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Hosseini K, Soleimani H, Tavakoli K, Maghsoudi M, Heydari N, Farahvash Y, Etemadi A, Najafi K, Askari MK, Gupta R, Hakim D, Rahimi K. Association between sleep duration and hypertension incidence: Systematic review and meta-analysis of cohort studies. PLoS One 2024; 19:e0307120. [PMID: 39008468 PMCID: PMC11249221 DOI: 10.1371/journal.pone.0307120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 06/19/2024] [Indexed: 07/17/2024] Open
Abstract
AIM Sleep duration has been suggested to be associated with hypertension (HTN). However, evidence of the nature of the relationship and its direction has been inconsistent. Therefore, we performed a meta-analysis to assess the relationship between sleep duration and risk of HTN incidence, and to distinguish more susceptible populations. METHODS PubMed, Embase, Scopus, Web of Science, and ProQuest were searched from January 2000 to May 2023 for cohort studies comparing short and long sleep durations with 7-8 hours of sleep for the risk of HTN incidence. Random-effect model (the DerSimonian-Laird method) was applied to pool risk ratios (RR) and 95% confidence interval (CI). RESULTS We included sixteen studies ranging from 2.4 to 18 years of follow-up duration evaluating HTN incidence in 1,044,035 people. Short sleep duration was significantly associated with a higher risk of developing HTN (HR: 1.07, 95% CI: 1.06-1.09). The association was stronger when the sleep duration was less than 5 hours (HR: 1.11, 95% CI: 1.08-1.14). In contrast to males, females (HR: 1.07, 95% CI: 1.04-1.09) were more vulnerable to developing HTN due to short sleep duration. No significant difference between different follow-up durations and age subgroups was observed. Long sleep duration was not associated with an increased incidence of HTN. CONCLUSION Short sleep duration was associated with higher risk of HTN incidence, however, there was no association between long sleep duration and incidence of HTN. These findings highlight the importance of implementing target-specific preventive and interventional strategies for vulnerable populations with short sleep duration to reduce the risk of HTN.
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Affiliation(s)
- Kaveh Hosseini
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Soleimani
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kiarash Tavakoli
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Science, Tehran, Iran
| | - Milad Maghsoudi
- Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Narges Heydari
- Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Yasmin Farahvash
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Etemadi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kimia Najafi
- Hakim Children Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Mani K Askari
- University of Toledo Medical Center, Toledo, Ohio, United States of America
| | - Rahul Gupta
- Lehigh Valley Health Network, Allentown, Pennsylvania, United States of America
| | - Diaa Hakim
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Kazem Rahimi
- Deep Medicine, Oxford Martin School, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Women's and Reproductive Health, Medical Science Division, University of Oxford, Oxford, United Kingdom
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Jalali N, Khalili P, Jamali Z, Jalali Z, Moghadam-Ahmadi A, Vakilian A, Ayoobi F. Sleep duration, hypnotic drug use, and risk factors: cross- sectional study. Sci Rep 2023; 13:3459. [PMID: 36859460 PMCID: PMC9977908 DOI: 10.1038/s41598-023-30501-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 02/24/2023] [Indexed: 03/03/2023] Open
Abstract
Both short sleep duration (SSD) and long sleep duration (LSD) are associated with an increased risk of morbidity and mortality. Here, we aimed to assess the prevalence of sleep duration disturbances among adults in association with demographic, medication use, personal habits, and chronic diseases, while also considering the impact of hypnotic drug use. We performed a cross-sectional study of 9991 adult participants of the Rafsanjan Cohort Study (RCS), as part of the Prospective epidemiological research studies in Iran (PERSIAN). Multivariate logistic regression analyses were conducted to assess the association between short (< 6 h) and long (> 9 h) sleep duration with demographic and lifestyle parameters and common non-communicable diseases. Additionally, we performed stratified analysis to investigate the association of sleep duration with the abovementioned factors and diseases, in groups with and without hypnotic drug use. We found higher odds of SSD significantly associated with age (P < 0.001), BMI (P < 0.001), physical activity (P < 0.001), and depression (P = 0.023). LSD displayed a positive association with the female sex (P < 0.001), opium consumption (P < 0.001), and history of MI (P = 0.045), and a reverse connection with education (P = 0.007), physical activity (P < 0.001) and alcohol consumption (P = 0.027). Stratifying for the hypnotic drug use, our sensitivity analyses indicated that in hypnotic drug users, education (P = 0.034) and physical activity (P < 0.001) were associated with LSD, in this group, significantly increased odds ratio of LSD were associated with opium consumption (P = 0.046) and thyroid dysfunction (P = 0.037). Our findings demonstrated the demographic and lifestyle factors and diseases associated with long and short sleep duration in the population of the RCS. Additionally, after stratifying for hypnotic drug use, our results indicated that some diseases are only associated with abnormal sleep duration upon using hypnotic drugs.
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Affiliation(s)
- Nazanin Jalali
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Neurology Department, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Parvin Khalili
- Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Epidemiology, School of Public Health, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Zahra Jamali
- Clinical Research Development Unit (CRDU), Niknafs Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Zahra Jalali
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Clinical Biochemistry, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Amir Moghadam-Ahmadi
- Neurology Department, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Neuro-Immunology Research Scholar, Neurological Research Laboratory, Jefferson Hospital for Neuroscience, Thomas Jefferson University, Philadelphia, PA, USA
| | - Alireza Vakilian
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Neurology Department, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Fatemeh Ayoobi
- Occupational Safety and Health Research Center, NICICO, World Safety Organization and Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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Ruan H, Zheng Y, Yang J, Li L, Zhang M, Wang Z, He S. Changes in daily sleep duration and subsequent risk of mortality among older people. Sleep Med 2023; 101:252-259. [PMID: 36455297 DOI: 10.1016/j.sleep.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/30/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Single self-reported measures of daily sleep duration are associated with adverse health outcomes; however, the association between changes in daily sleep duration and all-cause mortality has not been thoroughly evaluated among a large group of older people. METHODS Using data from the Chinese Longitudinal Healthy Longevity Surveys, a total of 8588 older participants were included in the present study. Changes in daily sleep duration were assessed using annual changes, and Cox regression analysis examined the association of the annual changes with mortality. RESULTS The median age of the study population was 82.00 (IQR: 72.00, 90.00) years, and 3974 (46.27%) participants were men. During a median follow-up period of 3.81 (IQR: 2.03, 6.74) years, 5100 (59.39%) deaths were recorded. After adjusting for initial daily sleep duration and other confounders, there was a non-linear relationship between annual changes in daily sleep duration and all-cause mortality. Annual changes were not associated with mortality before 0.0 h/year, and mortality risk increased after 0.0 h/year, specially after 1 h/year (adjusted HR: 1.32 per 1-hour/year increment, 95% CI: 1.18-1.47). Compared to the stable group (annual changes between -1 and 1 h), adjusted HRs for mortality were 0.98 (95% CI: 0.89-1.08) for the shorter group (annual decline more than 1 h) and 1.29 (95% CI: 1.19-1.41) for the longer group (annual increase greater than 1 h), respectively. Stratified and sensitivity analyses suggested robustness of the results. CONCLUSIONS The present study suggested there was a non-linear relationship between annual changes in daily sleep duration and all-cause mortality among older people: longer changes were associated with higher mortality; while, shorter changes were not associated with mortality. Specially, mortality risk increased significantly with longer than 1 h of annual changes. The findings highlight the importance of closely monitoring the changes in daily sleep duration among older people.
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Affiliation(s)
- Haiyan Ruan
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China; Department of Cardiology, Hospital of Traditional Chinese Medicine, Shuangliu District, Chengdu, China
| | - Yi Zheng
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Jing Yang
- Maternal and Child Health Hospital, Longquanyi District, Chengdu, China
| | - Liying Li
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Muxin Zhang
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China; Department of Cardiology, First People's Hospital, Longquanyi District, Chengdu, China
| | - Ziqiong Wang
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Sen He
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China.
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Chang X, Chen X, Ji JS, Luo G, Chen X, Sun Q, Zhang N, Guo Y, Pei P, Li L, Chen Z, Wu X. Association between sleep duration and hypertension in southwest China: a population-based cross-sectional study. BMJ Open 2022; 12:e052193. [PMID: 35760551 PMCID: PMC9237882 DOI: 10.1136/bmjopen-2021-052193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Hypertension is a major risk factor and cause of many non-communicable diseases in China. While there have been studies on various diet and lifestyle risk factors, we do not know whether sleep duration has an association to blood pressure in southwest China. This predictor is useful in low-resource rural settings. We examined the association between sleep duration and hypertension in southwest China. DESIGN Population-based cross-sectional study. SETTING This study was part of the baseline survey of a large ongoing prospective cohort study, the China Kadoorie Biobank. Participants were enrolled in 15 townships of Pengzhou city in Sichuan province during 2004-2008. PARTICIPANTS 55 687 participants aged 30-79 years were included. Sleep duration was assessed by a self-reported questionnaire. MAIN OUTCOME MEASURES Hypertension was defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg, or prior physician-diagnosed hypertension in hospitals at the township (community) level or above. RESULTS The prevalence of hypertension was 25.17%. The percentages of subjects with sleep durations of <6, 6, 7, 8 and ≥9 hours were 17.20%, 16.14%, 20.04%, 31.95% and 14.67%, respectively. In multivariable-adjusted analyses, the increased ORs of having hypertension were across those who reported ≥9 hours of sleep (men: 1.16, 95% CI 1.04 to 1.30; women: 1.19, 95% CI 1.08 to 1.32; general population: 1.17, 95% CI 1.08 to 1.26). The odds of hypertension was relatively flat until around 6.81 hours of sleep duration and then started to increase rapidly afterwards in subjects and a J-shaped pattern was observed. There was a U-shaped relationship between sleep duration and hypertension in females. CONCLUSION Long sleep duration was significantly associated with hypertension and a J-shaped pattern was observed among rural adults in southwest China, independent of potential confounders. However, this association was not obvious between short sleep duration and hypertension.
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Affiliation(s)
- Xiaoyu Chang
- Department of Chronic and Non-communicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Xiaofang Chen
- Department of Epidemiology and Statistics, Chengdu Medical College, Chengdu, Sichuan, China
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Guojin Luo
- Pengzhou Center for Disease Control and Prevention, Pengzhou, Sichuan, China
| | - Xiaofang Chen
- Pengzhou Center for Disease Control and Prevention, Pengzhou, Sichuan, China
| | - Qiang Sun
- Pengzhou Center for Disease Control and Prevention, Pengzhou, Sichuan, China
| | - Ningmei Zhang
- Department of Chronic and Non-communicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Pei Pei
- Chinese Academy of Medical Sciences, Beijing, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Center for Public Health and Epidemic Preparedness and Response, Peking University, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit (CTSU) and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Xianping Wu
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
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Abnormal Sleep Duration as Predictor for Cardiovascular Diseases: A Systematic Review of Prospective Studies. SLEEP DISORDERS 2022; 2022:9969107. [PMID: 35178257 PMCID: PMC8844105 DOI: 10.1155/2022/9969107] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 01/20/2022] [Indexed: 11/18/2022]
Abstract
Methods We searched the online database PubMed on 30 August 2020 for our data collection. We used the following keywords: sleep duration AND (cardiovascular disease OR cardiovascular event) AND (cohort OR prospective OR retrospective). We identified 653 studies, and after excluding studies that were published before 2015, we obtained 306 studies. After filtering the 306 studies through title and abstract screening and applying the inclusion and exclusion criteria, we further reviewed fourteen studies with full-text reading. We excluded three studies because of insufficient data required and included eleven studies in this systematic review. Results A total of 361,041 participants from ten studies were included in this systematic review. The incidence of hypertension, myocardial infarction, coronary artery disease, heart failure, cardiovascular events, and cardiovascular diseases in the short sleep duration group is 46.12%, 0.59%, 5.43%, 0.09%, 7.18%, 1.48%, and 6.8%, consecutively, while the incidence of hypertension, myocardial infarction, coronary artery disease, and heart failure in the long sleep duration group is 30.71%, 0.61%, 6.55%, 1.11%, and 6.04%, consecutively. Nine studies reported an association between sleep duration and cardiovascular diseases while one study reported no association. Seven studies reported that short sleep duration was significantly associated with CVD. Short sleep duration in this study was associated with hypertension and heart failure. Atrial fibrillation and coronary artery disease were associated with both short and long sleep duration. Conclusion Abnormal sleep duration (short and long sleep duration) may act as the predictor of cardiovascular diseases. The importance of having normal sleep duration should be stressed with other lifestyle modification to avoid the risk of getting cardiovascular diseases. However, further studies are needed to overcome the limitation of this systematic review.
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Effects of sleep deprivation on endothelial function in adult humans: a systematic review. GeroScience 2021; 43:137-158. [PMID: 33558966 DOI: 10.1007/s11357-020-00312-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/06/2020] [Indexed: 01/01/2023] Open
Abstract
Sleep deprivation is highly prevalent and is associated with increased cardiovascular disease (CVD) morbidity and mortality. Age-related alterations in sleep and chronobiology may exaggerate CVD susceptibility in older individuals. The mechanisms responsible for the association between sleep deprivation and CVD are not fully understood, but endothelial dysfunction may play a central role. Our objective was to conduct a systematic literature review to evaluate the evidence on the effects of sleep deprivation on endothelial function (EF). This review adhered to the PRISMA guidelines and was pre-registered with PROSPERO (#CRD42020192485, 07/24/2020). We searched PubMed, Web of Science, Embase, and Cochrane Library for articles published through May 1, 2020. Eligibility criteria included publication in English and use of well-established EF methodologies in adult humans. Two investigators independently performed the literature search, study selection, data extraction, risk-of-bias assessment, and qualitative data synthesis. Out of 3571 articles identified, 24 articles were included in the systematic review. Main findings include the following: (1) shorter sleep duration is associated with lower macrovascular EF; (2) not sleeping 7-9 h/night is linked with impaired microvascular EF; (3) sleep restriction impairs micro- and macrovascular EF; (4) acute total sleep deprivation impairs micro- and macrovascular EF but data on macrovascular EF are less consistent; and (5) shift work impairs macrovascular EF. In conclusion, sleep deprivation impairs EF, which may explain the link between insufficient sleep and CVD. Future investigations should fully elucidate the underlying mechanisms and develop strategies to combat the adverse endothelial effects of sleep deprivation across the lifespan.
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Yao F, Zhao J, Cui Y, Yu D, Tang X. Daytime Sleep as Compensation for the Effects of Reduced Nocturnal Sleep on the Incidence of Hypertension: A Cohort Study. Nat Sci Sleep 2021; 13:1061-1074. [PMID: 34262377 PMCID: PMC8273747 DOI: 10.2147/nss.s316113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/21/2021] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The role of sleep duration in the development of hypertension remains controversial. Little is known about the combined effects of nocturnal and daytime sleep. We assessed the association between total sleep duration and the development of hypertension in middle-aged and elderly Chinese adults. PATIENTS AND METHODS Data were obtained from 3 waves of China Health and Retirement Longitudinal Study surveys. Middle-aged and elderly Chinese initially without hypertension were followed biennially from 2011 to 2015. Sleep duration was self-reported. Hypertension was defined as a systolic and/or diastolic blood pressure ≥ 140/90 (mmHg), the current use of anti-hypertensive medications or self-reported hypertension. RESULTS Over 31,392 person-years of follow-up, 2682 of 10,176 participants developed hypertension. The multivariable adjusted hazard ratios (HR) (95% confidence intervals, 95% CI) for the development of hypertension between those with 0-30 minutes and ≥30 minutes daytime sleep vs those without daytime sleep were 0.67 (0.58, 0.77), and 0.73 (0.59, 0.92), respectively. The protective role of longer periods of daytime sleep (>30 minutes) varied between different subgroups. Compared with moderate nocturnal sleepers, long nocturnal sleepers (HR: 1.66, 95% CI=1.25-2.21) had an increased risk of hypertension. Compared with moderate nocturnal sleepers without daytime sleep, HRs (95% CI) for hypertension were 0.52 (0.45, 0.59) for short nocturnal sleep plus short daytime sleep and 0.55 (0.49, 0.62) for short nocturnal sleep plus long daytime sleep. People with extremely short (HR: 1.34, 95% CI=1.22-1.48) and long (HR: 1.28, 95% CI=1.13-1.44) combined sleep periods had an increased risk of hypertension. Consistent results were also found in subgroups stratified by age and gender. CONCLUSION Both extremely long and short total sleep periods were associated with an increased risk of hypertension. People with short or moderate nocturnal sleep durations, especially short nocturnal sleep duration, can benefit from habitual daytime sleep to prevent hypertension.
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Affiliation(s)
- Feifei Yao
- Accreditation Department, Shekou People's Hospital, Shenzhen City, Guangdong Province, 518067, People's Republic of China
| | - Jing Zhao
- Department of Preventive Health, Daqing People's Hospital, Daqing City, Heilongjiang Province, People's Republic of China
| | - Yong Cui
- Department of Oncology, Shekou People's Hospital, Shenzhen City, Guangdong Province, 518067, People's Republic of China
| | - Dandan Yu
- Jiangsu Center for Adverse Drug Reaction Monitoring, Nanjing, 210002, People's Republic of China
| | - Xiangyu Tang
- Gastroenterology Department, Shekou People's Hospital, Shenzhen City, Guangdong Province, 518067, People's Republic of China
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Wang L, Hu Y, Wang X, Yang S, Chen W, Zeng Z. The association between sleep duration and hypertension: a meta and study sequential analysis. J Hum Hypertens 2020; 35:621-626. [PMID: 32587332 DOI: 10.1038/s41371-020-0372-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/27/2020] [Accepted: 06/11/2020] [Indexed: 01/10/2023]
Abstract
Hypertension is a global public issue, and sleep duration was regarded as its risk factors, however, the results were inconsistent. This study aims to deeply investigate and assess the association between sleep duration and hypertension. The electronic databases Cochrane Library, Pubmed and Embase updated to April, 30, 2020 were retrieved. Cohort studies that compared the long or short sleep duration versus normal sleep duration for the incidence of hypertension were included. The associations between sleep duration and hypertension were analyzed by meta-analyses, using risk ratio and 95% confidence interval as effect indexes. TSA software was used to assess the reliability of the pooled results and estimate the required sample size. A total of 11 studies (involving 85,838 subjects) were eligible for this meta-analysis. The association between short sleep duration and hypertension had statistical significances (RR = 1.161, 95% CI: 1.058-1.274), while there was no significant difference in ≥8 h group (RR = 1.059, 95% CI: 0.951-1.180). For short sleep hours, the required information size was calculated to be 44,889, and the number of subjects included in the meta-analysis exceeded the required information size. For long sleep hours, the required information size was 92,368, and the number of included subjects was less than that. The short sleep duration was confirmed to be a risk factor of the incidence of hypertension, future research should be conducted for some in-depth exploration. However, the significant association between long sleep duration and hypertension was not found, more studies should be conducted to confirm the pooled results.
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Affiliation(s)
- Luyao Wang
- Department of Preventive Medicine, Chengdu Medical College, Sichuan, China
| | - Youdan Hu
- Department of Epidemiology and Statistics, Chengdu Medical College, Sichuan, China
| | - Xin Wang
- Department of Epidemiology and Biostatistics, First Affiliated Hospital, Army Medical University, Chongqing, China
| | - Shu Yang
- Department of Epidemiology and Statistics, Chengdu Medical College, Sichuan, China
| | - Weizhong Chen
- Department of Epidemiology and Statistics, Chengdu Medical College, Sichuan, China
| | - Ziqian Zeng
- Department of Epidemiology and Statistics, Chengdu Medical College, Sichuan, China.
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Han B, Chen WZ, Li YC, Chen J, Zeng ZQ. Sleep and hypertension. Sleep Breath 2019; 24:351-356. [PMID: 31402441 PMCID: PMC7127991 DOI: 10.1007/s11325-019-01907-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 06/28/2019] [Accepted: 07/23/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE Hypertension is a global public issue, and sleep status was regarded as its risk factor; however, the results were inconsistent. This study aims to deeply investigate the correlation between sleep status and hypertension. METHODS The electronic databases Cochrane Library, Pubmed, and Embase updated to May 31, 2019, were retrieved. Studies were selected according to the predefined screening criteria, and their qualities were assessed by using quality check scales. Based on Stata 15.1 software, the associations between sleep status and hypertension were analyzed by meta-analyses, using odds ratio and 95% confidence interval as effect indexes. Furthermore, publication bias and small study bias were evaluated using Begg and Egger's test. In addition, sensitivity analysis was conducted through ignoring one study per time and then observing its influences on the pooled results. RESULTS A total of 54 studies (involving 1,074,207 subjects) were eligible for this meta-analysis. Six factors were included in this study. Raised blood pressure was associated with obstructive sleep apnea (OSA), oxygen desaturation index (ODI), short sleep duration, and long sleep duration. The differences in ≤ 5 h, 6 h, ≥ 9 h, and 10 h groups had statistical significances, while there was no significant difference in ≥ 8 h group. Snoring is a risk factor of hypertension (OR = 1.94, 95%CI 1.41-2.67). Subgroup analysis was conducted and results were varied. CONCLUSIONS The hypertension risk might be reduced by treated OSA, ODI, and snoring, as well as appropriate sleep duration. More studies with large sample sizes and high qualities should be included to support the findings further.
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Affiliation(s)
- B Han
- Department of Preventive Medicine, Chengdu Medical College, Chengdu, China
| | - W Z Chen
- Department of Epidemiology and Statistics, Chengdu Medical College, Chengdu, China
| | - Y C Li
- Department of Epidemiology and Statistics, Chengdu Medical College, Chengdu, China
| | - J Chen
- Department of Epidemiology and Statistics, Chengdu Medical College, Chengdu, China
- School of Public Health, Chengdu Medical College, Chengdu, China
| | - Z Q Zeng
- Department of Epidemiology and Statistics, Chengdu Medical College, Chengdu, China.
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Chen X, Fang Y, Liu X, Zhao D, Feng X, Li P. Gender differences in latent classes of sleep quality in community-dwelling adults based on the Pittsburgh sleep quality index. PSYCHOL HEALTH MED 2019; 24:901-910. [PMID: 31230460 DOI: 10.1080/13548506.2019.1634825] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
This study investigated the latent classes of sleep quality based on the Pittsburgh Sleep Quality index (PSQI) in Chinese adults, and analyzed whether these latent classes differed between men and women. A total of 982 adults (age: 18-59 years) participated in the questionnaire survey, and the PSQI was used to assess sleep quality. Two latent classes of sleep quality were found in men, and the cut-off value of PSQI for predicting the poor sleep quality group was 6. Four latent classes were found in women, which were named 'good sleep', 'daytime dysfunction', 'inadequate sleep', and 'poor sleep', respectively. In women, the optimal cut-off values of the PSQI for predicting the poor and good sleep quality groups were 9 and 6, respectively. Women who were not included in the 'poor sleep' group but had a score not less than 2 in the 'sleep duration' or 'daytime dysfunction' dimensions of PSQI were classified into the 'inadequate sleep' group or the 'daytime dysfunction' group. The findings may benefit the identification of sleep problems and assist in more effective alleviation of these issues.
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Affiliation(s)
- Xiaoyun Chen
- Society and Law school, Shandong women's University, Jinan, Shandong, P.R. China
| | - Yueyan Fang
- School of Nursing, Shandong University, Jinan, Shandong, P.R. China
| | - Xiaohua Liu
- Out-Patient Department, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Di Zhao
- School of Nursing, Shandong University, Jinan, Shandong, P.R. China
| | - Xiujuan Feng
- School of Nursing, Shandong University, Jinan, Shandong, P.R. China
| | - Ping Li
- School of Nursing, Shandong University, Jinan, Shandong, P.R. China
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Li H, Ren Y, Wu Y, Zhao X. Correlation between sleep duration and hypertension: a dose-response meta-analysis. J Hum Hypertens 2018; 33:218-228. [DOI: 10.1038/s41371-018-0135-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 10/25/2018] [Accepted: 10/30/2018] [Indexed: 12/22/2022]
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12
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Cumulative mean arterial pressure and risks of adverse cardiac and cerebrovascular events: a prospective cohort study of 53,813 adults. J Hum Hypertens 2018; 32:585-593. [PMID: 29891907 DOI: 10.1038/s41371-018-0075-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 04/23/2018] [Accepted: 05/03/2018] [Indexed: 11/08/2022]
Abstract
The association between cumulative mean arterial blood pressure (MAP) and risks of adverse cardiac and cerebrovascular events (CCVEs) has not been characterized. This prospective cohort study included 53,813 participants, free of prior myocardial infarction or stroke in or before 2010 (baseline) from a community-based cohort including 101,510 participants. Cumulative MAP was defined as the summed average MAP for each pair of consecutive examinations multiplied by the time interval with the data from previous surveys (2006- 2007, 2008 to 2009, 2010-2011). Incident adverse CCVEs were ascertained by both the information collection in biennial follow-up surveys (2012-2013, 2014-2015) and surveying each year's discharge lists from local hospitals and death certificates from state vital statistics offices by three experienced physicians blinded to the study design. The study population were stratified into quartiles based on cumulative MAP (<354.62 mmHg, n = 13,454; 354.62 to 392.82 mmHg, n = 13,452; 392.82 to 438.04 mmHg, n = 13 453; ≥ 438.04 mmHg, n = 13,454). We documented 1055 incident adverse CCVEs, including 271 myocardial infarction and 794 stroke (10 comorbid with myocardial infarction), which consisted of 673 ischemic stroke and 134 hemorrhagic stroke (13 comorbid with ischemic stroke). The incidence of adverse CCVEs increased with the increase of cumulative MAP with significant difference (p < 0.001). Cox proportional hazards regression models revealed the elevated cumulative MAP as an independent risk factor for adverse CCVEs, especially hemorrhagic stroke, after adjusting potential confounders. A J-shaped relationship between cumulative MAP and hemorrhagic stroke was also observed.
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13
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Liu X, Song Q, Hu W, Han X, Gan J, Zheng X, Wang X, Wu S. Night Sleep Duration and Risk of Incident Anemia in a Chinese Population: A Prospective Cohort Study. Sci Rep 2018; 8:3975. [PMID: 29507334 PMCID: PMC5838258 DOI: 10.1038/s41598-018-22407-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 02/22/2018] [Indexed: 12/13/2022] Open
Abstract
The purpose was to study the association between sleep duration and the prevalence of anemia in Chinese people. There were 84,791 participants (men: 79.1%; women: 20.9%) aged 18–98 years in the prospective study. We divided the participants into five categories based on the individual sleep duration: ≤5 h, 6 h, 7 h(reference), 8 h, and ≥9 h. Anemia was defined based on hemoglobin <12 g/dL for men and <11 g/dL for women. The Cox proportional hazards model was used to assess the association between sleep duration and anemia. During median follow-up of 7.9 years, 2698 cases of anemia had occurred. The HRand (95% CI) of anemia (7 h as the reference group) for individuals reporting ≤5 h, 6 h, 8 h, and ≥9 h were 1.23(1.04–1.45), 1.26(1.11–1.44), 1.04(0.92–1.16) and 1.42(1.08–1.86), respectively. It showed that there was a significant interaction on the risk of anemia between sleep duration and sex in the secondary analysis (p < 0.001).The significant association between long sleepduration and anemia was found in women (HR, 2.29; 95% CI, 1.56–3.37), not in men(HR, 0.90; 95% CI, 0.60–1.34). Both short and long night sleep duration were associated with increased risk of anemia.
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Affiliation(s)
- Xiaoxue Liu
- Department of Cardiology, Tangshan People's Hospital, North China University of science and technology, Tangshan, China
| | - Qiaofeng Song
- Department of Cardiology, Tangshan People's Hospital, North China University of science and technology, Tangshan, China
| | - Wanning Hu
- The Cancer Institute, Tangshan People's Hospital, Tangshan, China.,Department of Head and Neck Surgery, Tangshan People's Hospital, Tangshan, China
| | - Xiaochen Han
- Department of Head and Neck Surgery, Tangshan People's Hospital, Tangshan, China
| | - Jianhui Gan
- Department of Anesthesia, Tangshan People's Hospital, Tangshan, China
| | - Xiang Zheng
- Department of Nuclear magnetic resonance, Tangshan People's Hospital, Tangshan, China
| | - Xizhu Wang
- Department of Cardiology, Tangshan People's Hospital, North China University of science and technology, Tangshan, China.
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of science and technology, Tangshan, China.
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Liu R, Li Y, Mao Z, Liu X, Zhang H, Yang K, Zhang H, Tu R, Qian X, Jiang J, Bie R, Wang C. Gender-specific independent and combined dose-response association of napping and night sleep duration with type 2 diabetes mellitus in rural Chinese adults: the RuralDiab study. Sleep Med 2018; 45:106-113. [PMID: 29680417 DOI: 10.1016/j.sleep.2017.12.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 12/13/2017] [Accepted: 12/30/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The aim of this study was to explore the independent and combined dose-response association of napping and night sleep duration with type 2 diabetes mellitus (T2DM) among different genders in the rural Chinese population. METHODS For this research, a total of 19,257 participants were enrolled in the Rural Diabetes, Obesity and Lifestyle (RuralDiab) study. Napping and night sleep duration were assessed using the Pittsburgh Sleep Quality Index (PSQI). Restricted cubic splines and logistic regression were used to estimate the relationship between napping and night sleep duration with T2DM. RESULTS A linear dose-response relationship between napping duration and T2DM as well as a U-shaped relationship between night sleep duration and T2DM were found. Compared with those who reported no napping, participants who had a napping duration of ≥91 min were associated with a 19% increase in prevalence of T2DM. Adjusted odds ratios (ORs) (95% confidence intervals (CIs)) for T2DM were 1.48 (1.03, 2.14) and 1.50 (1.22, 1.85) for shorter (≤5 h) and longer (>9 h) night sleep duration compared with the referential group. Additionally, the combination of longer napping duration (≥91 min) and night sleep duration (>9 h) increased 104% (95% CI: 45%, 128%) prevalence for T2DM. These associations were not found in males but were evident in females. CONCLUSIONS Longer napping duration and extreme night sleep duration increased the prevalence of T2DM. Meanwhile, longer napping and night sleep duration might be jointly associated with a higher prevalence of T2DM.
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Affiliation(s)
- Ruihua Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Henan, PR China
| | - Yuqian Li
- Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Henan, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Henan, PR China
| | - Haiqing Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Henan, PR China
| | - Kaili Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Henan, PR China
| | - Honglei Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Henan, PR China
| | - Runqi Tu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Henan, PR China
| | - Xinling Qian
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Henan, PR China
| | - Jingjing Jiang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Henan, PR China
| | - Ronghai Bie
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Henan, PR China.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Henan, PR China.
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Song Q, Liu X, Hu W, Zhou W, Liu A, Wang X, Wu S. Long Sleep Duration Is an Independent Risk Factor for Incident Atrial Fibrillation in a Chinese Population: A Prospective Cohort Study. Sci Rep 2017. [PMID: 28623265 PMCID: PMC5473920 DOI: 10.1038/s41598-017-04034-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
There is limited information on the relation between sleep duration and incident atrial fibrillation. We aimed to investigate this association in a Chinese population using cohort data from a study in Kailuan. The analysis included 87,693 participants (age range, 18–98 years) free of atrial fibrillation at the baseline survey. Participants were divided into three categories according to self-reported sleep duration: ≤6.0 hours, 7 hours (ref), ≥8.0 hours. Atrial fibrillation diagnosis was made on a standard 12-lead electrocardiogram and via self-reported history. Cox proportional hazards models were used to calculate hazard ratio (HR) and confidence interval (CI) for atrial fibrillation, according to sleep duration. During median follow-up of 7.89 (range, 6.36–8.57) years, 322 cases of atrial fibrillation had occurred. Using 7 hours of sleep as the reference group, multivariable adjusted HRs (95% CI) for atrial fibrillation were 1.07 (0.75–1.53), 1.0 (ref), and 1.50 (1.07–2.10), from lowest to highest category of sleep duration. Secondary analysis showed no evidence of interactions between sleep duration and sex and snoring on the risk of incident atrial fibrillation (p = 0.75/0.25). We conclude long sleep duration may be a potential predictor/marker for incident atrial fibrillation.
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Affiliation(s)
- Qiaofeng Song
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan, China
| | - Xiaoxue Liu
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan, China
| | - Wanning Hu
- The Cancer Institute, Tangshan People's Hospital, Tangshan, China
| | - Wenhua Zhou
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan, China
| | - Aijuan Liu
- Department of Medical, Tangshan People's Hospital, North China University of Science and Technology, Tangshan, China
| | - Xizhu Wang
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan, China.
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
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Yadav D, Hyun DS, Ahn SV, Koh SB, Kim JY. A prospective study of the association between total sleep duration and incident hypertension. J Clin Hypertens (Greenwich) 2016; 19:550-557. [DOI: 10.1111/jch.12960] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 11/03/2016] [Accepted: 11/11/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Dhananjay Yadav
- Department of Preventive Medicine; Yonsei University Wonju College of Medicine; Wonju South Korea
| | - Dae Sung Hyun
- Department of Preventive Medicine; Yonsei University Wonju College of Medicine; Wonju South Korea
| | - Song Vogue Ahn
- Department of Preventive Medicine; Yonsei University Wonju College of Medicine; Wonju South Korea
| | - Sang-Baek Koh
- Department of Preventive Medicine; Yonsei University Wonju College of Medicine; Wonju South Korea
| | - Jang Young Kim
- Department of Cardiology; Yonsei University Wonju College of Medicine; Wonju South Korea
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