1
|
Kikuti-Koyama KA, Lemes ÍR, de Morais LC, Monteiro HL, Turi-Lynch BC, Fernandes RA, Codogno JS. Combined association of insufficient physical activity and sleep problems with healthcare costs: a longitudinal study. SAO PAULO MED J 2024; 142:e2023241. [PMID: 38896745 PMCID: PMC11185864 DOI: 10.1590/1516-3180.2023.0241.r2.25032024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 02/26/2023] [Accepted: 03/25/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND The magnitude of economic losses attributed to sleep problems and insufficient physical activity (PA) remains unclear. This study aimed to investigate the association between insufficient PA, sleep problems, and direct healthcare costs. OBJECTIVE To investigate the association between insufficient physical activity (PA), sleep problems, and direct healthcare costs among adults. DESIGN AND SETTING Adults aged ≥ 50 years attended by the Brazilian National Health Service were tracked from 2010 to 2014. METHODS Direct healthcare costs were assessed using medical records and expressed in US$. Insufficient PA and sleep problems were assessed through face-to-face interviews. Differences were identified using the analysis of covariance and variance for repeated measures. RESULTS In total, 454 women and 166 men were enrolled. Sleep problems were reported by 28.9% (95%CI: 25.2% to 32.4%) of the sample, while insufficient PA was reported by 84.8% (95%CI: 82.1% to 87.6%). The combination of sleep problems and insufficient PA explained 2.3% of all healthcare costs spent on these patients from 2010 to 2014, which directly accounts for approximately US$ 4,765.01. CONCLUSION The combination of sleep problems and insufficient PA plays an important role in increasing direct healthcare costs in adults. Public health stakeholders, policymakers, and health professionals can use these results to reinforce the need for strategies to improve sleep quality and increase PA, especially in nations that finance their National Health Systems.
Collapse
Affiliation(s)
- Kelly Akemi Kikuti-Koyama
- Student, Department of Physical Education, Laboratory of InVestigation in Exercise (LIVE), Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil
| | - Ítalo Ribeiro Lemes
- Assistant Professor, Physiotherapy Department, Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil; Assistant Professor, Physiotherapy Department, Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), São Paulo (SP), Brazil
| | - Luana Carolina de Morais
- Student, Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil
| | - Henrique Luiz Monteiro
- Assistant Professor, Department of Physical Education, Universidade Estadual Paulista (UNESP), Bauru (SP), Brazil
| | - Bruna Camilo Turi-Lynch
- Assistant Professor, Physical Education and Exercise Science Department, Lander University, Greenwood, United States
| | - Rômulo Araújo Fernandes
- Associate Professor, Laboratory of InVestigation in Exercise – LIVE, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil
| | - Jamile Sanches Codogno
- Assistant Professor, Laboratory of InVestigation in Exercise – LIVE, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil
| |
Collapse
|
2
|
Qi X, Pan C, Yang J, Liu L, Hao J, Wen Y, Zhang N, Wei W, Cheng B, Cheng S, Zhang F. Disadvantaged social status contributed to sleep disorders: An observational and genome-wide gene-environment interaction analysis. Sleep Health 2024:S2352-7218(24)00059-7. [PMID: 38772848 DOI: 10.1016/j.sleh.2024.03.003] [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: 07/31/2023] [Revised: 01/23/2024] [Accepted: 03/13/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND Sleep is a natural and essential physiological need for individuals. Our study aimed to research the associations between accumulated social risks and sleep disorders. METHODS In this study, we came up with a polysocial risk score (PsRS), which is a cumulative social risk index composed of 13 social determinants of health. This research includes 239,165 individuals with sleep disorders and social determinants of health data from the UK Biobank cohort. First, logistic regression models were performed to examine the associations of social determinants of health and sleep disorders, including chronotype, narcolepsy, insomnia, snoring, short and long sleep duration. Then, PsRS was calculated based on statistically significant social determinants of health for each sleep disorder. Third, a genome-wide gene-environment interaction study was conducted to explore the interactions between single-nucleotide polymorphisms and PsRS in relation to sleep disorders. RESULTS Higher PsRS scores were associated with worse sleep status, with the adjusted odds ratio (OR) ranging from 1.10 (95% Confidence interval [CI]: 1.09-1.11) to 1.29 (95% CI: 1.27-1.30) for sleep disorders. Emotional stress (OR = 1.36, 95% CI: 1.28-1.43) and not in paid employment (OR = 2.62, 95% CI: 2.51-2.74) were found to have significant contributions for sleep disorders. Moreover, multiple single-nucleotide polymorphisms were discovered to have interactions with PsRS, such as FRAS1 (P = 2.57 × 10-14) and CACNA1A (P = 8.62 × 10-14) for narcolepsy, and ACKR3 (P = 1.24 × 10-8) for long sleep. CONCLUSIONS Our findings suggested that cumulative social risks was associated with sleep disorders, while the interactions between genetic susceptibility and disadvantaged social status are risk factors for the development of sleep disorders.
Collapse
Affiliation(s)
- Xin Qi
- Precision medicine center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
| | - Chuyu Pan
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Jin Yang
- Precision medicine center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China; Cancer Center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China; Department of Medical Oncology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
| | - Li Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Jingcan Hao
- Medical department, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Na Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Wenming Wei
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Bolun Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Shiqiang Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China.
| |
Collapse
|
3
|
Menezes-Júnior LAAD, de Moura SS, Miranda AG, de Souza Andrade AC, Machado-Coelho GLL, Meireles AL. Sedentary behavior is associated with poor sleep quality during the COVID-19 pandemic, and physical activity mitigates its adverse effects. BMC Public Health 2023; 23:1116. [PMID: 37308867 PMCID: PMC10258778 DOI: 10.1186/s12889-023-16041-8] [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: 01/06/2023] [Accepted: 06/02/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND We aimed to evaluate the association of sedentary behavior (SB) and moderate to vigorous leisure-time physical activity (MVPA) with sleep quality during the COVID-19 pandemic. METHODS Cross-sectional, population-based study in adults, conducted from October to December 2020 in the Iron Quadrangle region, Brazil. The outcome was sleep quality, evaluated with the Pittsburgh Sleep Quality Index. SB was assessed by self-report of total sitting time, before and during the pandemic. Individuals with ≥ 9 h of total sitting time were classified as SB. In addition, the ratio of time spent in MVPA to time in SB was analyzed. A contrasted directed acyclic graph (DAG) model was constructed to adjust logistic regression models. RESULTS A total of 1629 individuals were evaluated, the prevalence of SB before the pandemic was 11.3% (95%CI: 8.6-14.8), and during the pandemic 15.2% (95%CI: 12.1-18.9). In multivariate analysis, the chance of poor sleep quality was 77% higher in subjects with SB ≥ 9 h per day (OR: 1.77; 95% CI: 1.02-2.97). Furthermore, a one-hour increase in SB during the pandemic, increased the chance of poor sleep quality by 8% (OR: 1.08; 95%CI 1.01-1.15). In the analysis of the ratio of MVPA per SB in individuals with SB ≥ 9 h, practicing 1 min of MVPA per hour of SB reduces the chance of poor sleep quality by 19% (OR: 0.84; 95%CI: 0.73-0.98). CONCLUSION SB during the pandemic was a factor associated with poor sleep quality, and the practice of MVPA can reduce the effects of SB.
Collapse
Affiliation(s)
- Luiz Antônio Alves de Menezes-Júnior
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro, Preto, Ouro Preto, Minas Gerais, Brazil.
- Research and Study Group on Nutrition and Public Health (GPENSC), Federal University of Ouro Preto, Ouro Preto, Brazil.
| | - Samara Silva de Moura
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro, Preto, Ouro Preto, Minas Gerais, Brazil
- Research and Study Group on Nutrition and Public Health (GPENSC), Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Amanda Gonçalves Miranda
- Research and Study Group on Nutrition and Public Health (GPENSC), Federal University of Ouro Preto, Ouro Preto, Brazil
| | | | | | - Adriana Lúcia Meireles
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro, Preto, Ouro Preto, Minas Gerais, Brazil
- Research and Study Group on Nutrition and Public Health (GPENSC), Federal University of Ouro Preto, Ouro Preto, Brazil
- Department of Clinical and Social Nutrition, School of Nutrition, Federal University of Ouro, Preto, Ouro Preto, Minas Gerais, Brazil
| |
Collapse
|