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Tian H, Wang L, He Q, Xu X, Zhang Y, Yang J, Ye H, Jiang L. Association between sleep quality and cardiovascular disease in maintenance hemodialysis patients: a prospective cohort study. Ren Fail 2023; 45:2278310. [PMID: 37936488 PMCID: PMC10653692 DOI: 10.1080/0886022x.2023.2278310] [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: 05/10/2023] [Accepted: 10/29/2023] [Indexed: 11/09/2023] Open
Abstract
OBJECTIVE This study aimed to analyze the association between sleep quality and cardiovascular disease in patients on maintenance hemodialysis (MHD). METHODS A total of 601 patients with MHD in the second affiliated hospital of Nanjing Medical University, were prospectively enrolled in this cohort study from January 2019 to December2019. The global Pittsburgh sleep quality index (PSQI) score > 7 indicates that a person with poor sleep quality. Patients were divided into two groups according to the PSQI score. Follow-up was conducted about 3 years with all-cause death and major adverse cardiovascular events (MACEs) as the endpoint events. RESULTS Of the 601 patients, 595 patients completed the PSQI assessment, with 278 patients having poor sleep quality. Patients in the PSQI > 7 group were older and had a higher proportion of cardiovascular disease or diabetes. Years of education, diastolic blood pressure, and heart rate were lower in the PSQI > 7 group. At a mean follow-up period of 3 years, 116 patients died, 64 patients were lost to follow-up, and 115 patients experienced MACEs. After adjusting for confounding factors such as age, gender, dialysis age, and previous cardiovascular disease, the risk of MACE in patients with poor sleep quality was twice that of patients with good sleep quality (HR = 2.037 (1.339, 3.097), p = 0.001). There was no significant difference in the risk of all-cause death between the two groups. CONCLUSION The prevalence of poor sleep quality was 46.7% in patients with MHD. Poor sleep quality was an independent risk factor for MACEs in patients with MHD.
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Affiliation(s)
- Han Tian
- Center for Kidney Disease, The second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lulu Wang
- Center for Kidney Disease, The second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qingyun He
- Center for Kidney Disease, The second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xinxin Xu
- Center for Kidney Disease, The second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yan Zhang
- Center for Kidney Disease, The second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Junwei Yang
- Center for Kidney Disease, The second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hong Ye
- Center for Kidney Disease, The second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lei Jiang
- Center for Kidney Disease, The second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
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Izquierdo Coronel B, López Pais J, Nieto Ibáñez D, Olsen Rodríguez R, Galán Gil D, Perela Álvarez C, Abad Romero R, Álvarez Bello M, Martín Muñoz M, Espinosa Pascual MJ, Mata Caballero R, Fraile Sanz A, Awamleh García P, Fernández-Avilés F, Alonso Martín JJ. Prevalence and prognosis of anxiety, insomnia, and type D personality in patients with myocardial infarction: A Spanish cohort. Cardiol J 2023; 31:261-270. [PMID: 37067334 PMCID: PMC11076035 DOI: 10.5603/cj.a2023.0025] [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: 11/17/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND It has been suggested that patients with myocardial infarction and non-obstructive coronary arteries (MINOCA) have more psycho-emotional disorders than patients with obstructive coronary artery disease (MICAD). The aim of this study is to compare the prevalence of anxiety, insomnia, and type D personality between MINOCA and MICAD and their impact on prognosis. METHODS Patients with myocardial infarction undergoing coronary angiography were prospectively enrolled. Psychological questionnaires were completed by each patient during admission. RESULTS Among a total of 533 patients, 56 had MINOCA and 477 had MICAD. There were no differences in the prevalence of anxiety and insomnia between both groups: trait anxiety median value (M) MINOCA = 18 (11-34) vs. MICAD M = 19 (12-27), p = 0.8; state anxiety MINOCA M = 19 (11-29) vs. MICAD M = 19 (12.2-26), p = 0.6; and insomnia MINOCA M = 7 (3-11) vs. MICAD M = 7 (3-12), p = 0.95. More MINOCA patients had type D personality (45.0% vs. 28.5%, p = 0.03). At 3-year follow-up, there were no differences in mortality between MINOCA and MICAD (hazard ratio [HR] 0.78, 95% confidence interval [CI] 0.28-2.17) in major adverse cerebral or cardiovascular events (MACCE) (HR 0.71, 95% CI 0.38-1.31). Scores of trait anxiety and negative affectivity were significantly associated with MACCE (HR 1.65, 95% CI [1.05-2.57]; HR 1.75, 95% CI [1.11-2.77], respectively). High insomnia levels were associated with greater mortality (HR 2.72, 95% CI [1.12-6.61]). CONCLUSIONS Anxiety and insomnia levels were similar between patients with MINOCA and those with MICAD, whilst the prevalence of type D personality was higher in the MINOCA than in the MICAD group. Higher scores in trait anxiety, insomnia, and negative affectivity were related to a worse prognosis at 3-year follow-up.
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Affiliation(s)
| | | | | | | | - David Galán Gil
- Cardiology Department, 12 de Octubre University Hospital, Madrid, Spain
| | | | | | | | | | | | - Rebeca Mata Caballero
- Cardiology Department, Getafe University Hospital, Madrid, Spain
- European University of Madrid, Spain
| | - Alfonso Fraile Sanz
- Cardiology Department, Getafe University Hospital, Madrid, Spain
- European University of Madrid, Spain
| | | | - Francisco Fernández-Avilés
- Cardiology Department, Gregorio Marañón University Hospital, Madrid, Spain
- Complutense University of Madrid, Spain
| | - Joaquín J Alonso Martín
- Cardiology Department, Getafe University Hospital, Madrid, Spain
- European University of Madrid, Spain
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He L, Ma T, Cheng X, Bai Y. The association between sleep characteristics and the risk of all-cause mortality among individuals with cardiometabolic multimorbidity: a prospective study of UK Biobank. J Clin Sleep Med 2023; 19:651-658. [PMID: 36644852 PMCID: PMC10071379 DOI: 10.5664/jcsm.10404] [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: 08/20/2022] [Revised: 11/13/2022] [Accepted: 11/14/2022] [Indexed: 01/17/2023]
Abstract
STUDY OBJECTIVES To investigate the implications of both sleep factors and sleep patterns on the prognosis of cardiometabolic multimorbidity. METHODS From UK Biobank, individuals with cardiometabolic multimorbidity , defined as the coincidence of at least 2 cardiometabolic diseases (hypertension, diabetes mellitus, coronary heart disease, and stroke) were included in this study. Four low-risk sleep factors, including early chronotype, sleep 7-8 h/d, free of insomnia, and no frequent excessive daytime sleepiness, were used to generate a healthy sleep score ranging from 0 to 4. Participants with a score of 0-1, 2, 3-4 were clustered into groups with poor, intermediate, and healthy sleep pattern, respectively. We assessed the adjusted hazard ratios and 95% confidence intervals for all-cause mortality using the Cox proportional hazards model. RESULTS Among included 35,757 participants, the mean age (standard deviation)) was 61.82 (6.3) years. After full adjustment, early chronotype, sleep 7-8 h/d, no frequent excessive daytime sleepiness, and free of insomnia were independently associated with 8%, 12%, 11%, and 8% lower risk of all-cause mortality among all persons with cardiometabolic multimorbidity. We found the fully adjusted hazard ratio (95% confidence interval) for all-cause mortality was 0.90 (0.88-0.92) for a 1-point increase in the healthy sleep score. Compared with the reference group, participants with the intermediate and healthy sleep pattern had 9% and 23% lower risk of all-cause death, respectively, in the fully adjusted model. CONCLUSIONS A healthy sleep pattern combining 4 low-risk sleep factors could be regarded as a healthy lifestyle for individuals with cardiometabolic multimorbidity to lower the risk of all-cause mortality. CITATION He L, Ma T, Cheng X, Bai Y. The association between sleep characteristics and the risk of all-cause mortality among individuals with cardiometabolic multimorbidity: a prospective study of UK Biobank. J Clin Sleep Med. 2023;19(4):651-658.
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Affiliation(s)
- Lingfang He
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Tianqi Ma
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Xunjie Cheng
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yongping Bai
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Hayes BL, Vabistsevits M, Martin RM, Lawlor DA, Richmond RC, Robinson T. Establishing causal relationships between sleep and adiposity traits using Mendelian randomization. Obesity (Silver Spring) 2023; 31:861-870. [PMID: 36790827 PMCID: PMC10946465 DOI: 10.1002/oby.23668] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 02/16/2023]
Abstract
OBJECTIVE The aim of this study was to systematically evaluate the direction of any potential causal effect between sleep and adiposity traits. METHODS Two-sample Mendelian randomization was used to assess the association of genetically predicted sleep traits with adiposity and vice versa. Using data from UK Biobank and 23andMe, the sleep traits explored were morning preference (chronotype; N = 697,828), insomnia (N = 1,331,010), sleep duration (N = 446,118), napping (N = 452,633), and daytime sleepiness (N = 452,071). Using data from the Genetic Investigation of ANthropometric Traits (GIANT) and Early Growth Genetics (EGG) consortia, the adiposity traits explored were adult BMI, hip circumference (HC), waist circumference (WC), waist-hip ratio (WHR; N = 322,154), and childhood BMI (N = 35,668). RESULTS This study found evidence that insomnia symptoms increased mean WC, BMI, and WHR (difference in means, WC = 0.39 SD [95% CI: 0.13-0.64], BMI = 0.47 SD [95% CI: 0.22-0.73], and WHR = 0.34 SD [95% CI: 0.16-0.52]). Napping increased mean WHR (0.23 SD [95% CI: 0.08-0.39]). Higher HC, WC, and adult BMI increased odds of daytime sleepiness (HC = 0.02 SD [95% CI: 0.01-0.04], WC = 0.04 SD [95% CI: 0.01-0.06], and BMI 0.02 SD [95% CI: 0.00-0.04]). This study also found that higher mean childhood BMI resulted in lower odds of napping (-0.01 SD [95% CI: 0.02-0.00]). CONCLUSIONS The effects of insomnia on adiposity and of adiposity on daytime sleepiness suggest that poor sleep and weight gain may contribute to a feedback loop that could be detrimental to overall health.
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Affiliation(s)
- Bryony L. Hayes
- Medical Research Council Integrative Epidemiology UnitUniversity of BristolBristolUK
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Marina Vabistsevits
- Medical Research Council Integrative Epidemiology UnitUniversity of BristolBristolUK
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Richard M. Martin
- Medical Research Council Integrative Epidemiology UnitUniversity of BristolBristolUK
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
- NIHR Bristol Biomedical Research CentreUniversity Hospitals Bristol and Weston National Health Services Foundation Trust and the University of BristolBristolUK
| | - Deborah A. Lawlor
- Medical Research Council Integrative Epidemiology UnitUniversity of BristolBristolUK
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
- NIHR Bristol Biomedical Research CentreUniversity Hospitals Bristol and Weston National Health Services Foundation Trust and the University of BristolBristolUK
| | - Rebecca C. Richmond
- Medical Research Council Integrative Epidemiology UnitUniversity of BristolBristolUK
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Timothy Robinson
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
- Bristol Cancer InstituteUniversity Hospitals Bristol and Weston National Health Services Foundation TrustBristolUK
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Sánchez-Díaz M, Rodríguez-Pozo JÁ, Latorre-Fuentes JM, Salazar-Nievas MC, Alejandro ML, Arias-Santiago S. Sleep Quality as a Predictor of Quality-of-Life and Emotional Status Impairment in Patients with Chronic Spontaneous Urticaria: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3508. [PMID: 36834203 PMCID: PMC9964690 DOI: 10.3390/ijerph20043508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/08/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
Chronic Spontaneous Urticaria (CSU) leads to a decreased quality of life in patients because of pruritus and skin lesions. However, there is still little evidence on the impact that a worse sleep quality could have on the quality of life and emotional disorders in these patients. The aims of the present study are to analyze the potential impact of sleep quality on the quality-of-life and emotional status of patients with CSU. A cross-sectional study of 75 CSU patients was performed. Socio-demographic variables and disease activity, quality of life, sleep, sexual disfunction, anxiety, depression and personality traits were collected. A majority of 59 of the patients suffered from poor sleep quality. Sleep quality impairment was associated with worse disease control, greater pruritus and swelling and poorer general and urticaria-related quality-of-life (p < 0.05). Patients with poor sleep quality showed an increased prevalence of anxiety (1.62-fold) and depression risk (3.93-fold). Female sexual dysfunction, but not male, was found to be linked to poorer sleep quality (p = 0.04). To conclude, sleep quality impairment in patients with CSU is related to poor quality-of-life, worse disease control and higher rates of anxiety and depression. Global management of the disease should take sleep quality into account to improve the care of CSU patients.
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Affiliation(s)
- Manuel Sánchez-Díaz
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), 18002 Granada, Spain
| | - Juan Ángel Rodríguez-Pozo
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), 18002 Granada, Spain
| | - José María Latorre-Fuentes
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), 18002 Granada, Spain
| | - Maria Carmen Salazar-Nievas
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), 18002 Granada, Spain
- Urticaria Clinic, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
| | - Molina-Leyva Alejandro
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), 18002 Granada, Spain
| | - Salvador Arias-Santiago
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), 18002 Granada, Spain
- Urticaria Clinic, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- Dermatology Department, School of Medicine, University of Granada, 18071 Granada, Spain
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Gao X, Ma X, Lin P, Wang Y, Zhao Z, Zhang R, Yu B, Hao Y. Predictive Value of Cardiovascular Health Score for Health Outcomes in Patients with PCI: Comparison between Life's Simple 7 and Life's Essential 8. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3084. [PMID: 36833779 PMCID: PMC9965286 DOI: 10.3390/ijerph20043084] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
The American Heart Association recently published an updated algorithm for quantitative assessments of cardiovascular health (CVH) metrics, namely Life's Essential 8 (LE8). This study aimed to compare the predictive value between Life's Simple 7 (LS7) and LE8 and predict the likelihood of major adverse cardiac events (MACEs) in patients undergoing percutaneous coronary intervention (PCI) to determine the utility of the LE8 in predicting CVH outcomes. A total of 339 patients with acute coronary syndrome (ACS) who had undergone PCI were enrolled to assess the CVH scores using the LS7 and LE8. Multivariable Cox regression analysis was employed to evaluate the predictive value of the two different CVH scoring systems at 2 years for MACEs. Multivariable Cox regression analysis revealed that both the LS7 and LE8 scores were protective factors for MACEs (HR = 0.857, [95%CI: 0.78-0.94], HR = 0.964, [95%CI: 0.95-0.98]; p < 0.05, respectively). Receiver operator characteristic analysis indicated that the area under the curve (AUC) of LE8 was higher than that of LS7 (AUC: 0.662 vs. 0.615, p < 0.05). Lastly, in the LE8 score, diet, sleep health, serum glucose levels, nicotine exposure, and physical activity were found to be correlated with MACEs (HR = 0.985, 0.988, 0.993, 0.994, 0.994, respectively). Our study established that LE8 is a more reliable assessment system for CVH. This population-based prospective study reports that an unfavorable cardiovascular health profile is associated with MACEs. Future research is warranted to evaluate the effectiveness of optimizing diet, sleep health, serum glucose levels, nicotine exposure, and physical activity in reducing the risk of MACEs. In conclusion, our findings corroborated the predictive value of Life's Essential 8 and provided further evidence for the association between CVH and the risk of MACEs.
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Affiliation(s)
- Xueqin Gao
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin 150086, China
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Xinrui Ma
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Ping Lin
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Yini Wang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Zhenjuan Zhao
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Rui Zhang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Bo Yu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Yanhua Hao
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin 150086, China
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Sánchez-Díaz M, Díaz-Calvillo P, Soto-Moreno A, Molina-Leyva A, Arias-Santiago S. The Impact of Sleep Quality on Mood Status and Quality of Life in Patients with Alopecia Areata: A Comparative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13126. [PMID: 36293700 PMCID: PMC9603703 DOI: 10.3390/ijerph192013126] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
Alopecia Areata (AA) is a chronic condition which has been associated with poor quality of life and mood status disturbances. The aim of this study is to compare the sleep quality between AA patients and controls, and to analyze the impact of poor sleep quality on patients with AA regarding mood status disturbances, quality of life and sexuality. A cross-sectional study including patients suffering from mild-to-severe AA and sex- and age-matched healthy controls was performed. Socio-demographic and clinical variables, sleep quality, quality of life, sexual disfunction, anxiety, depression and personality were collected using validated questionnaires. A total of 120 participants (60 patients and 60 controls) were included. Patients with AA showed worse sleep scores than controls (p = 0.003), as well as higher rates of anxiety and depression (p < 0.05). After a multivariate analysis, a worse sleep quality was found to be linked to anxiety, depression, a poorer quality of life and a type D personality score independently of the disease severity. In light of the results, patients with AA have a worse sleep quality than healthy controls. A poor sleep quality is associated with anxiety, depression and a worse quality of life, therefore being a general marker of a poor quality of life. Screening for sleep disturbances in specialized units could be useful to detect patients who could benefit from additional psychological support.
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Affiliation(s)
- Manuel Sánchez-Díaz
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18002 Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), 18002 Granada, Spain
| | - Pablo Díaz-Calvillo
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18002 Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), 18002 Granada, Spain
| | - Alberto Soto-Moreno
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18002 Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), 18002 Granada, Spain
| | - Alejandro Molina-Leyva
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18002 Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), 18002 Granada, Spain
| | - Salvador Arias-Santiago
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18002 Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), 18002 Granada, Spain
- Trichology Clinic, Hospital Universitario Virgen de las Nieves, 18002 Granada, Spain
- Dermatology Department, School of Medicine, University of Granada, 18016 Granada, Spain
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Huang YM, Xia W, Ge YJ, Hou JH, Tan L, Xu W, Tan CC. Sleep duration and risk of cardio-cerebrovascular disease: A dose-response meta-analysis of cohort studies comprising 3.8 million participants. Front Cardiovasc Med 2022; 9:907990. [PMID: 36237900 PMCID: PMC9551171 DOI: 10.3389/fcvm.2022.907990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 09/09/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe effect of extreme sleep duration on the risk of cardiovascular and cerebrovascular diseases (CCDs) remains debatable. The pathology of CCDs is consistent in some respects (e.g., vascular factors), suggesting that there may be an overlapping range of sleep duration associated with a low risk of both diseases We aimed to quantify the dose-response relationship between sleep duration and CCDs.Study objectiveTo explore whether there is an optimal sleep duration (SD) in reducing the risk of CCDs.MethodsPubMed and EMBASE were searched until June 24, 2022 to include cohort studies that investigated the longitudinal relationships of SD with incident CCDs, including stroke and coronary heart disease (CHD). The robusterror meta-regression model (REMR model) was conducted to depict the dose-response relationships based on multivariate-adjusted risk estimates.ResultsA total of 71 cohorts with 3.8 million participants were included for meta-analysis, including 57 for cardiovascular diseases (CVD) and 29 for cerebrovascular disease. A significant U-shaped relationship was revealed of nighttime sleep duration with either cardiovascular or cerebrovascular disease. The nighttime sleep duration associated with a lower risk of CVD was situated within 4.3–10.3 h, with the risk hitting bottom at roughly 7.5 h per night (pnon–linearity < 0.0001). Sleep duration associated with a lower risk of cerebrovascular diseases ranges from 5 to 9.7 h per night, with the inflection at 7.5 h per night (pnon–linearity = 0.05). Similar non-linear relationship exited in daily sleep duration and CCDs. Other subgroup analyses showed non-linear relationships close to the above results.ConclusionRational sleep duration (7.5 h/night) is associated with a reduced risk of cardio-cerebrovascular disease for adults.
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Affiliation(s)
- Yi-Ming Huang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Wei Xia
- Department of Cardiology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Yi-Jun Ge
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Jia-Hui Hou
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
- *Correspondence: Lan Tan,
| | - Wei Xu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
- Wei Xu,
| | - Chen-Chen Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
- Chen-Chen Tan,
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Mujahid M, Nasir K, Qureshi R, Dhrolia M, Ahmad A. Comparison of the Quality of Sleep in Patients With Chronic Kidney Disease and End-Stage Renal Disease. Cureus 2022; 14:e23862. [PMID: 35530875 PMCID: PMC9073072 DOI: 10.7759/cureus.23862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 11/19/2022] Open
Abstract
Objective In this study, we aimed to compare the quality of sleep between patients with (CKD) and those with end-stage renal disease (ESRD). Methodology We performed a cross-sectional study between August 2020 and January 2021. We included 240 patients, among which 178 (74.2%) were CKD patients and 62 (25.8%) were ESRD patients on maintenance hemodialysis (MHD). Demographic data were collected on a pre-designed proforma. The quality of sleep was evaluated using the Pittsburgh Sleep Quality Index (PSQI). PSQI assesses subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. A PSQI score >5 indicates poor sleep quality. Results Out of the 240 patients, 159 (66%) had poor sleep quality. We found a significant difference in mean PSQI scores between CKD and ESRD patients (9.6 ± 12.4 vs. 11.4 ± 3.9 respectively), indicating poorer sleep quality in ESRD patients as compared to those with CKD (p<0.001). In our study, among all comorbidities, poor sleep was significantly associated with ischemic heart disease (IHD) (p = 0.025), after adjusting for confounding factors. Conclusions Our study showed that two-thirds of the study population had poor sleep quality. ESRD patients suffered from more disturbed sleep as compared to CKD patients.
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