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Xiang W, Shen Y, Chen S, Tan H, Cao Q, Xu L. Causal relationship between sleep disorders and the risk of Alzheimer's disease: A Mendelian randomization study. Sleep Med 2024; 120:34-43. [PMID: 38865787 DOI: 10.1016/j.sleep.2024.06.007] [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: 03/29/2024] [Revised: 06/03/2024] [Accepted: 06/07/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND AND OBJECTIVE Epidemiological studies have shown that sleep disorders are risk factors for Alzheimer's disease (AD), but the causal relationship between sleep disorders and AD risk is unknown. We aim to assess the potential genetic causal association between sleep characteristics and AD, which may contribute to early identification and prediction of risk factors for AD. METHODS Seven sleep-related traits and the outcome phenotype AD were selected from published genome-wide association studies (GWASs). These sleep-related characteristics and instrumental variables (IVs) for AD were extracted. Two-sample and multivariate Mendelian randomization (MR) analyses were performed to assess the causal relationships between sleep characteristics and AD. The inverse variance weighted (IVW), weighted median (WME), weighted mode (WM), MR-Egger regression (MR-Egger) and simple mode (SM) models were used to evaluate causality. The existence of pleiotropy was detected and corrected by MR-Egger regression, MR pleiotropy residuals and outliers. RESULTS A two-sample MR study revealed a positive causal association between sleep duration and the onset of AD (OR = 1.002, 95 % CI: 1.000-1.004), and the risk of AD increased with increasing sleep duration. The MR-Egger regression method and MR-PRESSO were used to identify and correct pleiotropy, indicating that there was no horizontal pleiotropy. Heterogeneity was evaluated by Cochran's Q, which indicated no heterogeneity. In a multivariate MR study with seven sleep characteristics corrected for each other, we found that sleep duration remained causally associated with AD (OR = 1.004, 95 % CI: 1.000-1.007). Moreover, we found that after mutual correction, daytime napping had a causal relationship with the onset of AD, and daytime napping may reduce the risk of AD (OR = 0.995, 95 % CI: 0.991-1.000). CONCLUSION This study is helpful for the early identification and prediction of risk factors for AD, long sleep durations are a risk factor for AD, and daytime napping can reduce the risk of AD.
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Affiliation(s)
- Wenwen Xiang
- Department of Neurology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Yu Shen
- Department of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Shenjian Chen
- Department of Neurology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Huadong Tan
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, China Three Gorges University, Yichang, China
| | - Qian Cao
- Department of Neurology, Saarland University, Homburg, Germany
| | - Lijun Xu
- Department of Neurology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
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Jiang Y, Yu M, Gong X, Zhao Y, Gao X. Association of night-time sleep and daytime napping with painful temporomandibular disorder. J Oral Rehabil 2024. [PMID: 38894533 DOI: 10.1111/joor.13786] [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: 01/09/2024] [Revised: 06/04/2024] [Accepted: 06/10/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Painful temporomandibular disorder (TMD) is the common cause of chronic oro-facial pain, which may interfere with sleep. Previous studies have documented an association between sleep and TMD. OBJECTIVES This study aimed to further explore the association of night-time sleep and daytime napping with painful TMD. METHODS A total of 419 patients (aged 31.88 ± 11.54 years with women forming 85.4%) from a TMD/Orofacial Pain center were enrolled. Patients' sleep conditions were evaluated with the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and information on night-time sleep duration, napping duration and napping frequency was interviewed. TMD was diagnosed according to the Diagnostic Criteria for TMD protocol and stratified into myalgia (muscle pain), arthralgia (joint pain) and combined (muscle and joint pain) subgroups. The severity of TMD was measured with the Fonseca Anamnestic Index (FAI) questionnaire. Restricted cubic spline (RCS) regression models were established to explore relationships between sleep and painful TMD subgroups. RESULTS Patients with poor sleep quality (PSQI≥6) had higher FAI scores (median 60, p < .001) and higher proportions of painful TMDs. The myalgia subgroup had higher PSQI scores (median 8, p < .001) than the arthralgia subgroup. The RCS models indicated a non-linear relationship between night-time sleep duration and myalgia (p < .001), which was not observed in arthralgia. However, there were no significant findings concerning napping and painful TMD subgroups. CONCLUSION This study found that the association between sleep and TMD is mainly related to painful TMD conditions, which are associated with night-time sleep duration.
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Affiliation(s)
- Yang Jiang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- Center for Oral Therapy of Sleep Disordered Breathing, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology, Beijing, China
| | - Min Yu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- Center for Oral Therapy of Sleep Disordered Breathing, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology, Beijing, China
| | - Xu Gong
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- Center for Oral Therapy of Sleep Disordered Breathing, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology, Beijing, China
| | - Yanping Zhao
- National Center for Stomatology, Beijing, China
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, China
- Center for Temporomandibular Disorders and Orofacial Pain, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xuemei Gao
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- Center for Oral Therapy of Sleep Disordered Breathing, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology, Beijing, China
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Noordam R, Ao L, Stroo JF, Willems van Dijk K, van Heemst D. No evidence linking sleep traits with white blood cell counts: Multivariable-adjusted and Mendelian randomization analyses. Eur J Clin Invest 2024; 54:e14189. [PMID: 38429948 DOI: 10.1111/eci.14189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 02/12/2024] [Accepted: 02/22/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Disturbances in habitual sleep have been associated with multiple age-associated diseases. However, the biological mechanisms underpinning these associations remain largely unclear. We assessed the possible involvement of the circulating immune system by determining the associations between sleep traits and white blood cell counts using multivariable-adjusted linear regression and Mendelian randomization. METHODS Cross-sectional multivariable-adjusted linear regression analyses were done using participants within the normal range of total white blood cell counts (>4.5 × 109 and <11.0 × 109/μL) from UK Biobank. For the sleep traits, we examined (short and long) sleep duration, chronotype, insomnia symptoms and daytime dozing. Two-sample Mendelian randomization analyses were done using instruments for sleep traits derived from European-ancestry participants from UK Biobank (over 410,000 participants) and using SNP-outcome data derived from European-ancestry participants from the Blood Cell Consortium (N = 563,946) to which no data from UK Biobank contributed. RESULTS Using data from 357,656 participants (mean [standard deviation] age: 56.5 [8.1] years, and 44.4% men), we did not find evidence that disturbances in any of the studied sleep traits were associated with differences in blood cell counts (total, lymphocytes, neutrophiles, eosinophiles and basophiles). Also, we did not find associations between disturbances in any of the studied sleep traits and white blood cell counts using Mendelian Randomization. CONCLUSION Based on the results from two different methodologies, disturbances in habitual sleep are unlikely to cause changes in blood cell counts and thereby differences in blood cell counts are unlikely to be underlying the observed sleep-disease associations.
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Affiliation(s)
- Raymond Noordam
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Linjun Ao
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | - Jasmijn F Stroo
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Ko Willems van Dijk
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands
- Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
- Leiden Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Diana van Heemst
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
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Addo PNO, Mundagowa PT, Zhao L, Kanyangarara M, Brown MJ, Liu J. Associations between sleep duration, sleep disturbance and cardiovascular disease biomarkers among adults in the United States. BMC Public Health 2024; 24:947. [PMID: 38566084 PMCID: PMC10985959 DOI: 10.1186/s12889-024-18381-5] [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: 04/12/2023] [Accepted: 03/18/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Sleep problems are associated with abnormal cardiovascular biomarkers and an increased risk of cardiovascular diseases (CVDs). However, studies investigating associations between sleep problems and CVD biomarkers have reported conflicting findings. This study examined the associations between sleep problems and CVD biomarkers in the United States. METHODS Data were from the National Health and Nutrition Examination Survey (NHANES) (2007-2018) and analyses were restricted to adults ≥ 20 years (n = 23,749). CVD biomarkers [C-reactive Protein (CRP), low-density lipoproteins, high-density lipoproteins (HDL), triglycerides, insulin, glycosylated hemoglobin (HbA1c), and fasting blood glucose] were categorized as abnormal or normal using standardized cut-off points. Sleep problems were assessed by sleep duration (short [≤ 6 h], long [≥ 9 h], and recommended [> 6 to < 9 h) and self-reported sleep disturbance (yes, no). Multivariable logistic regression models explored the associations between sleep duration, sleep disturbance, and CVD biomarkers adjusting for sociodemographic characteristics and lifestyle behaviors. RESULTS The mean sleep duration was 7.1 ± 1.5 h and 25.1% of participants reported sleep disturbances. Compared to participants with the recommended sleep duration, those with short sleep duration had higher odds of abnormal levels of HDL (adjusted odds ratio [aOR] = 1.20, 95% confidence interval [CI] = 1.05-1.39), CRP (aOR = 3.08, 95% CI = 1.18-8.05), HbA1c (aOR = 1.25, 95% CI = 1.05-1.49), and insulin (aOR = 1.24, 95% CI = 1.03-1.51). Long sleep duration was associated with increased odds of abnormal CRP (aOR = 6.12, 95% CI = 2.19-17.15), HbA1c (aOR = 1.54, 95% CI = 1.09-2.17), and blood glucose levels (aOR = 1.45, 95% CI = 1.07-1.95). Sleep disturbance predicted abnormal triglyceride (aOR = 1.18, 95% CI = 1.01-1.37) and blood glucose levels (aOR = 1.24, 95% CI = 1.04-1.49). CONCLUSION Short and long sleep durations were positively associated with abnormal CRP, HDL, HbA1c, blood glucose, and insulin levels, while sleep disturbance was associated with abnormal triglyceride and blood glucose levels. Since sleep is a modifiable factor, adopting healthy sleeping habits may create a balanced metabolism and reduce the risk of developing a CVD. Our study may provide insights into the relationship between sleep duration, sleep disturbance, and CVD risk.
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Affiliation(s)
- Prince Nii Ossah Addo
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, 29208, Columbia, South Carolina, USA.
| | - Paddington T Mundagowa
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, 29208, Columbia, South Carolina, USA
| | - Longgang Zhao
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, 29208, Columbia, South Carolina, USA
| | - Mufaro Kanyangarara
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, 29208, Columbia, South Carolina, USA
| | - Monique J Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, 29208, Columbia, South Carolina, USA
- Arnold School of Public Health, South Carolina Smart State Center for Healthcare Quality, University of South Carolina, Columbia, South Carolina, USA
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Office for the Study on Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, 29208, Columbia, South Carolina, USA
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Nakie G, Takelle GM, Rtbey G, Andualem F, Tinsae T, Kassa MA, Tadesse G, Fentahun S, Wassie YA, Segon T, Kibralew G, Melkam M. Sleep quality and associated factors among university students in Africa: a systematic review and meta-analysis study. Front Psychiatry 2024; 15:1370757. [PMID: 38559402 PMCID: PMC10979362 DOI: 10.3389/fpsyt.2024.1370757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
Background Poor sleep quality significantly impacts academic performance in university students. However, inconsistent and inconclusive results were found in a study on sleep among university students in several African nations. Therefore, this study aimed to estimate the pooled prevalence and associated factors of poor sleep quality among university students in Africa. Methods The databases PubMed, Scopus, Cochrane Library, Science Direct, African Journal Online, and Google Scholar were searched to identify articles. A total of 35 primary articles from 11 African countries were assessed and included in this systematic review and meta-analysis. Data were extracted by using a Microsoft Excel spreadsheet and exported to STATA version 14 for analysis. The I2 test was used to assess the statistical heterogeneity. A random effect meta-analysis model was employed with 95% confidence intervals. Funnel plots analysis and Egger regression tests were used to check the presence of publication bias. A subgroup analysis and a sensitivity analysis were done. Results A total of 16,275 study participants from 35 studies were included in this meta-analysis and systematic review. The overall pooled prevalence of poor sleep quality among university students in Africa was 63.31% (95% CI: 56.91-65.71) I2 = 97.2. The subgroup analysis shows that the combined prevalence of poor sleep quality in East, North, West, and South Africa were 61.31 (95% CI: 56.91-65.71), 62.23 (95% CI: 54.07-70.39), 54.43 (95% CI: 47.39-61.48), and 69.59 (95% CI: 50.39-88.80) respectively. Being stressed (AOR= 2.39; 95% CI: 1.63 to 3.51), second academic year (AOR= 3.10; 95% CI: 2.30 to 4.19), use of the electronic device at bedtime (AOR= 3.97 95% CI: 2.38 to 6.61)) and having a comorbid chronic illness (AOR = 2.71; 95% CI: 1.08, 6.82) were factors significantly associated with poor sleep quality. Conclusion This study shows that there is a high prevalence of poor sleep quality among university students in Africa. Being stressed, in the second year, using electronic devices at bedtime, and having chronic illness were factors associated with poor sleep quality. Therefore, addressing contributing factors and implementing routine screenings are essential to reduce the burden of poor sleep quality. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023493140.
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Affiliation(s)
- Girum Nakie
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Girmaw Medfu Takelle
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Gidey Rtbey
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Fantahun Andualem
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Techilo Tinsae
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mulat Awoke Kassa
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Gebresilassie Tadesse
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Setegn Fentahun
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Yilkal Abebaw Wassie
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tesfaye Segon
- Department of Psychiatry, College of Health Science, Mettu University, Mettu, Ethiopia
| | - Getasew Kibralew
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Zamora S, Full KM, Ambeba E, Savin K, Crist K, Natarajan L, Sears DD, Alismail S, Letellier N, Benmarhnia T, Jankowska MM. Objective sleep and cardiometabolic biomarkers: results from the community of mine study. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2023; 4:zpad052. [PMID: 38107604 PMCID: PMC10721447 DOI: 10.1093/sleepadvances/zpad052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 11/04/2023] [Indexed: 12/19/2023]
Abstract
Study Objectives Examining multiple dimensions of sleep health may better capture associations between sleep and health risks, including cardiometabolic disease (CMD). Hispanics have elevated risk for inadequate sleep and CMD biomarkers. Few studies have explored whether associations between sleep and CMD differ by Hispanic ethnicity. Methods Leveraging data from the Community of Mine (CoM) study, a cross-sectional investigation of 602 ethnically diverse participants, we derived accelerometer-measured sleep duration and efficiency, and self-reported sleep quality. Accelerometer-measured sleep exposures were analyzed both as continuous and categorical variables. Multivariate and quantile regression models were used to assess associations between sleep and CMD biomarkers (insulin resistance, systolic blood pressure, and low-density-lipoprotein cholesterol), controlling for age, sex, ethnicity, education, smoking status, and body mass index. We examined the potential effect modification of Hispanic ethnicity. Results We observed mixed results based on CMD biomarkers and sleep exposure. Increased sleep duration was significantly related to low-density lipoprotein cholesterol in adjusted models (estimate = 0.06; 95% CI: 0.02, 0.11). Poor sleep efficiency was associated with greater insulin resistance in the adjusted quantile (estimate = 0.20; 95% CI: 0.04, 0.36) model at the 90th percentile. Self-reported sleep quality was not associated with CMD outcomes. There was no evidence of effect modification by Hispanic ethnicity. Conclusions In this cohort, sleep health measures were found to have mixed and at times opposing effects on CMD outcomes. These effects did not demonstrate an interaction with Hispanic ethnicity.
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Affiliation(s)
- Steven Zamora
- Department of Climate, Atmospheric Sciences, and Physical Oceanography, Scripps Institution of Oceanography, UCSD, La Jolla, CA, USA
| | - Kelsie M Full
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville TN, USA
| | - Erica Ambeba
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, CA, USA
| | - Kimberly Savin
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology, SDSU, San Diego, CA, USA
| | - Katie Crist
- Urban Studies and Planning Department, San Diego University, San Diego, CA, USA
| | - Loki Natarajan
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, CA, USA
| | - Dorothy D Sears
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Sarah Alismail
- Department of Population Sciences, Beckman Research Institute, Duarte, CA, USA
| | - Noémie Letellier
- Department of Climate, Atmospheric Sciences, and Physical Oceanography, Scripps Institution of Oceanography, UCSD, La Jolla, CA, USA
| | - Tarik Benmarhnia
- Department of Climate, Atmospheric Sciences, and Physical Oceanography, Scripps Institution of Oceanography, UCSD, La Jolla, CA, USA
| | - Marta M Jankowska
- Department of Population Sciences, Beckman Research Institute, Duarte, CA, USA
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Whittaker AC, De Nys L, Brindle RC, Drayson MT. Physical activity and sleep relate to antibody maintenance following naturalistic infection and/or vaccination in older adults. Brain Behav Immun Health 2023; 32:100661. [PMID: 37456624 PMCID: PMC10344668 DOI: 10.1016/j.bbih.2023.100661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 07/18/2023] Open
Abstract
Health behaviours such as being physically active and having good quality sleep have been associated with decreased susceptibility to infection and stronger antibody responses to vaccination. Less is known about how such factors might influence the maintenance of immunity following naturalistic infection and/or prior vaccination, particularly among older adults who may have formed initial antibodies some time ago. This analysis explored antibody levels against a range of common infectious diseases in 104 older adults (60 women) aged 65+ years, and whether these relate to self-reported physical activity (PA) and sleep. PA and sleep were measured subjectively through standardized questions. Antibody levels to a range of common pathogens, including pneumococcal (Pn) and meningococcal (Men) serotypes, Haemophilus influenza type b, diphtheria, and tetanus were assayed using Multiplex technology. Higher PA at baseline related to higher antibody levels against three Pn serotypes and MenY, and higher PA at one month with higher levels against six Pn serotypes. Longer time in bed related to higher antibody levels against Pn4, and longer sleep related to higher levels against Pn19f. More difficulty staying awake in the day related to lower antibodies against Pn19a, Pn19f, MenA and MenY, and more frequent daytime napping related to lower levels against three Pn serotypes and MenY. Using clinically protective antibody thresholds as an outcome showed similar results for PA, but effects for sleep became non-significant, with the exception of time in bed. This extends beyond existing literature demonstrating associations between PA and sleep and peak antibody response to vaccination to antibody maintenance. Longitudinal research with objective measures of health behaviours is warranted.
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Affiliation(s)
| | - Len De Nys
- Faculty of Health Sciences and Sport, University of Stirling, UK
| | - Ryan C. Brindle
- Department of Cognitive and Behavioural Science & Neuroscience Program, Washington and Lee University, USA
| | - Mark T. Drayson
- Institute of Immunology and Immunotherapy, University of Birmingham, UK
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Stager LM, Thompson-Phillips K, Morgan CH, Watson CS, Grant M, Fobian AD. The Impact of Longitudinal Patterns of Adolescent Sleep Duration on Adult C-Reactive Protein (CRP), Waist-To-Height Ratio, and Body Mass Index (BMI) Among Black and White Individuals. J Adolesc Health 2023; 73:776-783. [PMID: 37395694 PMCID: PMC10524665 DOI: 10.1016/j.jadohealth.2023.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 04/05/2023] [Accepted: 05/14/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE To assess the impact of longitudinal adolescent sleep duration on adult C-reactive protein (CRP), waist-to-height ratio (WtHR), and body mass index (BMI) by race. METHODS Participants (N = 2,399; Mage = 15.7; 40.2% male; 79.2% White, 20.8% Black; Grades 7-12 at Wave I) from the Add Health database provided self-reported sleep duration in Waves I-IV. During Wave V, CRP, WtHR, and BMI were objectively measured. Trajectory analysis was performed using a group-based modeling approach. Chi-square test determined racial differences between groups. General linear models determined relationships between trajectory group, race, and group/race interaction with Wave V CRP, WtHR, and BMI. RESULTS Three sleep trajectories emerged: Group 1 "shortest" (24.4%), Group 2 "stable recommended" (67.6%), and Group 3 "varied" (8%). Black individuals and older individuals were more likely to be in Group 1 compared with Group 2. Regardless of race, individuals with patterns of sleep duration increasing to above what is recommended across waves (Group 3) had elevated CRP. Individuals with stable patterns of adequate sleep (Group 2) had lower WtHR. Black individuals with consistently stable patterns of adequate sleep duration had lower BMI compared to those with low sleep duration. DISCUSSION Black individuals were more likely to obtain chronically short sleep during the transition from adolescence to adulthood, highlighting a significant health disparity. Poor longitudinal sleep predicted elevated CRP and WtHR. Sleep only impacted BMI for Black individuals. This may relate to racial differences in BMI measurement.
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Affiliation(s)
- Lindsay M Stager
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Kathryn Thompson-Phillips
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama; Children's Behavioral Health, Children's of Alabama, Birmingham, Alabama
| | - Casie H Morgan
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Caroline S Watson
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Merida Grant
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Aaron D Fobian
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama.
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Irwin MR, Straub RH, Smith MT. Heat of the night: sleep disturbance activates inflammatory mechanisms and induces pain in rheumatoid arthritis. Nat Rev Rheumatol 2023; 19:545-559. [PMID: 37488298 DOI: 10.1038/s41584-023-00997-3] [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] [Accepted: 06/29/2023] [Indexed: 07/26/2023]
Abstract
Sleep has a homeostatic role in the regulation of the immune system and serves to constrain activation of inflammatory signalling and expression of cellular inflammation. In patients with rheumatoid arthritis (RA), a misaligned inflammatory profile induces a dysregulation of sleep-wake activity, which leads to excessive inflammation and the induction of increased sensitivity to pain. Given that multiple biological mechanisms contribute to sleep disturbances (such as insomnia), and that the central nervous system communicates with the innate immune system via neuroendocrine and neural effector pathways, potential exists to develop prevention opportunities to mitigate the risk of insomnia in RA. Furthermore, understanding these risk mechanisms might inform additional insomnia treatment strategies directed towards steering and reducing the magnitude of the inflammatory response, which together could influence outcomes of pain and disease activity in RA.
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Affiliation(s)
- Michael R Irwin
- Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience and Human Behaviour, Los Angeles, CA, USA.
| | - Rainer H Straub
- Laboratory of Experimental Rheumatology and Neuroendocrine Immunology, Department of Internal Medicine I, University Hospital, Regensburg, Germany
| | - Michael T Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
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Cai C, Atanasov S. Long Sleep Duration and Stroke-Highly Linked, Poorly Understood. Neurol Int 2023; 15:764-777. [PMID: 37489354 PMCID: PMC10366725 DOI: 10.3390/neurolint15030048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/26/2023] Open
Abstract
Stroke is one of the leading causes of disability and mortality. Both short and long sleep durations are associated with adverse health outcomes. Cross-sectional studies have shown an increased prevalence of stroke in long sleepers. Long sleep duration increases stroke incidence and mortality in prospective epidemiological studies. Accumulating evidence suggests that the magnitude of the association between sleep and stroke appears to be stronger for longer sleep than shorter sleep, yielding a J-shaped curve. Potential links between long sleep duration and stroke include increased incidence of diabetes and atrial fibrillation, elevated levels of inflammation, arterial stiffness, and blood pressure variability. Long sleep duration is a strong marker and a plausible risk factor for stroke and should be considered in future scoring for risk stratification and stroke prevention.
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Affiliation(s)
- Chumeng Cai
- Department of Neuroscience, College of Natural Sciences, The University of Texas at Austin, Austin, TX 78712-0805, USA
| | - Strahil Atanasov
- Division of Pulmonary Critical Care & Sleep Medicine, University of Texas Medical Branch, Galveston, TX 77555-0561, USA
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Yeh MSL, Poyares D, D'Elia ATD, Coimbra BM, Mello AF, Tufik S, Mello MF. Sleep characteristics and inflammatory markers in women with post-traumatic stress disorder. BMC Psychiatry 2023; 23:273. [PMID: 37081449 PMCID: PMC10116752 DOI: 10.1186/s12888-023-04765-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/10/2023] [Indexed: 04/22/2023] Open
Abstract
INTRODUCTION Sexual violence is one of the most severe traumatic events. It is associated with a higher risk for post-traumatic stress disorder (PTSD) development. Sleep disturbances such as insomnia are frequently reported by PTSD patients and play a key role in the development and course of the disorder. Sleep disturbances are associated with higher levels of pro-inflammatory cytokines emphasizing the importance of sleep studies in individuals with PTSD. OBJECTIVES To investigate the association between subjective and objective sleep measurements and PTSD symptoms with inflammatory markers in women with PTSD following sexual assault. METHODS In this longitudinal study fifty-seven women with PTSD were evaluated for sleep measurements and inflammatory markers. Participants completed the Clinician-Administered PTSD Scale, the Beck Depression Inventory, the Pittsburgh Sleep Quality Index (PSQI), and the Insomnia Severity Index. In addition, patients underwent full in-lab polysomnography and serum levels of interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP) measurement. All assessments were performed at baseline and after one year. Patients received pharmacological and/or psychological interventions between baseline and one-year follow-up. RESULTS Despite improving PTSD symptoms severity and sleep quality (expressed in PSQI), we found an increase in the inflammatory markers IL-1β, TNF-α, IL-6 and CRP after one year of follow-up. These findings suggest that neurobiological processes may advance independently of PTSD symptoms. We found a significant increase in the levels of IL-1β and TNF-α associated with decreased slow-wave sleep (p = 0.019 and p = 0.018 respectively), IL-6 associated with arousal index (p = 0.024), and CRP associated with insomnia severity (p = 0.012), and sleep duration longer than 6 h per night (p < 0.001). CONCLUSIONS Sleep impairments in PTSD may be associated with a gradual and persistent alteration in the immune system, resulting in a progressive inflammatory process. Our results suggest that sleep mechanisms are involved in this incident inflammatory process in young women with PTSD.
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Affiliation(s)
- Mary Sau Ling Yeh
- Department of Psychiatry, Universidade Federal de Sao Paulo (UNIFESP), Rua Major Maragliano, 241, São Paulo, 04017-030, SP, Brazil.
| | - Dalva Poyares
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Ana Teresa D D'Elia
- Department of Psychiatry, Universidade Federal de Sao Paulo (UNIFESP), Rua Major Maragliano, 241, São Paulo, 04017-030, SP, Brazil
| | - Bruno M Coimbra
- Department of Psychiatry, Universidade Federal de Sao Paulo (UNIFESP), Rua Major Maragliano, 241, São Paulo, 04017-030, SP, Brazil
| | - Andrea Feijo Mello
- Department of Psychiatry, Universidade Federal de Sao Paulo (UNIFESP), Rua Major Maragliano, 241, São Paulo, 04017-030, SP, Brazil
| | - Sergio Tufik
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Marcelo Feijo Mello
- Department of Psychiatry, Universidade Federal de Sao Paulo (UNIFESP), Rua Major Maragliano, 241, São Paulo, 04017-030, SP, Brazil
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Zhang X, Zhang M, Sui H, Li C, Huang Z, Liu B, Song X, Liao S, Yu M, Luan T, Zuberbier T, Wang L, Zhao Z, Wu J. Prevalence and risk factors of allergic rhinitis among Chinese adults: A nationwide representative cross-sectional study. World Allergy Organ J 2023; 16:100744. [PMID: 37008533 PMCID: PMC10050653 DOI: 10.1016/j.waojou.2023.100744] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/02/2022] [Accepted: 12/19/2022] [Indexed: 03/28/2023] Open
Abstract
Background The prevalence of allergic rhinitis (AR) has been increasing steadily worldwide, especially in countries with increasing industrialization such as China. However, available evidence regarding AR prevalence among Chinese adults is scarce and limited to regional data collected in earlier years. We therefore aimed to provide a more recent and robust estimate of AR prevalence using a nationwide representative cross-sectional study in China. Methods Data of 184 326 participants aged 18 years or older were obtained from the China Chronic Disease and Risk Factor Surveillance conducted in 2018-2019. AR was determined by self-reported sneezing, nasal itching, obstruction, or rhinorrhea symptoms for at least 1 h in the absence of a cold or flu within the last 12 months. Multivariable logistic model was used to examine the risk factors of AR, and a possible non-linear relationship was further tested by restricted cubic spline. Potential additive interactions of risk factors with sex, residence, and geographic region were assessed by relative excess risk due to interaction (RERI). Results The weighted prevalence of AR was 8.1% (95% confidence interval [CI], 7.4%-8.7%), of whom 23.7% (95% CI, 21.3%-26.0%) were aware of their diagnosis. Increased odds of AR were associated with younger age, men, living in urban area or north region, more education, smoking, underweight, and higher income. Despite the nonsignificant linear trend, the spline regression demonstrated a non-linear association between AR and sleep duration, with higher odds at both ends. Additionally, the observed associations were generally stronger among men and people living in urban area and north region, with significant RERI ranging from 0.07 (95% CI, 0.00-0.14) to 0.40 (95% CI, 0.12-0.67). Conclusions AR is prevalent in China and the associated factors and interactions are helpful to design targeted preventive strategies towards certain subpopulations. The low awareness of AR calls for a national effort on AR screening.
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Winders S, Lyon DE, Stechmiller JK, Kelly DL. Biomarkers of sleep disturbance in adults with chronic illness: A scoping review. Chronic Illn 2023; 19:3-25. [PMID: 35179070 DOI: 10.1177/17423953211073697] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES The purpose of this scoping review was to identify which biomarkers for sleep disturbance were the most prevalent and significant in the literature across chronic illnesses. METHODS A scoping review was conducted, following Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, to provide a map of the existing literature on the biomarkers of sleep disturbance in adults with chronic illness. Peer-reviewed articles published between 2010-2020 were included if they measured a biomarker and discussed sleep deprivation, disturbance, or dysfunction secondary to a chronic illness. RESULTS A total of 21 articles were included and synthesized using data charting. There were 24 different biomarkers identified, most commonly collected through serum. Biomarkers were grouped, then biomarkers and correlations with sleep were identified and mapped. DISCUSSION Overall, the most common biomarkers studied were interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), c-reactive protein (CRP), and interleukin-1 beta (IL-1β). Cytokines were the most commonly studied biomarkers, with a majority of studies focusing on pro-inflammatory cytokines. Based on the results of this review, CRP, IL-6, TNF-α, and erythrocyte sedimentation rate (ESR) showed themost significant correlations with sleep across all chronic illnesses. Future research is still needed to identify an ideal biomarker for sleep disturbance that can be used across chronic illnesses.
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Affiliation(s)
- Samantha Winders
- 3463University of Florida School of Nursing, Gainesville, FL, USA
| | - Debra E Lyon
- 3463University of Florida School of Nursing, Gainesville, FL, USA
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Zhou B, Jiang C, Zhang W, Jin Y, Zhu T, Zhu F, Xu L. Association of sleep duration and napping with stroke mortality in older Chinese: A 14-year prospective cohort study of the Guangzhou Biobank Cohort study. Sleep Med 2023; 101:384-391. [PMID: 36512889 DOI: 10.1016/j.sleep.2022.11.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/13/2022] [Accepted: 11/27/2022] [Indexed: 12/03/2022]
Abstract
STUDY OBJECTIVE Evidence regarding the association of short sleep duration and napping with stroke remains limited and controversial. We examined the association of sleep duration and napping with risk of stroke mortality in an older Chinese cohort. METHODS Sleep duration and daytime napping were assessed by face-to-face interview during 2003-2008. Information of causes of death until April 30, 2021 was collected via record linkage with the Death Registry. Cox regression was used to calculate the hazard ratio (HR) and 95% confidence interval (CI). RESULTS Of 27,254 participants aged average 62.0 (standard deviation = 7.1) years, 818 stroke deaths occurred within 388,798 person-years (mean = 14.3 years) of follow-up. A U-shaped relation between sleep duration and risk of stroke mortality was observed. Participants with short (≤5 h/day) or long sleep duration (≥9 h/day) showed higher risks of total stroke mortality, with adjusted HRs (95% CIs) being 1.27 (1.01-1.59) and 1.37 (1.07-1.75), respectively. However, non-significant association of short or long sleep duration with hemorrhagic or ischemic stroke mortality was found. The associations of short and long sleep duration with total stroke mortality were more pronounced in those with hypertension (P for interaction with hypertension = 0.01), with HRs (95% CIs) being 1.37 (1.04-1.82) and 1.77 (1.33-2.36), respectively. No association between napping and risk of stroke mortality was found. CONCLUSIONS Both short and long sleep duration, but not daytime napping, were associated with higher risk of stroke mortality. Public health messages to encourage good sleep hygiene may be important, especially for people with hypertension.
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Affiliation(s)
- Baijing Zhou
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Chaoqiang Jiang
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
| | - Weisen Zhang
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China.
| | - Yali Jin
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
| | - Tong Zhu
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
| | - Feng Zhu
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
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Effect of weekend catch-up sleep on high-sensitivity C-reactive protein levels according to bedtime inconsistency: a population-based cross-sectional study. Sci Rep 2022; 12:21619. [PMID: 36517526 PMCID: PMC9751111 DOI: 10.1038/s41598-022-25787-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 12/05/2022] [Indexed: 12/15/2022] Open
Abstract
To investigate the associations of weekend catch-up sleep (WCS) and high-sensitivity C-reactive protein (hs-CRP) levels according to bedtime inconsistency in the Korean population. In this cross-sectional study using the Korea National Health and Nutrition Examination Survey (2016-2018) with 17,665 participants, four groups were defined: no-WCS (WCS within ± 1 h of weekday sleep time), moderate WCS (1 ≤ , < 3 h), severe WCS (≥ 3 h), and inverse WCS (≤ - 1 h). An inconsistent bedtime was defined as a > 2 h difference between weekend and weekday bedtimes. Outcomes were divided into quartiles based on the hs-CRP level: Lowest (< 0.34), Middle-low (≥ 0.34, < 0.55), Middle-high (≥ 0.55, < 1.10), Highest (≥ 1.10). Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated using multinomial logistic regression, controlling for relevant covariates. Moderate WCS was associated with a lower risk for the highest hs-CRP levels than no WCS (aOR = 0.87, 95% CI 0.78-0.97), and a similar association was observed only in participants with consistent bedtimes (aOR = 0.88, 95% CI 0.78-0.99). Significant interactions of those associations of WCS and hs-CRP levels with bedtime inconsistency were found. These findings provide evidence that people with inconsistent bedtimes would have limited protective effect of WCS on hs-CRP.
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Booker R, Holmes ME, Newton RL, Norris KC, Thorpe RJ, Carnethon MR. Compositional analysis of movement behaviors' association on high-sensitivity c-reactive protein: the Jackson heart study. Ann Epidemiol 2022; 76:7-12. [PMID: 36210008 PMCID: PMC9879574 DOI: 10.1016/j.annepidem.2022.09.009] [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: 06/28/2022] [Revised: 09/22/2022] [Accepted: 09/29/2022] [Indexed: 01/28/2023]
Abstract
PURPOSE Movement behaviors (i.e. physical activity [PA], sedentary behavior [SB], and sleep) are intrinsically codependent, an issue resolved using compositional data analysis (CoDA). High-sensitivity C-reactive protein (hs-CRP) is a nonspecific inflammatory marker positively associated with cardiovascular diseases and affected by movement behaviors. Examine the relation between movement behaviors using CoDA and how time reallocation between two movement behaviors was associated with hs-CRP concentration. METHODS The Jackson Heart Study was designed to investigate cardiovascular disease risk factors among African American participants in the Jackson, MS area. PA and sleep were self-reported with SB calculated as the remaining time in the day. RESULTS The median untransformed hs-CRP concentration was 0.28 mg·dL-1 (interquartile range; 0.11, 0.61). Reallocating 15 minutes of PA with SB, the hypothetical change in log hs-CRP concentration was 0.08 mg·dL-1 (95% CIs; 0.04, 0.11) greater than the average log hs-CRP concentration. Substituting 15 minutes of SB or sleep with PA was associated with a hypothetical change in log hs-CRP concentration difference of -0.05 mg·dL-1 (-0.08, -0.03) and -0.06 mg·dL-1 (-0.08, -0.03), respectively. Reallocations between SB and sleep were not associated with the hypothetical difference in log hs-CRP concentration. CONCLUSIONS Modeling estimates suggest replacing 15 minutes of SB with PA is associated with lower inflammation.
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Affiliation(s)
- Robert Booker
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
| | - Megan E Holmes
- Department of Kinesiology, Mississippi State University, Mississippi State, MS
| | | | - Keith C Norris
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Roland J Thorpe
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, John Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
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Abstract
PURPOSE OF REVIEW We discuss the relationship between sleep and circadian factors with cardiovascular disease (CVD) risk, including physiologic, behavioral, and psychological mechanisms along this pathway. RECENT FINDINGS The relationship between short and long sleep duration, as well as insomnia, with CVD risk is well-established. Recent work has highlighted how other sleep factors, such as sleep regularity (i.e., consistency of sleep timing), multidimensional sleep health, and circadian factors like chronotype and social jetlag, relate to CVD risk. Sleep-focused interventions (e.g., cognitive behavioral therapy for insomnia and sleep extension) may be effective to reduce CVD risk and disease burden. Sleep is increasingly recognized as an integral component of cardiovascular health. This was underscored by the recent inclusion of sleep duration as a health behavior in the American Heart Association's Life's Essential 8 for defining optimal cardiovascular health.
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Affiliation(s)
- Joseph Belloir
- School of Nursing, Columbia University, New York, NY, USA
| | - Nour Makarem
- Department of Epidemiology, Mailman School of Public Health Columbia University Irving Medical Center, New York, NY, USA
| | - Ari Shechter
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Irving Medical Center, 622 West 168th Street, 9th Floor, New York, NY, 10032, USA.
- Center of Excellence for Sleep & Circadian Research, Columbia University Irving Medical Center, New York, NY, USA.
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Liu X, Yuan Z, Ji Y. The association between electronic cigarettes, sleep duration, and the adverse cardiovascular outcomes: Findings from behavioral risk factor surveillance system, 2020. Front Cardiovasc Med 2022; 9:909383. [PMID: 36277785 PMCID: PMC9582666 DOI: 10.3389/fcvm.2022.909383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
The joint effect of electronic cigarette smoking and insufficient sleep duration on cardiovascular disease (CVD) was unclear. This cross-sectional study aimed to evaluate the association between electronic cigarettes, sleep duration, and risk of CVD among American adults. The participants who completed the survey from the behavioral risk factor surveillance system in 2020 were included in this study. The status of electronic cigarette smoking was divided into never, former, and current use. The duration of sleep was categorized into insufficient (<6 h), appropriate (6–9 h), and excessive (>9 h) groups. The CVD group was defined as a patient having any of the following conditions: heart attack, coronary heart disease, or stroke according to self-report. The multivariate logistic regression model was adopted to determine the association between electronic cigarettes, sleep duration, and the risk of CVD. Sensitivity analyses were performed to assess the joint effects on the risk of CVD subtypes, including heart attack, coronary heart disease, and strokes, respectively. Subgroup analyses were performed to estimate the joint effects within the stratum of the age group. The total number of participants included in the present study was 253,561. Of which, 22,908 patients had CVD. In total, 61,293 participants had previously or currently used electronic cigarettes and 37,429 participants had inappropriate sleep duration. Former electronic cigarette users had a 10.8% increased risk of having CVD (OR = 1.108, 95% CI: 1.001–1.227) compared to users who never had electronic cigarettes. Insufficient and excessive sleep durations are associated with increased risks of CVD (OR = 1.592, 95% CI: 1.460–1.735; OR = 1.523, 95% CI: 1.320–1.758). The participants with current vaping status and lack of sleep had a 159.6% increased risk of CVD (OR = 2.596, 95% CI: 1.810–3.723). Sensitivity analyses found similar joint effects of current vaping and insufficient sleep on the risk of heart attack, coronary heart attack, and stroke. The subgroup analyses across each age stratum found that the middle-aged group is most vulnerable to the joint effect of current vaping and insufficient sleep. This study found that both current vaping and inappropriate sleep duration were associated with CVD. Additionally, there was a significant joint effect of current vaping and insufficient sleep on the risk of CVD, especially for middle-aged participants.
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Affiliation(s)
- Xingyou Liu
- First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China
| | - Zhichao Yuan
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China,*Correspondence: Yuelong Ji
| | - Yuelong Ji
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China,Zhichao Yuan
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Pak VM, Paul S, Swieboda D, Balthazar MS, Wharton W. Sleep duration and biomarkers of inflammation in African American and white participants with a parental history of Alzheimer's disease. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12332. [PMID: 36177446 PMCID: PMC9473642 DOI: 10.1002/trc2.12332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/24/2022] [Accepted: 06/01/2022] [Indexed: 01/13/2023]
Abstract
Introduction African Americans (AA)s have worse inflammation, worse sleep, and a greater incidence of Alzheimer's disease (AD) compared to whites; however, no studies have examined associations between biomarkers, sleep, and cognition, and differences by race. Methods Seventy-six cognitively normal, middle aged (45-65 years) adults with a parental history of AD were included in this study. Associations between biomarkers (tumor necrosis factor-α [TNF-α], interleukin-10 [IL-10], intercellular adhesion molecule-1 [ICAM-1],, and C-reactive protein [CRP]) and self-reported sleep or cognition measures, were assessed. Results Average sleep duration was significantly lower for AA versus whites (average[SD]) in hours: 6.02(1.18) versus 7.23(0.91), P = .000004). We found a statistically significant association between plasma IL-10 and sleep duration (Spearman's ρ = 0.26, P = .04) and CSF ICAM-1 and sleep quality (Spearman's ρ = 0.30, P = .03). Discussion Longer sleep duration is positively associated with plasma IL-10 levels irrespective of race. Sleep quality was positively associated with CSF ICAM-1 only in African Americans.
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Affiliation(s)
| | | | | | - Monique S. Balthazar
- School of NursingEmory UniversityAtlantaGeorgiaUSA,Byrdine F. Lewis College of Nursing and Health ProfessionsGeorgia State UniversityAtlantaGeorgiaUSA
| | - Whitney Wharton
- School of NursingEmory UniversityAtlantaGeorgiaUSA,Cognitive Neurology DepartmentEmory UniversityAtlantaGeorgiaUSA
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Associations of somatic depressive symptoms with body mass index, systemic inflammation, and insulin resistance in primary care patients with depression. J Behav Med 2022; 45:882-893. [PMID: 36074315 DOI: 10.1007/s10865-022-00356-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/05/2022] [Indexed: 10/14/2022]
Abstract
The somatic depressive symptom cluster (including appetite and sleep disturbances) is more strongly associated with insulin resistance (a diabetes risk marker) than other depressive symptom clusters. Utilizing baseline data from 129 primary care patients with depression but no diabetes in the eIMPACT trial (Mage = 59 years, 78% female, 50% Black), we examined associations of somatic depressive symptoms with insulin resistance (HOMA-IR), body mass index (BMI), and high-sensitivity C-reactive protein (hsCRP). We tested BMI and hsCRP as mediators and race as a moderator of these relationships. Hyperphagia was positively associated HOMA-IR (β = 0.19, p = .048) and BMI (β = 0.30, p < .001); poor appetite was negatively associated with HOMA-IR (β = -0.24, p = .02); hypersomnia was positively associated with HOMA-IR (β = 0.28, p = .003), BMI (β = 0.26, p = .003), and hsCRP (β = 0.23, p = .01); and disturbed sleep was positively associated with hsCRP (β = 0.21, p = .04). BMI partially mediated hyperphagia and hypersomnia's associations with HOMA-IR; hsCRP partially mediated the hypersomnia-HOMA-IR association; and race moderated the hyperphagia-HOMA-IR association (positive for White participants but null for Black participants). People with depression experiencing hyperphagia and/or hypersomnia may be a subgroup with greater insulin resistance; BMI and hsCRP are likely pathways in these relationships. This study highlights the importance of considering the direction of somatic depressive symptoms in the context of cardiometabolic disease risk.
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Irwin MR. Sleep disruption induces activation of inflammation and heightens risk for infectious disease: Role of impairments in thermoregulation and elevated ambient temperature. Temperature (Austin) 2022; 10:198-234. [PMID: 37332305 PMCID: PMC10274531 DOI: 10.1080/23328940.2022.2109932] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/25/2022] [Accepted: 07/30/2022] [Indexed: 10/15/2022] Open
Abstract
Thermoregulation and sleep are tightly coordinated, with evidence that impairments in thermoregulation as well as increases in ambient temperature increase the risk of sleep disturbance. As a period of rest and low demand for metabolic resources, sleep functions to support host responses to prior immunological challenges. In addition by priming the innate immune response, sleep prepares the body for injury or infection which might occur the following day. However when sleep is disrupted, this phasic organization between nocturnal sleep and the immune system becomes misaligned, cellular and genomic markers of inflammation are activated, and increases of proinflammatory cytokines shift from the nighttime to the day. Moreover, when sleep disturbance is perpetuated due to thermal factors such as elevated ambient temperature, the beneficial crosstalk between sleep and immune system becomes further imbalanced. Elevations in proinflammatory cytokines have reciprocal effects and induce sleep fragmentation with decreases in sleep efficiency, decreases in deep sleep, and increases in rapid eye movement sleep, further fomenting inflammation and inflammatory disease risk. Under these conditions, sleep disturbance has additional potent effects to decrease adaptive immune response, impair vaccine responses, and increase vulnerability to infectious disease. Behavioral interventions effectively treat insomnia and reverse systemic and cellular inflammation. Further, insomnia treatment redirects the misaligned inflammatory- and adaptive immune transcriptional profiles with the potential to mitigate risk of inflammation-related cardiovascular, neurodegenerative, and mental health diseases, as well as susceptibility to infectious disease.
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Affiliation(s)
- Michael R. Irwin
- University of California, Los Angeles – Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, California, USA
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Abstract
BACKGROUND As recurrent myocardial infarctions (MIRs) constitute almost a third of the annual incidence of myocardial infarction, identifying the traditional and novel variables related to MIR is important. OBJECTIVE The aim of this study was to examine modifiable cardiac risks, adiposity, symptoms associated with inflammation (fatigue, depression, sleep) and inflammatory cytokines, and MIR by sex and race. METHODS Using a cross-sectional descriptive design, we recruited a convenience sample of adults (N = 156) discharged with first myocardial infarction or had MIR in the last 3 to 7 years. Surveys measured demographics, cardiac risk factors, depression, sleep, and fatigue. Anthropometric measures and cytokines tumor necrosis factor-α, interleukin-6, and high-sensitivity C-reactive protein (hsCRP) were obtained. A maximum likelihood regression was calculated to predict MIR. RESULTS The sample included 57% male and 30% Black participants, and the mean (SD) age was 65 (12) years. The hsCRP was the only cytokine related to symptoms: fatigue ( r = 0.309, P < .001) and depression ( r = 0.255, P = .002). An MIR was not associated with race despite White participants reporting better sleep ( t146 = -3.25, P = .002), lower body mass index ( t154 = -3.49, P = .001), and fewer modifiable risk factors ( t152 = -2.05, P = .04). An MIR was associated with being male, higher hsCRP and tumor necrosis factor-α levels ( P < .001), and higher inflammatory symptoms of fatigue ( P = .04), depression ( P = .01), and poor sleep ( P < .001). CONCLUSION Further examination of biomarkers to understand the mechanisms associated with inflammatory symptoms of fatigue, depression, and poor sleep and MIR is needed.
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Affiliation(s)
- Willie M. Abel
- School of Nursing, The University of North Carolina at
Charlotte
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Yoshimura S, Miyano I, Yasuda N. Associations of sleep duration with the incidence of needed support/long-term care certification according to presence or absence of sleep complaints in community-dwelling Japanese older adults. Arch Gerontol Geriatr 2022; 101:104712. [DOI: 10.1016/j.archger.2022.104712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/17/2022] [Accepted: 04/28/2022] [Indexed: 11/16/2022]
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杨 若, 王 梦, 李 春, 于 欢, 王 小, 吴 俊, 王 斯, 王 伽, 陈 大, 吴 涛, 胡 永. [Interaction between ischemic stroke risk loci identified by genome-wide association studies and sleep habits]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2022; 54:412-420. [PMID: 35701116 PMCID: PMC9197694 DOI: 10.19723/j.issn.1671-167x.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To explore the relationship between sleep habits (sleep duration, sleep efficiency, sleep onset timing) and ischemic stroke, and whether there is an interaction between sleep habits and ischemic stroke susceptibility gene loci. METHODS A questionnaire survey, physical examination, blood biochemical testing and genotyping were conducted among rural residents in Beijing, and the gene loci of ischemic stroke suggested by previous genome-wide association studies (GWAS) were screened. Multivariable generalized linear model was used to analyze the correlation between sleep habits, sleep-gene interaction and ischemic stroke. RESULTS A total of 4 648 subjects with an average age of (58.5±8.7) years were enrolled, including 1 316 patients with ischemic stroke. Compared with non-stroke patients, stroke patients with sleep duration ≥9 hours, sleep efficiency < 80%, and sleep onset timing earlier than 22:00 accounted for a higher proportion (P < 0.05). There was no significant association between sleep duration and risk of ischemic stroke (OR=1.04, 95%CI: 0.99-1.10, P=0.085). Sleep efficiency was inversely associated with the risk of ischemic stroke (OR=0.18, 95%CI: 0.06-0.53, P=0.002). The risk of ischemic stroke in the subjects with sleep efficiency < 80% was 1.47-fold (95%CI: 1.03-2.10, P=0.033) of that in the subjects with sleep efficiency ≥80%. Falling asleep earlier than 22:00 was associated with 1.26 times greater risk of stroke than falling asleep between 22:00 and 22:59 (95%CI: 1.04-1.52, P=0.017). Multifactorial adjustment model showed that rs579459 on ABO gene had an interaction with sleep time (P for interaction =0.040). When there were two T alleles for rs579459 on the ABO gene, those who fell asleep before 22:00 had 1.56 times (95%CI: 1.20-2.04, P=0.001) the risk of stroke compared with those who fell asleep between 22:00 and 22:59, and there was no significant difference when the number of pathogenic alleles was 0 or 1. In the model adjusted only for gender, age and family structure, sleep duration and the number of T allele rs2634074 on PITX2 gene had an interaction with ischemic stroke (P for interaction=0.033). CONCLUSION Decreased sleep efficiency is associated with increased risk of ischemic stroke, and falling asleep earlier than 22:00 is associated with higher risk of ischemic stroke. Sleep onset timing interacted with rs579459 in ABO gene and the risk of ischemic stroke. Sleep duration and PITX2 rs2634074 may have a potential interaction with ischemic stroke risk.
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Affiliation(s)
- 若彤 杨
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 梦莹 王
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 春男 李
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 欢 于
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 小文 王
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 俊慧 吴
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 斯悦 王
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 伽婷 王
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 大方 陈
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 涛 吴
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 永华 胡
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
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杨 若, 王 梦, 李 春, 于 欢, 王 小, 吴 俊, 王 斯, 王 伽, 陈 大, 吴 涛, 胡 永. [Interaction between ischemic stroke risk loci identified by genome-wide association studies and sleep habits]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2022; 54:412-420. [PMID: 35701116 PMCID: PMC9197694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Indexed: 08/30/2024]
Abstract
OBJECTIVE To explore the relationship between sleep habits (sleep duration, sleep efficiency, sleep onset timing) and ischemic stroke, and whether there is an interaction between sleep habits and ischemic stroke susceptibility gene loci. METHODS A questionnaire survey, physical examination, blood biochemical testing and genotyping were conducted among rural residents in Beijing, and the gene loci of ischemic stroke suggested by previous genome-wide association studies (GWAS) were screened. Multivariable generalized linear model was used to analyze the correlation between sleep habits, sleep-gene interaction and ischemic stroke. RESULTS A total of 4 648 subjects with an average age of (58.5±8.7) years were enrolled, including 1 316 patients with ischemic stroke. Compared with non-stroke patients, stroke patients with sleep duration ≥9 hours, sleep efficiency < 80%, and sleep onset timing earlier than 22:00 accounted for a higher proportion (P < 0.05). There was no significant association between sleep duration and risk of ischemic stroke (OR=1.04, 95%CI: 0.99-1.10, P=0.085). Sleep efficiency was inversely associated with the risk of ischemic stroke (OR=0.18, 95%CI: 0.06-0.53, P=0.002). The risk of ischemic stroke in the subjects with sleep efficiency < 80% was 1.47-fold (95%CI: 1.03-2.10, P=0.033) of that in the subjects with sleep efficiency ≥80%. Falling asleep earlier than 22:00 was associated with 1.26 times greater risk of stroke than falling asleep between 22:00 and 22:59 (95%CI: 1.04-1.52, P=0.017). Multifactorial adjustment model showed that rs579459 on ABO gene had an interaction with sleep time (P for interaction =0.040). When there were two T alleles for rs579459 on the ABO gene, those who fell asleep before 22:00 had 1.56 times (95%CI: 1.20-2.04, P=0.001) the risk of stroke compared with those who fell asleep between 22:00 and 22:59, and there was no significant difference when the number of pathogenic alleles was 0 or 1. In the model adjusted only for gender, age and family structure, sleep duration and the number of T allele rs2634074 on PITX2 gene had an interaction with ischemic stroke (P for interaction=0.033). CONCLUSION Decreased sleep efficiency is associated with increased risk of ischemic stroke, and falling asleep earlier than 22:00 is associated with higher risk of ischemic stroke. Sleep onset timing interacted with rs579459 in ABO gene and the risk of ischemic stroke. Sleep duration and PITX2 rs2634074 may have a potential interaction with ischemic stroke risk.
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Affiliation(s)
- 若彤 杨
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 梦莹 王
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 春男 李
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 欢 于
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 小文 王
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 俊慧 吴
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 斯悦 王
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 伽婷 王
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 大方 陈
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 涛 吴
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 永华 胡
- />北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
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Grandner MA. Sleep, Health, and Society. Sleep Med Clin 2022; 17:117-139. [DOI: 10.1016/j.jsmc.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Akbarpour E, Paridar Y, Mohammadi Z, Mard A, Danehchin L, Abolnezhadian F, Azadpour S, Rahimi Z, Zamani M, Cheraghian B, Poustchi H, Shayesteh AA. Anemia prevalence, severity, types, and correlates among adult women and men in a multiethnic Iranian population: the Khuzestan Comprehensive Health Study (KCHS). BMC Public Health 2022; 22:168. [PMID: 35073904 PMCID: PMC8787906 DOI: 10.1186/s12889-022-12512-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/05/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Despite all recent health-related improvements, anemia remains an extensive global public health issue affecting the lives of about one-fourth of the world population in a geographically heterogeneous pattern. We, therefore, aimed to illustrate the prevalence, severity, most common types, and major determinants of anemia among adults in Khuzestan, Iran, from 2016 to 2019. METHODS In a large population-based cross-sectional study comprising of a diverse population, each participant underwent a questionnaire-based interview and laboratory testing for hematological analysis. A hemoglobin (HGB) concentration of < 12 g/dL in non-pregnant women and < 13 g/dL in men were defined anemic. The multivariate logistic regression analysis was performed to explore the association between anemia and its potential determinants. RESULTS Data on 29,550 (96.87%) males and non-pregnant females between 20-65 years of age (mean age: 41.90 ± 11.88 years; female sex: 63.58%; Arab ethnicity: 48.65%), whose HGB level was available, were included in the study. The mean ± SD HGB concentration was 13.75 ± 1.65 g/dL. The age- and sex-standardized prevalence rate of anemia was 10.86% (95% CI: 10.51-11.23%). The most prevalent degree was mild anemia (7.71%, 95% CI: 7.40-8.03%) and only 0.17% were severely anemic. Of those considered anemic, the highest proportion was related to normochromic/microcytic (50.65%), followed by hypochromic/microcytic (30.29%). In the multiple logistic regression, the parameters of female gender (OR: 3.17, 95% CI: 2.68-3.76), age group of 35-49 years (OR: 1.66, 95% CI: 1.52-1.82), being underweight (OR: 1.58, 95% CI: 1.29-1.93), being unemployed or retired (OR: 1.55, 95% CI: 1.33-1.81), and living in urban areas (OR: 1.18, 95% CI: 1.09-1.29) were major determinants of anemia. Additionally, we observed a minor but significant positive association between anemia status and CKD, older ages, increased night sleep duration, being a housewife and married, as well as a negative association between anemia and factors including hookah smoking, presence of metabolic syndrome, and overweight and obesity. CONCLUSIONS Taken together, the anemia prevalence in this study population was of mild public health significance. The major suspected causes might be iron deficiency and chronic disease anemias. Comparably higher rates of anemia were observed amongst women, individuals aged 35-49 years, underweights, unemployed or retired subjects, and urban residents.
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Affiliation(s)
- Elham Akbarpour
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, N. Kargar St., 14117 Tehran, Iran
| | - Yousef Paridar
- School of Medicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Zahra Mohammadi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, N. Kargar St., 14117 Tehran, Iran
| | - Ali Mard
- Alimentary Tract Research Center, Imam Khomeini Hospital Clinical Research Development Unit, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | | | | | - Zahra Rahimi
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Zamani
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahman Cheraghian
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, N. Kargar St., 14117 Tehran, Iran
| | - Ali-Akbar Shayesteh
- Alimentary Tract Research Center, Imam Khomeini Hospital Clinical Research Development Unit, Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Gastroenterology Department, Imam Khomeini Hospital, Azadegan Ave, Ahvaz, Iran
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Gao C, Guo J, Gong TT, Lv JL, Li XY, Liu FH, Zhang M, Shan YT, Zhao YH, Wu QJ. Sleep Duration/Quality With Health Outcomes: An Umbrella Review of Meta-Analyses of Prospective Studies. Front Med (Lausanne) 2022; 8:813943. [PMID: 35127769 PMCID: PMC8811149 DOI: 10.3389/fmed.2021.813943] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 12/27/2021] [Indexed: 12/14/2022] Open
Abstract
Background To quantitatively evaluate the evidence of duration and quality of sleep as measured by multiple health outcomes. Methods This review is registered with PROSPERO, number CRD42021235587. We systematically searched three databases from inception until November 15, 2020. For each meta-analysis, the summary effect size using fixed and random effects models, the 95% confidence interval, and the 95% prediction interval were assessed; heterogeneity, evidence of small-study effects, and excess significance bias were also estimated. According to the above metrics, we evaluated the credibility of each association. Results A total of 85 meta-analyses with 36 health outcomes were included in the study. We observed highly suggestive evidence for an association between long sleep and an increased risk of all-cause mortality. Moreover, suggestive evidence supported the associations between long sleep and 5 increased risk of health outcomes (stroke, dyslipidaemia, mortality of coronary heart disease, stroke mortality, and the development or death of stroke); short sleep and increased risk of overweight and/or obesity; poor sleep quality and increased risk of diabetes mellitus and gestational diabetes mellitus. Conclusions Only the evidence of the association of long sleep with an increased risk of all-cause mortality was graded as highly suggestive. Additional studies are needed to be conducted. Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021235587
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Affiliation(s)
- Chang Gao
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jiao Guo
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Ting-Ting Gong
| | - Jia-Le Lv
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xin-Yu Li
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fang-Hua Liu
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Meng Zhang
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yi-Tong Shan
- Department of Statistics, University of Washington, Seattle, WA, United States
| | - Yu-Hong Zhao
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Qi-Jun Wu
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Sleep Health among Racial/Ethnic groups and Strategies to achieve Sleep Health Equity. Respir Med 2022. [DOI: 10.1007/978-3-030-93739-3_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Observational and genetic evidence highlight the association of human sleep behaviors with the incidence of fracture. Commun Biol 2021; 4:1339. [PMID: 34837057 PMCID: PMC8626439 DOI: 10.1038/s42003-021-02861-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 11/05/2021] [Indexed: 12/19/2022] Open
Abstract
We combined conventional evidence from longitudinal data in UK Biobank and genetic evidence from Mendelian randomization (MR) approach to infer the causality between sleep behaviors and fracture risk. We found that participants with insomnia showed 6.4% higher risk of fracture (hazard ratio [HR] = 1.064, 95% CI = 1.038-1.090, P = 7.84 × 10-7), falls and bone mineral density (BMD) mediated 24.6% and 10.6% of the intermediary effect; the MR analyses provided the consistent evidence. A U-shape relationship was observed between sleep duration and fracture risk (P < 0.001) with the lowest risk at sleeping 7-8 h per day. The excessive daytime sleepiness and "evening" chronotype were associated with fracture risk in observational study, but the association between chronotype and fracture did not show in MR analyses. We further generated a sleep risk score (SRS) with potential risk factors (i.e., insomnia, sleep duration, chronotype, and daytime sleepiness). We found that the risk of fracture increased with an increasing SRS (HR = 1.087, 95% CI = 1.065-1.111, P = 1.27 × 10-14). Moreover, 17.4% of the fracture cases would be removed if all participants exhibited a healthy sleep pattern. In conclusion, insomnia had a causal effect on fracture, falls had a larger intermediary effect than BMD in this association. Individuals with fracture risk could benefit from the intervention on unhealthy sleep pattern.
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Peng P, Chen Z, Zhang X, Guo Z, Dong F, Xu Y, He Y, Guo D, Wan F. Investigating Causal Relationships Between Psychiatric Traits and Intracranial Aneurysms: A Bi-directional Two-Sample Mendelian Randomization Study. Front Genet 2021; 12:741429. [PMID: 34737764 PMCID: PMC8560679 DOI: 10.3389/fgene.2021.741429] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/07/2021] [Indexed: 11/26/2022] Open
Abstract
Background Despite psychiatric traits were associated with intracranial aneurysms (IAs) in observational studies, their causal relationships remain largely undefined. We aimed to assess the causality between psychiatric traits and IAs. Methods We firstly collected the genome-wide association statistics of IAs (sample size, n = 79,429) and ten psychiatric traits from Europeans, including insomnia (n = 1,331,010), mood instability (n = 363,705), anxiety disorder (n = 83,566), major depressive disorder (MDD) (n = 480,359), subjective wellbeing (n = 388,538), attention deficit/hyperactivity disorder (ADHD) (n = 53,293), autism spectrum disorder (ASD) (n = 46,350), bipolar disorder (BIP) (n = 51,710), schizophrenia (SCZ) (n = 105,318), and neuroticism (n = 168,105). We then conducted a series of bi-directional two-sample Mendelian randomization (MR) analyses, of which the Robust Adjusted Profile Score (RAPS) was the primary method to estimate the causal effects between these psychiatric traits and IAs. Results We found that insomnia exhibited a significant risk effect on IAs with the odds ratio (OR) being 1.22 (95% CI: 1.11–1.34, p = 4.61 × 10–5) from the RAPS method. There was suggestive evidence for risk effect of mood instability on IAs (RAPS, OR = 4.16, 95% CI: 1.02–17.00, p = 0.047). However, no clear evidence of causal effects on IAs for the rest eight psychiatric traits (anxiety disorder, MDD, subjective wellbeing, ADHD, ASD, BIP, SCZ, and neuroticism) was identified. In the reverse MR analyses, no causal effects of IAs on psychiatric traits were found. Conclusions Our findings provide strong evidence for a causal risk effect of insomnia on IAs and suggestive evidence for mood instability as a causal risk effect on IAs. These results could inform the prevention and clinical intervention of IAs.
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Affiliation(s)
- Peng Peng
- Department of Neurosurgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zirong Chen
- Department of Neurosurgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaolin Zhang
- Department of Neurosurgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhongyin Guo
- Department of Neurosurgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fangyong Dong
- Department of Neurosurgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Xu
- Department of Neurosurgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yue He
- Department of Neurosurgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dongsheng Guo
- Department of Neurosurgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Feng Wan
- Department of Neurosurgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Abstract
Sleep is entwined across many physiologic processes in the brain and periphery, thereby exerting tremendous influence on our well-being. Yet sleep exists in a social-environmental context. Contextualizing sleep health with respect to its determinants—from individual- to societal-level factors—would enable neuroscientists to more effectively translate sleep health into clinical practice. Key challenges and opportunities pertain to (i) recognizing and exploring sleep’s functional roles, (ii) clarifying causal mechanisms in relation to key outcomes, (iii) developing richer model systems, (iv) linking models to known contextual factors, and (v) leveraging advances in multisensory technology. Meeting these challenges and opportunities would help transcend disciplinary boundaries such that social-environmental considerations related to sleep would become an ever-greater presence in the clinic.
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Affiliation(s)
- Michael A. Grandner
- Department of Psychiatry, University of Arizona College of Medicine – Tucson, 1501 N. Campbell Ave., Suite AHSC 7326, Tucson, AZ 85724, USA
| | - Fabian-Xosé Fernandez
- Department of Psychology, University of Arizona College of Science, 1503 E. University Blvd., Room 507, Tucson, AZ 85721, USA
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Xu Q, Wu K, Yang Y, Chang R, Qiu H, Wang Y, Lin T, Fu C, Chen Y, Wang N, Ruan X. Association Between Sleep Quality and Pain Intensity in Mild Patients with COPD: A Community Study. J Pain Res 2021; 14:2641-2649. [PMID: 34471380 PMCID: PMC8403565 DOI: 10.2147/jpr.s310036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/22/2021] [Indexed: 01/21/2023] Open
Abstract
Purpose Poor sleep quality and pain were common and had been proved as an important influenced factor of quality of life for patients with COPD. The association of sleep quality with pain has been observed in other population but remains unclear in mild patients with COPD from a community setting. Methods A cross-sectional study was conducted to include eligible mild patients with COPD in Pudong New District of Shanghai. A structured questionnaire was used to collect general and clinical information for the patients. The Chinese version of Pittsburgh Sleep Quality Index (PSQI) and the short form of McGill Pain Questionnaire (SF-MPQ) was used to assess sleep quality and intensity of pain. Logistic regression was performed to test the association between sleeping quality and pain intensity. Results Two hundred and sixty-four patients with COPD, with an average age of 64 years (SD 5.78 years), were enrolled, and of 52% were women. Seventy-one (26.9%) participants reported at least one exacerbation during the past year. About 28.2% of the patients were classified as having poor sleep quality. Sleep quality was significantly associated with PRI score (adjusted odds ratio (ORad)=2.16, 95% CI: 1.16–4.00) and PPI rank (ORad=1.90, 95% CI: 1.08–3.34). People with daytime disturbance were more likely to have pain (ORad =2.03, 95% CI: 1.18–3.50). Conclusion Poor sleep quality was common in mild patients with COPD in community and was associated with higher pain intensity. Pain may involve an impairment of sleep quality.
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Affiliation(s)
- Qian Xu
- School of Public Health, Fudan University, Pudong Preventive Medicine Research Institute of Fudan University, Shanghai, 200032, People's Republic of China
| | - Kang Wu
- Pudong New Area Center for Disease Control and Prevention, Pudong Preventive Medicine Research Institute of Fudan University, Shanghai, 200136, People's Republic of China
| | - Yi Yang
- Pudong New Area Center for Disease Control and Prevention, Pudong Preventive Medicine Research Institute of Fudan University, Shanghai, 200136, People's Republic of China
| | - Rui Chang
- School of Public Health, Fudan University, Pudong Preventive Medicine Research Institute of Fudan University, Shanghai, 200032, People's Republic of China
| | - Hua Qiu
- Pudong New Area Center for Disease Control and Prevention, Pudong Preventive Medicine Research Institute of Fudan University, Shanghai, 200136, People's Republic of China
| | - Yingying Wang
- School of Public Health, Fudan University, Pudong Preventive Medicine Research Institute of Fudan University, Shanghai, 200032, People's Republic of China
| | - Tao Lin
- Pudong New Area Center for Disease Control and Prevention, Pudong Preventive Medicine Research Institute of Fudan University, Shanghai, 200136, People's Republic of China
| | - Chaowei Fu
- School of Public Health, Fudan University, Pudong Preventive Medicine Research Institute of Fudan University, Shanghai, 200032, People's Republic of China
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Na Wang
- School of Public Health, Fudan University, Pudong Preventive Medicine Research Institute of Fudan University, Shanghai, 200032, People's Republic of China
| | - Xiaonan Ruan
- Pudong New Area Center for Disease Control and Prevention, Pudong Preventive Medicine Research Institute of Fudan University, Shanghai, 200136, People's Republic of China
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Li J, Cao D, Huang Y, Chen Z, Wang R, Dong Q, Wei Q, Liu L. Sleep duration and health outcomes: an umbrella review. Sleep Breath 2021; 26:1479-1501. [PMID: 34435311 DOI: 10.1007/s11325-021-02458-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/18/2021] [Accepted: 07/28/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE To collect existing evidence on the relationship between sleep duration and health outcomes. METHODS A thorough search was conducted in PubMed, Web of Science, Embase, and the Cochrane Database of Systematic Reviews from inception to January, 2021. Meta-analyses of observational and interventional studies were eligible if they examined the associations between sleep duration and human health. RESULTS In total, this umbrella review identified 69 meta-analyses with 11 outcomes for cancers and 30 outcomes for non-cancer conditions. Inappropriate sleep durations may significantly elevate the risk for cardiovascular disease (CVD), cognitive decline, coronary heart disease (CHD), depression, falls, frailty, lung cancer, metabolic syndrome (MS), and stroke. Dose-response analysis revealed that a 1-h reduction per 24 hours is associated with an increased risk by 3-11% of all-cause mortality, CHD, osteoporosis, stroke, and T2DM among short sleepers. Conversely, a 1-h increment in long sleepers is associated with a 7-17% higher risk of stroke mortality, CHD, stroke, and T2DM in adults. CONCLUSION Inappropriate sleep duration is a risk factor for developing non-cancer conditions. Decreasing and increasing sleep hours towards extreme sleep durations are associated with poor health outcomes.
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Affiliation(s)
- Jin Li
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Dehong Cao
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Yin Huang
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Zeyu Chen
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Ruyi Wang
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Qiang Dong
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Qiang Wei
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China.
| | - Liangren Liu
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China.
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Astronauts well-being and possibly anti-aging improved during long-duration spaceflight. Sci Rep 2021; 11:14907. [PMID: 34290387 PMCID: PMC8295322 DOI: 10.1038/s41598-021-94478-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/12/2021] [Indexed: 02/06/2023] Open
Abstract
This study assesses how circadian rhythms of heart rate (HR), HR variability (HRV) and activity change during long-term missions in space and how they relate to sleep quality. Ambulatory 48-h ECG and 96-h actigraphy were performed four times on ten healthy astronauts (44.7 ± 6.9 years; 9 men): 120.4 ± 43.7 days (Before) launch; 21.1 ± 2.5 days (ISS01) and 143.0 ± 27.1 days (ISS02) after launch; and 86.6 ± 40.6 days (After) return to Earth. Sleep quality was determined by sleep-related changes in activity, RR-intervals, HRV HF- and VLF-components and LF-band. The circadian amplitude of HR (HR-A) was larger in space (ISS01: 12.54, P = 0.0099; ISS02: 12.77, P = 0.0364) than on Earth (Before: 10.90; After: 10.55 bpm). Sleep duration in space (ISS01/ISS02) increased in 3 (Group A, from 370.7 to 388.0/413.0 min) and decreased in 7 (Group B, from 454.0 to 408.9/381.6 min) astronauts. Sleep quality improved in Group B from 7.07 to 8.36 (ISS01) and 9.36 (ISS02, P = 0.0001). Sleep-related parasympathetic activity increased from 55.2% to 74.8% (pNN50, P = 0.0010) (ISS02). HR-A correlated with the 24-h (r = 0.8110, P = 0.0044), 12-h (r = 0.6963, P = 0.0253), and 48-h (r = 0.6921, P = 0.0266) amplitudes of the magnetic declination index. These findings suggest associations of mission duration with increased well-being and anti-aging benefitting from magnetic fluctuations.
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Bowman MA, Kline CE, Buysse DJ, Kravitz HM, Joffe H, Matthews KA, Bromberger JT, Roecklein KA, Krafty RT, Hall MH. Longitudinal Association Between Depressive Symptoms and Multidimensional Sleep Health: The SWAN Sleep Study. Ann Behav Med 2021; 55:641-652. [PMID: 33410460 PMCID: PMC8240133 DOI: 10.1093/abm/kaaa107] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Depressive symptoms and sleep disturbances disproportionately affect midlife women. While there may be a bidirectional association, few studies have examined whether depressive symptoms are longitudinally associated with subsequent sleep. Sleep is typically considered unidimensional, despite emerging evidence that multidimensional sleep health provides novel information on the sleep-health link. PURPOSE The current study examined whether higher depressive symptoms were longitudinally associated with poorer multidimensional sleep health. METHOD Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale across six to nine annual assessments in 302 midlife women from the Study of Women's Health Across the Nation. Six months after their last assessment, actigraphy (mean ± standard deviation = 29.3 ± 6.9 days) and self-report were used to assess sleep health components: efficiency, duration, mid-sleep timing, regularity, alertness, and satisfaction, which were dichotomized and summed to create a composite multidimensional sleep health score. Mixed-effects models were used to evaluate the longitudinal associations between depressive symptoms and multidimensional sleep health, as well as individual sleep health components, adjusting for covariates. Exploratory analyses stratified models by race/ethnicity. RESULTS Higher depressive symptoms were associated with subsequent poorer multidimensional sleep health (p < .0.001) and lower alertness (p < .0001) and satisfaction with sleep (p < .0001). CONCLUSIONS Our finding that higher average depressive symptoms were associated longitudinally with actigraphy-measured poorer sleep health in midlife women is novel and converges with the larger body of evidence that these two common symptoms are strongly associated. The bidirectional relationship between these two prevalent symptoms needs to be studied in prospective longitudinal studies.
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Affiliation(s)
- Marissa A Bowman
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Christopher E Kline
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Howard M Kravitz
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Hadine Joffe
- Connors Center for Women’s Health and Gender Biology and the Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Karen A Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joyce T Bromberger
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Robert T Krafty
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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Wang L, Li J, Wang Z, Du Y, Sun T, Na L, Niu Y. Social capital and cognitive decline: Does sleep duration mediate the association? PLoS One 2021; 16:e0252208. [PMID: 34043692 PMCID: PMC8158899 DOI: 10.1371/journal.pone.0252208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 05/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background Studies have found that social capital (SC) is associated with the risk of cognitive decline; however, the mechanism explaining how SC leads to cognitive decline is unclear. The current study examines the mediation effect of sleep duration on the relationship between SC and cognitive decline in Chinese older adults. Methods A cross-sectional study of 955 community-dwelling aged 60 or over was conducted. The mini-mental state examination (MMSE), self-report sleep duration questionnaire, and social capital scales were administered during the face-to-face survey. The Bootstrap methods PROCESS program is employed to test the mediation model. Results After controlling for covariates, both social cohesion and social interaction were positively correlated with the MMSE score (p<0.001), and social cohesion was negatively correlated with sleep duration (p = 0.009); On the contrary, sleep duration was negatively correlated with MMSE score (p<0.001). Linear regression analysis showed social cohesion was positively associated with the MMSE score (β = 0.16, p = 0.005), while sleep duration was associated with an increased risk of cognitive decline (β = -0.72, p<0.001). Sleep duration has mediated the relationship between social cohesion and cognitive decline (explaining 21.7% of the total variance). Conclusions Social capital negatively associated with the risk of cognitive decline in this Chinese population, and sleep duration may partly explain this relationship. It may be a suggestive clue to identify those at a higher risk of progressing to cognitive impairment. Further prospective study in need to confirm this finding due to the cross-sectional design.
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Affiliation(s)
- Liqun Wang
- Department of Epidemiology and Statistics, School of Public Health and Management at Ningxia Medical University, Yinchuan, China
| | - Jiangping Li
- Department of Epidemiology and Statistics, School of Public Health and Management at Ningxia Medical University, Yinchuan, China
| | - Zhizhong Wang
- Department of Epidemiology and Statistics at School of Public Health of Guangdong Medical University, Dongguan, China
| | - Yong Du
- Surgical Laboratory of General Hospital, Ningxia Medical University, Yinchuan, China.,School of Clinical Medicine at Ningxia Medical University, Yinchuan, China
| | - Ting Sun
- Surgical Laboratory of General Hospital, Ningxia Medical University, Yinchuan, China
| | - Li Na
- Surgical Laboratory of General Hospital, Ningxia Medical University, Yinchuan, China
| | - Yang Niu
- Key Laboratory of the Ningxia Ethnomedicine Modernization, Ministry of Education, Ningxia Medical University, Yinchuan, China.,School of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, China
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Pre-stroke habitual prolonged sleep as a predictor for post-stroke sleep quality, stroke-related quality of life, and lifestyle values. J Clin Neurosci 2021; 90:26-31. [PMID: 34275560 DOI: 10.1016/j.jocn.2021.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 04/11/2021] [Accepted: 05/02/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Prolonged sleep is a higher stroke risk, but post-stroke prolonged sleep facilitates stroke recovery. No study has explored the relationship between pre- and post-stroke prolonged sleep and their involvement in stroke-related quality of life (QOL).This study aimed to clarify the role of pre- and post-stroke prolonged sleep in QOL and sleep quality during hospitalization. METHODS Fifty-one subacute stroke inpatients were enrolled. QOL was assessed by the Stroke and Aphasia QOL Scale-39-J. Sleep quality and lifestyle values were assessed by original questionnaires. RESULTS Patients in pre-stroke prolonged sleep > 8 h had a higher incidence of post-stroke poor sleep quality than those belonging to the normal or shorter hours (OR 5.33, 95% CI 1.30-21.84, p = 0.047). In addition, pre-stroke prolonged sleep was associated with lower scores of psychosocial QOL and lifestyle values of "accepting disability; caring about what other people think of what you do". In contrast, post-stroke prolonged sleep was associated with the lower risk of post-stroke poor sleep quality (OR 0.27, 95% CI 0.08-0.86, p = 0.045). Post-stroke high sleep quality had higher (better) scores of physical and energy QOL, and lifestyle values of "caring about what other people think of what you do; having some places to go out after discharge" compared with post-stroke poor sleep quality. Post-stroke prolonged sleep was derived from pre-stroke not prolonged sleep rather than pre-stroke prolonged sleep (p = 0.039, Chi-square test). CONCLUSIONS Pre-stroke prolonged sleep is associated with a higher incidence of post-stroke poor sleep quality and lower scores of QOL and lifestyle values after stroke.
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Ahn S, Lobo JM, Logan JG, Kang H, Kwon Y, Sohn MW. A scoping review of racial/ethnic disparities in sleep. Sleep Med 2021; 81:169-179. [PMID: 33713923 DOI: 10.1016/j.sleep.2021.02.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 02/08/2021] [Accepted: 02/11/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Despite remarkable achievements in ensuring health equity, racial/ethnic disparities in sleep still persist and are emerging as a major area of concern. Accumulating evidence has not yet been well characterized from a broad perspective. We conducted a scoping review of studies on sleep disparities by race/ethnicity to summarize characteristics of existing studies and identify evidence gaps. METHODS We searched PubMed, CINAHL, PsycINFO, and Web of Science databases for studies of racial/ethnic disparities in sleep. Studies that met inclusion criteria were retrieved and organized in a data charting form by study design, sleep measuring methods, sleep features, and racial/ethnic comparisons. RESULTS One hundred sixteen studies were included in this review. Most studies focused on disparities between Whites and Blacks. Disproportionately fewer studies examined disparities for Hispanic, Asian, and other racial/ethnic groups. Self-reported sleep was most frequently used. Sleep duration, overall sleep quality, and sleep disordered breathing were frequently studied, whereas other features including sleep efficiency, latency, continuity, and architecture were understudied, particularly in racial minority groups in the US. Current study findings on racial/ethnic disparities in most of sleep features is mixed and inconclusive. CONCLUSIONS This review identified significant evidence gaps in racial/ethnic disparities research on sleep. Our results suggest a need for more studies examining diverse sleep features using standardized and robust measuring methods for more valid comparisons of sleep health in diverse race/ethnicity groups.
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Affiliation(s)
- Soojung Ahn
- School of Nursing, University of Virginia, Charlottesville, VA, USA
| | - Jennifer M Lobo
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Jeongok G Logan
- School of Nursing, University of Virginia, Charlottesville, VA, USA
| | - Hyojung Kang
- College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Younghoon Kwon
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Min-Woong Sohn
- Department of Health Management and Policy, College of Public Health, University of Kentucky, Lexington, KY, USA.
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Chun MY, Kim JH, Kang JS. Relationship between Self-Reported Sleep Duration and Risk of Anemia: Data from the Korea National Health and Nutrition Examination Survey 2016-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094721. [PMID: 33925225 PMCID: PMC8124661 DOI: 10.3390/ijerph18094721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/25/2021] [Accepted: 04/27/2021] [Indexed: 12/18/2022]
Abstract
The importance of sleep has been gaining more and more attention nowadays. It has been widely studied that some major health issues, such as cardiovascular diseases or mortality, are closely related to the extreme ends of sleep durations. Anemia is one of the health problems in modern society. In this study, we aimed to find a relationship between anemia occurrence and sleep duration. Data of 11,131 Korean adults aged 19 years or older were recruited from the 2016-2017 Korea National Health and Nutrition Examination Survey and analyzed in this cross-sectional study. 'Anemia' was defined in this study by hemoglobin level of <13 g/dL in men and <12 g/dL in women. Selected data were sorted into five groups by sleep duration: <5 h, 5 h ~ <6 h, 6 h ~ <8 h, 8 h ~ <9 h, and ≥9 h per day. We performed multivariate logistic regression analysis to assess the relationship between sleep duration and risk of anemia after adjusting for covariates including age, gender, family income level, education level, physical activity, cigarette smoking, and alcohol usage. Other factors were assessed in the analysis, such as depression, hypertension, diabetes, dyslipidemia, stroke, coronary artery disease, malignancy, stress level, and body mass index (BMI). We found that sleep duration of <5 h was related to high risk of anemia (odds ratio = 1.87; 95% confidence interval = 1.01-3.49, sleep duration of 6 h ~ <8 h as the reference group). Also, sleep duration of ≥9 h was related to lower risk of anemia in most premenopausal women after adjusting for covariates (odds ratio = 0.61; 95% confidence interval = 0.38-0.96, sleep duration of 6 h ~ < 8 h as the reference group). Male individuals with sleep durations of <5 h (odds ratio = 2.01; 95% confidence interval =1.05-3.84) and of ≥9 h (odds ratio = 2.48; 95% confidence interval =1.63-3.81) had a significantly higher risk of anemia without covariate adjustment. Postmenopausal women with sleep durations of ≥9 h had a significantly higher risk of anemia (odds ratio =2.02; 95% confidence interval =1.33-3.08) without adjusting for covariates. However, the associations became statistically insignificant after adjusting for age and covariates in both men and postmenopausal women. In conclusion, we found significant associations between extreme ends of sleep duration and risk of anemia in premenopausal Korean women. However, we did not observe strong associations between self-reported sleep duration and anemia risk in men or postmenopausal women.
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Affiliation(s)
- Min-Young Chun
- School of Biopharmaceutical and Medical Science, Sungshin Women’s University, Seoul 01133, Korea;
- Department of Pharmacology & Clinical Pharmacology Lab, College of Medicine, Hanyang University, Seoul 04763, Korea
| | - Jeong-hoon Kim
- College of Medicine, American University of Antigua, University Park, Jabberwock Beach Road, Coolidge PO Box w 1451, Antigua and Barbuda;
| | - Ju-Seop Kang
- Department of Pharmacology & Clinical Pharmacology Lab, College of Medicine, Hanyang University, Seoul 04763, Korea
- Correspondence: ; Tel.: +82-22-220-0652; Fax: +82-22-292-6686
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Ghani SB, Begay TK, Grandner MA. Sleep-disordered Breathing and Insomnia as Cardiometabolic Risk Factors among U.S. Hispanics/Latinx(s). Am J Respir Crit Care Med 2021; 203:285-286. [PMID: 32916057 PMCID: PMC7874316 DOI: 10.1164/rccm.202008-3171ed] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Sadia B Ghani
- Sleep and Health Research Program University of Arizona College of Medicine Tucson, Arizona
| | - Tommy K Begay
- Sleep and Health Research Program University of Arizona College of Medicine Tucson, Arizona
| | - Michael A Grandner
- Sleep and Health Research Program University of Arizona College of Medicine Tucson, Arizona
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Qazi T, Smith A, Alexander M, Hammer D, Wu T, Auerbach S, Noronha A, Wasan S, Jones E, Weinberg J, Farraye FA. Disparities in Objective Sleep Quality as Assessed Through Wrist Actigraphy in Minority Patients With Inflammatory Bowel Disease. Inflamm Bowel Dis 2021; 27:371-378. [PMID: 32448906 DOI: 10.1093/ibd/izaa106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Indexed: 12/09/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is associated with a reduced quality of life. Minority patients with IBD specifically report more impairing symptoms compared with nonminority patients. Sleep quality, a key component of quality of life, is significantly compromised in minority patients compared with nonminority patients. Nevertheless, subjective and objective sleep assessments in minority patients with IBD have not explicitly been assessed. The purpose of this prospective cohort study is to assess and compare objective sleep parameters utilizing wrist actigraphy between minority and nonminority IBD patients. METHODS In this institutional review board approved study, 74 patients with IBD were recruited and stratified into 2 cohorts by self-identification: white nonminority patients and minority patients. Patients in the minority cohort included black and Hispanic individuals (black and nonblack). Exclusion criteria included significant comorbidity, a history of an underlying sleep disorder, or patients who did not self-identify into categorized cohorts. Sleep was measured not only through wrist-based actigraphy but also with sleep surveys. Sleep parameters were compared between minority and nonminority cohorts. Regression analyses were performed to assess for factors independently associated with parameters of poor sleep quality. RESULTS Sixty-four patients (86.4%) were included in the final analysis. Thirty-one individuals (48.4%) were categorized into the nonminority cohort, and 33 (51.6%) patients were in the minority cohort. A significantly higher number of minority patients had poorer sleep efficiency and fragmented sleep compared with nonminority patients (90.9% vs 67.7%; P = 0.03 and 87.8% vs 61.3%; P = 0.02). In the adjusted analysis, minority status was independently associated with poor sleep efficiency (odds ratio = 6.41; 95% confidence interval, 1.48-28.17; P = 0.0139) and fragmented sleep (odds ratio = 4.98; 95% confidence interval, 1.09-22.89; P = 0.0389). CONCLUSIONS Minority patients with IBD were shown to have poorer objective measures of sleep as assessed through wrist actigraphy compared to nonminority patients. Cultural competency in the care of minority patients with IBD, specifically focusing on the management of psychosocial issues, is needed to address these disparities in sleep. The inclusion of minority patients with IBD in studies investigating sleep and other psychosocial issues are warranted not only to assess potential disparities in disease course but also to determine the etiologies of poor sleep in minority patients with IBD.
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Affiliation(s)
- Taha Qazi
- Cleveland Clinic, Digestive Disease and Surgery Institute, Cleveland, Ohio, USA
| | - Alexander Smith
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Megan Alexander
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - David Hammer
- Department of Neurology, Boston University School of Medicine and Sleep Disorders Center, Boston Medical Center, Boston, Massachusetts, USA
| | - Ting Wu
- Department of Neurology, Boston University School of Medicine and Sleep Disorders Center, Boston Medical Center, Boston, Massachusetts, USA
| | - Sanford Auerbach
- Department of Neurology, Boston University School of Medicine and Sleep Disorders Center, Boston Medical Center, Boston, Massachusetts, USA
| | - Ansu Noronha
- Section of Gastroenterology, Boston Medical Center, Boston, Massachusetts, USA
| | - Sharmeel Wasan
- Section of Gastroenterology, Boston Medical Center, Boston, Massachusetts, USA
| | - Eric Jones
- Boston University School of Public Health, Department of Biostatistics, Boston, Massachusetts, USA
| | - Janice Weinberg
- Boston University School of Public Health, Department of Biostatistics, Boston, Massachusetts, USA
| | - Francis A Farraye
- Section of Gastroenterology, Boston Medical Center, Boston, Massachusetts, USA.,Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
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Ibáñez-del Valle V, Navarro-Martínez R, Ballestar-Tarín ML, Cauli O. Salivary Inflammatory Molecules as Biomarkers of Sleep Alterations: A Scoping Review. Diagnostics (Basel) 2021; 11:diagnostics11020278. [PMID: 33579032 PMCID: PMC7916754 DOI: 10.3390/diagnostics11020278] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/07/2021] [Accepted: 02/08/2021] [Indexed: 12/26/2022] Open
Abstract
Poor sleep quality and sleep disorders are the most common problems in people, affecting health-related quality of life. Various studies show an association between sleep disorders and altered levels of stress hormones and inflammatory cytokines measured in saliva. The main objective of this article is to provide an analysis of the current evidence related to changes in inflammatory markers in the saliva and their associations with sleep quality measurement (both objective and subjective methods) in healthy subjects and in sleep-related disorders. To that end, a scoping review was carried out, following the PRISMA criteria in the bibliographic search in several databases: PubMed, EBSCO, and SCOPUS. Eleven of the articles are from the adult population and two from the child-youth population. They mainly measure the relationship between sleep and interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNFα) alpha, as well as other inflammatory markers such as myeloperoxidase (MPO) and prostaglandin-endoperoxide synthase 2. An analysis shows the relationship between these salivary biomarkers and sleep quality, especially in the case of IL-6 in both healthy subjects and several pathologies associated with sleep-disorders. The results for TNFα and IL-1β measurements are still inconclusive and the difference with IL-6 was assessed. Two studies reported interventions that result in sleep improvement and are accompanied by the normalization of inflammatory changes detected in the saliva. As it is an easy-to-apply and non-invasive method, the measurement of salivary cytokines can be very useful in chronobiology studies. Further studies are required to determine the sensitivity of salivary inflammatory markers in monitoring biological rhythms and acting as biomarkers in the detection of sleep disorders and sleep interventions.
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Affiliation(s)
- Vanessa Ibáñez-del Valle
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, c/Jaume Roig s/n, 46010 Valencia, Spain; (V.I.-d.V.); (R.N.-M.); (M.L.B.-T.)
- Frailty and Cognitive Impairment Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
- Chair of Active Ageing, University of Valencia, 4610 Valencia, Spain
| | - Rut Navarro-Martínez
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, c/Jaume Roig s/n, 46010 Valencia, Spain; (V.I.-d.V.); (R.N.-M.); (M.L.B.-T.)
- Frailty and Cognitive Impairment Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
- Chair of Active Ageing, University of Valencia, 4610 Valencia, Spain
| | - Maria Luisa Ballestar-Tarín
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, c/Jaume Roig s/n, 46010 Valencia, Spain; (V.I.-d.V.); (R.N.-M.); (M.L.B.-T.)
| | - Omar Cauli
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, c/Jaume Roig s/n, 46010 Valencia, Spain; (V.I.-d.V.); (R.N.-M.); (M.L.B.-T.)
- Frailty and Cognitive Impairment Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
- Chair of Active Ageing, University of Valencia, 4610 Valencia, Spain
- Correspondence:
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Motomura Y, Kitamura S, Nakazaki K, Oba K, Katsunuma R, Terasawa Y, Hida A, Moriguchi Y, Mishima K. The Role of the Thalamus in the Neurological Mechanism of Subjective Sleepiness: An fMRI Study. Nat Sci Sleep 2021; 13:899-921. [PMID: 34234596 PMCID: PMC8253930 DOI: 10.2147/nss.s297309] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/26/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The thalamus, the region that forms the attentional network and transmits external sensory signals to the entire brain, is important for sleepiness. Herein, we examined the relationship between activity in the thalamus-seed brain network and subjective sleepiness. MATERIALS AND METHODS Fifteen healthy male participants underwent an experiment comprising a baseline evaluation and two successive interventions, a 9-day sleep extension followed by 1-night total sleep deprivation. Pre- and post-intervention tests included the Karolinska sleepiness scale and neuroimaging for arterial spin labeling and functional connectivity. We examined the association between subjective sleepiness and the functional magnetic resonance imaging indices. RESULTS The functional connectivity between the left or right thalamus and various brain regions displayed a significant negative association with subjective sleepiness, and the functional connectivity between the left and right thalamus displayed a significant positive association with subjective sleepiness. The graph theory analysis indicated that the number of positive functional connectivity related to the thalamus showed a strong negative association with subjective sleepiness, and conversely, the number of negative functional connectivity showed a positive association with subjective sleepiness. Arterial spin labeling analysis indicated that the blood flow in both the left and right thalami was significantly negatively associated with subjective sleepiness. Functional connectivity between the anterior cingulate cortex and salience network areas of the left insular cortex, and that between the anterior and posterior cingulate cortices showed a strong positive and negative association with subjective sleepiness, respectively. CONCLUSION Subjective sleepiness and the thalamic-cortical network dynamics are strongly related, indicating the application of graph theory to study sleepiness and consciousness. These results also demonstrate that resting functional connectivity largely reflects the "state" of the subject, suggesting that the control of sleep and conscious states is essential when using functional magnetic resonance imaging indices as biomarkers.
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Affiliation(s)
- Yuki Motomura
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan.,Faculty of Design, Kyushu University, Fukuoka, 815-8540, Japan.,Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan
| | - Shingo Kitamura
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan
| | - Kyoko Nakazaki
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan
| | - Kentaro Oba
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan.,Department of Human Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, 980-8575, Japan
| | - Ruri Katsunuma
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan.,Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan
| | - Yuri Terasawa
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan.,Department of Psychology, Keio University, Kanagawa, 223-8521, Japan
| | - Akiko Hida
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan
| | - Yoshiya Moriguchi
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan.,Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan
| | - Kazuo Mishima
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan.,Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, 010-8543, Japan.,International Institute for Integrative Sleep Medicine, University of Tsukuba, Ibaraki, Japan
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Dishakjian V, Fessler DMT, Sparks AM. Live fast, die young and sleep later: Life history strategy and human sleep behavior. EVOLUTION MEDICINE AND PUBLIC HEALTH 2020; 9:36-52. [PMID: 33738102 PMCID: PMC7953418 DOI: 10.1093/emph/eoaa048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/16/2020] [Indexed: 11/12/2022]
Abstract
Background and objectives Life History Theory (LHT) describes trade-offs that organisms make with regard to three investment pathways: growth, maintenance and reproduction. In light of the reparative functions of sleep, we examine sleep behaviors and corresponding attitudes as proximate manifestations of an individual's underlying relative prioritization of short-term reproduction versus long-term maintenance. Methodology We collected survey data from 568 participants across two online studies having different participant pools. We use a mixture of segmented and hierarchical regression models, structural equation modeling and machine learning to infer relationships between sleep duration/quality, attitudes about sleep and biodemographic/psychometric measures of life history strategy (LHS). Results An age-mediated U- or V-shaped relationship appears when LHS is plotted against habitual sleep duration, with the fastest strategies occupying the sections of the curve with the highest mortality risk: < 6.5 hr (short sleep) and > 8.5 hr (long sleep). LH 'fastness' is associated with increased sleepiness and worse overall sleep quality: delayed sleep onset latency, more wakefulness after sleep onset, higher sleep-wake instability and greater sleep duration variability. Hedonic valuations of sleep may mediate the effects of LHS on certain sleep parameters. Conclusions and implications The costs of deprioritizing maintenance can be parameterized in the domain of sleep, where 'life history fastness' corresponds with sleep patterns associated with greater senescence and mortality. Individual differences in sleep having significant health implications can thus be understood as components of lifelong trajectories likely stemming from calibration to developmental circumstances. Relatedly, hedonic valuations of sleep may constitute useful avenues for non-pharmacological management of chronic sleep disorders.Lay Summary: Sleep is essential because it allows the body to repair and maintain itself. But time spent sleeping is time that cannot be spent doing other things. People differ in how much they prioritize immediate rewards, including sociosexual opportunities, versus long-term goals. In this research, we show that individual differences in sleep behaviors, and attitudes toward sleep, correspond with psychological and behavioral differences reflecting such differing priorities. Orientation toward sleep can thus be understood as part of the overall lifetime strategies that people pursue.
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Affiliation(s)
- Vahe Dishakjian
- Department of Anthropology, University of California Los Angeles, Los Angeles, CA, USA.,Center for Behavior, Evolution and Culture, University of California Los Angeles, Los Angeles, CA, USA
| | - Daniel M T Fessler
- Department of Anthropology, University of California Los Angeles, Los Angeles, CA, USA.,Center for Behavior, Evolution and Culture, University of California Los Angeles, Los Angeles, CA, USA.,Bedari Kindness Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - Adam Maxwell Sparks
- Department of Anthropology, University of California Los Angeles, Los Angeles, CA, USA.,Center for Behavior, Evolution and Culture, University of California Los Angeles, Los Angeles, CA, USA
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Jiang B, He D, Guo Z, Mcclure MA, Gao Z. Insomnia Disorder Increases the Risk of Mortality: Pooled Analysis of Annual Cumulative Time-to-Event Data. Psychiatr Q 2020; 91:1431-1437. [PMID: 32424546 DOI: 10.1007/s11126-020-09768-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The association of mortality risk and insomnia disorder with daytime impairments has been plausible. The purpose of this study was to evaluate the strength of evidence for this relationship. We performed a comprehensive literature search for clinical Cohort trials including annual cumulative time-to-event data that evaluated the risk of mortality in insomnia disorder patients with daytime impairments. We used pooled hazard ratio (HR) as the main outcome measure and Kaplan-Meier survive curve to display outcome measures. The weighted cumulative mortality of 4.5% for patients with insomnia disorder was higher than that of 2.6% for those without insomnia (p<0.001). Higher risk of mortality presented in patients with insomnia disorder when compared to those without insomnia (HR = 1.66, 95% CI = 1.25-2.19, p<0.001). Patients with duration of more than 10 years were at a greater risk of annual cumulative mortality (R2 = 0.891, p<0.001). Insomnia disorder with daytime impairments increased the risk of mortality, and patients with duration of more than 10 years were at a greater risk of annual cumulative mortality.
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Affiliation(s)
- Binghu Jiang
- Department of Radiology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, 637000, Sichuan, China
| | - Dongmei He
- Department of Neurology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, 637000, Sichuan, China
| | - Zhiwei Guo
- Department of Radiology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, 637000, Sichuan, China
| | - Morgan A Mcclure
- Department of Radiology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, 637000, Sichuan, China
| | - Zhanhui Gao
- Department of Nephrology, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, 71 Hexi Street, Jianye District, Nanjing, 210019, Jiangsu, China.
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Park H, Chiang JJ, Bower JE, Irwin MR, Almeida DM, Seeman TE, McCreath H, Fuligni AJ. Sleep and Inflammation During Adolescents' Transition to Young Adulthood. J Adolesc Health 2020; 67:821-828. [PMID: 32586679 PMCID: PMC9869641 DOI: 10.1016/j.jadohealth.2020.04.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 03/19/2020] [Accepted: 04/17/2020] [Indexed: 01/26/2023]
Abstract
PURPOSE This study investigated the extent to which multiple sleep dimensions are associated with inflammation during adolescents' transition to young adulthood, a developmental period when sleep difficulties and systemic inflammation levels are on the rise. Additionally, the moderating roles of socioeconomic status (SES) and ethnicity were explored. METHODS A total of 350 Asian American, Latino, and European American youth participated at two-year intervals in wave 1 (n = 316, Mage = 16.40), wave 2 (n = 248 including 34 new participants to refresh the sample, Mage = 18.31), and wave 3 (n = 180, Mage = 20.29). Sleep duration (weekday and weekend) and variability in duration (nightly and weekday/weekend) were obtained from eight nights of wrist actigraphy. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index. Levels of C-reactive protein (CRP), a biomarker of systemic inflammation, were assayed from dried blood spots obtained from finger pricks. RESULTS Multilevel models demonstrated that greater weekday/weekend sleep variability and worse sleep quality were associated with higher CRP; shorter weekend duration was associated with higher CRP only at younger ages. Shorter weekday duration was associated with higher CRP only among high-SES youth, whereas greater nightly variability was associated with higher CRP only among European American youth. CONCLUSIONS Aspects of poor sleep may contribute to the rise of CRP during adolescents' transition to young adulthood, especially in earlier years. In addition, some sleep-CRP associations may vary as a function of youth's SES and ethnicity.
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Affiliation(s)
- Heejung Park
- Department of Psychology, Bryn Mawr College, Bryn Mawr, Pennsylvania.
| | - Jessica J. Chiang
- Department of Psychology, Georgetown University, 306N White-Gravenor Hall, 37th and O Streets, NW, Washington DC, 20057, U.S.A
| | - Julienne E. Bower
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, 760 Westwood Plaza, Los Angeles, CA 90095, U.S.A.,,Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, UCLA, 760 Westwood Plaza, Los Angeles, CA 90095, U.S.A.,,Department of Psychology, UCLA, 1285 Franz Hall, Los Angeles, CA 90095, U.S.A
| | - Michael R. Irwin
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, 760 Westwood Plaza, Los Angeles, CA 90095, U.S.A.,,Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, UCLA, 760 Westwood Plaza, Los Angeles, CA 90095, U.S.A.,,Department of Psychology, UCLA, 1285 Franz Hall, Los Angeles, CA 90095, U.S.A
| | - David M. Almeida
- Department of Human Development and Family Studies, The Pennsylvania State University, 119 Health and Human Development Building, University Park, PA 16802, U.S.A
| | - Teresa E. Seeman
- Department of Medicine, Division of Geriatrics, David Geffen School of Medicine, UCLA, 10945 Le Conte Avenue, Los Angeles, CA 90095, U.S.A
| | - Heather McCreath
- Department of Medicine, Division of Geriatrics, David Geffen School of Medicine, UCLA, 10945 Le Conte Avenue, Los Angeles, CA 90095, U.S.A
| | - Andrew J. Fuligni
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, 760 Westwood Plaza, Los Angeles, CA 90095, U.S.A.,,Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, UCLA, 760 Westwood Plaza, Los Angeles, CA 90095, U.S.A.,,Department of Psychology, UCLA, 1285 Franz Hall, Los Angeles, CA 90095, U.S.A
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Lee HW, Yoon HS, Yang JJ, Song M, Lee JK, Lee SA, Choi JY, Kang D. Association of sleep duration and quality with elevated hs-CRP among healthy Korean adults. PLoS One 2020; 15:e0238053. [PMID: 32841297 PMCID: PMC7446961 DOI: 10.1371/journal.pone.0238053] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 08/08/2020] [Indexed: 01/21/2023] Open
Abstract
This study aimed to investigate the association of sleep duration and quality with high-sensitivity C-reactive protein (hs-CRP) among middle-aged and elderly Koreans. Among a total of 74,867 participants (25,069 men and 49,798 women) recruited for the Health Examinees (HEXA) study, adjusted geometric means of hs-CRP level were compared across categories of sleep duration (<6, 6–7, 8–9, and ≥10 hours) and sleep quality (difficulty in initiating sleep and maintaining sleep) using ANCOVA models. Odds ratios (ORs) and 95% confidence intervals (CIs) for elevated hs-CRP (>3 mg/L) associated with sleep characteristics were estimated using multivariable-adjusted logistic regression models. Men who slept ≥10 hours per day were significantly associated with elevated hs-CRP (OR = 1.47, 95% CI 1.11–1.95). Whereas in women, difficulty in initiating sleep (OR = 1.28, 95% CI 1.04–1.57 for “Always”), and maintaining sleep was significantly associated with elevated hs-CRP levels (OR = 1.13, 95% CI 1.02–1.26 for “Often”; OR = 1.11, 95% CI 0.97–1.28 for “Always”). Additionally, women who experienced poor sleep quality presented an elevated level of hs-CRP (OR = 1.13, 95% CI 1.03–1.23). Our findings suggest that excessive sleep duration and poor sleep quality are significantly associated with the elevated inflammatory marker, specifically hs-CRP. Further research is needed to examine the effect of sleep interventions focused on these factors.
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Affiliation(s)
- Hwi-Won Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Hyung-Suk Yoon
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Jeong Yang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Minkyo Song
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jong-koo Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sang-Ah Lee
- Department of Preventive Medicine, Kangwon National University School of Medicine, Gangwon, Korea
| | - Ji-Yeob Choi
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
- * E-mail:
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Schmidlin PR, Khademi A, Fakheran O. Association between periodontal disease and non-apnea sleep disorder: a systematic review. Clin Oral Investig 2020; 24:3335-3345. [DOI: 10.1007/s00784-020-03475-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/24/2020] [Indexed: 12/22/2022]
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