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Kim SW, Madhavan S. Employment, income, and sleep in South Africa: An actor-partner interdependence model approach. Sleep Health 2024:S2352-7218(24)00165-7. [PMID: 39322527 DOI: 10.1016/j.sleh.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 06/20/2024] [Accepted: 07/07/2024] [Indexed: 09/27/2024]
Abstract
OBJECTIVE We analyze the relationship between employment status, income, and sleep in South Africa to address two research questions: (1) How does employment status influence the sleep quantity of the individual and their partner? (2) How does income impact the sleep quantity of the individual and their partner? METHOD Using data from 1600 Black African couples in the South African Time Use Study, we employ the Actor-Partner Interdependence Model to investigate the relationship between employment status, income, and sleep in couples. We categorize nighttime sleep into three categories: recommended sleep (7-9 hours), short sleep (<7 hours), and long sleep (>9 hours). RESULTS Employed individuals were more likely to get the recommended amount of sleep and less likely to experience long sleep. However, men whose wives are employed are almost twice as likely as men whose wives are unemployed to experience short sleep, and they experience 47% lower risk of long sleep. Men with a medium level of income have a higher risk of short sleep than those with low income, while those in the highest income category are more likely to get the recommended amount of sleep. CONCLUSION These results highlight the intricate dynamics between managing employment demands and securing economic stability for both men and women in the context of high unemployment and shifting gender norms.
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Affiliation(s)
- Seung Wan Kim
- Department of Sociology, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Sangeetha Madhavan
- Department of Sociology & Department of African American and Africana Studies, University of Maryland, College Park, Maryland, USA
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Njiro BJ, Ndumwa HP, Waithera HW, Chande R, Julius W, Mashili F, Mwita JC, Swahn MH, Staton C, Francis JM. Epidemiology of non-communicable diseases among professional drivers in LMICs: a systematic review and meta-analysis. Health Promot Int 2024; 39:daae087. [PMID: 39215468 PMCID: PMC11364521 DOI: 10.1093/heapro/daae087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
Abstract
This systematic review collected evidence on the burden of non-communicable diseases (NCDs) among professional drivers and reported on the most common factors that increase the risk of NCDs in this specific population in low- and middle-income countries (LMICs). The protocol for this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO). We conducted a thorough search on PubMed/MEDLINE, EMBASE, Scopus, Global Health, Web of Science and Africa-wide information databases on 11 May 2023. We adapted the Joanna Briggs Institute (JBI) tool to assess the quality of the studies. We estimated the prevalence of hypertension, prediabetes, diabetes mellitus (DM), overweight and obesity among professional drivers using a random effect model to compute pooled and subgroup analyses. In addition, we conducted a narrative synthesis of the risk factors and recommendations presented in the included studies. Forty-one studies, including 48 414 study participants, met the criteria for inclusion. The pooled prevalence of hypertension, DM and obesity among professional drivers was 36.7% [95% confidence interval (CI): 31.8-41.6%], 15.2% (95% CI: 7.0-23.4%) and 27.2% (95% CI: 18.7-35.8%), respectively. Unsupportive environment, work stress, sedentary lifestyle, consumption of unhealthy foods and shift work were the most common modifiable risk factors reported. Our findings also show a significant burden of hypertension, DM and obesity among professional drivers in LMICs. The prevalence of DM and obesity was two- and three-fold higher than findings in general populations, respectively. Our findings indicate an urgent need for tailored interventions for different occupation-related risk factors for NCDs among professional drivers in LMICs.
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Affiliation(s)
- Belinda J Njiro
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Harrieth P Ndumwa
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Hannah Wanjiku Waithera
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Rehema Chande
- Directorate of Library Services, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - William Julius
- Directorate of Library Services, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Fredirick Mashili
- Department of Physiology, School of Biomedical Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Julius C Mwita
- Department of Internal Medicine, University of Botswana and Princess Marina Hospital, Gaborone, Botswana
| | - Monica H Swahn
- Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA, USA
| | - Catherine Staton
- Department of Emergency Medicine, Duke School of Medicine/Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Joel Msafiri Francis
- Department of Family Medicine and Primary Care, University of the Witwatersrand, Johannesburg, South Africa
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Melese M, Mengistie BA, Delie AM, Limenh LW, Worku NK, Fenta ET, Hailu M, Abie A, Mehari MG, Eseyneh T, Esubalew D, Abuhay HW. Poor sleep quality and its associated factors among HIV/ADIS patients living in sub-Saharan African countries: a systematic review and meta-analysis. Sci Rep 2024; 14:16955. [PMID: 39043922 PMCID: PMC11266486 DOI: 10.1038/s41598-024-68074-7] [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: 05/02/2024] [Accepted: 07/19/2024] [Indexed: 07/25/2024] Open
Abstract
Good-quality sleep is defined by its ability to minimize disturbances, provide adequate duration, and maintain a balanced progression through sleep stages. Sleep disturbance is a common complaint in people living with HIV/AIDS. Despite the influence of sleep disturbance on treatment adherence, quality of life, work productivity, risk of chronic illness. Studies have reported sleep disturbances among HIV/AIDS patients in sub-Saharan African countries (SSA), yielding varied results at the country level. Therefore, conducting a systematic review and meta-analysis is essential. This systematic review and meta-analysis aimed to evaluate the prevalence of poor sleep quality and identify associated factors among HIV/AIDS patients in sub-Saharan African countries. We systematically searched across various databases, including PubMed, African Journals Online, Scopus, Cochrane Library, HINARI, and Science Direct. Additionally, we conducted searches using Google and Google Scholar search engines. Microsoft Excel was used for data extraction, and the data were analysed using STAT version 17.0. We assessed heterogeneity using Cochran's Q test and I2 test and checked for small study effects using funnel plot symmetry and Egger's test. Pooled prevalence and associated factors were estimated using a random-effects model at a 95% confidence interval (CI) and significance level of p < 0.05. To identify factors associated with poor sleep quality among individuals living with HIV/AIDS, odds ratios (ORs) and their corresponding 95% CI were calculated. This analysis combined data from 15 separate studies involving a total sample size of 5176 participants. The pooled prevalence of poor sleep quality among HIV/AIDS patients in SSA countries was 49.32% (95% CI 41.32-56.8%). Factors significantly associated with poor sleep quality included depression (OR 2.78; 95% CI 1.21-6.40) and CD4 count < 200 cells/mm3 (AOR 3.15; 95% CI 2.41-4.15). In this study the prevalence of poor sleep quality among HIV/AIDS patients in SSA was higher and differs across the countries, ranging from 21.7 to 73.7%. The findings underscore the urgent necessity for programs aimed at improving sleep quality, particularly in addressing factors such as participant income and depression that are linked to poor sleep quality in HIV/AIDS patients.Systematic review registration: PROSPERO CRD42024517229.
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Affiliation(s)
- Mihret Melese
- Department of Human Physiology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
| | - Berihun Agegn Mengistie
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Amare Mebrat Delie
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Liknaw Workie Limenh
- Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nigus Kassie Worku
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
- Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Eneyew Talie Fenta
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Mickiale Hailu
- Department of Midwifery, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Alemwork Abie
- Department of Midwifery, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Molla Getie Mehari
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Tenagnework Eseyneh
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Dereje Esubalew
- Department of Human Physiology, College of Medicine and Health Science, Ambo University, Ambo, Ethiopia
| | - Habtamu Wagnew Abuhay
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Oseni TIA, Udonwa NE, Oku AO, Makinde MT, Archibong F. Association between sleep quality and blood pressure control among hypertensive patients at a rural tertiary hospital in Southern Nigeria: a cross-sectional study. BMJ Open 2024; 14:e079774. [PMID: 38458777 DOI: 10.1136/bmjopen-2023-079774] [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] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVES Restorative sleep is critical in preventing hypertension and other chronic diseases. Limited research has explored the relationship between sleep quality and hypertension in Africa. This study investigated the association between sleep quality and blood pressure control among hypertensive patients in Southern Nigeria. DESIGN Cross-sectional study. SETTING A rural tertiary hospital in Southern Nigeria, April to June 2023. PARTICIPANTS 250 systematically selected hypertensive adults. Participants completed a validated semistructured interviewer-administered questionnaire to assess their sleep patterns, including sleep duration, self-reported trouble sleeping and a history of clinical diagnosis of sleep disorders. Sleep patterns were categorised as restorative (healthy) or non-restorative (unhealthy). The blood pressure of respondents was checked and categorised as controlled (<140/90 mm Hg) or uncontrolled (≥140/90 mm Hg). Data were analysed descriptively using SPSS V.24.0 OUTCOME MEASURES: Quality of sleep and blood pressure control. RESULTS Respondents had a mean age of 51.5±10.0 years, with the majority being female (156, 62.4%), married (135, 54.0%) and belonging to the Esan tribe (125, 50.0%). The prevalence of restorative sleep was 36%, while the blood pressure control rate was 23.6%. An association was found between restorative sleep and blood pressure control (adjusted OR =4.38; 95% CI=2.37-8.10; p<0.0001). Respondents aged ≥60 years had 3.5 times higher odds of experiencing non-restorative sleep than those aged ≤40 years (aOR=3.46; 95% CI=1.37-8.74; p=0.009). CONCLUSION The study found an association between poor quality sleep and poor blood pressure control. Incorporating sleep assessments and interventions into comprehensive hypertension management strategies could be explored as a possible approach to improve sleep quality and enhance blood pressure control. TRIAL REGISTRATION NUMBER PACTR202301917477205.
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Affiliation(s)
- Tijani Idris Ahmad Oseni
- Family Medicine, Edo State University Uzairue, Iyamho, Nigeria
- Department of Family Medicine, Edo State University Teaching Hospital Auchi, Auchi, Nigeria
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Cunha GHD, Ramalho AKL, Fontenele MSM, Dantas MB, Fechine FV, Abreu WCD. Quality of life and adherence to antiretroviral therapy in people living with HIV in the Ceará, Brazil. AIDS Care 2024; 36:400-413. [PMID: 37909100 DOI: 10.1080/09540121.2023.2275035] [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: 03/01/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023]
Abstract
The aim of this study was to investigate the quality of life (QOL) and adherence to antiretroviral therapy (ART) in people living with HIV (PLWH) in Fortaleza, Ceará, Brazil. A cross-sectional study with a sample of 385 patients followed-up on an outpatient basis. Interviews were conducted using the Sociodemographic, Epidemiological and Clinical Form, the World Health Organization's Quality of Life in PLWH Instrument, the Assessment of Adherence to Antiretroviral Treatment Questionnaire and Pittsburgh Sleep Quality Index. Descriptive statistics and univariate and multivariate logistic regression analysis were performed. The odds ratio and confidence interval were calculated, considering P < 0.05 as statistically significant. Of the 385 PLWH, 134 (34.8%) had unsatisfactory QOL which was associated with unemployment (P = 0.0037), monthly income less than the minimum wage (P < 0.0001), sleep disorders (P = 0.0039) and not doing regular exercise (P = 0.0032). Inadequate adherence to ART occurred in 24 patients (6.23%) and was associated with detectable viral load (P = 0.0001) and unsatisfactory QOL (P = 0.0033). QOL was more unsatisfactory for those unemployed and with low income, sleep disorders and sedentary lifestyle. People with detectable viral load and unsatisfactory QOL had more inadequate adherence to ART.
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Reisert H, Miner B, Farhadian S. Sleep deficiency among people living with human immunodeficiency virus: A growing challenge. HIV Med 2024; 25:5-15. [PMID: 37485570 PMCID: PMC10803648 DOI: 10.1111/hiv.13526] [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: 01/13/2023] [Accepted: 07/04/2023] [Indexed: 07/25/2023]
Abstract
PURPOSE OF REVIEW The purpose of this narrative review is to consolidate and summarize the existing literature on sleep deficiency among people living with human immunodeficiency virus (HIV; PLWH), to discuss the potential impact of antiretroviral therapy on sleep deficiency and to identify priorities for future research in this area. RECENT FINDINGS Three important domains of sleep deficiency include alterations in sleep quality (including sleep disorders), duration and timing. The existing HIV and sleep deficiency literature, which is robust for sleep quality but sparser for sleep duration or sleep timing, has identified epidemiological correlates and outcomes associated with sleep deficiency including sociodemographic factors, HIV-specific factors, aspects of physical and mental health and cognition. SUMMARY Sleep deficiency is a common problem among PLWH and is likely underdiagnosed, although more high-quality research is needed in this area. Sleep quality has received the most attention in the literature via methodologies that assess subjective/self-reported sleep quality, objective sleep quality or both. There is significantly less research on sleep duration and minimal research on sleep timing. Use of certain antiretroviral therapy drugs may be associated with sleep deficiency for some individuals. Future research should utilize larger, longitudinal studies with consistent, comprehensive and validated methods to assess both subjective and objective measures of sleep deficiency to better understand the prevalence, correlates and clinical implications of sleep deficiency in PLWH.
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Affiliation(s)
- Hailey Reisert
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA
| | - Brienne Miner
- Yale School of Medicine, Section of Geriatrics, New Haven, CT, USA
| | - Shelli Farhadian
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA
- Yale School of Medicine, Department of Neurology, New Haven, CT, USA
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, CT, USA
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Sosso FAE, Matos E, Papadopoulos D. Social disparities in sleep health of African populations: A systematic review and meta-analysis of observational studies. Sleep Health 2023; 9:828-845. [PMID: 37880077 DOI: 10.1016/j.sleh.2023.08.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/29/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVES To document the relationship between socioeconomic status (SES) and sleep health in African populations. METHODS Observational cross-sectional or cohort studies examining the association between SES indicators and sleep outcomes in participants from African countries were included. The search was performed in the MEDLINE, Embase, and Web of Science Core Collection electronic databases in June 2021. Selection, confounding, attrition/exclusion, detection, and selective reporting bias were assessed using the OHAT Risk of Bias Tool. Random effects meta-analysis was used for summarizing the effect estimates. RESULTS Forty-three reports were selected, having sampled 153,372 Africans from 26 countries. Education was the most frequent SES indicator and composite measures of sleep quality or disturbances was the most common sleep outcome. Low educational attainment was significantly associated with lower odds of short sleep (odds ratio [OR]=0.65, 95% confidence intervals [0.50, 0.84], p = .001) and higher odds of insomnia (OR=1.53, [1.18, 1.99], p = .001) or poor sleep quality (OR=1.60, [1.17, 2.18], p = .003). Low levels of income/assets were related to higher odds of insomnia (OR=1.38, [1.02, 1.86], p = .04) and low occupational/employment status was linked to lower odds of short sleep duration (OR=0.49, [0.30, 0.79], p = .004). CONCLUSIONS Socioeconomic disadvantage was a significant predictor of insomnia and poor sleep quality, while it was associated with longer sleep duration. Significant heterogeneity in terms of exposure and outcomes, scarcity of longitudinal designs, lack of objective outcome measurement, and low representation of rural samples and participants from low-income countries limit the quality of evidence.
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Affiliation(s)
| | - Elsa Matos
- Sleep Laboratory of Pulmonology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
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GebreEyesus FA, Degu FS, Yohanes YB, Azagew AW. Sleep quality and associated factors among adult people living with HIV on follow-up at Dessie Town Governmental Health Facilities Antiretroviral Therapy Clinics, Northeast, Ethiopia, 2020, a multicenter cross-sectional study. BMC Psychiatry 2023; 23:132. [PMID: 36864404 PMCID: PMC9983252 DOI: 10.1186/s12888-023-04619-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 02/20/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Poor sleep quality is an important health problem in people living with HIV. The exact cause of sleep disturbance is not well known, but it may relate to HIV itself, antiretroviral drug side effects, and other HIV-related disorders. As a result, the purpose of this study was to assess sleep quality and associated factors among adult HIV patients on follow-up at Dessie Town governmental health facilities' antiretroviral therapy clinics in Northeast Ethiopia in 2020. METHODS A multi-center cross-sectional study was conducted among 419 adult people living with HIV/AIDS from February 1/2020 to April 22/2020 in Dessie Town governmental antiretroviral therapy clinics. A systematic random sampling method was used to select the study participants. An interviewer-administered method of data collection with a chart review was used. The Pittsburgh Sleep Quality Index was used to evaluate sleep disruption. A binary logistic regression was conducted to see the relationship between a dependent variable and independent variables. Variables with a p-value of < 0.05 and a 95% confidence interval were used to declare an association between factors and a dependent variable. RESULTS A total of 419 study participants were enrolled in this study, with a response rate of 100%. The mean age of the study participants was 36 ± 6.5 SD years and 63.7% of the participants were female. The prevalence of poor sleep quality was found to be 36% (95% CI, 31-41%). Being female (AOR = 3.45, 95% CI: 1.52-7.79), viral loads 1000 copies/ml (AOR = 6.88, 95% CI: 2.79-16.9), CD4 cell count 200 cells/mm3 (AOR = 6.85, 95% CI: 2.42-19.39), WHO stage II and III (AOR = 4.29, 95% CI: 1.05-17.53), having anxiety (AOR = 10, 95% CI: 4.21-23.9. CONCLUSION The findings of this study showed that more than one-third of the study participants had poor-quality sleep at the Dessie Town Health Facility ART clinic. Being female, low CD4 cell counts, viral load ≥1000 copies/ml, WHO stage II and III, depression, anxiety, sleeping in a communal bedroom, and living alone were predictors of poor sleep quality.
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Affiliation(s)
- Fisha Alebel GebreEyesus
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, PO Box 07, Wolkite, Ethiopia.
| | - Fatuma Seid Degu
- Department of Adult Health Nursing, Wollo University, Dessie, Ethiopia.
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Papadopoulos D, Sosso FAE. Socioeconomic status and sleep health: a narrative synthesis of 3 decades of empirical research. J Clin Sleep Med 2023; 19:605-620. [PMID: 36239056 PMCID: PMC9978435 DOI: 10.5664/jcsm.10336] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 12/24/2022]
Abstract
STUDY OBJECTIVES This review aims to assess the association between socioeconomic status (SES) and sleep health in the general population and the mediating effects of lifestyle and mental and physical health in this relationship. METHODS Observational studies testing the independent association between objective or subjective SES indicators and behavioral/physiological or clinical sleep health variables in the general population were included. PubMed/MEDLINE was searched for reports published from January 1990 to December 2019. The direction of effect was used as the primary effect measure, testing the hypothesis that low SES is associated with poor sleep health outcomes. Results are presented in the form of direction effect plots and synthesized as binomial proportions. RESULTS Overall, 336 studies were identified. A high proportion of effects at the expected direction was noted for measures of sleep continuity (100% for sleep latency, 50-100% for awakenings, 66.7-100% for sleep efficiency), symptoms of disturbed sleep (75-94.1% for insomnia, 66.7-100% for sleep-disordered breathing, 60-100% for hypersomnia), and general sleep satisfaction (62.5-100%), while the effect on sleep duration was inconsistent and depended on the specific SES variable (92.3% for subjective SES, 31.7% for employment status). Lifestyle habits, chronic illnesses, and psychological factors were identified as key mediators of the SES-sleep relationship. CONCLUSIONS Unhealthy behaviors, increased stress levels, and limited access to health care in low-SES individuals may explain the SES-sleep health gradient. However, the cross-sectional design of most studies and the high heterogeneity in employed measures of SES and sleep limit the quality of evidence. Further research is warranted due to important implications for health issues and policy changes. CITATION Papadopoulos D, Etindele Sosso FA. Socioeconomic status and sleep health: a narrative synthesis of 3 decades of empirical research. J Clin Sleep Med. 2023;19(3):605-620.
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Pengpid S, Peltzer K. Tobacco use and incident sleep parameters among a rural ageing population in South Africa. Tob Induc Dis 2023; 21:02. [PMID: 36721863 PMCID: PMC9854341 DOI: 10.18332/tid/156844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 09/29/2022] [Accepted: 11/23/2022] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Tobacco use may be associated with incident insomnia. The aim of the study was to investigate the association between tobacco use and incident sleep parameters in a longitudinal study in South Africa. METHODS Longitudinal data from two consecutive waves of middle-aged and older adults in 2014-2015 (n=5059) and 2018-2019 (n=4176) in rural South Africa were analyzed. Tobacco use and sleep parameters were assessed by self-report. The associations between tobacco use and incident sleep parameters were estimated with multivariable logistic regression. RESULTS The prevalence of baseline sleep parameters was poor sleep quality 6.5%, sleep disturbance 13.6%, restless sleep 32.9%, and breathing stops 7.0%. In the fully adjusted model for people without poor sleep quality at baseline, daily tobacco smoking, smoking ≥10 units of tobacco products, current tobacco use and current smokeless tobacco use did not increase the odds of incident poor sleep quality. Smoking ≥10 units of tobacco products in a day (AOR=3.83; 95% CI: 1.77-8.28), current tobacco use (AOR=1.65; 95% CI: 1.09-2.51), and daily tobacco smoking (AOR=2.16; 95% CI: 1.15-4.07), were significantly positively associated with incident sleep disturbance. Furthermore, incident restless sleep was significantly positively associated with smoking ≥10 units of tobacco products in a day (AOR=3.97; 95% CI: 1.18-13.37), current smokeless tobacco use (AOR=2.78; 95% CI: 1.17-6.62) and current tobacco use (AOR=2.00; 95% CI: 1.00-4.00). Incident breathing stops were significantly positively associated with daily smoking tobacco (AOR=2.08; 95% CI: 1.11-3.34), smoking 1-9 units of tobacco products in a day (AOR=2.17; 95% CI: 1.20-3.94), and current tobacco use (AOR=1.77; 95% CI: 1.16-2.72). CONCLUSIONS Higher tobacco use was independently associated with incident sleep disturbance, incident restless sleep, and incident breathing stops, but not with incident poor sleep quality.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand,Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa,Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand,Department of Psychology, University of the Free State, Bloemfontein, South Africa,Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Shrivastava S, Kumar R, Khan S, Kavishwar A, Gupta A, Kaur H, Das M, Sharma R, Chakma T. Health profile of people living in the Gare Palma mining area of Tamnar block, Raigarh, Chhattisgarh, India. Front Public Health 2023; 11:1010025. [PMID: 37026149 PMCID: PMC10072258 DOI: 10.3389/fpubh.2023.1010025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/24/2023] [Indexed: 04/08/2023] Open
Abstract
Introduction A community-based health survey was conducted in Tamnar block, Raigarh district of Chhattisgarh, India. Methodology A total of 909 individuals (adults) were selected from 909 households from 33 sampled villages from March 2019 to February 2020. All individuals were clinically examined, and observations were recorded. Results Among adults older than 18 years, hypertension was observed in 21.7%. Type II diabetes was observed in only 4.0% of individuals. Tuberculosis was seen in 23 (2.5%) individuals. Discussion Common morbidities were similar in tribal and non-tribal communities living in the same area. For communicable diseases, being male, having nutritional deficiencies, and smoking were independent risk factors. For non-communicable diseases, the independent significant risk factors identified were being male, an altered body mass index, disturbed sleep, smoking, and nutritional deficiencies.
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Affiliation(s)
| | - Ravindra Kumar
- ICMR-National Institute of Research in Tribal Health, Jabalpur, India
| | - Sirin Khan
- ICMR-National Institute of Research in Tribal Health, Jabalpur, India
| | - Arvind Kavishwar
- ICMR-National Institute of Research in Tribal Health, Jabalpur, India
| | - Ashok Gupta
- ICMR-National Institute of Research in Tribal Health, Jabalpur, India
| | - Harpreet Kaur
- Indian Council of Medical Research, New Delhi, India
| | | | - Ravendra Sharma
- Indian Council of Medical Research National Institute of Medical Statistics (NIMS), New Delhi, India
| | - Tapas Chakma
- ICMR-National Institute of Research in Tribal Health, Jabalpur, India
- *Correspondence: Tapas Chakma
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Cook I, Mohlabe M. Objectively-measured sleep patterns and cardiometabolic health in a rural South African setting: a cross sectional analysis. SLEEP SCIENCE AND PRACTICE 2022. [DOI: 10.1186/s41606-022-00070-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To investigate the relationship between objectively-measured, free-living sleep patterns, and cardiometabolic health, in a rural South African health and demographic surveillance site.
Methods
Wrist-mounted actigraphy data was collected over nine days from 167 adults (≥ 40 years). Sleep patterns were constructed from tertiles of sleep quantity and quality parameters (TST: total sleep time, AC: activity counts during sleep) from valid minute-by-minute data. The reference category was Moderate TST/Low-to-Moderate AC. Self-reported data included behavioural, health and socio-demographic variables. Biological data included anthropometry, resting blood pressure and fasting blood glucose, insulin and lipids. Binary and ordinal logistic regression models were constructed to determine the association between TST and AC, the factors associated with sleeping patterns, and the association between sleeping patterns and Insulin resistance (HOMA-IR) and Metabolic Syndrome (MetS). HOMA-IR and MetS were also examined across sleep patterns using analysis of variance models.
Results
A total of 139 adults (71.2% female) had a complete dataset. In unadjusted analyses, females had poorer sleep quality, were more physically active, and displayed poorer cardiometabolc health and greater adiposity than males (p ≤ 0.017). There were no sex differences in TST or sleep pattern distribution (p ≤ 0.901). Not being classified as Low TST/High AC or exposed to ≥ 1 bout of Low TST/High AC sleep was associated with lower physical activity, longer sleep duration, better sleep quality and lower IR (p ≤ 0.0452). In multivariate analyses, there was no association between TST and AC (p = 0.921), while increasing age and people-to-bedroom density, and lower physical activity where significantly associated with increasing TST (p ≤ 0.027). Participants classified as Low TST/High AC had significantly higher HOMA-IR, but not MetS, compared with Moderate TST/Low AC (p = 0.021). Being exposed to ≥ 1 bout of Low TST/High AC sleep was significantly associated with hypertension (OR = 2.31, 95%CI: 1.00, 5.34), but not for HOMA-IR or MetS (p ≥ 0.227).
Conclusions
Long sleep was not associated with increased sleep fragmentation. Short, fragmented sleep was associated with insulin resistance. Exposure to at least one bout of short, fragmented sleep increased the likelihood of hypertension. Further studies are required to identify the factors associated with short, fragmented sleep in this setting.
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Roche J, Rae DE, Redman KN, Knutson KL, von Schantz M, Gómez-Olivé FX, Scheuermaier K. Impact of obstructive sleep apnea on cardiometabolic health in a random sample of older adults in rural South Africa: building the case for the treatment of sleep disorders in underresourced settings. J Clin Sleep Med 2021; 17:1423-1434. [PMID: 33687325 DOI: 10.5664/jcsm.9214] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The association between obstructive sleep apnea (OSA) and increased cardiometabolic risk (CMR) has been well documented in higher-income countries. However, OSA and its association with CMR have not yet been investigated, based on objective measures, in southern Africa. We measured polysomnography-derived sleep characteristics, OSA prevalence, and its association with cardiometabolic diseases in a rural, low-income, African-ancestry sample of older adult participants in South Africa. METHODS Seventy-five participants completed the study. Body mass index, hypertension, diabetes, dyslipidemia, and HIV status were determined. A continuous CMR score was calculated using waist circumference, random glucose, high-density-lipoprotein cholesterol, triglycerides, and mean arterial blood pressure. Sleep architecture, arousal index, and apnea-hypopnea index for detection of the OSA (apnea-hypopnea index ≥ 15 events/h) were assessed by home-based polysomnography. Associations between CMR score and age, sex, socioeconomic status, apnea-hypopnea index, and total sleep time were investigated by multivariable analysis. RESULTS In our sample (53 women, age 66.1 ± 10.7 years, 12 HIV+), 60.7% of participants were overweight/obese, 61.3% were hypertensive, and 29.3% had undiagnosed OSA. Being older (P = .02) and having a higher body mass index (P = .02) and higher waist circumference (P < .01) were associated with OSA. Apnea-hypopnea index severity (β = 0.011; P = .01) and being a woman (β = 0.369; P = .01) were independently associated with a higher CMR score in socioeconomic status- and age-adjusted analyses. CONCLUSIONS In this South African community with older adults with obesity and hypertension, OSA prevalence is alarming and associated with CMR. We show the feasibility of detecting OSA in a rural setting using polysomnography. Our results highlight the necessity for actively promoting health education and systematic screening and treatment of OSA in this population to prevent future cardiovascular morbidity, especially among women.
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Affiliation(s)
- Johanna Roche
- Wits Sleep Laboratory, Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Dale E Rae
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Kirsten N Redman
- Wits Sleep Laboratory, Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Kristen L Knutson
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Malcolm von Schantz
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - F Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Karine Scheuermaier
- Wits Sleep Laboratory, Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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14
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Polanka BM, Kundu S, So-Armah KA, Freiberg MS, Gupta SK, Zapolski TCB, Hirsh AT, Bedimo RJ, Budoff MJ, Butt AA, Chang CCH, Gottlieb SS, Marconi VC, Womack JA, Stewart JC. Insomnia symptoms and biomarkers of monocyte activation, systemic inflammation, and coagulation in HIV: Veterans Aging Cohort Study. PLoS One 2021; 16:e0246073. [PMID: 33561176 PMCID: PMC7872271 DOI: 10.1371/journal.pone.0246073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/12/2021] [Indexed: 12/11/2022] Open
Abstract
Background Insomnia may be a risk factor for cardiovascular disease in HIV (HIV-CVD); however, mechanisms have yet to be elucidated. Methods We examined cross-sectional associations of insomnia symptoms with biological mechanisms of HIV-CVD (immune activation, systemic inflammation, and coagulation) among 1,542 people with HIV from the Veterans Aging Cohort Study (VACS) Biomarker Cohort. Past-month insomnia symptoms were assessed by the item, “Difficulty falling or staying asleep?,” with the following response options: “I do not have this symptom” or “I have this symptom and…” “it doesn’t bother me,” “it bothers me a little,” “it bothers me,” “it bothers me a lot.” Circulating levels of the monocyte activation marker soluble CD14 (sCD14), inflammatory marker interleukin-6 (IL-6), and coagulation marker D-dimer were determined from blood specimens. Demographic- and fully-adjusted (CVD risk factors, potential confounders, HIV-related factors) regression models were constructed, with log-transformed biomarker variables as the outcomes. We present the exponentiated regression coefficient (exp[b]) and its 95% confidence interval (CI). Results We observed no significant associations between insomnia symptoms and sCD14 or IL-6. For D-dimer, veterans in the “Bothers a Lot” group had, on average, 17% higher D-dimer than veterans in the “No Difficulty Falling or Staying Asleep” group in the demographic-adjusted model (exp[b] = 1.17, 95%CI = 1.01–1.37, p = .04). This association was nonsignificant in the fully-adjusted model (exp[b] = 1.09, 95%CI = 0.94–1.26, p = .27). Conclusion We observed little evidence of relationships between insomnia symptoms and markers of biological mechanisms of HIV-CVD. Other mechanisms may be responsible for the insomnia-CVD relationship in HIV; however, future studies with comprehensive assessments of insomnia symptoms are warranted.
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Affiliation(s)
- Brittanny M Polanka
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Suman Kundu
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Kaku A So-Armah
- Division of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Matthew S Freiberg
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Samir K Gupta
- Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Tamika C B Zapolski
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, Indiana, United States of America
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, Indiana, United States of America
| | - Roger J Bedimo
- Division of Infectious Diseases, VA North Texas Healthcare System, Dallas, Texas, United States of America
| | - Matthew J Budoff
- Lundquist Institute, Torrance, California, United States of America
| | - Adeel A Butt
- VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, United States of America
- Weill Cornell Medical College, Doha, Qatar, and New York City, New York, United States of America
- Hamad Medical Corp, Doha, Qatar
| | - Chung-Chou H Chang
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Stephen S Gottlieb
- Department of Medicine, University of Maryland School of Medicine and Baltimore VAMC, Baltimore, Maryland, United States of America
| | - Vincent C Marconi
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America
- Atlanta VA Medical Center, Atlanta, Georgia, United States of America
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, Unites States of America
| | - Julie A Womack
- VA Connecticut Healthcare System, West Haven, Connecticut, United States of America
- Yale University School of Nursing, West Haven, Connecticut, United States of America
| | - Jesse C Stewart
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, Indiana, United States of America
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15
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Hixon B, Burgess HJ, Wilson MP, MaWhinney S, Jankowski CM, Erlandson KM. A supervised exercise intervention fails to improve subjective and objective sleep measures among older adults with and without HIV. HIV Res Clin Pract 2020; 21:121-129. [PMID: 33119991 DOI: 10.1080/25787489.2020.1839708] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Chronic sleep disruption can have significant negative health effects and prior studies suggest that people with HIV (PWH) have disproportionately higher rates of sleep problems. METHODS We evaluated baseline sleep of sedentary, older adults (50-75 years) with (n = 28) and without HIV (n = 29) recruited into a 24-week exercise study. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI); objective sleep parameters were assessed using wrist-worn actigraphy. Regression models were used to investigate changes in outcomes. RESULTS Fifty-seven participants completed the intervention. At baseline, PWH had significantly lower sleep efficiency (88.7 [95% CI 86, 91]%) compared to controls (91.8 [95% CI 91, 93]%; p = 0.02); other sleep measures indicated poorer sleep among PWH but did not reach statistical significance (p ≥ 0.12). Overall, sleep outcomes did not significantly change with the exercise intervention (all p > 0.05). In adjusted analyses, PWH demonstrated a decrease in total sleep time (-22.1 [-43.7, -0.05] p = 0.045) and sleep efficiency (-1.3 [-2.5, -.01], p = 0.03) during the 24 weeks of exercise; these differences were attenuated and no longer significant after adjusting for exercise intensity. At the completion of the intervention, compared to controls, PWH had significantly poorer sleep by PSQI score (2.2 [0.6, 3.8]; p = 0.006) and sleep efficiency (-2.8 [-5.4,-0.2]%; p = 0.04). CONCLUSIONS In this study, sleep disturbance was more prevalent in sedentary older PWH compared to uninfected controls. An exercise intervention had minimal effect on sleep impairments among PWH nor controls. Among older adults, interventions beyond cardiovascular and resistance exercise may be needed to significantly alter subjective and objective sleep outcomes.
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Affiliation(s)
- Brian Hixon
- University of Colorado, Colorado School of Public Health, Aurora, CO, USA
| | - Helen J Burgess
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Melissa P Wilson
- Department of Biostatistics and Informatics, University of Colorado, Aurora, CO, USA
| | - Samantha MaWhinney
- Department of Biostatistics and Informatics, University of Colorado, Aurora, CO, USA
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16
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Tomaz SA, Hinkley T, Jones RA, Watson ED, Twine R, Kahn K, Norris SA, Draper CE. Screen Time and Sleep of Rural and Urban South African Preschool Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155449. [PMID: 32751089 PMCID: PMC7432324 DOI: 10.3390/ijerph17155449] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 01/10/2023]
Abstract
This study aimed to investigate the extent to which preschool children meet guidelines for screen time (<1 h/day) and sleep (10-13 h/24-h) and explored home factors that affect these behaviors. Parents of preschoolers across income settings in South Africa (urban high-income n = 27, urban low-income n = 96 and rural low-income n = 142) completed a questionnaire. Urban high-income children had higher rates of exceeding screen time guidelines (67.0%) than children from urban low-income (26.0%) and rural low-income (3.5%) settings. Most children (81.0%) met sleep guidelines on weekdays and on weekends (75.0%). More urban high-income children met the sleep guideline, in comparison to both low-income settings. Fewer urban high-income parents (50.0%) thought that screen time would not affect their preschooler's health, compared to urban low-income (90.4%) and rural low-income (81.7%) parents. Weeknight bedtime was positively correlated with both weekday screen time (p = 0.001) and weekday TV time (p = 0.005), indicating that more time on screens correlated with later bedtimes. Meeting screen time and sleep guidelines differs across income settings, but it is evident that parents of preschoolers across all income settings would benefit from greater awareness about guidelines.
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Affiliation(s)
- Simone A. Tomaz
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town 7700, South Africa
- Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, Scotland, UK
- Correspondence: (S.A.T.); (C.E.D.)
| | - Trina Hinkley
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong 3125, Australia;
| | - Rachel A. Jones
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong 2500, Australia;
| | - Estelle D. Watson
- Centre for Exercise Science and Sports Medicine, School of Therapeutic Sciences, University of Witwatersrand, Johannesburg 2000, South Africa;
| | - Rhian Twine
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa; (R.T.); (K.K.)
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa; (R.T.); (K.K.)
| | - Shane A. Norris
- South African MRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa;
| | - Catherine E. Draper
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town 7700, South Africa
- South African MRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa;
- Correspondence: (S.A.T.); (C.E.D.)
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17
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Cook I, Mohlabe M, Alberts M. Descriptive epidemiology of objectively-measured, free-living sleep parameters in a rural African setting. BMC Res Notes 2020; 13:310. [PMID: 32611438 PMCID: PMC7329391 DOI: 10.1186/s13104-020-05153-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/25/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To investigate the descriptive nature of objectively-measured, free-living sleep quantity and quality, and the relationship to adiposity, in a rural African setting in 145 adults (≥ 40 years, female: n = 104, male: n = 41). Wrist-mounted, triaxial accelerometry data was collected over 9 days. Measures of sleep quantity and quality, and physical activity were extracted from valid minute-by-minute data. Adiposity indices were body-mass-index, waist circumference and conicity index. Self-reported data included behavioural, health and socio-demographic variables. Community consultation followed the quantitative data analyses, for validation and interpretation of findings. RESULTS Females had more nocturnal sleep than males (7.2 vs. 6.8 h/night, p = 0.0464) while males recorded more diurnal sleep time (p = 0.0290). Wake after sleep onset and number of awakenings were higher in females, and sleep efficiency was higher in males (p ≤ 0.0225). Sleep indices were generally similar between weekdays and weekends, except for sleep fragmentation index (p = 0.0458). Sleep quantity, but not sleep quality was independently and inversely associated with adiposity (p = 0.0453). Physical activity and morbidity measures were significantly and consistently associated with sleep and adiposity measures (p < 0.0458). The preliminary qualitative data suggests that future studies should include more detailed data around contextual issues of sleep (social, cultural, economic, environment).
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Affiliation(s)
- Ian Cook
- Physical Activity Epidemiology Laboratory (EDST), University of Limpopo (Turfloop Campus), Sovenga, PO Box X1106, Limpopo, 0727, South Africa.
| | - Matlawa Mohlabe
- Department of Pathology and Medical Sciences, University of Limpopo (Turfloop Campus), Sovenga, Limpopo, South Africa
| | - Marianne Alberts
- Department of Pathology and Medical Sciences, University of Limpopo (Turfloop Campus), Sovenga, Limpopo, South Africa
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18
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Rae DE, Dugas LR, Roden LC, Lambert EV, Bovet P, Plange-Rhule J, Forrester T, Riesen W, Korte W, Crowley SJ, Reutrakul S, Luke A. Associations between self-reported sleep duration and cardiometabolic risk factors in young African-origin adults from the five-country modeling the epidemiologic transition study (METS). Sleep Health 2020; 6:469-477. [PMID: 32321687 DOI: 10.1016/j.sleh.2020.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 02/14/2020] [Accepted: 03/04/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To investigate associations between self-reported sleep duration and cardiometabolic (CM) risk factors in African-origin adults residing in five countries spanning the epidemiologic transition. DESIGN Cross-sectional. SETTING AND PARTICIPANTS Ghanaian (n = 491), South African (n = 503), Jamaican (n = 508), Seychellois (n = 501) and American (n = 480) men and women. MEASUREMENTS Self-reported sleep duration was obtained using questionnaires. Sex- and site-stratified logistic regression analyses investigated relationships between sleep duration, individual CM risk factors and a binary CM risk variable (presence of ≥3 CM risk factors), adjusting for age, physical activity and education. RESULTS Sleep duration distributions varied by cohort: 44.5%, 41.4%, 35.9%, 16.8% and 2.5% of American, Jamaican, Seychellois, Ghanaian and South African men reported <7 h sleep per night respectively (p < 0.001). Similarly, 42.6%, 28.6%, 25.2%, 12.8% and 1.5% of American, Jamaican, Seychellois, Ghanaian and South African women reported <7 h sleep respectively (p < 0.001). American men reporting ≤6 h sleep were more likely to be in the elevated CM risk group (OR: 2.52, 95%CI: 1.02, 6.22, p = 0.045) and to have a high waist circumference (OR: 2.44, 95%CI: 1.07, 5.57, p = 0.034) compared to those reporting 8 h sleep. Jamaican women reporting ≤6 h sleep (OR: 2.53, 95%CI: 1.19, 5.36, p = 0.016) and American women reporting 7 h sleep (OR: 2.71, 95%CI: 1.17, 6.26, p = 0.002) were more likely to be obese than those reporting 8 h sleep. CONCLUSIONS Associations between short sleep and CM risk factors were only evident in the American men and women and Jamaican women. Future interventions to address CM risk and sleep health may need to be country-specific when targeting high-risk populations.
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Affiliation(s)
- Dale Elizabeth Rae
- Health through Physical Activity, Lifestyle and Sport Research Centre & Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - Lara Ruth Dugas
- Public Health Sciences, Loyola University Chicago, Chicago, IL, USA
| | - Laura Catherine Roden
- Health through Physical Activity, Lifestyle and Sport Research Centre & Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry CV1 2DS, UK
| | - Estelle Vicki Lambert
- Health through Physical Activity, Lifestyle and Sport Research Centre & Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Pascal Bovet
- University Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland & Ministry of Health, Seychelles
| | | | - Terrence Forrester
- Solutions for Developing Countries, University of the West Indies, Mona, Kingston, Jamaica
| | - Walter Riesen
- Center for Laboratory Medicine, Canton Hospital, St. Gallen, Switzerland
| | - Wolfgang Korte
- Center for Laboratory Medicine, Canton Hospital, St. Gallen, Switzerland
| | - Stephanie J Crowley
- Biological Rhythms Research Laboratory, Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Sirimon Reutrakul
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Amy Luke
- Public Health Sciences, Loyola University Chicago, Chicago, IL, USA
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19
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Pengpid S, Peltzer K. Sedentary Behaviour and 12 Sleep Problem Indicators among Middle-Aged and Elderly Adults in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1422. [PMID: 31010026 PMCID: PMC6518187 DOI: 10.3390/ijerph16081422] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/16/2019] [Accepted: 04/17/2019] [Indexed: 12/20/2022]
Abstract
The aim of this investigation was to assess the association of sedentary behaviour with 12 different sleep problem indicators among rural middle-aged and elderly adults in South Africa. Cross-sectional data were analysed from the "Health and Aging in Africa: A Longitudinal Study of an INDEPTH community in South Africa" (HAALSI) baseline survey. Participants responded to a questionnaire, including sociodemographic, health, anthropometric measures, sedentary behaviour and 12 different sleep problem indicators. The sample included 4782 individuals 40 years and older (median 61 years, interquartile range = 20 years). Overall, participants engaged <4 h (55.9%), 4-<8 h (34.1%), 8 or more hours a day (9.9%) sedentary time a day. In adjusted multinomial logistic regression, 8 h of more sedentary time was associated with short and long sleep. In adjusted logistic regression analysis, high sedentary time was positively associated with snoring, gasping, breathing stops and restless sleep and negatively associated with insufficient sleep and sleep problems due to a traumatic event. In combined analysis, compared to persons with low or moderate sedentary behaviour and moderate or high physical activity, persons with high sedentary behaviour and low physical activity were more likely to have long sleep, insufficient sleep, snoring, gasping, breathing stops, and restless sleep and less likely to have sleep problems due to traumatic events. Findings show an association between sedentary behaviour and/or combined sedentary behaviour and low physical activity with seven of 12 sleep problem indicators (short sleep, long sleep, insufficient sleep, snoring, gasping, breathing stops, and restless sleep).
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhonpathom 73170, Thailand.
- Deputy Vice Chancellor Research and Innovation Office, North West University, Potchefstroom 2531, South Africa.
| | - Karl Peltzer
- Deputy Vice Chancellor Research and Innovation Office, North West University, Potchefstroom 2531, South Africa.
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