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Gibson R, Akter T, Jones C, Towers A. Characteristics of Atypical Sleep Durations Among Older Compared to Younger Adults: Evidence from the New Zealand Health Survey. J Gerontol A Biol Sci Med Sci 2023; 78:1908-1918. [PMID: 36729936 PMCID: PMC10562883 DOI: 10.1093/gerona/glad042] [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: 07/26/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Understanding and supporting sleep is important across the life span. Disparities in sleep status are well documented in mid-life but under-explored among older populations. METHODS Data from 40,659 adults pooled from the New Zealand Health Surveys were used; 24.2% were "older adults" (aged ≥65 years), 57% were female, and 20.5% of Māori ethnicity. "Long," "short," or "typical" sleep categories were based on age-related National Sleep Foundation guidelines. Multinomial logistic regression examined predictors of atypical sleep, including sociodemographic characteristics, lifestyle factors, and health status. RESULTS Prevalence of short and long sleep among older adults was 296 (3.0%) and 723 (7.4%), respectively. Correspondingly, prevalence among younger adults was 2 521 (8.2%) and 364 (1.2%). Atypical sleep was more significantly associated with indicators of reduced socioeconomic status and ethnicity among younger rather than older adults. Within both age groups, lower physical activity was associated with long sleep status. Higher physical activity and smoking were related to short sleep status among younger adults only. Within both age groups, atypical sleep was associated with SF-12 scores indicating poorer physical and mental health. Having ≥3 health conditions was related to short sleep among the older adults, while for young adults, it was related to both atypical durations. CONCLUSIONS Indicators of negative lifestyle and health factors remain consistent predictors of atypical sleep with aging. However, demographic disparities are less apparent among older atypical sleepers. This study highlights individual and contextual factors associated with atypical sleep patterns which may be important for age-appropriate recognition and management of sleep problems.
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Affiliation(s)
- Rosemary Gibson
- Sleep/Wake Research Centre, College of Health, Massey University, Wellington, New Zealand
- School of Psychology, Massey University, Palmerston North, New Zealand
| | - Tasnima Akter
- School of Health Sciences, Massey University, Palmerston North, New Zealand
| | - Courtney Jones
- Sleep/Wake Research Centre, College of Health, Massey University, Wellington, New Zealand
| | - Andy Towers
- School of Health Sciences, Massey University, Palmerston North, New Zealand
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Muller D, Paine SJ, Signal TL. The role of sleep in health and health inequities in early childhood in Aotearoa New Zealand. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2109689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Diane Muller
- Sleep/Wake Research Centre, School of Health Sciences, College of Health, Massey University Wellington, Wellington, New Zealand
| | - Sarah-Jane Paine
- Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Tracey Leigh Signal
- Sleep/Wake Research Centre, School of Health Sciences, College of Health, Massey University Wellington, Wellington, New Zealand
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Association and Risk Factors for Obstructive Sleep Apnea and Cardiovascular Diseases: A Systematic Review. Diseases 2021; 9:diseases9040088. [PMID: 34940026 PMCID: PMC8700568 DOI: 10.3390/diseases9040088] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 02/03/2023] Open
Abstract
Obstructive sleep apnea (OSA) is a serious, potentially life-threatening condition. Epidemiologic studies show that sleep apnea increases cardiovascular diseases risk factors including hypertension, obesity, and diabetes mellitus. OSA is also responsible for serious illnesses such as congestive heart failure, stroke, arrhythmias, and bronchial asthma. The aim of this systematic review is to evaluate evidence for the association between OSA and cardiovascular disease morbidities and identify risk factors for the conditions. In a review of 34 studies conducted in 28 countries with a sample of 37,599 people, several comorbidities were identified in patients with severe OSA—these were: heart disease, stroke, kidney disease, asthma, COPD, acute heart failure, chronic heart failure, hyperlipidemia, thyroid disease, cerebral infarct or embolism, myocardial infarction, and psychological comorbidities including stress and depression. Important risk factors contributing to OSA included: age > 35 years; BMI ≥ 25 kg/m2; alcoholism; higher Epworth sleepiness scale (ESS); mean apnea duration; oxygen desaturation index (ODI); and nocturnal oxygen desaturation (NOD). Severe OSA (AHI ≥ 30) was significantly associated with excessive daytime sleepiness and oxygen desaturation index. The risk of OSA and associated disease morbidities can be reduced by controlling overweight/obesity, alcoholism, smoking, hypertension, diabetes mellitus, and hyperlipidemia.
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Poor sleep quality and physical performance in older adults. Sleep Health 2020; 7:205-211. [PMID: 33223446 DOI: 10.1016/j.sleh.2020.10.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 10/08/2020] [Accepted: 10/12/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVES This study aimed to examine the association between sleep quality and physical performance among a group of UK community-dwelling older adults, according to sex. METHODS Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Physical performance was assessed using a short physical performance battery (SPPB), a timed up-and-go, and a hand-grip strength test. RESULTS Of 591 eligible study members, 401 completed the Pittsburgh Sleep Quality Index. In regression analyses, men who reported poor sleep quality were significantly more likely to have a poor SPPB score, even after adjustment for confounding factors (OR = 2.54, 95% CI 1.10-5.89, P= .03). The direction of the relationship was reversed among women, where those who reported poor sleep were less likely to have a low SPPB score (OR = 0.36, 95% CI 0.15-0.85, P = .02). Poor sleep quality was associated with poorer hand-grip strength among women (regression coefficient = -0.34 z score, 95% CI -0.64, -0.04, P = .03), but this relationship was not observed among men (regression coefficient = 0.28 z score, 95% CI -0.01, 0.57, P = .06). CONCLUSION We found evidence of an association between poor sleep quality and poorer physical performance in older adults, though there appear to be important sex differences.
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Yiallourou SR, Maguire GP, Carrington MJ. Sleep quantity and quality and cardiometabolic risk factors in Indigenous Australians. J Sleep Res 2020; 30:e13067. [PMID: 32526810 DOI: 10.1111/jsr.13067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/19/2020] [Accepted: 04/20/2020] [Indexed: 01/11/2023]
Abstract
Poor sleep is associated with increased risk of cardiovascular disease (CVD). Indigenous Australians have 1.3 times higher risk of CVD compared to non-indigenous Australians. However, there are limited data describing sleep problems and cardiometabolic risk in this population. This study aimed to investigate sleep quantity and quality in indigenous Australians and assess its association with cardiometabolic risk. Two hundred and forty-five indigenous Australians aged > 18 years were recruited via convenience sampling from communities in the Northern Territory and Queensland. Sleep quantity and quality was assessed subjectively with questionnaires including the Epworth Sleepiness Scale. In a sub-population (n = 46), objective sleep assessment was performed over three nights of actigraphy. Cardiometabolic risk measures included glycated haemoglobin, lipids, anthropometric measurements and sitting blood pressure. Sleep duration measured subjectively and objectively averaged 7.5 ± 2.0 hr/night; however, over one-third of participants (self-report 35%; actigraphy 39%) obtained < 7 hr/night. Overall, more than a third of participants experienced poor-quality sleep, with 27% reporting severe daytime sleepiness (ESS score > 10) and a high number of objectively measured awakenings/night (6 ± 4). Short sleep duration (<6 hr/night) measured both subjectively and objectively was an independent predictor of diastolic (β = 5.37, p = .038) and systolic blood pressure (β = 14.30, p = .048). More objectively measured night-time awakenings were associated with increased glycated haemoglobin levels (β = 0.07, p = .020) and greater sleep fragmentation was associated with lower high-density lipoprotein levels (β = -0.01, p = .025). A large proportion of indigenous Australians experienced short sleep durations and had significant sleep disruption. Poor sleep quantity and quality may contribute to heightened cardiometabolic risk in this population.
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Affiliation(s)
| | - Graeme P Maguire
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.,General Internal Medicine, Western Health, Melbourne, Victoria, Australia
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Lo K, Huang YQ, Liu L, Yu YL, Chen CL, Huang JY, Feng YQ. Serum Vitamin D, Sleep Pattern and Cardiometabolic Diseases: Findings from the National Health and Nutrition Examination Survey. Diabetes Metab Syndr Obes 2020; 13:1661-1668. [PMID: 32523366 PMCID: PMC7234964 DOI: 10.2147/dmso.s256133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/04/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Although poor sleep health and vitamin D deficiency may be associated with diabetes and hypertension, whether this association shows a trend depending on vitamin D concentration is unclear. SUBJECTS AND METHODS We analyzed data from 10,742 participants (4997 men) from the 2007-2014 National Health and Nutrition Examination Survey. Abnormal sleep pattern (ie, short sleep duration, sleep complaint, and/or sleep disorder), lifestyle factors, serum vitamin D level, and the status of diabetes and hypertension were assessed. Logistic regression was performed to estimate the odds ratio (OR) and 95% confidence interval (CI). RESULTS Serum vitamin D significantly interacted with short sleep duration and abnormal sleep pattern (both p = 0.003) on the association with diabetes in men. Short sleep duration (OR: 1.82, 95% CI = 1.29, 2.57) and abnormal sleep pattern (OR: 1.95, 95% CI = 1.38, 2.77) were associated with diabetes in men with serum vitamin D of >75 nmol/L. Serum vitamin D significantly interacted with sleep complaint on the association with hypertension in men and women (both p < 0.05). The magnitude of association between sleep complaint and hypertension in men was stronger when serum vitamin D level was <50 nmol/L (OR: 2.26, 95% CI = 1.57, 3.25) than when the level was >75 nmol/L (OR: 1.28, 95% CI = 0.90, 1.83). Similarly, the magnitude of association between sleep complaint and hypertension in women was stronger when serum vitamin D level was <50 nmol/L (OR: 2.09, 95% CI = 1.53, 2.86) than when the level was >75 nmol/L (OR: 1.64, 95% CI = 0.98, 2.72). No significant interactions were observed between serum vitamin D level and other sleep variables. CONCLUSION Abnormal sleep pattern is associated with a high risk of diabetes and hypertension. The relationship between sleep complaint and hypertension may be strong in people with vitamin D deficiency, and this observation should be verified by prospective studies.
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Affiliation(s)
- Kenneth Lo
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People’s Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, People’s Republic of China
- Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, Providence, Rhode Island, USA
- Correspondence: Kenneth Lo; Ying-qing Feng Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People’s Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, People’s Republic of ChinaTel +86-13147550252 Email ;
| | - Yu-qing Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People’s Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, People’s Republic of China
| | - Lin Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People’s Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, People’s Republic of China
| | - Yu-ling Yu
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People’s Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, People’s Republic of China
| | - Chao-lei Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People’s Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, People’s Republic of China
| | - Jia-yi Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People’s Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, People’s Republic of China
| | - Ying-qing Feng
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People’s Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, People’s Republic of China
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Muller D, Paine SJ, Wu LJ, Signal TL. "Their Sleep Means More Harmony": Maternal Perspectives and Experiences of Preschoolers' Sleep in Ethnically and Socioeconomically Diverse Families in Aotearoa/New Zealand. QUALITATIVE HEALTH RESEARCH 2019; 29:2023-2034. [PMID: 30973062 DOI: 10.1177/1049732319842156] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Viewing sleep through a socioecological lens, maternal perceptions, and experiences of preschoolers' sleep were explored using semistructured interviews with 15 Māori (indigenous) and 16 non-Māori mothers, with low- and high socioeconomic position. Thematic analysis identified four themes: child happiness and health, maternal well-being, comfort and connection, and family functioning and harmony. Mothers perceived healthy preschooler sleep as supporting children's mental and physical health, parents' sleep/wake functioning, family social cohesion and emotional connectedness, and poor preschooler sleep as negatively influencing child, maternal and family well-being. Although many experiences were shared, some perceptions of sleep and sleep practices differed between mothers. Influences included health paradigms, socioeconomic circumstances, maternal autonomy, employment, parenting approaches, and societal expectations. Healthy preschooler sleep is valued by mothers and may play a protective role in family health and resilience. Preschooler sleep initiatives need to be responsive to maternal perspectives and address societal drivers of sleep experiences.
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Affiliation(s)
| | | | - Lora J Wu
- Massey University, Wellington, New Zealand
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Lee CH, Sibley CG. Sleep duration and psychological well-being among New Zealanders. Sleep Health 2019; 5:606-614. [PMID: 31377250 DOI: 10.1016/j.sleh.2019.06.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 06/02/2019] [Accepted: 06/17/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To identify the prevalence of short and long sleep duration and examine the relationship between sleep duration and psychological well-being among New Zealand adults. DESIGN Multiple regression using data from the New Zealand Attitudes Values Study postal questionnaire. PARTICIPANTS New Zealand Attitudes Values Study respondents in 2014, 2015, and/or 2016 (Ns =15,820, 13,942, and 21,937). MEASUREMENTS Participants were asked, "During the past month, on average, how many hours of actual sleep did you get per night?" They also reported their demographic characteristics, physical and psychological health, and personality traits. RESULTS Most New Zealanders reported having optimal sleep duration (7 to <9 hours, 58%), but more than a third reported having short (<7 hours, 37%) and 4.5% reported long sleep duration (≥ 9 hours). Māori and Pacific peoples showed particularly high rates of short sleepers. Compared to optimal sleep, short sleep consistently showed negative relationships with various measures of positive psychological well-being (eg, self-esteem, life satisfaction) independent of a broad range of demographic, health, and personality factors. Long sleep was only associated with an increased likelihood of depression. Personality traits, especially neuroticism, also showed strong associations with psychological well-being. CONCLUSIONS The high proportion of short sleepers in New Zealand is a major issue of concern because short sleep showed consistent associations with negative psychological well-being. It is vital to implement sleep awareness campaigns and increase research on the reasons for short sleep among different groups. Given the ethnic disparity in sleep duration, target interventions for Māori and Pacific peoples are particularly crucial.
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Affiliation(s)
- Carol Hj Lee
- School of Psychology, University of Auckland, Auckland, New Zealand.
| | - Chris G Sibley
- School of Psychology, University of Auckland, Auckland, New Zealand
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