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Fang Y, Yang MJ, Ning D, Huang H, He Y, Huang Y, Nagel E, Pan D, Wang W, Qin T, Wang M. Associations between sleep duration trajectories and risk of cardio-metabolic disease among middle-aged and older Chinese adults. J Affect Disord 2024; 362:126-133. [PMID: 38945401 DOI: 10.1016/j.jad.2024.06.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 05/18/2024] [Accepted: 06/27/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND The association of a single time-point measure of sleep duration with cardio-metabolic disease has been extensively studied, but few studies have focused on the impact of sleep duration trajectory. This study aims to model the sleep duration trajectory as predictors for the subsequent development of cardio-metabolic disease. METHODS This study recruited a notably large population (n = 9883) of subjects aged at least 45 years from the China Health and Retirement Longitudinal Study (CHARLS), who participated in sequential surveys conducted in 2011, 2013, 2015, and 2018. Sleep duration trajectories were plotted using data of night sleep duration recorded at intervals from 2011 to 2015 by latent class trajectory model. The onset of cardio-metabolic diseases from 2015 to 2018 were confirmed and then the risk of different sleep duration trajectories on incident cardio-metabolic disease was examined using cox proportional hazards regression model. RESULTS We identified four sleep duration trajectories. Compared to the normal-stable trajectory, the short-stable trajectory was significantly associated with higher risk of incident stroke (hazard ratio [HR], 1.32; 95 % confidence interval [CI], 1.02 to 1.70), dyslipidemia (HR, 1.22; 95%CI, 1.01 to 1.49), and diabetes (HR, 1.42; 95%CI, 1.13 to 1.78) within three years of follow-up, and the short-increasing trajectory predicted a higher risk of incident stroke (HR, 2.38; 95%CI, 1.25 to 4.55). CONCLUSIONS Short sleep trajectory could increase the risk of incident stroke, dyslipidemia, and diabetes, and an increasing sleep trajectory was associated with increased risk of incident stroke among middle-aged and older Chinese adults.
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Affiliation(s)
- Yuanyuan Fang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mia Jiming Yang
- Institute for Management in Medicine and Health Sciences, University of Bayreuth, Bayreuth, Germany
| | - Deng Ning
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Huang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuqin He
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanzhu Huang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Eckhard Nagel
- Institute for Management in Medicine and Health Sciences, University of Bayreuth, Bayreuth, Germany
| | - Dengji Pan
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tingting Qin
- Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Minghuan Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Chen X, Zhou M, Wang J, Liu M, Zhu C, Wu C, Dong M, Liu Y, Ai S, Feng H, Luo T, Liang YY, Zhang J, Wing YK, Jia F, Ning Y, Lei B. Associations of objective sleep duration and physical activity with risk of heart failure: A prospective cohort study. Gen Hosp Psychiatry 2024; 90:141-149. [PMID: 39182467 DOI: 10.1016/j.genhosppsych.2024.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 08/02/2024] [Accepted: 08/15/2024] [Indexed: 08/27/2024]
Abstract
OBJECTIVE This study aimed to investigate the independent and joint associations of accelerometer-derived sleep duration and physical activity (PA) in different intensities with the risk of incident heart failure (HF). METHODS The study included 89,572 participants (mean age 62.2 ± 7.8 years, 42.8% male) from the UK Biobank. Sleep duration (short: <6 h/day; normal: 6-8 h/day; long: >8 h/day) and PA [total PA, light PA (LPA), moderate-to-vigorous PA (MVPA), vigorous PA (VPA)] were measured using accelerometers over 7 days. MVPA and VPA were categorized according to the World Health Organization's recommended levels, while LPA and total PA were categorized based on the median. HF cases were identified through hospital records or death registries. RESULTS Over a 7-year follow-up period, 1324 participants (2.1%; incidence rate, 2.1 per 1000 person-years) developed HF. Short, but not long, sleep duration was linked to a 33% increased risk of HF [hazard ratio (HR) 1.33, 95% confidence interval (CI): 1.11-1.59]. This increased risk associated with short sleep could be mitigated by increasing PA, especially to the levels of recommended MVPA or VPA. In joint analyses, compared to participants meeting the recommended MVPA and with normal sleep duration, those not meeting the MVPA recommendation and with short sleep had the highest HF risk (HR 1.78, 95% CI: 1.42-2.25). CONCLUSIONS Accelerometer-derived short, but not long, sleep duration was associated with a higher risk of incident HF. Engaging in sufficient PA, especially recommended MVPA or VPA, can partially mitigate this risk.
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Affiliation(s)
- Xinru Chen
- The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China; Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China
| | - Mingqing Zhou
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510282, China
| | - Jinyu Wang
- Department of Rehabilitation, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Mingyang Liu
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China; School of Health Management, Guangzhou Medical University, Guangzhou 511436, China
| | - Changguo Zhu
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China
| | - Chao Wu
- Institute for Heart and Brain Health, University of Michigan Medical Center, Ann Arbor, MI 48109, USA
| | - Mingchao Dong
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China
| | - Yaping Liu
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510370, China
| | - Sizhi Ai
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510370, China; Department of Cardiology, Heart Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, China
| | - Hongliang Feng
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510370, China
| | - Tong Luo
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510370, China
| | - Yannis Yan Liang
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510370, China; Institute of Psycho-Neuroscience, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China
| | - Jihui Zhang
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510370, China
| | - Yun-Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR 999077, China; Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR 999077, China
| | - Fujun Jia
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510120, China.
| | - Yuping Ning
- The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510370, China; The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China.
| | - Binbin Lei
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University; Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510120, China.
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He L, Ma T, Wang X, Cheng X, Bai Y. Association between longitudinal change of sleep patterns and the risk of cardiovascular diseases. Sleep 2024; 47:zsae084. [PMID: 38635888 DOI: 10.1093/sleep/zsae084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/04/2024] [Indexed: 04/20/2024] Open
Abstract
STUDY OBJECTIVES To investigate the role of longitudinal change of sleep patterns in the incidence of cardiovascular diseases (CVD). METHODS Based on UK Biobank, a total of 18 172 participants were enrolled. Five dimensions of healthy sleep including early chronotype, sleep 7-8 hours/day, free of insomnia, no snoring, and no frequent excessive daytime sleepiness were used to generate a healthy sleep score (HSS) ranging from 0 to 5. Corresponding to the HSS of 0-1, 2-3, and 4-5, the poor, intermediate, and healthy sleep patterns were defined. Based on changes in HSS across assessments 1 and 2, we calculated the absolute difference of HSS. For the change in sleep patterns, we categorized five profiles (stable healthy, worsening, stable intermediate, optimizing, and stable poor sleep patterns). The outcomes were incidence of CVD including coronary heart disease (CHD) and stroke. We assessed the adjusted hazard ratios and 95% confidence intervals (CIs) by Cox hazard models. RESULTS Compared with participants with stable poor patterns, those who improved their sleep patterns or maintained healthy sleep patterns had a 26% and 32% lower risk of CVD, respectively. Stable healthy sleep pattern was associated with a 29% and 44% reduced risk of CHD and stroke. Per unit, longitudinal increment of the HSS was related to an 8% lower risk of CVD and CHD. Compared with individuals with constant HSS, those with decreased HSS had a 13% higher risk of developing CVD. CONCLUSIONS Optimizing sleep patterns and maintaining a healthy sleep pattern may reduce the risk of CVD.
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Affiliation(s)
- Lingfang He
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Tianqi Ma
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Xuerui Wang
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Xunjie Cheng
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yongping Bai
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Kim M, Lyon-Caen S, Bayat S, Philippat C, Plancoulaine S. Parents' Sleep Multi-Trajectory Modelling from 3 to 36 Months Postpartum in the SEPAGES Cohort. Nat Sci Sleep 2024; 16:247-261. [PMID: 38465330 PMCID: PMC10924785 DOI: 10.2147/nss.s430024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/14/2023] [Indexed: 03/12/2024] Open
Abstract
Objective We investigated maternal and paternal sleep evolution from 3 to 36 months postpartum, their interrelations and predictors in the SEPAGES cohort. Methods Sleep information (night sleep duration [NSD], weekend daytime sleep duration [DSD] and subjective sleep loss [SSL]) was collected by self-administered questionnaires at 3, 18, 24 and 36 months postpartum in the SEPAGES French cohort that included 484 mothers and 410 fathers. Group-based multi-trajectory modelling was used to identify maternal, paternal and couple sleep multi-trajectory groups among 188 couples reporting sleep data for at least 2 time points. Multinomial logistic regression was used to assess associations between parental sleep multi-trajectories and early characteristics such as sociodemographic, chronotypes, child sex, birth seasonality or breastfeeding duration. Results We identified three maternal (M1-M3), paternal (F1-F3) and couple (C1-C3) sleep multi-trajectory groups with similar characteristics: a group with short NSD and high SSL prevalence (M1, F2, C2), a group with long NSD but medium SSL prevalence (M2, F3, C3) and a group with long NSD and low SSL prevalence (M3, F1, C1). Mothers with the shortest NSD (M1) were less likely to have a partner with long NSD (F2). As compared with long NSD and low SSL prevalence (C1), couples with short NSD and high SSL prevalence (C2) were less likely to have had a first child born in the autumn and fathers in C2 had a later chronotype. Conclusion We identified distinct sleep multi-trajectory groups for mothers, fathers and couples from 3- to 36-month postpartum. Sleep patterns within couples were homogeneous.
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Affiliation(s)
- Mihyeon Kim
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, F-75004, France
| | - Sarah Lyon-Caen
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Sam Bayat
- STROBE Inserm UA7 Laboratory & Grenoble University Hospital, Sept. of Pulmonology, Grenoble, France
| | - Claire Philippat
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Sabine Plancoulaine
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, F-75004, France
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, WAKING, Bron, F-69500, France
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Jin X, Chen Y, Feng H, Zhou M, Chan JWY, Liu Y, Kong APS, Tan X, Wing YK, Liang YY, Zhang J. Association of accelerometer-measured sleep duration and different intensities of physical activity with incident type 2 diabetes in a population-based cohort study. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:222-232. [PMID: 36871624 PMCID: PMC10980868 DOI: 10.1016/j.jshs.2023.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/28/2022] [Accepted: 02/12/2023] [Indexed: 05/17/2023]
Abstract
PURPOSE The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity (PA) with the risk of incident type 2 diabetes in a population-based prospective cohort study. METHODS Altogether, 88,000 participants (mean age = 62.2 ± 7.9 years, mean ± SD) were included from the UK Biobank. Sleep duration (short: <6 h/day; normal: 6-8 h/day; long: >8 h/day) and PA of different intensities were measured using a wrist-worn accelerometer over a 7-day period between 2013 and 2015. PA was classified according to the median or World Health Organization-recommendation: total volume of PA (high, low), moderate-to-vigorous PA (MVPA) (recommended, not recommended), and light-intensity PA (high, low). Incidence of type 2 diabetes was ascertained using hospital records or death registries. RESULTS During a median follow-up of 7.0 years, 1615 incident type 2 diabetes cases were documented. Compared with normal sleep duration, short (hazard ratio (HR) = 1.21, 95% confidence interval (95%CI): 1.03-1.41) but not long sleep duration (HR = 1.01, 95%CI: 0.89-1.15) was associated with excessive type 2 diabetes risk. This increased risk among short sleepers seems to be protected against by PA. Compared with normal sleepers with high or recommended PA, short sleepers with low volume of PA (HR = 1.81, 95%CI: 1.46-2.25), not recommended (below the World Health Organization-recommended level of) MVPA (HR = 1.92, 95%CI: 1.55-2.36), or low light-intensity PA (HR = 1.49, 95%CI: 1.13-1.90) had a higher risk of type 2 diabetes, while short sleepers with a high volume of PA (HR = 1.14, 95%CI: 0.88-1.49), recommended MVPA (HR = 1.02, 95%CI: 0.71-1.48), or high light-intensity PA (HR = 1.14, 95%CI: 0.92-1.41) did not. CONCLUSION Accelerometer-measured short but not long sleep duration was associated with a higher risk of incident type 2 diabetes. A higher level of PA, regardless of intensity, potentially ameliorates this excessive risk.
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Affiliation(s)
- Xinyi Jin
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Yilin Chen
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; School of Medicine, South China University of Technology, Guangzhou 510641, China
| | - Hongliang Feng
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China; Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510180, China
| | - Mingqing Zhou
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510282, China; Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510120, China
| | - Joey W Y Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China; Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Yaping Liu
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Alice Pik Shan Kong
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Xiao Tan
- Department of Medical Sciences, Uppsala University, Uppsala 751 85, Sweden; Department of Big Data in Health Science, Zhejiang University School of Public Health, Hangzhou 310058, China
| | - Yun-Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China; Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Yannis Yan Liang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China.
| | - Jihui Zhang
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510180, China; Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510120, China; Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou 510260, China.
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Stavås JA, Nilsen KB, Matre D. The association between proportion of night shifts and musculoskeletal pain and headaches in nurses: a cross-sectional study. BMC Musculoskelet Disord 2024; 25:67. [PMID: 38229099 DOI: 10.1186/s12891-024-07196-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 01/11/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND AND PURPOSE Shift work is associated with musculoskeletal pain and headaches, but little is known about how the intensity of shift work exposure is related to musculoskeletal pain and headaches. This study aimed to investigate whether a higher proportion of night shifts is associated with a higher occurrence of musculoskeletal pain and headaches. Furthermore, to investigate whether sleep duration can mediate this potential association. METHOD The study included 684 nurses in rotating shift work who responded to a daily questionnaire about working hours, sleep, and pain for 28 consecutive days. The data were treated cross-sectionally. RESULTS A negative binomial regression analysis adjusted for age and BMI revealed that working a higher proportion of night shifts is not associated with a higher occurrence of musculoskeletal pain and headaches. On the contrary, those working ≥ 50% night shifts had a significantly lower occurrence of pain in the lower extremities than those who worked < 25% night shifts (IRR 0.69 95% CI 0.51, 0.94). There was no indication of a mediation effect with total sleep time (TST). CONCLUSION The results of this study indicate that working a higher proportion of night shifts is not associated with a higher occurrence of musculoskeletal pain and headaches.
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Affiliation(s)
- Jon Are Stavås
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- National Institute of Occupational Health (STAMI), Oslo, Norway
| | - Kristian Bernhard Nilsen
- Neuroscience Clinic, Department of Neurology and Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
| | - Dagfinn Matre
- National Institute of Occupational Health (STAMI), Oslo, Norway.
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Davis-Cheshire R, Bennington S, Hartsek A, Kelly T, Marinelli J, Perez A. The Impact of Weighted Blanket Use on Adults with Sensory Sensitivity and Insomnia. Occup Ther Int 2023; 2023:3109388. [PMID: 38152339 PMCID: PMC10752672 DOI: 10.1155/2023/3109388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/29/2023] [Accepted: 12/07/2023] [Indexed: 12/29/2023] Open
Abstract
Purpose This study's purpose was to determine the impact of weighted blanket use on moderate to severe insomnia in adults with sensory sensitivity greater than the average population. Methods For this study, a four-week, single-case, multiple-participant ABA study design was used. Through convenience sampling, four participants scoring 15 or greater on the Insomnia Severity Index (ISI), which categorizes them as having moderate to severe insomnia, and much more than most people in sensory sensitivity on the Adolescent/Adult Sensory Profile were recruited. First, seven-day baseline sleep data was gathered, followed by two weeks of weighted blanket use, concluding with a seven-day withdrawal phase. Additional outcome measures included: Tuck and Snooze Survey, Consensus Sleep Diary Morning, and Additional Sleep Diary Questions. Data analysis included visual analysis, mean comparisons, Tau-U calculations, and pre- to post-ISI category comparisons. Results All participants' ISI scores were categorized as one level less severe postintervention. All participants demonstrated increased sleep quality, and three participants showed an increase in sleep duration based on individual mean comparisons between baseline and intervention phases. Conclusion Weighted blankets appear beneficial in reducing insomnia severity in adults with much more than the average population sensory sensitivity. In addition, those with self-reported anxiety may have increased benefit from this intervention.
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Affiliation(s)
| | | | - Allison Hartsek
- Kettering College, 3737 Southern Blvd, Kettering, OH 45429, USA
| | - Teresa Kelly
- Kettering College, 3737 Southern Blvd, Kettering, OH 45429, USA
| | | | - Amanda Perez
- Kettering College, 3737 Southern Blvd, Kettering, OH 45429, USA
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Watanabe D, Yoshida T, Watanabe Y, Yamada Y, Miyachi M, Kimura M. Combined Use of Sleep Quality and Duration Is More Closely Associated With Mortality Risk Among Older Adults: A Population-based Kyoto-Kameoka Prospective Cohort Study. J Epidemiol 2023; 33:591-599. [PMID: 36155361 PMCID: PMC10635816 DOI: 10.2188/jea.je20220215] [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: 07/22/2022] [Accepted: 09/12/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Whether sleep quality and duration assessed from multiple domains, either individually or in combination, are strongly associated with mortality risk in older adults remains unelucidated. We aimed to clarify these relationships. METHODS We enrolled 7,668 older (age ≥65 years) Japanese adults in the Kyoto-Kameoka prospective cohort study who provided valid responses to the Pittsburgh Sleep Quality Index (PSQI) in a mail-in survey. Sleep quality and duration were classified into six groups using the previously validated PSQI: short sleep duration (SSD: <360 min/day)/sleep disturbance (SD: ≥5.5 PSQI points), n = 701; SSD/non-sleep disturbance (NSD: <5.5 PSQI points), n = 100; optimal sleep duration (OSD: 360-480 min/day)/NSD, n = 1,863; OSD/SD, n = 2,113; long sleep duration (LSD: >480 min/day)/NSD, n = 1,972; LSD/SD, n = 919. Mortality data were collected from February 15, 2012, to November 30, 2016. We evaluated the relationship between all-cause mortality risk and sleep quality and duration (and their combinations) using a multivariable Cox proportional hazards model that included baseline covariates. RESULTS The median follow-up period was 4.75 years (34,826 person-years), with a total of 616 deaths. After adjusting for confounders, compared with other groups, SSD/SD and LSD/SD had the highest hazard ratio (HR) of mortality (SSD/SD: HR 1.56; 95% confidence interval [CI], 1.10-2.19; SSD/NSD: HR 1.27; 95% CI, 0.47-3.48; OSD/NSD: reference; OSD/SD: HR 1.20; 95% CI, 0.91-1.59; LSD/NSD: HR 1.35; 95% CI, 1.03-1.77; LSD/SD: HR 1.83; 95% CI, 1.37-2.45). However, mortality risk was not associated with the interaction between sleep quality and duration. CONCLUSION Older adults with sleep disturbances involving SSD and LSD have a strong positive association with mortality risk, suggesting an additive effect between sleep quality and duration.
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Affiliation(s)
- Daiki Watanabe
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan
| | - Tsukasa Yoshida
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan
- Senior Citizen’s Welfare Section, Kameoka City Government, Kyoto, Japan
| | - Yuya Watanabe
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Tokyo, Japan
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan
| | - Motohiko Miyachi
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Misaka Kimura
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan
- Department of Nursing, Doshisha Women’s College of Liberal Arts, Kyoto, Japan
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - the Kyoto-Kameoka Study Group
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan
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9
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Li N, Wang H, Song Q, Su W, Guo X, Liang Q, Ding X, Liu H, Liang M, Zhang J, Sun L, Qin Q, Chen M, Qu G, Sun Y. Association between sleep change patterns and mental health among preschoolers: The mediating role of resilience. J Psychiatr Res 2023; 165:336-343. [PMID: 37579680 DOI: 10.1016/j.jpsychires.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 05/25/2023] [Accepted: 08/08/2023] [Indexed: 08/16/2023]
Abstract
Sleep disturbance has been recognized as an important factor influencing mental health problems in preschool children. However, no longitudinal studies have investigated the association between sleep change patterns and mental health in preschoolers or the mediating role of resilience. Here, data were collected from 1595 preschool children in 26 kindergartens in four counties in Anhui Province, China, who were followed up (T2) 1 year apart based on baseline surveys (T1). The primary caregivers of the children were asked to complete a structured questionnaire through face-to-face interviews or by completing it themselves. Pearson's correlation and linear regression were used to analyze the relationships among sleep patterns, mental health, and resilience in preschoolers. A structural equation model was used for the mediation analysis. Four patterns of sleep change were identified: persistent-low pattern (1.7%), decreasing pattern (9.8%), increasing pattern (7.3%), and persistent-high pattern (81.3%). Compared to the persistent-low pattern, the increasing pattern and persistent-high pattern were associated with emotional behavioral problems (EBPs) and anxiety. Resilience played a fully mediating role in the relationship between increasing pattern, persistent-high pattern, and EBPs. Resilience partially mediated the effects of increasing and persistent-high pattern on anxiety. More attention should be paid to sleep problems in children with increasing and persistent-high sleep patterns. Resilience is important for understanding the mechanism underlying the correlation between sleep patterns, EBPs, and anxiety. Considering the EBPs and anxiety of preschool children, early intervention for resilience should be considered.
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Affiliation(s)
- Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Department of Psychiatry, Xijing Hosptial, the fourth military medical university, Xi'an, 710032, China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Qiwei Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Children's Hospital of Anhui Medical University, No. 39 Wangjiang Road, Hefei, 230051, Anhui, China
| | - Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Center for Scientific Research and Experiment, the Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, 230601, Anhui, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Jian Zhang
- Children's Hospital of Anhui Medical University, No. 39 Wangjiang Road, Hefei, 230051, Anhui, China
| | - Liang Sun
- Fuyang Center for Disease Control and Prevention, No.19, Zhongnan Avenue, Fuyang, 236069, Anhui, China
| | - Qirong Qin
- Ma'anshan Center for Disease Control and Prevention, No.849, Jiangdong Avenue, Ma'anshan, 243011, Anhui, China
| | - Mingchun Chen
- Changfeng County Center for Disease Control and Prevention, Hefei, 231199, Anhui, China
| | - Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Center for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Center for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Chaohu Hospital, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238000, Anhui, China.
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10
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Waterman L, Selsick H. Insomnia and its treatment should be given more importance. Br J Gen Pract 2023; 73:344-345. [PMID: 37500456 PMCID: PMC10405942 DOI: 10.3399/bjgp23x734421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023] Open
Affiliation(s)
- Lauren Waterman
- Camden and Islington NHS Foundation Trust; Health Education England-funded Population Health Fellow, North Central London integrated care board, London
| | - Hugh Selsick
- Consultant in Psychiatry and Sleep Medicine, University College Hospitals NHS Foundation Trust, London
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11
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Lyall LM, Sangha N, Zhu X, Lyall DM, Ward J, Strawbridge RJ, Cullen B, Smith DJ. Subjective and objective sleep and circadian parameters as predictors of depression-related outcomes: A machine learning approach in UK Biobank. J Affect Disord 2023; 335:83-94. [PMID: 37156273 DOI: 10.1016/j.jad.2023.04.138] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 04/25/2023] [Accepted: 04/29/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Sleep and circadian disruption are associated with depression onset and severity, but it is unclear which features (e.g., sleep duration, chronotype) are important and whether they can identify individuals showing poorer outcomes. METHODS Within a subset of the UK Biobank with actigraphy and mental health data (n = 64,353), penalised regression identified the most useful of 51 sleep/rest-activity predictors of depression-related outcomes; including case-control (Major Depression (MD) vs. controls; postnatal depression vs. controls) and within-case comparisons (severe vs. moderate MD; early vs. later onset, atypical vs. typical symptoms; comorbid anxiety; suicidality). Best models (of lasso, ridge, and elastic net) were selected based on Area Under the Curve (AUC). RESULTS For MD vs. controls (n(MD) = 24,229; n(control) = 40,124), lasso AUC was 0.68, 95 % confidence interval (CI) 0.67-0.69. Discrimination was reasonable for atypical vs. typical symptoms (n(atypical) = 958; n(typical) = 18,722; ridge: AUC 0.74, 95 % CI 0.71-0.77) but poor for remaining models (AUCs 0.59-0.67). Key predictors across most models included: difficulty getting up, insomnia symptoms, snoring, actigraphy-measured daytime inactivity and lower morning activity (~8 am). In a distinct subset (n = 310,718), the number of these factors shown was associated with all depression outcomes. LIMITATIONS Analyses were cross-sectional and in middle-/older aged adults: comparison with longitudinal investigations and younger cohorts is necessary. DISCUSSION Sleep and circadian measures alone provided poor to moderate discrimination of depression outcomes, but several characteristics were identified that may be clinically useful. Future work should assess these features alongside broader sociodemographic, lifestyle and genetic features.
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Affiliation(s)
- Laura M Lyall
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
| | - Natasha Sangha
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Xingxing Zhu
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Donald M Lyall
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Joey Ward
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Rona J Strawbridge
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK; Health Data Research, UK; Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
| | - Breda Cullen
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Daniel J Smith
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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12
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Short sleep and social jetlag are associated with higher intakes of non-milk extrinsic sugars, and social jetlag is associated with lower fibre intakes in those with adequate sleep duration: a cross-sectional analysis from the National Diet and Nutrition Survey Rolling Programme (Years 1-9). Public Health Nutr 2022; 25:2570-2581. [PMID: 35039109 PMCID: PMC9991673 DOI: 10.1017/s1368980022000167] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate associations and interactions between sleep duration and social jetlag status with nutrient intake, nutrient status, body composition and cardio-metabolic risk factors in a nationally representative UK adult population. DESIGN A cross-sectional study using 4-d food diary and self-reported sleep data from the UK National Diet and Nutrition Survey Rolling Programme 2008-2017. SETTING UK free-living population. SUBJECTS Totally, 5015 adults aged 19-64 years. RESULTS Thirty-four per cent were short sleepers (< 7 h); 7 % slept ≥ 9 h; 14 % had > 2 h difference in average sleep duration between weeknights and weekend nights (social jetlag). Compared to those reporting optimal sleep duration (≥ 7-< 9 h), short sleep was associated with higher intakes of non-milk extrinsic sugars (NMES) (0·9 % energy, 95 % CI: 0·4, 1·4), total carbohydrate (0·8 % energy, 95 % CI: 0·2, 1·4) and a lower non-starch polysaccharides fibre intake (-0·5 g/d, 95 % CI -0·8, -0·2). There was a significant interaction between short sleep and social jetlag for fibre intakes, where adequate sleepers with social jetlag as well as all short sleepers (regardless of social jetlag) had lower fibre intakes than adequate sleepers with no social jetlag. Short sleep, but not social jetlag, was associated with greater adiposity, but there were no differences in other markers of cardiometabolic disease risk. CONCLUSIONS The present study reports that both short sleep and social jetlag are associated with higher intakes of NMES, but only sleep duration is associated with markers of adiposity. Social jetlag was associated with lower fibre intakes even in individuals with adequate weekly sleep duration, suggesting catch-up sleep does not prevent the adverse impact of irregular sleep habits on food choices.
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13
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Li W, Kadler BK, Brindley JH, Hood G, Devalia K, Loy J, Syn WK, Alazawi W. The contribution of daytime sleepiness to impaired quality of life in NAFLD in an ethnically diverse population. Sci Rep 2022; 12:5123. [PMID: 35332193 PMCID: PMC8948283 DOI: 10.1038/s41598-022-08358-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/18/2022] [Indexed: 11/09/2022] Open
Abstract
Health-related quality of life (HRQoL) is lower in people with NAFLD compared to the general population. Sleep disturbance resulting in daytime sleepiness is common in patients with NAFLD, but the effect of daytime sleepiness on HRQoL in NAFLD is unclear. The prevalence and natural history of NAFLD vary in different ethnic groups, but there has been limited ethnic diversity in HrQoL studies to date. We aimed to assess whether daytime sleepiness is independently associated with reduced HRQoL in an ethnically diverse UK population. We conducted HRQoL assessments using SF-36 version 2 and Epworth Sleepiness Scale (ESS) questionnaires in 192 people with NAFLD. Multivariate linear regression was used to identify factors independently affecting HRQoL scales. People with NAFLD reported significantly reduced physical health-related SF-36 scores compared to the general UK population. South Asian NAFLD patients reported impairment in physical health, but not mental health, approximately a decade before White NAFLD patients. In multivariate linear regression, daytime sleepiness (ESS score > 10), was the most significant independent predictor of reduced physical health. Age, BMI and liver stiffness score were also significantly associated. HRQoL is impaired earlier in patients of South Asian ethnicity. ESS score > 10, indicative of excessive daytime sleepiness, is an independent predictor of reduced HRQoL in people with NAFLD regardless of ethnicity. Daytime sleepiness should be considered as a contributing factor to reduced HRQoL in clinical practice and when evaluating patient-related outcomes in clinical trials.
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Affiliation(s)
- Wenhao Li
- Barts Liver Centre, Blizard Institute, Queen Mary University of London, London, UK.,Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, Missouri, USA
| | - Benjamin Karl Kadler
- Barts Liver Centre, Blizard Institute, Queen Mary University of London, London, UK.,Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, Missouri, USA
| | - James Hallimond Brindley
- Barts Liver Centre, Blizard Institute, Queen Mary University of London, London, UK.,Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, Missouri, USA
| | - Gillian Hood
- Barts Liver Centre, Blizard Institute, Queen Mary University of London, London, UK.,Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, Missouri, USA
| | - Kalpana Devalia
- Bariatric Surgery Department, Homerton University Hospital, London, UK.,Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, Missouri, USA
| | - John Loy
- Bariatric Surgery Department, Homerton University Hospital, London, UK.,Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, Missouri, USA
| | - Wing-Kin Syn
- Division of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, SC, USA.,Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country, Universidad del Pa S Vasco/Euskal Herriko Univertsitatea (UPV/EHU), Leioa, Spain.,Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, Missouri, USA
| | - William Alazawi
- Barts Liver Centre, Blizard Institute, Queen Mary University of London, London, UK. .,Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, Missouri, USA.
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14
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Oh J, Hong SC. Emotional Regulation Activities Moderates the Risk of Depression in People With Sleep Disturbance: Evidence From a Community Health Survey. SLEEP MEDICINE RESEARCH 2021. [DOI: 10.17241/smr.2021.01151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background and Objective It is widely known that poor sleep quality is closely related to depression, but there are limited studies on the mediating factors.Methods Based on national health survey data, the relationship between sleep quality and depressive symptoms was explored, and structural equations were drawn to determine whether emotional regulation activities, such as regular breakfast, regular exercise, smoking, and drinking contribute to poor sleep quality-induced depression.Results There was a significant correlation between poor sleep quality and depressive symptoms. Regular breakfast tended to mediate between poor sleep quality and depression the most, followed by smoking, drinking, and regular exercise.Conclusions Several emotional regulation activities including regular breakfast, can play a protective role in the process leading to poor sleep quality-induced depression. A follow-up study is required to examine the clinical aspect of how regular breakfast can prevent the process of poor sleep quality to depression.
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15
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O’Regan D, Jackson ML, Young AH, Rosenzweig I. Understanding the Impact of the COVID-19 Pandemic, Lockdowns and Social Isolation on Sleep Quality. Nat Sci Sleep 2021; 13:2053-2064. [PMID: 34795545 PMCID: PMC8593898 DOI: 10.2147/nss.s266240] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/17/2021] [Indexed: 12/15/2022] Open
Abstract
The uncertain, ever-changing and an ongoing nature of the COVID-19 pandemic means that it may take some time before we can fully appreciate the negative effect of the pandemic and lockdown on our sleep and mental health. It is increasingly recognised that in the aftermath of pandemic, several persistent sleep, neuropsychiatric and physical sequelae may continue long after the pandemic is over. A body of evidence to date also highlights a significant disparity in sleep and mental health difficulties in specific vulnerable groups in the community, with different temporal profiles and sleep issues that are reported. In this perspective, we argue for a possible mechanistic impact of the COVID-19 pandemic, with its imposed restrictions and social isolation on sleep quality. We similarly discuss some of the potential international differences, as well as similarities, behind reported idiosyncratic biological vulnerabilities that may have contributed to the genesis of sleep issues. Lastly, we propose some possible implementations and innovations that may be needed in restructuring of sleep disorders services in order to benefit recovering COVID-19 patients.
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Affiliation(s)
- David O’Regan
- Sleep Disorders Centre, Guy’s and St Thomas’ Hospital, GSTT NHS, London, UK
- Faculty of Life and Sciences Medicine, King’s College London, London, UK
| | - Melinda L Jackson
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Allan H Young
- School of Academic Psychiatry, IoPPN, King’s College London, London, UK
| | - Ivana Rosenzweig
- Sleep Disorders Centre, Guy’s and St Thomas’ Hospital, GSTT NHS, London, UK
- Sleep and Brain Plasticity Centre, CNS, IoPPN, King’s College London, London, UK
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16
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Pevernagie D, Bauters FA, Hertegonne K. The Role of Patient-Reported Outcomes in Sleep Measurements. Sleep Med Clin 2021; 16:595-606. [PMID: 34711384 DOI: 10.1016/j.jsmc.2021.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Several questionnaires aka patient-reported outcome measures (PROMs) have been developed for specific use in sleep medicine. Some PROMS are "disease-specific," that is, related to a specific sleep disorder, whereas others are generic. These PROMS constitute a valuable add-on to the conventional history taking. They can be used in the areas of research, clinical practice, and quality of health care appraisal. Still, these instruments have inherent limitations, requiring proficient application in the various areas of interest. Disease-specificity includes a risk for nosologic bias that may confound diagnostic and therapeutic results. Future research should provide solutions for shortcomings of presently available questionnaires.
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Affiliation(s)
- Dirk Pevernagie
- Department of Respiratory Medicine, Ghent University Hospital, Gent, Corneel Heymanslaan 10, Gent 9000, Belgium; Department of Internal Medicine and Paediatrics, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, Gent 9000, Belgium.
| | - Fré A Bauters
- Department of Respiratory Medicine, Ghent University Hospital, Gent, Corneel Heymanslaan 10, Gent 9000, Belgium; Department of Internal Medicine and Paediatrics, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, Gent 9000, Belgium
| | - Katrien Hertegonne
- Department of Respiratory Medicine, Ghent University Hospital, Gent, Corneel Heymanslaan 10, Gent 9000, Belgium; Department of Internal Medicine and Paediatrics, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, Gent 9000, Belgium
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17
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Saltychev M, Juhola J, Ervasti J, Kivimäki M, Pentti J, Myllyntausta S, Vahtera J. Association of changes in lifestyle with changes in sleep difficulties: an analysis of 38 400 participants over a 16-year follow-up. BMJ Open 2021; 11:e050046. [PMID: 34663659 PMCID: PMC8524278 DOI: 10.1136/bmjopen-2021-050046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
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.
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Affiliation(s)
- Mikhail Saltychev
- Department of Physical and Rehabilitation Medicine, University of Turku, Turku, Finland
- Department of Physical and Rehabilitation Medicine, Turku University Hospital, Turku, Finland
| | - Juhani Juhola
- Department of Physical and Rehabilitation Medicine, University of Turku, Turku, Finland
- Department of Physical and Rehabilitation Medicine, Turku University Hospital, Turku, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland, Helsinki, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Jaana Pentti
- Department of Public Health, University of Turku, Turku, Finland
- Department of Public Health, Turku University Hospital, Turku, Finland
| | - Saana Myllyntausta
- Department of Public Health, University of Turku, Turku, Finland
- Department of Public Health, Turku University Hospital, Turku, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku, Turku, Finland
- Department of Public Health, Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku, Turku, Finland
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18
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Zhu G, Cassidy S, Hiden H, Woodman S, Trenell M, Gunn DA, Catt M, Birch-Machin M, Anderson KN. Exploration of Sleep as a Specific Risk Factor for Poor Metabolic and Mental Health: A UK Biobank Study of 84,404 Participants. Nat Sci Sleep 2021; 13:1903-1912. [PMID: 34712066 PMCID: PMC8548259 DOI: 10.2147/nss.s323160] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/23/2021] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Short and long sleep durations have adverse effects on physical and mental health. However, most studies are based on self-reported sleep duration and health status. Therefore, this longitudinal study aims to investigate objectively measured sleep duration and subsequent primary health care records in older adults to investigate the impact of sleep duration and fragmentation on physical and mental health. METHODS Data on objective sleep duration were measured using accelerometry. Primary care health records were then obtained from the UK Biobank (n=84,404). Participants (mean age, 62.4 years) were divided into five groups according to their sleep duration derived from the accelerometry data: <5 hours, 5-6 hours, 6-7 hours, 7-8 hours and >8 hours. ICD-10 codes were used for the analysis of primary care data. Wake after sleep onset, activity level during the least active 5 hours and episodes of movement during sleep were analysed as an indication for sleep fragmentation. Binary regression models were adjusted for age, gender and Townsend deprivation score. RESULTS A "U-shaped" relationship was found between sleep duration and diseases including diabetes, hypertension and heart disease and depression. Short and long sleep durations and fragmented sleep were associated with increased odds of disease. CONCLUSION Six to eight hours of sleep, as well as less fragmented sleep, predicted better long-term metabolic and mental health.
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Affiliation(s)
- Gewei Zhu
- Faculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Sophie Cassidy
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Hugo Hiden
- National Innovation Centre for Data, School of Computing, The Catalyst, Newcastle Helix, Newcastle Upon Tyne, UK
| | - Simon Woodman
- National Innovation Centre for Data, School of Computing, The Catalyst, Newcastle Helix, Newcastle Upon Tyne, UK
| | - Michael Trenell
- NIHR Innovation Observatory, The Catalyst, Newcastle Helix, Newcastle upon Tyne, UK
| | - David A Gunn
- Colworth Science Park, Sharnbrook, Bedfordshire, UK
| | - Michael Catt
- National Innovation Centre for Ageing, The Catalyst, Newcastle Helix, Newcastle upon Tyne, UK
| | - Mark Birch-Machin
- Faculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK.,National Innovation Centre for Ageing, The Catalyst, Newcastle Helix, Newcastle upon Tyne, UK
| | - Kirstie N Anderson
- Department of Neurology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
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