality. Participants were divided into 2 groups: good and poor sleep quality. Receiver operating characteristics and logistic regression analysis were also performed to predict sleep quality.

RESULTS

The questionnaire was completed by 100 subjects. All PSQI components, except the sixth (sleep medication) component, improved in patients at the sixth postoperative month versus baseline values. In the receiver operating characteristic analysis to test the availability of excess weight loss (EWL%) cutoff values relative to predict successful sleepers, 65.1 of the sixth month EWL% was found for the diagnosis of successful sleeper patients with 72.6% sensitivity and 63% specificity (area under the curve: 0.706, P =0.002, 95% CI, 0.586 to 0.825).

CONCLUSIONS

For patients undergoing weight loss surgery, while assessing the sixth postoperative month, the EWL% value over 65.1 was recommended for better sleep quality.

Healthy Eating Index and Dietary Inflammatory Index are not correlated with body composition in female collegiate athletes

OBJECTIVE

This cross-sectional study investigated associations among the Healthy Eating Index (HEI)-2015, Dietary Inflammatory Index (DII), and body composition in female collegiate athletes.

PARTICIPANTS

Female NCAA Division I student-athletes (n = 41, 18-21 years old) were included from various sports and did not report any diagnosed chronic diseases.

METHODS

Demographics, dietary intake, anthropometrics, and body composition, including bone mineral density, were collected utilizing a questionnaire, three interview-based multiple-pass 24-h dietary recalls, and dual-energy X-ray absorptiometry.

RESULTS

Mean HEI-2015 and DII scores (using 39 of 45 components) were 56.2 ± 13.5 and -0.1 ± 1.9, respectively. Athletes did not meet recommended intake levels for servings of fruit, vegetables, fiber, calcium, vitamin D, omega-3, and omega-6. Saturated fat and added sugar intake exceeded the recommended intakes. Diet quality indices and body composition measures were not correlated.

CONCLUSIONS

Although female collegiate athletes consumed poor-quality diets, this was not associated with body composition or bone health.

Self-reported sleep quality and exercise in polycystic ovary syndrome: A secondary analysis of a pilot randomized controlled trial

OBJECTIVE

To examine the proportion of participants with poor sleep quality, evaluate the associations between sleep quality and anthropometric and cardiometabolic health markers, and evaluate the effect of high intensity interval training (HIIT) and continuous aerobic exercise training (CAET) on sleep quality in polycystic ovary syndrome (PCOS).

DESIGN

Secondary analysis of a pilot randomized controlled trial.

PATIENTS

Women with PCOS aged 18-40 years.

MEASUREMENTS

The Pittsburgh Sleep Quality Index (PSQI) was measured at baseline and following a 6-month exercise intervention. A PSQI score >5 indicates poor sleep. Linear regression was used to evaluate the associations between PSQI score and anthropometric and cardiometabolic health markers, and the effect of exercise training on these associations.

RESULTS

Thirty-four participants completed the PSQI at baseline, and 29 postintervention: no-exercise control (n = 9), HIIT (n = 12) and CAET (n = 8). At baseline, 79% had poor sleep quality. Baseline PSQI score was positively correlated with body mass index, waist circumference, body weight, haemoglobin A1c and insulin resistance. Mean PSQI score changes were -0.4 (SD 1.1), -0.7 (SD 0.6) and -0.5 (SD 0.9) for control, HIIT and CAET, respectively. For HIIT participants, change in PSQI score was associated with changes in body weight (B = .27, 95% CI 0.10-0.45) and waist circumference (B = .09, 95% CI 0.02-0.17).

CONCLUSION

Most participants had poor sleep quality which was associated with poorer anthropometric and cardiometabolic health markers. There were no statistically significant changes in PSQI score with exercise training. With HIIT training, decreases in the sleep efficiency score were associated with reductions in body weight and waist circumference. Further studies are needed to determine the effect of exercise training on sleep quality.

Interrelationships of Sleep Quality, Obesity Severity, and Clinical Headache Features among Women with Comorbid Migraine and Obesity

Obesity and migraine are often comorbid. Poor sleep quality is also common among individuals with migraine and may be influenced by comorbidities such as obesity. However, understanding of migraine's relationship with sleep and the potential exacerbating effect of obesity remains limited. This study evaluated the associations of migraine characteristics and clinical features with sleep quality among women with comorbid migraine and overweight/obesity and assessed the interplay between obesity severity and migraine characteristics/clinical features in relation to sleep quality. Women seeking treatment for migraine and obesity (n = 127; NCT01197196) completed a validated questionnaire assessing sleep quality (Pittsburgh Sleep Quality Index-PSQI). Migraine headache characteristics and clinical features were assessed using smartphone-based daily diaries. Weight was measured in-clinic, and several potential confounders were assessed using rigorous methods. Nearly 70% of participants endorsed poor sleep quality. Greater monthly migraine days and the presence of phonophobia related to poorer sleep quality, and specifically poorer sleep efficiency, controlling for confounders. Obesity severity was neither independently associated nor interacted with migraine characteristics/features to predict sleep quality. Poor sleep quality is common among women with comorbid migraine and overweight/obesity, although obesity severity does not appear to uniquely relate to or exacerbate the association between migraine and sleep in this population. Results can guide research on mechanisms of the migraine-sleep link and inform clinical care.

Habitual night sleep duration is associated with general obesity and visceral obesity among Chinese women, independent of sleep quality

Purpose

Research on the relationship between sleep duration and obesity defined using multiple anthropometric and bioelectrical indices in women remains scarce. We aimed to explore the association between sleep duration and body mass index (BMI), waist-hip ratio (WHR), body fat percentage (PBF) and visceral fat area (VFA) among females.

Methods

We recruited women for medical examination using multistage cluster sampling. Sleep was assessed using Pittsburgh Sleep Quality Index (PSQI) and sleep duration was categorized into short (<7 h), optimal (7 <9 h) and long sleep (≥ 9 h). Weight and height were measured using a calibrated stadiometer. Waist circumference was manually measured. PBF, and VFA were estimated by bioelectrical impedance analysis. Data on sociodemographic characteristics and lifestyle factors were also collected and included in the logistic regression models to explore the independent association between sleep duration and obesity defined by different indices.

Results

A total of 7,763 women with a mean age of 42.6 ± 13.5 years were included. The percentage of women reporting short and long sleep was 10.3 and 13.4% respectively. The mean BMI, WHR, PBF and VFA were 23.07 ± 3.30 kg/m², 0.78 ± 0.06, 32.23 ± 6.08% and 91.64 ± 35.97cm², respectively. Short sleep was independently associated with 35% (95% CI: 1.05-1.75) increased odds of general obesity (BMI ≥ 28 kg/cm²), and long sleep was associated with 18% (95% CI: 1.01-1.37) increased odds of visceral obesity (VFA > 100 cm²). No association was observed between sleep deprivation or excessive sleep and high WHR or high PBF.

Conclusion

In women, short sleep was associated with an increased odds of general obesity, whereas long sleep was associated with an increased odds of visceral obesity. Longitudinal observations are needed to confirm this cross-sectional relationship.

Trends and disparities in sleep quality and duration in older adults in China from 2008 to 2018: A national observational study

Background

Poor sleep status as a common concern is a risk factor for many health problems among older people. China with an aging society lacks relevant nationwide data on the sleep status among older people. Therefore, the purpose of this study was to investigate trends and disparities in sleep quality and duration among older adults, and exploring influencing factors of poor sleep in China between 2008 and 2018.

Method

We used the four-waves data of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018. Sleep quality and average sleep hours per day was investigated by using questionnaires in the CLHLS. We categorized sleep duration as three groups including ≤5 h (short duration), 5-9 h (normal duration), or ≥9 h (long duration) per day. Multivariate logistic regression models were used to examine trends and risk factors of poor sleep quality, short sleep duration, and long sleep duration.

Results

The prevalence of poor sleep quality significantly increased from 34.87% in 2008 to 47.67% in 2018 (p < 0.05). Short sleep duration significantly increased from 5.29 to 8.37%, whereas long sleep duration decreased from 28.77 to 19.27%. Multivariate analysis showed that female sex, poor economic status, a greater number of chronic diseases, underweight, poor self-reported quality of life, and poor self-reported health were associated with poor sleep quality and short sleep duration (p < 0.05).

Conclusion

Our findings revealed that older adults had increased prevalence of poor sleep quality and short sleep duration from 2008 to 2018. More attention should be paid to the increased sleep problems among older adults and early interventions should be made to improve sleep quality and guarantee enough sleep time.

The Effect of Family-Centered and Peer-Centered Education on the Sleep Quality of Hemodialysis Patients: A Randomized Clinical Trial

Introduction

Sleep disorders in hemodialysis patients are of high prevalence affecting the lives of these patients.

Objective

The present study was conducted to investigate the effect of family-centered and peer-centered education on the sleep quality of hemodialysis patients.

Methods

In this controlled clinical trial, 90 patients were randomly assigned to three groups (control, family-centered, and peer-centered). All three groups completed Pittsburgh Sleep Quality Index before the intervention. The intervention included five training sessions conducted by the researcher according to the patients' needs to improve their sleep quality. Routine ward interventions were performed for the control group. At the end of the study, the Pittsburgh Sleep Quality Index was completed by all three groups once again. Data were collected and analyzed using SPSS version 24 software and statistical tests.

Results

No significant difference was found between the two intervention and control groups regarding demographic variables and variables related to sleep quality before the intervention (p < .05). However, based on the results of the Wilcoxon test, there was a statistically significant difference between the mean rank of sleep quality in the intervention and control groups after the intervention (p-value = .008), indicating that sleep hygiene education was effective in the two intervention groups.

Conclusion

According to the findings, the mean rank of sleep quality in the two intervention groups was significant after the training, indicating the effectiveness of family-centered and peer-centered education. Accordingly, medical healthcare managers, policymakers, and planners, including nurses, are recommended to employ these convenient, safe, and cost-free training methods and provide better sleep quality and more comfort to patients by spending a short period of time for training.

Üniversite Öğrencilerinde Vücut Kompozisyonu ve Antropometrik Ölçümlerin Uyku Süresi ve Uyku Kalitesiyle İlişkisi

Amaç: Bu çalışmada üniversite öğrencilerinde vücut kompozisyonu ve antropometrik ölçümlerin uyku süresi ve uyku kalitesiyle ilişkisinin incelenmesi amaçlanmıştır.Yöntem: Kesitsel tipteki çalışma bir fakültede öğrenim gören, araştırmaya katılmayı kabul eden ve dahil edilme kriterlerini karşılayan Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri Fakültesinin 310 öğrencisiyle yürütülmüştür. Araştırmanın verileri Tanıtıcı Bilgi Formu ve Pittsburg Uyku Kalitesi İndeksi’ni içeren anket formu kullanılarak yüz yüze görüşme yöntemiyle toplanmıştır. Öğrencilerin vücut kompozisyonlarının belirlenmesinde Biyoelektrik İmpedans Analizi (BİA) ile yağsız vücut kütlesi, vücut yağ ve kas kütlesi incelenmiş, Beden Kütle İndeksi (BKİ), bel çevresi, Bel Kalça Oranı (BKO), Bel Boy Oranı (BBO) ve triseps, supskapular, biseps, suprailiak Deri Kıvrım Kalınlıkları (DKK) değerlendirilmiştir. Verilerin analizinde sayı, yüzde, ortalama, standart sapma, Student’s t testi ve Pearson korelasyon analizi kullanılmıştır.Bulgular: Öğrencilerin uyku süresi ortalama 7,10±1,66 saattir, %74,8’i kötü uyku kalitesine sahiptir. Her iki cinsiyette yağsız vücut kütlesi (kg) ve vücut kas kütlesi (kg) ile uyku kalitesi skoru arasında istatistiksel olarak anlamlı, negatif yönlü zayıf ilişki, erkek öğrencilerde ise suprailiak DKK ve biseps DKK ile uyku kalitesi arasında istatistiksel olarak anlamlı, pozitif yönlü zayıf ilişki saptanmıştır (p&lt;0,05).Sonuç: Üniversite öğrencilerinin uyku süreleri önerilen düzeydedir, buna karşın öğrencilerin dörtte üçü kötü uyku kalitesine sahiptir. Kız ve erkek öğrencilerde yağsız vücut kütlesi (kg) ve vücut kas kütlesi (kg) azaldıkça uyku kalitesi kötüleşmekte, erkek öğrencilerde ise suprailiak DKK ve biseps DKK arttıkça uyku kalitesi kötüleşmektedir.  

Exercise Training Program Improves Subjective Sleep Quality and Physical Fitness in Severely Obese Bad Sleepers

BACKGROUND

Sleep quality is an important modulator of neuroendocrine function, as sleep problems are related to metabolic and endocrine alterations.

OBJECTIVE

The main objective was to determine the effects of an exercise training program on the sleep quality of severely obese patients with sleep problems. The secondary objective was to determine the relationship between fitness and anthropometric parameters with sleep quality scores.

METHODS

Thirty severely obese patients participated in 16 weeks of PA intervention (age: 39.30 ± 11.62 y, BMI: 42.75 ± 5.27 kg/m²). Subjective sleep quality, anthropometric parameters, and fitness (i.e., handgrip strength and cardiorespiratory fitness) were measured.

RESULTS

Two groups were defined as good sleepers (n = 15, 38.06 ± 12.26, men = 1) and bad sleepers (n = 15, 40.53 ± 11.23, men = 3). The good sleeper group reported improvement in cardiorespiratory fitness (61.33 ± 68.75 m vs. 635.33 ± 98.91 m, p = 0.003) and handgrip strength (29.63 ± 9.29 kg vs. 31.86 ± 7.17 kg, p = 0.049). The bad sleeper group improved their cardiorespiratory fitness (472.66 ± 99.7 m vs. 611.33 ± 148.75 m, p = 0.001). In terms of sleep quality dimensions, the bad sleeper group improved their subjective sleep quality (p < 0.001), sleep latency (p = 0.045), sleep duration (p = 0.031), and habitual sleep efficiency (p = 0.015). Comparing the changes in both groups (∆), there were differences in subjective sleep quality scores (∆ = 2.23 vs. ∆ = -3.90, p = 0.002), where 86.6% of the bad sleeper group improved sleep quality (p = 0.030). An increase in handgrip strength was correlated to improving sleep quality scores (r = -0.49, p = 0.050).

CONCLUSIONS

Severely obese bad sleepers improved their subjective sleep quality, the components of sleep, and cardiorespiratory fitness through an exercise training program. Improvement in subjective sleep quality was linked to an increase in handgrip strength.

Obesity-related measures and successful ageing among community-dwelling older adults in India: a cross-sectional study

Obesity is a chief lifestyle disease globally and causes a significant increase in morbidities. Overweight/ obesity prevalence has been rising faster in India compared to the world average. Therefore, the study examined the association between overweight/ obesity and successful ageing among older population in India. We also explored the gender difference in risks posed by obesity on successful ageing and the different socio-economic correlates associated with successful ageing. This study utilized data from India's first nationally representative longitudinal ageing survey (LASI-2017-18). The effective sample size for the present study was 31,464 older adults with a mean age of 69.2 years (SD: 7.53). Overweight/ obesity was defined as having a body mass index of 25 or above. The study carried out a bivariate analysis to observe the association between dependent and independent variables. Further, multivariable analysis was conducted to examine the associations after controlling for individual socio-demographic, lifestyle and household/community-related factors. The study included 47.5% men and 52.5% women. It was found that the prevalence of obesity/overweight was higher among older women compared to older men (23.2% vs 15.5%). Similarly, high-risk waist circumference (32.7% vs 7.9%) and high-risk waist-hip ratio (69.2% vs 66.5%) were more prevalent among older women than older men. The study found significant gender differences (men-women: 8.7%) in the prevalence rate of successful ageing (p < 0.001). The chances of successful ageing were significantly higher among older adults who were not obese/overweight [AOR: 1.31; CI 1.31-1.55], had no high-risk waist circumference [AOR: 1.41; CI 1.29-1.54], and those who had no high-risk waist-hip ratio [AOR: 1.16; CI 1.09-1.24] compared to their respective counterparts. Interaction results revealed that older women who were not obese/overweight had a lower likelihood of successful ageing compared to the older men who was not obese/overweight [AOR: 0.86; CI 0.80-0.93]. Similarly, older womens who had no high-risk waist circumference [AOR: 0.86; CI 0.80-0.96] and no high risk-hip ratio [AOR: 0.81; CI 0.73-0.89] were less likely to have successful ageing compared to their counterparts, respectively. Being overweight/ obese and having high-risk waist circumference and waist-hip ratio were found to be significant factors associated with less successful ageing among older adults, especially women in this study. The current findings highlight the importance of understanding the modifiable factors, including nutritional awareness and developing targeted strategies for promoting successful ageing.

Association between sleep quality and urolithiasis among general population in Western China: a cross-sectional study

Background

Growing number of studies have evidently shown that sleep disorders are associated with the recently increased risk of various diseases in general human population. However, the relationship between sleep quality and urolithiasis condition in humans is still unclear. The present study explored the relationship between quality of sleep and urolithiasis in Chinese population of population, western China and hence investigated the effects of sleep quality on urolithiasis disease.

Methods

A cross-sectional analysis was performed using data from the West China Natural Population Cohort Study (WCNPCS). The data was collected between May 2019 and June 2021. This study evaluated the association between the sleep quality and urolithiasis. The sleep quality was assessed using the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) whereas urolithiasis, as the outcome was a binary variable. Multivariable logistic regression models that adjust the sociodemographic characteristics and health-related factors were used to assess the association between sleep quality and urolithiasis. Interaction was tested in prespecified subgroup of interest.

Results

After adjusting a series of confounding variables, the Pittsburgh Sleep Quality Index scores were found to have a significant positive correlation with the prevalence of urolithiasis (OR: 1.178; 95% CI = 1.083–1.282; p < 0.001). The risk of urolithiasis was significantly increased with an elevation of the component Pittsburgh Sleep Quality Index score in sleep latency, sleep duration, habitual sleep efficiency, and daytime dysfunction.

Conclusions

It was evident that there is an association between sleep quality and prevalence of renal stones in natural population in western China regions. Poor sleep quality is related to urolithiasis. The findings of the current study hence highlighted the need for future public health guidelines to develop detailed strategies for improving sleep quality.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14187-5.

Associations between Sleep Duration and Anthropometric Indices of Adiposity in Female University Students

OBJECTIVES

To examine associations between sleep duration as well as time of going to sleep and anthropometric indices related to the amount and distribution of adiposity.

MATERIAL

A total of 969 female university students, aged 19-24 years.

METHODS

Participants self-reported their sleep duration. Body weight, height, and waist circumference were measured. BMI, WHR and WHtR were calculated. Statistical analyses of results involved logistic regression models. Socioeconomic status and level of stress were added as covariates.

RESULTS

In 15% of the sample, sleep was too short (<6 h), and 10% slept too long (>8 h). Compared to women who followed the recommended sleep duration, among short sleepers, both underweight and overweight were more frequent, while long sleepers were more likely to be overweight. A higher prevalence of abdominal obesity and increased risk of metabolic syndrome were observed in both short and long sleepers than in recommended sleepers. Irregular sleep times were connected with higher OR, both for BMI < 18.5 and BMI > 25, for WC > 80, and WHtR below 0.4 and above 0.5. Irregular sleep times also led to an increased risk of metabolic diseases prevalence.

CONCLUSIONS

Both too long and too short sleep increases the risk of overweight, obesity and abdominal obesity and, as a consequence, the risk of metabolic syndrome in young women.

Nutritional Biomarkers and Factors Correlated with Poor Sleep Status among Young Females: A Case-Control Study

Poor sleep status is associated with several health problems. Nutritional biomarkers and factors related to poor sleep are understudied. This study aimed to identify nutrition biomarkers and factors related to sleep status in healthy young Saudi females. The study included 92 normal-weight and obese Saudi females aged 19−25. Fasting blood glucose, insulin, and lipid profiles were measured. Insulin resistance was calculated on the basis of the homeostasis model assessment of insulin resistance (HOMA-IR) method. Anthropometric, stress, physical activity, and dietary data were collected. Data on the polyphenol content in foods were retrieved from the Phenol-Explorer database. The sleep status was assessed using the Pittsburgh sleep quality index (PSQI). Associations between variables were assessed using the multiple logistic regression model. Around 76% of the participants had poor sleep status (PSQI > 5). Multiple logistic regression reported high polyphenol intake as a protective factor against poor sleep (OR 0.24; 95% CI 0.07−0.83; p = 0.03) and HOMA-IR as an independent risk for poor sleep (OR 4.97; 95% CI 1.11−22.31; p = 0.04). Other nutritional biomarkers and factors, such as BMI, lipid profile, and vitamins, revealed a trend but were not significant. In conclusion, poor sleep status is associated with insulin resistance and low polyphenol intake among women of reproductive age.

Short Sleep Duration Was Associated with Increased Regional Body Fat in US Adults: The NHANES from 2011 to 2018

Background: The relationship between sleep duration and different regional fat is unclear. We aimed to investigate the association between sleep duration and different regional fat mass (FM) among a population of US adults. Methods: 9413 participants were included from the National Health and Nutrition Examination Survey (NHANES), from 2011 to 2018. The sleep duration was divided into short sleep (<7 h/day), normal sleep (7−9 h/day) and long sleep (>9 h/day). Different regional FM was measured by dual-energy X-ray absorptiometry, including trunk FM, arms FM and legs FM. Fat mass index (FMI) was obtained by dividing FM (kg) by the square of body height (m2). Multiple linear regression was used to evaluate the relationship between sleep duration and regional FMI. Results: The mean sleep duration was 7.1 ± 1.5 h/day. After adjusting for socio-demographic, lifestyle information, comorbid diseases and medications, short sleepers had higher trunk FMI (β = 0.134, 95% confidence interval (CI): 0.051−0.216, p = 0.001), arms FMI (β = 0.038, 95% CI: 0.016−0.06, p < 0.001) and legs FMI (β = 0.101, 95% CI: 0.044−0.158, p < 0.001) compared to normal sleepers, whereas no significant difference was found in long sleepers. The similar results were also observed in men, while short sleepers only had higher arms FM in women (all p < 0.01). In addition, compared to normal sleepers, short sleepers had higher arms FMI and legs FMI in the obese group (all p < 0.05), while no relationship was observed in non-obese group. Conclusions: Short sleep duration, but not long sleep duration, was independently related to the increased different regional body fat in US adults, especially in men and those with obesity.

Is poor sleep quality related to disordered eating behavior and mental health among university students?

The role of sleep in eating behavior has received increasing attention in recent years. This paper aimed to determine the prevalence and associations between sleep quality and mental health, anthropometric measurements, and disordered eating in university students. This cross-sectional research was conducted among 568 students (78.7% women) aged 18-25 years. Students completed a survey including demographic information, Pittsburgh Sleep Quality Index (PSQI), Eating Attitude Test-26 (EAT-26), Night Eating Questionnaire (NEQ), and Beck Depression Inventory (BDI). Anthropometric measurements were taken. Students were grouped based on poor (PSQI > 5) and good (PSQI ≤ 5) sleep quality. The students' average age was 20.32 ± 1.61 years. Additionally, 36.3% (n = 206) of the students had PSQI > 5, and these students had more frequent night eating syndrome (NES) and depressive symptoms. Students with PSQI > 5 had significantly higher total NEQ and BDI scores than students with PSQI ≤ 5. Significant positive correlations were found between sleep quality and its subscale scores with NEQ and BDI scores. When anthropometric measurements were evaluated according to gender, a significant difference was found between sleep quality and body mass index and waist/hip ratio in men only. There was a significant association between PSQI > 5 and NES after adjusting for age, sex, class standing, residency, smoking status, and alcohol consumption on logistic regression. Our results suggest that PSQI > 5 is a significant risk for the NES, but not other disordered eating behaviors or obesity. The relationship between sleep, depression, anthropometric measurements, and disordered eating should be further evaluated in future studies.

The COVID-19 infodemic at your fingertips. Reciprocal relationships between COVID-19 information FOMO, bedtime smartphone news engagement, and daytime tiredness over time

Considering that insufficient sleep has long been regarded as a significant public health challenge, the COVID-19 pandemic and its co-evolving infodemic have further aggravated many people's sleep health. People's engagement with pandemic-related news, particularly given that many people are now permanently online via smartphones, has been identified as a critical factor for sleep health, such that public health authorities have recommended limited news exposure. This two-wave panel survey, conducted with a representative sample in Austria during its first COVID-19 lockdown, examines (a) how fear of missing out on pandemic-related news (i.e., COVID-19 information FOMO) is reciprocally related to smartphone-based bedtime news engagement, as well as (b) how both bedtime news engagement and COVID-19 information FOMO predict daytime tiredness. Partial metric measurement invariant structural equation modeling revealed that COVID-19 information FOMO and bedtime news engagement are reciprocally associated over time, indicating a potentially harmful reinforcing loop. However, results further suggested that COVID-19 information FOMO may be the primary driver of daytime tiredness, not smartphone-based bedtime news engagement. These findings suggest that a perceived loss of (informational) control over the pandemic outbreak more strongly than poor sleep habits accounts for depleted energy resources during lockdown. However, given the initial evidence for a reinforcing loop, this effect pattern may change in the long term.

A systematic review of incidence, prevalence, and trends in health outcomes for Australian and New Zealand paramedics

Introduction: The paramedic role carries inherent risk to practitioner health, due to a combination of work characteristics and the employment practices of different organisations. Emerging evidence suggests that paramedics worldwide may face a range of negative health outcomes. The purpose of this paper was to systematically review the literature of paramedic health outcomes in the Australian and New Zealand context.Methods: A systematic search of key databases and grey literature was conducted to identify all available studies reporting on quantitative health outcomes for paramedics working in Australia or New Zealand. The review was conducted using the JBI methodology for prevalence studies, and uses a narrative synthesis approach to reporting.Results: There were k = 20 studies that met inclusion criteria, and most used Australian samples. Results indicated between 57.3-66.5% of paramedics studied were classified as overweight or obese, while up to 80% reported poor sleep, and 55.6% reported fatigue. Incidence rates per 100,000 FTE included 26.62 for completed suicide, 5.46 for drug-caused death, and 9.3 for workplace fatalities. The most recent incidence per 1,000 FTE for injury compensation claims was 141.4.Conclusions: Australian and New Zealand paramedics demonstrate poor health according to several metrics. Our sample demonstrated considerably worse health than the general population or similar occupations. There is little trend data available, so it was difficult to ascertain if rates are changing. The range of health outcomes studied was limited, and correlations between different health outcomes were rarely considered by authors. Data relating to specific rates for gender and sexuality, location of work, and First Nations status or ethnicity was often not available.Systematic review registration number (PROSPERO): CRD42021232196.

Better Subjective Sleep Quality Partly Explains the Association Between Self-Reported Physical Activity and Better Cognitive Function

Background: Physical activity has been associated with better cognitive function and better sleep quality. Yet, whether the beneficial effect of physical activity on cognitive function can be explained by an indirect pathway involving better sleep quality is unclear. Objective: To investigate whether sleep quality mediates the association between physical activity and cognitive function in adults 50 years of age or older. Methods: 86,541 community-dwelling European adults were included in the study. Physical activity and sleep quality were self-reported. Indicators of cognitive function (immediate recall, delayed recall, verbal fluency) were assessed using objective tests. All measures were collected six times between 2004 and 2017. The mediation was tested using multilevel mediation analyses. Results: Results showed that self-reported physical activity was associated with better self-reported sleep quality, which was associated with better performance in all three indicators of cognitive function, demonstrating an indirect effect of physical activity on cognitive function through sleep quality. The mediating effect of sleep quality accounted for 0.41%, 1.46%, and 8.88% of the total association of physical activity with verbal fluency, immediate recall, and delayed recall, respectively. Conclusion: These findings suggest that self-reported sleep quality partly mediates the association between self-reported physical activity and cognitive function. These results need to be confirmed by device-based data of physical activity and sleep quality.

Evaluating the relationship of sleep quality and sleep duration with Framingham coronary heart disease risk score

Sleep is an important modulator of cardiovascular function and is recognized to play an important role in the pathogenesis and progression of cardiovascular disease. However, results of the studies investigating the relationship between sleep complaints and cardiovascular outcomes are still controversial. This study aimed to investigate the associations of sleep duration and sleep quality with Framingham 10-year hard coronary heart disease (CHD) risk score in Turkish adults. We included a total of 362 participants (mean age: 48.5 ± 9.0 years, 50.6% males) and measured sleep quality and sleep duration using Pittsburgh Sleep Quality Index (PSQI). Framingham risk scoring system was utilized to calculate the 10-year hard CHD risk of participants. Binary logistic regression analysis was performed to determine the association between sleep quality, sleep duration, and CHD risk. Both short sleep duration (<6 hours) (OR = 3.858, 95% CI: 1.245-11.956) and long sleep duration (≥8 hours) (OR = 2.944, 95% CI: 1.087-7.967) were identified as the predictors of 10-year hard CHD risk. However, sleep quality was not associated with 10-year CHD risk even as a categorical or continuous variable (OR = 0.864, 95% CI: 0.418-1.787 and OR = 0.985, 95% CI: 0.868-1.117, respectively). Our findings highlighted previous studies demonstrating the U-shaped relationship, with both short and long sleep durations to be associated with a higher CHD risk. Evaluation of habitual sleeping patterns may provide additional information in clinical cardiovascular risk assessment. Future research should investigate whether interventions to optimize sleep duration may help to prevent coronary events in large population-based cohorts.

Impacts of the Coronavirus Pandemic on the Emotional and Physical Health of Older Adults Compared with Younger Cohorts

OBJECTIVES

This study compared emotional and physical health and overall well-being related to social restrictions during the pandemic among older, middle-aged, and younger adults in the United States (n = 276).

METHODS

Online surveys collected information on mental and physical health, as well as positive and negative impacts of the pandemic. One-way MANOVAs and hierarchical regressions were used to analyze data.

RESULTS

Depressive symptoms and coronavirus anxiety differed significantly by age, with older adults reporting less depressive and anxious symptoms than younger cohorts. Negative COVID experiences significantly predicted higher levels of stress, anxiety, and insomnia symptoms in younger adults as compared to older cohorts.

CONCLUSIONS

Findings indicate that social restrictions had a more substantial negative impact amongst younger adults compared to older adults, particularly in terms of mental health and well-being.

CLINICAL IMPLICATIONS

Older adults may be more resilient to the impacts of the pandemic than younger cohorts and thus may serve as a critical resource for how to navigate crisis situations of this nature. Future studies should continue to monitor health outcomes as the pandemic subsides in conjunction with the vaccine rollout, as the long-term effects of social distancing and stay-at-home measures are yet to be determined.

Pilot study of tai chi and qigong on body composition, sleep, and emotional eating in midlife/older women

Weight gain and related adverse changes in body composition are prevalent among midlife and older women and contribute to chronic disease (e.g., type 2 diabetes, hypertension, depression). Tai Chi (TC) and Qigong (QG), forms of Meditative Movement, demonstrate improved physical/psychological symptoms and body composition. Using a standardized TC/QG protocol, we explored pre/post intervention differences in percent body fat and factors related to body composition in midlife/older women. In the context of a single-group pilot study, females ages 45-75 (N = 51) enrolled in an 8-week TC/QG intervention. Primary outcome measures of body composition, sleep quality, emotional eating and select secondary outcome psycho-emotional factors (perceived stress, mood state, mindfulness, self-compassion, body awareness) were collected. Change in percent body fat did not reach statistical significance (p = .30, M =  0.35, 95% CI [- 0.32, 1.0]). Sleep quality improved significantly, p = .04, M = - 0.88, 95% CI [-1.71, - 0.04]. Emotional eating changed in the expected direction, but not significantly, p = .08, M =  -0.16, 95% CI [-0.34, 0.02]. Significant differences were found in body awareness, p = .01, M =  0.36, 95% CI [0.08, 0.63] and perceived stress, p = .05, M =  -2.36, 95% CI [-4.76, 0.04]. Preliminary results are promising as results showed improvements in factors related to healthy body composition. Refined research is needed to understand if/how TC/QG may improve body composition among midlife and older women.

Open Hip Abductor Repair Hitting the Sack-Abductor Tendon Repair Significantly Improves Sleep Quality

PURPOSE

To (1) describe the prevalence of abnormal sleep quality in patients with hip abductor tears (HAT), to (2) determine whether sleep quality improves after open HAT repair, and to (3) to report clinical short-term outcomes in patients undergoing open HAT repair.

METHODS

The data of 28 patients (29 hips) who underwant open HAT repair were prospectively analyzed at midterm follow-up. The Pittsburgh Sleep Quality Index (PSQI), modified Harris Hip Score (mHHS), the University of California, Los Angeles activity scale (UCLA), and Visual Analog Scale (VAS) for pain were determined via questionnaire. Paired t-tests were applied to compare preoperative and post-operative Patient-reported Outcome Measures (PROMs). Logistic regression was performed to determine the association between PSQI improvement achievement and demographic variables (laterality, sex, age, body-mass-index (BMI), and preoperative mHHS). The minimal clinically important difference (MCID) was calculated for the mHHS.

RESULTS

A total of 28 patients were included. Four patients (14.3%) suffered post-operative complications after open HAT repair. The predominance of patients was female (77.4%), with a mean age of 60 ± 13 years. The average follow-up was 30.35 ± 16.62 months. Preoperatively, 27 (96.4%) patients experienced poor sleep quality (PSQI > 5); at follow-up, 7 (25%) patients experienced poor sleep quality. Univariate logistical regression analysis demonstrated no significant association between preoperative demographic data and achieving postoperative PSQI < 5. The MCID of mHHS was calculated to be 12.5. Overall, 90% of patients achieved MCID for mHHS.

CONCLUSION

Preoperative sleep quality was impaired in 96.4% of HAT patients (PSQI > 5). However, these patients showed an improvement in sleep disturbances after open HAT repair in the early postoperative period. Ninety percent of patients showed significant improvements in mHHS and achieved the corresponding MCID.

LEVEL OF EVIDENCE

Case series; Level IV.

Association of changes in lifestyle with changes in sleep difficulties: an analysis of 38 400 participants over a 16-year follow-up

OBJECTIVES

To investigate the association between changes in lifestyle risk factors and changes is sleep difficulties.

DESIGN

Longitudinal repeated measures cohort study.

SETTING

University and national institute of occupational health.

PARTICIPANTS

Participants of the Finnish Public Sector study with information on sleep and lifestyle-related risk factors collected in five repeat surveys with 4-year intervals from 2000 to 2017. The participants were those, who had responded at least twice and had a change in sleep difficulties (having sleep difficulties vs not) (142 969 observations from 38 400 respondents (mean age 45.5 (SD 9.2) years, 83% women).

PRIMARY AND SECONDARY OUTCOME MEASURES

Changes in sleep quality over time. Longitudinal fixed effects analysis, a method that accounts for time-invariant confounders by design, was used.

RESULTS

At first available response, sleep difficulties were experienced by 13 998 (36%) of the respondents. Respectively, the mean age was 44.3 (10.0) years, 7526 (20%) were obese, 13 487 (35%) reported low physical activity, 3338 (9%) extensively drinking and 6547 (17%) were smoking. Except for smoking, the changes in the studied modifiable risks were associated with changes in sleep difficulties. The ORs for having sleep difficulties were 1.41 (95% CI 1.35 to 1.48) for obesity, 1.10 (95% CI 1.06 to 1.13) for low physical activity and 1.43 (95% CI 1.35 to 1.51) for heavy drinking. For smoking, the association was negative with OR 0.81 (95% CI 0.76 to 0.86). Including all four modifiable risks into model changed the estimates only little.

CONCLUSIONS

The results of this longitudinal study suggest that changes in sleep quality are interconnected with changes in lifestyle.

Sleep and Diet: Mounting Evidence of a Cyclical Relationship

Two factors intrinsic to health are diet and sleep. These two behaviors may well influence one another. Indeed, that insufficient sleep adversely impacts dietary intakes is well documented. On the other hand, diet may influence sleep via melatonin and its biosynthesis from tryptophan. Experimental data exist indicating that provision of specific foods rich in tryptophan or melatonin can improve sleep quality. Whole diets rich in fruits, vegetables, legumes, and other sources of dietary tryptophan and melatonin have been shown to predict favorable sleep outcomes. Although clinical trials are needed to confirm a causal impact of dietary patterns on sleep and elucidate underlying mechanisms, available data illustrate a cyclical relation between these lifestyle factors. We recommend adopting a healthful diet to improve sleep, which may further promote sustained favorable dietary practices.

Associations of Diet Quality and Sleep Quality with Obesity

Short sleep duration or poor sleep quality has been associated with an increased risk of obesity. Although the underlying mechanism remains unclear, one proposed pathway is poor diet quality. This cross-sectional study investigated whether diet quality modifies the association between sleep status and obesity in Korean adults. We used the baseline data and samples of 737 men and 428 women (n = 1165) aged 19–64, who participated in the prospective Ewha–Boramae cohort study. Sleep duration was dichotomized into ≥7 h (adequate) and <7 h (insufficient). Pittsburgh Sleep Quality Index (PSQI) values, reflecting sleep quality, were dichotomized into >5 (poor quality) and ≤5 (good quality). Diet quality was evaluated by the Recommended Food Score (RFS). Obesity was associated with higher rates of insufficient sleep and poor sleep quality in women, but not in men. After adjustment for covariates, women with poor sleep quality had a higher risk of obesity than women with good sleep quality (OR = 2.198; 95% CI = 1.027–4.704); this association occurred only in the group with RFS ≤ median score. Our findings support a significant association between sleep quality and obesity, and this association has been potentially modified by dietary quality in women.

Syndrome Metabolic Markers, Fitness and Body Fat Is Associated with Sleep Quality in Women with Severe/Morbid Obesity

Background: Sleep is an important modulator of neuroendocrine function and glucose metabolism. Poor sleep quality is related to metabolic and endocrine alterations, including decreased glucose tolerance, decreased insulin sensitivity, and increased hunger and appetite. Objective: The aim of the present study was to determine the association between sleep quality with metabolic syndrome (MetS) markers, fitness and body fat of women with severe/morbid obesity. Methods: This cross-sectional study included 26 women with severe/morbid obesity. Fasting plasma glucose (FPG), high-density lipids (HDL-c), triglycerides (TGs), and the metabolic outcomes total cholesterol (Tc) and low-density lipids (LDL-c), systolic (SBP) and diastolic blood pressure (DBP), body composition and fitness were measured. Results: Poor sleep quality showed a positive association with body fat (%) ≥ 48.2 (OR; 8.39, 95% CI; 1.13–62.14, p = 0.037), morbid obesity (OR; 8.44, 95% CI; 1.15–66.0, p = 0.036), glucose ≥ 100 mg/dL (OR; 8.44, 95% CI; 1.15–66.0, p = 0.036) and relative handgrip strength ≤ 0.66 (OR; 12.2, 95% CI; 1.79–83.09, p = 0.011). Conclusion: sleep quality is associated with health markers in women with severe/morbid obesity.

Correlates of poor sleep based upon wrist actigraphy data in bipolar disorder

BACKGROUND

Wrist-worn actigraphy can objectively measure sleep, and has advantages over self-report, particularly for people with Bipolar Disorder (BD) for whom self-reports might be influenced by affect. Clinically useful data reduction approaches are needed to explore these complex data.

METHODS

We created a composite score of sleep metrics in BD based on 51 BD and 80 healthy comparison (HC) participants. Subjects wore an actigraph for up to 14 consecutive 24-h periods, and we assessed total sleep time (TST), wake after sleep onset (WASO), percent sleep (PS), and number of awakenings (NA). We focused on participants who had at least 5 nights of actigraphy data. We computed z-scores for within-person means of sleep measures for BD subjects versus HCs, which were averaged to create a composite measure. We correlated this composite with participant characteristics, and used LASSO regression to identify sleep measures best explaining variability in identified correlates.

RESULTS

Sleep measures and the composite did not differ between BDs and HCs; however, there was considerable variability in z-scores among those with BD. In BDs, the composite score was higher in women (t₍₄₉₎ = 2.28, p = 0.027) and those who were employed (t₍₃₄₎ = 2.34, p = 0.025), and positively correlated with medication load (r = 0.41, p = 0.003) while negatively correlated with Young Mania Rating Scale (YMRS; r = -0.35, p = 0.030). In LASSO regression, TST and NA best explained medication load while PS best explained employment and YMRS.

CONCLUSION

While a composite score of sleep metrics may provide useful information about sleep quality globally, our findings suggest that selection of theory-driven sleep measures may be more clinically meaningful.

Association between sleep quality and central obesity among southern Chinese reproductive-aged women

BACKGROUND

The connections between sleep quality and central obesity among reproductive-aged women are not clear. The study aimed to explore the association between sleep quality and central obesity among Chinese reproductive-aged women and identify the independent contributions of sociodemographic characteristics, health-related factors, and sleep quality to central obesity.

METHODS

In this cross-sectional survey, the minimal sample sizes were 2404 subjects; 2449 Chinese women aged 18-49 participated in this study. Sleep quality was assessed by the Chinese version of the Pittsburgh Sleep Quality Index (PSQI). Central obesity as the outcome of interest was a binary variable; women were categorized as with versus without central obesity measured by waist circumference (WC). The independent contribution of sociodemographic characteristics (Cluster 1), health-related variables (Cluster 2), and sleep quality (Cluster 3) to central obesity was derived from the corresponding R² change (individual R² change/total R² × 100%), using clustered multiple logistic regression analyses.

RESULTS

The risk of central obesity increased significantly with poor sleep quality (assessed by global PSQI score) [adjusted odds ratio (OR) = 2.20 per SD increase; 95% confidence interval (CI) = 1.28-3.78; P = 0.004], increased sleep disturbance score (adjusted OR = 1.11 per SD increase; 95% CI = 1.01-1.22; P = 0.042) and decreased subjective sleep quality score (adjusted OR = 0.81 per SD increase; 95% CI = 0.73-0.90; P < 0.001). The independent contribution of sleep quality was 9.9%, less than those of sociodemographic (73.3%) and health-related (16.8%) variables. Among complaints related to sleep disturbance, the inability to breathe comfortably, and having bad dreams showed significant associations with central obesity.

CONCLUSIONS

There exists some degree of correlation between sleep quality and central obesity among Chinese reproductive-aged women. These findings underscore the need for future public health guidelines to formulate some detailed strategies to improve sleep quality, such as preventing and intervening risk factors that influence sleep quality and suggesting optimal sleep duration, which might effectively reduce the incidence of central obesity in this population group.

Improved sleep efficiency is associated with reduced cardio-metabolic risk: Findings from the MODERN trial

Poor sleep increases cardio-metabolic risk, but limited information on the impact of sleep for the improvement of cardio-metabolic health exists. This analysis examined the impact of sleep on a health and lifestyle modification programme to reduce cardio-metabolic disease risk factors. Secondary analysis of the MODERN randomised controlled trial to reduce cardio-metabolic risk was undertaken at baseline and 24-month follow-up. Participants aged 40-70 years (n = 121) with three or more cardio-metabolic risk factors were randomised to a health and lifestyle modification intervention (n = 59) or usual care (n = 62), and underwent 7 day/night actigraphy to assess total sleep time, sleep efficiency (%), number of awakenings/night and physical activity levels. Blood pressure, blood lipid and glycaemic levels, anthropometric and diet measures were collected. The mean age was 59 ± 7 years and 37% were male. Baseline sleep measures were not different between groups. At the 24-month follow-up, both groups showed improvements in cardio-metabolic risk factors, albeit the change in blood pressure was greater in the intervention compared with the usual care group (systolic blood pressure: -11 versus -4 mmHg, p = .014). There were no differences between groups for diet, physical activity or sleep parameters. An increase in sleep efficiency was independently associated with lower systolic blood pressure (β = -2.117, p = .002) and higher high-density lipoprotein levels (β = 0.040, p = .033); an increase in total sleep time was associated with lower low-density lipoprotein levels (β = -0.003, p = .038) at 24 months. Overall, improvement in sleep quality over time was beneficial to reduce blood pressure and lipid levels. These findings highlight sleep as a potential target to reduce cardio-metabolic risk.

Physical activity across life stages and sleep quality in adulthood - an epidemiological study

OBJECTIVE

To analyze the association between the continuous physical activity (PA) at different life stages with sleep quality in adults.

METHODS

This is an observational study with a cross-sectional design. A sample of 843 adults (61.7% female) with a mean age of 56.6 (±18.3) years was randomly selected. The PA at different life stages was assessed retrospectively in childhood and adolescence, and the current PA was assessed by Baecke Physical Activity Questionnaire. Sleep quality was assessed using the Mini-Sleep Questionnaire. Variables of sex, age group, ethnicity, socioeconomic status, and current physical activity were covariates. The association between continuous PA at different life stages with sleep quality was analyzed by binary logistic regression models.

RESULTS

Overweight adults who practiced PA in adolescence were 46% less likely to have poor sleep quality when compared to those who did not practice physical activity in this life stage (Odds ratio = 0.54, p = 0.031). Adults who continued to practice PA at youth and adulthood were 49% less likely to have poor sleep quality when compared to those without continuous PA (Odds ratio = 0.51, p = 0.009).

CONCLUSIONS

Poor sleep quality was negatively associated with continuous PA between youth and adulthood in overall sample and negatively associated with PA in adolescence among overweight adults.

Sleep Quality Is Associated with Vitamin B12 Status in Female Arab Students

Studies have explored how vitamin B12 status affects sleep among elders and children, but this remains to be investigated among young adults. We used the Pittsburgh Sleep Quality Index (PSQI) to assess the association between serum vitamin B12 and sleep among female college students in Saudi Arabia. In this cross-sectional study, we enrolled 355 participants (age (years), 20.7 ± 1.5; body mass index, 23.6 kg/m² ± 5.2) at King Saud University, Riyadh, Saudi Arabia. Fasting blood samples were analyzed regarding the serum vitamin B12 and blood lipids. Anthropometric, socio-demographic, clinical history, stress, physical activity, and dietary data were collected. We assessed the sleep statuses of the participants using the PSQI. Around 72% of the participants were “poor” sleepers (PSQI > 5). Subgroup analysis within the tertiles showed that participants with higher vitamin B12 in the second and third tertiles reported better scores for sleep quality (B ± SE = −12.7 ± 5.6, p = 0.03; B ± SE = −32.7 ± 16.4, p = 0.05, respectively) and also reported a lower use of sleep medication (B ± SE = −21.2 ± 9.9, p = 0.03, in the second tertile only), after adjusting for the waist–hip ratio and stress. However, sleep was not found to be directly associated with either serum vitamin B12 or dietary vitamin B12. In conclusion, the serum vitamin B12 results show that the participants with higher vitamin B12 in the second and third tertiles reported better scores on the sleep quality scale and a lower use of sleep medication. However, no such associations were observed with the overall PSQI. More studies with larger sample sizes are needed to establish a direct relationship between sleep and vitamin B12.

Sleep disturbance in adult dermatologic patients: A cross-sectional study on prevalence, burden, and associated factors

BACKGROUND

Sleep disturbance remains insufficiently characterized in many dermatoses.

OBJECTIVE

To investigate the prevalence, burden, and factors associated with sleep disturbance in dermatologic patients.

METHODS

We recruited 800 patients and recorded pruritus characteristics and sociodemographic and clinical parameters. Validated questionnaires were used to assess sleep disturbance, psychological distress, health-related quality of life, and work productivity.

RESULTS

Two thirds of patients met criteria of poor sleep, which was associated with psychological distress, diminished health-related quality of life, and lost work productivity. Patients with average and maximum pruritus on the visual analog scale exceeding 5 and 6.5 points, respectively, were at high risk of suffering pruritus-related sleep disturbance. Overall pruritus intensity and its nocturnal exacerbation contributed independently to sleep disturbance. Psychological distress was of even higher impact on sleep than pruritus and almost a third of the relationship between pruritus intensity and sleep was mediated by psychological distress.

CONCLUSION

Sleep disturbance is prevalent in dermatologic patients and constitutes a considerable burden.

CLINICAL IMPLICATION

Dermatologic patients with intense pruritus and psychological distress should be examined for sleep disorders. Adequate antipruritic therapy and complementary psychotherapy in affected patients may help them regain restorative sleep.

Dietary nutrients' intake and sleep quality in peritoneal dialysis patients

Sleep disturbances are common in dialysis patients. However, there is a lack of information on nutritional determinants of sleep disorders in dialysis patients. The objective of the current study was to investigate the association between nutrients’ intake and sleep quality in peritoneal dialysis patients. The cross-sectional study was done on 114 peritoneal dialysis patients referred to Alzahra and Khorshid hospitals, Isfahan, Iran. Information on sleep quality and dietary intakes were collected using Pittsburgh sleep quality index and 168-item food frequency questionnaire respectively. Anthropometric measurements were done by a trained dietitian based on standard protocols. Socio-demographic and clinical data were obtained through a structured questionnaire. The binary logistic regression model was used to detect the association between nutrients’ intake and sleep quality. Our results indicated that there was not any significant difference in basic (socio-demographic and clinical) characteristics between peritoneal dialysis patients with good and poor sleep quality (p>0.05). The results of logistic regression indicated a positive significant association between dietary intake of carbohydrate (OR:3;95% CI:1.32-6.81; p<0.05), fat (OR:3;95% CI:1.32-6.81; p<0.05), and fiber (OR:2.53;95% CI: 1.12-5.67; p<0.05) with poor sleep quality in crude and adjusted models (p<0.05). However, there was not any significant association between dietary intake of protein and poor sleep quality (p>0.05). The results of the present study indicated that dietary intake of nutrients affect sleep quality in dialysis patients. These results help healthcare professionals in making nutritional interventions to improve sleep quality in dialysis patients.

Abuse in Childhood and Risk for Sleep Disruption in Adulthood in the Black Women's Health Study

OBJECTIVE

To investigate the association of early life abuse with sleep disruption risk in adulthood among U.S. Black women.

METHODS

We analyzed data from the Black Women's Health Study, a prospective cohort study. In 2005, 29,998 women completed a self-administered questionnaire on early-life experiences of abuse (child and teen) and exposure to danger at any life stage. Participants reported on their sleep quality (snoring and diagnosed sleep apnea) in 2001, whether their "sleep was restless" in 2005, and their average sleep duration in 2009. We used log-binomial regression models to derive risk ratios (RRs) and 95% confidence intervals (CIs) for the association of child/teen abuse and danger at any life stage with snoring, diagnosis of sleep apnea, restless sleep, and short sleep duration.

RESULTS

Nearly 50% of participants reported one or more measure of sleep disruption in adulthood. Higher severity of physical abuse was associated with increased risk of sleep disruption and higher severity of sexual abuse was associated with increased risk for most sleep disruptions. The RR comparing child/teen physical and sexual abuse relative to no abuse was highest for diagnosed sleep apnea (2.03, 95% CI: 1.70, 2.41). Feeling in danger at any life stage (child, teen, adult, past year) was generally associated with greater increases in risk of sleep disruption among women with a history of early life abuse than among women without such a history.

CONCLUSIONS

Our findings suggest that abuse as a child and/or teen is related to disrupted sleep in adulthood.

[Sleep-related problems and associated factors among the Brazilian population: National Health Survey, 2013]

The scope of this study was to estimate the frequency of sleep-related problems and associated factors. It was a study based on data from the National Health Survey conducted in Brazil in 2013. Sleep-related problems were assessed with the question "How often have you had sleep problems in the last two weeks, such as difficulty falling asleep, waking up frequently during the night or sleeping more than usual?" The answers were grouped into: none of the days, less than half of the days and more than half of the days. Of the individuals evaluated, 71.1% reported having no problems with sleep on any day, 14.0% on at least half of the days and 14.9% on more than half of the days. The highest frequencies of sleep-related problems were reported by women and more advanced age. For men and women, smoking, alcohol abuse, physical inactivity, sedentary behavior, and high blood pressure were significantly associated with the frequency of sleep problems on more than half of the days, and also excess weight for women. Thus, the frequency of sleep-related problems in the Brazilian population was high. Women, older individuals with lifestyle-related risk behaviors, high blood pressure, and overweight were the highest risk subgroups.

Association between habitual sleep duration/quality and appetite markers in individuals with obesity

STUDY OBJECTIVES

To assess if habitual sleep duration/quality was associated with appetite in individuals with obesity, and if the association was modulated by sex.

METHODS

Sleep duration/quality was measured with Pittsburgh Sleep Quality Index score in 95 healthy adults with obesity (BMI: 36.6 ± 4.2 kg/m²). Subjective feelings of appetite were assessed using visual analogue scales, and plasma concentrations of active ghrelin, total peptide YY, active glucagon-like peptide 1, cholecystokinin (CCK) and insulin were measured in fasting and every 30 min up to 2.5 h after a meal.

RESULTS

No significant associations were found between sleep duration, or overall quality, and appetite in all participants. However, a worse sleep efficiency was associated with lower postprandial CCK, a shorter habitual sleep was associated with lower postprandial desire to eat and a lower daytime dysfunction was associated with higher prospective food consumption in fasting (P<0.05, for all). In males, a shorter habitual sleep duration and a worse subjective sleep quality were associated with increased basal and postprandial active ghrelin (P<0.05, P<0.01, P<0.01 and P<0.05, respectively). Also, a shorter habitual sleep was associated with lower basal and postprandial insulin (P<0.05 for both) and a worse overall sleep quality with lower postprandial insulin (P<0.05). In females, a worse overall sleep quality was associated with lower postprandial active ghrelin (P<0.05), and short habitual sleep with higher postprandial insulin (P<0.05).

CONCLUSION

A worse habitual sleep efficiency is associated with blunted postprandial CCK secretion in individuals with obesity. The association between habitual sleep duration/quality and insulin and active ghrelin seems to be modulated by sex, but more studies are needed to confirm these findings.

Relevance of Physical Activities, Sedentary Behaviors, and Genetic Predisposition in Body Fatness: Population-Based Study on Chinese Adults

INTRODUCTION

Little attention has been paid to the interacting effect of specific intensities of physical activities (PAs) and sedentary lifestyle, like television watching, and genetic predisposition on body composition indices among Chinese adults. Herein, we aimed to examine whether specific types of PAs and sedentary behaviors (SBs) were associated with body composition indices among Chinese adults and to further explore whether these associations interacted with the genetic predisposition to high BMI.

METHODS

Cross-sectional data regarding PAs and time spent on SBs and dietary intake of 3,976 Chinese adults (54.9% women) aged 25-65 years in Southwest China were obtained via questionnaires in 2013-2015. Weight, height, and waist circumference (WC) were measured, and BMI, percentage of body fat (%BF), fat mass index (FMI), and fat-free mass index (FFMI) of the participants were calculated. Genetic risk score (GRS) was calculated on 9 established BMI-associated SNPs among Chinese adults.

RESULTS

When the participants were stratified by GRS for BMI, significant associations were only found for adults with high GRS for BMI: moderate-to-vigorous physical activity (MVPA) was negatively associated with WC and %BF and positively related to FFMI. The adjusted positive relationship of time spent watching television with BMI, WC, %BF, and FMI were also just found between adults with high weighted GRS for high BMI: for every 1 h increment in television watching, the BMI, WC, %BF, and FMI of the participants increased by 0.2 kg/m2, 0.9 cm, 0.3%, and 0.1 kg/m2, respectively (p < 0.02).

CONCLUSION

MVPA may be a protective factor against obesity, and prolonged television watching may accentuate adiposity. These putative effects may be more pronounced among individuals with a high genetic risk of a high BMI.

The impact of sleep quality and duration on leptin, appetite, and obesity indices in adults

BACKGROUND Poor sleep duration and quality were previously reported to increase the risk of obesity. This study was aimed to evaluate the impact of sleep quality and duration on leptin, appetite, and adiposity in Indonesian adults. METHODS This cross-sectional study recruited adults in Yogyakarta, Indonesia, in 2016. Sleep quality was assessed using the Pittsburgh sleep quality index, appetite was evaluated using the community nutrition appetite questionnaire, and dietary intake was assessed by interviews using the semi-quantitative food frequency questionnaire. Sleep duration was also asked. Obesity indices were measured using the body mass index (BMI), waist-hip circumference, and percentage of body fat. Leptin was analyzed using the enzyme-linked immunosorbent assay. A Spearman analysis was done to evaluate the correlation between sleep quality, sleep duration, anthropometric measures, dietary intake, appetite, and leptin. RESULTS 244 adults participated in this study. This study showed that lower sleep quality and duration was significantly correlated with higher body weight (r = 0.129, p = 0.043 and r = −0.228, p<0.001), BMI (r = 0.176, p = 0.006 and r = −0.202, p = 0.001), and waist circumference (r = 0.179, p = 0.005 and r = −0.254, p<0.001). There was a correlation between poor sleep quality and higher leptin concentration (r = 0.186, p = 0.004). Sleep quality and duration were not associated with appetite (r = 0.109, p = 0.109 and r = −0.043, p = 0.500). CONCLUSIONS This study found that lower sleep quality was correlated with higher BMI, higher leptin concentration, but not appetite.

Associations of sleep and depression with obesity and sarcopenia in middle-aged and older adults

OBJECTIVES

To analyze the association of depression and the quality and duration of sleep with general and abdominal obesity, sarcopenia, and sarcopenic obesity (SO) in Spanish middle-aged and older adults.

STUDY DESIGN AND OUTCOME MEASURES

A total of 304 people (mean age 72.04 ± 7.88 years, 83.88 % women) participated in this study. Body mass index, waist circumference, skeletal muscle mass index (bioelectrical impedance analysis), and hand-grip strength were used to evaluate sarcopenia, obesity, and SO. The Pittsburgh Sleep Quality Index was used to evaluate sleep quality. Sleep duration (hours) was categorized as either short (<6), normal (6-8), or long (>8). Depression was measured using the Hospital Anxiety and Depression Scale. Fatigue (Fatigue Severity Scale), nutritional status (Mini Nutritional Assessment Survey) and physical activity (PA) level (International Physical Activity Questionnaire-Short Form) were also assessed. Independent associations were evaluated by multivariate logistic regressions.

RESULTS

Only depression was associated with sarcopenia (OR = 1.10, 95 % CI = 1.02-1.19). Poorer sleep quality (OR = 1.06, 95 % CI = 1.06-1.11) and short sleep duration (OR = 2.63, 95 % CI = 1.45-4.78) were related to general obesity, as well as fatigue and low PA level. Poor sleep latency (OR = 1.43, 95 % CI = 1.09-1.87) was linked to abdominal obesity, along with fatigue, low PA level, older age, and female sex. Finally, short sleep duration (OR = 5.25, 95 % CI = 1.97-14.00), together with fatigue, low PA level, and male sex were associated with OS.

CONCLUSION

Among Spanish middle-aged and older adults, after adjusting for potential confounding variables, depression was uniquely associated with sarcopenia, while short sleep duration was related to general and sarcopenic obesity, and poor sleep quality was linked to general and abdominal obesity.