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Bommarito JC, Stapleton RK, Murray NS, Burr JF, Millar PJ. Acute partial sleep deprivation attenuates blood pressure responses to cycling exercise. Am J Physiol Heart Circ Physiol 2024; 327:H947-H955. [PMID: 39178028 DOI: 10.1152/ajpheart.00453.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 08/19/2024] [Accepted: 08/21/2024] [Indexed: 08/24/2024]
Abstract
Exaggerated blood pressure (BP) responses during exercise are independently associated with future development of hypertension. Partial sleep deprivation (PSD) can increase 24-h ambulatory BP, but the effects on exercise BP are unclear. We hypothesized that acute PSD would augment the BP response to constant load cycling exercise and a 20-min time trial. Twenty-two healthy adults (22 ± 3 yr old; 13 males; V̇o2peak, 43.6 ± 8.2 mL·kg-1·min-1) completed a randomized crossover trial in which they either slept normally (normal sleep-wake schedule for each participant) or sleep was partially deprived (early awakening, 40% of normal sleep duration). Each participant completed a 12-min warm-up consisting of two 6-min steps (step 1, 62 ± 25 W; step 2, 137 ± 60 W) followed by a 20-min time trial on a cycle ergometer. PSD did not alter power output during the 20-min time trial [(control vs. PSD) 170 ± 68 vs. 168 ± 68 W, P = 0.65]. Systolic BP did not differ during step 1 of the warm-up (141 ± 15 vs. 137 ± 12 mmHg, P = 0.39) but was lower following PSD during step 2 (165 ± 21 vs. 159 ± 22 mmHg, P = 0.004) and the 20-min time trial (171 ± 20 vs. 164 ± 23 mmHg, P < 0.001). These results were maintained when peak oxygen uptake (V̇o2peak) was included as a covariate. Systolic BP responses were modulated by sex (time × visit × sex interaction P = 0.03), with attenuated systolic BP during the warm-up and the 20-min time trial in males but not in females. In contrast to our hypothesis, acute PSD attenuates systolic BP responses during constant load and 20-min time trial cycling exercise; however, these observations appear to be primarily driven by changes in males.NEW & NOTEWORTHY A single night of partial sleep deprivation (PSD) can increase ambulatory blood pressure (BP) the following day. Despite this phenomenon, the present study found that acute PSD attenuates systolic BP responses to both constant load cycling and a 20-min cycling time trial in young healthy adults. Interestingly, the attenuated systolic BP responses following PSD appeared to be modulated by sex such that attenuations were observed in males but not in females.
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Affiliation(s)
- Julian C Bommarito
- Human Cardiovascular Physiology Laboratory, Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Rileigh K Stapleton
- Human Cardiovascular Physiology Laboratory, Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Nathan S Murray
- Human Cardiovascular Physiology Laboratory, Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Jamie F Burr
- Human Performance and Health Research Laboratory, Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Philip J Millar
- Human Cardiovascular Physiology Laboratory, Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
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Schneider KE, Martin EM, Urquhart GJ, Sisson LN, Rouhani S, Morris M, Spira AP, Sherman SG. Sleep-related impairment among people who use opioids: The critical role of structural vulnerability. Sleep Health 2024; 10:533-539. [PMID: 39068134 DOI: 10.1016/j.sleh.2024.07.003] [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: 02/01/2023] [Revised: 06/20/2024] [Accepted: 07/02/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVE People who use opioids are vulnerable to sleep disturbances due to a range of factors, including the substances they use and the various structural vulnerabilities they face. We aimed to understand the burden of sleep-related impairment and problems pertaining to sleep context and schedule among people who use opioids. METHODS We explored sleep quality and problems among a suburban sample of people who use opioids experiencing extensive structural vulnerabilities (N = 170). Participants reported their most urgent concern in the past week (e.g., sleep, drug use, housing), their sleep context, sleep problems, sleep schedules, and scores on the PROMIS Sleep-Related Impairment measure. We then quantified associations between Sleep-Related Impairment scores and sociodemographics and substance use. RESULTS Participants were primarily men (66%) and non-Hispanic Black (67%) with a mean age of 42 (SD: 12.1). Many experienced hunger (44%) and literal homelessness (40%). One-quarter (28%) reported that sleep was their most urgent concern in the past week. The most common problems when falling or staying asleep were mental health-related symptoms (81%) and pain/discomfort (32%). Literal homelessness (β = 2.2, 95% CI: 0.6, 3.7), hunger (β = 2.3, 95% CI: 1.0, 3.6), and frequent alcohol use (β = 1.5, 95% CI: 0.2, 2.7) were significantly associated with Sleep-Related Impairment scores. CONCLUSIONS Homelessness and hunger are associated with sleep-related impairment in people who use opioids. Poor sleep quality, substance use, structural vulnerability, and mental health problems are all interrelated sources of functional impairment in this population. Interventions that address poverty as an underlying cause of sleep-related impairment and provide safe sleeping environments are needed.
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Affiliation(s)
- Kristin E Schneider
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
| | - Emily M Martin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Glenna J Urquhart
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Laura N Sisson
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Saba Rouhani
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Epidemiology, New York University School of Global Public Health, New York, New York, USA
| | - Miles Morris
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA; Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA
| | - Susan G Sherman
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Noordam R, Wang W, Nagarajan P, Wang H, Brown MR, Bentley AR, Hui Q, Kraja AT, Morrison JL, O'Connel JR, Lee S, Schwander K, Bartz TM, de las Fuentes L, Feitosa MF, Guo X, Hanfei X, Harris SE, Huang Z, Kals M, Lefevre C, Mangino M, Milaneschi Y, van der Most P, Pacheco NL, Palmer ND, Rao V, Rauramaa R, Sun Q, Tabara Y, Vojinovic D, Wang Y, Weiss S, Yang Q, Zhao W, Zhu W, Abu Yusuf Ansari M, Aschard H, Anugu P, Assimes TL, Attia J, Baker LD, Ballantyne C, Bazzano L, Boerwinkle E, Cade B, Chen HH, Chen W, Ida Chen YD, Chen Z, Cho K, De Anda-Duran I, Dimitrov L, Do A, Edwards T, Faquih T, Hingorani A, Fisher-Hoch SP, Gaziano JM, Gharib SA, Giri A, Ghanbari M, Grabe HJ, Graff M, Gu CC, He J, Heikkinen S, Hixson J, Ho YL, Hood MM, Houghton SC, Karvonen-Gutierrez CA, Kawaguchi T, Kilpeläinen TO, Komulainen P, Lin HJ, Linchangco GV, Luik AI, Ma J, Meigs JB, McCormick JB, Menni C, Nolte IM, Norris JM, Petty LE, Polikowsky HG, Raffield LM, Rich SS, Riha RL, Russ TC, Ruiz-Narvaez EA, Sitlani CM, Smith JA, Snieder H, Sofer T, Shen B, Tang J, Taylor KD, Teder-Laving M, Triatin R, Tsai MY, Völzke H, Westerman KE, Xia R, Yao J, Young KL, Zhang R, Zonderman AB, Zhu X, Below JE, Cox SR, Evans M, Fornage M, Fox ER, Franceschini N, Harlow SD, Holliday E, Ikram MA, Kelly T, Lakka TA, Lawlor DA, Li C, Liu CT, Mägi R, Manning AK, Matsuda F, Morrison AC, Nauck M, North KE, Penninx BW, Province MA, Psaty BM, Rotter JI, Spector TD, Wagenknecht LE, Willems van Dijk K, Study LC, Jaquish CE, Wilson PW, Peyser PA, Munroe PB, de Vries PS, Gauderman WJ, Sun YV, Chen H, Miller CL, Winkler TW, Rao DC, Redline S, van Heemst D. A Large-Scale Genome-Wide Gene-Sleep Interaction Study in 732,564 Participants Identifies Lipid Loci Explaining Sleep-Associated Lipid Disturbances. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.09.02.24312466. [PMID: 39281768 PMCID: PMC11398441 DOI: 10.1101/2024.09.02.24312466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/18/2024]
Abstract
We performed large-scale genome-wide gene-sleep interaction analyses of lipid levels to identify novel genetic variants underpinning the biomolecular pathways of sleep-associated lipid disturbances and to suggest possible druggable targets. We collected data from 55 cohorts with a combined sample size of 732,564 participants (87% European ancestry) with data on lipid traits (high-density lipoprotein [HDL-c] and low-density lipoprotein [LDL-c] cholesterol and triglycerides [TG]). Short (STST) and long (LTST) total sleep time were defined by the extreme 20% of the age- and sex-standardized values within each cohort. Based on cohort-level summary statistics data, we performed meta-analyses for the one-degree of freedom tests of interaction and two-degree of freedom joint tests of the main and interaction effect. In the cross-population meta-analyses, the one-degree of freedom variant-sleep interaction test identified 10 loci (P int <5.0e-9) not previously observed for lipids. Of interest, the ASPH locus (TG, LTST) is a target for aspartic and succinic acid metabolism previously shown to improve sleep and cardiovascular risk. The two-degree of freedom analyses identified an additional 7 loci that showed evidence for variant-sleep interaction (P joint <5.0e-9 in combination with P int <6.6e-6). Of these, the SLC8A1 locus (TG, STST) has been considered a potential treatment target for reduction of ischemic damage after acute myocardial infarction. Collectively, the 17 (9 with STST; 8 with LTST) loci identified in this large-scale initiative provides evidence into the biomolecular mechanisms underpinning sleep-duration-associated changes in lipid levels. The identified druggable targets may contribute to the development of novel therapies for dyslipidemia in people with sleep disturbances.
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Hu H, Nakagawa T, Honda T, Yamamoto S, Mizoue T. Association of conventional cigarette smoking, heated tobacco product use and dual use with hypertension. Int J Epidemiol 2024; 53:dyae114. [PMID: 39174315 PMCID: PMC11341126 DOI: 10.1093/ije/dyae114] [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: 12/21/2023] [Accepted: 08/09/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND Heated tobacco products (HTPs) have emerged as alternatives to conventional cigarettes. However, their health effects remain largely unknown. This study aimed to prospectively explore the association between the use of cigarettes and HTPs and the risk of hypertension. METHODS This cohort study analysed data from 30 152 workers (82.0% men, mean age 42.9 ± 11.0 years) who were initially free of hypertension, participating in the Japan Epidemiology Collaboration on Occupational Health Study. Participants were categorized into five groups based on their self-reported tobacco product use: never smokers, past smokers, exclusive cigarette smokers, exclusive HTP users and dual users of cigarettes and HTPs. Hypertension cases were identified using three data points from annual health checkup data collected between 2019 and 2021. Cox proportional hazards regression models were used to investigate the association between tobacco product use and hypertension. RESULTS During a mean follow-up of 2.6 years (range: 0.1-4.0 years), 3656 new cases of hypertension were identified. Compared with never smokers, the risk of hypertension was higher among exclusive cigarette smokers [hazard ratio (HR) 1.26, 95% confidence interval (CI) 1.13-1.41] and exclusive HTP users (HR 1.19, 95% CI 1.06-1.34). There was also a suggestion of increased risk of hypertension among dual users (HR 1.16, 95% CI 0.98-1.38). Furthermore, the risk of hypertension increased with the intensity of cigarette/HTP use in all tobacco product users. CONCLUSIONS Similarly, both cigarette smoking and HTP use elevate the risk of hypertension. HTPs should not be regarded as less harmful alternatives to traditional cigarettes for preventing hypertension.
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Affiliation(s)
- Huan Hu
- Research Center for Prevention from Radiation Hazards of Workers, National Institute of Occupational Safety and Health, Kanagawa, Japan
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tohru Nakagawa
- Hitachi Health Care Center, Hitachi, Ltd, Ibaraki, Japan
| | - Toru Honda
- Hitachi Health Care Center, Hitachi, Ltd, Ibaraki, Japan
| | | | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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Springall De Pablo M, Lauderdale DS. Associations of actigraph sleep characteristics with blood pressure among older adults. Sleep Health 2024; 10:455-461. [PMID: 38906803 DOI: 10.1016/j.sleh.2024.04.002] [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: 12/18/2023] [Revised: 03/29/2024] [Accepted: 04/12/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVES Many studies have examined links between sleep and blood pressure, with mixed findings, mostly using self-reported sleep data and cross-sectional designs. We examined whether actigraph-estimated sleep characteristics are associated with concurrent blood pressure or 5-year blood pressure change in a national cohort of older adults (National Social Life, Health and Aging Project), and whether these associations differ by hypertension medication use. METHODS Subjects were 669 older adults (62-90years), 471 with 5-year follow-up data. Sleep characteristics were duration (linear plus quadratic terms); sleep percentage; and categorical onset, midpoint, and waking times. Multivariable linear models adjusted for age, race, gender, obesity, smoking, daytime napping, and hypertension medication use. Interactions between sleep characteristics and hypertension medication were tested among the 401 subjects with consistent hypertension medication status over time. RESULTS We found U-shaped cross-sectional and longitudinal relationships between duration and blood pressure, with shorter and longer sleep times associated with higher blood pressure. Later onset times were cross-sectionally associated with higher systolic blood pressure, while earlier onset times were longitudinally associated with systolic blood pressure increase. Midpoint, wake time, and sleep percentage were not significantly associated with blood pressure. Significant interaction terms suggested hypertension medications attenuated associations of sleep onset and wake time with diastolic blood pressure. CONCLUSIONS These results with actigraph-estimated parameters confirm some, but not all, associations reported from research based on self-reported sleep data. Our findings are consistent with recommended intermediate sleep durations for cardiovascular health and suggest hypertension medication use may attenuate some associations between sleep timing and blood pressure.
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Affiliation(s)
| | - Diane S Lauderdale
- University of Chicago Department of Public Health Sciences, Chicago, Illinois, USA
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Pitliya A, Kakarlapudi Y, Vasudevan SS, Kancherla N, Kumar L, Cheruvu NP, Irfan A, Garlapati SKP, Lavu DV, Pitliya A. The Global Prevalence of Metabolic Syndrome in Connection with Sleep Duration: A Systematic Review and Meta-Analysis. Metab Syndr Relat Disord 2024; 22:411-421. [PMID: 38634783 DOI: 10.1089/met.2024.0004] [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] [Indexed: 04/19/2024] Open
Abstract
The duration and quality of sleep are believed to significantly influence the onset of metabolic syndrome (MetS), but existing data lack consistency. The meta-analysis aims to evaluate the prevalence of the MetS in association with sleep duration. We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 guidelines. A comprehensive search of PubMed, Google Scholar, and Research Gate databases was performed to identify cohort and cross-sectional studies published in English between 2013 and 2023. We included studies that examined the association between sleep duration/quality and MetS, and two independent reviewers assessed study quality and bias using the Newcastle-Ottawa scale. The systematic review included 11 studies with a total of 343,669 participants, including 4 cohort studies and 7 cross-sectional studies. Sample sizes varied widely, ranging from 293 to 162,121 individuals. The studies had different follow-up periods, participant ages ranging from 10 to 80 years, and predominantly male populations. The prevalence of MetS was higher in average sleepers [52%, 95% confidence interval (CI): 40%-64%] compared with short sleepers (13%, 95% CI: 8%-18%) and long sleepers (15%, 95% CI: 9%-24%). Globally, North American countries exhibit the highest prevalence of MetS across short- (25.3%, 95% CI: 4.2%-72.4%) and long-sleeper (22.4%, 95% CI: 2.8%-74.1%) categories, whereas Asian countries experience the highest prevalence among the average sleeper category (58.7%, 95% CI: 44.1%-71.9%). Our meta-analysis indicates an elevated prevalence of MetS in average sleepers. Future research endeavors address delve into the underlying mechanisms and incorporate objective measures to understand the multifaceted connection between sleep patterns and MetS, guiding more effective preventive and management strategies.
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Affiliation(s)
- Aakanksha Pitliya
- Department of General Medicine, Sri Aurobindo Institute of Medical Sciences and PGI, Indore, India
| | | | - Srivatsa Surya Vasudevan
- Department of Otorhinolaryngology: Head and Neck Surgery, Louisiana State University Health Center, Shreveport, Louisiana, USA
| | - Neeraj Kancherla
- Department of General Medicine, King George Hospital, Visakhapatnam, India
| | - Lakshya Kumar
- Department of General Medicine, Pandit Deendayal Upadhyay Medical College, Rajkot, India
| | - Naga Pratyusha Cheruvu
- Department of Research, University of Florida Jacksonville Physicians Inc., Florida, USA
| | - Adan Irfan
- Department of General Medicine, Mubarak Medical Complex, Sargodha, Pakistan
| | | | - Diti Vinuthna Lavu
- Department of General Medicine, Government Siddhartha Medical College, Vijayawada, India
| | - Anmol Pitliya
- Department of Internal Medicine, Camden Clark Medical Center, University of West Virginia, Parkersburg, West Virginia, USA
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Venkatesh A, Varadarajan S. Quality of sleep among hypertensive patients attending a rural health training centre. J Family Med Prim Care 2024; 13:3111-3114. [PMID: 39228603 PMCID: PMC11368355 DOI: 10.4103/jfmpc.jfmpc_571_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/21/2023] [Accepted: 03/06/2024] [Indexed: 09/05/2024] Open
Abstract
Introduction Sleep is a vital biological, reparative, and restorative phenomenon, and poor sleep has a serious detrimental effect on health. Poor sleep quality is a serious problem as it adversely affects a person's ability to function physically and socially, as well as their potential for profession and quality of life. The degree of hypertension directly affects sleep quality, and poor sleep can exacerbate hypertensive symptoms. This study assesses hypertension patients' sleep quality in a rural health training centre in Chennai. Objectives 1. To study the prevalence of poor sleep quality among hypertensive patients. 2. To determine the association between selected socio-demographic factors and sleep quality among these patients. Materials and Methods Hypertensives attending the outpatient department of a rural health and training centre were selected in a systematic manner and administered a semi-structured interview schedule and the Pittsburgh Sleep Quality Index (PSQI) questionnaire followed by a basic clinical examination. Using the PSQI, they were categorised as having either poor or good sleep quality and the association between selected socio-demographic factors and sleep quality was assessed. Results Out of the 179 study participants, there were almost equal numbers of male and female participants. The mean age of participants was 57.80 years (standard deviation (SD) = 9.8 yrs.). Among the study participants, 44.13% had completed secondary level of school as an education qualification and 6.70% were illiterate. By the modified BG Prasad classification 2022, most of the study participants (34.08%) came under the class II socioeconomic classification. A large proportion (78.8%) of study participants had poor sleep quality. The difference in sleep quality was observed with respect to gender, socio-economic class, alcohol consumption and body mass index (BMI). Conclusion This observational study shows that individuals with hypertension suffer significantly from poor sleep. A poor quality of sleep was reported by 78.77% of the patients in this study. Statistically significant factors that influenced sleep quality were gender, alcohol consumption and BMI.
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Affiliation(s)
- Aishwarya Venkatesh
- Department of Community Medicine, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, Tamil Nadu, India
| | - Suresh Varadarajan
- Department of Community Medicine, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, Tamil Nadu, India
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Hosseini K, Soleimani H, Tavakoli K, Maghsoudi M, Heydari N, Farahvash Y, Etemadi A, Najafi K, Askari MK, Gupta R, Hakim D, Rahimi K. Association between sleep duration and hypertension incidence: Systematic review and meta-analysis of cohort studies. PLoS One 2024; 19:e0307120. [PMID: 39008468 PMCID: PMC11249221 DOI: 10.1371/journal.pone.0307120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 06/19/2024] [Indexed: 07/17/2024] Open
Abstract
AIM Sleep duration has been suggested to be associated with hypertension (HTN). However, evidence of the nature of the relationship and its direction has been inconsistent. Therefore, we performed a meta-analysis to assess the relationship between sleep duration and risk of HTN incidence, and to distinguish more susceptible populations. METHODS PubMed, Embase, Scopus, Web of Science, and ProQuest were searched from January 2000 to May 2023 for cohort studies comparing short and long sleep durations with 7-8 hours of sleep for the risk of HTN incidence. Random-effect model (the DerSimonian-Laird method) was applied to pool risk ratios (RR) and 95% confidence interval (CI). RESULTS We included sixteen studies ranging from 2.4 to 18 years of follow-up duration evaluating HTN incidence in 1,044,035 people. Short sleep duration was significantly associated with a higher risk of developing HTN (HR: 1.07, 95% CI: 1.06-1.09). The association was stronger when the sleep duration was less than 5 hours (HR: 1.11, 95% CI: 1.08-1.14). In contrast to males, females (HR: 1.07, 95% CI: 1.04-1.09) were more vulnerable to developing HTN due to short sleep duration. No significant difference between different follow-up durations and age subgroups was observed. Long sleep duration was not associated with an increased incidence of HTN. CONCLUSION Short sleep duration was associated with higher risk of HTN incidence, however, there was no association between long sleep duration and incidence of HTN. These findings highlight the importance of implementing target-specific preventive and interventional strategies for vulnerable populations with short sleep duration to reduce the risk of HTN.
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Affiliation(s)
- Kaveh Hosseini
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Soleimani
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kiarash Tavakoli
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Science, Tehran, Iran
| | - Milad Maghsoudi
- Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Narges Heydari
- Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Yasmin Farahvash
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Etemadi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kimia Najafi
- Hakim Children Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Mani K Askari
- University of Toledo Medical Center, Toledo, Ohio, United States of America
| | - Rahul Gupta
- Lehigh Valley Health Network, Allentown, Pennsylvania, United States of America
| | - Diaa Hakim
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Kazem Rahimi
- Deep Medicine, Oxford Martin School, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Women's and Reproductive Health, Medical Science Division, University of Oxford, Oxford, United Kingdom
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Liu C, Ye Z, Chen L, Wang H, Wu B, Li D, Pan S, Qiu W, Ye H. Interaction effects between sleep-related disorders and depression on hypertension among adults: a cross-sectional study. BMC Psychiatry 2024; 24:482. [PMID: 38956492 PMCID: PMC11221077 DOI: 10.1186/s12888-024-05931-9] [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: 07/04/2023] [Accepted: 06/25/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Hypertension, sleep disorders, and depression represent notable public health issues, and their interconnected nature has long been acknowledged. The objective of this study is to explore the interplay between sleep disorders and depression in the context of hypertension. METHODS This cross-sectional study involved 42,143 participants aged 18 and above from the NHANES database across seven survey cycles between 2005 and 2018. After excluding those with missing data on depression, sleep disorders, and hypertension, as well as incomplete main variables, 33,383 participants remained. We used weighted logistic regression to examine the relationship between sleep disorders, depression, and hypertension. Additionally, we assessed the interaction between sleep disorders and depression on hypertension using both multiplicative and additive approaches to quantify their combined effect. RESULTS Compared to individuals without sleep disorders, those with sleep disorders have an increased risk of hypertension (OR = 1.51, 95% CI: 1.37-1.67). Furthermore, individuals with depression experience a significantly higher risk of hypertension compared to those with sleep disorders alone (OR = 2.34, 95% CI: 1.95-2.80). Our study reveals a positive interaction between sleep disorders and depression in relation to hypertension risk (OR = 1.07, 95% CI: 1.02-1.13). In addition, we observed the quantitative additive interaction indicators (RERI = 0.73, 95% CI: 0.56 ~ 0.92; API = 0.31, 95% CI: 0.11 ~ 0.46; SI = 2.19, 95% CI: 1.08-3.46) influencing hypertension risk. Furthermore, our research also identified that individuals with less than 7 h of sleep, a sleep latency period between 5 and 30 min, or a latency period exceeding 30 min experience a significantly increased risk of hypertension. CONCLUSIONS Our research uncovered separate links between sleep disorders, depression, and hypertension prevalence. Moreover, we identified an interaction between depression and sleep disorders in hypertension prevalence. Enhancing mental well-being and tackling sleep disorders could help prevent and manage hypertension. Yet, more investigation is required to establish causation and clarify mechanisms.
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Affiliation(s)
- Chunhua Liu
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Zegen Ye
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Liping Chen
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Huaqiang Wang
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Binbin Wu
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Di Li
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Sisi Pan
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Weiwen Qiu
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China.
- Department of Neurology, Lishui Hospital of Traditional Chinese Medicine, Zhejiang University of Chinese Medicine, 800 Zhongshan Street, Lishui City, Zhejiang, 323000, China.
| | - Haiqin Ye
- Lishui Central Hospital, No. 289 Kuocang Road, Liandu District, Lishui City, Zhejiang Province, China.
- Department of Clinical Training, Lishui Municipal Central Hospital, Lishui, Zhejiang Province, 323000, China.
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D'agata MN, Hoopes EK, Keiser T, Patterson F, Szymanski KM, Matias AA, Brewer BC, Witman MA. Device-estimated sleep metrics do not mediate the relation between race and blood pressure dipping in young black and white women. J Clin Hypertens (Greenwich) 2024; 26:850-860. [PMID: 38923277 PMCID: PMC11232447 DOI: 10.1111/jch.14856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/01/2024] [Accepted: 05/17/2024] [Indexed: 06/28/2024]
Abstract
Short, disturbed, and irregular sleep may contribute to blunted nocturnal blood pressure (BP) dipping, a predictor of cardiovascular disease. Black women (BLW) demonstrate less BP dipping and poorer sleep health than White women (WHW). However, it remains unclear whether device-estimated sleep health metrics mediate the relation between race and BP dipping in young women. We hypothesized that the relation between race and BP dipping would be partly mediated by sleep health metrics of sleep duration, sleep efficiency, and sleep regularity. Participants (20 BLW, 17 WHW) were 18-29 years old, normotensive, nonobese, and without evidence of sleep disorders. Systolic and diastolic BP dipping were derived from 24-h ambulatory BP monitoring. Habitual sleep duration and sleep efficiency were estimated via 14 days of wrist actigraphy. Sleep duration regularity was calculated as the standard deviation (SD) of nightly sleep duration (SDSD). Sleep timing regularity metrics were calculated as the SD of sleep onset and sleep midpoint (SMSD). Mediation analysis tested the mediating effect of each sleep metric on the relation between race and BP dipping. BLW experienced less systolic (P = .02) and diastolic (P = .01) BP dipping. Sleep duration (P = .14) was not different between groups. BLW had lower sleep efficiency (P < .01) and higher SDSD (P = .02), sleep onset SD (P < .01) and SMSD (P = .01). No sleep metrics mediated the relation between race and BP dipping (all indirect effects P > .38). In conclusion, mediation pathways of sleep health metrics do not explain racial differences in nocturnal BP dipping between young BLW and WHW.
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Affiliation(s)
- Michele N. D'agata
- Department of Kinesiology and Applied PhysiologyCollege of Health SciencesUniversity of DelawareNewarkDelawareUSA
| | - Elissa K. Hoopes
- Department of Health Behavior and Nutrition SciencesCollege of Health SciencesUniversity of DelawareNewarkDelawareUSA
| | - Thomas Keiser
- Department of Health Behavior and Nutrition SciencesCollege of Health SciencesUniversity of DelawareNewarkDelawareUSA
| | - Freda Patterson
- Department of Health Behavior and Nutrition SciencesCollege of Health SciencesUniversity of DelawareNewarkDelawareUSA
| | - Krista M. Szymanski
- Department of Kinesiology and Applied PhysiologyCollege of Health SciencesUniversity of DelawareNewarkDelawareUSA
| | - Alexs A. Matias
- Department of Kinesiology and Applied PhysiologyCollege of Health SciencesUniversity of DelawareNewarkDelawareUSA
| | - Benjamin C. Brewer
- Department of EpidemiologyCollege of Health SciencesUniversity of DelawareNewarkDelawareUSA
| | - Melissa A. Witman
- Department of Kinesiology and Applied PhysiologyCollege of Health SciencesUniversity of DelawareNewarkDelawareUSA
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11
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Wang TL, Bryan SG, Jeyabalan A, Facco FL, Gandley RE, Hubel CA, Catov JM, Hauspurg AK. Sleep Quality in Individuals with and without Persistent Postpartum Hypertension. Am J Perinatol 2024; 41:1113-1119. [PMID: 38373709 PMCID: PMC11331418 DOI: 10.1055/s-0044-1780537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
OBJECTIVE This study aimed to compare sleep quality at 1 year postpartum following a hypertensive disorder of pregnancy (HDP) among individuals with persistent postpartum hypertension (HTN) compared with those with normal blood pressures (BPs). STUDY DESIGN We combined data from the Heart Health 4 New Moms pilot randomized trial (n = 118) and the Pathways prospective cohort study (n = 36). Individuals with a singleton pregnancy complicated by gestational HTN or preeclampsia underwent a research study visit at a mean 48.7 ± 9.5 weeks postpartum with standardized BP measurement and assessment of subjective sleep quality with the Pittsburgh Sleep Quality Index (PSQI). Persistent postpartum HTN was defined as Stage 1 HTN or greater (mean systolic BP ≥ 130 mm Hg or mean diastolic BP ≥ 80 mm Hg over three measurements at rest) or requiring antihypertensive medication. Statistical analysis was performed using univariate and multivariable logistic regression analyses. RESULTS Of 154 individuals with an HDP included in the analysis, 84 (55%) were normotensive at 1 year postpartum and 70 (45%) had persistent postpartum HTN. Individuals with persistent postpartum HTN were more likely to be older, self-identify as Black race, have higher prepregnancy and 1-year postpartum body mass index (BMI), be multiparous, and deliver at an earlier gestational age. The mean global PSQI score was 8.7 ± 3.7, with 81% reporting poor sleep (PSQI > 5), and scores were higher among individuals who were persistently hypertensive (9.6 ± 3.5) compared with those who were normotensive at 1 year postpartum (7.9 ± 3.6), p < 0.01. Findings were unchanged in a multivariable model adjusting for age, self-reported race, prepregnancy BMI, and parity. CONCLUSION Following an HDP, individuals reported poor sleep quality at 1 year postpartum. Individuals with persistent postpartum HTN reported lower sleep quality, suggesting that sleep behavior may be a target for intervention to improve maternal cardiovascular health following an HDP. KEY POINTS · After an HDP, poor sleep quality was common at 1 year postpartum.. · Those with persistent postpartum HTN reported worse sleep quality at 1 year postpartum.. · Sleep behavior may be a target for intervention to improve maternal cardiovascular health..
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Affiliation(s)
- Tiffany L. Wang
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Hospital, Pittsburgh, Pennsylvania
| | - Samantha G. Bryan
- Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Arundhathi Jeyabalan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Hospital, Pittsburgh, Pennsylvania
- Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Francesca L. Facco
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Hospital, Pittsburgh, Pennsylvania
| | - Robin E. Gandley
- Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Carl A. Hubel
- Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Janet M. Catov
- Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Alisse K. Hauspurg
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Hospital, Pittsburgh, Pennsylvania
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12
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Shetty NS, Gaonkar M, Patel N, Li P, Arora G, Arora P. Association of Life's Essential 8 and Simple 7 Scores With Mortality: Comparison With Pooled Cohort Equation. JACC. ADVANCES 2024; 3:100945. [PMID: 38938862 PMCID: PMC11198692 DOI: 10.1016/j.jacadv.2024.100945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/04/2024] [Accepted: 01/20/2024] [Indexed: 06/29/2024]
Abstract
Background In 2022, the Life's Simple 7 (LS7) score was replaced with the Life's Essential 8 (LE8) score as a tool to measure cardiovascular health. The risk prediction values of LE8 and LS7 scores for mortality have not been compared. Additionally, the risk prediction value of these scores has not been compared with the pooled cohort equations (PCE) in individuals aged 40 to 79 years. Objectives This study compared the risk prediction value of the: 1) LE8 and LS7 scores in the overall population; and 2) LE8 score, LS7 score, and PCE in the 40- to 79-year-old age group for all-cause and cardiovascular mortality in a nationally representative US population. Methods The LS7 and LE8 scores and the PCE were calculated in the National Health and Nutrition Examination Survey cycles 2007 to 2018. All-cause and cardiovascular mortality were identified by linking the participants to the National Death Index. The C-statistics of the respective weighted Cox models were used to compare the risk prediction value of the standardized scores. Results Among 21,721 individuals included, the C-statistics for all-cause mortality were 0.823 (95% CI: 0.803-0.843) and 0.819 (95% CI: 0.799-0.838) in the LE8 and LS7 score-based models, respectively. The C-statistics for cardiovascular mortality were 0.887 (95% CI: 0.857-0.905) for the LE8 score-based model and 0.883 (95% CI: 0.861-0.905) for the LS7 score-based model. Among 12,943 individuals aged 40 to 79 years, the C-statistics for the outcome of all-cause mortality were 0.756 (95% CI: 0.732-0.779), 0.674 (95% CI: 0.646-0.701), and 0.681 (95% CI: 0.656-0.706) for the PCE, LS7 score, and LE8 score-based models, respectively. Conclusions The LS7 and LE8 scores had similar risk prediction values for all-cause and cardiovascular mortality. Among 40- to 79-year-old individuals, the PCE had better risk discrimination in the LE8 and LS7 scores in predicting all-cause mortality.
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Affiliation(s)
- Naman S. Shetty
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mokshad Gaonkar
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Nirav Patel
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Peng Li
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Garima Arora
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Pankaj Arora
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA
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13
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Wilson-Barnes SL, Pagkalos I, Patra E, Kokkinopoulou A, Hassapidou M, Lalama E, Csanalosi M, Kabisch S, Pfeiffer AFH, DeCorte E, Cornelissen V, Bacelar P, Balula Dias S, Stefanidis K, Tsatsou D, Gymnopoulos L, Dimitropoulos K, Rouskas K, Argiriou N, Leoni R, Botana JM, Russell D, Lanham-New SA, Hart K. The development of an EU-wide nutrition and physical activity expert knowledge base to support a personalised mobile application across various EU population groups. NUTR BULL 2024; 49:220-234. [PMID: 38773712 DOI: 10.1111/nbu.12673] [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: 05/19/2023] [Revised: 03/18/2024] [Accepted: 03/26/2024] [Indexed: 05/24/2024]
Abstract
A healthy lifestyle comprising regular physical activity and an adequate diet is imperative for the prevention of non-communicable diseases such as hypertension and some cancers. Advances in information computer technology offer the opportunity to provide personalised lifestyle advice directly to the individual through devices such as smartphones or tablets. The overall aim of the PROTEIN project (Wilson-Barnes et al., 2021) was to develop a smartphone application that could provide tailored and dynamic nutrition and physical activity advice directly to the individual in real time. However, to create this mobile health (m-health) smartphone application, a knowledge base of reference ranges for macro-/micronutrient intake, anthropometry, biochemical, physiological and sleep parameters was required to underpin the parameters of the recommender systems. Therefore, the principal aim of this emerging research paper is to describe the process by which experts in nutrition and physiology from the PROTEIN consortium collaborated to develop the nutritional and physical activity requirements, based upon existing recommendations, for 10 separate population groups living within the EU including, but not limited to healthy adults, adults with type 2 diabetes mellitus, cardiovascular disease, excess weight, obesity and iron deficiency anaemia. A secondary aim is to describe the development of a library of 24-h meal plans appropriate for the same groups and also encompassing various dietary preferences and allergies. Overall, the consortium devised an extensive nutrition and physical activity knowledge base that is pertinent to 10 separate EU user groups, is available in 7 different languages and is practically implemented via a library of culturally appropriate, 24-h meal plans.
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Affiliation(s)
- S L Wilson-Barnes
- School of Biosciences & Medicine, University of Surrey, Guildford, UK
| | - I Pagkalos
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - E Patra
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - A Kokkinopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - M Hassapidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - E Lalama
- Department of Endocrinology, Diabetes and Nutrition, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - M Csanalosi
- Department of Endocrinology, Diabetes and Nutrition, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - S Kabisch
- Department of Endocrinology, Diabetes and Nutrition, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - A F H Pfeiffer
- Department of Endocrinology, Diabetes and Nutrition, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - E DeCorte
- Department of Rehabilitation Sciences and Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - V Cornelissen
- Department of Rehabilitation Sciences and Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - P Bacelar
- Healthium/Nutrium Software, Porto e Região, Portugal
| | - S Balula Dias
- Interdisciplinary Centre for the Study of Human Performance (CIPER), Faculdade de Motricidade Human, Universidade de Lisboa, Lisbon, Portugal
| | - K Stefanidis
- Centre for Research & Technology Hellas, Thessaloniki, Greece
| | - D Tsatsou
- Centre for Research & Technology Hellas, Thessaloniki, Greece
| | - L Gymnopoulos
- Centre for Research & Technology Hellas, Thessaloniki, Greece
| | - K Dimitropoulos
- Centre for Research & Technology Hellas, Thessaloniki, Greece
| | - K Rouskas
- Centre for Research & Technology Hellas, Thessaloniki, Greece
| | - N Argiriou
- Centre for Research & Technology Hellas, Thessaloniki, Greece
| | | | | | | | - S A Lanham-New
- School of Biosciences & Medicine, University of Surrey, Guildford, UK
| | - K Hart
- School of Biosciences & Medicine, University of Surrey, Guildford, UK
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14
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Ohkuma T, Iwase M, Kitazono T. Sleep duration and its association with constipation in patients with diabetes: The fukuoka diabetes registry. PLoS One 2024; 19:e0302430. [PMID: 38776319 PMCID: PMC11111002 DOI: 10.1371/journal.pone.0302430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 04/04/2024] [Indexed: 05/24/2024] Open
Abstract
AIMS Shorter and longer sleep durations are associated with adverse health consequences. However, available evidence on the association of sleep duration with constipation is limited, especially in patients with diabetes, who are at a high risk of both conditions. This study aimed to examine the association between sleep duration and constipation in patients with type 2 diabetes. METHODS A total of 4,826 patients with type 2 diabetes were classified into six groups according to sleep duration: <4.5, 4.5-5.4, 5.5-6.4, 6.5-7.4, 7.5-8.4, and ≥8.5 hours/day. The odds ratios for the presence of constipation, defined as a defecation frequency <3 times/week and/or laxative use, were calculated using a logistic regression model. RESULTS Shorter and longer sleep durations were associated with a higher likelihood of constipation than an intermediate duration (6.5-7.4 hours/day). This U-shaped association persisted after adjusting for confounding factors, including lifestyle behavior, measures of obesity and glycemic control, and comorbidities. Broadly identical findings were observed when decreased defecation frequency and laxative use were individually assessed. CONCLUSIONS This study shows a U-shaped association between sleep duration and constipation in patients with type 2 diabetes, and highlights the importance of assessing sleep duration in daily clinical practice.
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Affiliation(s)
- Toshiaki Ohkuma
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masanori Iwase
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Diabetes Center, Hakujyuji Hospital, Fukuoka, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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15
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Li W, Tiedt S, Lawrence JH, Harrington ME, Musiek ES, Lo EH. Circadian Biology and the Neurovascular Unit. Circ Res 2024; 134:748-769. [PMID: 38484026 DOI: 10.1161/circresaha.124.323514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 02/14/2024] [Indexed: 03/19/2024]
Abstract
Mammalian physiology and cellular function are subject to significant oscillations over the course of every 24-hour day. It is likely that these daily rhythms will affect function as well as mechanisms of disease in the central nervous system. In this review, we attempt to survey and synthesize emerging studies that investigate how circadian biology may influence the neurovascular unit. We examine how circadian clocks may operate in neural, glial, and vascular compartments, review how circadian mechanisms regulate cell-cell signaling, assess interactions with aging and vascular comorbidities, and finally ask whether and how circadian effects and disruptions in rhythms may influence the risk and progression of pathophysiology in cerebrovascular disease. Overcoming identified challenges and leveraging opportunities for future research might support the development of novel circadian-based treatments for stroke.
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Affiliation(s)
- Wenlu Li
- Neuroprotection Research Laboratories, Departments of Radiology and Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (W.L., E.H.L.)
- Consortium International pour la Recherche Circadienne sur l'AVC, Munich, Germany (W.L., S.T., J.H.L., M.E.H., E.S.M., E.H.L.)
| | - Steffen Tiedt
- Consortium International pour la Recherche Circadienne sur l'AVC, Munich, Germany (W.L., S.T., J.H.L., M.E.H., E.S.M., E.H.L.)
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany (S.T.)
| | - Jennifer H Lawrence
- Consortium International pour la Recherche Circadienne sur l'AVC, Munich, Germany (W.L., S.T., J.H.L., M.E.H., E.S.M., E.H.L.)
- Department of Neurology, Washington University School of Medicine, St. Louis, MO (J.H.L., E.S.M.)
| | - Mary E Harrington
- Consortium International pour la Recherche Circadienne sur l'AVC, Munich, Germany (W.L., S.T., J.H.L., M.E.H., E.S.M., E.H.L.)
- Neuroscience Program, Smith College, Northampton, MA (M.E.H.)
| | - Erik S Musiek
- Consortium International pour la Recherche Circadienne sur l'AVC, Munich, Germany (W.L., S.T., J.H.L., M.E.H., E.S.M., E.H.L.)
- Department of Neurology, Washington University School of Medicine, St. Louis, MO (J.H.L., E.S.M.)
| | - Eng H Lo
- Neuroprotection Research Laboratories, Departments of Radiology and Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (W.L., E.H.L.)
- Consortium International pour la Recherche Circadienne sur l'AVC, Munich, Germany (W.L., S.T., J.H.L., M.E.H., E.S.M., E.H.L.)
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16
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Tahsin CT, Anselmo M, Lee E, Stokes W, Fonkoue IT, Vanden Noven ML, Carter JR, Keller-Ross ML. Sleep disturbance and sympathetic neural reactivity in postmenopausal females. Am J Physiol Heart Circ Physiol 2024; 326:H752-H759. [PMID: 38214902 PMCID: PMC11221801 DOI: 10.1152/ajpheart.00724.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/02/2024] [Accepted: 01/09/2024] [Indexed: 01/13/2024]
Abstract
Sleep disturbance, one of the most common menopausal symptoms, contributes to autonomic dysfunction and is linked to hypertension and cardiovascular risk. Longitudinal studies suggest that hyperreactivity of blood pressure (BP) to a stressor can predict the future development of hypertension. It remains unknown if postmenopausal females who experience sleep disturbance (SDG) demonstrate greater hemodynamic and sympathetic neural hyperreactivity to a stressor. We hypothesized that postmenopausal females with reported sleep disturbance would exhibit increased hemodynamic and sympathetic reactivity to a stressor compared with postmenopausal females without sleep disturbance (non-SDG). Fifty-five postmenopausal females (age, 62 ± 4 yr old; SDG, n = 36; non-SDG; n = 19) completed two study visits. The Menopause-Specific Quality of Life Questionnaire (MENQOL) was used to assess the presence of sleep disturbance (MENQOL sleep scale, ≥2 units). Beat-to-beat BP (finger plethysmography), heart rate (HR; electrocardiogram), and muscle sympathetic nerve activity (MSNA; microneurography; SDG, n = 25; non-SDG, n = 15) were continuously measured during a 10-min baseline and 2-min stressor (cold pressor test; CPT) in both groups. Menopause age and body mass index were similar between groups (P > 0.05). There were no differences between resting BP, HR, or MSNA (P > 0.05). HR and BP reactivity were not different between SDG and non-SDG (P > 0.05). In contrast, MSNA reactivity had a more rapid increase in the first 30 s of the CPT in the SDG (burst incidence, Δ10.2 ± 14.8 bursts/100 hb) compared with the non-SDG (burst incidence, Δ4.0 ± 14.8 bursts/100 hb, time × group, P = 0.011). Our results demonstrate a more rapid sympathetic neural reactivity to a CPT in postmenopausal females with perceived sleep disturbance, a finding that aligns with and advances recent evidence that sleep disturbance is associated with sympathetic neural hyperactivity in postmenopausal females.NEW & NOTEWORTHY This is the first study to demonstrate that muscle sympathetic nerve activity (MSNA) to a cold pressor test is augmented in postmenopausal females with perceived sleep disturbance. The more rapid increase in MSNA reactivity during the cold pressor test in the sleep disturbance group was present despite similar increases in the perceived pain levels between groups. Baseline MSNA burst incidence and burst frequency, as well as blood pressure and heart rate, were similar between the sleep disturbance and nonsleep disturbance groups.
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Affiliation(s)
- Chowdhury Tasnova Tahsin
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
| | - Miguel Anselmo
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
| | - Emma Lee
- Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
| | - William Stokes
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
| | - Ida T Fonkoue
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
- Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
| | - Marnie L Vanden Noven
- Department of Exercise Science, Belmont University, Nashville, Tennessee, United States
| | - Jason R Carter
- Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, United States
| | - Manda L Keller-Ross
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
- Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
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17
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Deng YY, Ngai FW, Qin J, Yang L, Wong KP, Wang HH, Xie YJ. Combined Influence of Eight Lifestyle Factors on Metabolic Syndrome Incidence: A Prospective Cohort Study from the MECH-HK Study. Nutrients 2024; 16:547. [PMID: 38398871 PMCID: PMC10892175 DOI: 10.3390/nu16040547] [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: 01/05/2024] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
Although previous studies have shown significant associations between individual lifestyles and metabolic syndrome, limited studies have explored the combined effect of lifestyles. The purpose of this study was to investigate whether a combined lifestyle score was associated with metabolic syndrome incidence in Hong Kong Chinese women. This prospective cohort study included 1634 women (55.9 ± 8.6 years) without baseline metabolic syndrome, diabetes, myocardial infarction, or stroke. Eight lifestyle factors (smoking, physical activity, sedentary time, sleep, stress, fatigue, diet, and alcohol) were included by assigning 0 (unhealthy) or 1 point (healthy). The overall score was the sum of these points, ranging from 0 (the least healthy) to 8 points (the healthiest). Metabolic syndrome was diagnosed by the joint interim statement. During a 1.16-year follow-up, 179 (11.0%) new metabolic syndrome cases were identified. The incidences for the 0-3-point, 4-point, 5-point, and 6-8-point groups were 12.8% (79/618), 11.5% (42/366), 9.4% (29/309), and 8.5% (29/341), respectively. Compared to the lowest combined lifestyle score group, the highest group had a 47% reduced metabolic syndrome incidence, with an adjusted odds ratio and 95% confidence interval of 0.53 (0.33-0.86) (p = 0.010). These findings indicate that a higher combined lifestyle score was associated with a lower metabolic syndrome incidence in this population.
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Affiliation(s)
- Yun-Yang Deng
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China; (Y.-Y.D.); (F.-W.N.); (J.Q.); (L.Y.)
| | - Fei-Wan Ngai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China; (Y.-Y.D.); (F.-W.N.); (J.Q.); (L.Y.)
| | - Jing Qin
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China; (Y.-Y.D.); (F.-W.N.); (J.Q.); (L.Y.)
| | - Lin Yang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China; (Y.-Y.D.); (F.-W.N.); (J.Q.); (L.Y.)
| | - Ka-Po Wong
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China;
| | - Harry-Haoxiang Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China;
- College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh EH8 9AG, UK
| | - Yao-Jie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China; (Y.-Y.D.); (F.-W.N.); (J.Q.); (L.Y.)
- Research Centre for Chinese Medicine Innovation, The Hong Kong Polytechnic University, Hong Kong SAR, China
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18
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Agrawal P, Singh SM, Able C, Kohn TP, Herati AS. Sleep disorders are associated with testosterone deficiency and erectile dysfunction-a U.S. claims database analysis. Int J Impot Res 2024; 36:78-82. [PMID: 36473958 DOI: 10.1038/s41443-022-00649-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022]
Abstract
The relationship between male genitourinary conditions and sleep disorders has previously only been reported in single-institution studies with small cohorts. Our objective was to assess the association of erectile dysfunction (ED) and testosterone deficiency with various sleep disorders using a large claims database. The TriNetX Diamond database was queried in June 2022. In men aged 40-70 years, insomnia, sleep apnea, and circadian rhythm sleep disorder were each independently assessed to determine the association with ED and testosterone deficiency and then followed by propensity score matching performed for age, hypertension, hyperlipidemia, diabetes mellitus, ischemic heart disease, tobacco usage, and obesity. Testosterone deficiency was more likely to be found in men diagnosed with sleep apnea (odds ratio (OR) 1.66 [95% confidence interval (CI) 1.65-1.67]), insomnia (OR 1.74 [95% CI 1.73-1.76]), and circadian rhythm dysfunction (OR 2.63 [95% CI 2.54-2.73]) compared to matched controls. ED was more likely to be found in men diagnosed with sleep apnea (OR 1.02 [95% CI 1.01-1.03]), insomnia (OR 1.30 [95% CI 1.30-1.31]), and circadian rhythm dysfunction (OR 1.54 [95% CI 1.49-1.59]) compared to matched controls. Our results emphasize the negative impact of poor sleep on diseases of the male genitourinary system by identifying these relationships in the largest cohort in the U.S. reported to date.
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Affiliation(s)
- Pranjal Agrawal
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sajya M Singh
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Corey Able
- University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Taylor P Kohn
- The James Buchanan Brady Urological Institute at Johns Hopkins, Baltimore, MD, USA.
| | - Amin S Herati
- The James Buchanan Brady Urological Institute at Johns Hopkins, Baltimore, MD, USA
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Belladelli F, Li S, Zhang CA, Del Giudice F, Basran S, Muncey W, Glover F, Seranio N, Fallara G, Montorsi F, Salonia A, Eisenberg ML. The Association Between Insomnia, Insomnia Medications, and Erectile Dysfunction. Eur Urol Focus 2024; 10:139-145. [PMID: 37690918 DOI: 10.1016/j.euf.2023.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/31/2023] [Accepted: 08/15/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Sleep quality and duration have been investigated for their association with health. Insomnia affects up to one-third of adults and may impact male erectile function. In addition, medical treatments for insomnia (many of which are sedatives) may also affect erectile quality. OBJECTIVE To investigate the association of erectile dysfunction (ED) in patients diagnosed with and treated for insomnia. DESIGN, SETTING, AND PARTICIPANTS We utilized the IBM MarketScan (2007-2016) Commercial and Medicare Supplemental Databases (v 2.0). Age- and enrollment-matched controls were selected among patients without insomnia diagnosis or treatment. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Cox proportional hazard models were used to estimate the risk of incident ED (ie, diagnosis alone, or diagnosis and treatment with phosphodiesterase-5 inhibitors [PDE5i], intracavernous injection (ICI)/urethral suppositories, and penile prosthesis) after the diagnosis or treatment of insomnia while adjusting for relevant comorbidities. RESULTS AND LIMITATIONS In total, 539 109 men with an insomnia diagnosis were identified. Of these men, 356 575 were also medically treated for insomnia. The mean (±standard deviation) follow-up times for patients diagnosed with insomnia and those diagnosed with and treated for insomnia were 2.8 ± 1.6 and 3.1 ± 1.8 yr, respectively. Men with insomnia were more commonly smokers and had a higher number of office visits and comorbidities than controls (p < 0.001). On an adjusted analysis, both untreated and treated insomnia were associated with increased risks of ED diagnosis (hazard ratio or HR [95% confidence interval {CI}]: 1.58 [1.54-1.62] and 1.66 [1.64-1.69], respectively; p < 0.001). Similarly, men with treated insomnia had a higher risk of having ED treated with PDE5i (HR [95% CI]: 1.52 [1.49-1.55]; p < 0.001) and ICI (HR [95% CI]: 1.32 [1.14-1.54]; p < 0.001) when compared with controls. A limitation of this study was that a lack of granularity regarding patient clinical characteristics (eg, severity of disease, laboratory data, etc.) is inherent to insurance claims data. In addition, the follow-up was limited and may affect associations at longer time points. CONCLUSIONS In the current report, a consistent association between insomnia and ED diagnosis was identified. Men diagnosed with insomnia only were found to have a higher risk of developing ED. Moreover, men with pharmacological insomnia treatments were more often prescribed treatments for ED. Given the prevalence of insomnia, future studies are warranted to delineate the association of insomnia and its treatment with erectile function. PATIENT SUMMARY Insomnia affects up to one-third of adults and impact male erectile function. Men only diagnosed with insomnia were found to have a higher risk of developing erectile dysfunction (ED). Moreover, men with pharmacological insomnia treatments were more often prescribed treatments for ED.
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Affiliation(s)
- Federico Belladelli
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy; Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Shufeng Li
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA; Department of Dermatology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Chiyuan A Zhang
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Francesco Del Giudice
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA; Department of Urology, University Sapienza, Rome, Italy
| | - Satvir Basran
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Wade Muncey
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Frank Glover
- Department of Urology, University Sapienza, Rome, Italy
| | - Nicolas Seranio
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Giuseppe Fallara
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Michael L Eisenberg
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA.
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20
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Bommarito JC, Millar PJ. Effects of aerobic exercise on ambulatory blood pressure responses to acute partial sleep deprivation: impact of chronotype and sleep quality. Am J Physiol Heart Circ Physiol 2024; 326:H291-H301. [PMID: 38038716 DOI: 10.1152/ajpheart.00441.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/07/2023] [Accepted: 11/28/2023] [Indexed: 12/02/2023]
Abstract
Blood pressure (BP) follows a circadian rhythm intertwined with the sleep-wake cycle. Acute partial sleep deprivation (PSD; sleep ≤ 6 h) can increase BP, associated with increased cardiovascular risk. Acute exercise can reduce BP for up to 24 h, a phenomenon termed postexercise hypotension. The present study tested whether aerobic exercise could mitigate the augmented 24-h ambulatory BP caused by acute PSD. Twenty-four young otherwise healthy adults (22 ± 3 yr; 14 females; self-reported chronotypes: 6 early/10 intermediate/8 late; Pittsburgh sleep quality index: 17 good/7 poor sleepers) completed a randomized crossover trial in which, on different days, they slept normally (2300-0700), restricted sleep [0330-0700 (PSD)], and cycled for 50 min (70-80% predicted heart rate maximum) before PSD. Ambulatory BP was assessed every 30 min until 2100 the next day. Acute PSD increased 24-h systolic BP (control 117 ± 9 mmHg, PSD 122 ± 9 mmHg; P < 0.001) and prior exercise attenuated (exercise + PSD 120 ± 9 mmHg; P = 0.04 vs. PSD) but did not fully reverse this response (exercise + PSD, P = 0.02 vs. control). Subgroup analysis revealed that the 24-h systolic BP reduction following exercise was specific to late types (PSD 119 ± 7 vs. exercise + PSD 116 ± 6 mmHg; P < 0.05). Overall, habitual sleep quality was negatively correlated with the change in daytime systolic BP following PSD (r = -0.56, P < 0.01). These findings suggest that the ability of aerobic cycling exercise to counteract the hemodynamic effects of acute PSD in young adults may be dependent on chronotype and that habitual sleep quality can predict the daytime BP response to acute PSD.NEW & NOTEWORTHY We demonstrate that cycling exercise attenuates, but does not fully reverse, the augmented 24-h ambulatory blood pressure (BP) response caused by acute partial sleep deprivation (PSD). This response was primarily observed in late chronotypes. Furthermore, daytime BP after acute PSD is related to habitual sleep quality, with better sleepers being more prone to BP elevations. This suggests that habitual sleeping habits can influence BP responses to acute PSD and their interactions with prior cycling exercise.
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Affiliation(s)
- Julian C Bommarito
- Human Cardiovascular Physiology Laboratory, Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Philip J Millar
- Human Cardiovascular Physiology Laboratory, Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
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Oberhoffer FS, Dalla-Pozza R, Jakob A, Haas NA, Mandilaras G, Li P. Energy drinks: effects on pediatric 24-h ambulatory blood pressure monitoring. A randomized trial. Pediatr Res 2023; 94:1172-1179. [PMID: 37061642 PMCID: PMC10444612 DOI: 10.1038/s41390-023-02598-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/14/2023] [Accepted: 02/27/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Energy drinks (EDs) are popular beverages among minors. To date, clinical studies investigating ED-induced effects on the pediatric cardiovascular system are sparse. This study aimed to investigate the effects of a single, bodyweight-adjusted ED dosage on 24-h ambulatory blood pressure monitoring (ABPM) in healthy children and adolescents. METHODS This study was a randomized, single-blind, placebo-controlled, crossover clinical trial. Study participants received a single, bodyweight-adjusted ED amount or a placebo drink on 2 consecutive days at similar morning hours. Twenty-four-hour ABPM was assessed via an automated oscillometric blood pressure device after beverage consumption on both study days. RESULTS A total of 17 healthy children and teenagers (13.90 (12.29-17.89) years) were included in the final analysis. The ED consumption led, compared to the placebo intake, to a significantly higher 24-h systolic (115.90 (110.22-118.04) vs. 110.64 (108.09-115.45) mmHg, p = 0.013) and diastolic blood pressure (66.08 (64.20-68.32) vs. 62.63 (61.40-66.46) mmHg, p = 0.005). CONCLUSIONS The single, bodyweight-adjusted ED consumption is linked with a significantly higher systolic as well as diastolic 24-h blood pressure in healthy children and adolescents. Minors, particularly those with an increased cardiovascular morbidity, should be discouraged from drinking EDs. IMPACT Energy drinks (EDs) are consumed by many children and teenagers. While adverse cardiovascular events after ED consumption were reported in the literature, the effects of these beverages on the pediatric 24-h blood pressure profile have not been systematically evaluated yet. In our manuscript, we demonstrate for the first time that acute ED consumption is associated with a significantly higher 24-h systolic blood pressure and diastolic blood pressure in healthy minors.
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Affiliation(s)
- Felix S Oberhoffer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377, Munich, Germany.
| | - Robert Dalla-Pozza
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377, Munich, Germany
| | - André Jakob
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Nikolaus A Haas
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Guido Mandilaras
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Pengzhu Li
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377, Munich, Germany
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Wu H, Zheng Y, Liu DN, Liu XX, Yang QD, Su QY, Wang YQ, Wang YZ, La XN, Shi Y, Fu C. Association Between Sleep Duration and Stroke in Different Status of Metabolic Syndrome: A Cross-Sectional Study in Shanghai Adult Residents. Nat Sci Sleep 2023; 15:639-652. [PMID: 37581120 PMCID: PMC10423582 DOI: 10.2147/nss.s408669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/09/2023] [Indexed: 08/16/2023] Open
Abstract
Purpose This study aimed to investigate the relationship between sleep duration (SD) and stroke, and examine the effects of SD on stroke with or without metabolic syndrome (Mets) and its components among the adult residents in Shanghai, China. Participants and Methods A total of 20,245 participants (51.72% male, mean age 44.66 years) were included from Shanghai Chronic Disease and Risk Factors Surveillance (SCDRFS) in 2017. The weighted logistic regressions were performed to examine the associations between SD and stroke in different status of Mets and its components. Results The mean SD was 7.51±0.03 h/d. After adjusting for all the potential factors, SD<6 h/d (OR=1.73, 95% CI: 1.35-2.20) or ≥10 h/d (OR=1.66, 95% CI: 1.08-2.57) was significantly positively associated with stoke in the total participants; moreover, in the non-Mets group, only SD<6 h/d (OR=1.77, 95% CI: 1.19, 2.64) significantly increased the risk of stroke; while, in the Mets group, SD<6 h/d (OR=1.80, 95% CI:1.17-2.76) and ≥10 h/d (OR=1.97, 95% CI: 1.00-3.88) both had a positive significantly association with stoke. In addition, the effects of SD<6 h/d on stroke were more pronounced among those with high WC (OR=2.24, 95% CI: 1.40-3.58) and high TG (OR=2.60, 95% CI: 1.86-3.62), and the effects of SD≥10 h/d on stroke were more evident among those with high TG (OR=2.28, 95% CI: 1.02-5.08) and high FBG (OR=2.58, 95% CI: 1.30-5.10). Conclusion Both short and long SD were significantly positively associated with stroke in the total participants, and the associations were stronger in the Mets group; conversely, in the non-Mets group, only short SD was significantly positively associated with stroke, and no significant association was observed between long SD and stroke. Therefore, more precise sleep measures may be needed to prevent stroke according to the different status of Mets.
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Affiliation(s)
- Han Wu
- Division of Noncommunicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Yang Zheng
- Division of Noncommunicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Dan-Ni Liu
- Division of Noncommunicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Xiao-Xia Liu
- Division of Noncommunicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Qun-Di Yang
- Division of Noncommunicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Qiu-Yun Su
- Division of Noncommunicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Ying-Quan Wang
- Division of Noncommunicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Yu-Zhuo Wang
- Division of Noncommunicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Xue-Na La
- Division of Noncommunicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Yan Shi
- Division of Noncommunicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Chen Fu
- Division of Noncommunicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
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23
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Chen J, Li F, Wang Y, Cai D, Chen Y, Mei Z, Chen L. Short sleep duration and atrial fibrillation risk: A comprehensive analysis of observational cohort studies and genetic study. Eur J Intern Med 2023; 114:84-92. [PMID: 37183080 DOI: 10.1016/j.ejim.2023.05.001] [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: 10/11/2022] [Revised: 04/18/2023] [Accepted: 05/02/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Previous observational studies are inconclusive on whether an association exists between short sleep duration and the high risk of developing atrial fibrillation (AF). Understanding their potential association would be of great clinical significance. Thus, in this study, we aimed to explore their causal relationship. METHODS AND RESULTS We meta-analyzed the association between short sleep duration and the risk of developing AF by including six observational studies. Based on genetic susceptibility analysis using the mendelian randomization (MR) method, we identified 16 genetic loci that might link short sleep duration and the high risk of developing AF. Meta-analysis showed a significant association between short sleep duration and a higher risk of developing AF (RR = 1.06, 95% CI 1.02-1.11, P = 0.005). However, the fixed-effect and random-effect inverse variance weighted (IVW) models using the MR method showed a non-obvious effect of short sleep duration on the risk of developing AF (OR, 0.979; 95% CI, 0.880-1.089, P = 0.693; OR, 0.979; 95% CI, 0.857-1.117, P = 0.750, respectively). Other models, also showed no statistical difference. No heterogeneity or asymmetry was observed, as Cochran's Q test showed. The leave-one-out sensitivity analysis demonstrated good robust results, which were not subject to directional pleiotropy. CONCLUSION Meta-analysis and MR analysis demonstrated inconsistent results on the relationship between short sleep duration and a high risk of developing AF. Specifically, while meta-analysis confirmed that short sleep duration increases the risk of developing AF, MR analysis did not support a causal association between genetically determined short sleep and risk of AF.
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Affiliation(s)
- Jun Chen
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310000, China
| | - Fuhao Li
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310000, China
| | - Yucheng Wang
- Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Shanghai Medical College of Fudan University, Shanghai, China
| | - Dongsheng Cai
- Zhejiang University of Medical College, Hangzhou, Zhejiang 310000, China
| | - Yijie Chen
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310000, China
| | - Ziwei Mei
- Lishui Municipal Central Hospital, the Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang 323000, China.
| | - Lei Chen
- Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang 318000, China.
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Yen CF, Chou WP, Hsu CY, Wu HC, Wang PW. Effects of heart rate variability biofeedback (HRVBFB) on sleep quality and depression among methamphetamine users. J Psychiatr Res 2023; 162:132-139. [PMID: 37149922 DOI: 10.1016/j.jpsychires.2023.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/29/2023] [Accepted: 05/01/2023] [Indexed: 05/09/2023]
Abstract
Methamphetamine is garnering concern due to its increasing use worldwide. Depression and sleep quality are major mental health issues in substance users. Heart rate variability biofeedback (HRVBFB) has shown promising results in terms of reducing depression and increasing sleep quality. The present study aimed to explore the effects of HRVBFB on these two issues in methamphetamine users. Sixty-one methamphetamine users were enrolled and allocated randomly into a treatment as usual (TAU) group and a HRVBFB plus TAU group. The levels of depressive symptoms and sleep quality were assessed at intake, end of the intervention, and end of follow-up. Compared with baseline, the levels of depressive symptoms and poor sleep quality were decreased at the end of the intervention and follow-up in the HRVBFB group. The HRVBFB group exhibited a greater decrease in depressive symptoms and a better improvement in sleep quality than the TAU group. The associations of HRV indices with levels of depressive symptoms and poor sleep quality were different in the two groups. Our results showed that HRVBFB is a promising intervention for reducing depressive symptoms and improving sleep quality in methamphetamine users. The benefits with respect to depressive symptoms and poor sleep quality can extend beyond the end of HRVBFB intervention.
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Affiliation(s)
- Cheng-Fang Yen
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, 80708, Taiwan
| | - Wei-Po Chou
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, 80708, Taiwan
| | - Chih-Yao Hsu
- Department of Addiction Science, Kai-Suan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Hung-Chi Wu
- Department of Addiction Science, Kai-Suan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Peng-Wei Wang
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, 80708, Taiwan.
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Wright CJ, Milosavljevic S, Pocivavsek A. The stress of losing sleep: Sex-specific neurobiological outcomes. Neurobiol Stress 2023; 24:100543. [PMID: 37252645 PMCID: PMC10209346 DOI: 10.1016/j.ynstr.2023.100543] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/20/2023] [Accepted: 05/06/2023] [Indexed: 05/31/2023] Open
Abstract
Sleep is a vital and evolutionarily conserved process, critical to daily functioning and homeostatic balance. Losing sleep is inherently stressful and leads to numerous detrimental physiological outcomes. Despite sleep disturbances affecting everyone, women and female rodents are often excluded or underrepresented in clinical and pre-clinical studies. Advancing our understanding of the role of biological sex in the responses to sleep loss stands to greatly improve our ability to understand and treat health consequences of insufficient sleep. As such, this review discusses sex differences in response to sleep deprivation, with a focus on the sympathetic nervous system stress response and activation of the hypothalamic-pituitary-adrenal (HPA) axis. We review sex differences in several stress-related consequences of sleep loss, including inflammation, learning and memory deficits, and mood related changes. Focusing on women's health, we discuss the effects of sleep deprivation during the peripartum period. In closing, we present neurobiological mechanisms, including the contribution of sex hormones, orexins, circadian timing systems, and astrocytic neuromodulation, that may underlie potential sex differences in sleep deprivation responses.
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Affiliation(s)
- Courtney J. Wright
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Snezana Milosavljevic
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Ana Pocivavsek
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, USA
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Li K, Zhao J, Yang W, Ye Z. Sleep traits and risk of end-stage renal disease: a mendelian randomization study. BMC Med Genomics 2023; 16:76. [PMID: 37029366 PMCID: PMC10080763 DOI: 10.1186/s12920-023-01497-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 03/23/2023] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND Epidemiological evidence relating sleep disorders to end-stage renal disease (ESRD) has been obscure. The present study is sought to examine the association between sleep traits and ESRD. METHODS For this analysis, we selected genetic instruments for sleep traits from published genome-wide association studies (GWAS). As instrumental variables, independent genetic variations linked with seven sleep-related features (sleep duration, getting up in the morning, daytime napping, chronotype of morning/evening person, sleeplessness/insomnia, non-snoring, and daytime dozing) were chosen. A two-sample Mendelian randomization (TSMR) study was conducted to assess the causal relationship between sleep traits and ESRD (N = 33,061). The reverse MR analysis subsequently determined the causal relationship between ESRD and sleep traits. The causal effects were estimated using inverse variance weighted, MR-Egger, weighted median. To conduct sensitivity studies, Cochran's Q test, MR-Egger intercept test, MR-PRESSO, leave-one-out analysis, and funnel plot were used. To study the potential mediators, multivariable mendelian randomization analyses were undertaken further. RESULTS Genetically predicted sleeplessness/ insomnia (OR = 6.11, 95%CI 1.00-37.3, P = 0.049, FDR = 0.105), getting up in the morning easily(OR = 0.23, 95%CI 0.063-0.85; P = 0.0278, FDR = 0.105), non-snoring (OR = 4.76E-02, 95%CI 2.29E-03-0.985, P = 0.0488, FDR = 0.105) was suggestively associated with the risk of ESRD. However, we found no evidence favoring a causal association between other sleep traits and ESRD through the IVW method. CONCLUSION The present TSMR found no strong evidence of a bidirectional causal association between genetically predicted sleep traits and ESRD.
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Affiliation(s)
- Kaixin Li
- Department of Nephrology, Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Jiaxi Zhao
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Wenjing Yang
- Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Zhibin Ye
- Department of Nephrology, Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China.
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Zheng W, Chen Q, Yao L, Zhuang J, Huang J, Hu Y, Yu S, Chen T, Wei N, Zeng Y, Zhang Y, Fan C, Wang Y. Prediction Models for Sleep Quality Among College Students During the COVID-19 Outbreak: Cross-sectional Study Based on the Internet New Media. J Med Internet Res 2023; 25:e45721. [PMID: 36961495 PMCID: PMC10131726 DOI: 10.2196/45721] [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: 01/14/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND COVID-19 has been reported to affect the sleep quality of Chinese residents; however, the epidemic's effects on the sleep quality of college students during closed-loop management remain unclear, and a screening tool is lacking. OBJECTIVE This study aimed to understand the sleep quality of college students in Fujian Province during the epidemic and determine sensitive variables, in order to develop an efficient prediction model for the early screening of sleep problems in college students. METHODS From April 5 to 16, 2022, a cross-sectional internet-based survey was conducted. The Pittsburgh Sleep Quality Index (PSQI) scale, a self-designed general data questionnaire, and the sleep quality influencing factor questionnaire were used to understand the sleep quality of respondents in the previous month. A chi-square test and a multivariate unconditioned logistic regression analysis were performed, and influencing factors obtained were applied to develop prediction models. The data were divided into a training-testing set (n=14,451, 70%) and an independent validation set (n=6194, 30%) by stratified sampling. Four models using logistic regression, an artificial neural network, random forest, and naïve Bayes were developed and validated. RESULTS In total, 20,645 subjects were included in this survey, with a mean global PSQI score of 6.02 (SD 3.112). The sleep disturbance rate was 28.9% (n=5972, defined as a global PSQI score >7 points). A total of 11 variables related to sleep quality were taken as parameters of the prediction models, including age, gender, residence, specialty, respiratory history, coffee consumption, stay up, long hours on the internet, sudden changes, fears of infection, and impatient closed-loop management. Among the generated models, the artificial neural network model proved to be the best, with an area under curve, accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 0.713, 73.52%, 25.51%, 92.58%, 57.71%, and 75.79%, respectively. It is noteworthy that the logistic regression, random forest, and naive Bayes models achieved high specificities of 94.41%, 94.77%, and 86.40%, respectively. CONCLUSIONS The COVID-19 containment measures affected the sleep quality of college students on multiple levels, indicating that it is desiderate to provide targeted university management and social support. The artificial neural network model has presented excellent predictive efficiency and is favorable for implementing measures earlier in order to improve present conditions.
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Affiliation(s)
- Wanyu Zheng
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Qingquan Chen
- The School of Public Health, Fujian Medical University, Fuzhou, China
- The Graduate School of Fujian Medical University, Fuzhou, China
| | - Ling Yao
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
| | - Jiajing Zhuang
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
| | - Jiewei Huang
- The Graduate School of Fujian Medical University, Fuzhou, China
| | - Yiming Hu
- The School of Public Health, Fujian Medical University, Fuzhou, China
| | - Shaoyang Yu
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Tebin Chen
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Nan Wei
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
| | - Yifu Zeng
- Cyberspace Institute of Advanced Technology, Guangzhou University, Guangzhou, China
| | - Yixiang Zhang
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Chunmei Fan
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Youjuan Wang
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
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Saelee R, Haardörfer R, Johnson DA, Gazmararian JA, Suglia SF. Racial/Ethnic and Sex/Gender Differences in Sleep Duration Trajectories From Adolescence to Adulthood in a US National Sample. Am J Epidemiol 2023; 192:51-61. [PMID: 36004702 PMCID: PMC10144618 DOI: 10.1093/aje/kwac156] [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: 11/15/2021] [Revised: 07/07/2022] [Accepted: 08/23/2022] [Indexed: 01/11/2023] Open
Abstract
Racial/ethnic and sex/gender disparities in sleep duration have been documented in adolescence and adulthood. Identifying racial/ethnic and sex/gender differences in sleep duration trajectories from adolescence to adulthood can inform interventions on the developmental periods individuals are most at risk for short sleep duration. We examined racial/ethnic and sex/gender differences in self-reported sleep duration trajectories from adolescence to adulthood using data from waves I, III, IV, and V of the National Longitudinal Study of Adolescent to Adult Health (1994-2018; n = 12,593). Multigroup growth mixture modeling was used to enumerate sleep duration trajectories from adolescence to adulthood. There were 3 common trajectory types across race/ethnicity and sex/gender groups: 1) consistent increasing short sleepers (i.e., increasing probability of short sleep into adulthood) (67.3%); 2) late-onset short sleepers (i.e., no probability of short sleep duration in adolescence until adulthood) (20.2%); and 3) early-onset short sleepers (i.e., declining probability of short sleep duration from adolescence into adulthood) (12.5%). The prevalence of the consistent-increasing trajectory was highest among Black male respondents, while late onset was highest among White female respondents and early onset greatest among Latinx male respondents. Findings underscore the need to intervene in early adolescence to prevent short sleep duration in adulthood.
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Affiliation(s)
- Ryan Saelee
- Correspondence to Dr. Ryan Saelee, Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322 (e-mail: )
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Sleep Loss Influences the Interconnected Brain-Body Regulation of Cardiovascular Function in Humans. Psychosom Med 2023; 85:34-41. [PMID: 36417580 DOI: 10.1097/psy.0000000000001150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Poor sleep is associated with hypertension, a major risk factor for cardiovascular disease. However, the mechanism(s) through which sleep loss affects cardiovascular health remains largely unknown, including the brain and body systems that regulate vascular function. METHODS Sixty-six healthy adults participated in a repeated-measures, crossover, experimental study involving assessments of cardiovascular function and brain connectivity after a night of sleep and a night of sleep deprivation. RESULTS First, sleep deprivation significantly increased blood pressure-both systolic and diastolic. Interestingly, this change was independent of any increase in heart rate, inferring a vasculature-specific rather than direct cardiac pathway. Second, sleep loss compromised functional brain connectivity within the vascular control network, specifically the insula, anterior cingulate, amygdala, and ventral and medial prefrontal cortices. Third, sleep loss-related changes in brain connectivity and vascular tone were not independent, but significantly interdependent, with changes within the vascular control brain network predicting the sleep-loss shift toward hypertension. CONCLUSIONS These findings establish an embodied framework in which sleep loss confers increased risk of cardiovascular disease through an impact upon central brain control of vascular tone, rather than a direct impact on accelerated heart rate itself.
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Muacevic A, Adler JR, Dilibe A, Nriagu BN, Idowu AB, Eletta RY, Ohikhuai EE. Sleep Deprivation Is Associated With Increased Risk for Hypertensive Heart Disease: A Nationwide Population-Based Cohort Study. Cureus 2022; 14:e33005. [PMID: 36712752 PMCID: PMC9879308 DOI: 10.7759/cureus.33005] [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] [Accepted: 12/27/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Literature documenting the in-hospital cardiovascular outcomes of sleep deprivation (SD) patients is scarce. We aimed to compare inpatient cardiovascular outcomes in patients with sleep deprivation and those without sleep deprivation. METHOD We queried the National Inpatient Sample (NIS) database from 2016 to 2019 to conduct a retrospective observational study. Using the International Classification of Diseases, Tenth Revision (ICD-10) codes, we identified patients with sleep deprivation (SD) diagnosis and compared them to their counterparts without sleep deprivation (NSD). The cardiovascular outcomes of interest were hypertensive heart disease (HHD), atrial fibrillation (AF), and ST-segment and non-ST-segment elevation myocardial infarction (STEMI and NSTEMI, respectively). We used multivariable regression analysis to unearth the relationship between sleep deprivation and cardiovascular disease. RESULTS There were 28,484,087 patients admitted during the study period, among which 2.1% (6,08,059) with a mean age of 59 (sd=19) years had a sleep deprivation diagnosis unrelated to medical or psychiatric illness. Of these, 75.7% were Caucasians, 11.5% were Blacks, and 8% were Hispanics. Individuals with sleep deprivation had a higher odds ratio (OR) of HHD, i.e., OR=1.3 (1.29-1.31), p<0.0001. The odds of heart failure with reduced ejection fraction (HFrEF) was 0.9 (0.9-1.92), p=0.45; heart failure with preserved ejection fraction (HFpEF) was 0.98 (0.97-1.01), p=0.31; and the odds of the SD population for AF was 0.9 (0.89-1.03), p=0.11. CONCLUSION Sleep deprivation seems to be more prevalent in the Caucasian population. Individuals with sleep deprivation have a higher risk of hypertensive heart disease but similar outcomes to the general population in terms of AF, HFrEF, and HFpEF.
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Su Y, Ding N, Zhou Y, Yang G, Chai X. The association between bedtime at night and hypertension in adults. Postgrad Med 2022; 135:370-378. [PMID: 36333923 DOI: 10.1080/00325481.2022.2144031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This research was conducted to explore the association between bedtime at night and the prevalence of hypertension in adults. METHODS We conducted a cross-sectional study of 14,536 participants with data from the NHANES database. Bedtime was determined from the question in the sleep questionnaire: 'What time do you usually fall asleep on weekdays or workdays?.' Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg, or diastolic blood pressure (DBP) ≥ 90 mmHg, or having been told by a doctor to have high blood pressure, or taking antihypertensive medication. We conducted a weighted multiple logistic regression analysis to explore the relationship between bedtime at night and the prevalence of hypertension in adults. RESULTS The association between bedtime and hypertension showed a significantly U-shaped relationship. People who went to bed at 23:00 had the lowest risk of developing hypertension (OR, 0.68 [95%CI, 0.58, 0.81]). This U-shaped association still existed in different genders. In males (n = 7159), the adjusted OR was still lowest at 23:00. However, the adjusted OR was lowest at 0:00 in females(n = 7377). The interaction effect between bedtime and gender was significant (P = 0.0187). CONCLUSION With the delay in bedtime, the association between bedtime and hypertension showed a significantly U-shaped relationship. Falling asleep at 23:00 has the lowest risk of developing hypertension.
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Affiliation(s)
- Yingjie Su
- Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
- Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, Hunan Province, China
- Trauma center, Hunan Province, Changsha, Hunan Province, China
| | - Ning Ding
- Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
- Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, Hunan Province, China
- Trauma center, Hunan Province, Changsha, Hunan Province, China
| | - Yang Zhou
- Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
- Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, Hunan Province, China
- Trauma center, Hunan Province, Changsha, Hunan Province, China
| | - Guifang Yang
- Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
- Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, Hunan Province, China
- Trauma center, Hunan Province, Changsha, Hunan Province, China
| | - Xiangping Chai
- Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
- Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, Hunan Province, China
- Trauma center, Hunan Province, Changsha, Hunan Province, China
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Zhang X, Huang W, Xu H, Li X, Wang F, Wu K, Li C, Liu Y, Zou J, Zhu H, Yi H, Guan J, Qian D, Yin S. Associations between common sleep disturbances and cardiovascular risk in patients with obstructive sleep apnea: A large-scale cross-sectional study. Front Cardiovasc Med 2022; 9:1034785. [PMID: 36386313 PMCID: PMC9659611 DOI: 10.3389/fcvm.2022.1034785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/17/2022] [Indexed: 11/27/2022] Open
Abstract
Objectives Studies have shown that obstructive sleep apnea (OSA) is inextricably linked with cardiovascular diseases (CVD). However, the roles of certain common sleep disturbances, such as low slow-wave sleep, excessive daytime sleepiness and short sleep duration, in the pathogenesis and progression of CVD in patients with OSA have not been determined. Therefore, we conducted a large cross-sectional study to explore the effect of low slow-wave sleep, excessive daytime sleepiness and short sleep duration on the risk of CVD in patients with OSA. Methods Subjects were consecutively enrolled to participate in the sleep center of Shanghai Jiao Tong University Affiliated Sixth People’s Hospital. All OSA patients were diagnosed by standard polysomnography, while controls were all simple snorers. A total of 4,475 participants were strictly recruited. The Framingham Risk Score were employed to assess the 10-year risk of CVD, and logistic regression was used to measure the association between sleep disturbances and the moderate-to-high CVD risk. Results In the whole cohort, OSA, excessive daytime sleepiness, and low slow-wave sleep were all risk factors for the moderate-to-high 10-year CVD risk (odds ratio [OR] = 3.012, 95% confidence interval [CI] 2.418–3.751; OR = 1.407, 95% CI: 1.228–1.613, and OR = 0.973,95% CI: 0.967–0.980), but sleep duration did not contribute significantly to that risk. Whether in patients with OSA and controls, low SWS (<12.8%) could increase the risk of CVD. Subjective excessive daytime sleepiness would significantly increase the risk of CVD only in patients with severe OSA. Conclusion It is important to pay more attention to the impact of sleep on cardiovascular health. Patients with sleep disturbances should adopt a healthy lifestyle and undergo regular follow-up of cardiovascular indicators to prevent cardiovascular complications. Trial registration [http://www.chictr.org.cn/showproj.aspx?proj=43057], identifier [ChiCTr1900025714].
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Affiliation(s)
- Xiaoman Zhang
- Department of Otolaryngology Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
| | - Weijun Huang
- Department of Otolaryngology Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
| | - Huajun Xu
- Department of Otolaryngology Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
- Huajun Xu,
| | - Xinyi Li
- Department of Otolaryngology Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Xinyi Li,
| | - Fan Wang
- Department of Otolaryngology Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
| | - Kejia Wu
- Department of Otolaryngology Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
| | - Chenyang Li
- Department of Otolaryngology Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
| | - Yupu Liu
- Department of Otolaryngology Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
| | - Jianyin Zou
- Department of Otolaryngology Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
| | - Huaming Zhu
- Department of Otolaryngology Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
| | - Hongliang Yi
- Department of Otolaryngology Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
| | - Jian Guan
- Department of Otolaryngology Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
| | - Di Qian
- Department of Otolaryngology, People’s Hospital of Longhua, Shenzhen, China
- Di Qian,
| | - Shankai Yin
- Department of Otolaryngology Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
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High burden of hypertension amongst adult population in rural districts of Northwest Ethiopia: A call for community based intervention. PLoS One 2022; 17:e0275830. [PMID: 36227880 PMCID: PMC9560483 DOI: 10.1371/journal.pone.0275830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 09/24/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Hypertension is a serious public health issue in Ethiopia, but there is a paucity of evidence in the country's rural areas. The aim of this study was to determine the prevalence of hypertension and its risk factors among adults in rural districts in northwest Ethiopia. METHODS A community-based cross-sectional study was conducted from June to October 2020. The 1177 study participants were chosen using a multistage sampling procedure. A face-to-face interview was conducted using an adapted version of the WHO STEPwise approach questionnaire. Blood pressure was measured three times using an aneroid sphygmomanometer, and the mean of the last two readings were used for the analysis. Data was entered using Epidata and analyzed using STATA-16. Multivariable logistic regression was used to identify risk factors associated with hypertension. RESULTS Of the total participants, 218 (18.5%) were found to be hypertensive. The prevalence of hypertension consistently increases with age. Hypertension was positively and significantly associated with female sex ((adjusted odd ratio (AOR) = 2.30, 95% CI: 1.53, 3.45)), age group 45-54 years (AOR = 4.63, 95% CI: 1.01, 21.37), 55-64 years (AOR = 14.40, 95% CI: 3.07, 67.63), ≥65 years (AOR = 19.37, 95% CI: 4.03, 93.09), having history of alcohol consumption (AOR = 3.25, 95% CI: 1.17, 9.02), used much amount of salt (AOR = 2.37, 95% CI: 1.53, 3.60) and too much amount of salt (AOR = 3.78, 95% CI: 1.85, 7.72), sleeping for a short duration (AOR = 2.05, 95%CI: 1.30, 3.24), and having family history of hypertension (AOR = 2.12, 95% CI; 1.32, 3.39). CONCLUSIONS Hypertension was significantly high among the rural population we studied and is emerging as a public health problem. Female sex, advanced age, ever used alcohol, excessive salt intake, insufficient sleep, and a family history of hypertension were factors that were positively and significantly associated with hypertension. We recommend local health authorities integrate promotion of hypertension health education, lifestyle modification intervention on salt and alcohol reduction, and hypertension detection, particularly for the female and elderly population, at the health post level to avert the problem.
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Greening L, McBride S. A Review of Equine Sleep: Implications for Equine Welfare. Front Vet Sci 2022; 9:916737. [PMID: 36061116 PMCID: PMC9428463 DOI: 10.3389/fvets.2022.916737] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Sleep is a significant biological requirement for all living mammals due to its restorative properties and its cognitive role in memory consolidation. Sleep is ubiquitous amongst all mammals but sleep profiles differ between species dependent upon a range of biological and environmental factors. Given the functional importance of sleep, it is important to understand these differences in order to ensure good physical and psychological wellbeing for domesticated animals. This review focuses specifically on the domestic horse and aims to consolidate current information on equine sleep, in relation to other species, in order to (a) identify both quantitatively and qualitatively what constitutes normal sleep in the horse, (b) identify optimal methods to measure equine sleep (logistically and in terms of accuracy), (c) determine whether changes in equine sleep quantity and quality reflect changes in the animal's welfare, and (d) recognize the primary factors that affect the quantity and quality of equine sleep. The review then discusses gaps in current knowledge and uses this information to identify and set the direction of future equine sleep research with the ultimate aim of improving equine performance and welfare. The conclusions from this review are also contextualized within the current discussions around the “social license” of horse use from a welfare perspective.
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Affiliation(s)
- Linda Greening
- Hartpury University and Hartpury College, Gloucester, United Kingdom
- *Correspondence: Linda Greening
| | - Sebastian McBride
- Institute of Biological, Environmental and Rural Science, Aberystwyth University, Aberystwyth, United Kingdom
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Culver MN, McMillan NK, Cross BL, Robinson AT, Montoye AH, Riemann BL, Flatt AA, Grosicki GJ. Sleep duration irregularity is associated with elevated blood pressure in young adults. Chronobiol Int 2022; 39:1320-1328. [PMID: 35844152 DOI: 10.1080/07420528.2022.2101373] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Sleep irregularity (i.e., highly variable sleep patterns) is an emerging risk factor for cardiometabolic disease. Though irregular sleep patterns are common among young adults, the cardiometabolic health (CMH) repercussions of sleep irregularity in this population are unclear. We examined associations between sleep duration and irregularity with measures of CMH in 44 (24 M/20 F, 23 ± 5y, BMI 26 ± 4 kg/m2, blood pressure (BP): 125/71 ± 14/9 mmHg) young adults. Participants wore actigraphy monitors for seven-days and sleep duration irregularity was operationalized as the standard deviation of nightly sleep duration (sleep SD). CMH variables of interest included brachial and aortic BP, arterial stiffness (cf-PWV), augmentation index (AIx75), and fasting blood glucose and lipids. Associations between sleep duration and sleep SD with CMH variables were assessed via correlations adjusted for sex and BMI. Sleep duration generally was not associated with CMH indices. However, sleep SD was associated with brachial systolic (r = 0.433, p = .027) and diastolic BP (r = 0.415, p = .035). Similarly, sleep duration SD was associated with aortic systolic BP (r = 0.447, p = .022). Our findings show that sleep irregularity, but not duration, is associated with higher brachial and central BP in young adults.Abbreviations: AIx75: augmentation index at a heart rate of 75 beats per minute; BP: blood pressure; CMH: cardiometabolic health; cf-PWV: carotid-femoral pulse wave velocity; DXA: dual x-ray absorptiometry; mg/dl: milligrams per deciliter; PWA: pulse wave analysis; PWV: pulse wave velocity; sleep duration SD: standard deviation of nightly sleep duration.
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Affiliation(s)
- Meral N Culver
- Biodynamics and Human Performance Center, Georgia Southern University (Armstrong Campus), Savannah, Georgia, USA.,Neurovascular Physiology Laboratory, School of Kinesiology, Auburn University, Auburn, Alabama, USA
| | - Nathan K McMillan
- Biodynamics and Human Performance Center, Georgia Southern University (Armstrong Campus), Savannah, Georgia, USA
| | - Brett L Cross
- Biodynamics and Human Performance Center, Georgia Southern University (Armstrong Campus), Savannah, Georgia, USA
| | - Austin T Robinson
- Neurovascular Physiology Laboratory, School of Kinesiology, Auburn University, Auburn, Alabama, USA
| | - Alexander Hk Montoye
- Department of Integrative Physiology and Health Science, Alma College, Alma, Michigan, USA
| | - Bryan L Riemann
- Biodynamics and Human Performance Center, Georgia Southern University (Armstrong Campus), Savannah, Georgia, USA
| | - Andrew A Flatt
- Biodynamics and Human Performance Center, Georgia Southern University (Armstrong Campus), Savannah, Georgia, USA
| | - Gregory J Grosicki
- Biodynamics and Human Performance Center, Georgia Southern University (Armstrong Campus), Savannah, Georgia, USA
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Sex Modified the Association between Sleep Duration and worse Cognitive Performance in Chinese Hypertensive Population: Insight from the China H-Type Hypertension Registry Study. Behav Neurol 2022; 2022:7566033. [PMID: 35783996 PMCID: PMC9249484 DOI: 10.1155/2022/7566033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 05/23/2022] [Accepted: 06/05/2022] [Indexed: 11/26/2022] Open
Abstract
Objectives Cognitive decline could be seen as the sign of preclinical phase of dementia, which was found to be sex differentiated. Previous studies had discovered that there might be some link between abnormal sleep duration and cognitive performance. Additionally, hypertension was found to be one of the important risk factors for cognitive decline and abnormal sleep duration was also a significant risk factor for hypertension. Therefore, the purpose of this study was to investigate sex differences in the association of sleep duration with cognitive performance and to further explore potential effect modifiers that may exist. Methods Data analyzed in this study was from the China H-type Hypertension Registry Study. Sleep duration was assessed with a sleep questionnaire and categorized as <5 hours, 5-8 hours, and ≥8 hours. Cognitive performance was evaluated with the Mini-Mental State Examination (MMSE). Result A total of 9527 subjects were included. The average age was 63.7 ± 9.8 years. Linear regression analyses showed that the association between long sleep duration (≥8 h) and MMSE score adjusting for pertinent covariables was stronger in female (β = −0.95, 95% CI: -1.23 to -0.68, P < 0.001) than in male (β = −0.29, 95% CI: -0.53 to -0.06, P = 0.013). Furthermore, there was a significant interaction between sleep duration and age on cognitive performance only in female. Conclusion In summary, this study found that long sleep duration (≥8 h) was associated with poorer cognitive performance. Furthermore, this association was more pronounced in female than in male, especially in older female.
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Ogugu EG, Catz SL, Bell JF, Drake C, Bidwell JT, Gangwisch JE. The Association Between Habitual Sleep Duration and Blood Pressure Control in United States (US) Adults with Hypertension. Integr Blood Press Control 2022; 15:53-66. [PMID: 35642173 PMCID: PMC9148584 DOI: 10.2147/ibpc.s359444] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 05/17/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose This study examined the relationship between habitual sleep duration and blood pressure (BP) control in adults with hypertension. Methods This cross-sectional study used data of 5163 adults with hypertension obtained from the 2015–2018 National Health and Nutrition Examination Survey (NHANES). Multivariable logistic regression was used to analyze the association between habitual sleep duration and BP control. Habitual sleep duration was self-reported and defined as the amount of sleep usually obtained in a night or main sleep period during weekdays or workdays. It was categorized as <6, 6 - <7, 7–9, and >9 hours. BP control was defined as average systolic BP <130mmHg and diastolic BP <80mmHg. Results Results from the fully adjusted models show that among all adults with hypertension, habitual sleep duration of <6 hours night/main sleep period was associated with reduced odds of BP control (OR = 0.53, 95% CI: 0ss.37–0.76, P = 0.001) when compared to 7–9 hours. In the subpopulation of adults who were on antihypertensive medication, those with a sleep duration of <6 hours had lower odds of BP control than those with a sleep duration of 7–9 hours (OR = 0.53, 95% CI: 0.36–0.77, P = 0.002). No significant differences were noted in all adults with hypertension and in the subpopulation of those on antihypertensive medication in BP control between the reference sleep duration group (7–9 hours) and the 6 - <7 or >9 hours groups. There were no significant differences across age groups or gender in the relationship between habitual sleep duration and BP control. Conclusion Sleep duration of <6 hours is associated with reduced odds of hypertension control. These significant findings indicate that interventions to support adequate habitual sleep duration may be a promising addition to the current hypertension management guidelines.
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Affiliation(s)
- Everlyne G Ogugu
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, USA
| | - Sheryl L Catz
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, USA
| | - Janice F Bell
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, USA
| | - Christiana Drake
- Department of Statistics, University of California Davis, Davis, CA, USA
| | - Julie T Bidwell
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, USA
| | - James E Gangwisch
- Department of Psychiatry, Columbia University, New York City, NY, USA
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Abukanna AMA, Alanazi BFA, Alanazi STA, ALHarbi EAM, Alanazi TMM. Sleep Deficiency as a Risk Factor for Hypertension: A Systematic Review. PHARMACOPHORE 2022. [DOI: 10.51847/irvyhqbvik] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Hirano K, Komatsu Y, Shimbo T, Nakata H, Kobayashi D. OUP accepted manuscript. Clin Kidney J 2022; 15:1763-1769. [PMID: 36003661 PMCID: PMC9394714 DOI: 10.1093/ckj/sfac107] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Indexed: 11/16/2022] Open
Abstract
Background Evidence linking chronic kidney disease (CKD) and sleep duration is inconsistent. This study examined whether sleep duration is associated with a long-term risk of kidney function decline. Methods This retrospective, longitudinal cohort study included 82 001 participants who visited a primary care centre in Japan. Participants were categorized into CKD risk groups and sleep duration categories according to their self-reported average nightly sleep duration. The relationship between average nightly sleep duration and the incidence of composite renal outcome comprised a ≥40% reduction in estimated glomerular filtration rate (eGFR) from baseline and a decline in eGFR to <15 mL/min/1.73 m² was evaluated. Results The mean age and eGFR (±standard deviation) of the patient cohort were 45.8 (±12.4) years and 81.8 (±15.4) mL/min/1.73 m², respectively. A total of 41 891 participants (51.1%) were women. During the median follow-up of 5.1 years [interquartile range 2.2–9.6], 4214 (5.1%) participants achieved the composite renal outcome. Only the long and very long sleep durations (≥8 h/night) were associated with an increased incidence of the composite renal outcome compared with the reference duration (7 h/night) [adjusted odds ratio (OR) 1.22 and 1.44; 95% confidence interval (CI) 1.09–1.36 and 1.13–1.84, for long and very long sleep durations, respectively]. Furthermore, this association was significant for both long and very long sleep durations in the low CKD risk group but only for long sleep duration in the intermediate CKD risk group. The results of the sex-specific analysis showed that men had a decreased risk of achieving the composite renal outcome (OR 0.91; 95% CI 0.79–1.06), while there was an increased risk for women (OR 1.14; 95% CI 1.02–1.28). Conclusions Average sleep durations ≥8 h/night were associated with an increased incidence of poor renal outcomes over time. However, a longitudinal cohort study is required to confirm whether sleep duration can prevent poor renal outcomes.
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Affiliation(s)
- Keita Hirano
- Department of Nephrology, St Luke's International Hospital, Tokyo, Japan
| | - Yasuhiro Komatsu
- Department of Nephrology, St Luke's International Hospital, Tokyo, Japan
| | - Takuro Shimbo
- Department of Internal Medicine, Ohta Nishinouchi Hospital, Fukushima, Japan
| | - Hirosuke Nakata
- Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Daiki Kobayashi
- Division of General Internal Medicine, Department of Medicine, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan
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Wei DYW, Chew M, Sabanayagam C. Obstructive Sleep Apnoea, Other Sleep Parameters and Diabetic Retinopathy. Curr Diab Rep 2021; 21:58. [PMID: 34902078 DOI: 10.1007/s11892-021-01425-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/12/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW To summarise the association between obstructive sleep apnoea and diabetic retinopathy and diabetic macular oedema. To examine the effects of other sleep parameters on diabetic retinopathy and diabetic macular oedema. To discuss the pathophysiology of diabetic eye changes and how it is related to obstructive sleep apnoea. RECENT FINDINGS Conflicting data exists in terms of the association of diabetic eye changes with sleep apnoea and/or other sleep parameters. Various cross-sectional studies show PDR to be associated with the prevalence of OSA. Patients who underwent continuous positive airway pressure (CPAP) treatment were significantly less likely to develop pre/proliferative DR. Secondary sleep parameters generally are not associated with DR except for long duration of sleep. Differences in reporting could be due to the different thresholds set to define OSA/ODI and severity of DR/DME, in addition to factors used in multivariate analysis. There is a need for further studies with long-term follow-up and to assess the impact of CPAP on the development and progression of diabetic eye change(s).
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Affiliation(s)
- Dayna Yong Wei Wei
- Department of Ophthalmology, National University Hospital, National University Health System, Singapore, Singapore
| | - Merwyn Chew
- Department of Ophthalmology, JurongHealth, National University Health System, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
- Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.
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Blanchflower DG, Bryson A. Unemployment and sleep: evidence from the United States and Europe. ECONOMICS AND HUMAN BIOLOGY 2021; 43:101042. [PMID: 34271429 DOI: 10.1016/j.ehb.2021.101042] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 06/11/2021] [Accepted: 07/02/2021] [Indexed: 06/13/2023]
Abstract
Using data for over 2.5 million individuals in the United States over the period 2006-2019 from the Behavioral Risk Factor Surveillance System (BRFSS) survey series we show the unemployed suffer sleep disruption. The unemployed suffer more short and long sleep than the employed and are more likely to suffer from disturbed sleep. These are especially problematic for the long-term unemployed and for the jobless who say they are unable to work. Similar findings on unemployment and poor sleep quality are found in European data. Increases in the unemployment rate raise the incidence of short sleep and lower sleep durations.
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Affiliation(s)
- David G Blanchflower
- Dartmouth College, Adam Smith BusIness School, University of Glasgow, NBER and Bloomberg, United States.
| | - Alex Bryson
- University College London, NIESR and IZA, United Kingdom.
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Li ZH, Huang QM, Gao X, Chung VCH, Zhang PD, Shen D, Zhang XR, Zhong WF, Liu D, Chen PL, Chen Q, Cai MC, Cheng X, Yang HL, Song WQ, Wu XB, Kraus VB, Mao C. Healthy Sleep Associated With Lower Risk of Hypertension Regardless of Genetic Risk: A Population-Based Cohort Study. Front Cardiovasc Med 2021; 8:769130. [PMID: 34869684 PMCID: PMC8637045 DOI: 10.3389/fcvm.2021.769130] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/18/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Hypertension is a leading contributor to the global burden of disease and to mortality. The combined effects of sleep factors on the risk of hypertension are unclear. We aimed to evaluate the effect of combined sleep factors on the risk of hypertension and to explore whether this association is independent of genetic risk. Methods: This population-based prospective cohort study included 170,378 participants from the UK Biobank study. We conducted a healthy sleep score based on a combination of major five sleep factors and a genetic risk score based on 118 risk variants. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: A total of 170,378 participants were included. Compared to participants with a healthy sleep score of 0-1, those with healthy sleep scores of 2 (HR, 0.90; 95% CI, 0.83-0.98), 3 (HR, 0.81; 95% CI, 0.75-0.88), 4 (HR, 0.74; 95% CI, 0.68-0.81), or 5 (HR, 0.67; 95% CI, 0.59-0.77) had increasingly lower risks of hypertension (P for trend <0.001). Participants with high genetic risk and an unfavorable sleep pattern had a 1.80-fold greater risk of hypertension than participants with low genetic risk and a favorable sleep pattern. The association between sleep patterns and hypertension persisted in subgroup analysis, stratified by the genetic risk. Nearly 18.2% of hypertension events in this cohort could be attributed to unfavorable sleep pattern. Conclusions: Favorable sleep pattern was associated with a low risk of hypertension, regardless of genetic risk. These findings highlight the potential of sleep interventions to reduce risk of hypertension across entire populations.
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Affiliation(s)
- Zhi-Hao Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Qing-Mei Huang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xiang Gao
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, United States
| | - Vincent C. H. Chung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Pei-Dong Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Dong Shen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xi-Ru Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Wen-Fang Zhong
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Dan Liu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Pei-Liang Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Qing Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Miao-Chun Cai
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xin Cheng
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Hai-Lian Yang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Wei-Qi Song
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xian-Bo Wu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Virginia Byers Kraus
- Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Duke Molecular Physiology Institute, Durham, NC, United States
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
- Division of Laboratory Medicine, Microbiome Medicine Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Yuan Y, Heizhati M, Wang L, Li M, Lin M, Gan L, Cai X, Yang W, Yao L, Wang Z, Abudereyimu R, Li N. Poor sleep quality is associated with new-onset hypertension in a diverse young and middle-aged population. Sleep Med 2021; 88:189-196. [PMID: 34781033 DOI: 10.1016/j.sleep.2021.10.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/23/2021] [Accepted: 10/13/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Sleep disorders have been proposed as the potential risk factors for hypertension, thus we aimed to investigate the association of sleep quality with new-onset hypertension. METHODS We evaluated sleep quality using Pittsburgh Sleep Quality Index (PSQI) and it's seven components in normotensive population aged 18 years old and over in Emin Xinjiang, China in 2016 and followed up till 2019 using annual health checkup data. Poor sleep quality was defined as a PSQI score>5, and good sleep quality was defined as a PSQI score⩽5. RESULTS Among 9344 analytic sample 57.29% were female. A total of 2958 (31.66%) subjects developed hypertension during 22,960 person-years of follow-up. Poor sleep quality (HR 1.131, 95% CI 1.045, 1.224) showed had higher risk of development hypertension in total population in adjusted Cox models. Fairly bad subjective sleep quality (HR 1.148, 95% CI 1.015, 1.298), habitual sleep efficiency of <65%-75% group (HR 1.174, 95% CI 1.026, 1.344), and mild (HR 1.194, 95% CI 1.098, 1.299) and moderate (HR 1.264, 95% CI 1.080, 1.479) sleep disturbance increased the risk of developing hypertension compared to their counterparts. In age stratification, poor sleep quality (HR 1.100, 95% CI 1.007, 1.202) had higher risk of developing hypertension in the young and middle-aged population after adjusted all covariates. CONCLUSIONS Poor sleep quality is associated with higher risk of new-onset hypertension in young and middle-aged population.
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Affiliation(s)
- Yujuan Yuan
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China
| | - Mulalibieke Heizhati
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China
| | - Lin Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China
| | - Mei Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China
| | - Mengyue Lin
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China
| | - Lin Gan
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China
| | - Xintian Cai
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China
| | - Wenbo Yang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China
| | - Ling Yao
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China
| | - Zhongrong Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China
| | - Reyila Abudereyimu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China
| | - Nanfang Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.
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Feng X, Wu W, Zhao F, Li X, Han D, Li C, Xu F, Lyu J. Relationship between self-reported sleep duration during week-/work-days and metabolic syndrome from NHANES 2013 to 2016. Sleep Breath 2021; 26:1593-1601. [PMID: 34780004 DOI: 10.1007/s11325-021-02522-w] [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: 09/02/2020] [Revised: 10/28/2021] [Accepted: 11/02/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE This research aimed at determining the relationship between self-reported sleep duration during week-/work-days and metabolic syndrome (MetS) from NHANES 2013 to 2016. METHODS This study analyzed data from 11,181 people aged 16 or older who took part in the NHANES (National Health and Nutrition Examination Surveys) from 2013 to 2016. A standard questionnaire was used to define self-reported sleep duration, and MetS was defined on the basis of the NCEP (National Cholesterol Education Program)/ATP III revised diagnostic criteria. Logistic regression and restricted cubic splines (RCS) models were used to assess the relationship between self-reported sleep duration and MetS. RESULTS The overall prevalence of MetS in the study cohort was 26.1%, with 24.8% for males and 27.3% for females. After adjusting for potential confounding factors, MetS was significantly associated with self-reported short sleep duration (odds ratio = 1.16, 95% confidence interval = 1.03-1.31, P = 0.013) but not with long sleep duration (P = 0.117). RCS regression revealed that self-reported sleep duration was nonlinearly related to MetS (P for nonlinearity = 0.0026). The risk of MetS decreased with increased sleep duration for durations of less than 7 h/day, while there was no association for longer sleep durations. CONCLUSION These results suggest that self-reported short sleep duration is a risk factor for MetS, while long sleep duration is not.
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Affiliation(s)
- Xiaojie Feng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, 613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, Guangdong, China
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Wentao Wu
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Fanfan Zhao
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, 613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, Guangdong, China
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Xiang Li
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, 710049, Shaanxi, China
| | - Didi Han
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, 613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, Guangdong, China
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Chengzhuo Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, 613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, Guangdong, China
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Fengshuo Xu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, 613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, Guangdong, China
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, 613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, Guangdong, China.
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China.
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Lunyera J, Park YMM, Ward JB, Gaston SA, Bhavsar N, Muntner P, Sandler DP, Jackson CL. A prospective study of multiple sleep dimensions and hypertension risk among white, black and Hispanic/Latina women: findings from the Sister Study. J Hypertens 2021; 39:2210-2219. [PMID: 34620810 PMCID: PMC8501231 DOI: 10.1097/hjh.0000000000002929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Poor sleep is associated with increased hypertension risk, but few studies have evaluated multiple sleep dimensions or investigated racial/ethnic disparities in this association among women. METHOD We investigated multiple sleep dimensions (sleep duration, inconsistent weekly sleep patterns, sleep debt, frequent napping and difficulty falling or staying asleep) and hypertension risk among women, and determined modification by age, race/ethnicity and menopausal status. We used data from the Sister Study, a national cohort of 50 884 women who had sisters diagnosed with breast cancer in the United States enrolled in 2003-2009 and followed through September 2018. RESULTS Of 33 497 women without diagnosed hypertension at baseline (mean age ± standard deviation: 53.9 ± 8.8 years; 88.7% White, 6.4% Black and 4.9% Hispanic/Latina), 23% (n = 7686) developed hypertension over a median follow-up of 10.1 years [interquartile range: 8.2-11.9 years]. Very short, short or long sleep duration, inconsistent weekly sleep patterns, sleep debt, frequent napping, insomnia, insomnia symptoms as well as short sleep and exploratory cumulative poor sleep score were associated with incident hypertension after adjustment for demographics factors. After additional adjustment for lifestyle and clinical factors, insomnia [hazard ratio = 1.09, 95% confidence interval (95% CI): 1.03-1.15] and insomnia symptoms plus short sleep (hazard ratio = 1.13, 95% CI: 1.05-1.21) remained associated with incident hypertension. These associations were stronger in younger (age<54 vs. ≥54 years) and premenopausal vs. postmenopausal women (all P-interaction < 0.05). Associations did not differ by race/ethnicity (all P-interaction > 0.05). CONCLUSION Thus, screening for multiple sleep dimensions and prioritizing younger and premenopausal women may help identify individuals at high risk for hypertension.
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Affiliation(s)
- Joseph Lunyera
- Division of General Internal Medicine, Duke University School of Medicine, Durham
| | - Yong-Moon Mark Park
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock
| | - Julia B. Ward
- Social & Scientific Systems, Inc., Durham, North Carolina
| | - Symielle A. Gaston
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina
| | - Nrupen Bhavsar
- Division of General Internal Medicine, Duke University School of Medicine, Durham
| | - Paul Muntner
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina
| | - Chandra L. Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina
- Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
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Al-Raddadi R, Al-Ahmadi J, Bahijri S, Ajabnoor GM, Jambi H, Enani S, Eldakhakhny BM, Alsheikh L, Borai A, Tuomilehto J. Gender Differences in The Factors associated with Hypertension in Non-Diabetic Saudi Adults-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111371. [PMID: 34769893 PMCID: PMC8583204 DOI: 10.3390/ijerph182111371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/26/2021] [Accepted: 10/26/2021] [Indexed: 12/11/2022]
Abstract
The association between lifestyle practices, obesity and increased BP are under-investigated. We aimed to investigate this association to identify the factors associated with hypertension and prehypertension in Saudis. Non-diabetic adults were recruited from public healthcare centers using a cross-sectional design. Recruits were interviewed using a predesigned questionnaire. Weight, height, waist circumference (WC), hip circumference (HC), neck circumference (NC) and BP were measured. The variables were analyzed by comparing the prehypertensive and hypertensive groups with the normotensive group. A total of 1334 adults were included. The study found that 47.2% of men and 24.7% of women were prehypertensive, and 15.1% of men and 14.4% of women were hypertensive. High BMI, WC, NC, and WC: HC ratios were associated with an increased risk of prehypertension and hypertension in men and women. Low physical activity was associated with an increased risk of elevated BP in men, while sleep duration of ≤6 h and sitting for ≥4 h were associated with increased risk in women. Women from central Asia, southeast Asia, and those of mixed origin had a higher prevalence of hypertension compared to those from Arabian tribes. In conclusion, prehypertension and hypertension increase with age and obesity. Gender differences were apparent in the association between several lifestyle practices and prehypertension or hypertension among various ethnic/racial groups.
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Affiliation(s)
- Rajaa Al-Raddadi
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Department of Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Jawaher Al-Ahmadi
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Suhad Bahijri
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Correspondence: ; Tel.: +966-564-370-571
| | - Ghada M. Ajabnoor
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Hanan Jambi
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah 3270, Saudi Arabia
| | - Sumia Enani
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah 3270, Saudi Arabia
| | - Basmah Medhat Eldakhakhny
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Lubna Alsheikh
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Anwar Borai
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), College of Medicine, King Abdulaziz Medical City, Jeddah 22384, Saudi Arabia
| | - Jaakko Tuomilehto
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- Department of Public Health, University of Helsinki, 00014 Helsinki, Finland
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
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Rafati S, Isheh M, Azarbad A, Ghadiri Soufi F, Rahimi A, Kheirandish M. The association of sleep duration and metabolic syndrome in the Bandare-Kong cohort study, a cross-sectional survey (finding from PERSIAN cohort study). Diabetol Metab Syndr 2021; 13:114. [PMID: 34670597 PMCID: PMC8527607 DOI: 10.1186/s13098-021-00737-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 10/12/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND A variety of health problems, such as metabolic syndrome (MetS), have been linked to sleep disorders. While numerous epidemiological studies have shown a U-shaped relationship between sleep duration and poor health outcomes, the results were limited and inconsistent. This study was designed to evaluate the relationship between sleep duration and MetS. METHODS This population-based study was conducted on the participants aged 35-70 of Bandare-Kong Non-Communicable Diseases (BKNCD) Cohort Study, a part of Prospective Epidemiological Research Studies in IrAN (PERSIAN). MetS was diagnosed according to the National Cholesterol Education Program (NCEP) criteria and the Iranian-specific cut-off for waist circumference (≥ 95 cm). Sleep information was extracted through a standard questionnaire based on self-reported information. Data were analyzed by R software using generalized additive models (GAMs). A statistically significant level was considered as P < 0.05. RESULTS A total of 3695 participants were included in the analyses. The mean age was 48.05 years (SD 9.36), and 2067 (55.9%) were female. The estimated Prevalence of MetS was 35.9%, and women appeared to be more likely to have MetS than men (P < 0.001). There was a non-linear and linear association between sleep duration and the risk of MetS in women and men, respectively. The lowest risk was observed among those with 7-7.5 h of sleep duration per night. CONCLUSION Long sleep duration was associated with increased risk of MetS and higher MetS severity score in both genders, while the short sleep duration increased the risk of Mets as well as MetS severity score just in women. The longitudinal studies would be suggested to assess the relationship between sleep quality and quantity components and MetS.
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Affiliation(s)
- Shideh Rafati
- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Maryam Isheh
- Student Research Committee, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Abnoos Azarbad
- Department of Pharmacology, Faculty of Pharmacy, Eastern Mediterranean University, via Mersin 10, Famagusta, North Cyprus, Turkey
| | - Farhad Ghadiri Soufi
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Arash Rahimi
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Masoumeh Kheirandish
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
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48
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Xie J, Li Y, Zhang Y, Vgontzas AN, Basta M, Chen B, Xu C, Tang X. Sleep duration and metabolic syndrome: An updated systematic review and meta-analysis. Sleep Med Rev 2021; 59:101451. [PMID: 33618187 DOI: 10.1016/j.smrv.2021.101451] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 08/11/2020] [Accepted: 11/22/2020] [Indexed: 02/05/2023]
Abstract
We examined the association between self-reported sleep duration and metabolic syndrome (MetS). Data were collected from 36 cross-sectional and 9 longitudinal studies with a total of 164,799 MetS subjects and 430,895 controls. Odds ratios (ORs) for prevalent MetS and risk ratios (RRs) for incident MetS were calculated through meta-analyses of adjusted data from individual studies. Short sleep duration was significantly associated with increased prevalent MetS (OR = 1.11, 95% CI = 1.05-1.18) and incident MetS (RR = 1.28, 95% CI = 1.07-1.53) in cross-sectional and longitudinal studies, respectively. Furthermore, long sleep duration was significantly associated with increased prevalent MetS in cross-sectional studies (OR = 1.14, 95% CI = 1.05-1.23), but not incident MetS (RR = 1.16, 95% CI = 0.95-1.41) in longitudinal studies. Interestingly, the association between long sleep and prevalent MetS was found in sleep duration defined by 24-h sleep (including naps) rather than nighttime sleep. Our findings suggest 1) a "U-shape" relationship between sleep duration and MetS in cross-sectional studies and 2) association between short sleep duration, but not long sleep duration with incident MetS. Future studies should shed light on the underlying mechanisms related to the association between sleep duration and MetS and examine if normalizing sleep duration reduces MetS risk in the general population.
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Affiliation(s)
- Jing Xie
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Yun Li
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China.
| | - Yajun Zhang
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Alexandros N Vgontzas
- Sleep Research & Treatment Center, Department of Psychiatry, Pennsylvania State University, College of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Maria Basta
- Sleep Research & Treatment Center, Department of Psychiatry, Pennsylvania State University, College of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Baixin Chen
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Chongtao Xu
- Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Xiangdong Tang
- Sleep Medicine Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
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49
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Li J, Cao D, Huang Y, Chen Z, Wang R, Dong Q, Wei Q, Liu L. Sleep duration and health outcomes: an umbrella review. Sleep Breath 2021; 26:1479-1501. [PMID: 34435311 DOI: 10.1007/s11325-021-02458-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/18/2021] [Accepted: 07/28/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE To collect existing evidence on the relationship between sleep duration and health outcomes. METHODS A thorough search was conducted in PubMed, Web of Science, Embase, and the Cochrane Database of Systematic Reviews from inception to January, 2021. Meta-analyses of observational and interventional studies were eligible if they examined the associations between sleep duration and human health. RESULTS In total, this umbrella review identified 69 meta-analyses with 11 outcomes for cancers and 30 outcomes for non-cancer conditions. Inappropriate sleep durations may significantly elevate the risk for cardiovascular disease (CVD), cognitive decline, coronary heart disease (CHD), depression, falls, frailty, lung cancer, metabolic syndrome (MS), and stroke. Dose-response analysis revealed that a 1-h reduction per 24 hours is associated with an increased risk by 3-11% of all-cause mortality, CHD, osteoporosis, stroke, and T2DM among short sleepers. Conversely, a 1-h increment in long sleepers is associated with a 7-17% higher risk of stroke mortality, CHD, stroke, and T2DM in adults. CONCLUSION Inappropriate sleep duration is a risk factor for developing non-cancer conditions. Decreasing and increasing sleep hours towards extreme sleep durations are associated with poor health outcomes.
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Affiliation(s)
- Jin Li
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Dehong Cao
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Yin Huang
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Zeyu Chen
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Ruyi Wang
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Qiang Dong
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Qiang Wei
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China.
| | - Liangren Liu
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China.
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Actigraphy-derived rest-activity rhythms are associated with nocturnal blood pressure in young women. J Hypertens 2021; 39:2413-2421. [PMID: 34387571 DOI: 10.1097/hjh.0000000000002966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Misalignment between lifestyle behaviors and endogenous circadian rhythms is associated with elevated nocturnal blood pressure (BP) in experimental studies; however, less is known about free-living (i.e. nonlaboratory) circadian disruption and nocturnal BP. Additionally, sex-specific cardiovascular implications of circadian disruption are unclear. OBJECTIVE To examine the associations between rest--activity rhythms (RAR), a field-based estimate of circadian disruption, and nocturnal BP characteristics in male and female young adults. METHODS Fifty participants (20 ± 1 years; 20 men/30 women) underwent 24-h ambulatory BP monitoring following 14 days of wrist actigraphy. RAR variables of interdaily stability (day-to-day consistency in RAR), intradaily variability (within-day fragmentation of RAR), and relative amplitude (difference between peak vs. trough activity) were derived from actigraphy. Multivariable regression models of mean nocturnal SBP, DBP, and SBP dipping were generated to test main associations with RAR variables, and sex × RAR interactions. Daytime BP, race, BMI, physical activity, sleep duration, alcohol, caffeine, and sodium intake were considered as covariates. RESULTS In the full sample, no main associations between RAR and nocturnal BP characteristics were found. Sex interacted with RAR such that in women, higher interdaily stability (β = -5.39, 95% CI = -10.04 to -0.73, P = 0.024) and relative amplitude (β = -4.78, 95% CI = -9.22 to -0.34, P = 0.036) were both associated with lower nocturnal SBP. Sex-stratified multivariable models of nocturnal BP also revealed associations between interdaily stability and relative amplitude with SBP dipping in women (all P ≤ 0.01). No associations were apparent in men. CONCLUSION Consistent and high-amplitude RAR are favorably associated with nocturnal BP characteristics in young female adults.
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