1
|
Chen L, Nini W, Jinmei Z, Jingmei Y. Implications of sleep disorders for periodontitis. Sleep Breath 2023; 27:1655-1666. [PMID: 36547852 DOI: 10.1007/s11325-022-02769-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/14/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Periodontitis is a chronic inflammatory disease caused by multi-factors. Sleep is a natural physiologic process, and the sleep duration, quality, and patterns might be associated with periodontitis. Meanwhile, periodontitis might in turn induce systemic inflammation and thus impact sleep in different ways as well. METHODS To investigate the bidirectional relationship between sleep disorder and periodontitis, a literature search was conducted to reveal the interaction and possible mechanism between these two diseases. RESULTS The results show that sleep disorders can affect the progression of periodontitis via some pathomechanisms, and periodontitis also has a reverse impact on sleep. CONCLUSION Although the epidemiologic and clinical trials found the possible associations between sleep disorder and periodontitis, their relationship is still not that explicit. Further studies are warranted to shed light on them, to improve preventive health care.
Collapse
Affiliation(s)
- Li Chen
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Disease, Department of Periodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, China
| | - Wang Nini
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Disease, Department of Periodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, China
| | - Zhang Jinmei
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Disease, Department of Periodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, China
| | - Yang Jingmei
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Disease, Department of Periodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, China.
| |
Collapse
|
2
|
Salwen-Deremer JK, Ballou S. Painful GI Conditions and Their Bidirectional Relationships with Sleep Disturbances. CURRENT SLEEP MEDICINE REPORTS 2022. [DOI: 10.1007/s40675-022-00230-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
3
|
Besedovsky L, Dang R, Engert LC, Goldstein MR, Devine JK, Bertisch SM, Mullington JM, Simpson N, Haack M. Differential effects of an experimental model of prolonged sleep disturbance on inflammation in healthy females and males. PNAS NEXUS 2022; 1:pgac004. [PMID: 36380854 PMCID: PMC9648610 DOI: 10.1093/pnasnexus/pgac004] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/04/2022] [Accepted: 01/19/2022] [Indexed: 11/29/2022]
Abstract
Sleep disturbances, including disrupted sleep and short sleep duration, are highly prevalent and are prospectively associated with an increased risk for various widespread diseases, including cardiometabolic, neurodegenerative, chronic pain, and autoimmune diseases. Systemic inflammation, which has been observed in populations experiencing sleep disturbances, may mechanistically link disturbed sleep with increased disease risks. To determine whether sleep disturbances are causally responsible for the inflammatory changes reported in population-based studies, we developed a 19-day in-hospital experimental model of prolonged sleep disturbance inducing disrupted and shortened sleep. The model included delayed sleep onset, frequent nighttime awakenings, and advanced sleep offset, interspersed with intermittent nights of undisturbed sleep. This pattern aimed at providing an ecologically highly valid experimental model of the typical sleep disturbances often reported in the general and patient populations. Unexpectedly, the experimental sleep disturbance model reduced several of the assessed proinflammatory markers, namely interleukin(IL)-6 production by monocytes and plasma levels of IL-6 and C-reactive protein (CRP), presumably due to intermittent increases in the counterinflammatory hormone cortisol. Striking sex differences were observed with females presenting a reduction in proinflammatory markers and males showing a predominantly proinflammatory response and reductions of cortisol levels. Our findings indicate that sleep disturbances causally dysregulate inflammatory pathways, with opposing effects in females and males. These results have the potential to advance our mechanistic understanding of the pronounced sexual dimorphism in the many diseases for which sleep disturbances are a risk factor.
Collapse
Affiliation(s)
- Luciana Besedovsky
- Harvard Medical School, Boston, MA 02115, USA
- Department of Neurology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Dana 779, Boston, MA 02215, USA
- Institute of Medical Psychology, Ludwig-Maximilians-Universität München, 80336 Munich, Germany
| | - Rammy Dang
- Department of Neurology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Dana 779, Boston, MA 02215, USA
| | - Larissa C Engert
- Harvard Medical School, Boston, MA 02115, USA
- Department of Neurology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Dana 779, Boston, MA 02215, USA
| | - Michael R Goldstein
- Harvard Medical School, Boston, MA 02115, USA
- Department of Neurology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Dana 779, Boston, MA 02215, USA
| | - Jaime K Devine
- Institutes for Behavior Resources, Inc., Baltimore, MD 21218, USA
| | - Suzanne M Bertisch
- Harvard Medical School, Boston, MA 02115, USA
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Janet M Mullington
- Harvard Medical School, Boston, MA 02115, USA
- Department of Neurology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Dana 779, Boston, MA 02215, USA
| | - Norah Simpson
- Stanford Sleep Heath and Insomnia Program, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA 94305, USA
| | - Monika Haack
- Harvard Medical School, Boston, MA 02115, USA
- Department of Neurology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Dana 779, Boston, MA 02215, USA
| |
Collapse
|
4
|
Khurana S, Soda N, Shiddiky MJA, Nayak R, Bose S. Current and future strategies for diagnostic and management of obstructive sleep apnea. Expert Rev Mol Diagn 2021; 21:1287-1301. [PMID: 34747304 DOI: 10.1080/14737159.2021.2002686] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Obstructive sleep apnea (OSA) is a common sleep disorder with multiple comorbidities including hypertension, diabetes, and cardiovascular disorders. Detected based on an overnight sleep study is called polysomnography (PSG); OSA still remains undiagnosed in majority of the population mainly attributed to lack of awareness. To overcome the limitations posed by PSG such as patient discomfort and overnight hospitalization, newer technologies are being explored. In addition, challenges associated with current management of OSA using continuous positive airway pressure (CPAP), etc. presents several pitfalls. AREAS COVERED Conventional and modern detection/management techniques including PSG, CPAP, smart wearable/pillows, bio-motion sensors, etc., have both pros and cons. To fulfill the limitations in OSA diagnostics, there is an imperative need for new technology for screening of symptomatic and more importantly asymptomatic OSA patients to reduce the risk of several associated life-threatening comorbidities. In this line, molecular marker-based diagnostics have shown great promises. EXPERT OPINION A detailed overview is presented on the OSA management and diagnostic approaches and recent advances in the molecular screening methods. The potentials of biomarker-based detection and its limitations are also portrayed and a comparison between the standard, current modern approaches, and promising futuristic technologies for OSA diagnostics and management is set forth.ABBREVIATIONS AHI: Apnea hypopnea index; AI: artificial intelligence; CAM: Cell adhesion molecules; CPAP: Continuous Positive Airway Pressure; COVID-19: Coronavirus Disease 2019; CVD: Cardiovascular disease; ELISA: Enzyme linked immunosorbent assay; HSAT: Home sleep apnea testing; IR-UWB: Impulse radio-ultra wideband; MMA: maxillomandibular advancement; PSG: Polysomnography; OSA: Obstructive sleep apnea; SOD: Superoxide dismutase; QD: Quantum dot.
Collapse
Affiliation(s)
- Sartaj Khurana
- Amity Institute of Biotechnology, Amity University Uttar Pradesh, Noida, India.,Amity Institute of Molecular Medicine and Stem Cell Research, Amity University Uttar Pradesh, Noida, India
| | - Narshone Soda
- Queensland Micro- and Nanotechnology Centre (Qmnc) and School of Environment and Science (ESC), Griffith University, Brisbane, Australia
| | - Muhammad J A Shiddiky
- Queensland Micro- and Nanotechnology Centre (Qmnc) and School of Environment and Science (ESC), Griffith University, Brisbane, Australia
| | - Ranu Nayak
- Amity Institute of Nanotechnology, Amity University Uttar Pradesh, Noida, India
| | - Sudeep Bose
- Amity Institute of Biotechnology, Amity University Uttar Pradesh, Noida, India.,Amity Institute of Molecular Medicine and Stem Cell Research, Amity University Uttar Pradesh, Noida, India
| |
Collapse
|
5
|
Manolis TA, Manolis AA, Apostolopoulos EJ, Melita H, Manolis AS. Cardiovascular Complications of Sleep Disorders: A Better Night's Sleep for a Healthier Heart / From Bench to Bedside. Curr Vasc Pharmacol 2021; 19:210-232. [PMID: 32209044 DOI: 10.2174/1570161118666200325102411] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/26/2020] [Accepted: 02/26/2020] [Indexed: 12/27/2022]
Abstract
Sleep is essential to and an integral part of life and when lacking or disrupted, a multitude of mental and physical pathologies ensue, including cardiovascular (CV) disease, which increases health care costs. Several prospective studies and meta-analyses show that insomnia, short (<7h) or long (>9h) sleep and other sleep disorders are associated with an increased risk of hypertension, metabolic syndrome, myocardial infarction, heart failure, arrhythmias, CV disease risk and/or mortality. The mechanisms by which insomnia and other sleep disorders lead to increased CV risk may encompass inflammatory, immunological, neuro-autonomic, endocrinological, genetic and microbiome perturbations. Guidelines are emerging that recommend a target of >7 h of sleep for all adults >18 years for optimal CV health. Treatment of sleep disorders includes cognitive-behavioral therapy considered the mainstay of non-pharmacologic management of chronic insomnia, and drug treatment with benzodiazepine receptor agonists binding to gamma aminobutyric acid type A (benzodiazepine and non-benzodiazepine agents) and some antidepressants. However, observational studies and meta-analyses indicate an increased mortality risk of anxiolytics and hypnotics, although bias may be involved due to confounding and high heterogeneity in these studies. Nevertheless, it seems that the risk incurred by the non-benzodiazepine hypnotic agents (Z drugs) may be relatively less than the risk of anxiolytics, with evidence indicating that at least one of these agents, zolpidem, may even confer a lower risk of mortality in adjusted models. All these issues are herein reviewed.
Collapse
|
6
|
Lee HW, Yoon HS, Yang JJ, Song M, Lee JK, Lee SA, Choi JY, Kang D. Association of sleep duration and quality with elevated hs-CRP among healthy Korean adults. PLoS One 2020; 15:e0238053. [PMID: 32841297 PMCID: PMC7446961 DOI: 10.1371/journal.pone.0238053] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 08/08/2020] [Indexed: 01/21/2023] Open
Abstract
This study aimed to investigate the association of sleep duration and quality with high-sensitivity C-reactive protein (hs-CRP) among middle-aged and elderly Koreans. Among a total of 74,867 participants (25,069 men and 49,798 women) recruited for the Health Examinees (HEXA) study, adjusted geometric means of hs-CRP level were compared across categories of sleep duration (<6, 6–7, 8–9, and ≥10 hours) and sleep quality (difficulty in initiating sleep and maintaining sleep) using ANCOVA models. Odds ratios (ORs) and 95% confidence intervals (CIs) for elevated hs-CRP (>3 mg/L) associated with sleep characteristics were estimated using multivariable-adjusted logistic regression models. Men who slept ≥10 hours per day were significantly associated with elevated hs-CRP (OR = 1.47, 95% CI 1.11–1.95). Whereas in women, difficulty in initiating sleep (OR = 1.28, 95% CI 1.04–1.57 for “Always”), and maintaining sleep was significantly associated with elevated hs-CRP levels (OR = 1.13, 95% CI 1.02–1.26 for “Often”; OR = 1.11, 95% CI 0.97–1.28 for “Always”). Additionally, women who experienced poor sleep quality presented an elevated level of hs-CRP (OR = 1.13, 95% CI 1.03–1.23). Our findings suggest that excessive sleep duration and poor sleep quality are significantly associated with the elevated inflammatory marker, specifically hs-CRP. Further research is needed to examine the effect of sleep interventions focused on these factors.
Collapse
Affiliation(s)
- Hwi-Won Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Hyung-Suk Yoon
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Jeong Yang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Minkyo Song
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jong-koo Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sang-Ah Lee
- Department of Preventive Medicine, Kangwon National University School of Medicine, Gangwon, Korea
| | - Ji-Yeob Choi
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
- * E-mail:
| |
Collapse
|
7
|
Patel SP, Khanna R, Choi J, Williams KA, Roh YS, Hong MS, Sutaria NH, Pritchard T, Kwatra MM, Kwatra SG. Sleep disturbance in adults with chronic pruritic dermatoses is associated with increased C-reactive protein levels. J Am Acad Dermatol 2020; 84:265-272. [PMID: 32822785 DOI: 10.1016/j.jaad.2020.08.059] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 07/13/2020] [Accepted: 08/07/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Pruritus is a common symptom that can significantly reduce quality of life through sleep disruption. OBJECTIVE To examine features of disturbed sleep in patients with chronic pruritic dermatoses and test the hypothesis that systemic inflammation may serve as a biomarker for impaired sleep in these patients. METHODS Cross-sectional analysis of the National Health and Nutrition Examination Survey investigating systemic inflammation using C-reactive protein (CRP) levels. Logistic regression was used to compare patients with and without sleep disturbances, adjusting for demographics (model 1) and medical comorbidities (model 2). RESULTS Chronic pruritic dermatoses were associated with multiple sleep disturbances, including nighttime awakenings (model 1: odds ratio [OR], 1.646; 95% confidence interval [CI], 1.031-2.627; model 2: OR, 1.329; 95% CI, 0.888-1.989) and early morning awakening (model 1: OR, 1.669, 95% CI, 1.118-2.493; model 2: OR, 1.582; 95% CI, 1.008-2.481). Mean CRP levels were 52.8% higher among patients with pruritic dermatoses reporting trouble sleeping compared with those who did not (0.663 vs 0.434 mg/dL; P = .034). Trouble sleeping was also positively correlated with CRP levels (β = 0.142, P = .025). LIMITATIONS Potential recall bias among participants. CONCLUSIONS In addition to confirming sleep disturbances with pruritic dermatoses, we found these disturbances are more likely to present with elevated CRP levels. Clinicians should consider the potential risk for sleep-related and cardiac comorbidities in patients diagnosed with itchy skin conditions.
Collapse
Affiliation(s)
- Sagar P Patel
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Raveena Khanna
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Creighton University School of Medicine, Omaha, Nebraska
| | - Justin Choi
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kyle A Williams
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Youkyung S Roh
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Michael S Hong
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nishadh H Sutaria
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Thomas Pritchard
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Madan M Kwatra
- Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - Shawn G Kwatra
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
| |
Collapse
|
8
|
Mayat Z, Giardina EGV, Liao M, Aggarwal B. Associations of Inflammation, Physical Activity, and Sleep in a Diverse Population of Women. J Womens Health (Larchmt) 2020; 29:1007-1016. [PMID: 32175800 DOI: 10.1089/jwh.2019.7663] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background: Cardiovascular disease (CVD) is the leading cause of mortality in United States with a recent rise seen in young adults, particularly women. Systemic inflammation, physical activity, and sleep are each individually linked to CVD risk. Whether there is an interaction of these variables, however, is unclear. We evaluated physical activity and sleep among racially ethnically diverse women, ages 20-79 years, to assess associations with systemic inflammation. Methods: We performed a cross-sectional study of 506 women (61% racial/ethnic minority; mean (standard deviation [SD]) age = 37 [15.7] years, body mass index 26.0 [5.7] kg/m2) enrolled in the American Heart Association (AHA) Go Red for Women Strategically Focused Research Network at Columbia University Irving Medical Center (CUIMC). Inflammation, assessed by C-reactive protein (CRP), was analyzed in the Biomarkers Core Laboratory at CUIMC. Physical activity and sleep were assessed using validated questionnaires. Multivariable models adjusted for demographic and clinical confounders were used to evaluate associations between CRP, physical activity, and sleep. Results: Mean (SD) physical activity was 282 (557.2) minutes/week, and mean (SD) sleep duration was 6.75 (1.24) hours/night. Mean CRP was 2.08 (3.56), and 17% of participants were categorized as high risk for obstructive sleep apnea (OSA). Participants who slept <6 hours/night were less likely to be physically active ≥150 minutes/week (odds ratios, ORs [95% confidence interval, CI]: 0.53 [0.33-0.84]). This association was nonsignificant after adjustment. High risk of OSA was associated with CRP ≥2 mg/L (OR [95% CI]: 1.91 [1.11-3.30]) following adjustment. Stratification by race/ethnicity showed that high risk of OSA was associated with CRP ≥2 mg/L among racial/ethnic minorities but not white women (OR [95% CI]: 2.75 [1.43-5.30] vs. 0.94 [0.31-2.88]). Conclusion: High risk of OSA and elevated CRP was significantly associated in women, particularly minority women. Both play a role in CVD, highlighting potential causes for the increased risk of CVD in younger women.
Collapse
Affiliation(s)
- Zara Mayat
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Elsa-Grace V Giardina
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Ming Liao
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Brooke Aggarwal
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| |
Collapse
|
9
|
Iyegha ID, Chieh AY, Bryant BM, Li L. Associations between poor sleep and glucose intolerance in prediabetes. Psychoneuroendocrinology 2019; 110:104444. [PMID: 31546116 PMCID: PMC6981225 DOI: 10.1016/j.psyneuen.2019.104444] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/11/2019] [Accepted: 09/11/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVES A cross-sectional study was designed to investigate the association between sleep quality and glucose metabolism among people with prediabetes, and to explore the potential pathways linking poor sleep to glucose intolerance. METHODS One hundred fifty-five females and males, Caucasians and African Americans, aged 19-70 completed the study for data analysis. All participants were assessed for sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Fasting glucose and 2-h glucose levels were collected via a 2-h oral glucose tolerance test (OGTT) and used to define prediabetes. Participants provided blood samples for measuring inflammatory markers. Associations were conducted using Pearson's correlation with adjustments for gender, age, and body mass index (BMI). Analysis of covariance (ANCOVA) was applied to compare the two groups, prediabetes group versus the control group, after controlling for gender, age, and BMI. Regression was used to investigate predictive power of sleep subscales for inflammatory factors and glucose levels. RESULTS More people with prediabetes suffered from poor sleep than in the normal glucose group (62% vs. 46%). The OGTT measures, i.e. fasting glucose and 2-h glucose levels, correlated with PSQI measures, but these associations did not maintain statistical significance after adjusting for gender, age, and BMI. The C-reactive protein (CRP) levels were greater in the prediabetes group than the normal glucose group (0.37 ± 0.07 vs. 0.18 ± 0.06 mg/L). Additionally, there was a positive correlation between sleep disturbance and CRP levels (r = 0.30, p = 0.04). Regression analysis found that sleep disturbance predicted CRP levels and significance remained after adding covariates (β = 0.20, p = 0.04). No significant difference was observed in other measured inflammatory factors, including interleukin (IL)-6, IL-8, IL-10 and tumor necrosis factor alpha (TNFα), between the two groups. CONCLUSION Prediabetes is positively associated with poor sleep. Increased CRP levels may be a potential underlying mechanism of this association between prediabetes and poor sleep which warrants further study. Our findings highlight the importance for clinicians to evaluate sleep quality as part of preventing the onset of future diabetes in this particular population.
Collapse
Affiliation(s)
| | | | | | - Li Li
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, 35294, United States of America.
| |
Collapse
|
10
|
Beydoun HA, Hossain S, Beydoun MA, Weiss J, Zonderman AB, Eid SM. Periodontal disease, sleep duration, and white blood cell markers in the 2009 to 2014 National Health and Nutrition Examination Surveys. J Periodontol 2019; 91:582-595. [PMID: 31554016 DOI: 10.1002/jper.19-0055] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 08/22/2019] [Accepted: 09/23/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Elevated levels of inflammatory biomarkers are consistently associated with chronic conditions, for which periodontitis and sleep are established risk factors. We examined the relationships between periodontitis, hours of sleep and white blood cell (WBC) markers among a nationally representative sample of US adults. METHODS Cross-sectional study using existing demographic, examination, laboratory and questionnaire data on 11,813 participants (5,814 men and 5,999 women, mean age ± SE; range: 52.74 ± 0.24; 30 to 80 years) from the 2009 to 2014 National Health and Nutrition Examination Surveys. Unadjusted, sex- and age-adjusted, as well as fully adjusted linear and logistic regression models were conducted in addition to generalized structural equations models, while considering sampling design complexity. β, odds ratios with their 95% confidence intervals, indirect effects and mediation proportions were estimated. RESULTS The weighted mean WBC count was 7,130 cells/µL, with the WBC 5-part differential estimated in terms of percentages of lymphocytes (29.50%), monocytes (7.99%), neutrophils (59.03%), eosinophils (2.84%), and basophils (71.88%). Furthermore, 36.2% of participants reported <7 hours of sleep and 49.8% had periodontitis. In fully adjusted models controlling for sociodemographic, lifestyle, and health characteristics, neither WBC markers nor periodontitis were related to hours of sleep. By contrast, periodontitis was directly related to WBC count and %neutrophils and inversely related to %lymphocytes, especially among men. However, the relationship of periodontitis with %neutrophils and %lymphocytes may be modified by hours of sleep, as it was specific to individuals reporting ≥7 hours of sleep. CONCLUSION Periodontitis may be directly related to WBC count and %neutrophils and inversely related to %lymphocytes, especially among men and individuals reporting ≥7 hours of sleep, with implications for primary and secondary prevention.
Collapse
Affiliation(s)
- Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA
| | - Sharmin Hossain
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | - May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | - Jordan Weiss
- Population Studies Center and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | - Shaker M Eid
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD
| |
Collapse
|
11
|
Besedovsky L, Lange T, Haack M. The Sleep-Immune Crosstalk in Health and Disease. Physiol Rev 2019; 99:1325-1380. [PMID: 30920354 PMCID: PMC6689741 DOI: 10.1152/physrev.00010.2018] [Citation(s) in RCA: 636] [Impact Index Per Article: 127.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 02/08/2023] Open
Abstract
Sleep and immunity are bidirectionally linked. Immune system activation alters sleep, and sleep in turn affects the innate and adaptive arm of our body's defense system. Stimulation of the immune system by microbial challenges triggers an inflammatory response, which, depending on its magnitude and time course, can induce an increase in sleep duration and intensity, but also a disruption of sleep. Enhancement of sleep during an infection is assumed to feedback to the immune system to promote host defense. Indeed, sleep affects various immune parameters, is associated with a reduced infection risk, and can improve infection outcome and vaccination responses. The induction of a hormonal constellation that supports immune functions is one likely mechanism underlying the immune-supporting effects of sleep. In the absence of an infectious challenge, sleep appears to promote inflammatory homeostasis through effects on several inflammatory mediators, such as cytokines. This notion is supported by findings that prolonged sleep deficiency (e.g., short sleep duration, sleep disturbance) can lead to chronic, systemic low-grade inflammation and is associated with various diseases that have an inflammatory component, like diabetes, atherosclerosis, and neurodegeneration. Here, we review available data on this regulatory sleep-immune crosstalk, point out methodological challenges, and suggest questions open for future research.
Collapse
Affiliation(s)
- Luciana Besedovsky
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen , Tübingen , Germany ; Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School , Boston, Massachusetts ; and Department of Rheumatology and Clinical Immunology, University of Lübeck , Lübeck , Germany
| | - Tanja Lange
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen , Tübingen , Germany ; Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School , Boston, Massachusetts ; and Department of Rheumatology and Clinical Immunology, University of Lübeck , Lübeck , Germany
| | - Monika Haack
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen , Tübingen , Germany ; Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School , Boston, Massachusetts ; and Department of Rheumatology and Clinical Immunology, University of Lübeck , Lübeck , Germany
| |
Collapse
|
12
|
Rigobon AV, Kanagasabai T, Taylor VH. Obesity moderates the complex relationships between inflammation, oxidative stress, sleep quality and depressive symptoms. BMC OBESITY 2018; 5:32. [PMID: 30524737 PMCID: PMC6276225 DOI: 10.1186/s40608-018-0208-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 08/21/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND The relationship between obesity and depression is complex. This study assessed the impact of body mass index (BMI) on the link between BMI, inflammation, oxidative stress, sleep quality and self-reported depressive symptoms. METHODS We used data from the U.S. National Health and Nutritional Examination Survey 2005-2008 cycles (n = 9133; ≥20y). Depressive symptoms and sleep quality were determined from questionnaires. C-reactive Protein (CRP) was used as a biomarker of inflammation and γ-glutamyltransferase was used to assess oxidative stress. The relationship between depressive symptoms, sleep quality, and biomarkers were assessed with regression models. The moderating effects of BMI and sex were tested. RESULTS BMI was a significant moderator of the relationship between γ-glutamyltransferase and depressive symptoms (p = 0.02), but not CRP or sleep quality. Higher BMI increased odds of depressive symptoms in women (OR (95% CI): 3.92 (1.85-8.30) for BMI ≥25 to < 30 kg/m2; 3.17 (1.53-6.58) for BMI ≥30 to < 35 kg/m2; and 7.38 (2.11-25.76) for BMI ≥35 kg/m2). BMI was also a significant moderator of γ-glutamyltransferase levels in those with vs without depressive symptoms. Those with depressive symptoms had 24% poorer sleep quality compared to those without depressive symptoms after adjusting for inflammation, oxidative stress and other confounders. CONCLUSIONS The link between oxidative stress and depressive symptoms may be particularly relevant for females and people living with obesity. People with depressive symptoms also have a substantial reduction in sleep quality. Thus, research should examine these relationships prospectively to inform and improve the mental health of the adult population in developed countries.
Collapse
Affiliation(s)
| | - Thirumagal Kanagasabai
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Valerie H. Taylor
- Women’s College Research Institute, University of Toronto, Toronto, Canada
- Women’s College Hospital, 76 Grenville Street Room E947, Toronto, ON M5S 1B2 Canada
| |
Collapse
|
13
|
Dennis JA, Alazzeh A, Kumfer AM, McDonald-Thomas R, Peiris AN. The Association of Unreported Sleep Disturbances and Systemic Inflammation: Findings from the 2005-2008 NHANES. SLEEP DISORDERS 2018; 2018:5987064. [PMID: 30402295 PMCID: PMC6198565 DOI: 10.1155/2018/5987064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 08/15/2018] [Accepted: 09/24/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND/OBJECTIVE Sleep apnea is associated with elevated inflammatory markers. A subgroup of patients never report sleep disturbances to their physician. The inflammatory status of this subgroup is not known. The present study aims to evaluate two inflammatory markers, C-reactive protein (CRP) and red cell distribution width (RDW), in those with unreported sleep disturbances and compares these findings to those with and without reported sleep disorders. We also investigate the utility of RDW as an inflammatory marker in sleep disorders. METHODS Sample includes 9,901 noninstitutionalized, civilian, nonpregnant adults from the 2005-2008 National Health and Nutrition Examination Survey, a nationally representative, cross-sectional U.S. study. Sleep questionnaire and laboratory data were used to compare inflammatory markers (CRP and RDW) in five subgroups of individuals: reporting physician-diagnosed sleep apnea, reporting another physician-diagnosed sleep disorder, reported sleep disturbance to physician with no resulting diagnosis, unreported sleep disturbance (poor sleep quality not reported to physician), and no diagnosed sleep disorder or sleep disturbance. RESULTS Individuals with unreported sleep disturbance had significantly higher odds of elevated RDW (>13.6%) when compared to those without a sleep disturbance in adjusted models (OR=1.33). Those with unreported sleep disturbance had significantly higher odds of elevated CRP levels (>1 mg/L) than those without sleep disturbances (OR 1.34), although the association was not significant when adjusted for obesity and other controls. CONCLUSION Self-identified unreported sleep disturbances are associated with significantly higher odds of elevated RDW than those without sleep disturbances. RDW may serve as a valuable indicator in identifying individuals at higher risk for sleep apnea and other sleep disorders.
Collapse
Affiliation(s)
- Jeff A. Dennis
- Department of Public Health, Texas Tech University Health Sciences Center, 3601 4th St., MS 9430, Lubbock, TX 79430, USA
| | - Ahmad Alazzeh
- Department of Pulmonary and Critical Care, East Tennessee State University, Quillen College of Medicine, VA Bldg. 1, Johnson City, TN 37614-0622, USA
| | - Ann Marie Kumfer
- Department of Internal Medicine, Texas Tech University Health Sciences Center, 3601 4th St., MS 9410, Lubbock, TX 79430, USA
| | - Rebecca McDonald-Thomas
- Department of Internal Medicine, Texas Tech University Health Sciences Center, 3601 4th St., MS 9410, Lubbock, TX 79430, USA
| | - Alan N. Peiris
- Department of Internal Medicine, Texas Tech University Health Sciences Center, 3601 4th St., MS 9410, Lubbock, TX 79430, USA
- Clinical Research Institute, Texas Tech University Health Sciences Center, 3601 4th St., MS 8183, Lubbock, TX 79430, USA
| |
Collapse
|
14
|
Khurana S, Sharda S, Saha B, Kumar S, Guleria R, Bose S. Canvassing the aetiology, prognosis and molecular signatures of obstructive sleep apnoea. Biomarkers 2018; 24:1-16. [DOI: 10.1080/1354750x.2018.1514655] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Sartaj Khurana
- Amity Institute of Biotechnology, Amity University, Noida, India
| | - Shivani Sharda
- Amity Institute of Biotechnology, Amity University, Noida, India
| | - Biswajit Saha
- Amity Institute of Biotechnology, Amity University, Noida, India
| | - Sachin Kumar
- Department of Medical Oncology, IRCH, AIIMS, New Delhi, India
| | - Randeep Guleria
- Department of Pulmonary Medicine and Sleep Disorders, AIIMS, New Delhi, India
| | - Sudeep Bose
- Amity Institute of Biotechnology, Amity University, Noida, India
| |
Collapse
|
15
|
Short Sleep Duration Is Associated With Abnormal Serum Aminotransferase Activities and Nonalcoholic Fatty Liver Disease. Clin Gastroenterol Hepatol 2018; 16:588-590. [PMID: 28882688 DOI: 10.1016/j.cgh.2017.08.049] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 08/29/2017] [Accepted: 08/29/2017] [Indexed: 02/07/2023]
|
16
|
|
17
|
Benham G. The Association Between Body Mass Index and Sleep in a Predominantly Hispanic College Population. HISPANIC JOURNAL OF BEHAVIORAL SCIENCES 2017. [DOI: 10.1177/0739986317707721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
An association between inadequate sleep and body mass index (BMI) has been demonstrated in previous studies, but there is a relative paucity of data from Latino/Hispanic populations. In the present study, 750 college students, 93% of whom were Hispanic, completed an online survey that included standardized measures of sleep quantity, sleep quality, and insomnia. BMI was significantly higher in those who had inadequate sleep quantity, in those with poor sleep quality, and in those who experienced insomnia. Our results extend previous research, demonstrating an association between BMI and three measures of sleep in a predominantly Hispanic college student sample.
Collapse
Affiliation(s)
- Grant Benham
- The University of Texas Rio Grande Valley, Edinburg, USA
| |
Collapse
|
18
|
Huang WY, Huang CC, Chang CC, Kor CT, Chen TY, Wu HM. Associations of Self-Reported Sleep Quality with Circulating Interferon Gamma-Inducible Protein 10, Interleukin 6, and High-Sensitivity C-Reactive Protein in Healthy Menopausal Women. PLoS One 2017; 12:e0169216. [PMID: 28060925 PMCID: PMC5218483 DOI: 10.1371/journal.pone.0169216] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 12/13/2016] [Indexed: 02/07/2023] Open
Abstract
Introduction Sleep disturbance is very common in menopausal women and poor sleep quality has been linked to systemic inflammation. However, the impact of poor sleep quality on health outcomes of menopausal women remains unclear. This study evaluated the relationships between sleep quality and inflammation in menopausal women. Participants and design This cross-sectional study enrolled 281 healthy women aged 45 to 60 years. The Pittsburgh Sleep Quality Index (PSQI) was used to measure quality of sleep. Multiplex assays were used to measure the levels of 9 cytokines in morning fasting plasma samples. Other variables measured in this study included clinical characteristics and high-sensitivity C-reactive protein (hs-CRP). Setting The study was performed at a medical center. Results The 281 participants comprised 79 (28%) perimenopausal women and 202 (72%) postmenopausal women. Global PSQI scores were positively correlated with plasma hs-CRP levels (P = 0.012) and were marginally associated with interferon gamma-inducible protein-10 (IP10), interleukin 6 (IL6), and macrophage inflammatory protein-1beta (MIP-1β) levels. After adjusting for age, body mass index, menopause duration, and follicle stimulating hormone, multiple linear regression analysis revealed that high PSQI scores and sleep efficiency < 65% were associated with elevated plasma levels of hs-CRP, IP10, and IL6. In addition, sleep duration < 5 hours was associated with high hs-CRP levels. Conclusion Our data show that poor sleep quality and low sleep efficiency are associated with elevated levels of circulating inflammatory factors IP10, IL6 and hs-CRP and that short sleep duration is associated with high levels of hs-CRP in menopausal women. These findings provide novel evidence that poor sleep quality is linked to low-grade systemic inflammation in menopausal women.
Collapse
Affiliation(s)
- Wan-Yu Huang
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Cheng Huang
- Department of Obstetrics & Gynecology, Changhua Christian Hospital, Changhua, Taiwan
| | - Chia-Chu Chang
- Department of Nephrology, Changhua Christian Hospital, Changhua, Taiwan
| | - Chew-Teng Kor
- Division of statistics, Internal Medicine Research Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Ting-Yu Chen
- Inflammation Research & Drug Development Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Hung-Ming Wu
- Inflammation Research & Drug Development Center, Changhua Christian Hospital, Changhua, Taiwan
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
- Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan
- * E-mail:
| |
Collapse
|
19
|
Twig G, Shina A, Afek A, Derazne E, Tzur D, Cukierman-Yaffe T, Shechter-Amir D, Gerstein HC, Tirosh A. Sleep quality and risk of diabetes and coronary artery disease among young men. Acta Diabetol 2016; 53:261-70. [PMID: 26077170 DOI: 10.1007/s00592-015-0779-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 05/26/2015] [Indexed: 12/24/2022]
Abstract
AIMS To assess the time-dependent effect of sleep quality on diabetes and coronary artery disease (CAD) incidence among young adults. METHODS Incident rates of diabetes and CAD during a mean follow-up of 6.4 ± 4.1 years were assessed among 26,023 men (mean age 30.9 ± 5.6 years) of the Metabolic Lifestyle and Nutrition Assessment in Young Adults stratified by sleep quality at baseline, as assessed by the Mini-Sleep Questionnaire (MSQ). Incident diabetes and CAD were analyzed using a Cox proportional hazard model. RESULTS There were 445 cases of diabetes and 92 cases of CAD during 151,312 person-years. An abnormal MSQ score was associated with a 53 % higher incidence of diabetes (95 % CI 1.22-1.94, p < 0.001) compared to those with a normal score, after adjustment for clinical and biochemical diabetes risk factors. The increased risk associated with abnormal sleep quality remained when MSQ was modeled as a continuous time-dependent variable in a multivariable model (HR = 1.036, 95 % CI 1.024-1.049, p < 0.001). The increased risk was higher among overweight or obese participants (BMI and MSQ interaction p = 0.046). Sustained abnormality in MSQ score resulted in higher HR for diabetes (2.35; 95 % CI 1.564-3.519, p < 0.001). In addition, abnormal sleep quality was associated with a 2.38 higher incidence of CAD (95 % CI 1.38-4.11, p = 0.002), after adjustment for traditional clinical and biochemical risk factors. CONCLUSIONS Sleep quality contributes to the development of diabetes and CAD in apparently healthy young adults in a time-dependent manner. The use of a simple questionnaire to assess sleep quality may be a useful tool for risk stratification in this population.
Collapse
Affiliation(s)
- Gilad Twig
- Department of Medicine B, Sheba Medical Center, 52621, Ramat Gan, Israel.
- The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Ramat Gan, Israel.
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel.
| | - Avi Shina
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel
| | - Arnon Afek
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Israel Ministry of Health, Jerusalem, Israel
| | - Estela Derazne
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dorit Tzur
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Tali Cukierman-Yaffe
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Center for Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Ramat Gan, Israel
| | | | - Hertzel C Gerstein
- Division of Endocrinology and Metabolism, and Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Amir Tirosh
- The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Ramat Gan, Israel
- The Center for Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Ramat Gan, Israel
- The Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
20
|
Beydoun HA, Beydoun MA, Jeng HA, Zonderman AB, Eid SM. Bisphenol-A and Sleep Adequacy among Adults in the National Health and Nutrition Examination Surveys. Sleep 2016; 39:467-76. [PMID: 26446109 DOI: 10.5665/sleep.5466] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 08/14/2015] [Indexed: 12/14/2022] Open
Abstract
STUDY OBJECTIVES To evaluate bisphenol-A (BPA) level and its relationship to sleep adequacy in a nationally representative sample of U.S. adults. METHODS A population-based cross-sectional study was conducted using 2005-2010 National Health and Nutrition Examination Survey whereby data were collected using in-person interviews, physical examination and laboratory testing. BPA level was measured in urine samples and analyzed as loge-transformed variable and in quartiles (< 0.9 ng/mL; 0.9 to < 1.9 ng/mL; 1.9 to < 3.7 ng/mL; 3.7+ ng/mL). Sleep adequacy was operationalized with three questions: "How much sleep do you usually get at night on weekdays or workdays?", "Have you ever told a doctor or other health professionals that you have trouble sleeping?" and "Have you ever been told by a doctor or other health professional that you have a sleep disorder?" Sleep duration was further categorized as (< 6 h, ≥ 6 h); (< 7 h, 7-8 h, > 8 h); (< 5 h, 5-6 h, 7-8 h, ≥ 9 h). Linear, binary, and ordinal logistic regression models were constructed. RESULTS Loge-transformed BPA level was inversely related to sleep duration defined, in hours, as a continuous variable, a dichotomous variable (≥ 6, < 6), or an ordinal variable (≥ 9, 7-8, 5-6, < 5), after adjustment for confounders. Help-seeking behavior for sleep problems and diagnosis with sleep disorders were not significantly associated with loge-transformed BPA level in fully adjusted models. CONCLUSIONS Loge-transformed BPA level may be associated with fewer hours of sleep among U.S. adults, with implications for prevention. Further research involving diverse populations are needed to confirm these study findings.
Collapse
Affiliation(s)
- Hind A Beydoun
- Graduate Program in Public Health, Eastern Virginia Medical School, Norfolk, VA
| | - May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD
| | - Hueiwang Anna Jeng
- Department of Community & Environmental Health, Old Dominion University, Norfolk, VA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD
| | - Shaker M Eid
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| |
Collapse
|
21
|
Ramtahal R, Khan C, Maharaj-Khan K, Nallamothu S, Hinds A, Dhanoo A, Yeh HC, Hill-Briggs F, Lazo M. Prevalence of self-reported sleep duration and sleep habits in type 2 diabetes patients in South Trinidad. J Epidemiol Glob Health 2015; 5:S35-43. [PMID: 26073574 PMCID: PMC4666733 DOI: 10.1016/j.jegh.2015.05.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 04/24/2015] [Accepted: 05/10/2015] [Indexed: 01/26/2023] Open
Abstract
The present study aims to determine the prevalence of self-reported sleep duration and sleep habits and their associated factors in patients with type 2 diabetes in Trinidad. This was a cross-sectional multicenter study. There were 291 patients with type 2 diabetes studied. Sleep habits were assessed using the Epworth Sleepiness Scale (ESS) and the National Health and Nutrition Examination Survey sleep disorder questionnaire. Demographic, anthropometric and biochemical data were also collected. The sample had a mean age of 58.8 years; 66.7% were female. The mean BMI was 28.9 kg/m(2). The prevalence of Excessive Daytime Sleepiness (EDS) was 11.3%. The prevalence of patients with short sleep (⩽6h) was 28.5%. The prevalence of patients with poor sleep was 63.9%. Poor sleep was associated with age, intensive anti-diabetic treatment and longer duration of diabetes. Short sleep was associated with intensive anti-diabetic treatment and BMI, while EDS was associated with increased BMI. In a sample of patients with type 2 diabetes, a high prevalence of self-reported sleep duration and unhealthy sleep habits was found. There needs to be an increased awareness of sleep conditions in adults with type 2 diabetes by doctors caring for these patients.
Collapse
Affiliation(s)
- Rishi Ramtahal
- South West Regional Health Authority, Trinidad and Tobago; Trinidad and Tobago Health Sciences Initiative, Johns Hopkins Medicine International and Government of the Republic of Trinidad and Tobago, Trinidad and Tobago.
| | - Claude Khan
- South West Regional Health Authority, Trinidad and Tobago
| | | | | | - Avery Hinds
- Trinidad and Tobago Health Sciences Initiative, Johns Hopkins Medicine International and Government of the Republic of Trinidad and Tobago, Trinidad and Tobago; Communicable Diseases and Emergency Response Department, Surveillance, Disease-Prevention and Control Division, Caribbean Public Health Agency, Trinidad and Tobago
| | - Andrew Dhanoo
- Trinidad and Tobago Health Sciences Initiative, Johns Hopkins Medicine International and Government of the Republic of Trinidad and Tobago, Trinidad and Tobago; Department of Life Sciences, Faculty of Science and Technology, University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Hsin-Chieh Yeh
- Trinidad and Tobago Health Sciences Initiative, Johns Hopkins Medicine International and Government of the Republic of Trinidad and Tobago, Trinidad and Tobago; Department of Medicine, Division of General Internal Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Felicia Hill-Briggs
- Trinidad and Tobago Health Sciences Initiative, Johns Hopkins Medicine International and Government of the Republic of Trinidad and Tobago, Trinidad and Tobago; Department of Medicine, Division of General Internal Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Mariana Lazo
- Trinidad and Tobago Health Sciences Initiative, Johns Hopkins Medicine International and Government of the Republic of Trinidad and Tobago, Trinidad and Tobago; Department of Medicine, Division of General Internal Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| |
Collapse
|
22
|
Inflammation, Oxidative Stress, and Antioxidants Contribute to Selected Sleep Quality and Cardiometabolic Health Relationships: A Cross-Sectional Study. Mediators Inflamm 2015; 2015:824589. [PMID: 26568665 PMCID: PMC4629050 DOI: 10.1155/2015/824589] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 09/21/2015] [Indexed: 12/14/2022] Open
Abstract
Sleep is vital for cardiometabolic health, but a societal shift toward poor sleep is a prominent feature of many modern cultures. Concurrently, factors such as diet and lifestyle have also changed and may mediate the relationship between sleep quality and cardiometabolic health. Objectives were to explore (1) the interrelationship and (2) mediating effect of inflammation, oxidative stress, and antioxidants on sleep quality and cardiometabolic health. Cross-sectional data from the US National Health and Nutritional Examination Survey 2005-06 (≥20 y; N = 2,072) was used. Cardiometabolic health was defined as per the Joint Interim Statement; overall sleep quality was determined from six sleep habits and categorized as good, fair, poor, and very poor. Fair quality sleepers had optimal inflammation, oxidative stress, and antioxidant levels. Inflammation was above the current clinical reference range across all sleep quality categories, while oxidative stress was only within the clinical reference range for fair sleep quality. Selected sleep quality-cardiometabolic health relationships were mediated by inflammation, oxidative stress, and antioxidants and were moderated by sex. Our results provide initial evidence of a potential role for inflammation, oxidative stress, and antioxidants in the pathway between poor sleep quality-cardiometabolic decline. Further prospective research is needed to confirm our results.
Collapse
|
23
|
Morgenthaler TI, Croft JB, Dort LC, Loeding LD, Mullington JM, Thomas SM. Development of the National Healthy Sleep Awareness Project Sleep Health Surveillance Questions. J Clin Sleep Med 2015; 11:1057-62. [PMID: 26235156 DOI: 10.5664/jcsm.5026] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 07/20/2015] [Indexed: 11/13/2022]
Abstract
OBJECTIVES For the first time ever, as emphasized by inclusion in the Healthy People 2020 goals, sleep health is an emphasis of national health aims. The National Healthy Sleep Awareness Project (NHSAP) was tasked to propose questions for inclusion in the next Behavioral Risk Factor Surveillance System (BRFSS), a survey that includes a number of questions that target behaviors thought to impact health, as a means to measure community sleep health. The total number of questions could not exceed five, and had to include an assessment of the risk for obstructive sleep apnea (OSA). METHODS An appointed workgroup met via teleconference and face-to-face venues to develop an inventory of published survey questions being used to identify sleep health, to develop a framework on which to analyze the strengths and weaknesses of current survey questions concerning sleep, and to develop recommendations for sleep health and disease surveillance questions going forward. RESULTS The recommendation was to focus on certain existing BRFSS questions pertaining to sleep duration, quality, satisfaction, daytime alertness, and to add to these other BRFSS existing questions to make a modified STOP-BANG questionnaire (minus the N for neck circumference) to assess for risk of OSA. CONCLUSIONS Sleep health is an important dimension of health that has previously received less attention in national health surveys. We believe that 5 questions recommended for the upcoming BRFSS question banks will assist as important measures of sleep health, and may help to evaluate the effectiveness of interventions to improve sleep health in our nation.
Collapse
Affiliation(s)
| | - Janet B Croft
- Centers for Disease Control and Prevention, Atlanta, GA
| | | | | | | | | |
Collapse
|
24
|
Fields AJ, Hoyt RE, Linnville SE, Moore JL. Physical activity, sleep, and C-reactive protein as markers of positive health in resilient older men. J Health Psychol 2015; 21:1928-38. [PMID: 25673372 DOI: 10.1177/1359105314568578] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This study explored whether physical activity and sleep, combined with the biomarker C-reactive protein, indexed positive health in older men. Many were former prisoners of war, with most remaining psychologically resilient and free of any psychiatric diagnoses. Activity and sleep were recorded through actigraphy in 120 veterans (86 resilient and 34 nonresilient) for 7 days. Resilient men had higher physical activity, significantly lower C-reactive protein levels, and 53 percent had lower cardiac-disease risk compared to nonresilient men. Sleep was adequate and not associated with C-reactive protein. Results suggest continued study is needed in actigraphy and C-reactive protein as means to index positive health.
Collapse
Affiliation(s)
| | - Robert E Hoyt
- Robert E. Mitchell Center for Prisoner of War Studies, USA
| | | | | |
Collapse
|
25
|
|