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Sheehan CM. Rural/nonrural sleep duration patterns among adults in middle and older adulthood. Sleep Health 2024; 10:237-239. [PMID: 38151375 DOI: 10.1016/j.sleh.2023.11.007] [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: 02/27/2023] [Revised: 11/03/2023] [Accepted: 11/13/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVES To document sleep duration differences between rural and nonrural adults in middle/older adulthood. METHODS Data consisted of adults aged 50-80 from the 2014, 2016, 2018, and 2020 Behavioral Risk Factor Surveillance System (n = 669,978). Hierarchical multinomial logistic regression models were fit predicting self-reported short (ie, 6 or fewer hours per 24-hour period) and long (ie, 9 or more hours per 24-hour period) compared to normal-sleep duration (ie, 7-8hours per 24-hour period). RESULTS Rural adults aged 50+ had slightly but significantly lower levels of short sleep (30.0% vs. 30.8%), and slightly but significantly higher levels of long sleep (10.6% vs. 9.4%). In multinomial logistic models that accounted for demographics, rural adults had significantly higher levels of long sleep (OR 1.16, 95% CI 1.12-1.21). The long-sleep differences were explained by socioeconomic measures. CONCLUSIONS Sleep researchers should continue to investigate and conceptualize sleeping patterns and heterogeneity among rural adults.
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Affiliation(s)
- Connor M Sheehan
- School of Social and Family Dynamics, Arizona State University, Tempe, Arizona, USA.
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2
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Patel SK, Breen EC, Paz IB, Kruper L, Mortimer J, Wong FL, Bhatia S, Irwin MR, Behrendt CE. Inflammation-related proteins as biomarkers of treatment-related behavioral symptoms: A longitudinal study of breast cancer patients and age-matched controls. Brain Behav Immun Health 2023; 32:100670. [PMID: 37637432 PMCID: PMC10450410 DOI: 10.1016/j.bbih.2023.100670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 07/28/2023] [Accepted: 07/30/2023] [Indexed: 08/29/2023] Open
Abstract
Background Behavioral symptoms in breast cancer (BC) survivors have been attributed to cancer treatment and resulting inflammation. However, studies linking behavioral symptoms to BC treatment have observed patients only after some treatment. Our prospective study with pre-treatment baseline investigates post-treatment changes in inflammation-related biomarkers and whether those changes correlate with changes in symptoms. Methods Participants were postmenopausal women, newly-diagnosed with stage 0-3 BC before any treatment (n = 173 "patients"), and age-matched women without cancer (n = 77 "controls"), who were assessed on plasma markers [soluble tumor necrosis factor receptor type 2 (sTNF-RII), interleukin (IL)-6, IL-1 receptor antagonist (IL-1RA), C-reactive protein (CRP)]) and symptoms (Physical Functioning, Pain, Attention/concentration, Perceived Cognitive Problems, Fatigue, Sleep Insufficiency, Depression). Participants were assessed again 1 month, 1 year, and 2 years after completing primary treatment or similar interval in controls. Generalized linear mixed models tested 4 treatments (surgery alone or with chemotherapy, radiation, or both) for association with change per marker. Joint models tested change per marker for association with change per symptom. Models considered demographic, socioeconomic, and clinical covariates. False Discovery Rate method controlled risk of error from multiple hypotheses. Results At one month post-completion of treatment, sTNF-RII and IL-6 were elevated by all BC treatments, as were IL-1RA and CRP after surgery alone (all, p < 0.05). By 1 year, markers' average values returned to baseline. Throughout 2-year follow-up, increase-from-baseline in sTNF-RII, IL-1RA, and IL-6 coincided with worsened Physical Functioning, and increase-from-baseline in sTNF-RII coincided with increased Pain (all, p < 0.01). These biomarker-symptom associations (excepting IL-6) were exclusive to patients. No other symptoms worsened, and baseline Fatigue and Depression improved in all participants. Conclusions BC treatment, even surgery, is associated with transient elevation in inflammatory markers. In patients post-treatment, increase-from-baseline in sTNF-RII accompanies increased Pain and decreased Physical Functioning, suggesting that sTNF-RII merits development as a clinical biomarker in BC patients.
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Affiliation(s)
- Sunita K. Patel
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, USA
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, USA
| | - Elizabeth C. Breen
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - I. Benjamin Paz
- Department of Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
- Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Laura Kruper
- Department of Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
- Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Joanne Mortimer
- Department of Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - F. Lennie Wong
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Michael R. Irwin
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Carolyn E. Behrendt
- Department of Computational and Quantitative Medicine, Division of Biostatistics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
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Sheehan CM, Garcia MA, Chiu CT, Cantu PA. Racial and Ethnic Differences in Sleep Duration Life Expectancies among Men and Women in Mid-to-Late Life. Res Aging 2023; 45:620-629. [PMID: 36548945 DOI: 10.1177/01640275221146478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This analysis documents U.S. racial/ethnic and gender differences in life expectancies with different self-reported sleep durations among adults aged 50 and older. We used self-reported sleep duration and linked mortality information from the 2004-2015 National Health Interview Survey (n = 145,015) to calculate Sullivan Method Lifetables for life expectancies with different self-reported sleep duration states: short (≤6 hours), optimal (seven to 8 hours), and long (≥9 hours) sleep duration per-day by race/ethnicity and gender. Non-Hispanic Black men (35.8%, 95% CI: 34.8%-36.8%) and women (36.5%, 95% CI: 35.7%-37.1%) exhibited the highest proportion of years lived with short sleep duration followed by Hispanic men (31.1%, 95% CI: 29.9%-32.3%) and women (34.1%, 95% CI: 33.1%-35.1%) and Non-Hispanic White men (25.8%, 95% CI: 25.4%-26.2%) and women (27.4%, 95% CI: 27.0%-27.7%). These results highlight how race/ethnic inequality in sleep duration and life expectancy are intertwined among older adults in the U.S.
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Affiliation(s)
- Connor M Sheehan
- School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
| | - Marc A Garcia
- Department of Sociology, Aging Studies Institute, Center for Aging and Policy Studies, Lerner Center for Public Health Promotion, Syracuse University, Syracuse, New York, USA
| | - Chi-Tsun Chiu
- Institute of European and American Studies, Academia Sinica, Taipei, Taiwan
| | - Phillip A Cantu
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
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Rozanski A, Sakul S, Narula J, Berman D. Assessment of lifestyle "vital signs" in healthcare settings. Prog Cardiovasc Dis 2023; 77:107-118. [PMID: 36848965 DOI: 10.1016/j.pcad.2023.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 02/20/2023] [Indexed: 02/27/2023]
Abstract
Unhealthy lifestyles, such as maintenance of poor diets and physical inactivity, are a powerful driver of disease-producing risk factors and chronic illnesses. This has led to an increasing call to assess adverse lifestyle factors in healthcare settings. This approach could be aided by designating health-related lifestyle factors as "vital signs" that can be recorded during patient visits. Just such an approach has been used for assessing patients' smoking habits since the 1990s. In this review, we assess the rationale for addressing six other health-related lifestyle factors, beyond smoking, in patient care settings: physical activity (PA), sedentary behavior (SB), participation in muscle strengthening exercises, mobility limitations, diet, and sleep quality. For each domain, we evaluate the evidence that supports currently proposed ultra-short screening tools. Our analysis indicates strong medical evidence to support the use of one to two-item screening questions for assessing patients' PA, SB, muscle strengthening activities, and presence of "pre-clinical" mobility limitations. We also present a theoretical basis for measuring patients' diet quality through use of an ultrashort dietary screen, based on evaluation of healthy food intake (fruits/vegetables) and unhealthy food intake (high consumption of highly processed meats and/or consumption of sugary foods and beverages) and a proposed evaluation of sleep quality using a single-item screener. The result is a 10-item lifestyle questionnaire that is based on patient self-report. As such, this questionnaire has the potential to be employed as a practical tool for assessing health behaviors in clinical care settings without impairing the normal workflow of healthcare providers.
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Affiliation(s)
- Alan Rozanski
- Division of Cardiology, Mount Sinai Morningside Hospital, Mount Sinai Heart, and the Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
| | - Sakul Sakul
- Division of Cardiology, Mount Sinai Morningside Hospital, Mount Sinai Heart, and the Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Jagat Narula
- Division of Cardiology, Mount Sinai Morningside Hospital, Mount Sinai Heart, and the Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Daniel Berman
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America
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How did trends in sleep duration in 2020 compare to previous years and how did they vary by sex, race/ethnicity, and educational attainment? Sleep Med 2023; 101:570-577. [PMID: 36584502 PMCID: PMC9753452 DOI: 10.1016/j.sleep.2022.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/03/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Abstract
Recent evidence utilizing online samples indicates that sleep patterns were significantly altered during the initial months of the SARS-CoV-2 (COVID-19) pandemic/lockdown. However, it remains less clear how sleep duration changed in population-based samples, in the later months of 2020, and across subpopulations. Here we used a population-based sample to document sleep duration trends for the entire year of 2020, compared these trends to the previous years of 2013, 2014, 2016, and 2018, and systematically analyzed whether self-reported sleep duration patterns in 2020 varied by sex, race/ethnicity, and educational attainment. Data were from the Behavioral Risk Factor Surveillance System (n = 2,203,861) and focused on Americans aged 18 years and older. Respondents self-reported the hours of sleep they got in a 24-h period. We fit multinomial and linear regression models to predict the category of sleep duration (six or fewer hours, seven to eight h (base), and nine or more hours) and the raw reports of sleep duration, net of demographic, socioeconomic, and behavioral health covariates. Results revealed significant increases in sleep duration during the months directly after the COVID-19 lockdown (March and April in particular). However, these increases were short lived; reports of sleep duration reverted to historical levels by the Fall of 2020. We also found that the changes in sleep duration trends in 2020 were similar by sex, race/ethnicity, and educational attainment, cumulatively leading to little impact to disparities in sleep duration. In a dramatic, but brief, alteration of population-level sleep duration patterns, disparities in self-reported sleep duration remained intractable.
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Pabayo R, Patel P, Liu SY, Molnar BE. Sleepless in inequality: findings from the 2018 behavioral risk factor surveillance system, a cross-sectional study. BMC Public Health 2022; 22:1973. [PMID: 36303178 PMCID: PMC9615368 DOI: 10.1186/s12889-022-14292-5] [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: 06/16/2022] [Accepted: 09/30/2022] [Indexed: 11/10/2022] Open
Abstract
Background Despite the large body of research on the adverse effects of income inequality, to date, few studies have examined its impact on sleep. The objective of this investigation is to examine the association between US state income inequality and the odds for regularly obtaining inadequate (< 7 h) and very inadequate (< 5 h) of sleep in the last 24 h. Methods We analysed data from 350,929 adults participating in the US 2018 Behavioral Risk Factor Surveillance System (BRFSS). Multilevel modeling was used to determine the association between state-level income inequality, as measured by the Gini coefficient, and the odds for obtaining inadequate and very inadequate sleep. We also determined if associations were heterogeneous across gender. Results A standard deviation increase in the Gini coefficient was associated with increased odds for inadequate (OR = 1.06, 95% CI: 1.00, 1.13) and very inadequate sleep (OR = 1.11, 95% CI: 1.03,1.20). Also, a cross-level Gini Coefficient X Gender interaction term was significant (OR = 1.07, 95% CI:1.01,1.13), indicating that increasing income inequality was more detrimental to women’s sleep behavior. Conclusion Future work should be conducted to determine whether decreasing the wide gap between incomes can alleviate the burden of income inequality on inadequate sleep in the United States.
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Affiliation(s)
- Roman Pabayo
- University of Alberta School of Public Health, T6G 2R3, 3-300 Edmonton Clinic Health Academy, 11405-87 Ave., Edmonton, Alberta, Canada.
| | - Priya Patel
- University of Alberta School of Public Health, T6G 2R3, 3-300 Edmonton Clinic Health Academy, 11405-87 Ave., Edmonton, Alberta, Canada
| | - Sze Y Liu
- Public Health Department, Montclair State University, New Jersey, USA
| | - Beth E Molnar
- Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
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Mader EC, Mader ACL, Singh P. Insufficient Sleep Syndrome: A Blind Spot in Our Vision of Healthy Sleep. Cureus 2022; 14:e30928. [PMID: 36337802 PMCID: PMC9626376 DOI: 10.7759/cureus.30928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 11/05/2022] Open
Abstract
Chronic sleep deficiency (CSD) poses a threat to physical health, mental well-being, and social functioning. The concept of behaviorally induced CSD has not changed much since it was first introduced four decades ago. Behaviorally induced CSD is currently referred to as insufficient sleep syndrome (ISS). In the latest edition of the International Classification of Sleep Disorders (ICSD-3, 2014), ISS is considered a disorder of central hypersomnolence with diagnostic codes ICD-9-CM 307.44 and ICD-10-CM F51.12. In this review, we will describe the biological importance of sleep, the ramifications of CSD on the individual and society, the nosological status and diagnostic features of ISS, and the apparent lack of attention to ISS in contemporary medical practice and public health programs. The last three decades have seen a global rise in voluntary sleep curtailment such that ISS may already be the leading cause of CSD, not only in adults but also in school-aged children and adolescents. Acknowledging ISS as a public health priority is a necessary first step in our response to the global threat of CSD and CSD-related health consequences. It is only by confronting ISS directly that we can hope to develop and implement effective educational and advocacy programs, along with more responsible public health policies and regulations.
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Affiliation(s)
- Edward C Mader
- Department of Neurology, Louisiana State University Health Sciences Center, New Orleans, USA
| | | | - Prachi Singh
- Sleep and Cardiometabolic Health Laboratories, Louisiana State University Pennington Biomedical Research Center, Baton Rouge, USA
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Jamil H, Alakkari M, Al-Mahini MS, Alsayid M, Al-Jandali O. The Impact of Anxiety and Depression on Academic Performance: A Cross-Sectional Study among Medical Students in Syria. Avicenna J Med 2022; 12:111-119. [PMID: 36092387 PMCID: PMC9458347 DOI: 10.1055/s-0042-1755181] [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] [Indexed: 12/01/2022] Open
Abstract
Background
The National Medical Unified Examination (NMUE) is a milestone in the life of medical students in Syria. The selection for residency programs depends mainly on the NMUE score, where competitive specialties require higher scores. Therefore, preparation for the NMUE might be a source of anxiety and depression. This study aims at evaluating the impact of anxiety and depression on the NMUE score. A secondary objective is to determine the effect of some factors (i.e., exercise, having breakfast, adequate sleep, and social media) on anxiety and depression.
Methods
A cross-sectional study was conducted using an online questionnaire and included medical students who were preparing for the October 2019 NMUE exam. The Generalized Anxiety Disorder scale (GAD-7) and the Patient Health Questionnaire (PHQ-9) were used to screen for anxiety and depression, respectively. NMUE scores were obtained from the official score report. Demographics and other potential confounding factors, such as Cumulative Grade Point Average, were obtained through the questionnaire.
Results
One hundred and thirty (
n
= 130) students participated in the study, 83 of them were women (63.8%). The prevalence of anxiety and depression were 59.2 and 58%, respectively, with no difference between men and women. Both anxiety and depression were negatively correlated with the NMUE score. However, this relationship did not persist after controlling for other important predictors through multiple regression. Only exercising was statically significant in reducing PHQ-9 scores. None of the studied factors were significant in reducing GAD-7 scores.
Conclusion
Although participants with higher anxiety/depression had lower NMUE scores, this association does not imply causation. The high prevalence of anxiety and depression (approximately two-thirds of the participants) is concerning and may pose a great threat to students' well-being and adversely affect the quality of care provided by them as future health care professionals.
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Affiliation(s)
- Hasan Jamil
- Graduate School of Public Health, St. Luke's International University, Akashi-cho, Chuo-ku, Tokyo, Japan
| | | | | | - Muhammad Alsayid
- Division of Digestive Diseases, Rush University Medical Center, Chicago, Illinois, United States
| | - Omar Al-Jandali
- Department of Internal Medicine, Damascus University, Damascus, Syria
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Businelle MS, Garey L, Gallagher MW, Hébert ET, Vujanovic A, Alexander A, Kezbers K, Matoska C, Robison J, Montgomery A, Zvolensky MJ. An Integrated mHealth App for Smoking Cessation in Black Smokers With Anxiety: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e38905. [PMID: 35635746 PMCID: PMC9153912 DOI: 10.2196/38905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 04/24/2022] [Accepted: 04/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Black smokers have greater difficulty in quitting and higher rates of smoking-related diseases and disabilities than the general population. The smoking disparities experienced by this group are, in part, a consequence of multiple chronic life stressors (eg, racial discrimination) that engender increased exposure to interoceptive stress symptoms (eg, anxiety), which can ultimately lead to smoking as a means of immediate emotion regulation. OBJECTIVE This study aimed to culturally adapt and initially test a novel mobile intervention (ie, Mobile Anxiety Sensitivity Program for Smoking [MASP]) that targets anxiety sensitivity (AS; a proxy for difficulty and responsivity to interoceptive stress) among Black smokers. The MASP intervention is culturally informed to address interoceptive stress management difficulties among Black smokers and is thus hypothesized to facilitate smoking cessation. METHODS In phase 1, a total of 25 Black smokers with elevated AS will be administered MASP for 6 weeks. Following the completion of phase 1, we will further refine the MASP based on qualitative and quantitative data from participants to produce the final MASP iteration. In phase 2, a total of 200 Black smokers with elevated AS will be enrolled and randomly assigned to receive nicotine replacement therapy and either the smartphone-based National Cancer Institute QuitGuide app for standard mobile smoking cessation treatment or the MASP intervention. All participants in phases 1 and 2 will be enrolled remotely and will complete a web-based study screener; smartphone-based baseline assessment; daily smartphone-based ecological momentary assessments for 6 weeks; phone-based end-of-treatment qualitative interviews; and smartphone-based follow-up assessments at postbaseline weeks 1, 2 (quit date), 3, 4, 5, 6, 28, and 54 (weeks 28 and 54 follow-ups will be completed by phase 2 participants only). The MASP intervention is intended to offset barriers to treatment and encourage treatment engagement via smartphones. RESULTS This project was funded in September 2020. Phase 1 data collection began in January 2022. Phase 2 data collection is scheduled to begin in July 2022. CONCLUSIONS If successful, data from this study will support culturally informed treatment approaches for Black smokers and, pending findings of efficacy, provide an evidence-based mobile intervention for smoking cessation that is ready for dissemination and implementation. TRIAL REGISTRATION ClinicalTrials.gov NCT04838236; https://clinicaltrials.gov/ct2/show/NCT04838236. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/38905.
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Affiliation(s)
- Michael S Businelle
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- HEALTH Institute, University of Houston, Houston, TX, United States
| | - Lorra Garey
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Matthew W Gallagher
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
- Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, TX, United States
| | - Emily T Hébert
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Austin, TX, United States
| | - Anka Vujanovic
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Adam Alexander
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Krista Kezbers
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Cameron Matoska
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Jillian Robison
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Audrey Montgomery
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Michael J Zvolensky
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
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Questionnaires measuring movement behaviours in adults and older adults: Content description and measurement properties. A systematic review. PLoS One 2022; 17:e0265100. [PMID: 35275936 PMCID: PMC8916622 DOI: 10.1371/journal.pone.0265100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/22/2022] [Indexed: 01/14/2023] Open
Abstract
Background Sleep, sedentary behaviour and physical activity are constituent parts of a 24h period and there are several questionnaires to measure these movement behaviours, the objective was to systematically review the literature on content and measurement properties of self- and proxy-reported questionnaires measuring movement behaviours in adults and older adults. Methods The databases PubMed, CINAHL, PsycINFO and SPORTDiscus were systematically searched until April 2021. Articles were included if: the questionnaires were design for adults and older adults; the sample size for validity studies had at least 50 participants; at least, both validity and test-retest reliability results of questionnaire that were developed specifically to measure the amount of sleep, sedentary behaviour or physical activity, or their combination were reported; and articles had to be written in English, Spanish, French, Portuguese, German, Italian or Chinese. Findings and conclusions Data extraction, results, studies’ quality, and risk of bias were evaluated using the Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Fifty-five articles were included in this review, describing 60 questionnaires. None of the questionnaires showed adequate criterion validity and adequate reliability, simultaneously; 68.3% showed adequate content validity. The risk of bias for criterion validity and reliability were very low in 72.2% and 23.6% of the studies, respectively. Existing questionnaires have insufficient measurement properties and frequent methodologic limitations, and none was developed considering the 24h movement behaviour paradigm. The lack of valid and reliable questionnaires assessing 24h movement behaviours in an integrated way, precludes accurate monitoring and surveillance systems of 24h movement behaviours.
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Lee PH. Validation of the National Health And Nutritional Survey (NHANES) single-item self-reported sleep duration against wrist-worn accelerometer. Sleep Breath 2021; 26:2069-2075. [PMID: 34845630 DOI: 10.1007/s11325-021-02542-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/18/2021] [Accepted: 11/25/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE AND METHODS This study aimed to validate the single-item sleep duration question used in the National Health And Nutritional Survey (NHANES), "How much sleep do you usually get at night on weekdays or workdays (hours)?", against a wrist-worn accelerometer (ActiGraph GT3X +) in waves 2011-2012 and 2013-2014 among an adult population aged 20 or above (n = 8,438, mean age 49.7, 48% male). RESULTS The accelerometer-measured and self-reported sleep duration were 6.01 (SD 1.48) and 6.88 (SD 1.40) h/day, respectively, representing a 0.87 h/day of over-reporting (SD 1.90, p < 0.001). Such an over-reporting was observed in all subgroups, where the over-reporting ranged from 0.72 (those aged 41-50) to 1.13 h/day (those aged 71 or above). The correlation between accelerometer-measured and self-reported sleep duration was low (ρ = 0.14, p < 0.001). CONCLUSIONS The associations between sleep duration and other health outcomes identified using NHANES data should be further tested using more accurate and valid measures of sleep duration.
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Affiliation(s)
- Paul H Lee
- Department of Health Sciences, George Davies Centre, University of Leicester, University Road, Leicester, LE1 7RH, UK.
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12
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Perez LG, Dong L, Beckman R, Meadows SO. Movement behaviors associated with mental health among US military service members. MILITARY PSYCHOLOGY 2021. [DOI: 10.1080/08995605.2021.1987084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Lu Dong
- The RAND Corporation, Santa Monica, California, USA
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13
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Sheehan C, Zajacova A, Connor D, Montez JK. State-Level Variation in the Association Between Educational Attainment and Sleep. POPULATION RESEARCH AND POLICY REVIEW 2021. [DOI: 10.1007/s11113-021-09684-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Skovlund SE, Troelsen LH, Klim L, Jakobsen PE, Ejskjaer N. The participatory development of a national core set of person-centred diabetes outcome constructs for use in routine diabetes care across healthcare sectors. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:62. [PMID: 34507618 PMCID: PMC8434700 DOI: 10.1186/s40900-021-00309-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 08/31/2021] [Indexed: 05/17/2023]
Abstract
BACKGROUND This study sought to utilise participatory research methods to identify the perspectives of people with diabetes regarding which diabetes outcomes were most important to them. These findings were then used to support an expert working group representing multiple health sectors and healthcare disciplines and people with diabetes to establish a core set of patient-important outcome constructs for use in routine diabetes care. METHODS 26 people with diabetes and family members were recruited through purposive sampling to participate in interviews, focus groups, voting and plenary activities in order to be part of identifying outcome constructs. Content and qualitative analysis methods were used with literature reviews to inform a national multi-stakeholder consensus process for a core set of person-centred diabetes outcome constructs to be used in routine diabetes care across health care settings. RESULTS 21 people with diabetes and 5 family members representing type 1 and 2 diabetes and a range of age groups, treatment regimens and disease burden identified the following patient-reported outcome constructs as an important supplement to clinical indicators for outcome assessment in routine diabetes care: self-rated health, psychological well-being, diabetes related emotional distress and quality of life, symptom distress, treatment burden, blood sugar regulation and hypoglycemia burden, confidence in self-management and confidence in access to person-centred care and support. Consensus was reached by a national multi-stakeholder expert group to adopt measures of these constructs as a national core diabetes outcome set for use in routine value-based diabetes care. CONCLUSIONS We found that patient-reported outcome (PRO) constructs and clinical indicators are needed in core diabetes outcome sets to evaluate outcomes of diabetes care which reflect key needs and priorities of people with diabetes. The incorporation of patient-reported outcome constructs should be considered complementary to clinical indicators in multi-stakeholder value-based health care strategies. We found participatory research methods were useful in facilitating the identification of a core prioritised set of diabetes outcome constructs for routine value-based diabetes care. The use of our method for involving patients may be useful for similar efforts in other disease areas aimed at defining suitable outcomes of person-centred value-based care. Future research should focus on developing acceptable and psychometrically valid measurement instruments to evaluate these outcome constructs as part of routine diabetes care.
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Affiliation(s)
- Soren Eik Skovlund
- Department of Clinical Medicine, Aalborg University, Sønderskovvej 15, 9000, Aalborg, Denmark.
- Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark.
| | - Lise H Troelsen
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
| | - Lotte Klim
- Danish Group for European Patients' Academy on Therapeutic Innovation (EUPATI), Copenhagen, Denmark
| | - Poul Erik Jakobsen
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
| | - Niels Ejskjaer
- Department of Clinical Medicine, Aalborg University, Sønderskovvej 15, 9000, Aalborg, Denmark
- Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
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Thorne HB, Rockloff MJ, Ferguson SA, Vincent GE, Browne M. Gambling Problems Are Associated with Alcohol Misuse and Insomnia: Results from a Representative National Telephone Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136683. [PMID: 34206276 PMCID: PMC8296877 DOI: 10.3390/ijerph18136683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/05/2021] [Accepted: 06/13/2021] [Indexed: 11/24/2022]
Abstract
Gambling has significant costs to the community, with a health burden similar in scale to major depression. To reduce its impact, it is necessary to understand factors that may exacerbate harm from gambling. The gambling environment of late-night licensed venues and 24/7 online gambling has the potential to negatively impact sleep and increase alcohol consumption. This study explored gambling, alcohol, and sleep problems to understand whether there is a relationship between these three factors. Telephone interviews were conducted with a representative sample of Australian adults (n = 3760) combined across three waves of the National Social Survey. Participants completed screening measures for at-risk gambling, at-risk alcohol consumption, insomnia (2015 wave only), and sleep quality. There were small but significant positive correlations between problem gambling and alcohol misuse, problem gambling and insomnia, and problem gambling and poor sleep quality. A regression model showed that gambling problems and alcohol misuse were significant independent predictors of insomnia. A separate regression showed gambling problems (and not alcohol misuse) were a significant predictor of poor sleep quality, but only in one survey wave. Findings suggest that gambling, alcohol, and sleep problems are related within persons. Further research should examine the mechanisms through which this relationship exists.
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16
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Kianersi S, Zhang Y, Rosenberg M, Macy JT. Association between e-cigarette use and sleep deprivation in U.S. Young adults: Results from the 2017 and 2018 Behavioral Risk Factor Surveillance System. Addict Behav 2021; 112:106646. [PMID: 32977271 DOI: 10.1016/j.addbeh.2020.106646] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/18/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Few studies have assessed the association between e-cigarette use and sleep deprivation. This is an important question given the rapid increase in e-cigarette use among young adults in recent years. PURPOSE To determine whether e-cigarette use is associated with sleep deprivation in a sample of young (18-24 years-old) American adults. METHODS We used pooled cross-sectional data from the 2017 and 2018 Behavioral Risk Factor Surveillance System (BRFSS), selecting respondents aged 18 to 24 from forty-one states and U.S. territories that included the e-cigarette and sleep modules in the interview (N = 19,701). Poisson regression models tested the relationship between e-cigarette use and sleep deprivation. We adjusted for sociodemographic variables, physical activity, mental health, BMI, smokeless tobacco products use, alcohol drinking, and smoking. RESULTS In the pooled dataset, the weighted prevalence of current or former e-cigarette use was 47% and 35% of participants self-reported sleep deprivation. After adjusting for confounders, former e-cigarette users were 1.17 times more likely to report sleep deprivation, compared to never users (95%CI: 1.06, 1.29). The prevalence ratio for self-reported sleep deprivation increased to 1.42 (95%CI: 1.23, 1.65) for everyday users, compared to never e-cigarette users. CONCLUSIONS These findings suggest that e-cigarette use might be related to sleep deprivation in young adults. Future longitudinal studies should assess the causal and dose-response nature of this relationship.
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17
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Bennie JA, De Cocker K, Duncan MJ. Associations of muscle-strengthening and aerobic exercise with self-reported components of sleep health among a nationally representative sample of 47,564 US adults. Sleep Health 2020; 7:281-288. [PMID: 33071201 DOI: 10.1016/j.sleh.2020.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 07/06/2020] [Accepted: 08/16/2020] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Evidence demonstrates that physical activity is favorably associated with indicators of sleep health. However, population-based studies rarely examine the relationship between different physical activity modalities (ie, aerobic exercise vs muscle-strengthening exercise) with components of sleep health. METHODS Cross-sectional analyses were conducted on the US 2017 Behavioral Risk Factor Surveillance System. Validated items assessed self-reported moderate-to-vigorous-intensity aerobic physical activity (MVPA), muscle-strengthening exercise (MSE), sleep duration, difficulties and disorders. Poisson regression assessed prevalence ratios (PR) of 5 components of detrimental sleep health (short sleep; long sleep; poor quality sleep; observed snoring; and observed breathing stoppage) separately for adults 18-64 years and ≥65 years, across 4 categories of physical activity guideline adherence (met neither [reference]; MSE only; MVPA only; met both). RESULTS The sample comprised 47,564 adults (mean age: 48.4 years; ±1.4; 51.6% female). Among those 18-64 years, with the exception of short sleep (4-6 hours), for all other detrimental sleep health components, the lowest PRs were observed among those meeting both MVPA-MSE guidelines. Among those aged ≥65 years, for all 5 detrimental sleep health components, compared to the other physical activity categories, the lowest PRs were observed among those meeting both MVPA-MSE guidelines. All associations remained after adjusting for potential confounders (sex, education, income, smoking, alcohol, depression, hypertension, diabetes). CONCLUSION A physical activity routine that includes both MVPA and MSE is likely to be beneficial for better sleep health. Longitudinal studies are needed to establish the temporal relationships between MVPA/MSE guideline adherence and sleep health.
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Affiliation(s)
- Jason A Bennie
- Physically Active Lifestyles Research Group (USQ PALs), Institute for Resilient Regions, University of Southern Queensland, Education City, 37 Sinnathamby Boulevard, Springfield, Queensland 4300, Australia.
| | - Katrien De Cocker
- Physically Active Lifestyles Research Group (USQ PALs), Institute for Resilient Regions, University of Southern Queensland, Education City, 37 Sinnathamby Boulevard, Springfield, Queensland 4300, Australia
| | - Mitch J Duncan
- School of Medicine & Public Health; Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan NSW 2308, Australia; Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan NSW 2308, Australia
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Gibson DG, Wosu AC, Pariyo GW, Ahmed S, Ali J, Labrique AB, Khan IA, Rutebemberwa E, Flora MS, Hyder AA. Effect of airtime incentives on response and cooperation rates in non-communicable disease interactive voice response surveys: randomised controlled trials in Bangladesh and Uganda. BMJ Glob Health 2019; 4:e001604. [PMID: 31565406 PMCID: PMC6747927 DOI: 10.1136/bmjgh-2019-001604] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 08/19/2019] [Accepted: 08/25/2019] [Indexed: 12/31/2022] Open
Abstract
Background The global proliferation of mobile phones offers opportunity for improved non-communicable disease (NCD) data collection by interviewing participants using interactive voice response (IVR) surveys. We assessed whether airtime incentives can improve cooperation and response rates for an NCD IVR survey in Bangladesh and Uganda. Methods Participants were randomised to three arms: a) no incentive, b) 1X incentive or c) 2X incentive, where X was set to airtime of 50 Bangladesh Taka (US$0.60) and 5000 Ugandan Shillings (UGX; US$1.35). Adults aged 18 years and older who had a working mobile phone were sampled using random digit dialling. The primary outcomes, cooperation and response rates as defined by the American Association of Public Opinion Research, were analysed using log-binomial regression model. Results Between 14 June and 14 July 2017, 440 262 phone calls were made in Bangladesh. The cooperation and response rates were, respectively, 28.8% (353/1227) and 19.2% (580/3016) in control, 39.2% (370/945) and 23.9% (507/2120) in 50 Taka and 40.0% (362/906) and 24.8% (532/2148) in 100 Taka incentive groups. Cooperation and response rates, respectively, were significantly higher in both the 50 Taka (risk ratio (RR) 1.36, 95% CI 1.21 to 1.53) and (RR 1.24, 95% CI 1.12 to 1.38), and 100 Taka groups (RR 1.39, 95% CI 1.23 to 1.56) and (RR 1.29, 95% CI 1.16 to 1.43), as compared with the controls. In Uganda, 174 157 phone calls were made from 26 March to 22 April 2017. The cooperation and response rates were, respectively, 44.7% (377/844) and 35.2% (552/1570) in control, 57.6% (404/701) and 39.3% (508/1293) in 5000 UGX and 58.8% (421/716) and 40.3% (535/1328) in 10 000 UGX groups. Cooperation and response rates were significantly higher, respectively in the 5000 UGX (RR 1.29, 95% CI 1.17 to 1.42) and (RR 1.12, 95% CI 1.02 to 1.23), and 10 000 UGX groups (RR 1.32, 95% CI 1.19 to 1.45) and (RR 1.15, 95% CI 1.04 to 1.26), as compared with the control group. Conclusion In two diverse settings, the provision of an airtime incentive significantly improved both the cooperation and response rates of an IVR survey, with no significant difference between the two incentive amounts. Trial registration number NCT03768323.
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Affiliation(s)
- Dustin G Gibson
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Adaeze C Wosu
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - George William Pariyo
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Saifuddin Ahmed
- Population, Family And Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Joseph Ali
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.,Johns Hopkins University Berman Institute of Bioethics, Baltimore, Maryland, USA
| | - Alain B Labrique
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Iqbal Ansary Khan
- Institute of Epidemiology Disease Control and Research, Dhaka, Dhaka District, Bangladesh
| | | | - Meerjady Sabrina Flora
- Institute of Epidemiology Disease Control and Research, Dhaka, Dhaka District, Bangladesh
| | - Adnan A Hyder
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.,George Washington University Milken Institute of Public Health, Washington, District of Columbia, USA
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Patterns of Diet, Physical Activity, Sitting and Sleep Are Associated with Socio-Demographic, Behavioural, and Health-Risk Indicators in Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132375. [PMID: 31277386 PMCID: PMC6651368 DOI: 10.3390/ijerph16132375] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/01/2019] [Accepted: 07/01/2019] [Indexed: 01/12/2023]
Abstract
Our understanding of how multiple health-behaviours co-occur is in its infancy. This study aimed to: (1) identify patterns of physical activity, diet, sitting, and sleep; and (2) examine the association between sociodemographic and health-risk indicators. Pooled data from annual cross-sectional telephone surveys of Australian adults (2015–2017, n = 3374, 51.4% women) were used. Participants self-reported physical activity, diet, sitting-time, sleep/rest insufficiency, sociodemographic characteristics, smoking, alcohol use, height and weight to calculate body mass index (BMI), and mental distress frequency. Latent class analysis identified health-behaviour classes. Latent class regression determined the associations between health-behaviour patterns, sociodemographic, and health-risk indicators. Three latent classes were identified. Relative to a ‘moderate lifestyle’ pattern (men: 43.2%, women: 38.1%), a ‘poor lifestyle’ pattern (men: 19.9%, women: 30.5%) was associated with increased odds of a younger age, smoking, BMI ≥ 30.0 kg/m2, frequent mental distress (men and women), non-partnered status (men only), a lower Socioeconomic Index for Areas centile, primary/secondary education only, and BMI = 25.0–29.9 kg/m2 (women only). An ‘active poor sleeper’ pattern (men: 37.0%, women: 31.4%) was associated with increased odds of a younger age (men and women), working and frequent mental distress (women only), relative to a ‘moderate lifestyle’ pattern. Better understanding of how health-behaviour patterns influence future health status is needed. Targeted interventions jointly addressing these behaviours are a public health priority.
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Ogilvie RP, Patel SR. Changing national trends in sleep duration: did we make America sleep again? Sleep 2019; 41:4954024. [PMID: 29590485 DOI: 10.1093/sleep/zsy055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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21
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Sullivan K, Rochani H, Huang LT, Donley DK, Zhang J. Adverse childhood experiences affect sleep duration for up to 50 years later. Sleep 2019; 42:5485469. [DOI: 10.1093/sleep/zsz087] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 02/25/2019] [Indexed: 01/10/2023] Open
Abstract
Abstract
Study Objectives
The main objective for this study was to assess the association of adverse childhood experiences (ACEs) and subsequent short sleep duration among adults.
Methods
This cross-sectional examination used data from the 2011 Behavioral Risk Factor Surveillance System, a nationwide telephone-administered survey. Participants completed a standardized questionnaire to report childhood experiences of abuse, neglect, household challenges, and sleep time. Multinominal logistic regression analyses included survey weighting procedures and adjusted for age, race, education, income, sex, and body mass index; associations were also examined by age strata, using age as a proxy for time since ACEs occurred.
Results
Complete data were available for 22 403 adults (mean age = 46.66 years) including 14 587 (65%) with optimum sleep duration (7–9 h/night) and 2069 (9%) with short sleep duration (<6 h/night). Compared with adults with optimum sleep duration, the number of ACEs was associated with the odds of short sleep duration (odds ratio [OR] = 1.22, 95% CI = 1.16 to 1.28), and the odds increased as the number of ACEs increased. The association held for each decade of age until the 60s, although the magnitude attenuated. Mental health challenges or poor physical health did not account for the association.
Conclusion
ACEs increased the odds of chronic short sleep duration during adulthood and showed both a time-dependent and dose–response nature. These associations were independent of self-reported mental health challenges or poor physical health. The association of ACEs with short sleep duration throughout the adult lifespan emphasizes the importance of child health and identifying underlying psychological challenges in adults with sleep difficulties.
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Affiliation(s)
- Kelly Sullivan
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Georgia Southern University, Statesboro, GA
| | - Haresh Rochani
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Georgia Southern University, Statesboro, GA
| | - Li-Ting Huang
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Georgia Southern University, Statesboro, GA
| | | | - Jian Zhang
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Georgia Southern University, Statesboro, GA
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23
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Gordon S, Vandelanotte C, Rayward AT, Murawski B, Duncan MJ. Sociodemographic and behavioral correlates of insufficient sleep in Australian adults. Sleep Health 2018; 5:12-17. [PMID: 30670159 DOI: 10.1016/j.sleh.2018.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 05/29/2018] [Accepted: 06/23/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Insufficient sleep is being increasingly recognized as a public health issue. There is a need to identify correlates of insufficient sleep to guide future preventative health interventions. This study aims to determine the sociodemographic and behavioral correlates of frequent perceived insufficient sleep in the Australian population. DESIGN Pooled analyses of two cross-sectional, self-report national telephone surveys were conducted in 2015 (July-August) and 2016 (June-August). SETTING Adults living in Australia. PARTICIPANTS Data from participants (age 18 years and over) of both surveys were pooled for analysis (2015 n = 1041; 2016 n = 1170), with 2211 participants being included in the current study. MEASUREMENTS Participants self-reported their age, gender, education and employment level, language spoken at home, urbanization, chronic disease, and height and weight to calculate BMI. Self-reported physical activity, sitting time, smoking, and consumption of fruit, vegetables, fast food, alcohol and frequency of perceived insufficient sleep were also assessed. Binary logistic regression analysis examined the relationship between insufficient sleep (≥14 days out of 30), sociodemographic and behavioral variables. RESULTS The overall prevalence of insufficient sleep was 24%. Female gender, obesity, >8 h/d sitting time, smoking, and frequent consumption of fast food were positively associated with frequent insufficient sleep (P < .05). Higher levels of physical activity and being aged 51 years or older were negatively associated with frequent insufficient sleep (P < .05). CONCLUSIONS The sociodemographic and behavioral characteristics associated with frequent perceived insufficient sleep can be used to guide the development of future interventions to reduce sleep insufficiency.
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Affiliation(s)
- Sophie Gordon
- Faculty of Health and Medicine, School of Biomedical Science & Pharmacy, The University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Corneel Vandelanotte
- Physical Activity Research Group, Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland 4702, Australia
| | - Anna T Rayward
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; Faculty of Health and Medicine, School of Medicine & Public Health; The University of Newcastle, University Drive, Callaghan NSW 2308, Australia
| | - Beatrice Murawski
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; Faculty of Health and Medicine, School of Medicine & Public Health; The University of Newcastle, University Drive, Callaghan NSW 2308, Australia
| | - Mitch J Duncan
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; Faculty of Health and Medicine, School of Medicine & Public Health; The University of Newcastle, University Drive, Callaghan NSW 2308, Australia.
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Lubetkin EI, Jia H. Burden of disease due to sleep duration and sleep problems in the elderly. Sleep Health 2018; 4:182-187. [DOI: 10.1016/j.sleh.2017.11.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 11/03/2017] [Accepted: 11/08/2017] [Indexed: 12/15/2022]
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25
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Barger LK, Rajaratnam SMW, Cannon CP, Lukas MA, Im K, Goodrich EL, Czeisler CA, O'Donoghue ML. Short Sleep Duration, Obstructive Sleep Apnea, Shiftwork, and the Risk of Adverse Cardiovascular Events in Patients After an Acute Coronary Syndrome. J Am Heart Assoc 2017; 6:e006959. [PMID: 29018021 PMCID: PMC5721882 DOI: 10.1161/jaha.117.006959] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 08/14/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND It is unknown whether short sleep duration, obstructive sleep apnea, and overnight shift work are associated with the risk of recurrent cardiovascular events in patients after an acute coronary syndrome. METHODS AND RESULTS SOLID-TIMI 52 (The Stabilization of PLaques UsIng Darapladib-Thrombolysis in Myocardial Infarction 52 Trial) was a multinational, double-blind, placebo-controlled trial that enrolled 13 026 patients ≤30 days of acute coronary syndrome. At baseline, all patients were to complete the Berlin questionnaire to assess risk of obstructive sleep apnea and a sleep and shift work survey. Median follow-up was 2.5 years. The primary outcome was major coronary events (MCE; coronary heart disease death, myocardial infarction, or urgent revascularization). Cox models were adjusted for clinical predictors. Patients who reported <6 hours sleep per night had a 29% higher risk of MCE (adjusted hazard ratio, 1.29; 95% confidence interval, 1.12-1.49; P<0.001) compared with those with longer sleep. Patients who screened positive for obstructive sleep apnea had a 12% higher risk of MCE (1.12; 1.00-1.24; P=0.04) than those who did not screen positive. Overnight shift work (≥3 night shifts/week for ≥1 year) was associated with a 15% higher risk of MCE (1.15; 1.03-1.29; P=0.01). A step-wise increase in cardiovascular risk was observed for individuals with more than 1 sleep-related risk factor. Individuals with all 3 sleep-related risk factors had a 2-fold higher risk of MCE (2.01; 1.49-2.71; P<0.0001). CONCLUSIONS Short sleep duration, obstructive sleep apnea, and overnight shift work are under-recognized as predictors of adverse outcomes after acute coronary syndrome. Increased efforts should be made to identify, treat, and educate patients about the importance of sleep for the potential prevention of cardiovascular events. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01000727.
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Affiliation(s)
- Laura K Barger
- Sleep Health Institute and Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
- Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Shantha M W Rajaratnam
- Sleep Health Institute and Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
- Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Christopher P Cannon
- Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Brigham and Women's Hospital Harvard Medical School, Boston, MA
| | - Mary Ann Lukas
- Metabolic Pathways and Cardiovascular Therapeutic Area, GlaxoSmithKline, Philadelphia, PA
| | - KyungAh Im
- Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Brigham and Women's Hospital Harvard Medical School, Boston, MA
| | - Erica L Goodrich
- Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Brigham and Women's Hospital Harvard Medical School, Boston, MA
| | - Charles A Czeisler
- Sleep Health Institute and Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Michelle L O'Donoghue
- Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Brigham and Women's Hospital Harvard Medical School, Boston, MA
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Jung Y, Junna MR, Mandrekar JN, Morgenthaler TI. The National Healthy Sleep Awareness Project Sleep Health Surveillance Questionnaire as an Obstructive Sleep Apnea Surveillance Tool. J Clin Sleep Med 2017; 13:1067-1074. [PMID: 28728624 DOI: 10.5664/jcsm.6724] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 06/14/2017] [Indexed: 12/31/2022]
Abstract
STUDY OBJECTIVES To validate the previously published National Healthy Sleep Awareness Project (NHSAP) Surveillance and Epidemiology Workgroup questionnaire for ability to determine risk for moderate to severe obstructive sleep apnea (OSA). METHODS The NHSAP sleep questions, part of the next Behavioral Risk Factor Surveillance System (BRFSS), were constructed to mimic elements of the STOP sleep apnea questionnaire, and included number of days with sleep disruption and unintentional dozing and a history of snoring and apneas. The responses to four sleep questions from the BRFSS were collected from 352 adults undergoing in-laboratory polysomnography at Mayo Clinic, Rochester, Minnesota. Demographic and clinical information, including sex, age, body mass index (BMI), and presence of hypertension, which will be available in other parts of the complete BRFSS, were obtained by chart review. Univariate and logistic regression analyses were performed, and values of P < .05 were considered to be statistically significant. RESULTS Fifty-five percent of subjects were men and 45% were women with a median age of 58 years and BMI 32.2 kg/m2. Sixty percent had no or mild OSA, and 40% had moderate to severe OSA. No single question was superior in screening for moderate to severe OSA, although a history of snoring and witnessed apneas was more likely to predict moderate to severe OSA. Male sex, age ≥ 50 years, BMI ≥ 30 kg/m2, presence of hypertension, and a history of snoring and witnessed apneas were the most highly weighted factors in predicting moderate to severe OSA. When each variable was dichotomized to a single point, a cutoff of 5 points significantly predicted a high risk of moderate to severe OSA with an odds ratio of 3.87 (2.39-6.27). CONCLUSIONS Although many variables were positively associated with the apnea-hypopnea index, no single factor was superior in predicting moderate to severe OSA. Male sex, increased age, higher BMI, hypertension, and a history of snoring and witnessed apneas are the most highly predictive of moderate to severe OSA. Combined use of the NHSAP questionnaire and demographic and clinical characteristics could be considered for screening for moderate to severe OSA.
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Affiliation(s)
- Youngsin Jung
- Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota.,Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Mithri R Junna
- Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota.,Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Jayawant N Mandrekar
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Timothy I Morgenthaler
- Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota.,Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
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J. Klingman K, R. Jungquist C, L. Perlis M. Introducing the Sleep Disorders Symptom Checklist-25: A Primary Care Friendly and Comprehensive Screener for Sleep Disorders. SLEEP MEDICINE RESEARCH 2017. [DOI: 10.17241/smr.2017.00010] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Obradovich N, Migliorini R, Mednick SC, Fowler JH. Nighttime temperature and human sleep loss in a changing climate. SCIENCE ADVANCES 2017; 3:e1601555. [PMID: 28560320 PMCID: PMC5446217 DOI: 10.1126/sciadv.1601555] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 03/23/2017] [Indexed: 05/18/2023]
Abstract
Human sleep is highly regulated by temperature. Might climate change-through increases in nighttime heat-disrupt sleep in the future? We conduct the inaugural investigation of the relationship between climatic anomalies, reports of insufficient sleep, and projected climate change. Using data from 765,000 U.S. survey respondents from 2002 to 2011, coupled with nighttime temperature data, we show that increases in nighttime temperatures amplify self-reported nights of insufficient sleep. We observe the largest effects during the summer and among both lower-income and elderly respondents. We combine our historical estimates with climate model projections and detail the potential sleep impacts of future climatic changes. Our study represents the largest ever investigation of the relationship between sleep and ambient temperature and provides the first evidence that climate change may disrupt human sleep.
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Affiliation(s)
- Nick Obradovich
- Belfer Center for Science and International Affairs, Kennedy School of Government, Harvard University, Cambridge, MA 02138, USA
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Corresponding author. ,
| | - Robyn Migliorini
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA 92182, USA
| | - Sara C. Mednick
- Department of Psychology, University of California, Riverside, Riverside, CA 92521, USA
| | - James H. Fowler
- Departments of Political Science and Medicine, University of California, San Diego, La Jolla, CA 92093, USA
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Jungquist CR, Klingman KJ, Dickerson SS. Revisions to the Behavioral Risk Factor Surveillance System Sleep Questions. J Clin Sleep Med 2016; 12:1585-1592. [PMID: 27655452 DOI: 10.5664/jcsm.6336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 07/26/2016] [Indexed: 12/18/2022]
Abstract
STUDY OBJECTIVES To revise and enhance the current Behavioral Risk Factor Surveillance System (BRFSS) sleep questions for detection of sleep/wake disorders that contribute to health burden. METHODS A descriptive qualitative design was used to guide the investigation. The three methods were (1) a review of the current evidence on sleep related screening questions (including the results from the parent study validating the current BRFSS questions), (2) interviews with sleep experts about the questions they use in their clinical practice to screen for sleep problems, and (3) interviews with lay people to discuss contextual meanings, feelings, and beliefs about sufficient and restful sleep and not feeling rested. RESULTS Recommendations for revisions of the current BRFSS questions. CONCLUSIONS The current BRFSS questions should be refined to better screen for sleep disorders.
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