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Ting A, Tsai TC, Zeitzer JM, Mendez A, Kim Y. Sleep Composition of Patients With Colorectal Cancer and Their Sleep-Partner Caregivers: Physical Health Correlates of Sleep Diary and Actigraphy Measurements. Psychooncology 2024; 33:e9302. [PMID: 39123341 PMCID: PMC11328964 DOI: 10.1002/pon.9302] [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: 07/27/2023] [Revised: 07/12/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Disturbed sleep is frequently identified in adult patients with cancer and their caregivers, with detrimental impact on physical health. Less known is the extent to which self-reported and actigraph-measured sleep patterns are similar between patients and their sleep-partner caregivers, and how these different modes of sleep measurements are related to physical health. METHODS Patients diagnosed with colorectal cancer and their sleep-partner caregivers (81 dyads) completed a questionnaire for physical functioning and collected saliva samples for seven consecutive days, from which cortisol slope was quantified. Additionally, participants completed a daily sleep diary and wore actigraph for 14 consecutive days, from which sleep duration, sleep onset latency (SOL), and duration of wake after sleep onset (WASO) were calculated. RESULTS Participants reported sleep patterns that fell within or close to the optimal range, which were similar between patients and their caregivers. Self-reported and actigraph-measured sleep duration had moderate levels of agreement (ICC = 0.604), whereas SOL and WASO had poor agreement (ICC = 0.269). Among patients, longer self-reported WASO was associated with poorer physical health and flatter cortisol slope (p ≤ 0.013). Among caregivers, longer self-reported SOL was associated with poorer physical functioning, actigraph-measured WASO was associated with steeper cortisol slope, and longer self-reported sleep markers studied than actigraph-measured were associated with poorer physical functioning (p ≤ 0.042). CONCLUSION Findings suggest that employing multiple assessment modes for sleep and physical health is vital for comprehensive understanding of sleep health. Furthermore, when addressing patients' sleep health, it may be beneficial to include their sleep-partner caregivers who may experience similar disturbed sleep.
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Affiliation(s)
- Amanda Ting
- University of Miami, Coral Gables, Florida, USA
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Hassinger AB, Kwon M, Wang J, Mishra A, Wilding GE. Pilot study comparing sleep logs to a commercial wearable device in describing the sleep patterns of physicians-in-training. PLoS One 2024; 19:e0305881. [PMID: 39037970 PMCID: PMC11262664 DOI: 10.1371/journal.pone.0305881] [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: 01/22/2024] [Accepted: 06/05/2024] [Indexed: 07/24/2024] Open
Abstract
With the increasing burden of professional burnout in physicians, attention is being paid to optimizing sleep health, starting in training. The multiple dimensions of physicians' sleep are not well described due to obstacles to easily and reliably measuring sleep. This pilot study tested the feasibility of using commercial wearable devices and completing manual sleep logs to describe sleep patterns of medical students and residents. Prospective pilot study of 50 resident physicians and medical students during a single year of training. Participants completed a manual sleep log while concurrently wearing the Fitbit Inspire device for 14-consecutive days over three clinical rotations of varying work schedules: light, medium, and heavy clinical rotations. Study completion was achieved in 24/50 (48%) participants. Overall correlation coefficients between the sleep log and Fitbit were statistically low; however, the discrepancies were acceptable, i.e., Fitbit underestimated time in bed and total sleep time by 4.3 and 2.7 minutes, respectively. Sleep onset time and waketime were within 8 minutes, with good agreement. Treatment of sleep episodes during the day led to variance in the data. Average missingness of collected data did not vary between medical students or residents or by rotation type. When comparing the light to heavy rotations, hours slept went from 7.7 (±0.64) to 6.7 (±0.88), quality-of-life and sleep health decreased and stress, burnout, and medical errors increased. Burnout was significantly associated with worse sleep health, hours worked, and quality-of-life. Prospective data collection of sleep patterns using both sleep logs and commercial wearable devices is burdensome for physicians-in-training. Using commercial wearable devices may increase study success as long as attention is paid to daytime sleep. In future studies investigating the sleep of physicians, the timing of data collection should account for rotation type.
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Affiliation(s)
- Amanda B. Hassinger
- Department of Pediatrics, Division of Pulmonology and Sleep Medicine, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, New York, United States of America
- Attending Physician, John R. Oishei Children’s Hospital, Buffalo, New York, United States of America
| | - Misol Kwon
- Division of Sleep Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America
- University of Buffalo School of Nursing, Buffalo, New York, United States of America
| | - Jia Wang
- Department of Biostatistics, University at Buffalo School of Public Health and Health Professions, Buffalo, New York, United States of America
| | - Archana Mishra
- Department of Medicine, Division of Pulmonology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Critical Care and Sleep Medicine, Buffalo, New York, United States of America
| | - Gregory E. Wilding
- Department of Biostatistics, University at Buffalo School of Public Health and Health Professions, Buffalo, New York, United States of America
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Robbins R. Employee Sleep Promotion Programs in Workplace Settings: An Exciting, Viable Area for Lifestyle Medicine. Am J Lifestyle Med 2024; 18:335-339. [PMID: 38737884 PMCID: PMC11082868 DOI: 10.1177/15598276231197179] [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] [Indexed: 05/14/2024] Open
Abstract
In the past several decades, our population sleep health has fallen short of recommendations. Moreover, there has been an increase in sleep difficulties amidst COVID-19. Work consumes a huge proportion of our waking lives, and the nature of our work can impact the quantity and quality of employee sleep. Conversely, employee sleep also matters for work-related outcomes as evidence demonstrates poor employee sleep health is associated with increased presenteeism, absenteeism, and health care costs. Given the prevalence of poor sleep health in our population, the changing nature of work and increasing demands on capped time, the worksite represents a promising and potentially underexplored venue for lifestyle medicine practitioners to consider employee sleep health and, where possible, novel employee sleep health promotion programs. This article outlines the impact of work on sleep and reviews the potential for incorporating sleep into lifestyle interventions in workplace settings.
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Affiliation(s)
- Rebecca Robbins
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA (RR)
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital (RR)
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Mu CX, Lee S. The moderating role of trait and state mindfulness between daily sleep and physical pain symptoms: an ecological momentary assessment and actigraphy study. Psychol Health 2024; 39:91-108. [PMID: 35510694 DOI: 10.1080/08870446.2022.2069245] [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: 09/14/2021] [Accepted: 04/17/2022] [Indexed: 10/18/2022]
Abstract
Objective: Poorer sleep quality and insufficient sleep increase the risk of physical pain. The current study examined the daily associations between sleep and physical pain symptoms and tested the moderating role of trait and state mindfulness in this relationship. Methods: Sixty hospital nurses (Mage=35.4 ± 11.8 years) completed 14-day ecological momentary assessment (EMA) and sleep actigraphy. EMA measured physical pain frequency and interference (1×/day) and state mindfulness (3×/day). Multilevel modelling was used to examine the associations at the between-person and within-person levels. Results: After nights with poorer sleep quality, lower sleep sufficiency, and more insomnia symptoms, the frequency of physical pain symptoms and pain interference were greater than usual. Overall, those with poorer sleep quality, lower sleep sufficiency, and more insomnia symptoms reported more physical pain symptoms and greater pain interference. Higher state mindfulness buffered the negative within-person association between sleep efficiency and physical pain frequency. There was evidence that the joint moderating effects of trait and state mindfulness yielded more protective benefits in the relationship between sleep quality and physical pain than trait or state mindfulness alone. Conclusion: Even without mindfulness training, one's mindfulness may be protective against the adverse effects of poor sleep quality on physical pain.
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Affiliation(s)
- Christina X Mu
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Soomi Lee
- School of Aging Studies, University of South Florida, Tampa, FL, USA
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Berkman LF, Kelly EL, Hammer LB, Mierzwa F, Bodner T, McNamara T, Koga HK, Lee S, Marino M, Klein LC, McDade TW, Hanson G, Moen P, Buxton OM. Employee Cardiometabolic Risk Following a Cluster-Randomized Workplace Intervention From the Work, Family and Health Network, 2009-2013. Am J Public Health 2023; 113:1322-1331. [PMID: 37939328 PMCID: PMC10632833 DOI: 10.2105/ajph.2023.307413] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Objectives. To examine whether workplace interventions to increase workplace flexibility and supervisor support and decrease work-family conflict can reduce cardiometabolic risk. Methods. We randomly assigned employees from information technology (n = 555) and long-term care (n = 973) industries in the United States to the Work, Family and Health Network intervention or usual practice (we collected the data 2009-2013). We calculated a validated cardiometabolic risk score (CRS) based on resting blood pressure, HbA1c (glycated hemoglobin), HDL (high-density lipoprotein) and total cholesterol, height and weight (body mass index), and tobacco consumption. We compared changes in baseline CRS to 12-month follow-up. Results. There was no significant main effect on CRS associated with the intervention in either industry. However, significant interaction effects revealed that the intervention improved CRS at the 12-month follow-up among intervention participants in both industries with a higher baseline CRS. Age also moderated intervention effects: older employees had significantly larger reductions in CRS at 12 months than did younger employees. Conclusions. The intervention benefited employee health by reducing CRS equivalent to 5 to 10 years of age-related changes for those with a higher baseline CRS and for older employees. Trial Registration. ClinicalTrials.gov Identifier: NCT02050204. (Am J Public Health. 2023;113(12):1322-1331. https://doi.org/10.2105/AJPH.2023.307413).
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Affiliation(s)
- Lisa F Berkman
- Lisa F. Berkman is with the Harvard Center for Population and Development Studies, Cambridge, MA. Erin L. Kelly is with the Massachusetts Institute of Technology Sloan School of Management, Cambridge. Leslie B. Hammer is with the Center for Occupational Health Sciences, Oregon Health Sciences University, Portland. Frank Mierzwa is with RTI International, Research Triangle Park, NC. Todd Bodner is with the Department of Psychology, Portland State University, Portland, OR. Tay McNamara is with the Women's Studies Research Center, Brandeis University, Waltham, MA. Hayami K. Koga is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Soomi Lee is with the Department of Human Development and Family Studies, Pennsylvania State University, University Park. Miguel Marino is with the Department of Family Medicine, Oregon Health & Science University, Portland. Laura C. Klein and Orfeu M. Buxton are with the Department of Biobehavioral Health, Pennsylvania State University, University Park. Thomas W. McDade is with the Department of Anthropology, Northwestern University, Evanston, IL. Ginger Hanson is with the Johns Hopkins School of Nursing, Baltimore, MD. Phyllis Moen is with the Department of Sociology, University of Minnesota, Minneapolis
| | - Erin L Kelly
- Lisa F. Berkman is with the Harvard Center for Population and Development Studies, Cambridge, MA. Erin L. Kelly is with the Massachusetts Institute of Technology Sloan School of Management, Cambridge. Leslie B. Hammer is with the Center for Occupational Health Sciences, Oregon Health Sciences University, Portland. Frank Mierzwa is with RTI International, Research Triangle Park, NC. Todd Bodner is with the Department of Psychology, Portland State University, Portland, OR. Tay McNamara is with the Women's Studies Research Center, Brandeis University, Waltham, MA. Hayami K. Koga is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Soomi Lee is with the Department of Human Development and Family Studies, Pennsylvania State University, University Park. Miguel Marino is with the Department of Family Medicine, Oregon Health & Science University, Portland. Laura C. Klein and Orfeu M. Buxton are with the Department of Biobehavioral Health, Pennsylvania State University, University Park. Thomas W. McDade is with the Department of Anthropology, Northwestern University, Evanston, IL. Ginger Hanson is with the Johns Hopkins School of Nursing, Baltimore, MD. Phyllis Moen is with the Department of Sociology, University of Minnesota, Minneapolis
| | - Leslie B Hammer
- Lisa F. Berkman is with the Harvard Center for Population and Development Studies, Cambridge, MA. Erin L. Kelly is with the Massachusetts Institute of Technology Sloan School of Management, Cambridge. Leslie B. Hammer is with the Center for Occupational Health Sciences, Oregon Health Sciences University, Portland. Frank Mierzwa is with RTI International, Research Triangle Park, NC. Todd Bodner is with the Department of Psychology, Portland State University, Portland, OR. Tay McNamara is with the Women's Studies Research Center, Brandeis University, Waltham, MA. Hayami K. Koga is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Soomi Lee is with the Department of Human Development and Family Studies, Pennsylvania State University, University Park. Miguel Marino is with the Department of Family Medicine, Oregon Health & Science University, Portland. Laura C. Klein and Orfeu M. Buxton are with the Department of Biobehavioral Health, Pennsylvania State University, University Park. Thomas W. McDade is with the Department of Anthropology, Northwestern University, Evanston, IL. Ginger Hanson is with the Johns Hopkins School of Nursing, Baltimore, MD. Phyllis Moen is with the Department of Sociology, University of Minnesota, Minneapolis
| | - Frank Mierzwa
- Lisa F. Berkman is with the Harvard Center for Population and Development Studies, Cambridge, MA. Erin L. Kelly is with the Massachusetts Institute of Technology Sloan School of Management, Cambridge. Leslie B. Hammer is with the Center for Occupational Health Sciences, Oregon Health Sciences University, Portland. Frank Mierzwa is with RTI International, Research Triangle Park, NC. Todd Bodner is with the Department of Psychology, Portland State University, Portland, OR. Tay McNamara is with the Women's Studies Research Center, Brandeis University, Waltham, MA. Hayami K. Koga is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Soomi Lee is with the Department of Human Development and Family Studies, Pennsylvania State University, University Park. Miguel Marino is with the Department of Family Medicine, Oregon Health & Science University, Portland. Laura C. Klein and Orfeu M. Buxton are with the Department of Biobehavioral Health, Pennsylvania State University, University Park. Thomas W. McDade is with the Department of Anthropology, Northwestern University, Evanston, IL. Ginger Hanson is with the Johns Hopkins School of Nursing, Baltimore, MD. Phyllis Moen is with the Department of Sociology, University of Minnesota, Minneapolis
| | - Todd Bodner
- Lisa F. Berkman is with the Harvard Center for Population and Development Studies, Cambridge, MA. Erin L. Kelly is with the Massachusetts Institute of Technology Sloan School of Management, Cambridge. Leslie B. Hammer is with the Center for Occupational Health Sciences, Oregon Health Sciences University, Portland. Frank Mierzwa is with RTI International, Research Triangle Park, NC. Todd Bodner is with the Department of Psychology, Portland State University, Portland, OR. Tay McNamara is with the Women's Studies Research Center, Brandeis University, Waltham, MA. Hayami K. Koga is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Soomi Lee is with the Department of Human Development and Family Studies, Pennsylvania State University, University Park. Miguel Marino is with the Department of Family Medicine, Oregon Health & Science University, Portland. Laura C. Klein and Orfeu M. Buxton are with the Department of Biobehavioral Health, Pennsylvania State University, University Park. Thomas W. McDade is with the Department of Anthropology, Northwestern University, Evanston, IL. Ginger Hanson is with the Johns Hopkins School of Nursing, Baltimore, MD. Phyllis Moen is with the Department of Sociology, University of Minnesota, Minneapolis
| | - Tay McNamara
- Lisa F. Berkman is with the Harvard Center for Population and Development Studies, Cambridge, MA. Erin L. Kelly is with the Massachusetts Institute of Technology Sloan School of Management, Cambridge. Leslie B. Hammer is with the Center for Occupational Health Sciences, Oregon Health Sciences University, Portland. Frank Mierzwa is with RTI International, Research Triangle Park, NC. Todd Bodner is with the Department of Psychology, Portland State University, Portland, OR. Tay McNamara is with the Women's Studies Research Center, Brandeis University, Waltham, MA. Hayami K. Koga is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Soomi Lee is with the Department of Human Development and Family Studies, Pennsylvania State University, University Park. Miguel Marino is with the Department of Family Medicine, Oregon Health & Science University, Portland. Laura C. Klein and Orfeu M. Buxton are with the Department of Biobehavioral Health, Pennsylvania State University, University Park. Thomas W. McDade is with the Department of Anthropology, Northwestern University, Evanston, IL. Ginger Hanson is with the Johns Hopkins School of Nursing, Baltimore, MD. Phyllis Moen is with the Department of Sociology, University of Minnesota, Minneapolis
| | - Hayami K Koga
- Lisa F. Berkman is with the Harvard Center for Population and Development Studies, Cambridge, MA. Erin L. Kelly is with the Massachusetts Institute of Technology Sloan School of Management, Cambridge. Leslie B. Hammer is with the Center for Occupational Health Sciences, Oregon Health Sciences University, Portland. Frank Mierzwa is with RTI International, Research Triangle Park, NC. Todd Bodner is with the Department of Psychology, Portland State University, Portland, OR. Tay McNamara is with the Women's Studies Research Center, Brandeis University, Waltham, MA. Hayami K. Koga is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Soomi Lee is with the Department of Human Development and Family Studies, Pennsylvania State University, University Park. Miguel Marino is with the Department of Family Medicine, Oregon Health & Science University, Portland. Laura C. Klein and Orfeu M. Buxton are with the Department of Biobehavioral Health, Pennsylvania State University, University Park. Thomas W. McDade is with the Department of Anthropology, Northwestern University, Evanston, IL. Ginger Hanson is with the Johns Hopkins School of Nursing, Baltimore, MD. Phyllis Moen is with the Department of Sociology, University of Minnesota, Minneapolis
| | - Soomi Lee
- Lisa F. Berkman is with the Harvard Center for Population and Development Studies, Cambridge, MA. Erin L. Kelly is with the Massachusetts Institute of Technology Sloan School of Management, Cambridge. Leslie B. Hammer is with the Center for Occupational Health Sciences, Oregon Health Sciences University, Portland. Frank Mierzwa is with RTI International, Research Triangle Park, NC. Todd Bodner is with the Department of Psychology, Portland State University, Portland, OR. Tay McNamara is with the Women's Studies Research Center, Brandeis University, Waltham, MA. Hayami K. Koga is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Soomi Lee is with the Department of Human Development and Family Studies, Pennsylvania State University, University Park. Miguel Marino is with the Department of Family Medicine, Oregon Health & Science University, Portland. Laura C. Klein and Orfeu M. Buxton are with the Department of Biobehavioral Health, Pennsylvania State University, University Park. Thomas W. McDade is with the Department of Anthropology, Northwestern University, Evanston, IL. Ginger Hanson is with the Johns Hopkins School of Nursing, Baltimore, MD. Phyllis Moen is with the Department of Sociology, University of Minnesota, Minneapolis
| | - Miguel Marino
- Lisa F. Berkman is with the Harvard Center for Population and Development Studies, Cambridge, MA. Erin L. Kelly is with the Massachusetts Institute of Technology Sloan School of Management, Cambridge. Leslie B. Hammer is with the Center for Occupational Health Sciences, Oregon Health Sciences University, Portland. Frank Mierzwa is with RTI International, Research Triangle Park, NC. Todd Bodner is with the Department of Psychology, Portland State University, Portland, OR. Tay McNamara is with the Women's Studies Research Center, Brandeis University, Waltham, MA. Hayami K. Koga is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Soomi Lee is with the Department of Human Development and Family Studies, Pennsylvania State University, University Park. Miguel Marino is with the Department of Family Medicine, Oregon Health & Science University, Portland. Laura C. Klein and Orfeu M. Buxton are with the Department of Biobehavioral Health, Pennsylvania State University, University Park. Thomas W. McDade is with the Department of Anthropology, Northwestern University, Evanston, IL. Ginger Hanson is with the Johns Hopkins School of Nursing, Baltimore, MD. Phyllis Moen is with the Department of Sociology, University of Minnesota, Minneapolis
| | - Laura C Klein
- Lisa F. Berkman is with the Harvard Center for Population and Development Studies, Cambridge, MA. Erin L. Kelly is with the Massachusetts Institute of Technology Sloan School of Management, Cambridge. Leslie B. Hammer is with the Center for Occupational Health Sciences, Oregon Health Sciences University, Portland. Frank Mierzwa is with RTI International, Research Triangle Park, NC. Todd Bodner is with the Department of Psychology, Portland State University, Portland, OR. Tay McNamara is with the Women's Studies Research Center, Brandeis University, Waltham, MA. Hayami K. Koga is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Soomi Lee is with the Department of Human Development and Family Studies, Pennsylvania State University, University Park. Miguel Marino is with the Department of Family Medicine, Oregon Health & Science University, Portland. Laura C. Klein and Orfeu M. Buxton are with the Department of Biobehavioral Health, Pennsylvania State University, University Park. Thomas W. McDade is with the Department of Anthropology, Northwestern University, Evanston, IL. Ginger Hanson is with the Johns Hopkins School of Nursing, Baltimore, MD. Phyllis Moen is with the Department of Sociology, University of Minnesota, Minneapolis
| | - Thomas W McDade
- Lisa F. Berkman is with the Harvard Center for Population and Development Studies, Cambridge, MA. Erin L. Kelly is with the Massachusetts Institute of Technology Sloan School of Management, Cambridge. Leslie B. Hammer is with the Center for Occupational Health Sciences, Oregon Health Sciences University, Portland. Frank Mierzwa is with RTI International, Research Triangle Park, NC. Todd Bodner is with the Department of Psychology, Portland State University, Portland, OR. Tay McNamara is with the Women's Studies Research Center, Brandeis University, Waltham, MA. Hayami K. Koga is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Soomi Lee is with the Department of Human Development and Family Studies, Pennsylvania State University, University Park. Miguel Marino is with the Department of Family Medicine, Oregon Health & Science University, Portland. Laura C. Klein and Orfeu M. Buxton are with the Department of Biobehavioral Health, Pennsylvania State University, University Park. Thomas W. McDade is with the Department of Anthropology, Northwestern University, Evanston, IL. Ginger Hanson is with the Johns Hopkins School of Nursing, Baltimore, MD. Phyllis Moen is with the Department of Sociology, University of Minnesota, Minneapolis
| | - Ginger Hanson
- Lisa F. Berkman is with the Harvard Center for Population and Development Studies, Cambridge, MA. Erin L. Kelly is with the Massachusetts Institute of Technology Sloan School of Management, Cambridge. Leslie B. Hammer is with the Center for Occupational Health Sciences, Oregon Health Sciences University, Portland. Frank Mierzwa is with RTI International, Research Triangle Park, NC. Todd Bodner is with the Department of Psychology, Portland State University, Portland, OR. Tay McNamara is with the Women's Studies Research Center, Brandeis University, Waltham, MA. Hayami K. Koga is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Soomi Lee is with the Department of Human Development and Family Studies, Pennsylvania State University, University Park. Miguel Marino is with the Department of Family Medicine, Oregon Health & Science University, Portland. Laura C. Klein and Orfeu M. Buxton are with the Department of Biobehavioral Health, Pennsylvania State University, University Park. Thomas W. McDade is with the Department of Anthropology, Northwestern University, Evanston, IL. Ginger Hanson is with the Johns Hopkins School of Nursing, Baltimore, MD. Phyllis Moen is with the Department of Sociology, University of Minnesota, Minneapolis
| | - Phyllis Moen
- Lisa F. Berkman is with the Harvard Center for Population and Development Studies, Cambridge, MA. Erin L. Kelly is with the Massachusetts Institute of Technology Sloan School of Management, Cambridge. Leslie B. Hammer is with the Center for Occupational Health Sciences, Oregon Health Sciences University, Portland. Frank Mierzwa is with RTI International, Research Triangle Park, NC. Todd Bodner is with the Department of Psychology, Portland State University, Portland, OR. Tay McNamara is with the Women's Studies Research Center, Brandeis University, Waltham, MA. Hayami K. Koga is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Soomi Lee is with the Department of Human Development and Family Studies, Pennsylvania State University, University Park. Miguel Marino is with the Department of Family Medicine, Oregon Health & Science University, Portland. Laura C. Klein and Orfeu M. Buxton are with the Department of Biobehavioral Health, Pennsylvania State University, University Park. Thomas W. McDade is with the Department of Anthropology, Northwestern University, Evanston, IL. Ginger Hanson is with the Johns Hopkins School of Nursing, Baltimore, MD. Phyllis Moen is with the Department of Sociology, University of Minnesota, Minneapolis
| | - Orfeu M Buxton
- Lisa F. Berkman is with the Harvard Center for Population and Development Studies, Cambridge, MA. Erin L. Kelly is with the Massachusetts Institute of Technology Sloan School of Management, Cambridge. Leslie B. Hammer is with the Center for Occupational Health Sciences, Oregon Health Sciences University, Portland. Frank Mierzwa is with RTI International, Research Triangle Park, NC. Todd Bodner is with the Department of Psychology, Portland State University, Portland, OR. Tay McNamara is with the Women's Studies Research Center, Brandeis University, Waltham, MA. Hayami K. Koga is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Soomi Lee is with the Department of Human Development and Family Studies, Pennsylvania State University, University Park. Miguel Marino is with the Department of Family Medicine, Oregon Health & Science University, Portland. Laura C. Klein and Orfeu M. Buxton are with the Department of Biobehavioral Health, Pennsylvania State University, University Park. Thomas W. McDade is with the Department of Anthropology, Northwestern University, Evanston, IL. Ginger Hanson is with the Johns Hopkins School of Nursing, Baltimore, MD. Phyllis Moen is with the Department of Sociology, University of Minnesota, Minneapolis
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Pienaar PR, Roden LC, Boot CRL, van Mechelen W, Twisk JWR, Lambert EV, Rae DE. Longitudinal associations between self-reported sleep duration and cardiometabolic disease risk in corporate executives. Prev Med 2023; 175:107724. [PMID: 37827208 DOI: 10.1016/j.ypmed.2023.107724] [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: 05/17/2023] [Revised: 10/07/2023] [Accepted: 10/09/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVE This study aimed to determine the longitudinal associations between self-reported sleep duration and cardiometabolic disease (CMD) risk in corporate executives. METHODS Self-reported sleep duration and lifestyle, occupational, psychological, and anthropometrical, blood pressure and blood marker variables were obtained from 1512 employees at annual health risk assessments in South Africa between 2016 and 2019. Gender-stratified linear mixed models, adjusting for age, lifestyle, occupational and psychological covariates were used to explore these longitudinal associations. RESULTS Among women, shorter sleep duration was associated with higher body mass index (BMI) covarying for age only (ß with 95% confidence intervals: -0.19 [-0.36, -0.03]), age and occupational factors (-0.20 [-0.36, -0.03]) and age and psychological factors (-0.20 [-0.37, -0.03]). Among men, shorter sleep was associated with both BMI and waist circumference (WC) covarying for age only (BMI: -0.15 [-0.22; -0.08]; WC: -0.62 [-0.88; -0.37]); age and lifestyle factors (BMI: -0.12 [-0.21; -0.04]); WC: -0.016 [-0.92; -0.29], age and occupational factors (BMI: -0.20 [-0.22; 0.08]; WC: -0.62 [-0.88; -0.36]), and age and psychological factors (BMI: -0.15 [-0.22; -0.07]; WC: -0.59 [-0.86; -0.33]). Among men, shorter sleep was also longitudinally associated with higher CMD risk scores in models adjusted for age and lifestyle factors (CMD: -0.12 [-0.20; -0.04]) and age and psychological factors (CMD: -0.08 [-0.15; -0.01]). CONCLUSION Corporate executives who report shorter sleep durations may present with poorer CMD risk profiles, independent of age, lifestyle, occupational and psychological factors. Addressing sleep health in workplace health programmes may help mitigate the development of CMD in such employees.
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Affiliation(s)
- Paula R Pienaar
- Health Through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Van der Boechorststraat 7, Amsterdam 1081 BT, the Netherlands.
| | - Laura C Roden
- Health Through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Centre for Health and Life Sciences, Coventry University, Coventry CV1 2DS, United Kingdom
| | - Cécile R L Boot
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Van der Boechorststraat 7, Amsterdam 1081 BT, the Netherlands
| | - Willem van Mechelen
- Health Through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Van der Boechorststraat 7, Amsterdam 1081 BT, the Netherlands; Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia; School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland; Center of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Estelle V Lambert
- Health Through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Dale E Rae
- Health Through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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7
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Lee S, Kaufmann CN. Multidimensional sleep health approach to evaluate the risk of morbidity and mortality in diverse adult populations. Sleep 2023; 46:zsad075. [PMID: 37523675 DOI: 10.1093/sleep/zsad075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Affiliation(s)
- Soomi Lee
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Christopher N Kaufmann
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville FL, USA
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8
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Keller E, Hittle BM, Smith CR. Tiredness Takes Its Toll: An Integrative Review on Sleep and Occupational Outcomes for Long-Term Care Workers. J Gerontol Nurs 2023; 49:27-33. [PMID: 36594911 DOI: 10.3928/00989134-20221206-01] [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] [Indexed: 01/04/2023]
Abstract
Poor sleep quality and duration among health care professionals have negative impacts on worker safety, work readiness, and well-being. However, the consequences of impaired sleep among long-term care (LTC) workers remain understudied. The current integrative review sought to explore associations between sleep and occupational outcomes in LTC workers. Multiple database searches yielded 1,543 articles; nine articles met inclusion criteria. Results synthesized from included articles revealed sleep-associated occupational outcomes across three themes, Burnout/Fatigue, Mental and Physical Health, and Well-Being, which may affect performance measures and predict injuries/errors. Exploring outcomes of poor sleep quality and duration among LTC workers has highlighted the needs of this population and may inform future intervention development. LTC organizations should consider implementing strategies to better support the sleep quality of their workforce. In addition, further research is needed to explore how impaired sleep contributes to negative worker outcomes and patient care quality. [Journal of Gerontological Nursing, 49(1), 27-33.].
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9
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Farmer HR, Slavish DC, Ruiz J, Dietch JR, Ruggero CJ, Messman BA, Kelly K, Kohut M, Taylor DJ. Racial/ethnic variations in inflammatory markers: exploring the role of sleep duration and sleep efficiency. J Behav Med 2022; 45:855-867. [PMID: 36029411 PMCID: PMC10062430 DOI: 10.1007/s10865-022-00357-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/05/2022] [Indexed: 11/29/2022]
Abstract
Individuals from minoritized racial/ethnic groups have higher levels of circulating inflammatory markers. However, the mechanisms underlying these differences remain understudied. The objective of this study was to examine racial/ethnic variations in multiple markers of inflammation and whether impaired sleep contributes to these racial/ethnic differences. Nurses from two regional hospitals in Texas (n = 377; 71.62% White; 6.90% Black; 11.14% Hispanic, 10.34% Asian; mean age = 39.46; 91.78% female) completed seven days of sleep diaries and actigraphy to assess mean and variability in total sleep time (TST) and sleep efficiency (SE). On day 7, blood was drawn to assess 4 inflammatory markers: C-reactive protein (CRP), Interleukin-6 (IL-6), Interleukin-1 beta (IL-1β), and tumor necrosis factor-alpha (TNF-α). Results from regression models showed differences in inflammatory markers by race/ethnicity, adjusting for age and gender. The associations between sleep parameters and inflammatory markers also varied by race/ethnicity. Among White nurses, lower mean and greater variability in actigraphy-determined TST and greater variability in diary-determined TST were associated with higher levels of IL-6. Among Black nurses, lower mean diary-determined SE was associated with higher levels of IL-6 and IL-1β. Among Hispanic nurses, greater diary-determined mean TST was associated with higher CRP. Among Asian nurses, greater intraindividual variability in actigraphy-determined SE was associated with lower CRP. Among nurses, we did not find racial/ethnic disparities in levels of inflammation. However, analyses revealed differential relationships between sleep and inflammatory markers by race/ethnicity. Results highlight the importance of using a within-group approach to understand predictors of inflammatory markers.
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Affiliation(s)
- Heather R Farmer
- Department of Human Development and Family Sciences, University of Delaware, Newark, DE, 19716, USA.
| | - Danica C Slavish
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - John Ruiz
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Jessica R Dietch
- School of Psychological Science, Oregon State University, Corvallis, OR, USA
| | - Camilo J Ruggero
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Brett A Messman
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Kimberly Kelly
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Marian Kohut
- Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - Daniel J Taylor
- Department of Psychology, University of Arizona, Tucson, AZ, USA
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10
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Weale V, Lambert KA, Stuckey R, Graham M, Cooklin A, Oakman J. Working From Home During COVID-19: Does Work-Family Conflict Mediate the Relationship Between Workplace Characteristics, Job Satisfaction, and General Health? J Occup Environ Med 2022; 64:848-855. [PMID: 35902340 PMCID: PMC9524521 DOI: 10.1097/jom.0000000000002635] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study is to investigate whether work-family conflict and/or family-work conflict mediated the relationship between workplace characteristics and general health and job satisfaction in a sample of workers working from home in a recommended/mandatory context due to COVID-19 measures. METHODS Data were collected via online questionnaire as part of the Employees Working from Home study. Analyses in this article used data collected at 2 time points 6 months apart, including 965 complete responses from the first questionnaire and 451 complete responses from the second questionnaire. RESULTS Relationships between predictor and outcome variables were in the directions expected, and both work-family conflict and family-work conflict mediated these relationships. CONCLUSIONS Work-life interaction partly explains the relationship between work characteristics and general health and job satisfaction health in a population undertaking involuntary working from home.
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11
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Makarem N, Alcantara C, Musick S, Quesada O, Sears DD, Chen Z, Tehranifar P. Multidimensional Sleep Health Is Associated with Cardiovascular Disease Prevalence and Cardiometabolic Health in US Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710749. [PMID: 36078471 PMCID: PMC9518578 DOI: 10.3390/ijerph191710749] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 06/01/2023]
Abstract
Individual sleep dimensions have been linked to cardiovascular disease (CVD) risk and cardiometabolic health (CMH), but sleep health is multifaceted. We investigated associations of a multidimensional sleep health (MDSH) score, enabling the assessment of sleep health gradients, with CVD and CMH. Participants were 4555 adults aged ≥20 years from the 2017-2018 National Health and Nutrition Examination Survey. A MDSH score, capturing poor, moderate, and ideal sleep was computed from self-reported sleep duration, sleep regularity, difficulty falling asleep, symptoms of sleep disorders, and daytime sleepiness. Survey-weighted multivariable linear and logistic models examined associations of MDSH with CVD and CMH. Ideal and moderate vs. poor MDSH were related to lower odds of hypertension (62% and 41%), obesity (73% and 56%), and central adiposity (68% and 55%), respectively; a statistically significant linear trend was observed across gradients of MDSH (p-trend < 0.001). Ideal vs. moderate/poor MDSH was associated with 32% and 40% lower odds of prevalent CVD and type 2 diabetes, respectively. More favorable MDSH was associated with lower blood pressure, BMI, waist circumference, and fasting glucose. In sex-stratified analyses, ideal vs. moderate/poor MDSH was associated with lower CVD odds and blood pressure in women only. The MDSH framework may be more than just the sum of its parts and could better capture information regarding CVD risk.
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Affiliation(s)
- Nour Makarem
- Department of Epidemiology, Mailman School of Public Heath, Columbia University Irving Medical Center, New York, NY 10032, USA
| | | | - Sydney Musick
- Department of Epidemiology, Mailman School of Public Heath, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Odayme Quesada
- Women’s Heart Center, The Christ Hospital Heart and Vascular Institute, Cincinnati, OH 45219, USA
| | - Dorothy D. Sears
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
- Department of Medicine, University of California San Diego, San Diego, CA 92093, USA
- Center for Circadian Biology, University of California San Diego, San Diego, CA 92093, USA
| | - Ziyu Chen
- Department of Epidemiology, Mailman School of Public Heath, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Parisa Tehranifar
- Department of Epidemiology, Mailman School of Public Heath, Columbia University Irving Medical Center, New York, NY 10032, USA
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12
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Hittle BM, Norrell RM, Omololu SO, Gresham-Ulrich M. Retirement Center Worker Sleep Health Assessment During the COVID-19 Pandemic. Workplace Health Saf 2022; 70:268-277. [PMID: 35112602 DOI: 10.1177/21650799211054863] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Sleep health disturbances can increase risks for workplace injury, error, and poor worker health. Essential workers have reported sleep disturbances since the COVID-19 pandemic onset, which may jeopardize their health and safety. The aims of this project were to assess sleep health among Continuing Care Retirement Community (CCRC) workers, examine potential differences between worker types, and describe the self-perceived impact of COVID-19 on workers' workload and sleep. METHODS Through an academic-practice partnership, this needs assessment used a cross-sectional design that collected self-report data during fall 2020 from CCRC workers. Guided by the Workplace Health Model, survey questions included work characteristics, sleep health, and COVID-19 impact on sleep and workload. FINDINGS Ninety-four respondents completed the survey across multiple departments. Respondents (n = 34, 36.2%) reported sleeping below recommended hours on workdays. The majority scored above the population mean on Patient-Reported Outcomes Measurement (PROMIS) measures of sleep disturbance (n = 52, 55.3%), sleep-related impairment (n = 49, 52.1%), and fatigue (n = 49, 52.1%). Differences in workday total sleep time and fatigue were noted among shift workers versus nonshift workers, with shift workers reporting less sleep and more fatigue. Shorter sleep duration was noted among respondents working shifts 10 or more hours compared with those working 8 hours. Pandemic-related workload increase was reported by 22.3% (n = 21) of respondents, with 17% (n = 16) noting more than one type of workload change. Since COVID-19 onset, 36.2% (n = 34) reported no sleep changes and 35.1% (n = 33) reported sleeping less. A medium, positive relationship was found between increased changes in work due to COVID-19 and increased difficulties sleeping (r = .41, n = 73, p = .000). CONCLUSION/APPLICATION TO PRACTICE Proper sleep health is essential to workplace safety and worker health. By assessing sleep health during a crisis, occupational health nurses can identify opportunities to support worker health and safety, through sleep education, monitoring for sleepiness and fatigue, ensuring countermeasures are available (e.g., caffeine), and assessing for opportunities to change organizational policies.
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13
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Lee S, Mu CX, Wallace ML, Andel R, Almeida DM, Buxton OM, Patel SR. Sleep health composites are associated with the risk of heart disease across sex and race. Sci Rep 2022; 12:2023. [PMID: 35132087 PMCID: PMC8821698 DOI: 10.1038/s41598-022-05203-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/06/2022] [Indexed: 01/17/2023] Open
Abstract
We examined whether subjectively and objectively measured sleep health composites have a relationship with heart disease. 6,820 adults (Mage = 53.4 years) from the Midlife in the United States study provided self-reported sleep characteristics and heart disease history. A smaller sample (n = 663) provided actigraphy sleep data. We tested two sleep health composites, based on self-report only and both self-report and actigraphy, across multiple sleep dimensions. We used a weighted sum approach, where higher scores indicated more sleep health problems. Modified Poisson regressions adjusted for sociodemographics and known risk factors. Having more sleep health problems was associated with a higher risk of heart disease using the self-report sleep health composite (aRR = 54%, P < .001) and the actigraphy/self-report composite (aRR = 141%, P < .001). Individual sleep dimensions of satisfaction, alertness, and efficiency (from the self-report composite) and regularity, satisfaction, and timing (from the actigraphy/self-report composite) were associated with the risk of heart disease. The effect size of each sleep health composite was larger than the individual sleep dimensions. Race moderated the association between the actigraphy/self-report sleep health composite and heart disease. There was no significant moderation by sex. Findings suggest poorer sleep health across multiple dimensions may contribute to heart disease risk among middle-aged adults.
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Affiliation(s)
- Soomi Lee
- School of Aging Studies, University of South Florida, 4202 E. Fowler Avenue, MHC 1344, Tampa, FL, 33620, USA.
| | - Christina X Mu
- School of Aging Studies, University of South Florida, 4202 E. Fowler Avenue, MHC 1344, Tampa, FL, 33620, USA
| | - Meredith L Wallace
- Department of Psychiatry, Statistics and Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ross Andel
- School of Aging Studies, University of South Florida, 4202 E. Fowler Avenue, MHC 1344, Tampa, FL, 33620, USA.,Department of Neurology, Second Faculty of Medicine, Charles University/Motol University Hospital, Prague, Czech Republic
| | - David M Almeida
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
| | - Orfeu M Buxton
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
| | - Sanjay R Patel
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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14
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Dejenie TA, G/Medhin MT, Admasu FT, Adella GA, Enyew EF, Kifle ZD, Seid MA, Mengstie MA, Abebe EC. Impact of objectively-measured sleep duration on cardiometabolic health: A systematic review of recent evidence. Front Endocrinol (Lausanne) 2022; 13:1064969. [PMID: 36601010 PMCID: PMC9806213 DOI: 10.3389/fendo.2022.1064969] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
Cardiometabolic disease is a spectrum of diseases including, cardiovascular diseases, and metabolic syndrome. It is the leading cause of morbidity and mortality worldwide, with premature deaths being preventable. Currently, sleep has emerged as a potential target for cardiometabolic disease prevention. Several epidemiological studies have provided ample evidence that objectively measured short sleep duration increases the risk of cardiometabolic disease. However, the findings are inconsistent, and few studies measure sleep duration on cardiometabolic profiles objectively. Therefore, in this review, we focused on the recently published literature that explored the association between objectively measured sleep duration and cardiometabolic profiles (cardiovascular diseases, type 2 diabetes mellitus, and metabolic syndrome), seeking more insights regarding the applicability and, in turn, the impact of objectively measured sleep duration on cardiometabolic health, which is relatively understudied. We retrieved the information manually from PubMed, Google Scholar, HINARI, and the Cochrane Library from 2015 to 2022 using appropriate search terms, we included 49 articles. In this review, we found a strong relationship between objectively measured sleep duration and the risk of cardiometabolic disease, indicating that objectively measured short sleep durations increase cardiometabolic risks. In general, the association between objectively measured sleep duration and increased cardiometabolic risks (CMR) has been well-documented in higher-income countries. Several studies found that longer sleep duration was associated with a more favorable cardiometabolic profile in early adolescence, independent of other risk factors. On the other hand, objectively measured short sleep duration is associated with adverse cardiometabolic health outcomes such as coronary heart disease, hypertension, type 2 diabetes mellitus, and metabolic syndrome.
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Affiliation(s)
- Tadesse Asmamaw Dejenie
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Markeshaw Tiruneh G/Medhin
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fitalew Tadele Admasu
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Getachew Asmare Adella
- Department of Reproductive health and nutrition, School of public health, Woliata Sodo University, Woliata Sodo, Ethiopia
| | - Engidaw Fentahun Enyew
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zemene Demelash Kifle
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Abdu Seid
- Department of Physiology, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Misganaw Asmamaw Mengstie
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Endeshaw Chekol Abebe
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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15
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Liu X, Wang G, Wang X, Wang Y, Min Y, Zhang J, Chang RT, Zhao X, He W, Moshfeghi DM, Lu Y, Hsing AW, Yao K, Zhu S. Daytime napping is associated with retinal microcirculation: a large population-based study in China. Sleep 2021; 45:6432408. [PMID: 34875091 DOI: 10.1093/sleep/zsab277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/04/2021] [Indexed: 11/15/2022] Open
Abstract
STUDY OBJECTIVES To investigate the association between daytime napping and retinal microcirculation. METHODS This is a cross-sectional study from a prospective population-based cohort. 2,662 participants were recruited after quota sampling. Information on napping was collected through face-to-face interviews. Retinal vascular calibers (RVCs), including central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), and arterio-to-venous ratio (AVR), were obtained from fundus photography. Multivariate regression and restricted cubic spline curve were performed to determine the association between RVCs and daytime napping duration. RESULTS 56.4% participants reported daytime napping regularly. Compared to no nap, daytime nap was related to higher CRAE, with nap duration of 0.5-1 h showing the most significant association. 0.5-1 h daytime nappers displayed an average of 4.18 µm (95% confidence interval [CI] 2.45-5.91, p < 0.001) wider CRAE than non-nappers after adjustment. No significant association was found between CRVE and daytime napping. Moreover, individuals with 0.5-1 h daytime napping had a lower risk for AVR reduction (odds ratio [OR] 0.70, 95% confidence interval [CI] 0.56-0.86, p = 0.001) than non-nappers. Similar association persisted in non-hypertensive population. Restricted cubic spline indicated a J-shaped relationship between AVR reduction and nap duration. CONCLUSION Retinal microcirculation was positively associated with self-reported 0.5-1 h daytime napping. Better indicators of retinal microcirculation were probably related to nap duration in a J-shaped manner. Also, the possibly beneficial role of 0.5-1 h daytime napping on retinal microcirculation might be independent of clinically diagnosed vascular diseases.
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Affiliation(s)
- Xin Liu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Guowei Wang
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaoyan Wang
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yueye Wang
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yan Min
- Stanford Prevention Research Center, Department of Medicine, Stanford School of Medicine, Stanford University, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford University, Stanford, CA, USA
| | - Janice Zhang
- Stanford Prevention Research Center, Department of Medicine, Stanford School of Medicine, Stanford University, Stanford, CA, USA
| | - Robert T Chang
- Department of Ophthalmology, Stanford School of Medicine, Stanford University, Stanford, CA, USA
| | - Xueyin Zhao
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Wei He
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Darius M Moshfeghi
- Department of Ophthalmology, Stanford School of Medicine, Stanford University, Stanford, CA, USA
| | - Ying Lu
- Department of Biomedical Data Science, Stanford School of Medicine, Stanford University, Stanford, CA, USA
- Stanford Cancer Institute, Stanford School of Medicine, Stanford University, Stanford, CA, USA
| | - Ann W Hsing
- Stanford Prevention Research Center, Department of Medicine, Stanford School of Medicine, Stanford University, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford University, Stanford, CA, USA
- Stanford Cancer Institute, Stanford School of Medicine, Stanford University, Stanford, CA, USA
| | - Ke Yao
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shankuan Zhu
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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16
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Amaral KV, Galdino MJQ, Martins JT. Burnout, daytime sleepiness and sleep quality among technical-level Nursing students. Rev Lat Am Enfermagem 2021; 29:e3487. [PMID: 34730763 PMCID: PMC8570253 DOI: 10.1590/1518-8345.5180.3487] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/27/2021] [Indexed: 01/23/2023] Open
Abstract
Objective: to evaluate the association of the burnout syndrome with daytime sleepiness
and sleep quality among technical-level Nursing students. Method: a cross-sectional, analytical and quantitative study, conducted with 213
students from four technical Nursing courses in a city of Paraná, Brazil.
Data collection was carried out using an instrument containing
characterization information, the Maslach Burnout Inventory - Student
Survey, the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index.
The data were analyzed using descriptive statistics and logistic
regression. Results: the prevalence values of the burnout syndrome, excessive daytime sleepiness
and poor sleep quality were 4.7%, 34.7% and 58.7%, respectively. Excessive
daytime sleepiness significantly increased the chances of high emotional
exhaustion (ORadj: 5.714; p<0.001) and high depersonalization
(ORadj: 4.259; p<0.001). Poor sleep quality, especially
sleep disorders, was associated with all dimensions of the syndrome
(p<0.05). Conclusion: high levels of the burnout syndrome dimensions were associated with excessive
daytime sleepiness and poor sleep quality. Educational institutions should
include sleep hygiene and psychosocial support in their student health
promotion programs.
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17
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Hassinger AB, Breuer RK, Mishra A. Sleep patterns of US healthcare workers during the first wave of the COVID-19 pandemic. Sleep Breath 2021; 26:1351-1361. [PMID: 34664182 PMCID: PMC8523119 DOI: 10.1007/s11325-021-02515-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/15/2021] [Accepted: 10/11/2021] [Indexed: 11/28/2022]
Abstract
Purpose
During the first few months of the COVID-19 outbreak, healthcare workers (HCW) faced levels of personal risk, emotional distress, and professional strain not seen in their lifetimes. This study described how these stressors influenced various aspects of their sleep patterns. Methods From May 19 to June 20, 2020, an electronic, cross-sectional survey was administered to a convenience sample of in- and outpatient HCW in a large, nonprofit healthcare system. Respondents described the pandemic’s initial impact on personal and professional life and various sleep dimensions: regularity, efficiency, duration, timing, quality, and daytime sleepiness. Results Two hundred seven providers responded, representing 17 different healthcare roles. Most (82%) were women with a median age of 39 years (IQR1–3, 31–53). A majority of respondents (81%) worked in an inpatient setting, with half (46%) primarily on the “frontline.” Approximately one-third of respondents (37%) were physicians and one-quarter (28%) were nurses. Overall, 68% of HCW reported at least one aspect of sleep worsened during the beginning of the pandemic; the most impacted were daytime sleepiness (increased in 43%) and sleep efficiency (worse in 37%). After adjusting for COVID exposure and burnout, frontline providers had twofold higher odds of poor pandemic sleep, aOR 2.53, 95%CI 1.07–5.99. Among frontline providers, physicians were fivefold more likely to develop poor pandemic sleep compared to nurses (OR 5.73, 95%CI 1.15–28.57). Conclusions During the initial wave of COVID-19, a majority of HCW reported a decline in sleep with an increase in daytime sleepiness and insomnia. Frontline workers, specifically physicians, were at higher risk. Supplementary Information The online version contains supplementary material available at 10.1007/s11325-021-02515-9.
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Affiliation(s)
- Amanda B Hassinger
- Department of Pediatrics, Division of Pediatric Pulmonology and Sleep Medicine, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, 955 Main Street, Buffalo, NY, 14203, USA.
| | - Ryan K Breuer
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, 955 Main Street, Buffalo, NY, 14203, USA
| | - Archana Mishra
- Department of Medicine, Division of Pulmonology, Critical Care and Sleep Medicine, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, 955 Main Street, Buffalo, NY, 14203, USA
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18
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Romano KA, Stamates A, Heron KE, Braitman AL, Lau-Barraco C. Sex and Racial Differences in Patterns of Disordered Eating and Alcohol Use. Behav Med 2021; 47:272-284. [PMID: 32275196 DOI: 10.1080/08964289.2020.1748862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The present study aimed to determine how young adults' use of disordered eating behaviors (DEBs) and alcohol uniquely cluster with one another, how these clusters differ by sex and race, and map onto health-related correlates. As a part of a cross-sectional study assessing college student health and experiences, female (n = 1,026), male (n = 336), White (n = 640), and Black (n = 561) young adult college students at three universities (Mage = 20.54, SD = 1.80) completed measures assessing DEBs and alcohol use, and physical and mental health. Multigroup mixture modeling was used to identify subgroups of female, male, White, and Black young adults that are characterized by different levels of DEBs (fasting, food avoidance, loss of control eating, overeating) and alcohol use (binge drinking, drinking quantity). Whether group membership relates to theoretically and clinically relevant health correlates (stress, depressive symptoms, sleep health) was examined via auxiliary analyses. Qualitative and quantitative differences were identified in the best-fitting mixture models for female (four groups), male (four groups), White (five groups), and Black (three groups) participants that suggest sex and racial variations exist in patterns of DEBs and alcohol use severity. Generally, classification in groups characterized by moderate to high probabilities of DEBs only, or the combination of moderate to high DEBs and alcohol use, was associated with worse affective concerns across sexes and races. Targeting young adults' DEBs and alcohol use via diversity-informed treatments focused on coping skill development may help promote health and well-being.
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Affiliation(s)
- Kelly A Romano
- Psychology, The Virginia Consortium Program in Clinical Psychology
| | - Amy Stamates
- Psychology, Old Dominion University, Norfolk, VA, USA
| | - Kristin E Heron
- Psychology, The Virginia Consortium Program in Clinical Psychology.,Psychology, Old Dominion University, Norfolk, VA, USA
| | - Abby L Braitman
- Psychology, The Virginia Consortium Program in Clinical Psychology.,Psychology, Old Dominion University, Norfolk, VA, USA
| | - Cathy Lau-Barraco
- Psychology, The Virginia Consortium Program in Clinical Psychology.,Psychology, Old Dominion University, Norfolk, VA, USA
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19
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Veal BM, Mu CX, Small BJ, Lee S. Subjective cognitive abilities correlate with poor sleep among day-shift and night-shift nurses. J Sleep Res 2021; 30:e13359. [PMID: 33987895 DOI: 10.1111/jsr.13359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/16/2021] [Accepted: 03/29/2021] [Indexed: 11/28/2022]
Abstract
Experimental studies have shown that sleep deprivation may lead to worse performance on cognitive tests. However, few studies have considered how sleep is associated with perceived cognitive performance in the daily lives of hospital nurses who require high cognitive abilities to deliver high-quality patient care. The current study examined the relationship between sleep and subjective cognition in nurses, and whether the relationship differed by work shift and workdays. Sixty in patient nurses working full-time (M = 35 years; 39 day-shift nurses, 21 night-shift nurses) reported their sleep characteristics and daily subjective cognition using ecological momentary assessment for 14 days. Concurrently, objective sleep characteristics were measured with a sleep actigraphy device for 14 days. Using multilevel modelling, results indicated that at the within-person and between-person level, better sleep quality and higher sleep sufficiency were associated with better subjective cognition at the daily-level and on average. Moderation analyses indicated at the within-person level, better sleep quality and longer time in bed were associated with better next-day cognition; these associations were stronger for night-shift nurses compared with day-shift nurses. At the between-person level, better sleep quality and higher sleep sufficiency were also associated with better subjective cognition overall; these associations were significant for day-shift nurses, but not for night-shift nurses. The sleep-subjective cognition relationships were more apparent on workdays versus non-workdays. Findings suggest that sufficient sleep recovery is important for nurses' reports of daily and overall cognitive functioning. Night-shift nurses' subjective cognitive abilities may be more protected on days following better sleepquality and more sufficient sleep.
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Affiliation(s)
- Britney M Veal
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Christina X Mu
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Brent J Small
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Soomi Lee
- School of Aging Studies, University of South Florida, Tampa, FL, USA
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20
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Lawson KM, Lee S, Maric D. Not Just Work-to-Family Conflict, But How you React to It Matters for Physical and Mental Health. WORK AND STRESS 2021; 35:327-343. [PMID: 35173354 PMCID: PMC8845083 DOI: 10.1080/02678373.2021.1888821] [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] [Received: 03/21/2020] [Accepted: 12/07/2020] [Indexed: 10/22/2022]
Abstract
Individuals with higher work-to-family conflict (WTFC) in general are more likely to report poorer physical and mental health. Less research, however, has examined the daily implications of WTFC, such as whether individuals' reactions to minor WTFC day-to-day (e.g., missing family dinner due to work obligation) are associated with health outcomes. We examined whether affective reactivity to daily WTFC was associated with poorer sleep, health behaviors, and mental health in a sample who may be particularly vulnerable to daily WTFC. Employed parents in the IT industry with adolescent-aged children (N = 118, M age = 45.01, 44.07 % female) reported daily WTFC and negative affect on 8 consecutive days, in addition to completing a survey that assessed sleep, health behaviors (smoking, drinking, exercise, fast food consumption), and psychological distress. Multilevel modeling outputted individual reactivity slopes by regressing daily negative affect on the day's WTFC. Results of general linear models indicated that affective reactivity to WTFC was associated with poorer sleep quality and higher levels of psychological distress - even when controlling for average daily negative affect on non-WTFC days. Individual differences in reactivity to daily WTFC have implications for health. Interventions aimed to reduce daily WTFC and reactivity to it are needed.
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Affiliation(s)
- Katie M Lawson
- Department of Psychological Science, Ball State University, United States of America, 106 North Quad Building, Muncie, IN, 43706
| | - Soomi Lee
- School of Aging Studies, United States of America, University of South Florida, 4202 E Fowler Avenue, MHC 1344, Tampa, FL
| | - Danka Maric
- STEM Education Innovation and Research Institute, Indiana University-Purdue University Indianapolis, United States of America, Indianapolis, IN, 46202
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21
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Dashti HS, Daghlas I, Lane JM, Huang Y, Udler MS, Wang H, Ollila HM, Jones SE, Kim J, Wood AR, Weedon MN, Aslibekyan S, Garaulet M, Saxena R. Genetic determinants of daytime napping and effects on cardiometabolic health. Nat Commun 2021; 12:900. [PMID: 33568662 PMCID: PMC7876146 DOI: 10.1038/s41467-020-20585-3] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 12/08/2020] [Indexed: 12/14/2022] Open
Abstract
Daytime napping is a common, heritable behavior, but its genetic basis and causal relationship with cardiometabolic health remain unclear. Here, we perform a genome-wide association study of self-reported daytime napping in the UK Biobank (n = 452,633) and identify 123 loci of which 61 replicate in the 23andMe research cohort (n = 541,333). Findings include missense variants in established drug targets for sleep disorders (HCRTR1, HCRTR2), genes with roles in arousal (TRPC6, PNOC), and genes suggesting an obesity-hypersomnolence pathway (PNOC, PATJ). Association signals are concordant with accelerometer-measured daytime inactivity duration and 33 loci colocalize with loci for other sleep phenotypes. Cluster analysis identifies three distinct clusters of nap-promoting mechanisms with heterogeneous associations with cardiometabolic outcomes. Mendelian randomization shows potential causal links between more frequent daytime napping and higher blood pressure and waist circumference.
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Affiliation(s)
- Hassan S Dashti
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Broad Institute, Cambridge, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Iyas Daghlas
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Broad Institute, Cambridge, MA, USA
| | - Jacqueline M Lane
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Broad Institute, Cambridge, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Miriam S Udler
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Broad Institute, Cambridge, MA, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Heming Wang
- Broad Institute, Cambridge, MA, USA
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Hanna M Ollila
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Broad Institute, Cambridge, MA, USA
- Institute for Molecular Medicine FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Samuel E Jones
- Institute for Molecular Medicine FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
- Genetics of Complex Traits, University of Exeter Medical School, Exeter, UK
| | | | - Andrew R Wood
- Genetics of Complex Traits, University of Exeter Medical School, Exeter, UK
| | - Michael N Weedon
- Genetics of Complex Traits, University of Exeter Medical School, Exeter, UK
| | | | - Marta Garaulet
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
- Department of Physiology, University of Murcia, Murcia, Spain.
- IMIB-Arrixaca, Murcia, Spain.
| | - Richa Saxena
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
- Broad Institute, Cambridge, MA, USA.
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
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22
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Lee S, Gonzalez BD, Small BJ. My job impacts my sleep: signs and symptoms of insomnia among healthcare workers. INDUSTRIAL HEALTH 2021; 59:86-98. [PMID: 33762517 PMCID: PMC8010164 DOI: 10.2486/indhealth.2020-0191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 11/30/2020] [Indexed: 06/12/2023]
Abstract
Potential insomnia in healthcare workers is a public health concern as it may degrade the quality of patient care. We examined the prevalence of insomnia symptoms in healthcare workers and their perceived need for a sleep intervention. Participants were 62 nurses working full-time at a U.S. hospital. These nurses were asked about background characteristics, perceived stress, sleep concerns, and need for a sleep intervention. They also participated in 14-d ecological momentary assessment (EMA) and actigraphy sleep study. A qualitative analysis showed that the majority (92%) of participants reported at least one sleep concern with insomnia-related concerns being most prevalent (68%). Quantitative analyses indicated that those with insomnia-related concerns had higher perceived stress overall and lower EMA sleep sufficiency and sleep quality. Moreover, participants with insomnia concerns had shorter actigraphy-measured nap duration prior to non-workdays than those without. Nearly all (95%) expressed interest in participating in a sleep intervention; an online format and mindfulness contents were most preferred. Our results suggest a high prevalence of insomnia symptoms and a high interest in a sleep intervention in nurses. Information obtained from this study could be used to deliver a tailored sleep intervention for nurses whose role in public health is essential.
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Affiliation(s)
- Soomi Lee
- School of Aging Studies, University of South Florida, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, USA
| | - Brent J Small
- School of Aging Studies, University of South Florida, USA
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23
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Arora T, Alhelali E, Grey I. Poor sleep efficiency and daytime napping are risk factors of depersonalization disorder in female university students. Neurobiol Sleep Circadian Rhythms 2020; 9:100059. [PMID: 33364526 PMCID: PMC7752711 DOI: 10.1016/j.nbscr.2020.100059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 09/20/2020] [Accepted: 10/07/2020] [Indexed: 12/29/2022] Open
Abstract
Objectives Depersonalization is characterized by feelings of detachment from reality and has been associated with anxiety and depression, both of which have a bi-directional relationship with sleep. To date, few studies have directly examined the potential relationship between sleep and depersonalization, which was the primary objective of our study. Design/methods A cross-sectional study of female, Emirati, university students (n = 100) was conducted. Participants completed the Pittsburgh Sleep Quality Index (PSQI), the Cambridge Depersonalization Scale (CDS) and the Hospital Anxiety and Depression Scale (HADS). Additionally, 36 of the 100 participants wore wrist actigraphy for two consecutive weekdays. Average sleep duration, and average sleep efficiency (SE; %) across the two nocturnal sleep episodes were calculated. Total number of sleep episodes were obtained from wrist actigraphy and sleep logs. Results A significant, positive relationship was observed between PSQI global score and CDS total score (r = 0.21, p = 0.04). Actigraphy-estimated average nocturnal sleep duration was not significantly associated with the CDS. Compared to nocturnal sleepers only, those who undertook daytime naps had almost three times the risk of meeting the criteria for depersonalization disorder (OR = 2.95, 95% CI: 1.04–8.41), after adjustment. For each 1% increase in SE a 23% decreased risk of depersonalization was observed (OR = 0.77, 95% CI: 0.61–0.96), after adjustment. Conclusions Sleep screening in young adults may help to ensure better detection and management of psychological health outcomes. Our findings need to be confirmed prospectively in larger samples and amongst different populations but reiterate the importance of sleep habits pertaining to mental health. We show a novel relationship between depersonalization and sleep in a non-clinical sample. Actigraphy determined poor sleep efficiency was significantly associated with subjective reports of depersonalization. Daytime nappers were ~3 times more likely to report depersonalization symptoms and meet the diagnositic criteria.
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Affiliation(s)
- Teresa Arora
- Zayed University, Abu Dhabi, United Arab Emirates
| | | | - Ian Grey
- Lebanese American University, Beirut, Lebanon
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24
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Oftedal S, Aguiar EJ, Duncan MJ. Associations between multiple positive health behaviors and cardiometabolic risk using 3 alternative measures of physical activity: NHANES 2005-2006. Appl Physiol Nutr Metab 2020; 46:617-625. [PMID: 33301364 DOI: 10.1139/apnm-2020-0588] [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: 11/22/2022]
Abstract
The study aimed to investigate the association between clustered cardiometabolic risk (CCMR) and health-behavior indices comprising 3 different measures of physical activity, screen time, diet and sleep in NHANES 2005-2006. CCMR was calculated by standardizing and summarizing measures of blood pressure, fasting glucose, triglycerides, insulin, high-density lipoprotein and waist circumference to create a z score. Three health behavior indices were constructed with a single point allocated to each of the following lower risk behaviors: muscle strengthening activity, healthy eating score, sleep disorder/disruption, sleep duration, screen time and physical activity (self-reported moderate-to-vigorous physical activity [MVPA] (Index Score-SR), accelerometer-measured MVPA (Index Score-MVPA) or accelerometer-measured steps Index Score-Steps). Linear regression models explored associations between index scores and CCMR. In the sample (n = 1537, 52% male, aged 45.5 [SE: 0.9] years), reporting 0-5 vs. 6 health behaviors using Index Score-SR and Index Score-MVPA, and 0-4 vs. 6 health behaviors using Index Score-Steps, were associated with a significantly higher CCMR. The beta (β [95% CI]) for zero vs. 6 behaviors were Index Score-SR (2.86 [2.02, 3.69], Index Score-MVPA (2.41 [1.49, 3.33] and Index Score-Steps (2.41 [1.68, 3.15]). Irrespective of the measure of physical activity, engaging in fewer positive health behaviors was associated with greater CCMR. Novelty: Physical activity, screen time, diet and sleep may exert synergistic/cumulative effects on clustered cardiometabolic risk. A greater number of positive health behaviors was associated with a lower clustered cardiometabolic risk factor score. The reduction in cardiometabolic risk was similar irrespective of which physical activity measure was used.
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Affiliation(s)
- Stina Oftedal
- School of Medicine & Public Health, Faculty of Health and Medicine and Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan NSW 2308, Australia
| | - Elroy J Aguiar
- Department of Kinesiology, The University of Alabama, Tuscaloosa, AL, USA
| | - Mitch J Duncan
- School of Medicine & Public Health, Faculty of Health and Medicine and Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan NSW 2308, Australia
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25
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Lee S, Mu C, Gonzalez BD, Vinci CE, Small BJ. Sleep health is associated with next-day mindful attention in healthcare workers. Sleep Health 2020; 7:105-112. [PMID: 33012668 DOI: 10.1016/j.sleh.2020.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/15/2020] [Accepted: 07/17/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Previous studies have focused on the role of mindfulness in improving sleep health. Sleep health may also increase daily mindfulness; however, this potential directionality is understudied, with a lack of research on healthcare workers who need high-quality sleep and mindful attention for patient care. This study examined whether sleep health predicts next-day mindful attention, and vice versa, in nurses. DESIGN Smartphone-based ecological momentary assessment. SETTING U.S. hospitals. PARTICIPANTS Sixty-one full-time nurses. MEASUREMENTS For 2 consecutive weeks, participants provided actigraphy-measured and self-reported daily sleep characteristics. We examined 8 sleep variables across 5 key dimensions: satisfaction (self-report of sleep sufficiency, quality, and insomnia symptoms), alertness (self-report of daytime sleepiness), timing (actigraphy bed- and wake- times), efficiency (actigraphy percentage of time spent asleep during time in bed), and duration (actigraphy sleep duration). Participants reported state mindfulness specific to attention and awareness. Covariates included previous night's sleep, sociodemographics, work shift, workday (vs. nonworkday), and weekend (vs. weekday). RESULTS Multilevel modeling revealed that, at the within-person level, after nights with greater sleep sufficiency, better sleep quality, lower efficiency, and longer sleep duration, daily mindful attention was greater than usual. Daily mindful attention was inversely associated with sleepiness, but not predictive of other sleep characteristics. At the between-person level, participants with greater sleep sufficiency, higher sleep quality, and fewer insomnia symptoms reported greater mindful attention overall. CONCLUSION Findings show that optimal sleep health is an antecedent of daily mindful attention in nurses. Improving sleep may provide important benefits to their well-being and to the quality of patient care.
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Affiliation(s)
- Soomi Lee
- School of Aging Studies, University of South Florida, Tampa, Florida, USA.
| | - Christina Mu
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Christine E Vinci
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Brent J Small
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
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26
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Adams EL, Master L, Buxton OM, Savage JS. Patterns of infant-only wake bouts and night feeds during early infancy: An exploratory study using actigraphy in mother-father-infant triads. Pediatr Obes 2020; 15:e12640. [PMID: 32319729 DOI: 10.1111/ijpo.12640] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/17/2020] [Accepted: 03/30/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Infants' ability to fall back to sleep without parental involvement may reduce nighttime feeding frequency. OBJECTIVE We describe the associations between infant-only wake bouts ("self-soothing") and nighttime feeds using actigraphy from 6 to 24 weeks of age. METHODS Mother-father-infant triads (N = 20) wore sleep monitors, and mothers recorded infant night feeds, when infants were 6, 15 and 24 weeks of age. Actigraphy data were matched within-families to quantify infant-only wake bouts (infants woke; mothers/fathers remained asleep). Mixed models tested associations between infant-only wake bouts and night feeding frequency. RESULTS The proportion of infant-only wake bouts/night increased from 6 to 15 weeks of age (6 weeks: 52% [95% CI: 45-59]; 15 weeks: 64% [57-71]; 24 weeks: 62% [55-69]; P < .01). For every 10% increase in the proportion of infant-only wake bouts/night, there were 0.36 fewer feeds/night (P < .01) at 24 weeks; these concurrent associations were not found at 6 and 15 weeks. The proportion of infant-only wake bouts/night at 6 weeks predicted a faster rate of decline in the number of feeds/night from 6 to 24 weeks (P < .01). CONCLUSION Infants' ability to fall back to sleep without parent involvement at 6 weeks was associated with the trajectory of nighttime feeding frequency across early infancy.
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Affiliation(s)
- Elizabeth L Adams
- Department of Nutritional Sciences, Center for Childhood Obesity Research, Penn State University, Pennsylvania, USA.,Department of Nutrition Sciences, Penn State University, Pennsylvania, USA
| | - Lindsay Master
- Department of Biobehavioral Health, The Pennsylvania State University, Pennsylvania, USA
| | - Orfeu M Buxton
- Department of Biobehavioral Health, The Pennsylvania State University, Pennsylvania, USA
| | - Jennifer S Savage
- Department of Nutritional Sciences, Center for Childhood Obesity Research, Penn State University, Pennsylvania, USA.,Department of Nutrition Sciences, Penn State University, Pennsylvania, USA
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27
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Chaput JP, Dutil C, Featherstone R, Ross R, Giangregorio L, Saunders TJ, Janssen I, Poitras VJ, Kho ME, Ross-White A, Zankar S, Carrier J. Sleep timing, sleep consistency, and health in adults: a systematic review. Appl Physiol Nutr Metab 2020; 45:S232-S247. [DOI: 10.1139/apnm-2020-0032] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The objective of this systematic review was to examine the associations between sleep timing (e.g., bedtime/wake-up time, midpoint of sleep), sleep consistency/regularity (e.g., intra-individual variability in sleep duration, social jetlag, catch-up sleep), and health outcomes in adults aged 18 years and older. Four electronic databases were searched in December 2018 for articles published in the previous 10 years. Fourteen health outcomes were examined. A total of 41 articles, including 92 340 unique participants from 14 countries, met inclusion criteria. Sleep was assessed objectively in 37% of studies and subjectively in 63% of studies. Findings suggest that later sleep timing and greater sleep variability were generally associated with adverse health outcomes. However, because most studies reported linear associations, it was not possible to identify thresholds for “late sleep timing” or “large sleep variability”. In addition, social jetlag was associated with adverse health outcomes, while weekend catch-up sleep was associated with better health outcomes. The quality of evidence ranged from “very low” to “moderate” across study designs and health outcomes using GRADE. In conclusion, the available evidence supports that earlier sleep timing and regularity in sleep patterns with consistent bedtimes and wake-up times are favourably associated with health. (PROSPERO registration no.: CRD42019119534.) Novelty This is the first systematic review to examine the influence of sleep timing and sleep consistency on health outcomes. Later sleep timing and greater variability in sleep are both associated with adverse health outcomes in adults. Regularity in sleep patterns with consistent bedtimes and wake-up times should be encouraged.
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Affiliation(s)
- Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Caroline Dutil
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Ryan Featherstone
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Robert Ross
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Lora Giangregorio
- Department of Kinesiology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Travis J. Saunders
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada
| | - Ian Janssen
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON K7L 3N6, Canada
| | | | - Michelle E. Kho
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON L8S 1C7, Canada
| | - Amanda Ross-White
- Queen’s University Library, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Sarah Zankar
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Julie Carrier
- Départment de psychologie, Université de Montréal, Montreal, QC H2V 2S9, Canada
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28
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Brindle RC, Yu L, Buysse DJ, Hall MH. Empirical derivation of cutoff values for the sleep health metric and its relationship to cardiometabolic morbidity: results from the Midlife in the United States (MIDUS) study. Sleep 2020; 42:5488780. [PMID: 31083710 DOI: 10.1093/sleep/zsz116] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 03/15/2019] [Indexed: 12/27/2022] Open
Abstract
STUDY OBJECTIVES Emerging evidence supports a multidimensional perspective of sleep in the context of health. The sleep health model, and composite sleep health score, are increasingly used in research. However, specific cutoff values that differentiate "good" from "poor" sleep, have not been empirically derived and its relationship to cardiometabolic health is less-well understood. We empirically derived cutoff values for sleep health dimensions and examined the relationship between sleep health and cardiometabolic morbidity. METHODS Participants from two independent Biomarker Studies in the MIDUS II (N = 432, 39.8% male, age = 56.92 ± 11.45) and MIDUS Refresher (N = 268, 43.7% male, age = 51.68 ± 12.70) cohorts completed a 1-week study where sleep was assessed with daily diaries and wrist actigraphy. Self-reported physician diagnoses, medication use, and blood values were used to calculate total cardiometabolic morbidity. Receiver operating characteristic (ROC) curves were generated in the MIDUS II cohort for each sleep health dimension to determine cutoff values. Using derived cutoff values, logistic regression was used to examine the relationship between sleep health scores and cardiometabolic morbidity in the MIDUS Refresher cohort, controlling for traditional risk factors. RESULTS Empirically derived sleep health cutoff values aligned reasonably well to cutoff values previously published in the sleep health literature and remained robust across physical and mental health outcomes. Better sleep health was significantly associated with a lower odds of cardiometabolic morbidity (OR [95% CI] = 0.901 [0.814-0.997], p = .044). CONCLUSIONS These results contribute to the ongoing development of the sleep health model and add to the emerging research supporting a multidimensional perspective of sleep and health.
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Affiliation(s)
- Ryan C Brindle
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA.,Department of Psychology and Neuroscience Program, Washington and Lee University, Lexington, VA
| | - Lan Yu
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
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29
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Lee S, Stone KL, Engeland CG, Lane NE, Buxton OM. Arthritis, Sleep Health, and Systemic Inflammation in Older Men. Arthritis Care Res (Hoboken) 2020; 72:965-973. [PMID: 31074577 PMCID: PMC6842405 DOI: 10.1002/acr.23923] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 05/07/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To examine the associations of prevalent arthritis with systemic inflammation in older men and to test whether sleep health mediates the associations. METHODS Cross-sectional data came from 2,562 community-dwelling older men (all were age 65 years or older; mean age 76 years) in the Osteoporotic Fractures in Men Study who participated in a sleep ancillary study in 2003-2005. Participants were classified as having osteoarthritis (OA) (24%) or rheumatoid arthritis (RA) (0.7%) based on self-reported diagnoses and medication use. We constructed a composite score of multidimensional sleep health (i.e., perceived sleep quality, sleepiness, frequency of daytime napping, wake after sleep onset, and sleep duration) measured by both self-report and actigraphy. We also created binary indicators of elevated inflammation using C-reactive protein (CRP) (>3 mg/liter) and interleukin-6 (IL-6) (>1.08 pg/ml) levels. Analyses controlled for age, diagnosed sleep disorders, body mass index, smoking status, relevant medication use, and comorbidities. RESULTS Older men with OA did not have higher risk of elevated CRP or IL-6 levels. However, indirect associations of OA through sleep health were found. OA was associated with poorer sleep health, which was further associated with 16% higher odds of elevated CRP (P < 0.001) and 12% higher odds of elevated IL-6 (P < 0.01) levels after controlling for OA. Older men with RA had higher odds of elevated CRP and IL-6 levels, but the associations were not mediated by sleep health. CONCLUSION Findings suggest that promoting sleep health may help reduce the risk of systemic inflammation in older men with OA.
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Affiliation(s)
- Soomi Lee
- School of Aging Studies, University of South Florida
- Center for Healthy Aging, Pennsylvania State University
| | - Katie L. Stone
- Research Institute, California Pacific Medical Center, Sutter Bay Hospitals
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Christopher G. Engeland
- Center for Healthy Aging, Pennsylvania State University
- Department of Biobehavioral Health, Pennsylvania State University
- College of Nursing, Pennsylvania State University
| | - Nancy E. Lane
- Center for Musculoskeletal Health/Medicine and Rheumatology, University of California, Davis
| | - Orfeu M. Buxton
- Center for Healthy Aging, Pennsylvania State University
- Department of Biobehavioral Health, Pennsylvania State University
- Division of Sleep Medicine, Harvard Medical School
- Department of Social and Behavioral Sciences, Harvard Chan School of Public Health
- Sleep Health Institute, Departments of Medicine and Neurology, Brigham and Women’s Hospital
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Adams EL, Master L, Buxton OM, Savage JS. A longitudinal study of sleep-wake patterns during early infancy using proposed scoring guidelines for actigraphy. Sleep Med 2019; 63:98-105. [DOI: 10.1016/j.sleep.2019.05.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 05/28/2019] [Accepted: 05/30/2019] [Indexed: 02/03/2023]
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