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Kogon AJ, Maqsood AM, LoGuidice J, Amaral S, Meyers K, Mitchell JA. Sleep Duration and Blood Pressure in Youth Referred for Elevated Blood Pressure Evaluation. Pediatrics 2024; 154:e2023062940. [PMID: 38887814 DOI: 10.1542/peds.2023-062940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 04/15/2024] [Accepted: 04/18/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVES Sleep promotion is not specifically recommended as a target for hypertension management. We examined associations of sleep duration and timing with blood pressure parameters in patients referred to pediatric nephrology clinic for elevated blood pressure evaluation. METHODS This is a retrospective study of initial ambulatory blood pressure monitoring data and self-report sleep data collected from patients referred to nephrology clinic for the evaluation of elevated blood pressure. Linear and logistic regression modeling determined associations between sleep exposures (duration and timing) and continuous and dichotomous blood pressure outcomes, respectively, adjusted for age, sex, body mass index, and weekday versus weekend status. RESULTS The study sample included 539 patients with mean age 14.6 years and 56% meeting hypertension criteria. Sleep duration averaged 9.1 hours per night. Average timing of sleep onset and offset were 11:06 pm and 8:18 am, respectively. Longer sleep duration was associated with better daytime blood pressure parameters (eg, every extra hour of sleep duration was associated with a reduced odds of wake hypertension [odds ratio, 0.88; 95% CI, 0.79-0.99]). Later sleep onset was associated with worse daytime blood pressure parameters (eg, each additional hour of later sleep onset was associated with higher wake systolic blood pressure index [mean wake blood pressure/95th percentile]) (β = 0.07; 95% CI, 0.02-0.13). Associations were consistent across sex, age, body mass index, and weekday status. CONCLUSIONS Longer sleep duration and earlier sleep onset were associated with lower blood pressure. This suggests that sleep optimization may be an important target for intervention in hypertension management.
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Affiliation(s)
- Amy J Kogon
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Anam M Maqsood
- Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jill LoGuidice
- Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Sandra Amaral
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kevin Meyers
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jonathan A Mitchell
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Makker K, Wang X. Early Life Origins of Cardio-Metabolic Outcomes in Boston Birth Cohort: Review of Findings and Future directions. PRECISION NUTRITION 2023; 2:e00050. [PMID: 38283709 PMCID: PMC10810337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Affiliation(s)
- Kartikeya Makker
- Division of Neonatology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
| | - Xiaobin Wang
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
- Center on the Early Life Origins of Disease, Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Cui L, Li J, Lou X, Yang L, Chen T, Guo Y, Zhou H, Yang X, Li Z, Wang X. Associations between sleep characteristics and risk for high blood pressure among students aged 9-18: A cross-sectional study in China. Sleep Med 2023; 107:72-80. [PMID: 37121222 DOI: 10.1016/j.sleep.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 04/02/2023] [Accepted: 04/06/2023] [Indexed: 05/02/2023]
Abstract
OBJECTIVE The aim was to investigate the association of multidimensional sleep indicators with high blood pressure (HBP) of Chinese students. METHODS Participants in this cross-sectional study included 11561 students aged 9-18. Sleep was characterized by sleep timing (e.g., bedtime), sleep duration and sleep consistency (e.g., bedtime/wake-up time deviations and social jet lag (SJL)). We used odds ratios (OR) and 95% confidence intervals (95% CI) to assess the relationship between sleep and HBP. RESULTS Primary school students who slept 8.00-9.00h had a lower risk of HBP compared with sleeping >10h (OR 0.370, 95%CI 0.208, 0.658), while junior middle school students reporting ≤8.00h on weekday night had a lower risk of HBP compared with sleeping >10h (OR 0.303, 95%CI 0.111, 0.829). Moreover, compared with deviations = 0h, the OR (95%CI) for wake-up time deviations <0h and bedtime deviations >0h in primary school students with HBP were 0.314 (0.125, 0.790) and 2.155 (1.205, 3.853). Furthermore, compared with SJL = 0h, senior high school students reporting SJL = 0.01-0.50h, SJL = 0.51-1.00h and SJL = 1.01-2.00h had greater risk of HBP (OR 1.566, 95%CI 1.039, 2.361; OR 1.760, 95%CI 1.177, 2.631; OR 1.660, 95%CI 1.124, 2.452, respectively). Bedtime at night was associated with HBP for three educational periods students, however, there was no significant association between mid-day nap and HBP. CONCLUSIONS Sleep timing, sleep duration and sleep consistency are associated with high blood pressure in children and adolescents.
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Affiliation(s)
- Lingling Cui
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Jiaxin Li
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Xiaomin Lou
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Liying Yang
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Tingting Chen
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Yingying Guo
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Huijun Zhou
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Xiaoli Yang
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Zhiqian Li
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Xian Wang
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China.
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Wang YM, Dandoy CE, Smith DF, Hogenesch J. Go to bed!: Sleep as a risk factor for adolescent hypertension. PROGRESS IN PEDIATRIC CARDIOLOGY 2023. [DOI: 10.1016/j.ppedcard.2023.101613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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5
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Chang X, Chen X, Ji JS, Luo G, Chen X, Sun Q, Zhang N, Guo Y, Pei P, Li L, Chen Z, Wu X. Association between sleep duration and hypertension in southwest China: a population-based cross-sectional study. BMJ Open 2022; 12:e052193. [PMID: 35760551 PMCID: PMC9237882 DOI: 10.1136/bmjopen-2021-052193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Hypertension is a major risk factor and cause of many non-communicable diseases in China. While there have been studies on various diet and lifestyle risk factors, we do not know whether sleep duration has an association to blood pressure in southwest China. This predictor is useful in low-resource rural settings. We examined the association between sleep duration and hypertension in southwest China. DESIGN Population-based cross-sectional study. SETTING This study was part of the baseline survey of a large ongoing prospective cohort study, the China Kadoorie Biobank. Participants were enrolled in 15 townships of Pengzhou city in Sichuan province during 2004-2008. PARTICIPANTS 55 687 participants aged 30-79 years were included. Sleep duration was assessed by a self-reported questionnaire. MAIN OUTCOME MEASURES Hypertension was defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg, or prior physician-diagnosed hypertension in hospitals at the township (community) level or above. RESULTS The prevalence of hypertension was 25.17%. The percentages of subjects with sleep durations of <6, 6, 7, 8 and ≥9 hours were 17.20%, 16.14%, 20.04%, 31.95% and 14.67%, respectively. In multivariable-adjusted analyses, the increased ORs of having hypertension were across those who reported ≥9 hours of sleep (men: 1.16, 95% CI 1.04 to 1.30; women: 1.19, 95% CI 1.08 to 1.32; general population: 1.17, 95% CI 1.08 to 1.26). The odds of hypertension was relatively flat until around 6.81 hours of sleep duration and then started to increase rapidly afterwards in subjects and a J-shaped pattern was observed. There was a U-shaped relationship between sleep duration and hypertension in females. CONCLUSION Long sleep duration was significantly associated with hypertension and a J-shaped pattern was observed among rural adults in southwest China, independent of potential confounders. However, this association was not obvious between short sleep duration and hypertension.
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Affiliation(s)
- Xiaoyu Chang
- Department of Chronic and Non-communicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Xiaofang Chen
- Department of Epidemiology and Statistics, Chengdu Medical College, Chengdu, Sichuan, China
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Guojin Luo
- Pengzhou Center for Disease Control and Prevention, Pengzhou, Sichuan, China
| | - Xiaofang Chen
- Pengzhou Center for Disease Control and Prevention, Pengzhou, Sichuan, China
| | - Qiang Sun
- Pengzhou Center for Disease Control and Prevention, Pengzhou, Sichuan, China
| | - Ningmei Zhang
- Department of Chronic and Non-communicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Pei Pei
- Chinese Academy of Medical Sciences, Beijing, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Center for Public Health and Epidemic Preparedness and Response, Peking University, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit (CTSU) and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Xianping Wu
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
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Associations of maternal gestational hypertension with high blood pressure and overweight/obesity in their adolescent offspring: a retrospective cohort study. Sci Rep 2022; 12:3800. [PMID: 35260718 PMCID: PMC8904808 DOI: 10.1038/s41598-022-07903-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 02/25/2022] [Indexed: 12/19/2022] Open
Abstract
Maternal hypertensive disorders during pregnancy may have an impact on fetal development and the health of the offspring in later life. The aim of the study was to evaluate the associations of maternal gestational hypertension (GH) with high blood pressure (HBP) (prehypertension/hypertension) and overweight/obesity in their adolescent offspring at the age of 12 to 15 years. We analyzed data of 4819 participants born in Kaunas city during 1995-1998 who were included in the study "Prevalence and Risk Factors of HBP in 12-15-Year-Old Lithuanian Children and Adolescents". The diagnosis of maternal gestational hypertension was obtained from medical records. Associations of maternal GH with their offspring's HBP and overweight/obesity in adolescence were assessed by multivariate logistic regression analysis. Among 4819 adolescents of 12-15 years of age, 25.7% had HBP, 12% had overweight, and 2.5% had obesity. Of 4819 mothers, 92.3% were normotensive during pregnancy, and 7.7% had GH. In the multivariate analysis after adjustment for age, sex, birth weight, adolescent BMI, and maternal pre/early pregnancy BMI, adolescent offspring born to mothers with GH had higher odds of prehypertension, hypertension, and prehypertension/hypertension (aOR 1.58; 95% CI 1.13-2.22; aOR 1.87; 95% CI 1.41-2.47; and aOR 1.76, 95% CI 1.39-2.24; respectively), compared to the offspring of normotensive mothers. After adjustment for age, sex, birth weight, and maternal pre/early pregnancy BMI, a significant association was found between maternal GH and the offspring's overweight/obesity in adolescence (aOR 1.41; 95% CI 1.04-1.91). The findings of this study suggest that maternal GH is associated with an increased odds of HBP (prehypertension and hypertension, both separately and combined) and overweight/obesity in their offspring during adolescence.
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Jurkovičová J, Hirošová K, Vondrová D, Samohýl M, Štefániková Z, Filová A, Kachútová I, Babjaková J, Argalášová Ľ. The Prevalence of Insulin Resistance and the Associated Risk Factors in a Sample of 14-18-Year-Old Slovak Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030909. [PMID: 33494341 PMCID: PMC7908586 DOI: 10.3390/ijerph18030909] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/14/2021] [Accepted: 01/18/2021] [Indexed: 02/06/2023]
Abstract
The prevalence of cardiometabolic risk factors has increased in Slovakian adolescents as a result of serious lifestyle changes. This cross-sectional study aimed to assess the prevalence of insulin resistance (IR) and the associations with cardiometabolic and selected lifestyle risk factors in a sample of Slovak adolescents. In total, 2629 adolescents (45.8% males) aged between 14 and 18 years were examined in the study. Anthropometric parameters, blood pressure (BP), and resting heart rate were measured; fasting venous blood samples were analyzed; and homeostasis model assessment (HOMA)-insulin resistance (IR) was calculated. For statistical data processing, the methods of descriptive and analytical statistics for normal and skewed distribution of variables were used. The mean HOMA-IR was 2.45 ± 1.91, without a significant sex differences. IR (cut-off point for HOMA-IR = 3.16) was detected in 18.6% of adolescents (19.8% males, 17.6% females). IR was strongly associated with overweight/obesity (especially central) and with almost all monitored cardiometabolic factors, except for total cholesterol (TC) and systolic BP in females. The multivariate model selected variables such as low level of physical fitness, insufficient physical activity, breakfast skipping, a small number of daily meals, frequent consumption of sweetened beverages, and low educational level of fathers as significant risk factors of IR in adolescents. Recognizing the main lifestyle risk factors and early IR identification is important in terms of the performance of preventive strategies. Weight reduction, regular physical activity, and healthy eating habits can improve insulin sensitivity and decrease the incidence of metabolic syndrome, type 2 diabetes, and cardiovascular disease (CVD).
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Sajjadieh A, Shahsavari A, Safaei A, Penzel T, Schoebel C, Fietze I, Mozafarian N, Amra B, Kelishadi R. The Association of Sleep Duration and Quality with Heart Rate Variability and Blood Pressure. TANAFFOS 2020; 19:135-143. [PMID: 33262801 PMCID: PMC7680518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 11/29/2019] [Indexed: 12/04/2022]
Abstract
BACKGROUND The current study was conducted to evaluate the relation of sleep duration and quality with blood pressure (BP) and heart rate variability (HRV). MATERIALS AND METHODS This cross-sectional study was carried out in 2017 among 260 staff of a university hospital in Isfahan, Iran. They were selected by multi-stage random method from different wards. Time domain spectral analysis was used to measure a number of HRV parameters. The long-term components of the HRV were estimated using the standard deviation of the normal-to-normal interval (SDNN). The square root of the mean squared differences of successive NN intervals (RMSSD) was calculated by statistical time domain measurements; SNN50, and PNN50 were measured. Pittsburg sleep quality index (PSQI) questionnaire was used to assess sleep quality. RESULTS Higher PSQI score correlated with lower SDANN rise (OR=0.92). Fairly bad to very good subjective sleep quality had association with lower SDANN (OR=0.43). Very high sleep latency to very low sleep latency ratio had association with lower SDANN (OR=0.39) and lower PNN50 (OR= 0.44). Sleep duration and HRV parameters had no significant association. Fairly bad sleep efficiency to very good sleep efficiency ratio was correlated with lower SDANN (OR= 0.29). Very high daytime dysfunction to very low daytime dysfunction ratio had correlation with lower SDANN (OR=0.35). Very bad compared to very good subjective sleep quality had significant correlation with higher Heart rate (HR) (B=0.03). Very high sleep latency compared to no sleep latency was associated with higher HR (B=4.74). Very high compared to very low amount of sleep disturbances correlated with higher SBP levels (B=15.2). Using sleep medication less than once a week compared with no history of taking such drugs was associated with higher HR (B=16.4). CONCLUSION Our findings showed that poor sleep quality are adversely associated with HRV, HR and BP. This finding should be considered in clinical and preventive recommendations.
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Affiliation(s)
- Amirreza Sajjadieh
- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Shahsavari
- Medical Student, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Safaei
- Medical Student, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Thomas Penzel
- Center of Sleep Medicine, Charite e Universitatsmedizin€ Berlin, Berlin, Germany
| | - Christoph Schoebel
- Charite e Universitatsmedizin€ Berlin, Department of Cardiology and Pulmonology, Center of Sleep Medicine, Berlin, Germany
| | - Ingo Fietze
- Charite e Universitatsmedizin€ Berlin, Department of Cardiology and Pulmonology, Center of Sleep Medicine, Berlin, Germany
| | - Nafiseh Mozafarian
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Babak Amra
- Department of Pulmonology, Bamdad Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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dos Santos EDSG, de Souza OF. EVIDENCE OF THE ASSOCIATION BETWEEN SLEEP DURATION AND BLOOD PRESSURE IN ADOLESCENTS: A SYSTEMATIC REVIEW. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2020; 39:e2019225. [PMID: 32785432 PMCID: PMC7409100 DOI: 10.1590/1984-0462/2021/39/2019225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/27/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To review the epidemiological evidence of the association between sleep duration and blood pressure in adolescents. DATA SOURCES We performed a systematic review of observational studies in Medline, Scopus, Lilacs, Web of Science, Science Direct databases and Virtual Libraries in English, Spanish and Portuguese published until September 2018. Studies were selected first by title and abstract, then by complete reading, according to the eligibility criteria. The reference list of selected articles was evaluated in order to retrieve relevant studies. DATA SYNTHESIS Initially, 1,455 articles were retrieved. After exclusion due to duplicity or not meeting the eligibility criteria, 13 articles were included in the review. Studies varied greatly in sample size (143 to 6,940 patients), methods of measuring blood pressure and sleep duration, cutoff points, categorization and adjustment of variables. The main evidence from the studies is that short sleep duration is associated with high blood pressure in adolescence, although the presence of association between high blood pressure and long sleep duration is possible, but not clear in the literature. CONCLUSIONS Sleep duration, especially short duration, is associated with high blood pressure in adolescents. Such evidence draws attention to implications on cardiovascular health in this age group.
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Gender-Specific Longitudinal Association of Sleep Duration with Blood Pressure among Children: Evidence from CHNS 2004-2015. Int J Hypertens 2020; 2020:5475297. [PMID: 32765906 PMCID: PMC7374217 DOI: 10.1155/2020/5475297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 06/17/2020] [Accepted: 06/19/2020] [Indexed: 12/05/2022] Open
Abstract
Purpose We conducted this study to add the evidence regarding the gender-specific association between sleep duration and blood pressure (BP) in children. Methods A secondary analysis was performed among 1000 children aged 7–13 years, who had at least two rounds of survey records in China Health and Nutrition Survey through 2004–2015. Generalized estimating equation was used to explore the gender-specific association of sleep duration with BP. The subgroup analysis was applied in those participants with normal weight. Results The time trend of decreasing sleep duration, along with increasing BP level, was observed in each age group during the survey period. Short sleepers (<9 hours per day) have higher level of both systolic BP (SBP) and diastolic BP (DBP) than long sleepers in girls (all p < 0.05). By contrast, only SBP was higher in short sleepers among boys (p < 0.05). There was gender difference in the association between sleep duration and DBP (p for interaction <0.05). The stratification analysis showed that short sleep duration could consistently predict a higher level of diastolic BP (DBP) in both crude (β = 2.968, 95% CI: 1.629, 4.306) and adjusted models (β = 1.844, 95% CI: 0.273, 3.416) only in girls. Sleep duration was also analyzed as continuous variable, and the very similar associations were observed. Moreover, the established associations can be verified among children with normal weight. Conclusions There was a time trend of decreasing sleep duration alongside increasing BP among children from 2004 to 2015. Short sleep duration was independently associated with increased DBP; however, only girls were susceptible to the association.
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Dos Santos EDSG, De Souza OF. Association of Sleep Duration and Blood Pressure in Adolescents: A Multicenter Study. Am J Hypertens 2020; 33:77-83. [PMID: 31407771 DOI: 10.1093/ajh/hpz129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/18/2019] [Accepted: 08/07/2019] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Evidence suggests that sleep duration is related to blood pressure (BP), but the findings are still inconsistent for adolescents. OBJECTIVE To analyze the association between sleep duration and BP in Brazilian adolescents between 12 and 17 years of age. METHODS This study is part of the Study of Cardiovascular Risk in Adolescents (ERICA), a multicenter, school-based, cross-sectional study in 273 municipalities in Brazil. The sample consisted of 65,643 adolescents. Sleep duration was measured by a subjective method, and BP was measured by the oscillometric method. Multiple linear regression analyses were performed to evaluate the association between sleep duration and BP. RESULTS The mean sleep duration was 8.14 hours (± 1.40), with significant difference between the groups according to BP levels (P < 0.0001). The mean systolic and diastolic BP were 110.59 (± 11.87) and 65.85 (± 7.94) mm Hg, respectively, in the group of adolescents. Sleep duration was significantly associated with BP. Each increase 1 hour in sleep was associated with BP reduction in both sexes combined (P < 0.0001). Considering the effects of covariates, each increase 1 hour in sleep was associated with systolic BP (SBP) reduction among boys (P = 0.004) and SBP elevation among girls (P = 0.009), after full adjustment. CONCLUSION The results suggest that each increase in sleep duration was associated with SBP elevation among girls. Such findings may have important implications for cardiovascular health in adolescence.
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Affiliation(s)
- Emanuela De Souza Gomes Dos Santos
- Instituto Federal de Educação, Ciência e Tecnologia do Acre (Federal Institute of Education, Science and Technology of Acre; IFAC), Rio Branco (AC), Brazil
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Guan Y, Zhang M, Zhang X, Zhao Z, Huang Z, Li C, Xiao Q, Wang L. Association between sleep duration and hypertension of migrant workers in China: a national cross-sectional surveillance study. BMJ Open 2019; 9:e031126. [PMID: 31784437 PMCID: PMC6924713 DOI: 10.1136/bmjopen-2019-031126] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES To examine the relationship between sleep duration and hypertension of migrant workers aged 18-59 years in China. DESIGN Population-based cross-sectional study using a complex survey sampling design. PARTICIPANTS There were 43 655 subjects in our analysis, after excluding people with missing information for key exposure and outcome variables and abnormal values for sleep duration (≤2 or ≥17 hours). PRIMARY OUTCOME MEASURE Hypertension was defined as systolic blood pressure (BP) ≥140 mm Hg and/or diastolic BP ≥90 mm Hg, or self-reported history of hypertension diagnosis in hospitals at the township (community) level or above and use of hypertensive medicine in the last 2 weeks. RESULTS Of 43 655 subjects, 15.6% (95% CI 15.1% to 16.1%) of migrant workers had hypertension. The prevalence of hypertension decreased with the increased sleep duration, both in males and females. Logistic regression models, using 7-8 hours sleep/day as the reference, showed a greater odds for hypertension among men and women who reported <6 hours of sleep after adjusting for sociodemographic characteristics, behavioural risk factors, body mass index, diabetes, stroke and myocardial infarction (men: OR 1.26; 95% CI 1.03 to 1.54, women: OR 1.55; 95% CI 1.13 to 2.06, pinteraction=0.096). Further stratified by age and migration time, it revealed that among adults less than 45 years old, those sleeping 9 or more hours had adjusted odds for hypertension of 0.82 (95% CI 0.72 to 0.93, pinteraction=0.020),while there was no evidence of an association between sleep duration and hypertension among adults aged 45-59 years. Among adults whose migration time was less than 4.5 years, those sleeping 9 or more hours had adjusted odds for hypertension of 0.80 (95% CI 0.68 to 0.94, pinteraction=0.097). CONCLUSION The association between sleep duration and hypertension varies by age. Short sleep duration (<6 hours) is associated with an increased prevalence of hypertension in both genders.
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Affiliation(s)
- Yunqi Guan
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mei Zhang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao Zhang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhenping Zhao
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhengjing Huang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chun Li
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qian Xiao
- Department of Health and Human Physiology and Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Limin Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Sawyer E, Heussler H, Gunnarsson R. Defining short and long sleep duration for future paediatric research: A systematic literature review. J Sleep Res 2019; 28:e12839. [DOI: 10.1111/jsr.12839] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 01/17/2019] [Accepted: 02/08/2019] [Indexed: 01/13/2023]
Affiliation(s)
- Emily Sawyer
- Cairns Clinical School College of Medicine and Dentistry James Cook University Cairns Qld Australia
| | - Helen Heussler
- Centre for Children's Health Research University of Queensland South Brisbane Australia
- Child Development Service and Respiratory and Sleep Medicine – Children's Health Queensland South Brisbane Qld Australia
| | - Ronny Gunnarsson
- Research and Development Unit Primary Health Care and Dental Care Narhalsan Southern Alvsborg County, Region Vastra Gotaland Sweden
- Department of Public Health and Community Medicine Institute of Medicine The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
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14
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Pressão arterial elevada em escolares: fatores sociodemográficos e bioquímicos associados. Rev Port Cardiol 2019; 38:195-201. [DOI: 10.1016/j.repc.2018.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 06/11/2018] [Accepted: 06/24/2018] [Indexed: 11/30/2022] Open
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15
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Reuter CP, Rodrigues ST, Barbian CD, Silveira JFDC, Schneiders LDB, Soares SS, Burgos LT, Burgos MS. High blood pressure in schoolchildren: Associated sociodemographic and biochemical factors. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.repce.2018.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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16
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Jiang W, Hu C, Li F, Hua X, Zhang X. Association between sleep duration and high blood pressure in adolescents: a systematic review and meta-analysis. Ann Hum Biol 2019; 45:457-462. [PMID: 30387692 DOI: 10.1080/03014460.2018.1535661] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
CONTEXT Sleep has been assessed as a risk factor for health consequences. Among adults, excessively longer and shorter sleep durations are associated with high blood pressure (BP), but knowledge of the association between sleep duration and high BP among adolescents is limited. OBJECTIVES To estimate the associations between sleep duration and high BP in adolescents. METHODS PubMed, Web of Science, and Cochrane databases were searched for eligible publications up until 20 November 2017. This study reviewed the reference lists from retrieved articles to search for relevant studies. Pooled odds ratios (ORs) were calculated using a random-effects meta-analysis. Sub-group and sensitivity analyses were conducted to identify heterogeneity. Publication bias was evaluated using Egger's test. RESULTS Seven studies involving 21,150 participants were included, with ages ranging from 10-18 years. For primary analysis, compared with the reference sleep duration, the pooled OR for high BP was 1.51 (95% confidence interval [CI] = 1.04-2.19) for the short sleep duration overall. For long sleep duration, the pooled OR was 1.04 (95% CI = 0.78-1.38). Further sub-group analysis showed that short sleep duration had a higher risk of incident high BP in males (OR = 1.55, 95% CI = 1.24-1.93) than in females (OR = 1.23, 95% CI = 0.47-3.22). CONCLUSIONS Among adolescents, and particularly male adolescents, short sleep duration may be a risk factor for high BP. More attention should be given to this lifestyle factor.
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Affiliation(s)
- Wen Jiang
- a Department of Epidemiology and Biostatistics, School of Public Health , Anhui Medical University , Hefei , China
| | - Chengyang Hu
- a Department of Epidemiology and Biostatistics, School of Public Health , Anhui Medical University , Hefei , China
| | - Fengli Li
- a Department of Epidemiology and Biostatistics, School of Public Health , Anhui Medical University , Hefei , China
| | - Xiaoguo Hua
- a Department of Epidemiology and Biostatistics, School of Public Health , Anhui Medical University , Hefei , China
| | - Xiujun Zhang
- a Department of Epidemiology and Biostatistics, School of Public Health , Anhui Medical University , Hefei , China
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Li M, Yan S, Jiang S, Ma X, Gao T, Li B. Relationship between sleep duration and hypertension in northeast China: a cross-sectional study. BMJ Open 2019; 9:e023916. [PMID: 30670514 PMCID: PMC6347883 DOI: 10.1136/bmjopen-2018-023916] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Previous studies have reported that sleep duration might increase the risk of hypertension. However, the results have been conflicting. We investigated whether sleep duration is independently associated with hypertension. We aimed to assess the relationship between sleep duration and hypertension in a population-based cross-sectional study. METHODS In this study we used multistage stratified cluster sampling. A total of 19 407 adults aged 18-79 years were enrolled in the study. The participants were divided into three groups (<7 hours/day, 7-8 hours/day and >8 hours/day) according to self-reported sleep duration. Hypertension was defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or the use of anti-hypertensive medications. Univariate and multivariate logistic regressions were performed to determine the association between hypertension and sleep duration adjusted for sociodemographic, body mass index, and lifestyle covariates. RESULTS The overall prevalence of hypertension was 32.6%. Among participants aged 18-44 years, individuals sleeping less than 7 hours per day had a higher risk of hypertension (OR=1.24, 95% CI: 1.05 to 1.46), compared with those who slept 7-8 hours per day. There were no significant associations between sleep duration and hypertension in the total sample, among middle-aged adults (45-59 years) or older adults (60-79 years). CONCLUSIONS Our study demonstrates that short sleep duration was significantly associated with hypertension among people aged 18-44 years in northeast China.
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Affiliation(s)
- Meng Li
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, China
| | - Shoumeng Yan
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, China
| | - Shan Jiang
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, China
| | - Xiaoyu Ma
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, China
| | - Tianyu Gao
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, China
- Department of Medical Health Inspection, Changchun Health Supervision Institute, Changchun, China
| | - Bo Li
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, China
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18
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Li H, Ren Y, Wu Y, Zhao X. Correlation between sleep duration and hypertension: a dose-response meta-analysis. J Hum Hypertens 2018; 33:218-228. [DOI: 10.1038/s41371-018-0135-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 10/25/2018] [Accepted: 10/30/2018] [Indexed: 12/22/2022]
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19
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Insomnia in Adolescence. Med Sci (Basel) 2018; 6:medsci6030072. [PMID: 30200388 PMCID: PMC6164454 DOI: 10.3390/medsci6030072] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 08/28/2018] [Accepted: 08/29/2018] [Indexed: 11/16/2022] Open
Abstract
Adolescent insomnia is a common condition that negatively impacts a developing young adult's mental and physical health. While the treatment of adult insomnia has been standardized, the treatment of pediatric insomnia is very practitioner-dependent and few large-scale studies are available to determine a standard recommended practice. There is great hope that as the adolescent medicine and sleep medicine fields flourish, larger cohort analyses will be performed to determine the prevalence and precipitating factors of adolescent insomnia, allowing for standardized treatment recommendations and systematic efforts to make these recommendations available to all adolescents.
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20
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Simonyte S, Kuciene R, Dulskiene V, Lesauskaite V. Association between ATP2B1 and CACNB2 polymorphisms and high blood pressure in a population of Lithuanian children and adolescents: a cross-sectional study. BMJ Open 2018; 8:e019902. [PMID: 29982197 PMCID: PMC6042568 DOI: 10.1136/bmjopen-2017-019902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Recently, genome-wide associated studies have identified several genetic loci that are associated with elevated blood pressure and could play a critical role in intracellular calcium homeostasis. The aim of this study was to assess the associations of ATP2B1 rs2681472 and CACNB2 rs12258967 gene polymorphisms with high blood pressure (HBP) among Lithuanian children and adolescents aged 12-15 years. STUDY DESIGN AND PARTICIPANTS This was a cross-sectional study of a randomly selected sample of 646 12-15-year-old adolescents who participated in the survey 'The Prevalence and Risk Factors of HBP in 12-15 Year-Old Lithuanian Children and Adolescents (from November 2010 to April 2012)'. Anthropometric parameters and BP were measured. The participants with HBP were screened on two separate occasions. Subjects were genotyped ATP2B1 rs2681472 and CACNB2 rs12258967 gene polymorphisms using real-time PCR method. RESULTS The prevalence of HBP was 36.7%, significantly higher for boys than for girls. In the multivariate analysis, after adjustment for body mass index and waist circumference, boys with CACNB2 CG genotype, CACNB2 GG genotype and CACNB2 CG +GG genotype had higher odds of having HBP in codominant (adjusted OR (aOR)=1.92; 95% CI 1.16 to 3.18, p=0.011; and aOR=2.64; 95% CI 1.19 to 5.90, p=0.018) and in dominant (aOR=2.05; 95% CI 1.27 to 3.30, p=0.003) inheritance models. Girls carrying CACNB2 CG genotype and CACNB2 CG +GG genotype had increased odds of HBP in codominant (aOR=1.82; 95% CI 1.02 to 3.24, p=0.044) and in dominant (aOR=1.89; 95% CI 1.09 to 3.28, p=0.023) inheritance models. Furthermore, significant associations were found in additive models separately for boys (aOR=1.72; 95% CI 1.20 to 2.46, p=0.003) and girls (aOR=1.52; 95% CI 1.05 to 2.20, p=0.027). No significant association was found between ATP2B1 gene polymorphism and the odds of HBP. CONCLUSIONS Our results indicate that CACNB2 gene polymorphism was significantly associated with higher odds of HBP in Lithuanian adolescents aged 12-15 years.
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Affiliation(s)
- Sandrita Simonyte
- Institute of Cardiology of the Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Renata Kuciene
- Institute of Cardiology of the Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Virginija Dulskiene
- Institute of Cardiology of the Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vaiva Lesauskaite
- Institute of Cardiology of the Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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21
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Wang H, Mueller N, Wang G, Hong X, Chen T, Ji Y, Pearson C, Appel LJ, Wang X. The Joint Association of Small for Gestational Age and Nighttime Sleep with Blood Pressure in Childhood. Sci Rep 2018; 8:9632. [PMID: 29941998 PMCID: PMC6018546 DOI: 10.1038/s41598-018-27815-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 05/23/2018] [Indexed: 11/09/2022] Open
Abstract
Children born small for gestational age (SGA) are more likely to develop high blood pressure. In prior studies, longer sleep duration is associated with lower BP, and SGA is associated with shorter sleep duration in childhood. We investigated whether sleep duration in early childhood modifies the association between SGA and higher childhood SBP in 1178 children recruited at birth and followed up to age 9 years. We ascertained birthweight and gestational age from medical records. We derived child sleep duration from maternal questionnaire interview. We calculated child SBP percentile according to U.S. reference data. We defined elevated SBP as SBP ≥75th percentile. In this sample, 154 (13.1%) children were born SGA. Children born SGA had higher SBP percentiles and higher risk of elevated SBP. Among children born SGA, those in the highest compared to the lowest tertile for sleep had a 12.28 lower (−22.00, −2.57) SBP percentile and 0.44 (0.25 to 0.79) times lower risk of developing elevated SBP. Our data are consistent with an interaction between SGA and sleep duration on childhood elevated SBP (Pinteraction = 0.0056). In conclusion, in this prospective birth cohort, longer sleep duration in early childhood may mitigate the blood pressure-raising effect of being born small.
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Affiliation(s)
- Hongjian Wang
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Noel Mueller
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Guoying Wang
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Xiumei Hong
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ting Chen
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yuelong Ji
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Colleen Pearson
- Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Lawrence J Appel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Xiaobin Wang
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. .,Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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22
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Pediatric Hypertension: Impact on the Heart, Brain, Kidney, and Retina. CURRENT CARDIOVASCULAR RISK REPORTS 2018. [DOI: 10.1007/s12170-018-0577-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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23
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Gupta N, Maranda L, Gupta R. Differences in self-reported weekend catch up sleep between children and adolescents with and without primary hypertension. Clin Hypertens 2018; 24:7. [PMID: 29636986 PMCID: PMC5887206 DOI: 10.1186/s40885-018-0092-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/28/2018] [Indexed: 01/14/2023] Open
Abstract
Background The data on the association of sleep duration and blood pressure in the pediatric age group have been mixed and most studies have focused on weekday sleep duration. The purpose of this study was to compare the weekday and weekend sleep patterns between children and adolescents with newly diagnosed primary hypertension and a normotensive control group. Methods Children and adolescents from a pediatric nephrology clinic, aged 6-18 years with newly diagnosed primary hypertension were compared to an age and sex matched normotensive control group from a general pediatric clinic. The questions about bed time and getting out of bed times from the Pediatric Sleep Questionnaire (PSQ) were used to obtain weekday and weekend bed time, getting out of bed time and sleep duration. The Pediatric Daytime Sleepiness Scale (PDSS) was used to assess subjective sleepiness. Results In both groups of 60 subjects each, weekday total sleep time was similar. Subjects in both groups went to bed later and woke up later on the weekends. However, in the hypertensive group, weekend getting out of the bed time was earlier (8:52 AM ±93 min vs. 9:36 AM ±88 min, p = 0.013) and weekend catchup sleep was about 40 min less (62.8 ± 85.5 vs. 102.7 ± 84.9, p = 0.035). Hypertensive children perceived less subjective sleepiness (PDSS scores 8.28 ± 4.88 vs. 10.63 ± 5.41, p = 0.007). The p values were calculated after adjusting for body mass index (BMI), race, daytime nap, caffeine use, sleep related breathing disorder (SRBD) scale and periodic limb movement of sleep (PLMS) scale subcomponents of the PSQ. Conclusions Hypertensive children obtained less weekend catch up sleep and reported less subjective sleepiness compared to the control group. More weekend sleep may potentially mitigate the effect of weekday sleep deprivation on blood pressure.
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Affiliation(s)
- Neena Gupta
- 1University of Massachusetts Children's Medical Center, Division of Pediatric Nephrology, 55 Lake Avenue North, Benedict Bldg, A2 210, Worcester, MA 01655 USA
| | - Louise Maranda
- 2University of Massachusetts Memorial Medical Center, Quantitative Health Sciences, Worcester, MA 01655 USA
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24
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Bal C, Öztürk A, Çiçek B, Özdemir A, Zararsız G, Ünalan D, Ertürk Zararsız G, Korkmaz S, Göksülük D, Eldem V, İsmailoğulları S, Erdem E, Mazıcıoğlu MM, Kurtoğlu S. The Relationship Between Blood Pressure and Sleep Duration in Turkish Children: A Cross-Sectional Study. J Clin Res Pediatr Endocrinol 2018; 10:51-58. [PMID: 28619699 PMCID: PMC5838373 DOI: 10.4274/jcrpe.4557] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE As in adults, hypertension is also an important risk factor for cardiovascular disease in children. We aimed to evaluate the effect of sleep duration on blood pressure in normal weight Turkish children aged between 11-17 years. METHODS This cross-sectional study was conducted in the primary and secondary schools of the two central and ten outlying districts of Kayseri, Turkey. Subjects were 2860 children and adolescents (1385 boys, 1475 girls). Systolic and diastolic blood pressures were measured according to the recommendations of the Fourth Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. Sleep duration was classified as follows: ≤8 hours, 8.1-8.9 hours, 9.0-9.9 hours or ≥10 hours. RESULTS For short sleeper boys and girls (participants with a sleep duration ≤8 h) the prevalence of prehypertension and hypertension was 35.0% and 30.8%, respectively. In univariate binary logistic regression analyses (age-adjusted), each unit increment in sleep duration (hours) in boys and girls, decreased the prehypertension and hypertension risk by 0.89 [odds ratio (OR)] [confidance interval (CI); 0.82-0.98] and 0.88 (OR) (CI; 0.81-0.97), respectively (p<0.05). In multiple binary logistic regression analyses [age- and body mass index (BMI)-adjusted] the location of the school and sleep duration categories were shown to be the most important factors for prehypertension and hypertension in both genders, while household income was the most important factor, only in boys. CONCLUSIONS A sleep duration ≤8 h is an independent risk factor for prehypertension and hypertension in Turkish children aged 11-17 years.
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Affiliation(s)
- Cengiz Bal
- Eskişehir Osmangazi University Faculty of Medicine, Department of Biostatistics, Eskişehir, Turkey
| | - Ahmet Öztürk
- Erciyes University Faculty of Medicine, Department of Biostatistics; Erciyes Teknopark, Turcosa Analytics Solutions Ltd. Co, Kayseri, Turkey
| | - Betül Çiçek
- Erciyes University Faculty of Health Sciences, Department of Nutrition and Dietetics, Kayseri, Turkey,* Address for Correspondence: Erciyes University Faculty of Health Sciences, Department of Nutrition and Dietetics, Kayseri, Turkey Phone: +90 352 207 66 66/28654 E-mail:
| | - Ahmet Özdemir
- Erciyes University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kayseri, Turkey
| | - Gökmen Zararsız
- Erciyes University Faculty of Medicine, Department of Biostatistics; Erciyes Teknopark, Turcosa Analytics Solutions Ltd. Co, Kayseri, Turkey
| | - Demet Ünalan
- Erciyes University Halil Bayraktar Health Services Vocational College, Kayseri, Turkey
| | - Gözde Ertürk Zararsız
- Erciyes University Faculty of Medicine, Department of Biostatistics; Erciyes Teknopark, Turcosa Analytics Solutions Ltd. Co, Kayseri, Turkey
| | - Selçuk Korkmaz
- Trakya University Faculty of Medicine, Department of Biostatistics, Edirne, Turkey
| | - Dinçer Göksülük
- Hacettepe University Faculty of Medicine, Department of Biostatistics, Ankara, Turkey
| | - Vahap Eldem
- İstanbul University Faculty of Science, Department of Biology, İstanbul, Turkey
| | - Sevda İsmailoğulları
- Erciyes University Faculty of Medicine, Department of Neurology, Kayseri, Turkey
| | - Emine Erdem
- Erciyes University Faculty of Health Sciences, Department of Pediatric Nursing, Kayseri, Turkey
| | - Mümtaz M Mazıcıoğlu
- Erciyes University Faculty of Medicine, Department of Family Medicine, Kayseri, Turkey
| | - Selim Kurtoğlu
- Memorial Hospital, Department of Pediatrics, Kayseri, Turkey
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Sugar-sweetened beverages and school students' hypertension in urban areas of Nanjing, China. J Hum Hypertens 2018; 32:392-396. [PMID: 29410454 DOI: 10.1038/s41371-018-0030-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 10/15/2017] [Accepted: 11/06/2017] [Indexed: 11/08/2022]
Abstract
Literature showed that sugar-sweetened beverages (SSBs) could increase the risk of developing hypertension in school students, but there is no reported evidence from China yet, so this study aims to investigate the association of the SSBs consumption and school students' hypertension in urban areas of Nanjing, China. A cross-sectional survey was conducted among primary and junior high school students selected from 32 primary schools and 16 junior high schools using a multi-stage random sampling method, with a total number of 10,091 participants involved. The mean age of Grade 4 is 9.04 ± 0.38, while the mean age of Grade 7 is 12.03 ± 0.41. Blood pressure was measured and SSBs consumption was reported using a validated questionnaire. The overall prevalence of hypertension was 4.5% among the participants. After adjustment for school, parental education, physical activity, diet intake including meat and snacks, participants who had an experience of SSBs intake were at a higher risk of developing hypertension (odds ratio (OR) = 1.40, 95% confidence interval (CI) = 1.15, 1.70) compared with those who had no experience of SSBs intake. A significant association between the consumption of SSBs and hypertension was observed among the students who were at a healthy weight (OR = 1.78, 95% CI = 1.20, 2.65), as well as who were overweight or obese (OR = 1.28, 95% CI = 1.01, 1.61). SSBs may play a contributing role in developing childhood hypertension in this population in China, which is of important implications for future population-based childhood hypertension intervention in China and other countries.
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Sembiring K, Ramayani OR, Lubis M. Mean Blood Pressure Difference among Adolescents Based on Dyssomnia Types. Open Access Maced J Med Sci 2018. [PMID: 29531591 PMCID: PMC5839435 DOI: 10.3889/oamjms.2018.068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND: Dyssomnia is the most frequent sleep disturbance and associated with increased blood pressure. There has been no study determining the difference in mean blood pressure based on dyssomnia types among adolescents. OBJECTIVE: To determine the difference in mean blood pressure among adolescents based on dyssomnia types. METHODS: Cross-sectional study was conducted in SMP Negeri 1 Muara Batang Gadis in April 2016. Samples were students having sleep disturbance based on Sleep Disturbance Scale for Children (SDSC) questionnaire. Stature and blood pressure data were collected along with demographic data and sleep disorder questionnaire. Analyses were done with Kruskal-Wallis test and logistic regression. P - value < 0.05 was considered significant. RESULTS: Seventy-six samples were obtained with mean age 13.9 (SD 1.14) years - old. Dyssomnia proportion and hypertension were 72/76 and 20/76 respectively. Mean systolic (SBP) and diastolic blood pressure (DBP) was 111.1 (SD 16.46) mmHg and 70.3 (SD 11.98) mmHg respectively. Mean SDSC score was 49.7 (SD 8.96), and the most frequent dyssomnia type was disorders of initiating and maintaining sleep. Age and sex were not the risk factors of hypertension in dyssomnia. There was a significant difference in mean SBP (P = 0.006) and DBP (P = 0.022) based on dyssomnia types. Combination dyssomnia type had the highest mean blood pressure among dyssomnia types. CONCLUSION: There is a significant difference in mean blood pressure among adolescents based on dyssomnia types.
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Affiliation(s)
- Krisnarta Sembiring
- Department of Child Health, Medical School, University of Sumatera Utara, Medan, Indonesia
| | - Oke Rina Ramayani
- Department of Child Health, Medical School, University of Sumatera Utara, Medan, Indonesia
| | - Munar Lubis
- Department of Child Health, Medical School, University of Sumatera Utara, Medan, Indonesia
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Quan SF, Combs D, Parthasarathy S. Impact of Sleep Duration and Weekend Oversleep on Body Weight and Blood Pressure in Adolescents. SOUTHWEST JOURNAL OF PULMONARY AND CRITICAL CARE 2018; 16:31-41. [PMID: 29375933 DOI: 10.13175/swjpcc150-17] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Introduction Weekend oversleep or catchup sleep is a frequent occurrence in children, but there are relatively little data concerning its impact on weight and blood pressure. The aim of this study was to assess the association between sleep duration and oversleep, and weight and blood pressure in adolescents. Methods Sleep duration, weight and blood pressure of 327 children (51.4% boys, mean age 13.3 ± 1.7 years) who had polysomnograms performed during both exam cycles of the Tucson Children's Assessment of Sleep Apnea study (TuCASA) were analyzed. Sleep duration on school nights and non-school nights was used to compute a weighted average of child and parent reported overall sleep duration respectively. Oversleep was defined as the difference between self and parent reported weekend sleep and weekday sleep separately. Simple correlations between overall sleep duration, sleep on school and non-school nights and oversleep, and blood pressure, standardized body mass index (BMI), snoring, respiratory disturbance index (RDI) and age were calculated. Significant bivariate associations then were used to develop multivariate partial correlation models. Results Unadjusted negative correlations with BMI were noted for parent reported total sleep duration at the 1st exam cycle, parent and child reported total sleep and school night sleep duration, and parent reported non-school night sleep duration at the 2nd exam cycle. Additionally, for BMI, positive correlations were observed for log RDI at both exam cycles and snoring at the 2nd exam cycle. For blood pressure, there were positive associations with age, parent reported oversleep, caffeine consumption and snoring. Additionally, for blood pressure, negative relationships were observed with parent reported total sleep duration at the 1st exam cycle, and parent and child reported total sleep and school night sleep durations at the 2nd exam cycle. Partial correlations found that BMI was negatively correlated with parent reported total sleep duration at the 1st exam cycle and parent reported total sleep duration at the 2nd exam cycle, and positively correlated with snoring and log RDI at both exam cycles. Systolic blood pressure was only associated with age and snoring. Diastolic blood pressure was positively correlated with age and caffeine consumption, and negatively correlated with parent reported total and school night sleep duration. Oversleep and child reported sleep duration were not represented in any of these models. Conclusion Lower amounts of sleep especially on school nights is associated with higher body weight and blood pressure. Oversleep was not associated with either body weight or blood pressure.
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Affiliation(s)
- Stuart F Quan
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.,Asthma and Airways Research Center, University of Arizona College of Medicine, Tucson, AZ
| | - Daniel Combs
- Department of Pediatrics, University of Arizona College of Medicine, Tucson, AZ.,Center for Sleep and Circadian Sciences, University of Arizona Health Sciences Center, Tucson, AZ
| | - Sairam Parthasarathy
- Asthma and Airways Research Center, University of Arizona College of Medicine, Tucson, AZ.,Department of Medicine, University of Arizona College of Medicine, Tucson, AZ.,Center for Sleep and Circadian Sciences, University of Arizona Health Sciences Center, Tucson, AZ
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Mishra D, Tubaki BR. Effect of Brahmi vati and Sarpagandha Ghana vati in management of essential hypertension - A randomized, double blind, clinical study. J Ayurveda Integr Med 2017; 10:269-276. [PMID: 29242090 PMCID: PMC6938844 DOI: 10.1016/j.jaim.2017.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 03/29/2017] [Accepted: 04/07/2017] [Indexed: 11/18/2022] Open
Abstract
Background Essential hypertension (EHTN) is emerging as one of the most prevalent disorder with high rate of complications, morbidity and mortality. Brahmi vati, an Ayurvedic medicine is explored for its efficacy in the management of EHTN. Objective To evaluate the efficacy of Brahmi vati and sarpagandha Ghana vati in the management of EHTN. Methods Total 68 patients meeting the JNC 7 criteria of EHTN of age group 20 to 60 years of either sex participated in the study. They were randomly divided into two groups, group A received capsule Brahmi vati 500 mg and group B capsule Sarpagandha Ghana vati 500 mg respectively twice a day for 30 days. Assessments were done through various variables like systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), lipid profiles, Hamilton anxiety rating scale, 2 weeks sleep diary, serum creatinine, hemoglobin, total leukocyte count and erythrocyte sedimentation rate. Follow up visit was on every 15th day. Results Study showed that both Brahmi vati and Sarpagandha Ghanavati produced improvement in most of the variables and were comparable. Improvements were seen in various variables like SBP, DBP, MAP, Hamilton anxiety rating scale, subjective sleep profiles and total cholesterol. However Brahmi vati showed increase in weight and Body Mass Index (BMI). SarpagandhaGhanavati produced reduction in total cholesterol and LDL. Both groups showed good safety profile evaluated through the assessment of serum creatinine levels. Conclusion Clinical efficacy of Sarpagandha Ghana vati and Brahmi vati on EHTN showed that both were effective, safe and comparable.
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Affiliation(s)
- Dhanpat Mishra
- Department of Kayachikitsa, KLEU BMK Ayurveda Mahavidyalaya, Belgaum 590003, Karnataka, India
| | - Basavaraj R Tubaki
- Department of Kayachikitsa, KLEU BMK Ayurveda Mahavidyalaya, Belgaum 590003, Karnataka, India.
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Chaput JP, Gray CE, Poitras VJ, Carson V, Gruber R, Olds T, Weiss SK, Connor Gorber S, Kho ME, Sampson M, Belanger K, Eryuzlu S, Callender L, Tremblay MS. Systematic review of the relationships between sleep duration and health indicators in school-aged children and youth. Appl Physiol Nutr Metab 2017; 41:S266-82. [PMID: 27306433 DOI: 10.1139/apnm-2015-0627] [Citation(s) in RCA: 475] [Impact Index Per Article: 67.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The objective of this systematic review was to examine the relationships between objectively and subjectively measured sleep duration and various health indicators in children and youth aged 5-17 years. Online databases were searched in January 2015 with no date or study design limits. Included studies were peer-reviewed and met the a priori-determined population (apparently healthy children and youth aged 5-17 years), intervention/exposure/comparator (various sleep durations), and outcome (adiposity, emotional regulation, cognition/academic achievement, quality of life/well-being, harms/injuries, and cardiometabolic biomarkers) criteria. Because of high levels of heterogeneity across studies, narrative syntheses were employed. A total of 141 articles (110 unique samples), including 592 215 unique participants from 40 different countries, met inclusion criteria. Overall, longer sleep duration was associated with lower adiposity indicators, better emotional regulation, better academic achievement, and better quality of life/well-being. The evidence was mixed and/or limited for the association between sleep duration and cognition, harms/injuries, and cardiometabolic biomarkers. The quality of evidence ranged from very low to high across study designs and health indicators. In conclusion, we confirmed previous investigations showing that shorter sleep duration is associated with adverse physical and mental health outcomes. However, the available evidence relies heavily on cross-sectional studies using self-reported sleep. To better inform contemporary sleep recommendations, there is a need for sleep restriction/extension interventions that examine the changes in different outcome measures against various amounts of objectively measured sleep to have a better sense of dose-response relationships.
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Affiliation(s)
- Jean-Philippe Chaput
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Casey E Gray
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Veronica J Poitras
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Valerie Carson
- b Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Reut Gruber
- c Attention, Behavior, and Sleep Laboratory, Douglas Mental Health University Institute, Verdun, QC, Canada
| | - Timothy Olds
- d Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute of Health Research, University of South Australia, Adelaide, Australia
| | - Shelly K Weiss
- e Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Sarah Connor Gorber
- f Office of the Task Force on Preventive Health Care, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Michelle E Kho
- g School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Margaret Sampson
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Kevin Belanger
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Sheniz Eryuzlu
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Laura Callender
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Mark S Tremblay
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
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Kuciene R, Dulskiene V, Medzioniene J. Associations between high birth weight, being large for gestational age, and high blood pressure among adolescents: a cross-sectional study. Eur J Nutr 2017; 57:373-381. [PMID: 28058464 PMCID: PMC5847040 DOI: 10.1007/s00394-016-1372-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 12/21/2016] [Indexed: 11/29/2022]
Abstract
Purpose Low birth weight and being small for gestational age are associated with increased risk of cardiometabolic diseases. However, the results from the studies examining the associations between high birth weight (HBW), being large for gestational age (LGA), and high blood pressure (HBP) are inconsistent. The aim of this study was to evaluate the associations between HBW and being LGA alone and in combinations with body mass index (BMI) categories in adolescence and HBP among Lithuanian adolescents aged 12–15 years. Methods The participants with HBP (≥90th percentile) were screened on two separate occasions. Data on the BMI, birth weight (BW), gestational age, and BP were analyzed in 4598 adolescents. Adjusted odds ratios (aORs) with 95% confidence intervals (CI) for the associations were estimated using multivariate logistic regression models. Results The overall prevalence of HBW (>4000 g), being LGA, adolescent overweight/obesity, and HBP were 13.9, 10.4, 14.5, and 25.6%, respectively. After adjustment for age, sex, and BMI, significant positive associations were found between HBW and being LGA and HBP (HBW: aOR 1.34; 95% CI, 1.11–1.63; LGA: aOR 1.44; 95% CI, 1.16–1.79). After adjustment for age and sex and compared to BW 2500–4000 g and being AGA (appropriate for gestational age) with normal weight in adolescence, the combinations that included both risk factors—HBW with overweight/obesity and being LGA with overweight/obesity—showed higher aORs (aOR 4.36; 95% CI, 3.04–6.26; and aOR 5.03; 95% CI, 3.33–7.60, respectively) than those with either of these risk factors alone did. Conclusions HBW and being LGA were positively associated with HBP in Lithuanian adolescents aged 12–15 years. The highest odds of having HBP were observed for subjects with both risk factors—neonatal HBW or being LGA and overweight/obesity in adolescence.
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Affiliation(s)
- Renata Kuciene
- Laboratory of Population Studies, Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 15, 50009, Kaunas, Lithuania.
| | - Virginija Dulskiene
- Laboratory of Population Studies, Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 15, 50009, Kaunas, Lithuania
| | - Jurate Medzioniene
- Laboratory of Population Studies, Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 15, 50009, Kaunas, Lithuania
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Paruthi S, Brooks LJ, D'Ambrosio C, Hall WA, Kotagal S, Lloyd RM, Malow BA, Maski K, Nichols C, Quan SF, Rosen CL, Troester MM, Wise MS. Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children: Methodology and Discussion. J Clin Sleep Med 2016; 12:1549-1561. [PMID: 27707447 DOI: 10.5664/jcsm.6288] [Citation(s) in RCA: 355] [Impact Index Per Article: 44.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 09/12/2016] [Indexed: 12/13/2022]
Abstract
ABSTRACT Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. After review of 864 published articles, the following sleep durations are recommended: Infants 4 months to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 1 to 2 years of age should sleep 11 to 14 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 3 to 5 years of age should sleep 10 to 13 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 6 to 12 years of age should sleep 9 to 12 hours per 24 hours on a regular basis to promote optimal health. Teenagers 13 to 18 years of age should sleep 8 to 10 hours per 24 hours on a regular basis to promote optimal health. Sleeping the number of recommended hours on a regular basis is associated with better health outcomes including: improved attention, behavior, learning, memory, emotional regulation, quality of life, and mental and physical health. Regularly sleeping fewer than the number of recommended hours is associated with attention, behavior, and learning problems. Insufficient sleep also increases the risk of accidents, injuries, hypertension, obesity, diabetes, and depression. Insufficient sleep in teenagers is associated with increased risk of self-harm, suicidal thoughts, and suicide attempts. COMMENTARY A commentary on this article apears in this issue on page 1439.
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Affiliation(s)
| | - Lee J Brooks
- Children's Hospital of Philadelphia, Philadelphia, PA.,Liaison for the American Academy of Pediatrics
| | | | - Wendy A Hall
- University of British Columbia School of Nursing, Vancouver, BC
| | | | | | - Beth A Malow
- Vanderbilt University Medical Center, Nashville, TN
| | | | | | | | | | | | - Merrill S Wise
- Methodist Healthcare Sleep Disorders Center, Memphis, TN
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Sun XM, Yao S, Hu SJ, Liu ZY, Yang YJ, Yuan ZY, Ye WM, Jin L, Wang XF. Short sleep duration is associated with increased risk of pre-hypertension and hypertension in Chinese early middle-aged females. Sleep Breath 2016; 20:1355-1362. [PMID: 27491292 DOI: 10.1007/s11325-016-1392-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 07/05/2016] [Accepted: 07/25/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim of this study is to investigate the relationship between sleep duration and hypertension in a middle-aged Chinese population. METHODS Cross-sectional data of 20,505 individuals aged 35-64 years from Taizhou longitudinal study was used. Logistic regression models were used to calculate odds ratios (ORs) for the risk of pre-hypertension and hypertension in association with sleep duration. RESULTS Short sleep duration was associated with high systolic and diastolic blood pressure in comparison with sleep duration of 7-8 h in females. Short sleep duration was also associated with an increased risk of hypertension in females. Age-stratified analysis showed that as compared with sleep duration of 7-8 h, sleep duration <6 h increased risk of hypertension after controlling for multiple covariates with an OR of 1.766 (1.024-2.775) in early middle-aged females of 35-44 years. More importantly, sleeping less than 6 h is associated with increased risk of pre-hypertension in females of this age category, after controlling for multiple covariates with an OR of 1.769 (1.058-2.958). CONCLUSIONS Sleeping less than 6 h a day is associated with increased risk of pre-hypertension and hypertension in Chinese early middle-aged females. The high-risk populations require sufficient sleep, which could probably prevent the increased risk of pre-hypertension as well as hypertension.
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Affiliation(s)
- Xun-Ming Sun
- Unit of Epidemiology, State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences and Institutes of Biomedical Sciences, Fudan University, 220 Handan Rd, Shanghai, 200433, China
| | - Shun Yao
- Unit of Epidemiology, State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences and Institutes of Biomedical Sciences, Fudan University, 220 Handan Rd, Shanghai, 200433, China
| | - Shu-Juan Hu
- Unit of Epidemiology, State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences and Institutes of Biomedical Sciences, Fudan University, 220 Handan Rd, Shanghai, 200433, China
| | - Zu-Yun Liu
- Unit of Epidemiology, State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences and Institutes of Biomedical Sciences, Fudan University, 220 Handan Rd, Shanghai, 200433, China
| | - Ya-Jun Yang
- Taizhou Research Institute of Health Sciences, Taizhou, Jiangsu, 225312, China
| | - Zi-Yu Yuan
- Taizhou Research Institute of Health Sciences, Taizhou, Jiangsu, 225312, China
| | - Wei-Min Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Li Jin
- Unit of Epidemiology, State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences and Institutes of Biomedical Sciences, Fudan University, 220 Handan Rd, Shanghai, 200433, China
| | - Xiao-Feng Wang
- Unit of Epidemiology, State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences and Institutes of Biomedical Sciences, Fudan University, 220 Handan Rd, Shanghai, 200433, China.
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Paciência I, Araújo J, Ramos E. Sleep duration and blood pressure: a longitudinal analysis from early to late adolescence. J Sleep Res 2016; 25:702-708. [PMID: 27256612 DOI: 10.1111/jsr.12433] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 05/05/2016] [Indexed: 11/29/2022]
Abstract
The aim of this study was to evaluate the association between sleep duration and blood pressure using a cross-sectional and longitudinal approach. As part of a population-based cohort, 1403 adolescents were evaluated at 13 and 17 years old. Sleep duration was estimated by the difference between self-reported usual bedtime and wake-up time. Blood pressure was measured using the auscultatory method. Regression coefficients (β) and respective 95% confidence intervals were computed to evaluate the association between sleep duration and blood pressure, using linear regression models adjusted for practice of sports and body mass index at 17 years old. The mean (standard deviation) sleep duration at 13 years old was 9.0 (0.76) h per day, and on average it decreased by 46 min up to 17 years old. The median (25th-75th) systolic blood pressure at 17 years old was 110.0 (103.5-119.0) mmHg in females and 114.0 (106.0-122.0)mmHg in males (P < 0.001); for diastolic blood pressure the values were 66.0 (60.0-71.0) and 69.0 (62.0-75.0) mmHg, respectively (P < 0.001). In cross-sectional analysis, at 17 years old, after adjustment, a positive association was found between sleep duration and blood pressure, significant only for systolic blood pressure among females [β = 0.730 (0.005; 1.455)]. In girls, no significant association was found between sleep duration at 13 years old and blood pressure at 17 years old, but in males an inverse association was found between sleep duration at 13 years old and blood pressure at 17 years old significant only for systolic blood pressure [β = -1.938 (-3.229; -0.647)]. This study found no association between sleep duration at 13 years old and blood pressure at 17 years old in girls, but among males an inverse association was found.
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Affiliation(s)
- Inês Paciência
- Institute of Public Health, University of Porto, Porto, Portugal.,GEAC, INEGI - Institute of Mechanical Engineering and Industrial Management, Porto, Portugal
| | - Joana Araújo
- Institute of Public Health, University of Porto, Porto, Portugal.,EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.,Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - Elisabete Ramos
- Institute of Public Health, University of Porto, Porto, Portugal.,EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.,Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
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Yunus FM, Khan S, Akter T, Jhohura FT, Reja S, Islam A, Rahman M. How many hours do people sleep in Bangladesh? A country-representative survey. J Sleep Res 2016; 25:365-76. [DOI: 10.1111/jsr.12381] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 11/27/2015] [Indexed: 02/05/2023]
Affiliation(s)
- Fakir M. Yunus
- Research and Evaluation Division; BRAC; Dhaka Bangladesh
- James P. Grant School of Public Health; BRAC University; Dhaka Bangladesh
| | - Safayet Khan
- Research and Evaluation Division; BRAC; Dhaka Bangladesh
| | - Tahera Akter
- Research and Evaluation Division; BRAC; Dhaka Bangladesh
| | | | - Saifur Reja
- Tuberculosis Control Programme; BRAC; Dhaka Bangladesh
| | - Akramul Islam
- Tuberculosis Control Programme; BRAC; Dhaka Bangladesh
- Water, Sanitation and Hygiene Programme; BRAC; Dhaka Bangladesh
- Disaster Environment and Climate Change Programme; BRAC; Dhaka Bangladesh
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Kuciene R, Dulskiene V, Medzioniene J. Association of neck circumference and high blood pressure in children and adolescents: a case-control study. BMC Pediatr 2015; 15:127. [PMID: 26383844 PMCID: PMC4574610 DOI: 10.1186/s12887-015-0444-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 09/09/2015] [Indexed: 01/03/2023] Open
Abstract
Background High blood pressure (BP) is a serious, common and growing global public health problem. The aim of this study was to evaluate the associations between high NC (neck circumference) alone and in combinations with BMI (body mass index), WC (waist circumference), and high BP among Lithuanian children and adolescents aged 12 to 15 years. Methods An epidemiological case–control study was performed between May 2012 and November 2013. NC, WC, hip circumference (HC), mid-upper arm circumference (MUAC), body height, weight, and BP were measured. The participants with high BP (≥90th percentile) were screened on two separate occasions. Data on NC, WC, HC, MUAC, BMI, body adiposity index (BAI), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), and BP were analyzed in 1947 children and adolescents aged 12–15 years. Age- and sex-adjusted odds ratios (aORs) with 95 % confidence intervals (CI) for the associations were estimated using multivariate logistic regression models. Results The prevalence rates of prehypertension (BP ≥90th– < 95th percentile) and hypertension (BP ≥95th percentile) was 6.3 and 25.1 %, respectively. The overall prevalence of high NC (if NC was in the ≥90th percentile), overweight/obesity (as measured by BMI), and abdominal overweight/obesity (if WC was in the ≥75th percentile) were 14.3, 15.8, and 13 %, respectively. After adjustment for age and sex, NC in the ≥90th percentile was significantly associated with an increased risk of elevated BP (prehypertension: aOR = 2.99; 95 % CI, 1.88–4.77; hypertension aOR = 4.05; 95 % CI, 3.03–5.41, and prehypertension/hypertension aOR = 3.75; 95 % CI, 2.86–4.91), compared to the participants with NC in the <90th percentile. Overweight/obesity and abdominal overweight/obesity were also significantly associated with an elevated BP. The combinations including both risk factors (high NC with overweight/obesity, and high NC with abdominal overweight/obesity) showed higher aORs than those with either risk factor alone. Conclusions High NC alone—but particularly in combinations with overweight/obesity and abdominal overweight/obesity—was associated with an increased risk of high BP.
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Affiliation(s)
- Renata Kuciene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu ave. 17, LT-50009, Kaunas, Lithuania.
| | - Virginija Dulskiene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu ave. 17, LT-50009, Kaunas, Lithuania.
| | - Jurate Medzioniene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu ave. 17, LT-50009, Kaunas, Lithuania.
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Matthews KA, Pantesco EJM. Sleep characteristics and cardiovascular risk in children and adolescents: an enumerative review. Sleep Med 2015; 18:36-49. [PMID: 26459685 DOI: 10.1016/j.sleep.2015.06.004] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 04/23/2015] [Accepted: 06/01/2015] [Indexed: 01/10/2023]
Abstract
Cardiovascular risk factors develop in childhood and adolescence. This enumerative review addresses whether sleep characteristics, including sleep duration, continuity, quality, and daytime sleepiness, are associated with cardiovascular risk factors in young people. Thirty-nine studies were identified, which examined the following risk factors: metabolic syndrome, glucose and insulin, lipids, blood pressure, and cardiovascular responses to psychological stressors. Due to the availability of other reviews, 16 longitudinal studies of obesity published in 2011 and later were also included in this report. Excluded from the review were studies of participants with suspected or diagnosed sleep disorders and reports from sleep deprivation experiments. Combining studies, evidence was strongest for obesity, followed by glucose, insulin, blood pressure (especially ambulatory blood pressure), and parasympathetic responses to psychological stressors. There was little evidence for metabolic syndrome cluster, lipids, and blood pressure responses to psychological stressors. The more positive associations were obtained for studies that incorporated objective measures of sleep and that included adolescents. The foundational evidence is almost entirely cross-sectional, except for work on obesity. In summary, available evidence suggests that the associations between sleep characteristics and cardiovascular risk vary by risk factor. It is time to conduct studies to determine antecedent and consequent relationships, and to expand risk factors to include markers of inflammation.
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Affiliation(s)
- Karen A Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
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Xu T, Zhu G, Liu J, Han S. Gender-specific prevalence and associated risk factors of high normal blood pressure and hypertension among multi-ethnic Chinese adolescents aged 8-18 years old. Blood Press 2015; 24:189-95. [PMID: 25830569 DOI: 10.3109/08037051.2015.1025474] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
AIM To date, accurate reports about the prevalence of high normal blood pressure (BP) and hypertension among Chinese adolescents have been rare. We examine the sex-specific and age-specific prevalence of high normal BP and hypertension, and the associated risk factors among multi-ethnic Chinese adolescents from a large and representative sample. METHODS 29,997 adolescents aged 8-18 years old received blood pressure measurement on one clinical visit. RESULTS The overall prevalence was 4.15% for hypertension (4.73% for boys and 3.62% for girls) and 29.85% for high normal BP (33.40% for boys and 26.65% for girls). The odds ratios (ORs) increased with age, but the absolute changes of ORs were significantly different between boys and girls. Compared with that of the Han counterparts, the risk of high normal BP was 1.960-fold, 1.283-fold and 1.618-fold for Yi boys, Mongolian boys and Yi girls, respectively, whereas the OR was 0.440 for Tibetan boys, 0.492 for Tibetan girls and 0.794 for Korean girls. Compared with those of normal weight, overweight and obese adolescents had significantly increased risk of high normal BP (OR = 3.377 for obese boys and OR = 2.009 for overweight boys; OR = 2.865 for obese girls and OR = 1.738 for overweight girls). Rural adolescents had a higher risk of hypertension than those living in urban areas. CONCLUSION The prevalence of high normal BP and hypertension was high in Chinese adolescents. Age, ethnicity, obesity, overweight, abnormal waist circumference, family history of cardiovascular diseases and dwelling at rural districts were significantly associated with pediatric high normal BP or hypertension.
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Affiliation(s)
- Tao Xu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College , Beijing 100005 , China
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