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Full KM, Shi H, Lipworth L, Dauer LT, Mumma MT, Xiao Q. Associations of Long-term Sleep Duration Trajectories with Overall and Cause-Specific Mortality Among Middle-to-older Aged Black and White Adults. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.23.24307845. [PMID: 38826310 PMCID: PMC11142262 DOI: 10.1101/2024.05.23.24307845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
Background Both short and long sleep durations are adversely associated with numerous chronic conditions, including cardiovascular disease (CVD), diabetes, hypertension, and mortality. The American Academy of Sleep Medicine recommends adults in the United States sleep at least 7 hours and less than 9 hours per night to maintain optimal health. It remains unclear how sleep duration trajectories over time are associated with mortality. Methods This observational cohort study includes 46,928 Black and White adults (mean age: 53 ± 9 years) who enrolled in the Southern Community Cohort Study between 2002-2009 and completed a follow-up survey in 2008-2013. Participants were categorized into nine sleep duration trajectory categories based on the reported average sleep duration between study enrollment and at follow-up. Participant vital status and date and cause of death were ascertained via linkage to the National Death Index through 2022. Cox regression analysis was performed to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between sleep duration trajectory and all-cause and cause-specific mortality (CVD, cancer, and neurodegenerative disease) after adjustment for sociodemographic characteristics, health behaviors, and clinical factors. Results During a median 12.6 years of follow-up, we documented 13,579 deaths, including 4,135 from CVD, 3,067 from cancer, and 544 from neurodegenerative diseases. Compared to the optimal sleep duration trajectory (maintaining 7-9 hours), all sub-optimal trajectories were associated with significant 6 to 33% greater risk of all-cause mortality in fully adjusted models. Compared to the optimal sleep trajectory, three of the sub-optimal trajectories were associated with increased CVD mortality, with HRs ranging from 1.20 to 1.34. The short-long trajectory was associated with the greatest risk of all-cause mortality (HR:1.33; 95%CI: 1.21, 1.46) and the long-short trajectory was associated with the greatest CVD mortality risk (HR:1.34; 95%CI: 1.10, 1.65). The healthy-long trajectory was associated with the greatest risk of cancer mortality (HR: 1.19; 95%CI:1.00, 1.41). None of the sub-optimal trajectories was associated with neurodegenerative disease mortality. Conclusions Suboptimal sleep duration trajectories were associated with increased risk of all-cause mortality as well as CVD mortality. Findings highlight the importance of maintaining healthy sleep duration throughout midlife to reduce mortality risk.
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Thapa A, Lahti T, Maukonen M, Partonen T. Consumption of fruits and vegetables and its association with sleep duration among Finnish adult population: a nationwide cross-sectional study. Front Nutr 2024; 11:1319821. [PMID: 38818133 PMCID: PMC11137275 DOI: 10.3389/fnut.2024.1319821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 04/09/2024] [Indexed: 06/01/2024] Open
Abstract
Introduction Sleep and diet are crucial determinants of overall health and wellbeing, with the potential to mutually influence each other. This study examined the association between sleep duration and fruits and vegetables (FV) consumption among Finnish adults. Methods The study analyzed data from the National FinHealth 2017 Study involving 5,043 adults aged 18 years and above. Participants reported their habitual sleep duration, and dietary consumption through a validated self-administered questionnaire. Confounders such as demographic, socio-economic factors, and chronotype were considered. A sensitivity analysis, which excluded energy under-reporters, was conducted to validate the findings. Results Mean dietary consumption was compared across three sleep duration categories (short, normal, long), revealing that short sleepers consumed 37 g/d fewer FV, and long sleepers consumed 73 g/d fewer FV than normal sleepers. Binary logistic regression analyses consistently demonstrated significant negative association between FV consumption and both short and long sleep duration across all models, even when adjusted for a range of covariates. Linear regression analyses revealed a positive but non-significant association between sleep duration and FV consumption that became significant when excluding energy under-reporters, particularly in model 1. Discussion This study suggests a consistent pattern where deviation from normal sleep duration was associated with decreased FV consumption, suggesting the need for considering sleep patterns in dietary intervention. The substantial role of accurate energy reporting in explaining these associations is highlighted. Further research, including longitudinal studies, is needed to better understand the mechanisms underlying these associations.
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Affiliation(s)
- Anupa Thapa
- Doctoral School of Health Sciences, University of Helsinki, Helsinki, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tuuli Lahti
- Doctoral School of Health Sciences, University of Helsinki, Helsinki, Finland
- Master School, Health and Wellbeing, Turku University of Applied Sciences, Turku, Finland
| | | | - Timo Partonen
- Finnish Institute for Health and Welfare, Helsinki, Finland
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Berntzen BJ, Tolvanen A, Kujala UM, Silventoinen K, Vuoksimaa E, Kaprio J, Aaltonen S. Longitudinal leisure-time physical activity profiles throughout adulthood and related characteristics: a 36-year follow-up study of the older Finnish Twin Cohort. Int J Behav Nutr Phys Act 2024; 21:47. [PMID: 38671483 PMCID: PMC11046842 DOI: 10.1186/s12966-024-01600-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Personalized interventions aiming to increase physical activity in individuals are effective. However, from a public health perspective, it would be important to stimulate physical activity in larger groups of people who share the vulnerability to be physically inactive throughout adulthood. To find these high-risk groups, we identified 36-year leisure-time physical activity profiles from young adulthood to late midlife in females and males. Moreover, we uncovered which anthropometric-, demographic-, lifestyle-, and health-related characteristics were associated with these physical activity profiles. METHODS We included 2,778 females and 1,938 males from the population-based older Finnish Twin Cohort Study, who responded to health and behavior surveys at the mean ages of 24, 30, 40 and 60. Latent profile analysis was used to identify longitudinal leisure-time physical activity profiles. RESULTS We found five longitudinal leisure-time physical activity profiles for both females and males. Females' profiles were: 1) Low increasing moderate (29%), 2) Moderate stable (23%), 3) Very low increasing low (20%), 4) Low stable (20%) and 5) High increasing high (9%). Males' profiles were: 1) Low increasing moderate (29%), 2) Low stable very low (26%), 3) Moderate decreasing low (21%), 4) High fluctuating high (17%) and 5) Very low stable (8%). In both females and males, lower leisure-time physical activity profiles were associated with lower education, higher body mass index, smoking, poorer perceived health, higher sedentary time, high blood pressure, and a higher risk for type 2 diabetes. Furthermore, lower leisure-time physical activity was linked to a higher risk of depression in females. CONCLUSIONS We found several longitudinal leisure-time physical activity profiles with unique changes in both sexes. Fewer profiles in females than in males remained or became low physically active during the 36-year follow-up. We observed that lower education, higher body mass index, and more smoking already in young adulthood were associated with low leisure-time physical activity profiles. However, the fact that several longitudinal profiles demonstrated a change in their physical activity behavior over time implies the potential for public health interventions to improve leisure-time physical activity levels.
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Affiliation(s)
- Bram J Berntzen
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, P.O. Box 20, FI-00014, Helsinki, Finland
| | - Asko Tolvanen
- Methodology Centre for Human Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland
| | - Karri Silventoinen
- Helsinki Institute for Demography and Population Health, University of Helsinki, P.O. Box 42, FI-00014, Helsinki, Finland
| | - Eero Vuoksimaa
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, P.O. Box 20, FI-00014, Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, P.O. Box 20, FI-00014, Helsinki, Finland
| | - Sari Aaltonen
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, P.O. Box 20, FI-00014, Helsinki, Finland.
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Elfaki NK, Alzahrani MJ, Abdalla YHA, Adeh AI, Osman Abdalla AMA, Alkhadher MA, Elrefaey SR, Abdelmagid WHH, Alshameri F, Jarelnape AA, Hakami MSA, Alghamdi FAA, Elhaj YHA, Dinar NMAA, Mohamed AAA, Abdulrahman EEH, Mohamed DHM, Sagiron EI, Ali MHM, Ahmed WAM. Perceived Social Stigma of Cutaneous Leishmaniasis in Hubuna, Saudi Arabia. J Multidiscip Healthc 2024; 17:867-876. [PMID: 38434481 PMCID: PMC10909324 DOI: 10.2147/jmdh.s454135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024] Open
Abstract
Background Cutaneous Leishmaniasis (CL) is a vector-borne skin infection that remains prevalent in regions with poor socioeconomic conditions. Stigmatization occurs when individuals with physical or psychological disorders interact with societal stereotypes. The aim of this study was to explore the perceived social stigma surrounding CL among people residing in Hubuna, Saudi Arabia. Methods This cross-sectional community-based survey recruited 618 individuals aged 18 years and above using the snowball sampling technique to reach hidden cases within the target population. Data was collected using a self-administered questionnaire and the Explanatory Model Interview Catalogue for Perceived Social Stigma (EMIC-SS-12) was used to assess the level of perceived social stigma. It includes questions on demographic variables, behaviors, and experiences. The analysis was performed using SPSS. Results The study included 618 participants, the majority of whom were women and girls (54.2%), with a mean age of 28 ± 12.7 years. The median score for perceived social stigma was 26.0. Only 2.1% (n = 13) of participants had the highest EMIC-SS-12 score of 36, while 7.6% (n = 47) scored zero. The mean score for overall perceived social stigma was 1.89 ± 0.91, while the mean score for experienced stigma was 1.99 ± 1.02. Univariate analysis showed that sex, employment, location of lesions, and number of lesions were insignificantly associated with stigmatization (P-value < 0.05), because these associations were uncertain because the CI includes or very close to 1. Conclusion The study reveals insights into stigmatization associated with CL in the Habuna area of Saudi Arabia. It found that the median of perceived social stigma was 26. Factors such as sex, employment status, and location of the lesion are uncertainly associated with stigma. It is crucial to explore negative behaviors and perceptions and develop suitable health education programs.
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Affiliation(s)
- Nahid K Elfaki
- Department of Community and Mental Health Nursing, College of Nursing, Najran University, Najran, Saudi Arabia
| | | | - Yahya Hussein Ahmed Abdalla
- Department of Community and Mental Health Nursing, College of Nursing, Najran University, Najran, Saudi Arabia
| | - Abdullah I Adeh
- Internal Medicine Department, College of Medicine, Najran University, Najran, Saudi Arabia
| | | | - Mugahed A Alkhadher
- Medical- Surgical Nursing Department, College of Nursing, Najran University, Najran, Saudi Arabia
| | - Samah R Elrefaey
- Department of Community and Mental Health Nursing, College of Nursing, Najran University, Najran, Saudi Arabia
| | | | - Faroq Alshameri
- Nursing Department, Faculty of Medical Sciences and Nursing, Alrayan Colleges, Almadina, Saudi Arabia
| | | | | | | | - Yagoub Hamadt Allah Elhaj
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha, Saudi Arabia
| | | | | | | | | | - Elwaleed Idris Sagiron
- Department of Community and Mental Health Nursing, College of Nursing, Najran University, Najran, Saudi Arabia
| | - Maha Hamed Mohamed Ali
- Department of Community and Mental Health Nursing, College of Nursing, Najran University, Najran, Saudi Arabia
- Public Health Department, Faculty of Applied Medical Sciences, King Khalid University, Khamis Mushait Aseer, Saudi Arabia
| | - Waled A M Ahmed
- Faculty of Nursing, Al-Baha University, Al-Baha, Saudi Arabia
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Chrysant SG. Effects of physical activity on sleep quality and wellbeing. Hosp Pract (1995) 2024; 52:13-18. [PMID: 38407170 DOI: 10.1080/21548331.2024.2320069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/12/2024] [Indexed: 02/27/2024]
Abstract
Physical activity (PA) has pluripotential beneficial effects on body functions. These benefits include reduction in the incidence of cardiovascular disease (CVD), coronary heart disease (CHD), hypertension, type 2 diabetes mellitus (T2DM), and death. In addition to these effects, PA exerts significant beneficial effects on sleep onset, duration and quality, which add to its beneficial effects. In contrast, lack of sleep has been associated with increased incidence of CVD complications and death. In this regard, PA serves as a non-pharmacologic means for sleep improvement especially in older people, who frequently have difficulties in falling asleep. Regarding the timing of exercise and its effect on sleep, there has been no difference between morning and evening exercise on the onset and quality of sleep. With respect the beneficial cardiovascular effects of PA on sleep, there has been a debate among several investigators with some reporting significant beneficial effects of PA, and others reporting not significant beneficial effects. In order to get a better perspective on the effects of PA on quality of sleep, and its cardiovascular beneficial effects, a Medline search of the English literature was conducted between 2017 and 2023 using the terms exercise, sleep, cardiovascular disease, death and 36 pertinent papers were selected (Figure 1). The findings from these papers together with collateral literature will be discussed in this review.
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Affiliation(s)
- Steven G Chrysant
- Department of Cardiology, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA
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Martins Teixeira C, Bressan J, Carla Gualandi Leal A, Ribeiro SAV, Lopes Juvanhol L, Marçal Pimenta A, Hermsdorff HHM. Higher caffeine consumption is associated with insufficient sleep time in Brazilian adults (CUME study). Int J Food Sci Nutr 2023:1-9. [PMID: 37905496 DOI: 10.1080/09637486.2023.2267793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 10/02/2023] [Indexed: 11/02/2023]
Abstract
We aimed to evaluate the association between caffeine intake and sleep time in Brazilian adults. This cross-sectional study was conducted with 6,356 participants from the Cohort of Universities of Minas Gerais (CUME Study). Data was collected through an online self-report questionnaire. Of the total, 31.9% of the participants had insufficient sleep. Women were found to sleep less than men (64.1 vs. 35.9%; p < 0.001), as well as being more likely to consume higher doses of caffeine (55.2%, p < 0.001). Coffee (35.7%), dark chocolate (25.2%), milk chocolate (15.2%), and diet soda (11.0%) were the foods that more contributed to caffeine intake. Individuals in the highest quartile of caffeine intake (87.0 - 572.0 mg/day) had a 19% higher prevalence of insufficient sleep compared with the lowest quartile (PR: 1.19; 95%CI: 1.08 - 1.31). Future studies are needed to investigate the genetic and hormonal factors involved in the interindividual response in this population.
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Affiliation(s)
- Carolynne Martins Teixeira
- Department of Nutrition and Health, Laboratory of Energy Metabolism and Body Composition, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Josefina Bressan
- Department of Nutrition and Health, Laboratory of Energy Metabolism and Body Composition, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Arieta Carla Gualandi Leal
- Department of Nutrition and Health, Laboratory of Energy Metabolism and Body Composition, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Sarah Aparecida Vieira Ribeiro
- Department of Nutrition and Health, Laboratory of Nutritional Epidemiology, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Leidjaira Lopes Juvanhol
- Department of Nutrition and Health, Laboratory of Nutritional Epidemiology, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | | | - Helen Hermana Miranda Hermsdorff
- Department of Nutrition and Health, Laboratory of Energy Metabolism and Body Composition, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
- Institute of Public Policies and Sustainable Development, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
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Hagos B, Zerihun Z. 'Self-stigma' of people with cutaneous leishmaniasis the unrecognized one: what do we think; what do we know; what can we prove? Int J Equity Health 2023; 22:180. [PMID: 37670383 PMCID: PMC10478415 DOI: 10.1186/s12939-023-01998-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/25/2023] [Indexed: 09/07/2023] Open
Abstract
Cutaneous leishmaniasis (CL) refers to a group of parasitic infections caused by the protozoan parasite Leishmania spp. Lack of knowledge and awareness regarding this disease creates a burden for patients with CL to deal with self-stigma. The aim of this ethnographic study is to provide an analysis of self-stigma experienced by patients with CL through an in-depth understanding of the self-stigma experienced by patients with cutaneous leishmaniasis. A qualitative data analysis approach was used for this study. Semi-structured interviews and participant observation were conducted with 33 individuals with CL, and data were analyzed using a thematic analysis method. Interviews revealed that individuals with CL experience severe self-stigma. The participants spoke of their struggle to live with physical appearances that differed from societal norms. Furthermore, they also highlighted that people with CL are often viewed as unclean and contagious, which further adds to their self-stigma. Fear of social exclusion often forced individuals with CL to isolate themselves, leading to a detrimental impact on their mental health and quality of life. This study provides valuable insights into the experiences of patients with CL who are subjected to self-stigma. The findings suggest that the lack of knowledge and the considerable misconceptions surrounding CL create barriers for patients to deal with the condition and the self-stigma attached to it. To address this issue, there is a need for dedicated public health campaigns and health education that increase awareness about CL and provide appropriate support and care for those affected.
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Affiliation(s)
- Binega Hagos
- Department of Social work, Mekelle University, Tigrai, Mekelle, Ethiopia.
| | - Zenawi Zerihun
- Department of Psychology, Mekelle University, Tigrai, Mekelle, Ethiopia
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Aribisala BS, Valdés Hernández MDC, Okely JA, Cox SR, Ballerini L, Dickie DA, Wiseman SJ, Riha RL, Muñoz Maniega S, Radakovic R, Taylor A, Pattie A, Corley J, Redmond P, Bastin ME, Deary I, Wardlaw JM. Sleep quality, perivascular spaces and brain health markers in ageing - A longitudinal study in the Lothian Birth Cohort 1936. Sleep Med 2023; 106:123-131. [PMID: 37005116 DOI: 10.1016/j.sleep.2023.03.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/07/2023] [Accepted: 03/11/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Sleep is thought to play a major role in brain health and general wellbeing. However, few longitudinal studies have explored the relationship between sleep habits and imaging markers of brain health, particularly markers of brain waste clearance such as perivascular spaces (PVS), of neurodegeneration such as brain atrophy, and of vascular disease, such as white matter hyperintensities (WMH). We explore these associations using data collected over 6 years from a birth cohort of older community-dwelling adults in their 70s. METHOD We analysed brain MRI data from ages 73, 76 and 79 years, and self-reported sleep duration, sleep quality and vascular risk factors from community-dwelling participants in the Lothian Birth Cohort 1936 (LBC1936) study. We calculated sleep efficiency (at age 76), quantified PVS burden (at age 73), and WMH and brain volumes (age 73 to 79), calculated the white matter damage metric, and used structural equation modelling (SEM) to explore associations and potential causative pathways between indicators related to brain waste cleaning (i.e., sleep and PVS burden), brain and WMH volume changes during the 8th decade of life. RESULTS Lower sleep efficiency was associated with a reduction in normal-appearing white matter (NAWM) volume (β = 0.204, P = 0.009) from ages 73 to 79, but not concurrent volume (i.e. age 76). Increased daytime sleep correlated with less night-time sleep (r = -0.20, P < 0.001), and with increasing white matter damage metric (β = -0.122, P = 0.018) and faster WMH growth (β = 0.116, P = 0.026). Shorter night-time sleep duration was associated with steeper 6-year reduction of NAWM volumes (β = 0.160, P = 0.011). High burden of PVS at age 73 (volume, count, and visual scores), was associated with faster deterioration in white matter: reduction of NAWM volume (β = -0.16, P = 0.012) and increasing white matter damage metric (β = 0.37, P < 0.001) between ages 73 and 79. On SEM, centrum semiovale PVS burden mediated 5% of the associations between sleep parameters and brain changes. CONCLUSION Sleep impairments, and higher PVS burden, a marker of impaired waste clearance, were associated with faster loss of healthy white matter and increasing WMH in the 8th decade of life. A small percentage of the effect of sleep in white matter health was mediated by the burden of PVS consistent with the proposed role for sleep in brain waste clearance.
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Affiliation(s)
- Benjamin S Aribisala
- Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK; Department of Computer Science, Lagos State University, Lagos, Nigeria
| | - Maria Del C Valdés Hernández
- Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute Centre at the University of Edinburgh, UK
| | - Judith A Okely
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Simon R Cox
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Lucia Ballerini
- Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | | | - Stewart J Wiseman
- Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute Centre at the University of Edinburgh, UK
| | - Renata L Riha
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK; Department of Sleep Medicine, Royal Infirmary of Edinburgh, NHS Lothian, UK
| | - Susana Muñoz Maniega
- Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute Centre at the University of Edinburgh, UK
| | - Ratko Radakovic
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK; Faculty of Health and Medical Sciences, University of East Anglia, Norwich, UK; Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK; Euan MacDonald Centre for MND Research, University of Edinburgh, Edinburgh, UK
| | - Adele Taylor
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Alison Pattie
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Janie Corley
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Paul Redmond
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Mark E Bastin
- Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Ian Deary
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Joanna M Wardlaw
- Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute Centre at the University of Edinburgh, UK.
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Timing of Meals and Sleep in the Mediterranean Population: The Effect of Taste, Genetics, Environmental Determinants, and Interactions on Obesity Phenotypes. Nutrients 2023; 15:nu15030708. [PMID: 36771415 PMCID: PMC9921798 DOI: 10.3390/nu15030708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/20/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023] Open
Abstract
Circadian rhythms regulate the sleep-wake and feeding-fasting cycles. Sleep and feeding constitute a complex cycle that is determined by several factors. Despite the importance of sleep duration and mealtimes for many obesity phenotypes, most studies on dietary patterns have not investigated the contribution of these variables to the phenotypes analyzed. Likewise, they have not investigated the factors related to sleep or mealtimes. Thus, our aims were to investigate the link between taste perception and eating/sleep patterns and to analyze the effect of the interactions between sleep/meal patterns and genetic factors on obesity phenotypes. We conducted a cross-sectional analysis on 412 adults from the Mediterranean population. We measured taste perception (bitter, sweet, salty, sour, and umami) and assessed sleep duration and waketime. The midpoint of sleep and social jetlag was computed. From the self-reported timing of meals, we estimated the eating window, eating midpoint, and eating jetlag. Adherence to the Mediterranean diet was measured with a validated score. Selected polymorphisms in the TAS2R38, CLOCK, and FTO genes were determined, and their associations and interactions with relevant phenotypes were analyzed. We found various associations between temporal eating, sleep patterns, and taste perception. A higher bitter taste perception was associated with an earlier eating midpoint (p = 0.001), breakfast time (p = 0.043), dinner time (p = 0.009), waketime (p < 0.001), and midpoint of sleep (p = 0.009). Similar results were observed for the bitter taste polymorphism TAS2R38-rs713598, a genetic instrumental variable for bitter perception, increasing the causality of the associations. Moreover, significant gene-sleep interactions were detected between the midpoint of sleep and the TAS2R38-rs713598 (p = 0.032), FTO-rs9939609 (p = 0.037), and CLOCK-rs4580704 (p = 0.004) polymorphisms which played a role in determining obesity phenotypes. In conclusion, our study provided more information on the sleep and mealtime patterns of the general Spanish Mediterranean population than on their main relationships. Moreover, we were able to show significant associations between taste perception, specifically bitter taste; sleep time; and mealtimes as well as an interaction between sleep time and several genetic variants linked to obesity phenotypes. However, additional research is needed to better characterize the causality and mechanisms behind these associations.
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Ayanampudi V, Kumar V, Krishnan A, Walker MP, Ivry RB, Knight RT, Gurumoorthy R. Personalized transcranial alternating current stimulation improves sleep quality: Initial findings. Front Hum Neurosci 2023; 16:1066453. [PMID: 36704097 PMCID: PMC9872012 DOI: 10.3389/fnhum.2022.1066453] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
Insufficient sleep is a major health issue. Inadequate sleep is associated with an array of poor health outcomes, including cardiovascular disease, diabetes, obesity, certain forms of cancer, Alzheimer's disease, depression, anxiety, and suicidality. Given concerns with typical sedative hypnotic drugs for treating sleep difficulties, there is a compelling need for alternative interventions. Here, we report results of a non-invasive electrical brain stimulation approach to optimizing sleep involving transcranial alternating current stimulation (tACS). A total of 25 participants (mean age: 46.3, S.D. ± 12.4, 15 females) were recruited for a null-stimulation controlled (Control condition), within subjects, randomized crossed design, that included two variants of an active condition involving 15 min pre-sleep tACS stimulation. To evaluate the impact on sleep quality, the two active tACS stimulation conditions were designed to modulate sleep-dependent neural activity in the theta/alpha frequency bands, with both stimulation types applied to all subjects in separate sessions. The first tACS condition used a fixed stimulation pattern across all participants, a pattern composed of stimulation at 5 and 10 Hz. The second tACS condition used a personalized stimulation approach with the stimulation frequencies determined by each individual's peak EEG frequencies in the 4-6 Hz and 9-11 Hz bands. Personalized tACS stimulation increased sleep quantity (duration) by 22 min compared to a Control condition (p = 0.04), and 19 min compared to Fixed tACS stimulation (p = 0.03). Fixed stimulation did not significantly increase sleep duration compared to Control (mean: 3 min; p = 0.75). For sleep onset, the Personalized tACS stimulation resulted in reducing the onset by 28% compared to the Fixed tACS stimulation (6 min faster, p = 0.02). For a Poor Sleep sub-group (n = 13) categorized with Clinical Insomnia and a high insomnia severity, Personalized tACS stimulation improved sleep duration by 33 min compared to Fixed stimulation (p = 0.02), and 30 min compared to Control condition (p < 0.1). Together, these results suggest that Personalized stimulation improves sleep quantity and time taken to fall asleep relative to Control and Fixed stimulation providing motivation for larger-scale trials for Personalized tACS as a sleep therapeutic, including for those with insomnia.
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Affiliation(s)
| | - V. Kumar
- StimScience Inc., Berkeley, CA, United States
| | - A. Krishnan
- StimScience Inc., Berkeley, CA, United States
| | - M. P. Walker
- Department of Psychology, Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, United States
| | - R. B. Ivry
- Department of Psychology, Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, United States
| | - R. T. Knight
- Department of Psychology, Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, United States
| | - R. Gurumoorthy
- StimScience Inc., Berkeley, CA, United States,*Correspondence: R. Gurumoorthy,
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Habitual Sleep Patterns and Chronic Sleep Problems in Relation to Sex, Age, and Circadian Preference in a Population-Based Sample of Norwegian Adults. Clocks Sleep 2023; 5:21-33. [PMID: 36648942 PMCID: PMC9844397 DOI: 10.3390/clockssleep5010003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/23/2022] [Accepted: 12/30/2022] [Indexed: 01/11/2023] Open
Abstract
Sleep patterns and problems vary in relation to internal (e.g., sex, age, circadian preference) and external (e.g., social structures) factors. The main aim of the present study was to describe habitual sleep patterns and chronic sleep problems in a population-based sample of Norwegian adults. During spring 2022, a sample of 1028 adults completed an online survey on sleep habits and problems. Response rate was 33.5%. The survey included the Munich ChronoType Questionnaire and items on circadian preference and chronic sleep problems. Mean workday sleep duration was 7:19 h (±199 min), and shorter in males (p = 0.035) and evening persons (p = 0.003). Short workday sleep duration (<6 h) was reported by 3.1% and was associated with evening preference (p = 0.001). Mean social jetlag was 0:51 h (±75 min), and longer in males (p = 0.036), younger adults (p < 0.001) and evening persons (p < 0.001). Long social jetlag (≥2 h) was reported by 11.2% and associated with younger age (p < 0.001) and evening preference (p < 0.001). Chronic sleep problems (≥3 months) were reported by 44.1%, and associated with female sex (p < 0.001) and evening preference (p = 0.002). Results underscore the importance of considering evening circadian preference as a risk factor for short workday sleep duration, long social jetlag and self-reported chronic sleep problems.
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12
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Ruan H, Zheng Y, Yang J, Li L, Zhang M, Wang Z, He S. Changes in daily sleep duration and subsequent risk of mortality among older people. Sleep Med 2023; 101:252-259. [PMID: 36455297 DOI: 10.1016/j.sleep.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/30/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Single self-reported measures of daily sleep duration are associated with adverse health outcomes; however, the association between changes in daily sleep duration and all-cause mortality has not been thoroughly evaluated among a large group of older people. METHODS Using data from the Chinese Longitudinal Healthy Longevity Surveys, a total of 8588 older participants were included in the present study. Changes in daily sleep duration were assessed using annual changes, and Cox regression analysis examined the association of the annual changes with mortality. RESULTS The median age of the study population was 82.00 (IQR: 72.00, 90.00) years, and 3974 (46.27%) participants were men. During a median follow-up period of 3.81 (IQR: 2.03, 6.74) years, 5100 (59.39%) deaths were recorded. After adjusting for initial daily sleep duration and other confounders, there was a non-linear relationship between annual changes in daily sleep duration and all-cause mortality. Annual changes were not associated with mortality before 0.0 h/year, and mortality risk increased after 0.0 h/year, specially after 1 h/year (adjusted HR: 1.32 per 1-hour/year increment, 95% CI: 1.18-1.47). Compared to the stable group (annual changes between -1 and 1 h), adjusted HRs for mortality were 0.98 (95% CI: 0.89-1.08) for the shorter group (annual decline more than 1 h) and 1.29 (95% CI: 1.19-1.41) for the longer group (annual increase greater than 1 h), respectively. Stratified and sensitivity analyses suggested robustness of the results. CONCLUSIONS The present study suggested there was a non-linear relationship between annual changes in daily sleep duration and all-cause mortality among older people: longer changes were associated with higher mortality; while, shorter changes were not associated with mortality. Specially, mortality risk increased significantly with longer than 1 h of annual changes. The findings highlight the importance of closely monitoring the changes in daily sleep duration among older people.
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Affiliation(s)
- Haiyan Ruan
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China; Department of Cardiology, Hospital of Traditional Chinese Medicine, Shuangliu District, Chengdu, China
| | - Yi Zheng
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Jing Yang
- Maternal and Child Health Hospital, Longquanyi District, Chengdu, China
| | - Liying Li
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Muxin Zhang
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China; Department of Cardiology, First People's Hospital, Longquanyi District, Chengdu, China
| | - Ziqiong Wang
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Sen He
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China.
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Shimizu Y, Yamamura R, Yokoi Y, Ayabe T, Ukawa S, Nakamura K, Okada E, Imae A, Nakagawa T, Tamakoshi A, Nakamura K. Shorter sleep time relates to lower human defensin 5 secretion and compositional disturbance of the intestinal microbiota accompanied by decreased short-chain fatty acid production. Gut Microbes 2023; 15:2190306. [PMID: 36945116 PMCID: PMC10038026 DOI: 10.1080/19490976.2023.2190306] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
Sleep is essential for our health. Short sleep is known to increase disease risks via imbalance of intestinal microbiota, dysbiosis. However, mechanisms by which short sleep induces dysbiosis remain unknown. Small intestinal Paneth cell regulates the intestinal microbiota by secreting antimicrobial peptides including α-defensin, human defensin 5 (HD5). Disruption of circadian rhythm mediating sleep-wake cycle induces Paneth cell failure. We aim to clarify effects of short sleep on HD5 secretion and the intestinal microbiota. Fecal samples and self-reported sleep time were obtained from 35 healthy middle-aged Japanese (41 to 60-year-old). Shorter sleep time was associated with lower fecal HD5 concentration (r = 0.354, p = 0.037), lower centered log ratio (CLR)-transformed abundance of short-chain fatty acid (SCFA) producers in the intestinal microbiota such as [Ruminococcus] gnavus group (r = 0.504, p = 0.002) and Butyricicoccus (r = 0.484, p = 0.003), and lower fecal SCFA concentration. Furthermore, fecal HD5 positively correlated with the abundance of these genera and SCFA concentration. These findings suggest that short sleep relates to disturbance of the intestinal microbiota via decreased HD5 secretion.
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Affiliation(s)
- Yu Shimizu
- Department of Cell Biological Science, Faculty of Advanced Life Science, Hokkaido University, Hokkaido, Japan
| | - Ryodai Yamamura
- Division of Biomedical Oncology, Institute for Genetic Medicine, Hokkaido University, Hokkaido, Japan
| | - Yuki Yokoi
- Department of Cell Biological Science, Faculty of Advanced Life Science, Hokkaido University, Hokkaido, Japan
| | - Tokiyoshi Ayabe
- Department of Cell Biological Science, Faculty of Advanced Life Science, Hokkaido University, Hokkaido, Japan
| | - Shigekazu Ukawa
- Department of Social Welfare Science and Clinical Psychology, Osaka Metropolitan University Graduate School of Human Life and Ecology, Osaka, Japan
| | - Koshi Nakamura
- Department of Public Health and Hygiene, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Emiko Okada
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | | | | | - Akiko Tamakoshi
- Department of Public Health, Faculty of Medicine, Hokkaido University, Hokkaido, Japan
| | - Kiminori Nakamura
- Department of Cell Biological Science, Faculty of Advanced Life Science, Hokkaido University, Hokkaido, Japan
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14
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Radmanish M, Khalfallah O, Glaichenhaus N, Forhan A, Heude B, Charles MA, Davidovic L, Plancoulaine S. Sleep duration trajectories associated with levels of specific serum cytokines at age 5: A longitudinal study in preschoolers from the EDEN birth cohort. Brain Behav Immun Health 2022; 21:100429. [PMID: 35243407 PMCID: PMC8881417 DOI: 10.1016/j.bbih.2022.100429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/02/2022] [Accepted: 02/07/2022] [Indexed: 12/31/2022] Open
Abstract
Sleep is essential for optimal child development and health during the life course. However, sleep disturbances are common in early childhood and increase the risk of cognitive, metabolic and inflammatory disorders throughout life. Sleep and immunity are mutually linked, and cytokines secreted by immune cells could mediate this interaction. The sleep modulation of cytokines has been studied mostly in adults and adolescents; few studies have focused on school-aged children and none on preschoolers. We hypothesized that night sleep duration affects cytokine levels in preschoolers. In a sample of 687 children from the EDEN French birth cohort, we studied the associations between night sleep duration trajectories from age to 2–5 years old and serum concentrations of four cytokines (Tumor necrosis factor α [TNF-α], Interleukin 6 [IL-6], IL-10, Interferon γ [IFN)-γ] at age 5, adjusting for relevant covariates. As compared with the reference trajectory (≈11h30/night sleep, 37.4% of children), a shorter sleep duration trajectory (<10 h/night, 4.5% of children), and changing sleep duration trajectory (≥11h30/night then 10h30/night, 5.6% of children) were associated with higher serum levels of IL-6 and TNF-α, respectively at age 5. We found no associations between sleep duration trajectories and IL-10 or IFN-γ levels. This first longitudinal study among children aged 2–5 years old suggests an impact of sleep duration on immune activity in early childhood. Our study warrants replication studies in larger cohorts to further explore whether and how immune activity interacts with sleep trajectories to enhance susceptibility to adverse health conditions.
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Affiliation(s)
| | - Olfa Khalfallah
- Université Cote d’Azur, Centre National de la Recherche Scientifique, Institut de Pharmacologie Moléculaire et Cellulaire, Valbonne, France
| | - Nicolas Glaichenhaus
- Université Cote d’Azur, Centre National de la Recherche Scientifique, Institut de Pharmacologie Moléculaire et Cellulaire, Valbonne, France
| | - Anne Forhan
- Université de Paris, CRESS, Inserm, INRAE, F-75004 Paris, France
| | - Barbara Heude
- Université de Paris, CRESS, Inserm, INRAE, F-75004 Paris, France
| | | | - Laetitia Davidovic
- Université Cote d’Azur, Centre National de la Recherche Scientifique, Institut de Pharmacologie Moléculaire et Cellulaire, Valbonne, France
| | - Sabine Plancoulaine
- Université de Paris, CRESS, Inserm, INRAE, F-75004 Paris, France
- Corresponding author. INSERM U1153, Team 6 EAROH, Address: 16 Avenue Paul Vaillant Couturier, 94807 Villejuif Cedex, France.
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15
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Langenberg SCN, Kocevska D, Luik AI. The multidimensionality of sleep in population‐based samples: a narrative review. J Sleep Res 2022; 31:e13608. [PMID: 35429087 PMCID: PMC9339471 DOI: 10.1111/jsr.13608] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 03/25/2022] [Accepted: 03/25/2022] [Indexed: 12/03/2022]
Abstract
The identification of optimal sleep duration recommendations for the general population has long been an important goal on the public health agenda, as both short and long sleep duration have been linked to unfavourable health outcomes. Yet, sleep is more than duration alone and can be described across multiple domains, such as timing, regularity, satisfaction, alertness, and efficiency. We reviewed observational population‐based studies that examined differences in age, sex, and origin across multiple dimensions of sleep. Reviewed literature suggests an increasing prevalence of insomnia symptoms, shorter and less deep sleep in old age. Overall, women report poorer sleep quality than men despite objective measures revealing shorter and more fragmented sleep in men. Minorities generally have poorer quantity and quality of sleep, but multi‐ethnic studies have reported mixed results regarding the subjective experience of sleep. In sum, effects of age, sex and origin differ across sleep dimensions, thereby suggesting that the multidimensionality of sleep and how these different aspects interact should be studied across individuals. Studies should include both self‐reported measures and objective assessments in diverse population‐based samples, as both aspects are important to understand sleep health in the general population. Data‐driven descriptions could provide researchers and clinicians with insights into how well individuals are sleeping and offer concrete targets for promotion of sleep health across the population.
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Affiliation(s)
| | - Desana Kocevska
- Department of Epidemiology Erasmus MC University Medical Center Rotterdam the Netherlands
- Department of Sleep and Cognition Netherlands Institute for Neuroscience Amsterdam the Netherlands
| | - Annemarie I. Luik
- Department of Epidemiology Erasmus MC University Medical Center Rotterdam the Netherlands
- Department of Child and Adolescent Psychiatry/Psychology Erasmus MC University Medical Center Rotterdam the Netherlands
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16
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Greenlund IM, Carter JR. Sympathetic neural responses to sleep disorders and insufficiencies. Am J Physiol Heart Circ Physiol 2022; 322:H337-H349. [PMID: 34995163 PMCID: PMC8836729 DOI: 10.1152/ajpheart.00590.2021] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Short sleep duration and poor sleep quality are associated with cardiovascular risk, and sympathetic nervous system (SNS) dysfunction appears to be a key contributor. The present review will characterize sympathetic function across several sleep disorders and insufficiencies in humans, including sleep deprivation, insomnia, narcolepsy, and obstructive sleep apnea (OSA). We will focus on direct assessments of sympathetic activation, e.g., plasma norepinephrine and muscle sympathetic nerve activity, but include heart rate variability (HRV) when direct assessments are lacking. The review also highlights sex as a key biological variable. Experimental models of total sleep deprivation and sleep restriction are converging to support several epidemiological studies reporting an association between short sleep duration and hypertension, especially in women. A systemic increase of SNS activity via plasma norepinephrine is present with insomnia and has also been confirmed with direct, regionally specific evidence from microneurographic studies. Narcolepsy is characterized by autonomic dysfunction via both HRV and microneurographic studies but with opposing conclusions regarding SNS activation. Robust sympathoexcitation is well documented in OSA and is related to baroreflex and chemoreflex dysfunction. Treatment of OSA with continuous positive airway pressure results in sympathoinhibition. In summary, sleep disorders and insufficiencies are often characterized by sympathoexcitation and/or sympathetic/baroreflex dysfunction, with several studies suggesting women may be at heightened risk.
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Affiliation(s)
- Ian M. Greenlund
- 1Department of Health and Human Development, Montana State University, Bozeman, Montana,2Department of Psychology, Montana State University, Bozeman, Montana
| | - Jason R. Carter
- 1Department of Health and Human Development, Montana State University, Bozeman, Montana,2Department of Psychology, Montana State University, Bozeman, Montana
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Influence of Sleep Characteristic Changes on Nurses' Quality of Life during Their Transition to Practice: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010573. [PMID: 35010831 PMCID: PMC8744848 DOI: 10.3390/ijerph19010573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/22/2021] [Accepted: 12/31/2021] [Indexed: 12/13/2022]
Abstract
Aim: To explore the effect of changes in sleep characteristics on changes in quality of life during the transition period of new graduate nurses. Background: Sleep problems among nurses are associated with negative physical and psychological consequences. Methods: This prospective cohort study was conducted at a tertiary hospital in South Korea. Participants included 88 newly graduated nurses. Data were collected twice, prior to shift work and after 4 months of working as a nurse, via online structured self-report questionnaires created using Survey Monkey from March 2018 to February 2020. A generalized linear mixed model was used to analyze the influence of changes in sleep characteristics on quality of life. Results: A generalized linear mixed model showed that changes in the subjective quality of sleep, subjective health perception, and daytime dysfunction influenced quality of life changes during the transition. This implies that deterioration already existed. From their undergraduate period to four months after they began working as nurses, a significant decrease was observed in the quality of sleep. Participants’ quality of life significantly decreased. Conclusions: Changes in the quality of life of new graduate nurses may show deterioration with a significant drop in subjective sleep quality. Institutions should improve existing work adaptation programs provided during new graduate nurses’ transition to practice by including information on changes in nurses’ health caused by changes in sleep characteristics and sleep quality.
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18
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Matias I, Daza EJ, Wac K. What possibly affects nighttime heart rate? Conclusions from N-of-1 observational data. Digit Health 2022; 8:20552076221120725. [PMID: 36046637 PMCID: PMC9421014 DOI: 10.1177/20552076221120725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/02/2022] [Indexed: 11/15/2022] Open
Abstract
Background Heart rate (HR), especially at nighttime, is an important biomarker for cardiovascular health. It is known to be influenced by overall physical fitness, as well as daily life physical or psychological stressors like exercise, insufficient sleep, excess alcohol, certain foods, socialization, or air travel causing physiological arousal of the body. However, the exact mechanisms by which these stressors affect nighttime HR are unclear and may be highly idiographic (i.e. individual-specific). A single-case or “ n-of-1” observational study (N1OS) is useful in exploring such suggested effects by examining each subject's exposure to both stressors and baseline conditions, thereby characterizing suggested effects specific to that individual. Objective Our objective was to test and generate individual-specific N1OS hypotheses of the suggested effects of daily life stressors on nighttime HR. As an N1OS, this study provides conclusions for each participant, thus not requiring a representative population. Methods We studied three healthy, nonathlete individuals, collecting the data for up to four years. Additionally, we evaluated model-twin randomization (MoTR), a novel Monte Carlo method facilitating the discovery of personalized interventions on stressors in daily life. Results We found that physical activity can increase the nighttime heart rate amplitude, whereas there were no strong conclusions about its suggested effect on total sleep time. Self-reported states such as exercise, yoga, and stress were associated with increased (for the first two) and decreased (last one) average nighttime heart rate. Conclusions This study implemented the MoTR method evaluating the suggested effects of daily stressors on nighttime heart rate, sleep time, and physical activity in an individualized way: via the N-of-1 approach. A Python implementation of MoTR is freely available.
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Affiliation(s)
- Igor Matias
- Quality of Life Technologies Lab, Center for Informatics, University of Geneva, Geneva, Switzerland
| | | | - Katarzyna Wac
- Quality of Life Technologies Lab, Center for Informatics, University of Geneva, Geneva, Switzerland
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