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Zhang KP, Buxton M, Rodríguez-Carmona Y, Peterson KE, Liu Y, Burgess HJ, Cantoral A, Tellez-Rojo MM, Torres-Olascoaga LA, Arboleda-Merino L, Jansen EC. Duration, timing, and consistency of sleep in relation to inflammatory cytokines in Mexican adolescents. Sleep Med 2022; 100:103-111. [PMID: 36041378 PMCID: PMC9997045 DOI: 10.1016/j.sleep.2022.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To evaluate whether sleep duration, timing, and variability were associated with inflammatory cytokines in a cohort of Mexico City adolescents. METHODS The analytic sample comprised >500 adolescents who were part of an ongoing longitudinal study in Mexico City. At two time points during mid-to-late puberty (average age 14, n = 391) and late-to-post puberty (average age 16, n = 345), adolescents completed a follow-up visit that included 7-day wrist actigraphy and clinical assessment of plasma inflammatory cytokines (high-sensitivity C-reactive protein, Interleukin 1β, Interleukin 6, and Tumor Necrosis Factor ɑ). Sleep characteristics included weekday and weekend sleep duration and midpoint (median of bed and wake time), as well as sleep variability (SD of sleep duration across 7 days) and social jetlag (midpoint difference from weekdays to weekends). At each time point, multivariable linear regression models were run with log inflammatory levels as the outcome and categories of sleep characteristics as predictors, while adjusting for potential confounders (specific to each model). Analyses were run unstratified and sex-stratified. RESULTS In the mid-to-late pubertal visit, weekday sleep duration was inversely associated with natural log hs-CRP after adjustment (Q4 vs Q1: β = -0.41, 95% Confidence Interval (CI) -0.81 to -0.01) and later sleep midpoint was positively associated with log hs-CRP (Q4 vs Q1: β = 0.55, 95% CI 0.13 to 0.97). Sleep duration variability was associated with higher IL-1β among boys, while in girls social jetlag was associated with higher IL-1β and weekend sleep duration was inversely associated with IL-6. At the late-to-post pubertal visit, there were few associations except for a positive association between weekday sleep duration and hs-CRP among boys (β = 0.60, 95% CI 0.04 to 1.16) and a non-linear positive association between social jetlag and hs-CRP among girls (β = 0.80, 95% CI 0.22 to 1.37 comparing 2 to 3 h of social jetlag vs <1 h). CONCLUSION Later timing, shorter duration, and inconsistency of sleep were related to higher levels of inflammatory biomarkers, but associations were more evident at the mid-to-late pubertal visit than the late-to-post pubertal visit.
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Affiliation(s)
- Kelvin Pengyuan Zhang
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Miatta Buxton
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Yanelli Rodríguez-Carmona
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA; Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Yun Liu
- Department of Epidemiology, Brown University, Providence, RI, USA
| | - Helen J Burgess
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | - Martha María Tellez-Rojo
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Libni A Torres-Olascoaga
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Laura Arboleda-Merino
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Erica C Jansen
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA; Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
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Noh JW, Kwon YD, Cheon J, Kim J. Factors affecting weekday-to-weekend sleep differences among Korean adolescent students: Focus on extracurricular tutoring time. PLoS One 2021; 16:e0259666. [PMID: 34793456 PMCID: PMC8601464 DOI: 10.1371/journal.pone.0259666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 10/24/2021] [Indexed: 11/25/2022] Open
Abstract
Objectives Discrepancy in weekday-weekend sleep induces negative effects on physical health, obesity, psychological disorders, and academic performance; this particularly affects adolescent students through extracurricular tutoring, including evening self-study, private tutoring, and home studies. The present research aimed to clarify sociodemographic and economic factors, including extracurricular tutoring time, associated with weekday-to-weekend sleep differences using longitudinal data. Study design Data from the Korean Children and Youth Panel Survey (KCYPS) data were analyzed. Weekday-to-weekend sleep differences and extracurricular tutoring, as well as other covariates, were measured using adolescent’s self-report questionnaires. Multilevel regression and structural equation modeling (SEM) of repeated measures were used to test the hypothesized relationship between variables. Results The time spent in weekly extracurricular tutoring was negatively associated with weekday-to-weekend sleep differences. However, increased tutoring time was positively associated with bedtime, and bedtime was in turn positively associated with differences in Korean adolescents’ weekday-to-weekend sleep patterns. The SEM analysis result showed a significant indirect effect of tutoring time on sleep differences via bedtime. Conclusions Limiting weekly extracurricular tutoring time is important to early bedtime and reducing weekday-to-weekend sleep pattern differences. Policymakers should develop alternatives to private tutoring to improve the sleep duration and reduce weekday-to-weekend sleep differences among adolescents.
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Affiliation(s)
- Jin-Won Noh
- Department of Health Administration, Yonsei University, Wonju, Korea
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, The Catholic University of Korea, Seoul, Korea
| | - Jooyoung Cheon
- Department of Nursing Science, Sungshin Women’s University, Seoul, Korea
| | - Jinseok Kim
- Department of Social Welfare, Seoul Women’s University, Seoul, Korea
- * E-mail:
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Zou Y, He MJ, Su DT, Huang LC, Fang YQ, Zhang RH. The Current Status of Insufficient Sleep Duration and Its Influencing Factors Among Children and Adolescents: A Household Based Cross-Sectional Study in Zhejiang Province, China. J Pediatr Nurs 2021; 60:e1-e5. [PMID: 33741220 DOI: 10.1016/j.pedn.2021.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE Insufficient sleep duration is common among children and adolescents worldwide, and the decline of sleep duration during the recent years is troubling. This study aimed to learn the status of insufficient sleep duration and to explore its influencing factors among children and adolescents in Zhejiang Province, China. DESIGN AND METHODS A stratified sampling technique was employed in the present cross-sectional study. Demographic characteristics, sports time as well as sedentary behavior were investigated. RESULTS A greater proportion of children than adolescents reported insufficient sleep duration (36.4% versus 19.2%, p = 0.001). For children, insufficient sleep duration was associated with age (OR = 1.290, 95%CI: 1.069-1.557), watching movies or TV shows with smartphones after school (OR = 3.098, 95%CI: 1.293-7.420), surf the internet after school (OR = 0.113, 95%CI: 0.013-0.969), walk to school (OR = 0.289, 95%CI: 0.105-0.793). For adolescents, insufficient sleep duration was associated with watch TV after school (OR = 0.379, 95%CI: 0.148-0.970), watching movies or TV shows with smartphones after school (OR = 4.744, 95%CI: 1.799-12.507), do homework after school (OR = 0.265, 95%CI: 0.086-0.813). CONCLUSIONS An unhealthy sedentary screen lifestyle profile may have influence on insufficient sleep duration. Urgent actions are needed to improve sleep duration among children and adolescents.
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Affiliation(s)
- Yan Zou
- Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Meng-Jie He
- Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Dan-Ting Su
- Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Li-Chun Huang
- Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Yue-Qiang Fang
- Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Rong-Hua Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, China.
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Jurkovičová J, Hirošová K, Vondrová D, Samohýl M, Štefániková Z, Filová A, Kachútová I, Babjaková J, Argalášová Ľ. The Prevalence of Insulin Resistance and the Associated Risk Factors in a Sample of 14-18-Year-Old Slovak Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030909. [PMID: 33494341 PMCID: PMC7908586 DOI: 10.3390/ijerph18030909] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/14/2021] [Accepted: 01/18/2021] [Indexed: 02/06/2023]
Abstract
The prevalence of cardiometabolic risk factors has increased in Slovakian adolescents as a result of serious lifestyle changes. This cross-sectional study aimed to assess the prevalence of insulin resistance (IR) and the associations with cardiometabolic and selected lifestyle risk factors in a sample of Slovak adolescents. In total, 2629 adolescents (45.8% males) aged between 14 and 18 years were examined in the study. Anthropometric parameters, blood pressure (BP), and resting heart rate were measured; fasting venous blood samples were analyzed; and homeostasis model assessment (HOMA)-insulin resistance (IR) was calculated. For statistical data processing, the methods of descriptive and analytical statistics for normal and skewed distribution of variables were used. The mean HOMA-IR was 2.45 ± 1.91, without a significant sex differences. IR (cut-off point for HOMA-IR = 3.16) was detected in 18.6% of adolescents (19.8% males, 17.6% females). IR was strongly associated with overweight/obesity (especially central) and with almost all monitored cardiometabolic factors, except for total cholesterol (TC) and systolic BP in females. The multivariate model selected variables such as low level of physical fitness, insufficient physical activity, breakfast skipping, a small number of daily meals, frequent consumption of sweetened beverages, and low educational level of fathers as significant risk factors of IR in adolescents. Recognizing the main lifestyle risk factors and early IR identification is important in terms of the performance of preventive strategies. Weight reduction, regular physical activity, and healthy eating habits can improve insulin sensitivity and decrease the incidence of metabolic syndrome, type 2 diabetes, and cardiovascular disease (CVD).
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Wang M, Zhong JM, Hu RY, Gong WW, Yu M. Sleep duration and behavioral correlates in middle and high school students: a cross-sectional study in Zhejiang province, China. Sleep Med 2021; 79:55-61. [PMID: 33476857 DOI: 10.1016/j.sleep.2021.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 12/28/2020] [Accepted: 01/02/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the sleep duration and correlates from lifestyle, dietary and weight control behaviors in Chinese adolescents. METHODS Data were from 2017 Zhejiang Youth Risk Behavior Survey. A total of 17059 adolescents were included in this study and sleep duration and other behaviors information was collected via a self-reported questionnaire. Regression coefficients (β), calculated by multivariable linear regression, were used to assess the effects of related behaviors on sleep duration, adjusting for potential confounding factors. RESULTS Overall, the mean sleep duration in adolescents was 7.99 h. Ever smoking, engaging in moderate physical activity and muscle strengthening activity, attending physical education classes, and watching television were significantly associated with longer sleep duration (P trend ≦0.01 for all). Adolescents with breakfast, fruits, vegetables, milk and soft drinks intake were more likely to have longer sleep duration (P trend <0.05 for all). Weight perception of overweight and weight control behaviors including exercising and eating less food, fewer calories were significantly associated with the short sleep duration (P trend <0.05 for all). CONCLUSION Chinese adolescents slept less than the counterparts in Western countries. Various lifestyle, dietary and weight control behaviors were associated with sleep duration.
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Affiliation(s)
- Meng Wang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China.
| | - Jie-Ming Zhong
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China.
| | - Ru-Ying Hu
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China.
| | - Wei-Wei Gong
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China.
| | - Min Yu
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China.
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Tekcan P, ÇaliŞkan Z, KocaÖz S. Sleep Quality and Related Factors in Turkish High School Adolescents. J Pediatr Nurs 2020; 55:120-125. [PMID: 32949851 DOI: 10.1016/j.pedn.2020.07.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/25/2020] [Accepted: 07/31/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of the study was to determine the sleep quality and related risk factors in high school adolescents. DESIGNS AND METHODS This descriptive and cross-sectional study was conducted with 400 adolescents. Data collection was with the 'Data Collection Form' and the 'Pittsburgh Sleep Quality Index' (PSQI). RESULTS More than half of the adolescents had poor sleep quality (53.0%). PSQI scores were found to be associated with age, sex, poor school success, chronic disease, exposure to domestic verbal violence, inability to participate in sports, and feeling tired. PRACTICE IMPLICATIONS Adolescents should be supported by educational and informative programs about sleep hygiene.
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Affiliation(s)
| | - Zehra ÇaliŞkan
- Department of Pediatric Nursing, Nursing Department, Semra and Vefa Küçük Faculty of Health Sciences, Nevşehir Hacı Bektaş Veli University, Turkey.
| | - Semra KocaÖz
- Department of Obstetrics and Gynecology Nursing, Nursing Department, Niğde Zübeyde Hanım School of Health, Niğde Ömer Halisdemir University, Turkey
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Associations between sleep practices and social behavior of children and adolescents: a systematic review. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-020-01388-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Kim J, Noh JW, Kim A, Kwon YD. Demographic and Socioeconomic Influences on Sleep Patterns among Adolescent Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124378. [PMID: 32570823 PMCID: PMC7345986 DOI: 10.3390/ijerph17124378] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/13/2020] [Accepted: 06/16/2020] [Indexed: 12/30/2022]
Abstract
Although proper sleep is an important topic in adolescent health, little is known about the sleep patterns of adolescents from a longitudinal and non-Western perspective. To fill this gap, the present research conducted a longitudinal study of the impact of demographic and socioeconomic factors on sleep patterns among Korean adolescent students. The relationship could positively or negatively affect sleep. Therefore, it is important to understand which demographic and socioeconomic factors are related to sleep patterns. This study used nationally representative panel data from the Korean Children and Youth Panel Survey. A series of descriptive analyses were conducted to provide overall characteristics of the sample. Furthermore, mixed effect regression analysis techniques were employed to test the relationship between demographic and socioeconomic factors and sleep patterns. Paternal employment status was associated with adolescent sleep patterns, while maternal employment status was not. Adolescents with both parents working compared to adolescents with one parent or none working showed different sleep patterns on weekdays but not on weekends. Both parents possessing college degrees, household income, living in an urban area, and family type were associated with adolescent sleep pattern indicators to varying degrees. Some of these associations varied according to adolescent sex. This study provides insight into the impact of demographic and socioeconomic factors on weekend and weekday sleep patterns among adolescent students by sex. These findings provide information for the promotion of healthy sleep in adolescents by addressing demographic and socioeconomic factors.
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Affiliation(s)
- Jinseok Kim
- Department of Social Welfare, Seoul Women’s University, Seoul 01797, Korea; (J.K.); (A.K.)
| | - Jin-Won Noh
- Department of Health Administration, Dankook University, Cheonan 31116, Korea;
- Global Health Unit, Department of Health Sciences, University Medical Centre Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Ahraemi Kim
- Department of Social Welfare, Seoul Women’s University, Seoul 01797, Korea; (J.K.); (A.K.)
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, The Catholic University of Korea, Seoul 06591, Korea
- Correspondence: ; Tel.: +82-2-2258-8251; Fax: +82-2-2258-8257
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Abiri B, Sarbakhsh P, Vafa M. Prevalence of overweight, obesity, and associated risk factors in healthy female adolescents in Tehran, Iran. Cent Asian J Glob Health 2019; 8:413. [PMID: 32002316 DOI: 10.5195/cajgh.2019.413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Introduction Obesity is an important health concern worldwide and is a growing problem in Iran. Adolescent obesity has a major role in development of adulthood obesity and its complications. The present study was conducted to evaluate the prevalence of overweight, obesity, and associated risk factors in female adolescents living in Tehran, Iran. Methods This cross-sectional study was carried out among 2,132 female adolescents aged 14-17 years in Tehran recruited between 2017 and 2018. Weight and height were measured and body mass index (BMI) was calculated. Underweight, overweight, and obesity were considered as < 5th, ≥ 85th, and ≥ 95th percentile, respectively, of CDC BMI-for age and sex criteria. Adolescents and their mothers filled in the questionnaires on physical activity, computer use, duration of breastfeeding, total sleep time, and family socioeconomic status. Statistical analysis was performed using SPSS version 22.0 software. P < 0.05 was considered statistically significant. Results The overall prevalence rates of overweight and obesity were 24.1% and 6.5%, respectively. The prevalences of overweight and obesity were highest in the South District (28.9% and 7.7%, respectively) and were lowest in the North District (19.1% and 5.2%, respectively). There were significant differences in physical activity level (P < 0.001), total sleep time (P < 0.001), duration of breastfeeding (P < 0.01), and daily computer use (P < 0.001) among the four groups (underweight, normal, overweight, and obese). Regarding the socioeconomic status, parental education level and economic status were significantly higher in those who had normal weight compared to other weight groups (in both, P < 0.001). Conclusion This study showed that overweight and obesity among female adolescents in Tehranhave become a major public health concern. Level of physical activity, computer use, sleep duration, breastfeeding duration, levels of parental education, and economic status were associated with overweight and obesity prevalence.
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Affiliation(s)
- Behnaz Abiri
- Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Sarbakhsh
- Department of Statistics and Epidemiology, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammadreza Vafa
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.,Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
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Associations of Meal Timing and Frequency with Obesity and Metabolic Syndrome among Korean Adults. Nutrients 2019; 11:nu11102437. [PMID: 31614924 PMCID: PMC6836094 DOI: 10.3390/nu11102437] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/05/2019] [Accepted: 10/10/2019] [Indexed: 12/15/2022] Open
Abstract
Emerging studies indicate that meal timing is linked to cardiometabolic risks by deterioration of circadian rhythms, however limited evidence is available in humans. This large-scale cross-sectional study explored the associations of meal timing and frequency with obesity and metabolic syndrome among Korean adults. Meal timing was defined as nightly fasting duration and morning, evening, and night eating, and meal frequency was estimated as the number of daily eating episodes using a single-day 24-hour dietary recall method. Meal frequency was inversely associated with prevalence of abdominal obesity, elevated blood pressure, and elevated triglycerides in men only. Independent of the nightly fasting duration and eating episodes, morning eating was associated with a lower prevalence of metabolic syndrome (odds ratio (OR), 0.73; 95% confidence interval (CI), 0.57–0.93 for men and OR, 0.69; 95% CI, 0.54–0.89 for women) than no morning eating, whereas night eating was associated with a 48% higher prevalence of metabolic syndrome (OR, 1.48; 95% CI, 1.15–1.90) than no night eating in men only. Longer fasting duration and less sleep were associated with obesity and metabolic syndrome. These findings suggest that overall eating patterns, including energy distribution across the day, eating frequency, and sleep duration, rather than fasting duration alone, are related to cardiometabolic risks in free-living Korean adults.
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