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Gan X, He P, Ye Z, Zhou C, Liu M, Yang S, Zhang Y, Zhang Y, Qin X. Adherence to a healthy sleep pattern and new-onset acute kidney injury. Sleep Health 2023; 9:977-983. [PMID: 37923669 DOI: 10.1016/j.sleh.2023.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/16/2023] [Accepted: 09/21/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVES To investigate the prospective association of individual sleep characteristics and a healthy sleep pattern with new-onset acute kidney injury in general population. METHODS The UK Biobank enrolled over 500,000 participants, aged 37-73years, across the UK from 2006 to 2010. Of these, 375,216 participants were included in the current study. A healthy sleep score, ranging from 0 to 5 points, was created by combining five major sleep characteristics, including sleep duration, chronotype, insomnia, snoring, and daytime sleepiness. New-onset acute kidney injury was defined by ICD-10 code N17, ascertained by primary care data, hospital inpatient data, death register records, or self-reported medical conditions. RESULTS During a median follow-up period of 12.0years, 14,492 (3.9%) participants developed acute kidney injury. Overall, the healthy sleep score was significantly inversely associated with the risk of new-onset acute kidney injury (per 1-point increment; hazards ratio, 0.95; 95%CI, 0.93-0.97), especially in nondiabetes (hazards ratio, 0.94; 95%CI, 0.92-0.96; vs. diabetes, hazards ratio, 1.01; 95%CI, 0.96-1.05; P-interaction=.008). The genetic predisposition of estimated glomerular filtration rate and acute kidney injury did not significantly modify the association between the healthy sleep score and acute kidney injury (both P-interactions >.05). Sleep 7-8 hours per day (vs. <7 hours or ≥9 hours; hazards ratio, 0.92; 95%CI, 0.88-0.96), early chronotype (vs. evening chronotype; hazards ratio, 0.93; 95%CI, 0.89-0.97), never or rarely insomnia (vs. sometimes/usually insomnia; hazards ratio, 0.93; 95%CI, 0.88-0.97) and no frequent daytime sleepiness (vs. often/always daytime sleepiness; hazards ratio, 0.90; 95%CI, 0.81-0.99) were significantly associated with a lower risk of new-onset acute kidney injury. CONCLUSIONS A healthy sleep pattern was significantly associated with a lower risk of new-onset acute kidney injury, regardless of the genetic risks.
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Affiliation(s)
- Xiaoqin Gan
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Sisi Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Yanjun Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China.
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Zhang YW, Lu PP, Li YJ, Wang H, Zhao YK, Chen H, Rui YF. Short report: relationship between self-reported sleep characteristics and falls-associated fractures in elderly individuals: a population-based study. PSYCHOL HEALTH MED 2023; 28:946-954. [PMID: 36050909 DOI: 10.1080/13548506.2022.2119482] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Currently, the data for effect of sleep on falls-associated fractures in elderly individuals are still limited. This current study was aimed to assess the link between self-reported sleep characteristics and falls-associated fractures in elderly individuals. This study included a total of 20,497 participants from National Health and Nutritional Examination Survey (NHANES) 2005-2008, and 6,174 participants aged 45 years and older were identified. Self-reported sleep characteristics and conditions of falls-associated fractures of individuals were obtained via the method of personal questionnaires. In a total of 610 participants with exact history of fractures, 168 individuals with falls-associated fractures were identified, and the prevalence was 27.5%. The mean age of falls-associated fractures group was (72.1 ± 8.8) years, and the female (P < 0.001) occupied a higher proportion. Factors of living alone (P = 0.003), combined with hypertension (P = 0.003) and osteoporosis (P < 0.001), sleeping less or more (P = 0.009), and frequent snoring (P = 0.007) were linked to falls-associated fractures. Compared with sleep duration of 6 to 8 h/night, sleep duration of ≤4 h/night (odds ratio [OR] 1.858, 95% confidence interval [CI] 1.115-3.094) and of ≥9 h/night (OR 1.932, 95% CI 1.195-3.123) were related to an increased risk of falls-associated fractures. Collectively, our nationwide data noted that sleep characteristics were closely related to falls-associated fractures in elderly individuals, and a longer sleep duration may exhibit a protective effect against the falls-associated fractures, but it should be limited within 9 h/night.
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Affiliation(s)
- Yuan-Wei Zhang
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China.,Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, China.,Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Pan-Pan Lu
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China.,Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, China.,Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Ying-Juan Li
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,Department of Geriatrics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Hao Wang
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China.,Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, China.,Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Ya-Kuan Zhao
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China.,Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, China.,Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Hui Chen
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China.,Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, China.,Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yun-Feng Rui
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China.,Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, China.,Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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3
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Zeng Z, Yang Y, Zhang Y, Wu X, Chen W, Gu D. Effect of antihypertensive medications on sleep status in hypertensive patients. Sleep Biol Rhythms 2022; 20:473-480. [PMID: 38468617 PMCID: PMC10899994 DOI: 10.1007/s41105-022-00391-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/20/2022] [Indexed: 11/26/2022]
Abstract
Purpose Antihypertensive medication is an effective way to control blood pressure. However, some studies reported that it may affect patients' sleep quality during the treatment. Due to the inconsistency of present results, a comprehensive systematic review and network meta-analysis are needed. Methods Electronic databases (MEDLINE, EMBASE, WEB OF SCIENCE, PUBMED) were searched up to April 10th, 2021 including no restriction of publication status. Randomized controlled trials (RCTs) or quasi-experimental studies or cohort studies were eligible. The network meta-analysis was used within a Bayesian framework. Results Finally, 16 publications (including 12 RCTs and 4 quasi-experimental studies) with 404 subjects were included in this study. Compared to placebo, the results of the network meta-analysis showed that diuretics were effective in improving sleep apnea with a mean difference (MD) of - 15.47 (95% confidence interval [CI]: - 23.56, - 6.59) which was consistent with the direct comparison result (MD: - 17.91; 95% CI - 21.60, - 14.23). In addition, diuretics were effective in increasing nocturnal oxygen saturation with an MD of 3.64 (95% CI 0.07, 7.46). However, the effects of β-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, and the others on sleep apnea were not statistically significant. Additionally, the effects of antihypertensive medication on the total sleep time (min), rapid eye movement (%), and sleep efficiency (%) were not statistically significant. Conclusion Our study found that diuretics could effectively reduce the severity of sleep apnea in hypertensive patients. However, the effects of antihypertensive drugs on sleep characteristics were not found. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-022-00391-8.
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Affiliation(s)
- Ziqian Zeng
- First Affiliated Hospital, Army Medical University, Chongqing, 400038 China
| | - Yanan Yang
- Department of Epidemiology and Statistics, Chengdu Medical College, Chengdu, Sichuan China
| | - Yuewen Zhang
- Department of Epidemiology and Statistics, Chengdu Medical College, Chengdu, Sichuan China
| | - Xiuming Wu
- Department of Epidemiology and Statistics, Chengdu Medical College, Chengdu, Sichuan China
| | - Weizhong Chen
- Department of Epidemiology and Statistics, Chengdu Medical College, Chengdu, Sichuan China
| | - Dongqing Gu
- First Affiliated Hospital, Army Medical University, Chongqing, 400038 China
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Visser SSM, van Diemen WJM, Kervezee L, van den Hoogen A, Verschuren O, Pillen S, Benders MJNL, Dudink J. The relationship between preterm birth and sleep in children at school age: A systematic review. Sleep Med Rev 2021; 57:101447. [PMID: 33611088 DOI: 10.1016/j.smrv.2021.101447] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/04/2020] [Accepted: 09/05/2020] [Indexed: 12/29/2022]
Abstract
Premature birth (before 37 weeks of gestation) has been linked to a variety of adverse neurological outcomes. Sleep problems are associated with decreased neurocognitive functioning, which is especially common in children born preterm. The exact relationship between prematurity and sleep at school age is unknown. A systematic review is performed with the aim to assess the relationship between prematurity and sleep at school age (5th to 18th year of life), in comparison to sleep of their peers born full-term. Of 347 possibly eligible studies, nine were included. The overall conclusion is that prematurity is associated with earlier bedtimes and a lower sleep quality, in particular more nocturnal awakenings and more non-rapid eye movement stage 2 sleep. Interpretations and limitations of the review are discussed. Moreover, suggestions for future research are brought forward, including the need for a systematic approach with consistent outcome measures in this field of research. A better understanding of the mechanisms that influence sleep in the vulnerable group of children born preterm could help optimize these children's behavioral and intellectual development.
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Affiliation(s)
- Simone S M Visser
- Department of Neonatology, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Laura Kervezee
- Department of Cell and Chemical Biology, Leiden University Medical Care, Leiden, the Netherlands
| | - Agnes van den Hoogen
- Department of Neonatology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Olaf Verschuren
- Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht, the Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Sigrid Pillen
- Sleep Medicine Center, Kempenhaeghe, Heeze, the Netherlands
| | - Manon J N L Benders
- Department of Neonatology, University Medical Center Utrecht, Utrecht, the Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jeroen Dudink
- Department of Neonatology, University Medical Center Utrecht, Utrecht, the Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands.
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Debellemaniere E, Gomez-Merino D, Erblang M, Dorey R, Genot M, Perreaut-Pierre E, Pisani A, Rocco L, Sauvet F, Léger D, Rabat A, Chennaoui M. Using relaxation techniques to improve sleep during naps. Ind Health 2018; 56:220-227. [PMID: 29332862 PMCID: PMC5985461 DOI: 10.2486/indhealth.2017-0092] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 01/05/2018] [Indexed: 06/07/2023]
Abstract
Insufficient sleep is a common occurrence in occupational settings (e.g. doctors, drivers, soldiers). The resulting sleep debt can lead to daytime sleepiness, fatigue, mood disorder, and cognitive deficits as well as altered vascular, immune and inflammatory responses. Short daytime naps have been shown to be effective at counteracting negative outcomes related to sleep debt with positive effects on daytime sleepiness and performance after a normal or restricted night of sleep in laboratory settings. However, the environmental settings in the workplace and the emotional state of workers are generally not conducive to beneficial effects. Here, we tested whether relaxation techniques (RT) involving hypnosis might increase total sleep time (TST) and/or deepen sleep. In this study, eleven volunteers (aged 37-52) took six early-afternoon naps (30 min) in their occupational workplace, under two different conditions: control 'Naps' or 'Naps + RT' with a within-subjects design. Our results demonstrate that adding RT to naps changes sleep architecture, with a significant increase in the TST, mostly due to N2 sleep stage (and N3, to a lesser extent). Therefore, the deepening of short naps with RT involving hypnosis might be a successful non-pharmacological way to extend sleep duration and to deepen sleep in occupational settings.
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Affiliation(s)
- Eden Debellemaniere
- EA7330 VIFASOM, Université Paris Descartes, France
- Départment Neurosciences et Contraintes Opérationnelles (NCO), Institut de Recherche Biomédicale des Armées (IRBA), France
- Rythm SAS, France
| | - Danielle Gomez-Merino
- EA7330 VIFASOM, Université Paris Descartes, France
- Départment Neurosciences et Contraintes Opérationnelles (NCO), Institut de Recherche Biomédicale des Armées (IRBA), France
| | - Mégane Erblang
- EA7330 VIFASOM, Université Paris Descartes, France
- Départment Neurosciences et Contraintes Opérationnelles (NCO), Institut de Recherche Biomédicale des Armées (IRBA), France
| | - Rodolphe Dorey
- EA7330 VIFASOM, Université Paris Descartes, France
- Départment Neurosciences et Contraintes Opérationnelles (NCO), Institut de Recherche Biomédicale des Armées (IRBA), France
| | - Michel Genot
- Centre National des Sports de la Défense (CNSD), France
| | - Edith Perreaut-Pierre
- Départment Neurosciences et Contraintes Opérationnelles (NCO), Institut de Recherche Biomédicale des Armées (IRBA), France
- Centre National des Sports de la Défense (CNSD), France
- Coévolution, France
| | - André Pisani
- Centre National des Sports de la Défense (CNSD), France
| | - Laurent Rocco
- Centre National des Sports de la Défense (CNSD), France
| | - Fabien Sauvet
- EA7330 VIFASOM, Université Paris Descartes, France
- Départment Neurosciences et Contraintes Opérationnelles (NCO), Institut de Recherche Biomédicale des Armées (IRBA), France
| | - Damien Léger
- EA7330 VIFASOM, Université Paris Descartes, France
| | - Arnaud Rabat
- EA7330 VIFASOM, Université Paris Descartes, France
- Départment Neurosciences et Contraintes Opérationnelles (NCO), Institut de Recherche Biomédicale des Armées (IRBA), France
| | - Mounir Chennaoui
- EA7330 VIFASOM, Université Paris Descartes, France
- Départment Neurosciences et Contraintes Opérationnelles (NCO), Institut de Recherche Biomédicale des Armées (IRBA), France
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Stangenes KM, Fevang SK, Grundt J, Donkor HM, Markestad T, Hysing M, Elgen IB, Bjorvatn B. Children born extremely preterm had different sleeping habits at 11 years of age and more childhood sleep problems than term-born children. Acta Paediatr 2017; 106:1966-1972. [PMID: 28714101 DOI: 10.1111/apa.13991] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 04/28/2017] [Accepted: 07/12/2017] [Indexed: 12/21/2022]
Abstract
AIM This study explored whether extremely preterm (EPT) children had different sleep characteristics in childhood than children born at term and how neurodevelopmental disabilities (NDD) affected sleep in children born EPT. METHODS A Norwegian national cohort of 231 children born EPT from 1999 to 2000 and separate study data on 556 children born at term in 2001 were compared. Parental questionnaires mapped the children's current sleep habits at 11 years of age, namely the prevalence of sleep problems throughout childhood until this age and five categories of sleep problems. In addition, the EPT children were clinically assessed at five years of age. RESULTS The EPT children had different sleep habits than the controls, for example they went to bed earlier. EPT children had a higher prevalence of sleep problems than the controls throughout childhood (26% versus 14%, p < 0.001) and this was also higher for the 93 EPT children with no NDD (20%) than for the controls (14%) and increased with increasing NDD to 67% (p = 0.015) for the six children with severe NDD. CONCLUSION EPT children had different sleep habits to term-born controls at 11 years of age, including those with no NDD. The prevalence of sleep problems increased with increasing NDD.
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Affiliation(s)
- Kristine Marie Stangenes
- Department of Clinical Science; University of Bergen; Bergen Norway
- Department of Pediatrics; Haukeland University Hospital of Bergen; Bergen Norway
| | | | - Jacob Grundt
- Department of Pediatrics; Innlandet Hospital Trust; Lillehammer Norway
| | | | - Trond Markestad
- Department of Clinical Science; University of Bergen; Bergen Norway
- Department of Pediatrics; Innlandet Hospital Trust; Lillehammer Norway
| | | | | | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care; University of Bergen; Bergen Norway
- Norwegian Competence Center for Sleep Disorders; Haukeland University Hospital; Bergen Norway
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Bokenberger K, Ström P, Dahl Aslan AK, Johansson ALV, Gatz M, Pedersen NL, Åkerstedt T. Association Between Sleep Characteristics and Incident Dementia Accounting for Baseline Cognitive Status: A Prospective Population-Based Study. J Gerontol A Biol Sci Med Sci 2016; 72:134-139. [PMID: 27402049 DOI: 10.1093/gerona/glw127] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 06/19/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Although research has shown that sleep disorders are prevalent among people with dementia, the temporal relationship is unclear. We investigated whether atypical sleep characteristics were associated with incident dementia while accounting for baseline cognitive functioning. METHODS Screening Across the Lifespan Twin (SALT) study participants were 11,247 individuals from the Swedish Twin Registry who were at least 65 years at baseline (1998-2002). Sleep and baseline cognitive functioning were assessed via the SALT telephone screening interview. Data on dementia diagnoses came from national health registers. Cox regression was performed to estimate hazard ratios for dementia. RESULTS After 17 years of follow-up, 1,850 dementia cases were identified. Short (≤6 hours) and extended (>9 hours) time in bed (TIB) compared to the middle reference group (hazard ratio = 1.40, 95% confidence interval = 1.06-1.85; hazard ratio = 1.11, 95% confidence interval = 1.00-1.24, respectively) and rising at 8:00 AM or later compared to earlier rising (hazard ratio = 1.12, 95% confidence interval = 1.01-1.24) were associated with higher dementia incidence. Bedtime, sleep quality, restorative sleep, and heavy snoring were not significant predictors. Findings stratified by baseline cognitive status indicated that the association between short TIB and dementia remained in those cognitively intact at the start. CONCLUSIONS Short and extended TIB and delayed rising among older adults predicted increased dementia incidence in the following 17 years. The pattern of findings suggests that extended TIB and late rising represent prodromal features whereas short TIB appeared to be a risk factor for dementia.
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Affiliation(s)
- Kathleen Bokenberger
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Peter Ström
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anna K Dahl Aslan
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Institute of Gerontology, School of Health and Welfare, Jönköping University, Sweden
| | - Anna L V Johansson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Margaret Gatz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, University of Southern California, Los Angeles
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, University of Southern California, Los Angeles
| | - Torbjörn Åkerstedt
- Stress Research Institute, Stockholm University, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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