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Balkin TJ, Simonelli G, Riedy S. Negative health outcomes in long sleepers: The societal sleep restriction hypothesis. Sleep Med Rev 2024; 77:101968. [PMID: 38936221 DOI: 10.1016/j.smrv.2024.101968] [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: 01/23/2024] [Revised: 05/15/2024] [Accepted: 06/04/2024] [Indexed: 06/29/2024]
Abstract
Society imposes work and school schedules, as well as social expectations, that militate against consistently obtaining more than 7-9 h of sleep every 24 h. For most but not all adults this sleep duration is adequate. But among those who consistently obtain more than 9 h of sleep per day ("long sleepers"), there likely exists a subpopulation of individuals who are nevertheless failing to obtain enough sleep to satisfy their physiological sleep needs - a consequence of "restricting" their daily sleep durations to whatever extent they can tolerate so as to conform as closely as possible to society's norms and expectations. It is hypothesized that the 'long sleep arm' of the seemingly paradoxical U-shaped relationship between sleep duration and negative health outcomes can be explained, at least in part, by the existence of a subpopulation of such 'sleep-restricted long sleepers.'
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Affiliation(s)
- Thomas J Balkin
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
| | - Guido Simonelli
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada; Department of Neuroscience, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada; Center for Advanced Research in Sleep Medicine, Centre Integre Universitaire de Sante et de Services Sociaux Du Nord-de-l'île-de-Montreal, Montreal, QC, Canada
| | - Samantha Riedy
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
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Zhu J, Zheng T, Jin H, Wei M, Yu J, Ni J, Sun K, Zhang J. Sleep Disturbances in Early Gestation and the Risks of Hypertensive Disorders of Pregnancy: A Prospective Cohort Study. Am J Epidemiol 2024; 193:479-488. [PMID: 37968336 DOI: 10.1093/aje/kwad223] [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: 09/07/2022] [Revised: 10/31/2023] [Accepted: 11/14/2023] [Indexed: 11/17/2023] Open
Abstract
Maternal poor sleep quality may increase blood pressure during pregnancy, but sound evidence is still limited and inconsistent. To evaluate whether sleep disturbances in early gestation are risk factors for the development of hypertensive disorders of pregnancy, we conducted the Early Life Plan Project from June 2016 to December 2019. Maternal sleep patterns were assessed at 12-16 weeks of gestation by using the Pittsburgh Sleep Quality Index questionnaire. For gestational hypertension and preeclampsia, we estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) using multinomial logistic regression models adjusting for potential confounders. Among 5,532 eligible women, we observed that maternal blood pressure in early gestation was significantly higher in women with low sleep efficiency (≤85%), long sleep duration (≥9 hours/night), and snoring. Compared with nonsnorers, snoring in early gestation was independently associated with preeclampsia (OR = 1.72 (95% CI: 1.09, 2.73) for snoring once or twice per week; OR = 2.06 (95% CI: 1.01, 4.31) for snoring 3 or more times per week), particularly for term preeclampsia (OR = 1.79 (95% CI: 1.08, 2.95) and 2.26 (95% CI: 1.03, 4.95), respectively). Results suggest that snoring in early gestation may be a significant risk factor for preeclampsia, with a dose-response pattern.
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Influence of Snoring on the Incidence of Metabolic Syndrome: A Community-Based Prospective Cohort Study in Rural Northeast China. J Clin Med 2023; 12:jcm12020447. [PMID: 36675375 PMCID: PMC9866208 DOI: 10.3390/jcm12020447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 12/28/2022] [Accepted: 01/03/2023] [Indexed: 01/08/2023] Open
Abstract
In recent years, there has been an increase in the incidence of metabolic syndrome (MetS) in rural China. Thus, for better intervention, it is necessary to identify the possible risk factors of MetS. This community-based prospective cohort study was performed to evaluate the relationship between the snoring status and incidence of MetS. In this Northeast China rural cardiovascular health study, 4980 residents aged ≥35 years (2586 men and 2394 women; follow-up proportion: 87.5%) at baseline were recruited between 2012 and 2013 and were followed up between 2015 and 2017. The primary outcome was the incidence of MetS, as defined by the unified criteria for MetS defined in 2009. The residents were classified based on their snoring status, and the outcomes were compared between the two groups. The odds ratio (OR) for MetS incidence was estimated using a logistic regression model and adjusted for confounding factors. With a median follow-up duration of 4.6 years, the MetS incidence was higher among the snorers (men, 26.2%; women, 33.5%) than in the non-snorers (men, 19.7%; women, 23.2%). The participants' diastolic blood pressure was increased at follow-up as compared with the baseline values among the male snorers; however, a decrease was noted among the male non-snorers. Similarly, the female snorers had higher blood glucose levels during the follow-up, whereas the non-snorers had lower blood sugar levels. A significant association was noted between snoring and the incidence of MetS (adjusted OR = 1.51; 95% confidence interval = 1.32-1.74). Moreover, the incidence of severe snoring increased with increased levels of snoring, with severe snorers having an OR twice as high as that of the non-snorers (adjusted OR = 2.10; 95% confidence interval = 1.38-3.20). Overall, snoring was independently associated with a higher incidence of newly diagnosed MetS in rural Northeast China. Thus, more attention should be paid to residents with snoring problems.
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Hu X, Meng L, Wei Z, Xu H, Li J, Li Y, Jia N, Li H, Qi X, Zeng X, Zhang Q, Li J, Liu D. Prevalence and potential risk factors of self-reported diabetes among elderly people in China: A national cross-sectional study of 224,142 adults. Front Public Health 2022; 10:1051445. [PMID: 36620236 PMCID: PMC9811661 DOI: 10.3389/fpubh.2022.1051445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Aim To evaluated the prevalence and potential risk factors of self-reported diabetes among the elderly in China, by demographic data, socioeconomic factors, and psychological factors. Methods Descriptive analysis and Chi-square analysis were used to assess the prevalence and variation between self-reported diabetes and non-diabetes by demographic data, living habits, socioeconomic factors and comorbidities. Univariate and multivariate logistic regression were used to describe the odds ratios (OR) of diabetes prevalence in different groups, while stratification analysis was performed to describe prevalence based on gender, age, and urban/rural areas. Results 215,041 elderly adults (102,692 males and 112,349 females) were eventually included in the analysis. The prevalence of self-reported diabetes among the elderly in China is about 8.7%, with the highest prevalence in Beijing (20.8%) and the lowest prevalence in Xizang (0.9%). Logistic regression analysis showed that urban area (P < 0.001), older age (65-84 years old, P < 0.001), female (P < 0.001), higher income(P < 0.001), poor sleep quality (P = 0.01) and some other factors were potential risk factors for diabetes. Conclusions This study illustrates the prevalence and potential risk factors of diabetes among the elderly in China Meanwhile, these results provide information to assist the government in controlling non-communicable diseases in the elderly.
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Affiliation(s)
- Xing Hu
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing, China.,Graduate School of Peking University Health Science Center, Beijing, China
| | - Lingbing Meng
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhimin Wei
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing, China
| | - Hongxuan Xu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Jianyi Li
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yingying Li
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Na Jia
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Hui Li
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Xin Qi
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Xuezhai Zeng
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | | | - Juan Li
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Deping Liu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
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Yuan Y, Zhang F, Qiu J, Chen L, Xiao M, Tang W, Luo Q, Ding X, Tang X. Association Between Snoring and Diabetes Among Pre- and Postmenopausal Women. Int J Gen Med 2022; 15:2491-2499. [PMID: 35282647 PMCID: PMC8904760 DOI: 10.2147/ijgm.s352593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 02/18/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose To examine the relationship between diabetes and snoring frequency and determine the effect of menopause and postmenopausal years on this relationship. Methods We included 12,218 premenopausal and postmenopausal women from part of the baseline of the China Multi-Ethnic Cohort study (CMEC) in Chongqing province. Face-to-face questionnaires, physical examination, and biological samples were used to collect data. Logistic regression and subgroup analysis were used to explore the relationship between snoring and diabetes in women with various menopausal statuses. Results The risk of diabetes increased with the snoring frequency, with adjusted odds ratios of 1.23 (95% CI:1.05–1.43) and 1.47 (95% CI:1.25–1.73) for sometimes snoring and frequent snoring, compared to non-snoring. In premenopausal and postmenopausal women, frequent snoring increased the odds of diabetes by 58% (95% CI: 7–132%) and 43% (95% CI: 20–72%), respectively, compared to non-snoring. Only in women who were ≥10 years postmenopausal had a statistical association between frequent snoring and diabetes, with a 54% (95% CI: 23–92%) increased odds of diabetes, compared to women who did not snore. Conclusion Snoring frequency is positively associated with diabetes. Women who snore frequently before and for at least ten years after menopause are at higher risk of developing diabetes. Frequent snorers and long-term postmenopausal women should monitor blood glucose levels to aid in the early detection and treatment of diabetes.
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Affiliation(s)
- Yun Yuan
- School of Public Health and Management, Medical and Social Development Research Center, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Fan Zhang
- School of Public Health and Management, Medical and Social Development Research Center, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Jingfu Qiu
- School of Public Health and Management, Medical and Social Development Research Center, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Liling Chen
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, People’s Republic of China
| | - Meng Xiao
- School of Public Health and Management, Medical and Social Development Research Center, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Wenge Tang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, People’s Republic of China
| | - Qinwen Luo
- School of Public Health and Management, Medical and Social Development Research Center, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Xianbin Ding
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, People’s Republic of China
- Xianbin Ding, Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, People’s Republic of China, Tel +86-13896096430, Email
| | - Xiaojun Tang
- School of Public Health and Management, Medical and Social Development Research Center, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Correspondence: Xiaojun Tang, School of Public Health and Management, Medical and Social Development Research Center, Chongqing Medical University, No. 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, People’s Republic of China, Tel +86-13668023656, Email
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Bawadi H, Al Sada A, Al Mansoori N, Al Mannai S, Hamdan A, Shi Z, Kerkadi A. Sleeping Duration, Napping and Snoring in Association with Diabetes Control among Patients with Diabetes in Qatar. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4017. [PMID: 33921201 PMCID: PMC8069870 DOI: 10.3390/ijerph18084017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/22/2021] [Accepted: 03/30/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Poor glycemic control is associated with chronic life-threatening complications. Several studies have revealed that sleep status is associated with glycemic control. AIM to examine the association between sleep duration, quality and glycemic control among adults with diabetes. METHODS Data on 2500 participants aged 18-60 years were collected from the Qatar Biobank (QBB). Sleep duration and quality were assessed by a self-completed health and lifestyle questionnaire, and glycemic control was assessed using HbA1c. Logistic regression was used to assess the association between sleep duration, napping, snoring and poor glycemic control. RESULTS After adjusting for age and gender, sleep duration was not associated with poor glycemic control. Lack of association persisted after controlling for smoking, physical activity, education, BMI, fruit and vegetable intake, insulin and medication use. However, sleeping for long hours at night (≥8 h) had a trend in increasing the risk of poor glycemic control (OR = 1.28; 95% CI: 0.94-1.74). Napping was positively associated with poor glycemic control. After adjusting for age and gender, patients who reported "sometimes, frequently, or always" napping had more than 30% increased risk of poor control as compared to patients who reported "never/rarely" napping. Snoring was not associated with poor glycemic control among the study sample when adjusted for age and gender (p = 0.61). Other factors were found to be associated with a better glycemic control such as female, high educational and high physical activity level. CONCLUSIONS our results suggest that napping may be an independent risk factor for a poor glycemic control in diabetes; further investigations are required.
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Affiliation(s)
- Hiba Bawadi
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha 2713, Qatar; (A.A.S.); (N.A.M.); (S.A.M.); (A.H.); (Z.S.); (A.K.)
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Ma J, Zhang H, Wang H, Gao Q, Sun H, He S, Meng L, Wang T. Association Between Self-Reported Snoring and Metabolic Syndrome: A Systematic Review and Meta-Analysis. Front Neurol 2020; 11:517120. [PMID: 33123068 PMCID: PMC7566901 DOI: 10.3389/fneur.2020.517120] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 08/28/2020] [Indexed: 01/03/2023] Open
Abstract
Background: Snoring is a common condition. Previous studies have reported the relationships between snoring and metabolic syndrome (MetS) and/or its five components: hypertension, hyperglycemia, low-high density lipoprotein (low-HDL), high-triglyceride level, and abdominal obesity. However, conclusions have been inconsistent, and there has been no comprehensive summary on this. Therefore, we performed a systematic review on the relationships between snoring and MetS, including each of MetS' components. Methods: A systematic review and a meta-analysis were conducted following the Meta-analysis of Observational Studies in Epidemiology group and Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. Electronic databases including PubMed, Embase, and the Cochrane Library were searched for publications from inception to 15 July 2020. The inverse-variance weighted method was used in the meta-analysis to calculate the pooled odds ratios (ORs) and their 95% confidence intervals (CIs) to determine the association between snoring and MetS (and its components) through a fixed or random effect model. A restricted cubic spline regression model and the linear regression model were used in a two-stage dose–response meta-analysis to evaluate the non-linear and the linear trends between snoring frequency and MetS and its components. Results: A total of 40 studies with 966,652 participants were included in this study. The pooled ORs between snoring and MetS and its components, hypertension, hyperglycemia, low-HDL, high-triglyceride level, and abdominal obesity, were 1.61 (95% CI, 1.43–1.78), 1.23 (95% CI, 1.15–1.31), 1.05 (95% CI, 1.04–1.07), 1.09 (95% CI, 1.00–1.18), 1.08 (95% CI, 1.00–1.17), and 1.75 (95% CI, 1.46–2.05), respectively. Non-linear trends were detected in the five associations except for low-HDL. A linear trend was detected in the association of snoring with hypertension, hyperglycemia, low-HDL, or abdominal obesity, with ORs of 1.07 (95% CI, 1.01–1.13), 1.05 (95% CI, 1.02–1.08), 1.03 (95% CI, 1.02–1.04), and 1.17 (95% CI, 1.16–2.89), respectively. Conclusion: Snoring was a risk factor of MetS, and a dose–response relationship existed between the two. Timely intervention in identifying snorers can minimize as much as possible the risk of metabolic syndrome in those who snore.
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Affiliation(s)
- Jinsha Ma
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Huifang Zhang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Hui Wang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Qian Gao
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Heli Sun
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Simin He
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Lingxian Meng
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Tong Wang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
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Zhang H, Li S, Chen G, Abdulai T, Liu X, Wang Y, Liang H, Hou J, Huo W, Mao Z, Wang C, Bie R. Ambient air pollutants aggravate association of snoring with prevalent hypertension: results from the Henan Rural Cohort. CHEMOSPHERE 2020; 256:127108. [PMID: 32464360 DOI: 10.1016/j.chemosphere.2020.127108] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 05/07/2020] [Accepted: 05/16/2020] [Indexed: 06/11/2023]
Abstract
AIM We aimed to assess if snoring and ambient air pollutants were jointly associated with prevalent hypertension in a cross-sectional study. METHODS A total of 28440 participants aged 18-79 years were obtained from the Henan Rural Cohort. Snoring evaluated using Pittsburgh sleep quality index (PSQI) scale was classified into 'Never', '<3 times/week' and '≥3 times/week' groups. Concentrations of air pollutants (PM1, PM2.5, PM10, and NO2) were evaluated by a satellite-based spatiotemporal model. The independent and joint associations between snoring and air pollutants on prevalence of hypertension were analyzed by logistic regression models. RESULTS The mean age of all participants was 56.0 ± 12.2 years. The frequencies and prevalence of participants with hypertension were 3666 (32.39%) in men and 5576(32.57%) in women, respectively. The odds ratio (OR) and 95% confidence interval (CI) of participants with snoring frequency of <3 times/week, ≥3 times/week was 1.10(1.02-1.20), and 1.15(1.08-1.23) for hypertension, compared to those without snoring. Participants with a snoring (≥3 times/week) and higher exposure concentrations of PM1, PM2.5, PM10, and NO2 had 2.58-fold(95% CI: 2.30-2.90), 3.03-fold(95% CI: 2.69-3.41), 2.89-fold(95% CI: 2.57-3.25) and 2.75-fold(95% CI: 2.44-3.10) for hypertension, compared to those without snoring and low concentrations of air pollutants. Additionally, participants with high PM1 and ≥3 times/week snoring (OR: 1.32, 95% CI: 1.18-1.48) was at a higher likelihood for prevalent hypertension, compared to those without snoring and with high PM1. CONCLUSIONS Snoring and high ambient air pollutants might be important predictors of hypertension, and higher concentration of PM1 might aggravate the association between snoring and hypertension.
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Affiliation(s)
- Haiqing Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China; Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, PR China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Gongbo Chen
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
| | - Tanko Abdulai
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yan Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Huiying Liang
- Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, PR China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
| | - Ronghai Bie
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
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Huang M, Yang Y, Huang Z, Yuan H, Lu Y. The association of nighttime sleep duration and daytime napping duration with hypertension in Chinese rural areas: a population-based study. J Hum Hypertens 2020; 35:896-902. [PMID: 32973309 DOI: 10.1038/s41371-020-00419-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/20/2020] [Accepted: 09/15/2020] [Indexed: 11/09/2022]
Abstract
We aimed to investigate the association of self-reported nighttime sleep duration and daytime napping duration with hypertension in rural areas of China. The participants, who were from rural areas of Hunan Province in China, were enrolled during 2016-2017. Nighttime sleep duration (<7 h, 7-8 h, and ≥9 h) and daytime napping duration(no nap, 0-1 h, and >1 h) were determined by a self-reported questionnaire. Hypertension was defined as a mean systolic blood pressure ≥140 mmHg and/or a mean diastolic blood pressure ≥90 mmHg or a self-reported physician diagnosis of hypertension and current use of antihypertensive medication. Of 1763 enrolled participants, 52% had hypertension. A total of 640 (36%) were male and 1123 (64%) were female; the mean age was 56 years. After adjusting for potential confounders, participants who slept for ≥9 h per night had a 1.29-fold (95% CI: 1.03, 1.60) increased odds of hypertension compared to the reference group (7-8 h per night). Daytime napping >1 h was negatively associated with hypertension, with an adjusted OR (95% CI) of 0.70 (0.51, 0.97), and the protective effect of longer daytime napping was still found in the subgroup sleeping 7-8 h per night. Among the rural population in China, long nighttime sleep duration is associated with a higher prevalence of hypertension, and longer daytime napping is related to a decreased prevalence of hypertension.
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Affiliation(s)
- Miao Huang
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, 410013, China
| | - Yiping Yang
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, 410013, China
| | - Zhijun Huang
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, 410013, China
| | - Hong Yuan
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, 410013, China. .,National-Local Joint Engineering Laboratory of Drug Clinical Evaluation Technology, Changsha, 410000, China.
| | - Yao Lu
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, 410013, China. .,National-Local Joint Engineering Laboratory of Drug Clinical Evaluation Technology, Changsha, 410000, China.
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Hu C, Zhang Y, Wang S, Lin L, Peng K, Du R, Qi H, Zhang J, Wang T, Zhao Z, Li M, Xu Y, Xu M, Li D, Bi Y, Wang W, Chen Y, Lu J. Association of bedtime with the risk of non-alcoholic fatty liver disease among middle-aged and elderly Chinese adults with pre-diabetes and diabetes. Diabetes Metab Res Rev 2020; 36:e3322. [PMID: 32268002 DOI: 10.1002/dmrr.3322] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/27/2020] [Accepted: 03/30/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Emerging evidence indicated that sleep characteristics may play important roles in the development of metabolic disorders. However, little is known as to the association between bedtime and the risk of non-alcoholic fatty liver disease (NAFLD) in individuals with pre-diabetes and diabetes. METHODS In a prospective cohort of 10 375 adults aged ≥40 years, 1960 of 3484 eligible pre-diabetic and diabetic individuals were identified for the current study. NAFLD was diagnosed using liver ultrasonography at baseline and at follow-up. Information on bedtime was obtained at baseline using a standard questionnaire. RESULTS We documented 433 incident cases of NAFLD among this study population. In multivariable-adjusted logistic regression model, later bedtime was associated with increased risk of NAFLD (29% increased risk per hour of later bedtime). Compared to individuals with bedtime ≤20:00, the odds ratios (95% confidence intervals) of NAFLD for bedtime of 20:00-22:00 and ≥22:00 were 1.56 (1.04-2.34) and 2.05 (1.31-3.20), respectively. In the subgroup analysis, significant associations were observed among those who were overweight or physically inactive, or those with metabolic syndrome or elevated 10-year risks for atherosclerotic cardiovascular disease. When estimating the joint effect of bedtime and other sleep characteristics, higher risk of incident NAFLD was observed in groups of late bed/early rise, late bed/napping (yes), late bed/bad sleeper, or late bed/shorter sleep durations. CONCLUSIONS Later bedtime was significantly associated with an increased risk of incident NAFLD in adults with pre-diabetes and diabetes, underscoring the importance of sleep behaviour management in the prevention of NAFLD.
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Affiliation(s)
- Chunyan Hu
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Yi Zhang
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Shuangyuan Wang
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Lin Lin
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Kui Peng
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Rui Du
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Hongyan Qi
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Jie Zhang
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Tiange Wang
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Zhiyun Zhao
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Mian Li
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Yu Xu
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Min Xu
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Donghui Li
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yufang Bi
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Weiqing Wang
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Yuhong Chen
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Jieli Lu
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
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The impact of sleep duration and sleep quality on glycaemic control in Asian population with type 2 diabetes mellitus: A systematic literature review and meta-analysis of observational studies. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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12
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The relationship between self-reported habitual snoring and hyperuricemia among Chinese urban adults: a cross-sectional study. Sleep Med 2019; 68:207-212. [PMID: 32143022 DOI: 10.1016/j.sleep.2019.11.1257] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/20/2019] [Accepted: 11/26/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Growing evidence suggests an independent relationship between habitual snoring and metabolic abnormalities. Currently, there are few data available on the association between snoring and hyperuricemia. Therefore, we evaluated the cross-sectional association between snoring and serum uric acid (UA) concentration and ascertain the effects of different snoring intensities on hyperuricemia among Chinese urban adults in Nanjing. METHODS We performed a cross-sectional study including 7699 participants (4197 men and 3502 women) from Nanjing Drum Tower Hospital aged ≥18 years over a two year (ie, 2016-2018) period. All participants were divided into four groups based on Snoring scores. Questionnaires, physical examinations and biochemical tests were conducted. Hyperuricemia was defined as levels of serum UA > 6.8 mg/dL in males and >6.0 mg/dL in females. We used a generalized linear model to investigate the association between snoring and serum UA concentration and logistic regression model to investigate the association between snoring and likelihood of having hyperuricemia in the age-, sex-adjusted model and in a multivariable model adjusting for demographic factor, plasma lipid profiles, blood glucose, blood pressure, smoking, and alcohol consumption. RESULTS The prevalence of hyperuricemia was 10.05% in the studied population and gradually increased across the snoring scores (P < 0.0001). We found that mild snoring, moderate, and severe snoring intensity were associated with high serum UA in the age-, sex-adjusted model and in a multivariable model adjusting for demographic and lifestyle/behavioral risk factors. The association was insisted with the addition of variables related to clinical outcomes such as diabetes, hypertension, and high-cholesterol levels. CONCLUSIONS Our results showed self-reported habitual snoring was associated with higher serum UA concentration among Chinese urban adults. Findings of this study indicate the significance of early detection and treatment of snoring to prevent hyperuricemia.
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Association of long-term sleep habits and hypertension: a cross-sectional study in Chinese adults. J Hum Hypertens 2019; 34:378-387. [PMID: 31431681 DOI: 10.1038/s41371-019-0225-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/24/2019] [Accepted: 06/06/2019] [Indexed: 01/22/2023]
Abstract
Poor sleep has been associated with risk of hypertension, but previous studies were limited by treating one or two sleep factors as predictor. Our previous study has developed a sleep factor questionnaire (SFQ) to comprehensively assess wide range of sleep characteristics including sleep duration, sleep quality, light at night (LAN) exposure, night/shift work, daytime napping, and frequency of nighttime waking, insomnia, and snoring. In this cross-sectional study we used the SFQ to evaluated the associations between these sleep domains and hypertension. Comparing with the subjects who slept 7-8 h, subjects with sleep duration 6-7 h (OR = 1.42, 95% CI: 1.01, 2.00), 8-9 h (OR = 1.60, 95% CI: 1.07, 2.40), and over 9 h (OR = 2.39, 95% CI: 1.60, 3.58) had an increased prevalence of hypertension. The associations were significant among individuals under 45 years sleeping 6-7 h and those over 45 years sleeping over 8 h. The OR of prevalent hypertension was 0.80 (95% CI: 0.62, 0.97) for habitual daytime napping compared with never napping, and the association was also significant among individuals over 45 years old. Moreover, among subjects with sleep duration 7-8 h, habitual daytime napping may decrease prevalent hypertension (OR = 0.635, 95% CI: 0.437, 0.924). In conclusion, our data suggested a positive association between both short (6-7 h) and long sleep duration and hypertension, and a preventive pattern for habitual daytime napping among over 45 years old and hypertension. Moreover, interaction analysis indicated that habitual midday nap may decrease prevalent hypertension among subjects with sleep duration 7-8 h.
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Lee C, Joo YS, Lee S, Kang S, Kim J, Nam KH, Yun HR, Jhee JH, Kim H, Han SH, Yoo TH, Kang SW, Park JT. Snoring and incident chronic kidney disease: a community-based prospective cohort study. BMJ Open 2019; 9:e030671. [PMID: 31383712 PMCID: PMC6687056 DOI: 10.1136/bmjopen-2019-030671] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Previous studies have shown that symptoms of sleep-disordered breathing are associated with metabolic derangements and vascular disease development. However, the relationship between snoring and renal function is not well investigated. The association between snoring and the development of incident chronic kidney disease (CKD) in subjects with normal renal function was evaluated. DESIGN Prospective cohort study. SETTING Ansung (rural community) and Ansan (urban community) cities. PARTICIPANTS Community-based cohort participants aged 40-69 years. METHODS A total of 9062 participants in the Ansung-Ansan cohort study were prospectively followed up from 2001 to 2014. The participants were classified into three groups: non-snorer, <1 day/week and ≥1 day/week. The main outcome was incident CKD, which was defined as an estimated glomerular filtration rate of <60 mL/min/1.73 m2 during the follow-up period. PRIMARY OUTCOME Incident CKD. RESULTS The mean subject age was 52.0±8.9 years, and 4372 (48.2%) subjects were male. The non-snorer,<1 day/week and ≥1 day/week groups included 3493 (38.5%), 3749 (41.4%), and 1820 (20.1%) subjects, respectively. Metabolic syndrome was more prevalent in the snoring groups than in the non-snoring group. Snoring frequency showed a significant positive relationship with age, waist:hip ratio, fasting glucose, total cholesterol (Tchol) and low-density lipoprotein cholesterol. During a mean follow-up of 8.9 years, 764 (8.4%) subjects developed CKD. Cox proportional hazards model analysis revealed that the risk of CKD development was significantly higher in subjects who snored ≥1 day/week than in non-snorers, even after adjustments for confounding factors (HR 1.23, 95% CI 1.09 to 1.38, p<0.01). CONCLUSION Snoring may increase the risk of CKD development in subjects with normal renal function.
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Affiliation(s)
- Changhyun Lee
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Young Su Joo
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Sangmi Lee
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Shinchan Kang
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Joohwan Kim
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Ki Heon Nam
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Hae-Ryong Yun
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Jong Hyun Jhee
- Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea
| | - Hyoungnae Kim
- Division of Nephrology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Seung Hyeok Han
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Tae-Hyun Yoo
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Shin-Wook Kang
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Jung Tak Park
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
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Wang F, Chow IHI, Li L, Li XH, Ng CH, Ungvari GS, Wang AH, Jia FJ, Zhang Y, Xiang YT. Sleep duration and patterns in Chinese patients with diabetes: A meta-analysis of comparative studies and epidemiological surveys. Perspect Psychiatr Care 2019; 55:344-353. [PMID: 30693541 DOI: 10.1111/ppc.12353] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/10/2018] [Accepted: 01/06/2019] [Indexed: 02/05/2023] Open
Abstract
PURPOSE A meta-analysis on sleep duration and patterns in patients with diabetes in China. DESIGN AND METHODS Two investigators independently carried out a systematic literature search in both international and Chinese databases. FINDINGS A total of 47 studies with 98 911 patients were included. The pooled mean sleep duration was 7.15 hours/day in patients with diabetes and 7.49 hours/day in healthy controls. The estimated percentage of short sleep duration of less than 6 hours/day was 23.0% in patients with diabetes and 12.3% in healthy controls, while the proportion of short sleep duration of less than 7 hours/day was 38.0% in patients with diabetes and 14.1% in healthy controls. PRACTICE IMPLICATIONS Short sleep duration was common in Chinese patients with diabetes.
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Affiliation(s)
- Fei Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China.,Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Ines H I Chow
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Lu Li
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Xiao-Hong Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Gabor S Ungvari
- University of Notre Dame Australia / Graylands Hospital, Perth, Australia.,Division of Psychiatry, Medical School, University of Western Australia, Perth, Australia
| | - Ai-Hong Wang
- Department of Endocrinology, the 306 Hospital of PLA, Beijing, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Ye Zhang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
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Song J, Wang C, Ma A, Zheng H, Zheng W, Hou X, Hu C, Chen L, Jia W. Self-reported snoring is associated with chronic kidney disease independent of metabolic syndrome in middle-aged and elderly Chinese. J Diabetes Investig 2019; 10:124-130. [PMID: 29694704 PMCID: PMC6319474 DOI: 10.1111/jdi.12855] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 04/13/2018] [Accepted: 04/17/2018] [Indexed: 11/29/2022] Open
Abstract
AIMS/INTRODUCTION To investigate the correlation between snoring and chronic kidney disease (CKD), and explore whether metabolic syndrome (MetS) plays an important role in this relationship among middle-aged and elderly Chinese. MATERIALS AND METHODS The participants included in the present study were categorized into three subgroups based on self-reported snoring frequency (regularly [≥3 times per week], occasionally [between 'regularly' and 'never'] or never [<1 time per month]). An estimated glomerular filtration rate <60 mL/min/1.73 m2 was considered as CKD. We diagnosed MetS based on the 2004 Chinese Diabetes Society criteria. We explored the relationship between snoring and CKD by using multiple logistic regressions. RESULTS The frequency of MetS, MetS components and CKD was dramatically higher in regular snorers than in non-snorers and occasional snorers. The odds ratios for MetS and all the MetS elements, except for hyperglycemia, increased progressively with the snoring frequency (P < 0.001). Upon additional adjustment for other MetS components, snoring was not significantly related with hypertension; however, the associations between snoring frequency and overweight/obesity and dyslipidemia became attenuated, but still remained statistically significant (P < 0.01). Interestingly, odds ratios for CKD also increasingly augmented with snoring frequency (P < 0.001). Upon further adjustment for individual MetS components or MetS, regular snoring also resulted in a significantly increased odds ratio for CKD (odds ratio 1.72; P = 0.034) relative to non-snoring. CONCLUSIONS Self-reported snoring is closely associated with CKD independent of MetS among middle-aged and elderly Chinese.
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Affiliation(s)
- Jun Song
- Shanghai Diabetes InstituteShanghai Key Laboratory of DiabetesShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
- Department of EndocrinologyQilu Hospital of Shandong UniversityJinanShandongChina
| | - Chuan Wang
- Department of EndocrinologyQilu Hospital of Shandong UniversityJinanShandongChina
| | - Aixia Ma
- Department of EndocrinologyQilu Hospital of Shandong UniversityJinanShandongChina
| | - Huizhen Zheng
- Department of EndocrinologyQilu Hospital of Shandong UniversityJinanShandongChina
| | - Wenjian Zheng
- Department of GeriatricsQingdao Haici Medical Treatment GroupQingdaoShandongChina
| | - Xinguo Hou
- Department of EndocrinologyQilu Hospital of Shandong UniversityJinanShandongChina
| | - Cheng Hu
- Shanghai Diabetes InstituteShanghai Key Laboratory of DiabetesShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Li Chen
- Department of EndocrinologyQilu Hospital of Shandong UniversityJinanShandongChina
| | - Weiping Jia
- Shanghai Diabetes InstituteShanghai Key Laboratory of DiabetesShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
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Yan M, Fu Z, Qin T, Wu N, Lv Y, Wei Q, Jiang H, Yin P. Associations of sleep duration and prediabetes prevalence in a middle-aged and elderly Chinese population with regard to age and hypertension: The China Health and Retirement Longitudinal Study baseline survey. J Diabetes 2018; 10:847-856. [PMID: 29573578 DOI: 10.1111/1753-0407.12662] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/04/2018] [Accepted: 03/17/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The aim of the present study was to examine the age-specific associations between self-reported sleep duration and prevalent prediabetes in middle-aged and elderly Chinese with or without hypertension. METHODS In all, 2985 Chinese adults aged ≥45 years from the China Health and Retirement Longitudinal Study (CHARLS) baseline survey were selected for analysis. Sleep duration was assessed by structured questionnaires and then categorized into three groups (≤6, 6-8, and >8 h). The prevalence of prediabetes was defined using fasting plasma glucose (100-125 mg/dL) and/or HbA1c (5.7%-6.4%) in conjunction with no previous diabetes diagnosis and no antidiabetic medication. Relationships between self-reported sleep duration and prevalent prediabetes were examined according to age (45-60 years, middle-aged; ≥60 years, elderly) and hypertension groups using Poisson regression models to estimate prevalence ratios (PRs) and 95% confidence intervals (CI). RESULTS Compared with the reference group of 6-8 h sleep/night, short sleep (≤6 h/night) was associated with an increased risk of prediabetes in the whole sample (PR 1.09, 95% CI 1.01-1.17) after adjusting for confounders. This association was more pronounced in elderly participants without hypertension (PR 1.27, 95% CI 1.07-1.51). CONCLUSION This study suggests that participants with a short sleep period are at a moderately increased risk of prediabetes, particularly in elderly subjects without hypertension. Aging and hypertension may be important in the relationship between short sleep and impaired glucose metabolism.
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Affiliation(s)
- Mingming Yan
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhen Fu
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tingting Qin
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nanjin Wu
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yalan Lv
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qinyun Wei
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongwei Jiang
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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18
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Whitaker KM, Lutsey PL, Ogilvie RP, Pankow JS, Bertoni A, Michos ED, Punjabi N, Redline S. Associations between polysomnography and actigraphy-based sleep indices and glycemic control among those with and without type 2 diabetes: the Multi-Ethnic Study of Atherosclerosis. Sleep 2018; 41:5089925. [PMID: 30184232 PMCID: PMC6231520 DOI: 10.1093/sleep/zsy172] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 07/03/2018] [Indexed: 12/19/2022] Open
Abstract
Study Objectives To examine the associations of sleep measures with hemoglobin A1c (HbA1c) among individuals with and without type 2 diabetes. Methods Data were from 2049 Multi-Ethnic Study of Atherosclerosis participants taking part in a sleep ancillary study. Cross-sectional linear regression models examined associations of actigraphy estimates of sleep (sleep duration, variability, and maintenance efficiency) and polysomnography measures (obstructive sleep apnea [OSA] and hypoxemia) with HbA1c, stratified by diabetes status. Primary models were adjusted for demographics, lifestyle behaviors, and obesity. Results Among individuals with diabetes (20 per cent population), those who slept <5 hr/night had greater HbA1c than those who slept 7-8 hr/night (7.44 vs. 6.98 per cent, ptrend = 0.04), with no attenuation of associations after adjusting for OSA/hypoxemia. In women with diabetes, but not men, those in the lowest quartile of sleep maintenance efficiency had greater HbA1c than those in the highest quartile of sleep maintenance efficiency (7.60 vs. 6.97 per cent, ptrend < 0.01). Among those without diabetes, individuals with severe OSA or in the highest quartile of hypoxemia had significantly greater HbA1c than those without OSA or who were in the lowest quartile of hypoxemia (5.76 vs. 5.66 per cent, ptrend = 0.01; 5.75 vs. 5.66 per cent, ptrend < 0.01, respectively). Associations did not meaningfully differ by race/ethnicity. Conclusions Among individuals with diabetes, HbA1c was significantly higher in men and women with short sleep duration and in women with poor sleep maintenance efficiency, suggesting a role for behavioral sleep interventions in the management of diabetes. Among individuals without diabetes, untreated severe OSA/hypoxemia may adversely influence HbA1c.
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Affiliation(s)
- Kara M Whitaker
- Department of Health and Human Physiology, College of Liberal Arts and Sciences, University of Iowa, Iowa City, IA
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Rachel P Ogilvie
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - James S Pankow
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Alain Bertoni
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, NC
| | - Erin D Michos
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Naresh Punjabi
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Susan Redline
- Department of Medicine, Brigham and Women’s Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
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Li G, Feng D, Wang Y, Fu J, Han L, Li L, Grant SFA, Li M, Li M, Gao S. Loss of Cardio-Protective Effects at the CDH13 Locus Due to Gene-Sleep Interaction: The BCAMS Study. EBioMedicine 2018; 32:164-171. [PMID: 29903569 PMCID: PMC6020797 DOI: 10.1016/j.ebiom.2018.05.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 05/21/2018] [Accepted: 05/29/2018] [Indexed: 12/17/2022] Open
Abstract
Left ventricular mass index (LVMI) provides a metric for cardiovascular disease risk. We aimed to assess the association of adiponectin-related genetic variants resulting from GWAS in East Asians (loci in/near CDH13, ADIPOQ, WDR11FGF, CMIP and PEPD) with LVMI, and to examine whether sleep duration modified these genetic associations in youth. The 559 subjects aged 15–28 years were recruited from the Beijing Child and Adolescent Metabolic Syndrome study. Among the six loci, CDH13 rs4783244 was significantly correlated with adiponectin levels (p = 8.07 × 10−7). The adiponectin-rising allele in rs4783244 locus was significantly associated with decreased LVMI (p = 6.99 × 10−4) after adjusting for classical cardiovascular risk factors, and further for adiponectin levels, while no significant association was found between the other loci and LVMI. Moreover, we observed a significant interaction effect between rs4783244 and sleep duration (p = .005) for LVMI; the genetic association was more evident in long sleep duration while lost in short sleep duration. Similar interaction was found in the subgroup analysis using longitudinal data (p = .025 for interaction). In this young Chinese population, CDH13 rs4783244 represents a key locus for cardiac structure, and confers stronger cardio-protection in longer sleep duration when contrasted with short sleep duration. CDH13 rs4783244 represents a key locus for cardiac structure. The effect of CDH13 rs4783244 on reduced left ventricular mass index is significantly modified by sleep duration. Short sleep may contribute to the loss of CDH13 locus-mediated cardio-protective effects.
We analyzed the associations of five adiponectin-associated genetic variants with left-ventricular mass index (LVMI), a cardiovascular risk factor, in a population of 559 youth. We found a significant protective association of CDH13 rs4783244 with decreased LVMI, independent of adiponectin and other conventional risk factors. Sleep duration has previously been described as a risk factor for increased LVMI in this population, therefore, we assessed modification of this association in CDH13 by sleep duration, and found that short sleep attenuated the cardio-protective effect of this SNP. Our study provides important insights into pathologic mechanisms and prevention strategies for early risk of cardiovascular disease.
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Affiliation(s)
- Ge Li
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China
| | - Dan Feng
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100043, China
| | - Yonghui Wang
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100043, China
| | - Junling Fu
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China
| | - Lanwen Han
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100043, China
| | - Lujiao Li
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China
| | - Struan F A Grant
- Division of Endocrinology, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania; Philadelphia, PA 19104, USA; Division of Human Genetics, The Children's Hospital of Philadelphia Research Institute, Philadelphia, PA 19104, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Mingyao Li
- Departments of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ming Li
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China.
| | - Shan Gao
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100043, China.
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Ding C, Lim LL, Xu L, Kong APS. Sleep and Obesity. J Obes Metab Syndr 2018; 27:4-24. [PMID: 31089536 PMCID: PMC6489488 DOI: 10.7570/jomes.2018.27.1.4] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 03/08/2018] [Accepted: 03/09/2018] [Indexed: 12/30/2022] Open
Abstract
Rising global prevalence and incidence of obesity lead to increased cardiovascular-renal complications and cancers. Epidemiological studies reported a worldwide trend towards suboptimal sleep duration and poor sleep quality in parallel with this obesity epidemic. From rodents and human models, it is highly plausible that abnormalities in sleep, both quantity and quality, impact negatively on energy metabolism. While excess dietary intake and physical inactivity are the known drivers of the obesity epidemic, promotion of healthy sleep habits has emerged as a new target to combat obesity. In this light, present review focuses on the existing literature examining the relationship between sleep physiology and energy homeostasis. Notably, sleep dysregulation perturbs the metabolic milieu via alterations in hormones such as leptin and ghrelin, eating behavior, neuroendocrine and autonomic nervous systems. In addition, shift work and trans-meridian air travel may exert a negative influence on the hypothalamic-pituitary-adrenal axis and trigger circadian misalignment, leading to impaired glucose tolerance and increased fat accumulation. Amassing evidence has also suggested that uncoupling of the circadian clock can increase the risk of adverse metabolic health. Given the importance of sleep in maintaining energy homeostasis and that it is potentially modifiable, promoting good sleep hygiene may create new avenues for obesity prevention and treatment.
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Affiliation(s)
- Chenzhao Ding
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong,
China
| | - Lee Ling Lim
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong,
China
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur,
Malaysia
| | - Li Xu
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong,
China
| | - Alice Pik Shan Kong
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong,
China
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21
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Wang H, Li Z, Chen Y, Ye N, Wang P, Sun Y. Sex-specific association between serum uric acid and self-reported snoring in rural China: a cross-sectional study. Sleep Breath 2017; 21:939-947. [DOI: 10.1007/s11325-017-1515-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 05/05/2017] [Accepted: 05/22/2017] [Indexed: 10/19/2022]
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Makino S, Hirose S, Kakutani M, Fujiwara M, Nishiyama M, Terada Y, Ninomiya H. Association between nighttime sleep duration, midday naps, and glycemic levels in Japanese patients with type 2 diabetes. Sleep Med 2017. [PMID: 29530368 DOI: 10.1016/j.sleep.2017.11.1124] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To clarify the relationship between nighttime sleep duration, midday naps, and glycemic control in Japanese patients diagnosed with type 2 diabetes (n = 355) or impaired glucose tolerance (n = 43). METHODS A total of 398 patients completed a self-administered questionnaire on sleep duration/quality and were divided into five groups according to their self-reported nighttime sleep duration: <5 h, 5-6 h, 6-7 h, 7-8 h, and >8 h. Each group was further divided into two subgroups each according to the presence or absence of midday naps. Poor glycemic control was defined as HbA1c ≥ 7.0%. RESULTS Short nighttime sleep (<5 h), poor sleep induction, daytime sleepiness, and low sleep satisfaction were associated with high HbA1c levels. HbA1c was higher in the short nighttime sleep/no nap group than in non-nappers with different nighttime sleep duration, whereas the short nighttime sleep/nap group showed similar HbA1c levels to the other nap subgroups. In multivariate logistic regression models, after adjusting for a number of potential confounders, short (<5 h) nighttime sleep without nap was significantly associated with poor glycemic control compared with 6-7 h nighttime sleep without nap (OR [95% CI]: 7.14 [2.20-23.20]). However, taking naps reduced this risk for poor glycemic control in short sleepers. Other risk factors for poor glycemic control were low sleep satisfaction (1.73 [1.10-2.70]) and poor sleep induction (1.69 [1.14-2.50]). CONCLUSIONS Poor sleep quality and quantity could aggravate glycemic control in type 2 diabetes. Midday naps could mitigate the deleterious effects of short nighttime sleep on glycemic control. CLINICAL TRIALS REGISTRATION UMIN 000017887.
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Affiliation(s)
- Shinya Makino
- Department of Internal Medicine, Osaka Gyomeikan Hospital, 5-4-8 Nishikujo, Konohana-ku, Osaka, 554-0012, Japan.
| | - Sachie Hirose
- Department of Internal Medicine, Osaka Gyomeikan Hospital, 5-4-8 Nishikujo, Konohana-ku, Osaka, 554-0012, Japan
| | - Miki Kakutani
- Department of Internal Medicine, Osaka Gyomeikan Hospital, 5-4-8 Nishikujo, Konohana-ku, Osaka, 554-0012, Japan
| | - Masayoshi Fujiwara
- Department of Internal Medicine, Osaka Gyomeikan Hospital, 5-4-8 Nishikujo, Konohana-ku, Osaka, 554-0012, Japan
| | - Mitsuru Nishiyama
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Okoh-cho, Nankoku-city, Kochi, 783-8505, Japan
| | - Yoshio Terada
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Okoh-cho, Nankoku-city, Kochi, 783-8505, Japan
| | - Hitoshi Ninomiya
- Data Management Division, Integrated Center for Advanced Medical Technologies, Kochi Medical School, Okoh-cho, Nankoku-city, Kochi, 783-8505, Japan
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Quartuccio M, Buta B, Kalyani RR. Comparative Effectiveness for Glycemic Control in Older Adults with Diabetes. CURRENT GERIATRICS REPORTS 2017; 6:175-186. [PMID: 28920012 PMCID: PMC5585298 DOI: 10.1007/s13670-017-0215-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW To review and summarize the current data for comparative effectiveness of glycemic control in older adults. RECENT FINDINGS In the last several years, professional societies have released guidelines for glycemic control in older adults, generally recommending individualized HbA1c goals. However, recent observational studies demonstrate that many older adults remain aggressively managed and are at increased risk of hypoglycemia. Large randomized trials of older adults with diabetes have failed to show cardiovascular benefit from intensive glycemic control and show only minimal microvascular benefit. Additionally, a few studies suggest that suboptimal glycemic control can increase the risk for geriatric syndromes. Emerging research suggests similar safety and efficacy of glucose-lowering therapies in older versus younger adults. SUMMARY Overall, there is a paucity of data supporting the benefit of intensive glycemic control in older adults. More research is needed in this vulnerable population.
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Affiliation(s)
- Michael Quartuccio
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 333, Baltimore, MD 21287 USA
| | - Brian Buta
- Department of Medicine, Johns Hopkins University, Baltimore, MD USA
- Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, MD USA
| | - Rita Rastogi Kalyani
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 333, Baltimore, MD 21287 USA
- Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, MD USA
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Guzman MA, Sgambati FP, Pho H, Arias RS, Hawks EM, Wolfe EM, Ötvös T, Rosenberg R, Dakheel R, Schneider H, Kirkness JP, Smith PL, Schwartz AR. The Efficacy of Low-Level Continuous Positive Airway Pressure for the Treatment of Snoring. J Clin Sleep Med 2017; 13:703-711. [PMID: 28356182 DOI: 10.5664/jcsm.6588] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 01/24/2017] [Indexed: 12/29/2022]
Abstract
STUDY OBJECTIVES To assess effects of low-level continuous positive airway pressure (CPAP) on snoring in habitual snorers without obstructive sleep apnea (OSA). METHODS A multicenter prospective in-laboratory reversal crossover intervention trial was conducted between September 2013 and August 2014. Habitual snorers were included if they snored (inspiratory sound pressure level ≥ 40 dBA) for ≥ 30% all sleep breaths on a baseline sleep study (Night 1), and if significant OSA and daytime somnolence were absent. Included participants then underwent a CPAP titration study at 2, 4, or 6 cm H2O (Night 2) to examine snoring responses to step-increases in nasal pressure, a treatment night at optimal pressure (Night 3), followed by baseline night (Night 4). At each pressure, snoring intensity was measured on each breath. Snoring frequency was quantified as a percentage of sleep breaths at thresholds of 40, 45, 50, and 55 dBA. Sleep architecture and OSA severity were characterized using standard measurements. RESULTS On baseline sleep studies, participants demonstrated snoring at ≥ 40 dBA on 53 ± 3% and ≥ 45 dBA on 35 ± 4% of breaths. Snoring frequency decreased progressively as nasal pressure increased from 0 to 4 cm H2O at each threshold, and plateaued thereafter. CPAP decreased snoring frequency by 67% and 85% at 40 and 45 dBA, respectively. Intervention did not alter sleep architecture and sleep apnea decreased minimally. CONCLUSIONS Low-level CPAP below the range required to treat OSA diminished nocturnal snoring, and produced uniform reduction in nightly noise production below the World Health Organization's limit of 45 dBA. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, identifier: NCT01949584.
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Affiliation(s)
- Michelle A Guzman
- Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland
| | - Francis P Sgambati
- Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland
| | - Huy Pho
- Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland
| | - Rafael S Arias
- Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland
| | - Erin M Hawks
- Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland
| | - Erica M Wolfe
- Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland
| | - Tamás Ötvös
- Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland
| | | | - Riad Dakheel
- Doctors Community Hospital Sleep Center, Lanham, Maryland
| | - Hartmut Schneider
- Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland
| | - Jason P Kirkness
- Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland
| | - Philip L Smith
- Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland
| | - Alan R Schwartz
- Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland
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25
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Zhang N, Chen Y, Chen S, Jia P, Guo X, Sun G, Sun Y. Self-Reported Snoring Is Associated with Dyslipidemia, High Total Cholesterol, and High Low-Density Lipoprotein Cholesterol in Obesity: A Cross-Sectional Study from a Rural Area of China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E86. [PMID: 28106727 PMCID: PMC5295337 DOI: 10.3390/ijerph14010086] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 01/11/2017] [Accepted: 01/12/2017] [Indexed: 02/01/2023]
Abstract
Studies to explore the relationship between self-reported snoring and dyslipidemia, especially high total cholesterol (TC) and high low-density lipoprotein cholesterol (LDL-C), in the general population are still lacking. Our study was designed to examine whether self-reported snoring is significantly associated with dyslipidemia and ascertain the effects of different snoring intensities on dyslipidemia. There were 10,139 participants in our study. After adjustment for all confounding factors, self-reported snoring (OR = 1.207; p = 0.003), moderate (OR = 1.229; p = 0.015), strong (OR = 1.222; p = 0.033), and very strong (OR = 1.467; p = 0.012) snoring intensity, but not low (OR = 1.110; p = 0.224) snoring intensity, were significantly associated with dyslipidemia among adults with BMI (body mass index) ≥ 25 kg/m². In addition, self-reported snoring was significantly associated with high TC (OR = 1.167; p = 0.048) and high LDL-C (OR = 1.228; p = 0.044), rather than low HDL-C (OR = 1.171; p = 0.057) and high triglyceride (TG) (OR = 1.110; p = 0.141). In conclusion, adults with BMI ≥ 25 kg/m² and who experience snoring, especially moderate, strong, and very strong intensity levels of snoring, should be on the alert regarding the possibility of dyslipidemia, especially high LDL-C and high TC.
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Affiliation(s)
- Naijin Zhang
- Department of Cardiology, the First Hospital of China Medical University, Shenyang 110001, China.
| | - Yintao Chen
- Department of Cardiology, the First Hospital of China Medical University, Shenyang 110001, China.
| | - Shuang Chen
- Department of Cardiology, the First Hospital of China Medical University, Shenyang 110001, China.
| | - Pengyu Jia
- Department of Cardiology, the First Hospital of China Medical University, Shenyang 110001, China.
| | - Xiaofan Guo
- Department of Cardiology, the First Hospital of China Medical University, Shenyang 110001, China.
| | - Guozhe Sun
- Department of Cardiology, the First Hospital of China Medical University, Shenyang 110001, China.
| | - Yingxian Sun
- Department of Cardiology, the First Hospital of China Medical University, Shenyang 110001, China.
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26
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Wu HB, Wang H, Hu RY, Zhong JM, Qian YJ, Wang CM, Xie KX, Chen LL, Gong WW, Guo Y, Bian Z, Chen ZM, Li LM, Yu M. The association between sleep duration, snoring and prevalent type 2 diabetes mellitus with regard to gender and menopausal status: the CKB study in Zhejiang rural area, China. Acta Diabetol 2017; 54:81-90. [PMID: 27665439 DOI: 10.1007/s00592-016-0918-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 09/10/2016] [Indexed: 01/13/2023]
Abstract
AIMS To evaluate the association between sleep duration, snoring and diabetes according to gender and menopausal status in rural China. METHODS The data were part of the baseline survey of China Kadoorie Biobank, from a rural county in the south-east costal Zhejiang province. Participants including 24,027 men and 33,677 women aged 30-79 years were enrolled during 2004-2008. Multivariable logistic regression was used to calculate adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) for diabetes. RESULTS Sleep duration was shown to have a U-shaped association with diabetes in women, in particular in postmenopausal women after adjustment for potential confounders. Compared with 7-h sleepers, ORs (95 % CIs) of sleep duration ≤5 and ≥10 h for diabetes were 1.32 (1.02-1.69) and 1.30 (1.03-1.65), respectively, in postmenopausal women (P for quadratic trend = 0.016). However, this U-shaped association was not obvious in men and premenopausal women. Frequently snoring was positively associated with diabetes in all participants. However, this association was not independent of socioeconomic status, health behaviors, obesity and chronic diseases. With increasing sleep duration, the proportion of frequently snoring increased in all participants (P trend <0.05). Postmenopausal women had 23 % (95 % CI 6-44 %) higher odds of diabetes compared with premenopausal women, and the duration of menopause had cumulative effects on diabetes. CONCLUSIONS Short and long sleep durations were significantly associated with diabetes in postmenopausal women, independent of potential confounders. The proportion of frequently snoring had linear trend with sleep duration. Postmenopausal status and the duration of menopause increased the odds of diabetes.
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Affiliation(s)
- Hai-Bin Wu
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China
| | - Hao Wang
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China
| | - Ru-Ying Hu
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China
| | - Jie-Ming Zhong
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China
| | - Yi-Jian Qian
- Tongxiang Center for Disease Control and Prevention, Tongxiang, China
| | - Chun-Mei Wang
- Tongxiang Center for Disease Control and Prevention, Tongxiang, China
| | - Kai-Xu Xie
- Tongxiang Center for Disease Control and Prevention, Tongxiang, China
| | - Ling-Li Chen
- Tongxiang Center for Disease Control and Prevention, Tongxiang, China
| | - Wei-Wei Gong
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Zheng-Ming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Li-Ming Li
- School of Public Health, Peking University Health Sciences Center, Beijing, China
- Chinese Academy of Medical Sciences, Beijing, China
| | - Min Yu
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China.
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27
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He Q, Sun H, Wu X, Zhang P, Dai H, Ai C, Shi J. Sleep duration and risk of stroke: a dose-response meta-analysis of prospective cohort studies. Sleep Med 2016; 32:66-74. [PMID: 28366344 DOI: 10.1016/j.sleep.2016.12.012] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 11/17/2016] [Accepted: 12/05/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Suboptimal sleep duration has been considered to increase the risk of stroke incidence. Thus we aimed to conduct a dose-response meta-analysis to examine the association between sleep duration and stroke incidence. METHODS We searched PubMed, Web of science and the Cochrane Library to identify all prospective studies evaluating the association of sleep duration and nonfatal and/or fatal stroke incidence. Then, restricted cubic spline functions and piecewise linear functions were used to evaluate the nonlinear and linear dose-response association between them. RESULTS We included a total of 16 prospective studies enrolling 528,653 participants with 12,193 stroke events. Nonlinear dose-response meta-analysis showed a J-shaped association between sleep duration and total stroke with the lowest risk observed with sleeping for 7 h. Considering people sleeping for 7 h as reference, long sleepers had a higher predicted risk of total stroke than short sleepers [the pooled risk ratios (95% confidence intervals): 4 h: 1.17 (0.99-1.38); 5 h: 1.17 (1.00-1.37); 6 h: 1.10 (1.00-1.21); 8 h: 1.17 (1.07-1.28); 9 h: 1.45 (1.23-1.70); 10 h: 1.64 (1.4-1.92); pnonlinearity<0.001]. Short sleep durations were only significantly associated with nonfatal stroke and with total stroke in the subgroups of structured interview and non-Asian countries. Additionally, we found a slightly decreased risk of ischemic stroke among short sleepers. For piecewise linear trends, compared to 7 h, every 1-h increment of sleep duration led to an increase of 13% [the pooled risk ratios (95% confidence intervals): 1.13 (1.07-1.20); p < 0.001] in risk of total stroke. CONCLUSION Both in nonlinear and piecewise linear dose-response meta-analyses, long sleep duration significantly increased the risk of stroke incidence.
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Affiliation(s)
- Qiao He
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China
| | - Hao Sun
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China
| | - Xiaomei Wu
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China
| | - Peng Zhang
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China
| | - Huixu Dai
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China
| | - Cong Ai
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China
| | - Jingpu Shi
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China; Center of Evidence Based Medicine, Liaoning Province & China Medical University, Shenyang, China.
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The impact of sleep amount and sleep quality on glycemic control in type 2 diabetes: A systematic review and meta-analysis. Sleep Med Rev 2016; 31:91-101. [PMID: 26944909 DOI: 10.1016/j.smrv.2016.02.001] [Citation(s) in RCA: 245] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 01/24/2016] [Accepted: 02/01/2016] [Indexed: 12/14/2022]
Abstract
Recent epidemiological studies have suggested that there is an association between glycemic control and sleep disturbances in patients with type 2 diabetes, but the extent is unclear. A systematic literature search was performed in nine electronic databases from inception until August 2015 without any language restriction. The search identified 20 studies (eight studies reporting duration of sleep and 15 studies evaluating sleep quality), and 15 were included in the meta-analysis. Short and long sleep durations were associated with an increased hemoglobin A1c (HbA1c) (weighted mean difference (WMD): 0.23% [0.10-0.36], short sleep; WMD: 0.13% [0.02-0.25], long sleep) compared to normal sleep, suggesting a U-shaped dose-response relationship. Similarly, poor sleep quality was associated with an increased HbA1c (WMD: 0.35% [0.12-0.58]). Results of this study suggest that amount of sleep as well as quality of sleep is important in the metabolic function of type 2 diabetes patients. Further studies are needed to identify for the potential causal role between sleep and altered glucose metabolism.
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Zhang N, Ye N, Chen Y, Guo X, Sun G, Sun Y. The relationship between snoring and left ventricular hypertrophy of China: a cross-sectional study. BMC Cardiovasc Disord 2016; 16:15. [PMID: 26772538 PMCID: PMC4714535 DOI: 10.1186/s12872-016-0185-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 01/07/2016] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Population-based investigations studying the association between snoring and left ventricular hypertrophy (LVH) are lacking. Therefore, our study aims to investigate whether snoring is significantly associated with LVH, and to make clear the effect of varying degrees of snoring intensity on LVH. METHODS A total of 10,139 participants were involved in this cross-sectional study. Snoring status and snoring intensity were evaluated by a structured questionnaire. LVH was defined as left ventricular mass index ≥ 51 g/m(2.7) for both men and women. RESULTS The total prevalence of LVH was 10.0%. the prevalence increased significantly in snorers according to snoring intensity, including low (10.3%), normal (13.1%), strong (14.7%) and very strong (16.7%). After adjustment for age, race, gender, educational status, physical activity, annual income, current smoking status, current drinking status, sleep duration, hypertension, body mass index, waist circumference, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, total cholesterol and fasting plasma glucose, snoring (OR, 1.371; 95% CI, 1.147-1.637, P < 0.001) was significantly associated with LVH. In addition, among the four kinds of intensity of snoring, normal (OR, 1.436; 95% CI, 1.126-1.832, P = 0.004), strong (OR, 1.462; 95% CI, 1.124-1.902, P < 0.001) and very strong (OR, 1.813; 95% CI, 1.273-2.684, P < 0.001), rather than low (OR, 1.094; 95% CI, 0.834-1.434, P = 0.518) were significantly associated with LVH. CONCLUSIONS Snoring is independently associated with LVH. What's more, with the rise in snoring intensity, snoring will exert an increasing effect on LVH.
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Affiliation(s)
- Naijin Zhang
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, 110001, Shenyang, Liaoning, China.
| | - Ning Ye
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, 110001, Shenyang, Liaoning, China.
| | - Yintao Chen
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, 110001, Shenyang, Liaoning, China.
| | - Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, 110001, Shenyang, Liaoning, China.
| | - Guozhe Sun
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, 110001, Shenyang, Liaoning, China.
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, 110001, Shenyang, Liaoning, China.
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