|
1
|
Fan M, Zhao X, Wang SL, Zhang XQ. Factors associated with sleep duration in a Chinese middle-aged and elderly diabetic population: a cross-sectional study. Acta Diabetol 2025:10.1007/s00592-025-02512-4. [PMID: 40402275 DOI: 10.1007/s00592-025-02512-4] [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: 09/11/2024] [Accepted: 04/16/2025] [Indexed: 05/23/2025]
Abstract
BACKGROUND The adverse effects of excessively short or long sleep duration on diabetes have been confirmed in previous studies. However, there is a lack of research on the factors associated with sleep duration in diabetic patients, and this study aims to identify the factors associated with sleep duration in diabetes mellitus. METHODS This study collected data from 2116 middle-aged and elderly individuals with diabetes mellitus who were surveyed by the China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2015. Sleep duration was assessed based on patient self-reports, defined as the total amount of sleep patients obtained on average at night over the past month (average nightly sleep duration), it was categorized into short sleep duration (< 6 h), adequate sleep duration (6-9 h) and long sleep duration (> 9 h). Stepwise multivariable multinomial logistic regression was used to explore the associated factors related to short sleep duration (< 6 h) and long sleep duration (> 9 h), using adequate sleep duration as the reference. RESULTS The mean self-reported sleep duration in the study sample was (6.34 ± 1.86) hours, with 66.6% reporting adequate sleep duration, 29.6% short sleep duration, and 3.8% long sleep duration. Short sleep duration was positively associated with older age, having low level of education, no health insurance, poor sleep quality, short napping time, and poor self-reported health status. The probability of short sleep duration was lower among good sleep quality (OR = 0.14; 95%CI = 0.11-0.18), good self-reported health status (OR = 0.62; 95%CI = 0.44-0.88). Long sleep duration was positively associated with being male, never smoked, good sleep quality, and traditional Chinese medicine treatment. Long sleep duration was negatively associated with the cognitive function score (OR = 0.94; 95%CI = 0.90-0.99), and having one comorbidity (OR = 0.42; 95%CI = 0.20-0.87). CONCLUSION Sleep duration was influenced by a combination of factors among middle-aged and elderly patients with diabetes in China. The study suggested that we should focus on key populations, such as older adults, individuals without health insurance, those with poor sleep quality, low cognitive function and poor self-reported health status, to promote healthy sleep.
Collapse
Affiliation(s)
- Min Fan
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Xia Zhao
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Sheng-Li Wang
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Xin-Qiong Zhang
- School of Nursing, Anhui Medical University, Hefei, Anhui, China.
| |
Collapse
|
|
2
|
Rouleau CR, Garland SN. A social ecological perspective on interventions to address short sleep duration in adults with coronary heart disease. Prog Cardiovasc Dis 2025:S0033-0620(25)00074-X. [PMID: 40373987 DOI: 10.1016/j.pcad.2025.05.003] [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: 05/11/2025] [Accepted: 05/12/2025] [Indexed: 05/17/2025]
Abstract
BACKGROUND Short sleep duration (<7 h/day) affects one-third of the population, is implicated in morbidity and mortality from coronary heart disease (CHD), and is driven by an interplay of individual, social, and societal factors. OBJECTIVE To review observational and experimental studies that have tested interventions to address short sleep in various clinical presentations (sleep disorders, behaviorally induced short sleep, lack of sleep opportunity) and describe considerations needed for CHD populations. CONCLUSIONS Few existing interventions have a primary aim to increase sleep duration in individuals with insufficient sleep, and none specifically target individuals with established CHD. Short sleep duration may be modifiable via treatment of insomnia, behavioral sleep extension, and system-level changes to healthcare settings, workplace policies, and communities. With further research on interventions that address diverse phenotypes of short sleep-while assessing long-term cardiometabolic outcomes, patient preferences, and mechanisms-of-action-sleep health could become an important component of CHD secondary prevention.
Collapse
Affiliation(s)
- Codie R Rouleau
- Department of Psychology, University of Calgary, Calgary, AB, Canada; TotalCardiology Research Network, Calgary, AB, Canada.
| | - Sheila N Garland
- Department of Psychology, Memorial University, St. John's, NL, Canada
| |
Collapse
|
|
3
|
Ungvari Z, Fekete M, Lehoczki A, Munkácsy G, Fekete JT, Zábó V, Purebl G, Varga P, Ungvari A, Győrffy B. Inadequate sleep increases stroke risk: evidence from a comprehensive meta-analysis of incidence and mortality. GeroScience 2025:10.1007/s11357-025-01593-x. [PMID: 40072786 DOI: 10.1007/s11357-025-01593-x] [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: 01/03/2025] [Accepted: 02/28/2025] [Indexed: 03/14/2025] Open
Abstract
The link between abnormal sleep duration and stroke outcomes remains contentious. This meta-analysis quantifies how both short and long sleep durations impact stroke incidence and mortality. A comprehensive search was conducted in PubMed, Web of Science, Cochrane Library, Embase, and Google Scholar up to November 1, 2024, to identify cohort studies evaluating sleep duration and stroke outcomes. Meta-analysis was performed using MetaAnalysisOnline.com and a random-effects model to estimate pooled hazard ratios (HRs). Results were visualized through Forest and Funnel plots. Analysis of 43 studies (35 on stroke incidence, 8 on mortality) revealed significant associations between sleep duration and stroke outcomes. Short sleep duration (≤ 5-6 h) was associated with increased stroke incidence (HR 1.29, 95% CI 1.19-1.40, p < 0.01) and modestly elevated mortality (HR 1.12, 95% CI 1.01-1.25, p = 0.03). Long sleep duration (> 8-9 h) demonstrated stronger associations with both increased stroke incidence (HR 1.46, 95% CI 1.33-1.60, p < 0.01) and mortality (HR 1.45, 95% CI 1.31-1.60, p < 0.01). Significant heterogeneity was observed in incidence studies (I2 = 74-75%), while mortality analyses showed moderate to low heterogeneity (I2 = 35-40%). This meta-analysis highlights a U-shaped association between sleep duration and stroke risk, with both short and long sleep durations linked to higher stroke incidence and mortality. These findings underscore the importance of balanced sleep duration as a modifiable risk factor in stroke prevention strategies and provide a foundation for the Semmelweis Study, a prospective workplace cohort investigating the role of modifiable lifestyle factors in unhealthy cerebrovascular and brain aging.
Collapse
Affiliation(s)
- Zoltan Ungvari
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral College, Health Sciences Division/Institute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary
| | - Mónika Fekete
- Institute of Preventive Medicine and Public Health, Semmelweis University, Semmelweis University, Budapest, Hungary
| | - Andrea Lehoczki
- Institute of Preventive Medicine and Public Health, Semmelweis University, Semmelweis University, Budapest, Hungary
- Doctoral College, Health Sciences Division, Semmelweis University, Budapest, Hungary
| | - Gyöngyi Munkácsy
- Dept. Of Bioinformatics, Semmelweis University, 1094, Budapest, Hungary
- Cancer Biomarker Research Group, Institute of Molecular Life Sciences, HUN-REN Research Centre for Natural Sciences, 1117, Budapest, Hungary
| | - János Tibor Fekete
- Dept. Of Bioinformatics, Semmelweis University, 1094, Budapest, Hungary
- Cancer Biomarker Research Group, Institute of Molecular Life Sciences, HUN-REN Research Centre for Natural Sciences, 1117, Budapest, Hungary
| | - Virág Zábó
- Institute of Preventive Medicine and Public Health, Semmelweis University, Semmelweis University, Budapest, Hungary
| | - György Purebl
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Péter Varga
- Institute of Preventive Medicine and Public Health, Semmelweis University, Semmelweis University, Budapest, Hungary
- Doctoral College, Health Sciences Division, Semmelweis University, Budapest, Hungary
| | - Anna Ungvari
- Institute of Preventive Medicine and Public Health, Semmelweis University, Semmelweis University, Budapest, Hungary.
| | - Balázs Győrffy
- Dept. Of Bioinformatics, Semmelweis University, 1094, Budapest, Hungary
- Cancer Biomarker Research Group, Institute of Molecular Life Sciences, HUN-REN Research Centre for Natural Sciences, 1117, Budapest, Hungary
- Dept. Of Biophysics, Medical School, University of Pecs, 7624, Pecs, Hungary
| |
Collapse
|
|
4
|
Chang X, Shih CC, Chen J, Lee AS, Tan P, Wang L, Liu J, Li J, Yuan JM, Khor CC, Koh WP, Dorajoo R. Predictive Capabilities of Polygenic Scores in an East-Asian Population-based Cohort: The Singapore Chinese Health Study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2025:2025.02.13.25322249. [PMID: 39990559 PMCID: PMC11844607 DOI: 10.1101/2025.02.13.25322249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2025]
Abstract
Background Existing polygenic scores (PGS) are derived primarily from studies performed in European populations. It is still unclear how these perform in improving risk predictions in East-Asians. Methods We generated 2,173 PGSs from 519 traits and assessed their associations with 58 baseline phenotypes in the Singapore Chinese Health Study (SCHS), a prospective cohort of 23,622 middle-aged and older Chinese residing in Singapore. We used linear regression to evaluate PGS performances for quantitative traits by calculating the explained variance (r²). For dichotomized phenotypes, we employed logistic regression to estimate the area under the receiver operating characteristic curve (AUC) in predictive models. Results Overall, traits with higher heritability scores exhibited stronger associations with PGSs, while behavioural traits, for example sleep duration and hours spent watching TV, showed weaker associations. Height and type 2 diabetes (T2D) exhibited the largest SNP-based heritability estimates with the largest increments in explained variance and AUC, respectively, compared to phenotypic models. We explored the effect of T2D risk factors on the association between the T2D PGS (PGS003444) and incident T2D. The PGS association was significantly mediated and modified by hypertension ( P indirect =1.56×10 -18 , P interaction =1.11×10 -6 ) and body mass index (BMI, P indirect =1.25×10 -36 , P interaction =2.10×10 -3 ). The prediction ability of PGS003444 for incident T2D was stronger was stronger among individuals who were non-overweight without hypertension (AUC=0.774) than in overweight individuals with hypertension (AUC=0.709). Conclusions In conclusion, our study demonstrated the divergent ability of PGSs in predictions of complex traits, and showed that for certain traits, such as T2D, PGSs may have the potential for improving risk prediction and personalized healthcare.
Collapse
|
|
5
|
Liu H, Shi Y, Yu M, Guo X, Ruan Y, Qin F, Zhou R, Feng J, Hu Z, Wu F, Jia Q, Yin Y, Guo Y, Wu F. Individual and joint associations between sleep duration and physical activity with cognitive function: A longitudinal analysis among middle-aged and older adults in China. Alzheimers Dement 2025; 21:e14212. [PMID: 39692596 PMCID: PMC11772731 DOI: 10.1002/alz.14212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/11/2024] [Accepted: 07/28/2024] [Indexed: 12/19/2024]
Abstract
INTRODUCTION Studies using cross-sectional data or with a short follow-up period fail to distinguish whether the associations between sleep duration and physical activity with cognitive function result from reverse causation. METHODS The longitudinal study examined the individual and joint associations, with specific temporality, between sleep duration and physical activity with cognitive function, using time-lagged linear mixed models and generalized additive mixed models. RESULTS A total of 14,694 participants aged ≥ 50 years were included, with an average lagged time of 4.5 (standard deviation 1.3) years. Long sleep duration was independently associated with cognitive decline, while short sleep duration and physical activity were not. The analysis of joint effects showed that increased physical activity slowed the rate of cognitive decline among participants reporting long sleep duration, consistent with the results of the stratified analyses. DISCUSSION Interventions on improving sleep should consider concurrent physical activity to maximize benefits for slowing cognitive decline. HIGHLIGHTS Long sleep duration was independently associated with worse cognitive function, while short sleep duration was not. Elevated levels of physical activity were not independently associated with better cognitive function. Increased physical activity appeared to mitigate the negative impact of long sleep duration on cognitive function.
Collapse
Affiliation(s)
- Hongwei Liu
- School of Public HealthFudan UniversityShanghaiChina
| | - Yan Shi
- Division of Chronic Non‐Communicable Disease and InjuryShanghai Municipal Center for Disease Control and PreventionShanghaiChina
| | - Min Yu
- Zhejiang Provincial Center for Disease Control and PreventionHangzhouChina
- The Department for Chronic and Non‐Communicable Disease Control and PreventionShandong Center for Disease Control and PreventionJinanChina
| | - Xiaolei Guo
- The Department for Chronic and Non‐Communicable Disease Control and PreventionShandong Center for Disease Control and PreventionJinanChina
| | - Ye Ruan
- Division of Chronic Non‐Communicable Disease and InjuryShanghai Municipal Center for Disease Control and PreventionShanghaiChina
| | - Fei Qin
- School of Public HealthFudan UniversityShanghaiChina
| | - Rongfei Zhou
- School of Public HealthFudan UniversityShanghaiChina
| | - Jingyuan Feng
- School of Public HealthFudan UniversityShanghaiChina
| | - Zihan Hu
- School of Public HealthFudan UniversityShanghaiChina
| | - Fei Wu
- School of Public HealthFudan UniversityShanghaiChina
| | - Qingqing Jia
- School of Public HealthFudan UniversityShanghaiChina
| | - Yanlu Yin
- School of Public HealthFudan UniversityShanghaiChina
| | - Yanfei Guo
- Division of Chronic Non‐Communicable Disease and InjuryShanghai Municipal Center for Disease Control and PreventionShanghaiChina
- School of Public Health and Community Medicine, Institution of Medicine, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Fan Wu
- School of Public HealthFudan UniversityShanghaiChina
| |
Collapse
|
|
6
|
Lu W, Yang J, Liu J, Ma L, Wu R, Lou C, Ma B, Zhao Y, Lu W, Lu Q. The Interplay between nighttime/midday sleep duration and the number of new-onset chronic diseases: A decade-long prospective study in China. Arch Gerontol Geriatr 2025; 128:105626. [PMID: 39270436 DOI: 10.1016/j.archger.2024.105626] [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: 07/25/2024] [Revised: 09/02/2024] [Accepted: 09/04/2024] [Indexed: 09/15/2024]
Abstract
OBJECTIVE To investigate the interplay between individual nighttime and midday sleep duration and the number of new-onset chronic diseases and determine the optimal sleep duration associated with lowest number of new-onset chronic diseases. METHODS We used data from the China Health and Retirement Longitudinal Study (CHARLS) covering a decade and involving 10,828 participants. A random intercept cross-lagged model was used to explore the interplay between nighttime/midday sleep durations and new-onset chronic diseases at both the within-individual and between-individual levels, followed by a dose-response analysis at the between-individual level to determine the optimal sleep duration. New-onset chronic diseases include 14 types of self-reported diseases diagnosed by doctors. RESULTS Within-individual analysis revealed that increased nighttime/midday sleep duration led to a higher number of new-onset chronic diseases, and an increased number of new-onset chronic diseases resulted in decreased nighttime sleep duration. Between nighttime and midday sleep, one type of sleep duration increase was likely to lead to an increase in another type. Between-individual analysis found a nonlinear relationship between the number of new-onset chronic diseases and nighttime sleep duration, identifying the optimal nighttime sleep duration as 7.46 h. CONCLUSIONS These findings elucidate the interplay between sleep duration and number of new-onset chronic diseases and underscore the need for public awareness and comprehensive interventions. Future studies should focus on refining sleep monitoring and exploring the sleep-chronic diseases nexus in greater depth.
Collapse
Affiliation(s)
- Wenfeng Lu
- School of Nursing, Tianjin Medical University, Tianjin 300070, China
| | - Jin Yang
- School of Nursing, Tianjin Medical University, Tianjin 300070, China
| | - Jingwen Liu
- School of Nursing, Tianjin Medical University, Tianjin 300070, China
| | - Lemeng Ma
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Rui Wu
- Department of Rehabilitation Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Chunrui Lou
- School of Nursing, Tianjin Medical University, Tianjin 300070, China
| | - Bingxin Ma
- School of Nursing, Tianjin Medical University, Tianjin 300070, China
| | - Yue Zhao
- School of Nursing, Tianjin Medical University, Tianjin 300070, China.
| | - Wenli Lu
- School of Public Health, Tianjin Medical University, Tianjin 300070, China.
| | - Qi Lu
- School of Nursing, Tianjin Medical University, Tianjin 300070, China.
| |
Collapse
|
|
7
|
Yang C, Yan P, Wu X, Zhang W, Cui H, Zhang L, Xu Z, Peng S, Tang M, Wang Y, Chen L, Zou Y, Liu Y, Zhang M, Zhao X, Xiao J, Xiao C, Zhang L, Yao Y, Li J, Liu Z, Yang C, Jiang X, Zhang B. Associations of sleep with cardiometabolic risk factors and cardiovascular diseases: An umbrella review of observational and mendelian randomization studies. Sleep Med Rev 2024; 77:101965. [PMID: 39137553 DOI: 10.1016/j.smrv.2024.101965] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 05/09/2024] [Accepted: 05/26/2024] [Indexed: 08/15/2024]
Abstract
Two researchers independently assessed studies published up to February 5, 2023, across PubMed, Web of Science, Embase, and Cochrane Library, to investigate the associations of sleep traits with cardiometabolic risk factors, as well as with cardiovascular diseases. Fourteen systematic reviews consisting of 23 meta-analyses, and 11 Mendelian randomization (MR) studies were included in this study. Short sleep duration was associated with a higher risk of obesity, type 2 diabetes (T2D), hypertension, stroke, and coronary heart disease (CHD) in observational studies, while a causal role was only demonstrated in obesity, hypertension, and CHD by MR. Similarly, long sleep duration showed connections with a higher risk of obesity, T2D, hypertension, stroke, and CHD in observational studies, none was supported by MR analysis. Both observational and MR studies indicated heightened risks of hypertension, stroke, and CHD in relation to insomnia. Napping was linked to elevated risks of T2D and CHD in observational studies, with MR analysis confirming a causal role in T2D. Additionally, snoring was correlated with increased risks of stroke and CHD in both observational and MR studies. This work consolidates existing evidence on a causal relationship between sleep characteristics and cardiometabolic risk factors, as well as cardiovascular diseases.
Collapse
Affiliation(s)
- Chao Yang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China; School of Public Health, Southwest Medical University, Luzhou, Sichuan, China
| | - Peijing Yan
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xueyao Wu
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wenqiang Zhang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Huijie Cui
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Zhang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhengxing Xu
- School of Public Health, Southwest Medical University, Luzhou, Sichuan, China
| | - Shanshan Peng
- Department of Occupational and Environmental Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Mingshuang Tang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yutong Wang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lin Chen
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yanqiu Zou
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yunjie Liu
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Min Zhang
- Clinical Research Center, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xunying Zhao
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jinyu Xiao
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chenghan Xiao
- Department of Maternal, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ling Zhang
- Department of Iatrical Polymer Material and Artificial Apparatus, School of Polymer Science and Engineering, Sichuan University, Chengdu, China
| | - Yuqin Yao
- Department of Occupational and Environmental Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jiayuan Li
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhenmi Liu
- Department of Maternal, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chunxia Yang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xia Jiang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
| | - Ben Zhang
- Hainan General Hospital and Hainan Affiliated Hospital, Hainan Medical University, Haikou, China; West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
| |
Collapse
|
|
8
|
Ma Y, Yu S, Li Q, Zhang H, Zeng R, Luo R, Lian Q, Leung FW, Duan C, Sha W, Chen H. Sleep patterns, genetic susceptibility, and digestive diseases: a large-scale longitudinal cohort study. Int J Surg 2024; 110:5471-5482. [PMID: 38781035 PMCID: PMC11392193 DOI: 10.1097/js9.0000000000001695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Sleep problems are prevalent. However, the impact of sleep patterns on digestive diseases remains uncertain. Moreover, the interaction between sleep patterns and genetic predisposition with digestive diseases has not been comprehensively explored. METHODS Four hundred ten thousand five hundred eighty-six participants from UK Biobank with complete sleep information were included in the analysis. Sleep patterns were measured by sleep scores as the primary exposure, based on five healthy sleep behaviors. Individual sleep behaviors were secondary exposures. Genetic risk of the digestive diseases was characterized by polygenic risk score. Primary outcome was incidence of 16 digestive diseases. RESULTS Healthy sleep scores showed dose-response associations with reduced risks of digestive diseases. Compared to participants scoring 0-1, those scoring 5 showed a 28% reduced risk of any digestive disease, including a 50% decrease in irritable bowel syndrome, 37% in non-alcoholic fatty liver disease, 35% in peptic ulcer, 34% in dyspepsia, 32% in gastroesophageal reflux disease, 28% in constipation, 25% in diverticulosis, 24% in severe liver disease, and 18% in gallbladder disease, whereas no correlation was observed with inflammatory bowel disease and pancreatic disease. Participants with poor sleep and high genetic risk exhibited approximately a 60% increase in the risk of digestive diseases. A healthy sleep pattern is linked to lower digestive disease risk in participants of all genetic risk levels. CONCLUSIONS In this large population-based cohort, a healthy sleep pattern was associated with a reduced risk of digestive diseases, regardless of genetic susceptibility. The authors' findings underscore the potential impact of healthy sleep traits in mitigating the risk of digestive diseases.
Collapse
Affiliation(s)
- Yuying Ma
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- The Second School of Clinical Medicine, Southern Medical University
| | - Shiyi Yu
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- The Second School of Clinical Medicine, Southern Medical University
- HKUMed Laboratory of Cellular Therapeutics, The University of Hong Kong
- Faculty of Synthetic Biology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen
| | - Qinming Li
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- The Second School of Clinical Medicine, Southern Medical University
| | - Haifeng Zhang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University
| | - Ruijie Zeng
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- Shantou University Medical College, Shantou, Guangdong, China
| | - Ruibang Luo
- Department of Computer Science, The University of Hong Kong
| | - Qizhou Lian
- Cord Blood Bank, Guangzhou Institute of Eugenics and Perinatology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou
- HKUMed Laboratory of Cellular Therapeutics, The University of Hong Kong
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong SAR
- Faculty of Synthetic Biology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen
| | - Felix W Leung
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles
- Sepulveda Ambulatory Care Center, Veterans Affairs Greater Los Angeles Healthcare System, North Hills, CA, USA
| | - Chongyang Duan
- Department of Biostatistics, School of Public Health, Southern Medical University
| | - Weihong Sha
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- The Second School of Clinical Medicine, Southern Medical University
- Shantou University Medical College, Shantou, Guangdong, China
| | - Hao Chen
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- The Second School of Clinical Medicine, Southern Medical University
- Shantou University Medical College, Shantou, Guangdong, China
| |
Collapse
|
|
9
|
Ogugu EG, Reilly MR, Mbe KTA, Bell JF. Habitual Sleep Duration and Health-Related Quality of Life in Family Caregivers: Findings from the Behavioral Risk Factor Surveillance System. Behav Sleep Med 2024; 22:499-515. [PMID: 38334029 DOI: 10.1080/15402002.2024.2314284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
BACKGROUND Insufficient sleep duration is associated with poor health-related quality of life (HRQoL). However, this relationship has not been studied in family caregivers, a group at high risk of insufficient sleep duration and poor HRQoL. OBJECTIVE To examine the associations between habitual sleep duration and HRQoL measures in family caregivers. METHODS This cross-sectional study used data from 23,321 caregivers in the 2016 Behavioral Risk Factor Surveillance System. The HRQoL measures were health status and poor mental and physical health days. A multivariable logistic regression model was used to assess the association between sleep duration (<7, 7-9, >9 hours) and health status (fair or poor versus good to excellent). Zero-inflated negative binomial models were used to analyze the association of sleep duration with poor mental and physical health days. RESULTS Fair or poor health status was significantly higher in caregivers with short (odds ratio [OR], 1.40; 95% CI: 1.12, 1.74) and long (OR, 2.07; 95% CI: 1.34, 3.21) sleep duration. Short sleep duration was associated with a higher number of poor mental health days (IRR [incident rate ratio], 1.17; 95% CI: 1.04, 1.31) and poor physical health days (IRR, 1.26; 95% CI: 1.10, 1.45). Long sleep duration was associated with more poor mental health days (IRR, 1.31; 95% CI: 1.08, 1.60). CONCLUSION Extremes in sleep duration were associated with lower HRQoL. These findings point to the need for interventions that promote adequate sleep and address factors underlying extremes in sleep duration in the context of family caregiving.
Collapse
Affiliation(s)
- Everlyne G Ogugu
- Betty Irene Moore School of Nursing, University of California, Davis, California, USA
| | - Maura R Reilly
- Betty Irene Moore School of Nursing, University of California, Davis, California, USA
| | - Kougang T Anne Mbe
- Betty Irene Moore School of Nursing, University of California, Davis, California, USA
| | - Janice F Bell
- Betty Irene Moore School of Nursing, University of California, Davis, California, USA
| |
Collapse
|
|
10
|
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: 3] [Impact Index Per Article: 1.5] [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.
Collapse
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
| |
Collapse
|
|
11
|
Davis JK, Mark S, Mackin L, Paul SM, Cooper BA, Conley YP, Hammer MJ, Levine JD, Miaskowski C. Sleep disturbance and decrements in morning energy contribute to a higher symptom burden in oncology patients. Sleep Med 2023; 108:124-136. [PMID: 37354746 DOI: 10.1016/j.sleep.2023.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/29/2023] [Accepted: 06/02/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVE/BACKGROUND An emerging area of research is the relationship between sleep disturbance and decrements in energy. Given the paucity of research on the co-occurrence of these two symptoms, study purposes were to identify subgroups of oncology patients with distinct joint sleep disturbance AND morning energy profiles and evaluate for differences among the subgroups in demographic, clinical, and sleep disturbance characteristics, as well as the severity of other common symptoms and QOL outcomes. PATIENTS/METHODS Patients (n = 1336) completed measures of sleep disturbance and energy 6 times over two cycles of chemotherapy. All of the other measures were completed at enrollment. Latent profile analysis was used to identify the distinct joint sleep disturbance and morning energy profiles. RESULTS Three distinct profiles were identified (i.e., Low Sleep Disturbance and High Morning Energy (Normal, 20.6%), Moderate Sleep Disturbance and Low Morning Energy (Moderately Severe, 52.1%), Very High Sleep Disturbance and Very Low Morning Energy (Very Severe, 27.3%). Compared to Normal class, other two classes were more likely to be female, less likely to be employed, and had higher comorbidity burden and poorer functional status. Symptom scores and QOL outcomes exhibited a dose response effect (i.e., as the profile worsened, symptom scores increased and QOL scores decreased). CONCLUSIONS Given the associations between sleep disturbance and decrements in energy and a higher symptom burden, poorer QOL outcomes, and increased mortality, assessment of these two symptoms needs to be a high priority for clinicians and appropriate interventions initiated.
Collapse
Affiliation(s)
| | - Sueann Mark
- School of Nursing, University of California, San Francisco, CA, USA.
| | - Lynda Mackin
- School of Nursing, University of California, San Francisco, CA, USA.
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, CA, USA.
| | - Bruce A Cooper
- School of Nursing, University of California, San Francisco, CA, USA.
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA.
| | | | - Jon D Levine
- School of Medicine, University of California, San Francisco, CA, USA.
| | | |
Collapse
|
|
12
|
Kuo WY, Chen MC, Shyu YIL. Predictors of Abnormal Sleep Duration in Older Adults With Hip Fracture and Diabetes. J Nurs Res 2023; 31:e269. [PMID: 36976540 DOI: 10.1097/jnr.0000000000000550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Abnormal sleep duration affects recovery in older adults with hip fracture and diabetes mellitus (DM) negatively. However, the predictors of abnormal sleep duration in this population remain unknown. PURPOSE This study was designed to explore the predictors of abnormal sleep duration among older adults with hip fracture and DM within 6 months of hospital discharge. METHODS A longitudinal study using secondary data from a randomized controlled trial was implemented. Data on fracture-related factors (diagnosis, surgical methods) were collected from medical charts. Information on the duration of DM, methods of DM control, and diabetes-related peripheral vascular disease was collected by asking simple questions. Diabetic peripheral neuropathy was assessed using the Michigan Neuropathy Screening Instrument. Sleep duration outcomes were determined using data collected from a SenseWear armband. RESULTS Having more comorbidities (OR = 3.14, p = .04), having undergone open reduction (OR = 2.65, p = .005), having undergone closed reduction with internal fixation (OR = 1.39, p = .04), and having DM (OR = 1.18, p = .01), diabetic peripheral neuropathy (OR = 9.60, p = .02), or diabetic peripheral vascular disease for a longer duration (OR = 15.62, p = .006) were all associated with a higher risk of abnormal sleep duration. CONCLUSIONS The findings indicate that patients with more comorbidities or who had undergone internal fixation, had a long DM history, or had complications are more likely to have abnormal sleep duration. Thus, greater attention should be focused on the sleep duration of diabetic older adults with hip fracture who are affected by these factors to achieve better postoperative recovery.
Collapse
Affiliation(s)
- Wen-Yu Kuo
- PhD, RN, Assistant Professor, School of Nursing, and Geriatric and Long-Term Care Research Center, Chang Gung University of Science and Technology, Taoyuan City, Taiwan, ROC
| | - Min-Chi Chen
- PhD, Professor, Department of Public Health & Biostatistics, Consulting Center, College of Medicine, Chang Gung University, and Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
| | - Yea-Ing Lotus Shyu
- PhD, RN, FAAN, Distinguished Professor, School of Nursing, College of Medicine, and Healthy Aging Research Center, Chang Gung University; Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital; Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology; and Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, ROC
| |
Collapse
|
|
13
|
Papadopoulos D, Sosso FAE. Socioeconomic status and sleep health: a narrative synthesis of 3 decades of empirical research. J Clin Sleep Med 2023; 19:605-620. [PMID: 36239056 PMCID: PMC9978435 DOI: 10.5664/jcsm.10336] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 12/24/2022]
Abstract
STUDY OBJECTIVES This review aims to assess the association between socioeconomic status (SES) and sleep health in the general population and the mediating effects of lifestyle and mental and physical health in this relationship. METHODS Observational studies testing the independent association between objective or subjective SES indicators and behavioral/physiological or clinical sleep health variables in the general population were included. PubMed/MEDLINE was searched for reports published from January 1990 to December 2019. The direction of effect was used as the primary effect measure, testing the hypothesis that low SES is associated with poor sleep health outcomes. Results are presented in the form of direction effect plots and synthesized as binomial proportions. RESULTS Overall, 336 studies were identified. A high proportion of effects at the expected direction was noted for measures of sleep continuity (100% for sleep latency, 50-100% for awakenings, 66.7-100% for sleep efficiency), symptoms of disturbed sleep (75-94.1% for insomnia, 66.7-100% for sleep-disordered breathing, 60-100% for hypersomnia), and general sleep satisfaction (62.5-100%), while the effect on sleep duration was inconsistent and depended on the specific SES variable (92.3% for subjective SES, 31.7% for employment status). Lifestyle habits, chronic illnesses, and psychological factors were identified as key mediators of the SES-sleep relationship. CONCLUSIONS Unhealthy behaviors, increased stress levels, and limited access to health care in low-SES individuals may explain the SES-sleep health gradient. However, the cross-sectional design of most studies and the high heterogeneity in employed measures of SES and sleep limit the quality of evidence. Further research is warranted due to important implications for health issues and policy changes. CITATION Papadopoulos D, Etindele Sosso FA. Socioeconomic status and sleep health: a narrative synthesis of 3 decades of empirical research. J Clin Sleep Med. 2023;19(3):605-620.
Collapse
|
|
14
|
Huang YM, Xia W, Ge YJ, Hou JH, Tan L, Xu W, Tan CC. Sleep duration and risk of cardio-cerebrovascular disease: A dose-response meta-analysis of cohort studies comprising 3.8 million participants. Front Cardiovasc Med 2022; 9:907990. [PMID: 36237900 PMCID: PMC9551171 DOI: 10.3389/fcvm.2022.907990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 09/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background The effect of extreme sleep duration on the risk of cardiovascular and cerebrovascular diseases (CCDs) remains debatable. The pathology of CCDs is consistent in some respects (e.g., vascular factors), suggesting that there may be an overlapping range of sleep duration associated with a low risk of both diseases We aimed to quantify the dose-response relationship between sleep duration and CCDs. Study objective To explore whether there is an optimal sleep duration (SD) in reducing the risk of CCDs. Methods PubMed and EMBASE were searched until June 24, 2022 to include cohort studies that investigated the longitudinal relationships of SD with incident CCDs, including stroke and coronary heart disease (CHD). The robusterror meta-regression model (REMR model) was conducted to depict the dose-response relationships based on multivariate-adjusted risk estimates. Results A total of 71 cohorts with 3.8 million participants were included for meta-analysis, including 57 for cardiovascular diseases (CVD) and 29 for cerebrovascular disease. A significant U-shaped relationship was revealed of nighttime sleep duration with either cardiovascular or cerebrovascular disease. The nighttime sleep duration associated with a lower risk of CVD was situated within 4.3-10.3 h, with the risk hitting bottom at roughly 7.5 h per night (p non-linearity < 0.0001). Sleep duration associated with a lower risk of cerebrovascular diseases ranges from 5 to 9.7 h per night, with the inflection at 7.5 h per night (p non-linearity = 0.05). Similar non-linear relationship exited in daily sleep duration and CCDs. Other subgroup analyses showed non-linear relationships close to the above results. Conclusion Rational sleep duration (7.5 h/night) is associated with a reduced risk of cardio-cerebrovascular disease for adults.
Collapse
Affiliation(s)
- Yi-Ming Huang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Wei Xia
- Department of Cardiology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Yi-Jun Ge
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Jia-Hui Hou
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Wei Xu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Chen-Chen Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| |
Collapse
|
|
15
|
Ogugu EG, Catz SL, Bell JF, Drake C, Bidwell JT, Gangwisch JE. Factors associated with habitual sleep duration in US adults with hypertension: a cross-sectional study of the 2015-2018 National Health and Nutrition Examination Survey. BMC Public Health 2022; 22:43. [PMID: 34991527 PMCID: PMC8739698 DOI: 10.1186/s12889-021-12465-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 12/20/2021] [Indexed: 12/22/2022] Open
Abstract
Background The relationship between inadequate sleep duration and hypertension risk has been established in the general population, but there is a gap in the literature on predictors of habitual sleep duration in adults with hypertension. This study examined factors associated with habitual sleep duration among adults with hypertension in the United States (US). Methods Data of 5660 adults with hypertension were obtained by combining the 2015–2018 cycles of the National Health and Nutrition Examination Survey (NHANES). Survey weighted multinomial logistic regression models were fit to examine factors associated with short (< 7 h) and long (> 9 h) sleep duration with adequate sleep duration (7–9 h) as the reference. Results The prevalence of self-reported adequate sleep duration was 65.7%, while short sleep duration was 23.6%, and long sleep duration 10.7%. Short sleep duration (compared to adequate sleep duration) was positively associated with history of seeking help for sleeping difficulties (relative risk ratio [RRR], 1.25; 95% confidence interval [CI], 1.02–1.53), Non-Hispanic Black race/ethnicity (RRR, 2.08; 95% CI, 1.61–2.67), working ≥45 h/week (RRR, 1.81; 95% CI, 1.32–2.48), and negatively associated with older age ≥ 65 years (RRR, 0.63; 95% CI, 0.45–0.91) and female gender (RRR, 0.70; 95% CI, 0.56–0.88). Long sleep duration was positively associated with female gender (RRR, 1.24; 95% CI, 1.001–1.54), chronic kidney disease (RRR, 1.48; 95% CI, 1.14–1.92), moderate depressive symptoms (RRR, 1.62; 95% CI, 1.08–2.44), moderately severe to severe depressive symptoms (RRR, 1.89; 95% CI, 1.05–3.43), being in retirement (RRR, 3.46; 95% CI, 2.18–5.49), and not working due to health reasons (RRR, 4.87; 95% CI, 2.89–8.22) or other reasons (RRR, 3.29; 95% CI, 1.84–5.88). Conclusion This population-based study identified factors independently associated with habitual sleep duration in adults with hypertension. These included help-seeking for sleeping difficulty, gender, age, chronic kidney disease, depressive symptoms, race/ethnicity, and employment status. These findings can help in the development of tailored approaches for promoting adequate sleep duration in adults with hypertension. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12465-2.
Collapse
Affiliation(s)
- Everlyne G Ogugu
- Betty Irene Moore School of Nursing, University of California, Davis 2570 48th Street, Sacramento, CA, 95817, USA.
| | - Sheryl L Catz
- Betty Irene Moore School of Nursing, University of California, Davis 2570 48th Street, Sacramento, CA, 95817, USA
| | - Janice F Bell
- Betty Irene Moore School of Nursing, University of California, Davis 2570 48th Street, Sacramento, CA, 95817, USA
| | - Christiana Drake
- Department of Statistics, University of California, Davis 399 Crocker Ln, Davis, CA, 95616, USA
| | - Julie T Bidwell
- Betty Irene Moore School of Nursing, University of California, Davis 2570 48th Street, Sacramento, CA, 95817, USA
| | - James E Gangwisch
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA
| |
Collapse
|
|
16
|
Zhang H, Ma W, Chen Y, Wang F, Wang J, Han P, Wang Y, Zhang C, Xie F, Niu S, Hu H, Wang H, Guo Q. Long Sleep Duration Associated With Cognitive Impairment in Chinese Community-Dwelling Older Adults. J Nerv Ment Dis 2021; 209:925-932. [PMID: 34333503 DOI: 10.1097/nmd.0000000000001401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT We aimed to examine the association between sleep duration and impaired cognitive function in different cognitive domains in Chinese community-dwelling older adults. A total of 1591 participants (≥60 years) were divided into five groups: ≤6 hours (very short sleep duration), >6 to 7 hours (short sleep duration), ≥7 to 8 hours (moderate sleep duration), >8 to 9 hours (moderately long sleep duration), and >9 hours (long sleep duration), according to sleep duration. Cognitive function was assessed using the Mini-Mental State Examination. Long sleep duration significantly increased the likelihood of cognitive impairment. In addition to attention, long sleep duration was negatively related to poorer global cognition and other cognitive domain functions. With the stratification of age groups, long sleep duration was negatively associated with other cognitive domain functions except delayed recall in older elderly (≥75 years) people, but not in younger elderly (60-74 years) people. Long sleep duration was associated with higher rates of cognitive impairment, poorer global cognition, and declined orientation, memory, language ability, and executive function in Chinese community-dwelling older adults, which was more significant in older elderly people.
Collapse
Affiliation(s)
- Hui Zhang
- Shanghai University of Medicine and Health Science Affiliated First Rehabilitation Hospital
| | - Weibo Ma
- Shanghai University of Traditional Chinese Medicine
| | - Yaoxin Chen
- Shanghai University of Traditional Chinese Medicine
| | - Feng Wang
- Shanghai University of Traditional Chinese Medicine
| | - Jingru Wang
- Shanghai University of Traditional Chinese Medicine
| | - Peipei Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Yiwen Wang
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Chenyu Zhang
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Fandi Xie
- Shanghai University of Medicine and Health Science Affiliated First Rehabilitation Hospital
| | - Shumeng Niu
- Shanghai University of Medicine and Health Science Affiliated First Rehabilitation Hospital
| | - Hao Hu
- Shanghai University of Medicine and Health Science Affiliated First Rehabilitation Hospital
| | - Hong Wang
- Shanghai University of Medicine and Health Science Affiliated First Rehabilitation Hospital
| | - Qi Guo
- Shanghai University of Medicine and Health Science Affiliated First Rehabilitation Hospital
| |
Collapse
|
|
17
|
Huang S, Sun H, Yu J, Shi H, Ren L, He Y, Zhang M, Peng H, Guo H. The Interaction Between Self-Reported Sleep Duration and Physical Activity on Peripheral Artery Disease in Chinese Adults: A Cross-Sectional Analysis in the Tianning Cohort Study. Risk Manag Healthc Policy 2021; 14:4063-4072. [PMID: 34616193 PMCID: PMC8488049 DOI: 10.2147/rmhp.s332098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 09/16/2021] [Indexed: 12/13/2022] Open
Abstract
Purpose Sleep duration was associated with large artery atherosclerosis, but its association with atherosclerosis in lower extremity arteries was not well studied. Together with sleep, physical activity constitutes main component of our daily life and influences sleep. Here, we aimed to examine the independent and joint associations of sleep duration and physical activity with peripheral artery disease (PAD) in Chinese adults. Patients and Methods In Tianning cohort, night-time sleep duration and physical activity were assessed by the Pittsburgh Sleep Quality Index and the Global Physical Activity Questionnaire, respectively, for 5130 participants (51.0±15.6 years, 58.7% female). PAD was defined as ankle-brachial index (ABI) <0.9. General linear, and logistic regression models were used to assess the associations of sleep duration and physical activity with PAD. The biological interaction between sleep duration and physical activity on PAD was examined using additive model. Results Compared to participants sleeping 6-8.9 h, those sleeping ≥9 h had a 0.02 lower ABI (β=-0.02, P=0.007) and 38% higher odds of PAD (OR=1.38, P=0.035). Compared to physically active participants sleeping 6-8.9 h, among ≥9 h group, physically inactive individuals had significantly increased odds of PAD (OR=2.40, P<0.001), whereas physically active individuals did not (OR=1.15, P=0.472). On additive scale, attributable proportion due to interaction (0.40, 95% CI: 0.07, 0.73) indicated a significant interaction between sleep duration and physical activity on PAD. Conclusion Being physically active may attenuate the detrimental association between prolonged sleep duration and PAD. Moreover, we found a significant interaction between prolonged sleep duration and physical inactivity in the prevalence of PAD.
Collapse
Affiliation(s)
- Shujing Huang
- Department of Public Health, School of Medicine, Shihezi University, Shihezi, People's Republic of China
| | - Hongyan Sun
- Center for Disease Prevention and Control of Tianning District, Changzhou, People's Republic of China
| | - Jia Yu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China
| | - Hongfei Shi
- Center for Disease Prevention and Control of Tianning District, Changzhou, People's Republic of China
| | - Liyun Ren
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China
| | - Yan He
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China
| | - Mingzhi Zhang
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China
| | - Hao Peng
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou, People's Republic of China
| | - Heng Guo
- Department of Public Health, School of Medicine, Shihezi University, Shihezi, People's Republic of China
| |
Collapse
|
|
18
|
Zhang H, Chen X, Han P, Ma W, Zhang Y, Song P, Wu Y, Zhu Y, Jiang Z, Cai M, Guo Q, Wang H. Mediating effects of lower extremity function on the relationship between night sleep duration and cardiovascular disease risk: a cross-sectional study in elderly Chinese without cardiovascular diseases. BMJ Open 2021; 11:e046015. [PMID: 34244261 PMCID: PMC8268917 DOI: 10.1136/bmjopen-2020-046015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE The purpose of this study is to investigate the mediating effect of physical performance on the relationship between night sleep duration and risk of cardiovascular disease (CVD) in elderly Chinese without CVD. METHODS 782 participants without CVD over 65 years (average: 70.82±3.86 years, 448 women) were included in this study. CVD risk was calculated by the Framingham Risk Score and participants were divided into four groups of night sleep duration (in hours): <7 hours, ≥7-8 hours, >8-9 hours and >9 hours. Upper extremity function was measured by grip strength and lower extremity function was measured by the Short Physical Performance Battery (SPPB), consisting of balance, 4 m walk and chair stands tests. RESULTS After adjusting for covariates, long night sleep duration (>9 hours) and CVD risk were significantly positively associated compared with moderate night sleep duration (≥7-8 hours) (β=1.152; 95% CI 0.05 to 2.25). SPPB total score (indirect effect ab=-0.122; 95% CI -0.291 to -0.0008) rather than grip strength partially mediated the relationship between long night sleep duration and CVD risk, in which chair stands played a major mediating role (indirect effect ab=-0.171; 95% CI -0.040 to -0.0006), while balance (indirect effect ab=-0.016; 95% CI -0.100 to 0.063) and 4 m walk (indirect effect ab=0.048; 95% CI -0.066 to 0.201) did not. CONCLUSIONS Lower extremity function, especially lower limb muscle strength, partially mediates a positive association between long night sleep duration and CVD risk in the elderly without CVD. Suitable interventions for physical performance and sleep may minimise the risk of subsequent CVD.
Collapse
Affiliation(s)
- Hui Zhang
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Xiaoyu Chen
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Peipei Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Weibo Ma
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Yuanyuan Zhang
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Peiyu Song
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Yunxiao Wu
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Yibo Zhu
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Zhengxing Jiang
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Ming Cai
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Qi Guo
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Hong Wang
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
| |
Collapse
|
|
19
|
Yi SJ, Jeong YM, Kim JH. Relationship between Sleep Duration Trajectories and Self-Rated Depressive Symptoms in South Koreans with Physical Disabilities. Healthcare (Basel) 2021; 9:healthcare9030361. [PMID: 33806836 PMCID: PMC8005137 DOI: 10.3390/healthcare9030361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/10/2021] [Accepted: 03/14/2021] [Indexed: 11/16/2022] Open
Abstract
Physically disabled persons can have sleep problems, which affects their mental health more than those in non-disabled people. However, there are few studies on the relationship between sleep duration and mental health targeting physically disabled people in South Korea, and existing studies on the disabled have mostly used data collected from convenience rather than nationally representative samples, limiting the generalization of the results. This study used data from the second wave of the Panel Survey of Employment for the Disabled (PSED, 2016-2018, 1st-3rd year). Participants included 1851 physically disabled individuals. The Chi-square test and generalized estimating equation (GEE) were used and the Akaike information criterion (AIC) value and the AIC log Bayes factor approximation were used to select sleep trajectories. This is the first study to elucidate multiple sleep trajectories in physically disabled people in Korea, and the relationship between sleep duration trajectories and self-rated depressive symptoms. People with physical disabilities who sleep more than 9 h have the highest risk of depression and need more intensive management as a priority intervention.
Collapse
Affiliation(s)
- Su Jeong Yi
- College of Nursing, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan-si 31116, Chungchungnam-do, Korea;
| | - Yoo Mi Jeong
- College of Nursing, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan-si 31116, Chungchungnam-do, Korea;
- Correspondence: (Y.M.J.); (J.-H.K.); Tel.: +82-041-550-1458 (Y.M.J.); +82-041-550-1472 (J.-H.K.)
| | - Jae-Hyun Kim
- Department of Health Administration, College of Health Science, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan-si 31116, Chungchungnam-do, Korea
- Correspondence: (Y.M.J.); (J.-H.K.); Tel.: +82-041-550-1458 (Y.M.J.); +82-041-550-1472 (J.-H.K.)
| |
Collapse
|
|
20
|
Wu J, Cheng GHL, Sheng LT, Feng L, Yuan JM, Chee M, Pan A, Koh WP. Prospective associations between change in sleep duration and cognitive impairment: Findings from the Singapore Chinese Health Study. J Affect Disord 2021; 281:125-130. [PMID: 33316717 DOI: 10.1016/j.jad.2020.12.007] [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: 10/04/2020] [Revised: 11/30/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The relation of changes in sleep duration with risk of cognitive impairment are inconclusive. This study evaluated the prospective relationships of changes in sleep duration with risk of cognitive impairment in Singapore Chinese. METHODS We used data from 16,948 Chinese men and women who were aged 45-74 years at baseline (1993-1998) during recruitment into the Singapore Chinese Health Study cohort. Daily sleep duration was assessed at baseline, follow-up 2 (2006 to 2010) and follow-up 3 interviews (2014-2016). Cognitive function was evaluated with a Singapore-Modified Mini-Mental State Examination at follow-up 3 interviews when participants were 61-96 years old. Multivariable logistic regression models were used to calculate odd ratios (ORs) and 95% confidence intervals (95% CIs) for cognitive impairment. RESULTS Of the 16,948 participants, 14.4% were defined to have cognitive impairment. Compared with 7 h/day sleep at both baseline and follow-up 2, the OR (95% CI) for cognitive impairment was 1.50 (1.04-2.16) for those who maintained long sleep duration (≥9 h/day), 2.18 (1.37-3.45) for those who prolonged sleep from short duration (≤5 h/day) to long duration (≥9 h/day), and 1.55 (1.20-2.02) for those who prolonged sleep from recommended duration (7 h/day) to long duration. The highest risk was observed in those who shortened sleep from long to short duration (2.93, 1.35-6.34). LIMITATIONS Measures of sleep were self-reported. CONCLUSIONS Substantial changes in sleep duration over time were associated with higher risks of cognitive impairment. The findings underscore the importance of maintaining optimal sleep duration for the prevention of cognitive impairment.
Collapse
Affiliation(s)
- Jing Wu
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Grand H-L Cheng
- School of Arts and Social Sciences, The Open University of Hong Kong, Hong Kong, China
| | - Li-Ting Sheng
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jian-Min Yuan
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michael Chee
- Centre for Cognitive Neuroscience, Duke-NUS Medical School Singapore, Singapore
| | - An Pan
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
| | - Woon-Puay Koh
- Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
| |
Collapse
|
|
21
|
Etindele Sosso FA, Matos E. Socioeconomic disparities in obstructive sleep apnea: a systematic review of empirical research. Sleep Breath 2021; 25:1729-1739. [PMID: 33452999 DOI: 10.1007/s11325-020-02274-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 12/02/2020] [Accepted: 12/11/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Considering socioeconomic status (SES) in the diagnosis of obstructive sleep apnea (OSA) will enhance our understanding of socioeconomic disparities in clinical practice of sleep medicine. This systematic review analyzes the relations between SES and OSA measures. METHODOLOGY Eleven articles were identified through the Pubmed database. The National Institute of Health's Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to rate the quality of these studies. RESULTS This systematic review revealed that associations between socioeconomic status and OSA measures are similar for both adults, children, and adolescents. Our findings showed that: (1) A lower SES is associated with an increased risk of OSA, both in adults and children/adolescents as well as for men and women. (2) Several studies assessed sleep outcomes with a single question, an approach that is unable to capture the multi-dimensionality and day-to-day variability of sleep in general or OSA in particular, (3) Low SES has detrimental effects on sleep health. (4) Sleep questionnaires are more commonly used than objective measure to assess OSA. CONCLUSIONS Interaction between SES and OSA must be better understood to improve current clinical guidelines. Living conditions influence the trajectory of OSA with unknown speed and for an, undetermined period, pointing to the need for more studies on this topic. Future work should identify the effect of SES on the development and progression of OSA, determine the effect of behavioral intervention and local public health programs to reduce social inequalities associated with OSA.
Collapse
Affiliation(s)
- F A Etindele Sosso
- Department on Global Health and Ecoepidemiology, Redavi Institute, Montréal, Canada.
| | - E Matos
- Sleep Laboratory of Pulmonology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro - Vila Real, Vila Real, Portugal
| |
Collapse
|
|
22
|
Lu H, Wu PF, Li RZ, Zhang W, Huang GX. Sleep Duration and Stroke: A Mendelian Randomization Study. Front Neurol 2020; 11:976. [PMID: 33117250 PMCID: PMC7575720 DOI: 10.3389/fneur.2020.00976] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 07/27/2020] [Indexed: 12/15/2022] Open
Abstract
Study Objectives: To clarify the effects of sleep duration on stroke and stroke subtypes, we adopted a Mendelian randomization (MR) approach to evaluate their causal relationship. Methods: A genome-wide association study including 446,118 participants from UK biobank was used to identify instruments for short sleep, long sleep and sleep duration. Summary-level data for all stroke, ischemic stroke, intracerebral hemorrhage, and their subtypes were obtained from meta-analyses conducted by the MEGASTROKE consortium. MR analyses were performed using the inverse-variance-weighted method, weighted median estimator, MR pleiotropy residual sum and outlier (MR-PRESSO) test, and MR-Egger regression. Sensitivity analyses were further performed using leave-one-out analysis, MR-PRESSO global test and Cochran's Q test to verify the robustness of our findings. Results: By two-sample MR, we didn't find causal associations between sleep duration and risk of stroke. However, in the subgroup analysis, we found weak evidence for short sleep in increasing risk of cardio-embolic stroke (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.11–1.60; P = 0.02) and long sleep in increasing risk of large artery stroke [OR, 1.41; 95% CI, 1.02–1.95; P = 0.04]. But the associations were not significant after Bonferroni correction for multiple comparisons. Conclusions: Our study suggests that sleep duration is not causally associated with risk of stroke and its subtypes.
Collapse
Affiliation(s)
- Hui Lu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Peng-Fei Wu
- Center for Medical Genetics & Hunan Provincial Key Laboratory for Medical Genetics, School of Life Sciences, Central South University, Changsha, China.,Department of Neurology, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, United States
| | - Rui-Zhuo Li
- School of Medicine, South China University of Technology, Guangzhou, China
| | - Wan Zhang
- Department of Neurology, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, United States.,Biology Department, College of Arts & Sciences, Boston University, Boston, MA, United States
| | - Guo-Xiang Huang
- Department of Neurology, Affiliated Hospital of Nantong University, Nantong, China
| |
Collapse
|
|
23
|
Chen X, Wang SB, Li XL, Huang ZH, Tan WY, Lin HC, Hou CL, Jia FJ. Relationship between sleep duration and sociodemographic characteristics, mental health and chronic diseases in individuals aged from 18 to 85 years old in Guangdong province in China: a population-based cross-sectional study. BMC Psychiatry 2020; 20:455. [PMID: 32938430 PMCID: PMC7493355 DOI: 10.1186/s12888-020-02866-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 09/10/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Sleep is vital for maintaining individual's physical and mental health. Prior studies have reported close relationships between sleep duration and chronic diseases. However, in China, the prevalence of aberrant sleep duration and the associations between sleep duration and chronic conditions still merit studying in Guangdong province. This study aimed at examining the relationship between sleep duration and multiple dimensions of sociodemographic characteristics, mental health and chronic diseases in Guangdong province in China, with a large population-based data of individuals aged from 18 to 85 years old. METHODS This study aimed at analyzing the sociodemographic and clinical characteristics of the population in Guangdong province. Multistage stratified cluster sampling was applied for this study. 13,768 participants from Guangdong province were interviewed with standardized assessment tools, including Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder (GAD-7). Basic socio-demographic information, mental health and chronic diseases information were collected. Self-reported sleep duration was classified as three types: short (< 7 h), normative (7-9 h) and long (≥9 h). RESULTS The mean sleep duration was 6.75 ± 1.11 h. Short sleepers had a higher prevalence of chronic diseases, including anemia (6.2%, p = 0.024), gout (2.8%, p = 0.010), hyperlipidemia (3.9%, p = 0.003) and low back pain (5.6%, p = 0.020) than other types of sleeper. Multinomial logistic regression analysis revealed that short sleepers were more likely to have low income level, have depressive symptoms, be ex- or current drinkers and be overweight. Anemia, hyperlipidemia and low back pain were all risk factors for short sleep, while malignant tumor was risky for long sleep. CONCLUSIONS Low income level, drinking status, being overweight, and chronic conditions may be associated with aberrant sleep duration in Guangdong province general population. Short sleepers have a higher risk of suffering from anemia, hyperlipidemia, and low back pain, while long sleepers are more likely to have malignant tumor. Health professionals should value the sleep patterns in general health care and attach importance to conduct further epidemiologic surveys to explore the relationship between sleep duration and health.
Collapse
Affiliation(s)
- Xie Chen
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.123, Huifu Xi Road, Guangzhou City, 510000 Guangdong Province China ,grid.411679.c0000 0004 0605 3373Medical College of Shantou University, No.22, Jinling Road, Shantou City, 515041 Guangdong Province China
| | - Shi-Bin Wang
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.123, Huifu Xi Road, Guangzhou City, 510000 Guangdong Province China
| | - Xue-Li Li
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.123, Huifu Xi Road, Guangzhou City, 510000 Guangdong Province China
| | - Zhuo-Hui Huang
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.123, Huifu Xi Road, Guangzhou City, 510000 Guangdong Province China
| | - Wen-Yan Tan
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.123, Huifu Xi Road, Guangzhou City, 510000 Guangdong Province China
| | - Hai-Cheng Lin
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.123, Huifu Xi Road, Guangzhou City, 510000 Guangdong Province China
| | - Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No.123, Huifu Xi Road, Guangzhou City, 510000, Guangdong Province, China. .,Affiliated School of Medicine of South China University of Technology, No. 381, Wushan Road, Guangzhou City, 510000, Guangdong Province, China.
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No.123, Huifu Xi Road, Guangzhou City, 510000, Guangdong Province, China. .,Affiliated School of Medicine of South China University of Technology, No. 381, Wushan Road, Guangzhou City, 510000, Guangdong Province, China.
| |
Collapse
|
|
24
|
Mesas AE, Hagen EW, Peppard PE. The bidirectional association between physical activity and sleep in middle-aged and older adults: a prospective study based on polysomnography. Sleep 2019; 41:5025915. [PMID: 29860437 DOI: 10.1093/sleep/zsy114] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Indexed: 01/06/2023] Open
Abstract
Study Objectives To examine the bidirectional association between physical activity (PA) and polysomnographically (PSG)-assessed sleep parameters characterized by total sleep time (TST), sleep onset latency (SOL), wake time after sleep onset (WASO), sleep efficiency and percentage of TST in N1, N2, and N3 stages and rapid eye movement (REM) sleep in middle-aged and older adults. Methods Longitudinal study based on a subsample of the Wisconsin Sleep Cohort. Self-reported PA information was used to estimate the metabolic equivalents of task (MET-minutes/week) activity and in-laboratory PSG exams provided information on sleep parameters at baseline and after 3-11 years of follow-up between 2004 and 2015. Poisson and linear regression models controlling for confounders estimated associations of sleep outcomes with changes in PA. Results A total of 424 participants (45.8% female; mean ± SD age 60.1 ± 7.5 years) were followed over an average of 5.0 ± 1.6 years. Compared to baseline PA of <500 MET-minutes/week (reference category), 500 to 1500 MET-minutes/week of PA was associated with lower incidences of TST <6 hours (relative risk, RR: 0.49; 95% confidence interval, CI: 0.27; 0.88), WASO >60 minutes (RR: 0.58; 95% CI: 0.41; 0.82) and sleep efficiency <80% (RR: 0.61; 95% CI: 0.39; 0.94), adjusting for sociodemographic, health behaviors and medical conditions. No significant associations were observed between baseline sleep characteristics and changes in PA through the follow-up. Conclusion In this prospective study, an intermediate level of PA at baseline predicted lower risk of incident short sleep time, higher WASO and lower sleep efficiency measured with PSG.
Collapse
Affiliation(s)
- Arthur E Mesas
- Department of Public Health, Health Sciences Center, State University of Londrina, Av. Robert Koch, Londrina, PR, Brazil.,Department of Population Health Sciences, University of Wisconsin - School of Medicine and Public Health, Madison, WI
| | - Erika W Hagen
- Department of Population Health Sciences, University of Wisconsin - School of Medicine and Public Health, Madison, WI
| | - Paul E Peppard
- Department of Population Health Sciences, University of Wisconsin - School of Medicine and Public Health, Madison, WI
| |
Collapse
|
|
25
|
Henry A, Katsoulis M, Masi S, Fatemifar G, Denaxas S, Acosta D, Garfield V, Dale CE. The relationship between sleep duration, cognition and dementia: a Mendelian randomization study. Int J Epidemiol 2019; 48:849-860. [PMID: 31062029 PMCID: PMC6659373 DOI: 10.1093/ije/dyz071] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Short and long sleep duration have been linked with poorer cognitive outcomes, but it remains unclear whether these associations are causal. METHODS We conducted the first Mendelian randomization (MR) study with 77 single-nucleotide polymorphisms (SNPs) for sleep duration using individual-participant data from the UK Biobank cohort (N = 395 803) and summary statistics from the International Genomics of Alzheimer's Project (N cases/controls = 17 008/37 154) to investigate the potential impact of sleep duration on cognitive outcomes. RESULTS Linear MR suggested that each additional hour/day of sleep was associated with 1% [95% confidence interval (CI) = 0-2%; P = 0.008] slower reaction time and 3% more errors in visual-memory test (95% CI = 0-6%; P = 0.05). There was little evidence to support associations of increased sleep duration with decline in visual memory [odds ratio (OR) per additional hour/day of sleep = 1.10 (95% CI = 0.76-1.57); P = 0.62], decline in reaction time [OR = 1.28 (95% CI = 0.49-3.35); P = 0.61], all-cause dementia [OR = 1.19 (95% CI = 0.65-2.19); P = 0.57] or Alzheimer's disease risk [OR = 0.89 (95% CI = 0.67-1.18); P = 0.41]. Non-linear MR suggested that both short and long sleep duration were associated with poorer visual memory (P for non-linearity = 3.44e-9) and reaction time (P for non-linearity = 6.66e-16). CONCLUSIONS Linear increase in sleep duration has a small negative effect on reaction time and visual memory, but the true association might be non-linear, with evidence of associations for both short and long sleep duration. These findings suggest that sleep duration may represent a potential causal pathway for cognition.
Collapse
Affiliation(s)
- Albert Henry
- Institute of Health Informatics, University College London, London, UK
- Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, London, UK
| | - Michail Katsoulis
- Institute of Health Informatics, University College London, London, UK
| | - Stefano Masi
- Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, London, UK
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Spiros Denaxas
- Institute of Health Informatics, University College London, London, UK
| | - Dionisio Acosta
- Institute of Health Informatics, University College London, London, UK
| | - Victoria Garfield
- Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, London, UK
| | - Caroline E Dale
- Institute of Health Informatics, University College London, London, UK
- Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, London, UK
| |
Collapse
|
|
26
|
Zhang S, Xie L, Yu H, Zhang W, Qian B. Association between nighttime-daytime sleep patterns and chronic diseases in Chinese elderly population: a community-based cross-sectional study. BMC Geriatr 2019; 19:124. [PMID: 31035939 PMCID: PMC6489270 DOI: 10.1186/s12877-019-1136-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 04/11/2019] [Indexed: 12/01/2022] Open
Abstract
Background This study aimed to assess the relationship between specific nighttime-daytime sleep patterns and prevalence of different chronic diseases in an elderly population. Methods We conducted a community-based cross-sectional study in 4150 elderly Chinese, with an average age of 74 years. Sleep-related variables (nighttime sleep duration, daytime napping and duration) and chronic disease status, including diabetes, cardiovascular diseases (CVD), dyslipidemia cancer and arthritis were collected for the study. Multivariable logistic regression models were used to analyze the relationship between nighttime-daytime sleep patterns and prevalence of chronic diseases. Results Overall prevalence of any of chronic diseases was 83.8%. Nighttime-daytime sleep patterns were defined according to nighttime sleep duration and habitual nappers/non-nappers. Taking the nighttime-daytime sleep pattern “short nighttime sleep with daytime napping” as reference, those with “long nighttime sleep without daytime napping” had higher prevalence of diabetes [OR and 95% CI, 1.35 (1.01–1.80)] and lower prevalence of arthritis [OR and 95% CI, 0.46 (0.33–0.63)]. And those with “long nighttime sleep with daytime napping” had higher prevalence of diabetes [OR and 95% CI, 1.36 (1.05–1.78)] while lower prevalence of cancer [OR and 95% CI, 0.48 (0.26–0.85)] and arthritis [OR and 95% CI, 0.67 (0.51–0.86)]. Further, in habitual nappers, subjects were classified according to duration of nighttime sleep and daytime naps. Compared to “short nighttime sleep with long daytime napping”, individuals with “long nighttime sleep with short daytime napping” had significantly positive association with diabetes prevalence [OR and 95% CI, 1.73 (1.15–2.68)] while border-significantly and significantly negative association with cancer [OR and 95% CI, 0.49 (0.23–1.07)] and arthritis [OR and 95% CI, 0.64 (0.44–0.94)], respectively. Conclusions Elderly individuals with chronic diseases had different nighttime-daytime sleep patterns, and understanding these relationships may help to guide the management of chronic diseases. Electronic supplementary material The online version of this article (10.1186/s12877-019-1136-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Shuo Zhang
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital & Faculty of Public Health, Shanghai Jiao Tong University School of Medicine, No. 227, South Chongqing Road, Shanghai, 200025, China.,Clinical research center, Shanghai Jiao Tong University School of Medicine, No. 227, South Chongqing Road, Shanghai, 200025, China
| | - Li Xie
- Clinical research center, Shanghai Jiao Tong University School of Medicine, No. 227, South Chongqing Road, Shanghai, 200025, China
| | - Herbert Yu
- Cancer Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Weituo Zhang
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital & Faculty of Public Health, Shanghai Jiao Tong University School of Medicine, No. 227, South Chongqing Road, Shanghai, 200025, China.,Clinical research center, Shanghai Jiao Tong University School of Medicine, No. 227, South Chongqing Road, Shanghai, 200025, China
| | - Biyun Qian
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital & Faculty of Public Health, Shanghai Jiao Tong University School of Medicine, No. 227, South Chongqing Road, Shanghai, 200025, China. .,Clinical research center, Shanghai Jiao Tong University School of Medicine, No. 227, South Chongqing Road, Shanghai, 200025, China.
| |
Collapse
|
|
27
|
Leng Y, Stone K, Ancoli-Israel S, Covinsky K, Yaffe K. Who Take Naps? Self-Reported and Objectively Measured Napping in Very Old Women. J Gerontol A Biol Sci Med Sci 2019; 73:374-379. [PMID: 28329031 DOI: 10.1093/gerona/glx014] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Indexed: 11/14/2022] Open
Abstract
Background Despite the widespread belief that napping is common among older adults, little is known about the correlates of napping. We examined the prevalence and correlates of self-reported and objectively measured napping among very old women. Methods We studied 2,675 community-dwelling women (mean age 84.5 ± 3.7 years; range 79-96). Self-reported napping was defined as a report of regular napping for ≥1 hour per day. Individual objective naps were defined as ≥5 consecutive minutes of inactivity as measured by actigraphy and women were characterized as "objective nappers" if they had at least 60 minutes of naps per day. Results Seven percent of the women only had self-reported napping, 29% only had objective napping, and 14% met the criteria for both. Multinomial logistic regression showed that the independent correlates of "both subjective and objective napping" were age (per 5 year odds ratio [OR] = 1.59; 95% CI: 1.31-1.93), depressive symptoms (per SD of score, OR = 1.53; 1.32-1.77), obesity (OR =1.93; 1.42-2.61), current smoking (OR = 3.37; 1.56-7.30), heavier alcohol drinking (OR = 0.49; 0.34-0.71), history of stroke (OR = 1.56; 1.08-2.26), diabetes (OR = 2.40; 1.61-3.57), dementia (OR = 3.31; 1.27-8.62), and Parkinson's disease (OR = 7.43; 1.87-29.50). Besides, having objective napping alone was associated with age and diabetes, whereas subjective napping was associated with stroke and myocardial infarction. These associations were independent of nighttime sleep duration and fragmentation. Conclusions Daytime napping is very common in women living in their ninth decade and both subjective and objective napping were significantly related to age and comorbidities. Future studies are needed to better understand napping and its health implications.
Collapse
Affiliation(s)
- Yue Leng
- Department of Psychiatry, University of California, San Francisco
| | - Katie Stone
- California Pacific Medical Center Research Institute, San Francisco
| | | | - Kenneth Covinsky
- Department of Medicine, Division of Geriatrics, University of California, San Francisco
| | - Kristine Yaffe
- Department of Psychiatry, University of California, San Francisco, San Francisco VA Medical Center.,Department of Neurology, University of California, San Francisco, San Francisco VA Medical Center.,Department of Epidemiology, University of California, San Francisco, San Francisco VA Medical Center
| |
Collapse
|
|
28
|
Sleep, hippocampal volume, and cognition in adults over 90 years old. Aging Clin Exp Res 2018; 30:1307-1318. [PMID: 30178444 DOI: 10.1007/s40520-018-1030-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 08/18/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Several lines of research support associations between sleep and cognition in older adults. However, there is a paucity of data regarding sleep and cognition in nonagenarians and centenarians. AIMS The current study examined self-reported sleep quantity and sleep quality in relation to hippocampal volume and cognition in adults aged 90 and older. METHODS A total of 144 participants of The 90+ Study completed The Medical Outcomes Study sleep questionnaire. Participants reported subjective sleep duration in hours and three sleep quality factors: sleep problems, adequacy, and somnolence. Neuropsychological assessments of memory, global cognition, language, and executive function were completed, on average, 61 days from the questionnaire. Hippocampal volume on 3 T MRI, adjusted for intracranial volume, was obtained in 82 participants. We performed multiple linear regressions, controlling for age, sex, education, sleep medication, and depression, to examine sleep characteristics in relation to hippocampal volume and cognitive performance in all the subjects and then stratified by cognition. RESULTS Sleep duration > 8 h was associated with lower scores in tests of global cognition, memory, and executive function compared to sleep duration of 7-8 h when collapsing across cognitive status, but only with memory in cognitively impaired subjects, and not in cognitively normal subjects. CONCLUSIONS AND DISCUSSION Long-sleep duration is associated with poorer global cognition, memory, and executive function in the oldest-old, and is only associated with memory in cognitively impaired oldest-old. Additional research is necessary to determine if sleep duration is a risk factor or a result of poor cognition in advanced age.
Collapse
|
|
29
|
Afolalu EF, Ramlee F, Tang NKY. Effects of sleep changes on pain-related health outcomes in the general population: A systematic review of longitudinal studies with exploratory meta-analysis. Sleep Med Rev 2018; 39:82-97. [PMID: 29056414 PMCID: PMC5894811 DOI: 10.1016/j.smrv.2017.08.001] [Citation(s) in RCA: 156] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/04/2017] [Accepted: 08/09/2017] [Indexed: 12/19/2022]
Abstract
Emerging longitudinal research has highlighted poor sleep as a risk factor of a range of adverse health outcomes, including disabling pain conditions. In establishing the causal role of sleep in pain, it remains to be clarified whether sleep deterioration over time is a driver of pain and whether sleep improvement can mitigate pain-related outcomes. A systematic literature search was performed using PubMed MEDLINE, Ovid EMBASE, and Proquest PsycINFO, to identify 16 longitudinal studies involving 61,000 participants. The studies evaluated the effect of sleep changes (simulating sleep deterioration, sleep stability, and sleep improvement) on subsequent pain-related outcomes in the general population. A decline in sleep quality and sleep quantity was associated with a two- to three-fold increase in risk of developing a pain condition, small elevations in levels of inflammatory markers, and a decline in self-reported physical health status. An exploratory meta-analysis further revealed that deterioration in sleep was associated with worse self-reported physical functioning (medium effect size), whilst improvement in sleep was associated with better physical functioning (small effect size). The review consolidates evidence that changes in sleep are prospectively associated with pain-related outcomes and highlights the need for further longitudinal investigations on the long-term impact of sleep improvements.
Collapse
Affiliation(s)
- Esther F Afolalu
- Department of Psychology, University of Warwick, United Kingdom.
| | - Fatanah Ramlee
- Department of Psychology, University of Warwick, United Kingdom; Department of Psychology and Counselling, Sultan Idris Education University, Malaysia
| | - Nicole K Y Tang
- Department of Psychology, University of Warwick, United Kingdom.
| |
Collapse
|
|
30
|
Kim SY, Choung RS, Lee SK, Choe JW, Jung SW, Hyun JJ, Koo JS, Lee SW, Shin C. Self-reported Sleep Impairment in Functional Dyspepsia and Irritable Bowel Syndrome. J Neurogastroenterol Motil 2018; 24:280-288. [PMID: 29605983 PMCID: PMC5885727 DOI: 10.5056/jnm17098;] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 11/18/2017] [Accepted: 12/12/2017] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND/AIMS Sleep impairment is a common complaint among patients with irritable bowel syndrome (IBS) and functional dyspepsia (FD). This study aimed to evaluate the prevalence of sleep impairment in FD or IBS patients, and to determine whether IBS-FD overlap induced more sleep disturbance than FD or IBS alone. METHODS A population-based cohort in South Korea including 2251 subjects was asked about gastrointestinal symptoms including IBS and dyspepsia-related symptoms. In addition, sleep disturbance was measured using the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale questionnaires. One-way ANOVA and logistic regression were used to assess differences among the 4 groups (healthy subjects, IBS alone, FD alone, and IBS-FD overlap). RESULTS Of 2251 subjects who were surveyed by questionnaire, 2031 responded (92.5% response rate) and were analyzed. The prevalence of IBS, FD, and IBS-FD overlap was 8.0% (95% confidence interval [CI], 6.8-9.2%), 4.8% (95% CI, 3.9-5.8%), and 1.8% (95% CI, 1.2-2.4%), respectively. FD alone, but not IBS alone, was significantly associated with a poorer sleep quality index (OR, 2.68; 95% CI, 1.43-5.01) and more daytime sleepiness (OR, 2.21; 95% CI, 1.14-4.30), compared to healthy subjects. IBS-FD overlap had the greatest likelihood of a poorer sleep quality index (OR, 3.88; 95% CI, 1.83-8.19), daytime sleepiness (OR, 2.47; 95% CI, 1.01-5.67), and insomnia (OR, 2.84; 95% CI, 1.39-5.82), compared to healthy subjects. CONCLUSION A correlation between functional gastrointestinal disorders and sleep disturbance was demonstrated, which was significantly pronounced in the context of IBS-FD overlap.
Collapse
Affiliation(s)
- Seung Young Kim
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Rok Seon Choung
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota,
USA
| | - Seung Ku Lee
- Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan,
Korea
| | - Jung Wan Choe
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Sung Woo Jung
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Jong Jin Hyun
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Ja Seol Koo
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Sang Woo Lee
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Chol Shin
- Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan,
Korea
| |
Collapse
|
|
31
|
Kim SY, Choung RS, Lee SK, Choe JW, Jung SW, Hyun JJ, Koo JS, Lee SW, Shin C. Self-reported Sleep Impairment in Functional Dyspepsia and Irritable Bowel Syndrome. J Neurogastroenterol Motil 2018; 24:280-288. [PMID: 29605983 PMCID: PMC5885727 DOI: 10.5056/jnm17098] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 11/18/2017] [Accepted: 12/12/2017] [Indexed: 12/13/2022] Open
Abstract
Background/Aims Sleep impairment is a common complaint among patients with irritable bowel syndrome (IBS) and functional dyspepsia (FD). This study aimed to evaluate the prevalence of sleep impairment in FD or IBS patients, and to determine whether IBS-FD overlap induced more sleep disturbance than FD or IBS alone. Methods A population-based cohort in South Korea including 2251 subjects was asked about gastrointestinal symptoms including IBS and dyspepsia-related symptoms. In addition, sleep disturbance was measured using the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale questionnaires. One-way ANOVA and logistic regression were used to assess differences among the 4 groups (healthy subjects, IBS alone, FD alone, and IBS-FD overlap). Results Of 2251 subjects who were surveyed by questionnaire, 2031 responded (92.5% response rate) and were analyzed. The prevalence of IBS, FD, and IBS-FD overlap was 8.0% (95% confidence interval [CI], 6.8–9.2%), 4.8% (95% CI, 3.9–5.8%), and 1.8% (95% CI, 1.2–2.4%), respectively. FD alone, but not IBS alone, was significantly associated with a poorer sleep quality index (OR, 2.68; 95% CI, 1.43–5.01) and more daytime sleepiness (OR, 2.21; 95% CI, 1.14–4.30), compared to healthy subjects. IBS-FD overlap had the greatest likelihood of a poorer sleep quality index (OR, 3.88; 95% CI, 1.83–8.19), daytime sleepiness (OR, 2.47; 95% CI, 1.01–5.67), and insomnia (OR, 2.84; 95% CI, 1.39–5.82), compared to healthy subjects. Conclusion A correlation between functional gastrointestinal disorders and sleep disturbance was demonstrated, which was significantly pronounced in the context of IBS-FD overlap.
Collapse
Affiliation(s)
- Seung Young Kim
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Rok Seon Choung
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Seung Ku Lee
- Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, Korea
| | - Jung Wan Choe
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Sung Woo Jung
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Jong Jin Hyun
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ja Seol Koo
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Sang Woo Lee
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Chol Shin
- Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, Korea
| |
Collapse
|
|
32
|
Soh AZ, Chee MWL, Yuan JM, Koh WP. Sleep lengthening in late adulthood signals increased risk of mortality. Sleep 2018; 41:4833044. [PMID: 29394410 PMCID: PMC5914333 DOI: 10.1093/sleep/zsy005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 12/17/2017] [Indexed: 11/14/2022] Open
Abstract
Study Objectives Epidemiological evidence indicates that both short and long sleep at midlife increase mortality risk, but few studies have examined how change in sleep duration between midlife and later life affects this risk. We examined the association between change in sleep duration and mortality risk. Methods The Singapore Chinese Health Study is a prospective cohort of 63257 Chinese in Singapore aged 45-74 years at recruitment (1993-1998). Self-reported sleep duration was collected from 39523 participants who completed both baseline (mean age 54.8 years) and follow-up II (mean age 67.9 years; 2006-2010) interviews, which were on average 12.7 years apart. Mortality data were obtained via linkage with national death registry up to December 31, 2015. Results Compared with participants who reported sleeping the recommended duration (7 hr) at both interviews, those with persistently short sleep (≤5 hr) had increased risk of all-cause mortality (hazard ratio [HR] 1.27, 95% confidence interval [CI] 1.06-1.53). Similarly, those with persistently long sleep (≥9 hr) had increased risk of all-cause (HR 1.47, 95% CI 1.24-1.73) and cardiovascular (HR 1.40, 95% CI 1.04-1.89) mortality. The proportion of long-sleepers increased with aging (6%-23.7%). Progression to long sleep from short (HR 1.50, 95% CI 1.24-1.81) or recommended (HR 1.43, 95% CI 1.25-1.64) duration was associated with increased all-cause mortality, especially for cardiovascular mortality. Change in sleep duration was not linked to cancer mortality. Conclusions Persistent short or long sleep or increasing sleep duration in late adulthood was associated with increased risk of all-cause mortality, especially from cardiovascular causes.
Collapse
Affiliation(s)
- Avril Z Soh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Michael W L Chee
- Centre for Cognitive Neuroscience, Duke-NUS Medical School Singapore, Singapore
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
| | - Woon-Puay Koh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Centre for Clinician-Scientist Development, Duke-NUS Medical School, Singapore
| |
Collapse
|
|
33
|
Stephan Y, Sutin AR, Bayard S, Križan Z, Terracciano A. Personality and sleep quality: Evidence from four prospective studies. Health Psychol 2018; 37:271-281. [PMID: 29172602 PMCID: PMC5837948 DOI: 10.1037/hea0000577] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE The present study examined the longitudinal association between personality traits and sleep quality in 4 samples of middle-aged and older adults. METHOD Participants (N > 22,000) were adults aged 30 to 107 years old from the Wisconsin Longitudinal Study (WLS), the Midlife in the United States Study (MIDUS), the Health and Retirement Study (HRS), and the Midlife in Japan Study (MIDJA). Personality and sleep quality were assessed at baseline and again 4 to 10 years later. RESULTS Scoring lower on neuroticism and higher on extraversion was associated with better sleep quality at baseline and over time, with effect sizes larger than those of demographic factors. Low conscientiousness was associated with a worsening of sleep quality over time. Openness and agreeableness were unrelated to sleep quality. Poor sleep quality at baseline was associated with steeper declines in extraversion, agreeableness, and conscientiousness and a smaller decrease in neuroticism over time. CONCLUSION Replicable findings across samples support longitudinal associations between personality and sleep quality. This study identified specific personality traits that are associated with poor and worsening sleep quality, and substantiated previous findings that poor sleep quality is associated with detrimental personality trajectories. (PsycINFO Database Record
Collapse
Affiliation(s)
| | - Angelina R. Sutin
- Florida State University College of Medicine, UNITED STATES OF AMERICA
| | | | | | | |
Collapse
|
|
34
|
Nakajima K, Suwa K, Toyama K. Age-dependent changes in the association between sleep duration and impaired glucose metabolism. World J Diabetes 2017; 8:397-406. [PMID: 28861177 PMCID: PMC5561039 DOI: 10.4239/wjd.v8.i8.397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 03/03/2017] [Accepted: 03/16/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To investigate whether the association between sleep duration and impaired glucose metabolism varies among younger and older populations. METHODS We reviewed data of self-reported habitual sleep duration per night, HbA1c levels, and clinically relevant factors in a cross-sectional checkup database of 75472 Japanese from the general population aged 20-79 years (51695 men and 23777 women). Associations of prediabetes (HbA1c ≥ 5.7% and/or diabetic pharmacotherapy) or diabetes (HbA1c ≥ 6.5% and/or diabetic pharmacotherapy) with short and long sleep durations compared with a reference sleep duration (7 h) were investigated by multivariate logistic regression analysis. We controlled for potential relevant confounders, including age, sex, and work duration per day according to younger and older subjects. RESULTS As age advanced, sleep duration became longer and this increase in the 40s and 50s was two times greater in men than in women. This finding was accompanied by a deterioration in HbA1c levels. In subjects aged younger than 40 years (n = 32929), HbA1c levels were inversely and linearly correlated with sleep duration in both sexes. However, in subjects aged 40 years or older (n = 42543), HbA1c levels showed a non-linear relationship against sleep duration with a nadir at 7 h. Multivariate logistic regression analysis showed that in younger subjects, short durations of sleep (≤ 5 h and 6 h) were positively associated with prediabetes (both P < 0.001), but a long duration of sleep (≥ 8 h) was inversely associated with prediabetes (P < 0.001). These associations remained significant after adjustment for relevant confounders, including age, sex, and work duration per day (ORs = 1.20, 95%CI: 1.05-1.37, P < 0.001; ORs = 1.12, 95%CI: 1.02-1.24, P < 0.05; and ORs = 0.84, 95%CI: 0.72-0.99, P < 0.05, respectively). In contrast, in older subjects, besides an association of prediabetes with a short duration of sleep (≤ 5 h) (ORs = 1.12, 95%CI: 1.03-1.21, P < 0.01), diabetes was significantly associated with a long duration of sleep (≥ 8 h) (ORs = 1.11, 95%CI: 1.02-1.25, P < 0.05). CONCLUSION A short sleep duration may be associated with prediabetes throughout life. However, the association between a long sleep duration and glucose metabolism can change with aging.
Collapse
|
|
35
|
Cheng GHL, Chan A, Lo JC. Factors of nocturnal sleep and daytime nap durations in community-dwelling elderly: a longitudinal population-based study. Int Psychogeriatr 2017; 29:1335-1344. [PMID: 28434419 DOI: 10.1017/s104161021700062x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Durations of nocturnal sleep and daytime nap influence the well-being of older adults. It is thus essential to understand their determinants. However, much previous research did not assess sleep duration and nap duration individually, and longitudinal data is lacking. This study aimed at examining the impact of demographic, psychosocial, and health factors, including ethnicity, social networks outside the household, smoking and physical exercise on sleep duration and nap duration among community-dwelling elderly. METHODS Our study involved over 2,600 older adults (≥60 years) from a longitudinal, nationally representative survey - the Panel on Health and Ageing of Singaporean Elderly. Sleep and nap durations at Time 2 (two years later) were regressed on predictors measured at Time 1. RESULTS Time 2 short nocturnal sleep duration was predicted by Malay ethnicity (relative to Chinese and Indian), older age, lower education level, more depressive symptoms, and obesity, whereas future long nocturnal sleep duration was predicted by weaker social networks, older age, and more chronic diseases. Furthermore, smoking, obesity, Malay or Indian (relative to Chinese), older age, male gender, and cognitive impairment predicted longer daytime nap duration in the future. CONCLUSIONS Older adults' nocturnal sleep and daytime nap durations may be affected by different demographic, psychosocial, and health factors. Thus, it is important to differentiate these two attributes in this age group.
Collapse
Affiliation(s)
- Grand H-L Cheng
- Centre for Ageing Research and Education,Duke-NUS Medical School,Singapore
| | - Angelique Chan
- Centre for Ageing Research and Education,Duke-NUS Medical School,Singapore
| | - June C Lo
- Centre for Cognitive Neuroscience,Duke-NUS Medical School,Singapore
| |
Collapse
|
|
36
|
Chen HC, Chou P. Predictors of Change in Self-Reported Sleep Duration in Community-Dwelling Older Adults: The Shih-Pai Sleep Study, Taiwan. Sci Rep 2017; 7:4729. [PMID: 28680142 PMCID: PMC5498583 DOI: 10.1038/s41598-017-04932-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 05/22/2017] [Indexed: 12/11/2022] Open
Abstract
The present study aims to examine and compare the predictors of changes in self-reported sleep duration in older adults. A total of 2,294 participants over the age of 65 in the Shih-Pai Sleep Study were followed-up for an average of 3 years. According to the self-reported sleep duration at baseline and the results of a follow-up survey conducted 3 years later, participants were classified into three categories: mid-range sleepers (6–7 hours), short sleepers (≤5 hours), and long sleepers (≥8 hours). The main outcome variable was the sleep duration at the follow-up survey. A comparison of the results of the baseline and follow-up surveys revealed that only 45.9% of participants remained in the same spectrum of sleep duration in both surveys, with baseline long sleepers having the lowest consistency rate (27.6%). Only incident diseases, with the exception of prevalent diabetes and physical disability, predicted shortening of sleep duration. In contrast, prevalent morbidities or baseline characteristics correlated with the lengthening of sleep duration. The findings suggested that the self-estimated sleep duration fluctuated in a significant proportion of study participants over time. Predictors of lengthening of sleep duration were essentially different from predictors of shortening of sleep duration.
Collapse
Affiliation(s)
- Hsi-Chung Chen
- Department of Psychiatry & Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
| | - Pesus Chou
- Community Medicine Research Center & Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
| |
Collapse
|
|
37
|
Long sleep duration and health outcomes: A systematic review, meta-analysis and meta-regression. Sleep Med Rev 2017; 39:25-36. [PMID: 28890167 DOI: 10.1016/j.smrv.2017.06.011] [Citation(s) in RCA: 499] [Impact Index Per Article: 62.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/19/2017] [Accepted: 06/28/2017] [Indexed: 01/17/2023]
Abstract
We examined the dose-response relationship between long sleep duration and health outcomes including mortality and the incidence of diabetes mellitus, hypertension, cardiovascular diseases, stroke, coronary heart diseases, obesity, depression and dyslipidemia. We collected data from 5,134,036 participants from 137 prospective cohort studies. For the independent variable, we categorized participants at baseline as having long sleep duration or normal sleep duration. Risk ratios (RRs) for mortality and incident health conditions during follow-up were calculated through meta-analyses of adjusted data from individual studies. Meta-regression analyses were performed to investigate the association between each outcome and specific thresholds of long sleep. Long sleep was significantly associated with mortality (RR, 1.39; 95% CI, 1.31-1.47), incident diabetes mellitus (1.26, 1.11-1.43), cardiovascular disease (1.25, 1.14-1.37), stroke (1.46, 1.26-1.69), coronary heart disease (1.24, 1.13-1.37), and obesity (1.08, 1.02-1.15). Long sleep was not significantly related to incident hypertension (1.01, 0.95-1.07). Insufficient data were available for depression and dyslipidemia. Meta-regression analyses found statistically significant linear associations between longer sleep duration and increased mortality and incident cardiovascular disease. Future studies should address whether the relationship between long sleep and health outcomes is causal and modifiable.
Collapse
|
|
38
|
Smagula SF, Harrison S, Cauley JA, Ancoli-Israel S, Cawthon PM, Cummings S, Stone KL. Determinants of Change in Objectively Assessed Sleep Duration Among Older Men. Am J Epidemiol 2017; 185:933-940. [PMID: 28453606 DOI: 10.1093/aje/kwx014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 05/11/2016] [Indexed: 12/22/2022] Open
Abstract
We examined potential risk factors for changes in objectively assessed sleep duration within a large sample of community-dwelling older men. Participants (n = 1,055; mean baseline age = 74.6 (standard deviation (SD), 4.7) years) had repeated ActiGraph assessments (ActiGraph LLC, Pensacola, Florida) taken at the baseline (2003-2005) and follow-up (2009-2012) waves of the Outcomes of Sleep Disorders in Older Men Study (an ancillary study to the Osteoporotic Fractures in Men (MrOS) Study conducted in 6 US communities). Among men with a baseline nighttime sleep duration of 5-8 hours, we assessed the odds of becoming a short-duration (<5 hours) or long-duration (>8 hours) sleeper at follow-up. The odds of becoming a short-duration sleeper were higher among men with peripheral vascular disease (adjusted odds ratio (aOR) = 6.54, 95% confidence interval (CI): 2.30, 18.55) and ≥1 impairment in Instrumental Activities of Daily Living (IADL) (aOR = 2.57, 95% CI: 0.97, 6.78). The odds of becoming a long-duration sleeper were higher among those with greater baseline age (per SD increment, aOR = 1.49, 95% CI: 1.12, 2.00), depression symptoms (aOR = 3.13, 95% CI: 1.05, 9.36), and worse global cognitive performance (per SD increment of Modified Mini-Mental State Examination score, aOR = 0.74, 95% CI: 0.58, 0.94). Peripheral vascular disease and IADL impairment, but not chronological age, may be involved in the etiology of short sleep duration in older men. The risk factors for long-duration sleep suggest that deteriorating brain health predicts elongated sleep duration in older men.
Collapse
|