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Hawkins MS, Pokutnaya DY, Duan D, Coughlin JW, Martin LM, Zhao D, Goheer A, Woolf TB, Holzhauer K, Lehmann HP, Lent MR, McTigue KM, Bennett WL. Associations between sleep health and obesity and weight change in adults: The Daily24 Multisite Cohort Study. Sleep Health 2023; 9:767-773. [PMID: 37268482 DOI: 10.1016/j.sleh.2023.03.006] [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: 11/11/2022] [Revised: 03/22/2023] [Accepted: 03/26/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To examine cross-sectional and longitudinal associations of individual sleep domains and multidimensional sleep health with current overweight or obesity and 5-year weight change in adults. METHODS We estimated sleep regularity, quality, timing, onset latency, sleep interruptions, duration, and napping using validated questionnaires. We calculated multidimensional sleep health using a composite score (total number of "good" sleep health indicators) and sleep phenotypes derived from latent class analysis. Logistic regression was used to examine associations between sleep and overweight or obesity. Multinomial regression was used to examine associations between sleep and weight change (gain, loss, or maintenance) over a median of 1.66 years. RESULTS The sample included 1016 participants with a median age of 52 (IQR = 37-65), who primarily identified as female (78%), White (79%), and college-educated (74%). We identified 3 phenotypes: good, moderate, and poor sleep. More regularity of sleep, sleep quality, and shorter sleep onset latency were associated with 37%, 38%, and 45% lower odds of overweight or obesity, respectively. The addition of each good sleep health dimension was associated with 16% lower adjusted odds of having overweight or obesity. The adjusted odds of overweight or obesity were similar between sleep phenotypes. Sleep, individual or multidimensional sleep health, was not associated with weight change. CONCLUSIONS Multidimensional sleep health showed cross-sectional, but not longitudinal, associations with overweight or obesity. Future research should advance our understanding of how to assess multidimensional sleep health to understand the relationship between all aspects of sleep health and weight over time.
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Affiliation(s)
- Marquis S Hawkins
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.
| | - Darya Y Pokutnaya
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Daisy Duan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Janelle W Coughlin
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Lindsay M Martin
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Di Zhao
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Attia Goheer
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thomas B Woolf
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; Department of Clinical Psychology, School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Katherine Holzhauer
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Harold P Lehmann
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Michelle R Lent
- Department of Clinical Psychology, School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Kathleen M McTigue
- Division of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Wendy L Bennett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Zhang C, Qin G. Irregular sleep and cardiometabolic risk: Clinical evidence and mechanisms. Front Cardiovasc Med 2023; 10:1059257. [PMID: 36873401 PMCID: PMC9981680 DOI: 10.3389/fcvm.2023.1059257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 01/31/2023] [Indexed: 02/19/2023] Open
Abstract
Sleep regularity is an essential part of the multidimensional sleep health framework. The phenomenon of irregular sleep patterns is widespread in contemporary lifestyles. This review synthesizes clinical evidence to summarize the measures of sleep regularity and discusses the role of different sleep regularity indicators in developing cardiometabolic diseases (coronary heart disease, hypertension, obesity, and diabetes). Existing literature has proposed several measurements to assess sleep regularity, mainly including the standard deviation (SD) of sleep duration and timing, sleep regularity index (SRI), interdaily stability (IS), and social jetlag (SJL). Evidence on associations between sleep variability and cardiometabolic diseases varies depending on the measure used to characterize variability in sleep. Current studies have identified a robust association between SRI and cardiometabolic diseases. In comparison, the association between other metrics of sleep regularity and cardiometabolic diseases was mixed. Meanwhile, the associations of sleep variability with cardiometabolic diseases differ across the population. SD of sleep characteristics or IS may be more consistently associated with HbA1c in patients with diabetes compared with the general population. The association between SJL and hypertension for patients with diabetes was more accordant than in the general population. Interestingly, the age-stratified association between SJL and metabolic factors was observed in the present studies. Furthermore, the relevant literature was reviewed to generalize the potential mechanisms through which irregular sleep increases cardiometabolic risk, including circadian dysfunction, inflammation, autonomic dysfunction, hypothalamic-pituitary-adrenal (HPA) axis disorder, and gut dysbiosis. Health-related practitioners should give more attention to the role of sleep regularity on human cardiometabolic in the future.
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Affiliation(s)
- Chengjie Zhang
- First School of Clinical Medicine, Shanxi Medical University, Taiyuan, China
| | - Gang Qin
- Department of Cardiology, First Hospital of Shanxi Medical University, Taiyuan, China
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Zhu B, Wang Y, Yuan J, Mu Y, Chen P, Srimoragot M, Li Y, Park CG, Reutrakul S. Associations between sleep variability and cardiometabolic health: A systematic review. Sleep Med Rev 2022; 66:101688. [PMID: 36081237 DOI: 10.1016/j.smrv.2022.101688] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 08/02/2022] [Accepted: 08/02/2022] [Indexed: 12/13/2022]
Abstract
This review explored the associations between sleep variability and cardiometabolic health. It was performed following PRISMA guidelines. We identified 63 studies. Forty-one studies examined the association between sleep variability and body composition, with 29 examined body mass index (BMI). Thirteen studies used social jet lag (SJL), n = 30,519, with nine reporting a null association. Eight studies used variability in sleep duration (n = 33,029), with five reporting a correlation with BMI. Fourteen studies (n = 133,403) focused on overweight/obesity; significant associations with sleep variability were found in 11 (n = 120,168). Sleep variability was associated with weight gain (seven studies; n = 79,522). Twenty-three studies examined glucose outcomes. The association with hemoglobin A1c (16 studies, n = 11,755) differed depending on populations, while associations with diabetes or glucose were mixed, and none were seen with insulin resistance (five studies; n = 6416). Sixteen studies examined cardiovascular-related outcomes, with inconsistent results. Overall significant associations were found in five studies focusing on metabolic syndrome (n = 7413). In summary, sleep variability was likely associated with obesity, weight gain, and metabolic syndrome. It might be associated with hemoglobin A1c in people with type 1 diabetes. The associations with other outcomes were mixed. This review highlighted the possible association between sleep variability and cardiometabolic health.
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Affiliation(s)
- Bingqian Zhu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Yueying Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Jinjin Yuan
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Yunping Mu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Pei Chen
- Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | | | - Yan Li
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Chang G Park
- College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Sirimon Reutrakul
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Illinois Chicago, Chicago, IL, USA.
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Young DR, Hong BD, Lewis KH, Paz SR, Bhakta BB, Macias M, Crawford CL, Drewnowski A, Ji M, Moore DD, Shen E, Murali SB, Coleman KJ. The association of 1-year weight loss from bariatric surgery and self-reported sleep: a prospective cohort. Obesity (Silver Spring) 2022; 30:2307-2316. [PMID: 36321277 PMCID: PMC9913885 DOI: 10.1002/oby.23543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/05/2022] [Accepted: 07/14/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study examined the association of weight loss following bariatric surgery with self-reported sleep quality after accounting for other sleep-related factors. METHODS Participants were from the Bariatric Experience Long Term (BELONG) study. Participants completed a survey up to 6 months before surgery and approximately 1 year after surgery. The Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. One-year percentage total weight loss (%TWL) was determined from electronic medical records. Covariates included demographics, Charlson Comorbidity Index, geocoded variables to assess neighborhood quality, and physical activity. The authors assessed the association between %TWL at 1 year and PSQI component scores with separate cumulative logit models. RESULTS There were 997 participants in the analytic cohort. Participants were 86.2% women, 37.0% Hispanic, and 13.7% Black adults. Mean one-year %TWL was 26.3 (SD 8.7). Each 1% increase in %TWL was associated with a 3% better daytime dysfunction score (odds ratio = 1.03; 95% CI: 1.02-1.05) and a 2% better sleep quality score (odds ratio = 1.02; 95% CI: 1.00-1.03). No significant differences were found for the other PSQI components. CONCLUSIONS Weight loss from bariatric surgery was associated with better self-reported sleep at 1 year. For people undergoing bariatric surgery, there may be an added benefit of better sleep.
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Affiliation(s)
- Deborah R. Young
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Benjamin D. Hong
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Kristina H. Lewis
- Division of Public Health Sciences, Department of Epidemiology & Prevention, Wake Forest University Health Sciences, Winston-Salem, North Carolina, USA
| | - Silvia R. Paz
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Bhumi B. Bhakta
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Mayra Macias
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Cecelia L. Crawford
- Regional Nursing Research Program, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, Washington, USA
| | - Ming Ji
- College of Nursing, University of South Florida, Tampa, Florida, USA
| | - Darren D. Moore
- Marriage and Family Therapy Program, The Family Institute, Northwestern University, Evanston, Illinois, USA
| | - Ernest Shen
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Sameer B. Murali
- Center for Obesity Medicine & Metabolic Performance, Department of Surgery, University of Texas McGovern Medical School, Houston, Texas, USA
| | - Karen J. Coleman
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
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