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Otsuka T, Ikegami H, Kodani E, Sakabe K, Hatano H, Takami M, Hironaka M, Fukai K, Yoshimoto K, the TAMAGAWA‐AF Study. Paroxysmal atrial fibrillation is associated with poor sleep quality: Tamagawa cross-sectional study on the relationship between lifestyle and atrial fibrillation (TAMAGAWA-AF study). J Arrhythm 2025; 41:e13189. [PMID: 39817018 PMCID: PMC11730727 DOI: 10.1002/joa3.13189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 10/22/2024] [Accepted: 11/11/2024] [Indexed: 01/18/2025] Open
Abstract
Background Quality of life (QOL) is reduced in patients with atrial fibrillation (AF). However, data regarding the association between sleep quality, one of the major components of QOL, and AF are insufficient. This cross-sectional study aimed to elucidate whether sleep quality is reduced in patients with AF. Methods We recruited 2054 consecutive outpatients (64 ± 10 years, 1089 men) who had regularly presented to 26 clinics affiliated with the Tamagawa Medical Association, Tokyo, Japan. The patients were divided into paroxysmal AF (PaAF), persistent or permanent AF (PeAF), and non-AF groups. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The global PSQI score was calculated according to the answer to each question, and poor sleep quality was defined as a global PSQI score ≥6 points. Logistic regression analysis was used to obtain odds ratio for poor sleep quality in the PaAF and PeAF groups, relative to the non-AF group. Results The PaAF group showed significantly increased odds ratio for poor sleep quality (1.49, 95% confidence interval 1.02-2.17), after adjusting for multiple potential confounders. In contrast, no significant odds ratio for poor sleep quality was observed in the PeAF group (1.09, 95% confidence interval 0.70-1.71). Among the PSQI components, poor subjective sleep quality and sleep disturbances were the main determinants of poor sleep quality in the PaAF group. Conclusion Sleep quality was found to be reduced in patients with PaAF, and this may be attributed to poor subjective sleep quality and sleep disturbances.
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Affiliation(s)
- Toshiaki Otsuka
- Department of Hygiene and Public HealthNippon Medical SchoolTokyoJapan
- Center for Clinical ResearchNippon Medical School HospitalTokyoJapan
| | | | - Eitaro Kodani
- Department of Cardiovascular MedicineNippon Medical School Tama Nagayama HospitalTokyoJapan
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Rias YA, Apriliyasari RW, Gautama MSN, Hasan F, Teli M, Chiu HY, Thato R. Effects of Physical and Mind-body Exercise on Sleep Quality in Individuals With Diabetes Mellitus: A Systematic Review and Meta-analysis. J Prev Med Public Health 2025; 58:1-10. [PMID: 39438008 PMCID: PMC11824629 DOI: 10.3961/jpmph.24.354] [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: 07/06/2024] [Revised: 08/27/2024] [Accepted: 09/10/2024] [Indexed: 10/25/2024] Open
Abstract
OBJECTIVES Physical and mind-body exercises represent distinct intervention strategies that may improve sleep quality by influencing physiological and psychological factors. Nevertheless, their effectiveness in individuals with diabetes is not well-established. This systematic review and meta-analysis aimed to examine the impacts of physical and mind-body exercise interventions on sleep quality in patients with diabetes mellitus. METHODS Six randomized controlled trials (RCTs) that met the inclusion criteria were identified from PubMed, CINAHL, Embase, Scopus, Web of Science, Cochrane, and Ovid-Medline Library. The effect size for sleep quality was calculated using the standardized mean difference (SMD) with a 95% confidence interval (CI), employing a random-effects model. Heterogeneity and publication bias were also examined, and subgroup, meta-regression, and sensitivity analyses were performed. RESULTS Physical and mind-body exercise interventions significantly improved sleep quality, with an SMD of -1.040 (95% CI, -1.686 to -0.394). Subgroup analysis revealed significant differences with respect to the type of intervention (p=0.047), or its duration (p=0.282). Meta-regression analysis indicated that mean hemoglobin A1c level was the only factor to be significantly related to the effect size for sleep quality, demonstrating a negative association (p=0.033). The assessment of publication bias and the sensitivity analysis suggested that the findings were reliable and robust. CONCLUSIONS Physical and mind-body exercises may serve as effective interventions for patients with diabetes mellitus who experience poor sleep quality. However, to substantiate these findings, additional rigorous RCTs with larger sample sizes, longer follow-up periods, and standardized interventions are required.
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Affiliation(s)
- Yohanes Andy Rias
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
- Faculty of Health, College of Nursing, Institut Ilmu Kesehatan Bhakti Wiyata Kediri, Kediri, Indonesia
| | - Renny Wulan Apriliyasari
- Department of Nursing, Institut Teknologi Kesehatan Cendekia Utama Kudus, Kabupaten Kudus, Indonesia
| | | | - Faizul Hasan
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| | - Margareta Teli
- Nursing School, Polytechnic of Health Ministry of Health Kupang, Kupang, Indonesia
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Ratsiri Thato
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
- Research Unit for Enhancing Well-being in Vulnerable and Chronic Illness Populations, Chulalongkorn University, Bangkok, Thailand
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Arora S, Sahadevan P, Sundarakumar JS. Association of sleep quality with physical and psychological health indicators in overweight and obese rural Indians. Sleep Med X 2024; 7:100112. [PMID: 38800099 PMCID: PMC11127281 DOI: 10.1016/j.sleepx.2024.100112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/02/2024] [Accepted: 05/02/2024] [Indexed: 05/29/2024] Open
Abstract
Objective To measure the association of sleep quality with physical (i.e., grip strength, functional mobility, balance) and psychological (depression, anxiety) health indicators in an overweight/obese population. Methods Baseline data of 2337 participants (1382 overweight/obese and 955 normal weight) from an aging cohort in rural southern India (CBR-SANSCOG) was analyzed retrospectively. Assessment tools included the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, dynamometry for Hand Grip Strength (HGS), Timed Up-and-Go (TUG) for functional mobility, Chair Stand Test (CST) for lower limb strength, Geriatric Depression scale (GDS-30) for depressive symptoms and Generalized Anxiety Disorder scale (GAD-7) for anxiety symptoms. Linear regression models, adjusted for known confounders, were used to examine the association of sleep quality with the health parameters in overweight/obese and normal-weight groups. Results In the fully adjusted model, higher global PSQI score was associated with higher TUG time (β = 0.06, 95 % CI: 0.004,0.12), higher scores on GDS (β = 1.08, 95 % CI: 0.96,1.20) and GAD (β = 0.71, 95 % CI: 0.62,0.79), and lower scores on CST (β = -0.12, 95 % CI: -0.19,-0.06) in overweight/obese individuals. The sleep disturbance sub-component of PSQI was associated with most of the physical (TUG, CST) and psychological (GDS and GAD) health indicators. Sleep duration and use of sleep medication showed no significant association with any of the health indicators. Conclusion The concurrent presence of poor sleep quality and overweight/obesity could worsen physical and psychological health in middle-aged and older adults. We highlight the importance of early detection and timely management of sleep problems in this population to reduce physical and psychological morbidities.
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Affiliation(s)
- Sakshi Arora
- Centre for Brain Research, Indian Institute of Science, Bangalore, 560012, India
| | - Pravin Sahadevan
- Centre for Brain Research, Indian Institute of Science, Bangalore, 560012, India
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Shah NM, Steier J, Hart N, Kaltsakas G. Effects of non-invasive ventilation on sleep in chronic hypercapnic respiratory failure. Thorax 2024; 79:281-288. [PMID: 37979970 DOI: 10.1136/thorax-2023-220035] [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: 05/28/2023] [Accepted: 10/23/2023] [Indexed: 11/20/2023]
Abstract
Chronic respiratory disease can exacerbate the normal physiological changes in ventilation observed in healthy individuals during sleep, leading to sleep-disordered breathing, nocturnal hypoventilation, sleep disruption and chronic respiratory failure. Therefore, patients with obesity, slowly and rapidly progressive neuromuscular disease and chronic obstructive airways disease report poor sleep quality. Non-invasive ventilation (NIV) is a complex intervention used to treat sleep-disordered breathing and nocturnal hypoventilation with overnight physiological studies demonstrating improvement in sleep-disordered breathing and nocturnal hypoventilation, and clinical trials demonstrating improved outcomes for patients. However, the impact on subjective and objective sleep quality is dependent on the tools used to measure sleep quality and the patient population. As home NIV becomes more commonly used, there is a need to conduct studies focused on sleep quality, and the relationship between sleep quality and health-related quality of life, in all patient groups, in order to allow the clinician to provide clear patient-centred information.
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Affiliation(s)
- Neeraj M Shah
- Lane Fox Clinical Respiratory Physiology Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Centre for Human and Applied Physiological Sciences (CHAPS), King's College London, London, UK
| | - Joerg Steier
- Lane Fox Clinical Respiratory Physiology Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Centre for Human and Applied Physiological Sciences (CHAPS), King's College London, London, UK
| | - Nicholas Hart
- Lane Fox Clinical Respiratory Physiology Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Centre for Human and Applied Physiological Sciences (CHAPS), King's College London, London, UK
| | - Georgios Kaltsakas
- Lane Fox Clinical Respiratory Physiology Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Centre for Human and Applied Physiological Sciences (CHAPS), King's College London, London, UK
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Lai HL, Chen CI, Lin YC, Lu LC, Huang CY. A path analysis investigation into menopausal osteoporosis, sarcopenia risk, and their impact on sleep quality, depressive symptoms and quality of life. Int J Orthop Trauma Nurs 2024; 52:101080. [PMID: 38218016 DOI: 10.1016/j.ijotn.2023.101080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/17/2023] [Accepted: 12/20/2023] [Indexed: 01/15/2024]
Abstract
PURPOSE The objective was to investigate the relationships among disease characteristics, sarcopenia risk, bone function, sleep quality, depressive symptoms, and health-related quality of life in menopausal women. Additionally, we also examined the potential mediating role of coping in the relationship between these factors and health outcomes for individuals with osteoporosis. METHODS In a cross-sectional approach, 201 participants were referred by a physician from the Family Medicine Department during their outpatient visits at a general hospital in Southern Taiwan. Data collection involved structured one-on-one interviews, and the analysis included descriptive and inferential statistics, along with a structural equation modeling. RESULTS The participants' bone function was strongly positively related to coping, physical and mental quality of life (QOL), and negatively related to sleep quality and depressive symptoms. The duration of osteoporosis was positively related to pain, sarcopenia risk, sleep quality, but negatively related to bone function, physical and mental QOL. This structural framework explains 36% of the variance in depressive symptoms, 25% in sleep disturbances, 54% in mental QOL, and 72% in physical QOL. The best-fit structural equation modeling showed that physical function, exercise, sarcopenia, pain, and coping were significant predictors of depressive symptoms, with coping acting as a mediator in these relationships. CONCLUSION Individuals who employed more active coping strategies exhibited fewer depressive symptoms, better sleep quality, and superior physical and mental QOL. Further, individuals with osteoporosis had lower pain levels, less sarcopenia risk, and higher engaged in exercise presentation improved physical and mental QOL. Future longitudinal research holds the promise of providing deeper insights into these complex relationships.
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Affiliation(s)
- Hui-Ling Lai
- Nursing Department, Tzu Chi University, Hualien, Taiwan, No.701, Sec.3, Jhongyang Rd., Hualien City, 97004, Taiwan.
| | - Chun-I Chen
- National Chung Cheng University, No.168, Sec. 1, University Rd., Minhsiung, Chiayi, 621301, Taiwan ROC.
| | - Yu-Ching Lin
- Department of Medical, E-Da DaChang Hospital, Kaohsiung, Taiwan; Department of Family Medicine and Physical Examination/ I-Shou University, Taiwan.
| | - Liu-Chun Lu
- E-DA DaChang Hospital, No.305, Dachang 1 Rd., Sanmin District, Kaohsiung City, 80794, Taiwan ROC.
| | - Chiung-Yu Huang
- Nursing Department, I-Shou University, No. 8, Yida Rd., Kaohsiung, 82445, Taiwan.
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Mohd Fahmi Teng NI, Norsham J, Nadhra A, Dalila A, Nursyafiqa, Nasuha SI, Das S. Chrononutrition behaviors, sugar-sweetened beverage consumption, sleep quality and the association with body mass index among Malaysian women. Chronobiol Int 2023; 40:1487-1499. [PMID: 37885231 DOI: 10.1080/07420528.2023.2267679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023]
Abstract
The present study aimed to determine the association between chrononutrition behaviors, sugar-sweetened beverage intake, and sleep quality among Malaysian women. A cross-sectional study using a validated, self-administered Chrononutrition Profile Questionnaire, Beverage Questionnaire and Sleep Quality Index were conducted among 934 Malaysian women. Multinomial logistic regression was performed to obtain odds ratios of being overweight/underweight and to test the association with poor sleep quality. 40% of Malaysian women were either overweight or obese and 65.4% had poor sleep quality. We found that breakfast skipping (OR: 4.101; CI: 2.378-7.070), poor evening eating (OR: 4.073; CI: 1.631-10.186), and eating the largest meal at night (OR: 6.970; CI: 1.944-24.994) increased the odds of being underweight. On the other hand, the daily consumption of 100% fruit juices (OR: 1.668; CI: 1.058-1.731), daily consumption of sweetened coffee or tea (OR: 1.707; CI: 1.162-2.508) and consumption of diet soft drinks by 6 times or fewer (OR: 1.484; CI: 1.066-2.064) are associated with increased odds of being overweight. However, when adjusted, only poor evening latency (AOR: 16.638; CI: 1.986-139.383) revealed an increased odd of being underweight. The highest odds predicting poor sleep quality were found for eating the largest meal during dinner (OR: 3.696; CI: 1.967-6.945) and (AOR: 2.194; CI: 1.119-4.304) when adjusted. Hence, the result indicates that multifactorial impacts on women's body weight and recommendations to adjust chrononutrition and sugar-sweetened beverages intake in lifestyle must be done carefully considering other parameters together.
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Affiliation(s)
- Nur Islami Mohd Fahmi Teng
- Centre for Dietetics Studies, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Malaysia
| | - Juliana Norsham
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | - Aina Nadhra
- Centre for Dietetics Studies, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Malaysia
| | - Aimi Dalila
- Centre for Dietetics Studies, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Malaysia
| | - Nursyafiqa
- Centre for Dietetics Studies, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Malaysia
| | - Siti Iylia Nasuha
- Centre for Dietetics Studies, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Malaysia
| | - Srijit Das
- Department of Human & Clinical Anatomy, Faculty of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
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Başak F, Şişik A, Demirpolat MT, Çalişkan YK, Ülgür HŞ. What Value of Sixth Month Excess Weight Loss (Postsleeve Gastrectomy) Is Necessary for Better Sleep Quality? Surg Laparosc Endosc Percutan Tech 2023; 33:270-275. [PMID: 37172023 DOI: 10.1097/sle.0000000000001174] [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: 12/01/2022] [Accepted: 03/20/2023] [Indexed: 05/14/2023]
Abstract
BACKGROUND Obesity, caused by caloric intake over output, is a global health problem. The relationship between sleep and obesity is discussed in the literature. Little is known about the compliance of sleep quality and patients' weight loss. This study aimed to review how sleep quality is affected by bariatric surgery, assess whether compliance with sleep quality can be predicted after bariatric surgery, and establish its correlation with excess weight loss. METHODS A cross-sectional study was conducted for patients undergoing bariatric surgery (laparoscopic sleeve gastrectomy). Sleep quality was assessed with the Pittsburgh sleep quality index (PSQI) scale preoperatively and in the sixth postoperative month. A PSQI global score above 5 indicated poor sleep quality. Participants were divided into 2 groups: good and poor sleep quality. Receiver operating characteristics and logistic regression analysis were also performed to predict sleep quality. RESULTS The questionnaire was completed by 100 subjects. All PSQI components, except the sixth (sleep medication) component, improved in patients at the sixth postoperative month versus baseline values. In the receiver operating characteristic analysis to test the availability of excess weight loss (EWL%) cutoff values relative to predict successful sleepers, 65.1 of the sixth month EWL% was found for the diagnosis of successful sleeper patients with 72.6% sensitivity and 63% specificity (area under the curve: 0.706, P =0.002, 95% CI, 0.586 to 0.825). CONCLUSIONS For patients undergoing weight loss surgery, while assessing the sixth postoperative month, the EWL% value over 65.1 was recommended for better sleep quality.
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Affiliation(s)
- Fatih Başak
- Department of General Surgery, University of Health Sciences, Umraniye Education and Research Hospital
| | - Abdullah Şişik
- Department of General Surgery, University of Health Sciences, Umraniye Education and Research Hospital
| | - Muhammed Taha Demirpolat
- Department of General Surgery, University of Health Sciences, Umraniye Education and Research Hospital
| | - Yahya Kemal Çalişkan
- Department of General Surgery, University of Health Sciences, Kanuni Education and Research Hospital, Istanbul, Turkey
| | - Hanife Şeyda Ülgür
- Department of General Surgery, University of Health Sciences, Umraniye Education and Research Hospital
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Schumacher LM, Farris SG, Thomas JG, Lipton RB, Pavlovic J, Vgontzas A, Bond DS. Interrelationships of Sleep Quality, Obesity Severity, and Clinical Headache Features among Women with Comorbid Migraine and Obesity. J Clin Med 2023; 12:1742. [PMID: 36902529 PMCID: PMC10003353 DOI: 10.3390/jcm12051742] [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: 01/06/2023] [Revised: 02/01/2023] [Accepted: 02/09/2023] [Indexed: 02/24/2023] Open
Abstract
Obesity and migraine are often comorbid. Poor sleep quality is also common among individuals with migraine and may be influenced by comorbidities such as obesity. However, understanding of migraine's relationship with sleep and the potential exacerbating effect of obesity remains limited. This study evaluated the associations of migraine characteristics and clinical features with sleep quality among women with comorbid migraine and overweight/obesity and assessed the interplay between obesity severity and migraine characteristics/clinical features in relation to sleep quality. Women seeking treatment for migraine and obesity (n = 127; NCT01197196) completed a validated questionnaire assessing sleep quality (Pittsburgh Sleep Quality Index-PSQI). Migraine headache characteristics and clinical features were assessed using smartphone-based daily diaries. Weight was measured in-clinic, and several potential confounders were assessed using rigorous methods. Nearly 70% of participants endorsed poor sleep quality. Greater monthly migraine days and the presence of phonophobia related to poorer sleep quality, and specifically poorer sleep efficiency, controlling for confounders. Obesity severity was neither independently associated nor interacted with migraine characteristics/features to predict sleep quality. Poor sleep quality is common among women with comorbid migraine and overweight/obesity, although obesity severity does not appear to uniquely relate to or exacerbate the association between migraine and sleep in this population. Results can guide research on mechanisms of the migraine-sleep link and inform clinical care.
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Affiliation(s)
- Leah M. Schumacher
- Department of Kinesiology, College of Public Health, Temple University, 1800 N. Broad St., Philadelphia, PA 19121, USA
| | - Samantha G. Farris
- Department of Psychology, Rutgers, The State University of New Jersey, 53 Avenue East, 211 Tillett Hall, Piscataway, NJ 08854, USA
| | - J. Graham Thomas
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI 02903, USA
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond Street, Providence, RI 02903, USA
| | - Richard B. Lipton
- Department of Neurology and the Montefiore Headache Center, Albert Einstein College of Medicine, 1250 Waters Pl #8, The Bronx, NY 10461, USA
- Department of Neurology and the Montefiore Headache Center, Montefiore Medical Center, 1250 Waters Pl #8, The Bronx, NY 10461, USA
| | - Jelena Pavlovic
- Department of Neurology and the Montefiore Headache Center, Albert Einstein College of Medicine, 1250 Waters Pl #8, The Bronx, NY 10461, USA
- Department of Neurology and the Montefiore Headache Center, Montefiore Medical Center, 1250 Waters Pl #8, The Bronx, NY 10461, USA
| | - Angeliki Vgontzas
- Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, 60 Fenwood Rd 1st Floor, Boston, MA 02115, USA
| | - Dale S. Bond
- Departments of Surgery and Research, Hartford Hospital, 80 Seymour St., Hartford, CT 06102, USA
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Tao Z, Feng Y, Liu J, Tao L. Trends and disparities in sleep quality and duration in older adults in China from 2008 to 2018: A national observational study. Front Public Health 2023; 11:998699. [PMID: 36875376 PMCID: PMC9982158 DOI: 10.3389/fpubh.2023.998699] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 01/31/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Poor sleep status as a common concern is a risk factor for many health problems among older people. China with an aging society lacks relevant nationwide data on the sleep status among older people. Therefore, the purpose of this study was to investigate trends and disparities in sleep quality and duration among older adults, and exploring influencing factors of poor sleep in China between 2008 and 2018. METHOD We used the four-waves data of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018. Sleep quality and average sleep hours per day was investigated by using questionnaires in the CLHLS. We categorized sleep duration as three groups including ≤5 h (short duration), 5-9 h (normal duration), or ≥9 h (long duration) per day. Multivariate logistic regression models were used to examine trends and risk factors of poor sleep quality, short sleep duration, and long sleep duration. RESULTS The prevalence of poor sleep quality significantly increased from 34.87% in 2008 to 47.67% in 2018 (p < 0.05). Short sleep duration significantly increased from 5.29 to 8.37%, whereas long sleep duration decreased from 28.77 to 19.27%. Multivariate analysis showed that female sex, poor economic status, a greater number of chronic diseases, underweight, poor self-reported quality of life, and poor self-reported health were associated with poor sleep quality and short sleep duration (p < 0.05). CONCLUSION Our findings revealed that older adults had increased prevalence of poor sleep quality and short sleep duration from 2008 to 2018. More attention should be paid to the increased sleep problems among older adults and early interventions should be made to improve sleep quality and guarantee enough sleep time.
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Affiliation(s)
- Zihao Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
- School of Basic Medical Sciences, Peking University, Beijing, China
| | - Yuting Feng
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Jue Liu
- School of Public Health, Peking University, Beijing, China
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
- Medical Examination Centre, Peking University Third Hospital, Beijing, China
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Haggerty D, Contreras DA, Carter A, Drake C, Tucker RM. SLeep Education for Everyone Program (SLEEP) Results in Sustained Improvements in Sleep Outcomes at Six Months. Behav Sleep Med 2022:1-7. [PMID: 36377788 DOI: 10.1080/15402002.2022.2146693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Community-delivered sleep education interventions have been demonstrated to be effective in improving sleep outcomes, but whether these benefits persist once the program ends is not well characterized. This study sought to determine whether the previously reported positive effects attributed to the SLeep Education for Elders Program (SLEEP) were maintained six months after program completion. METHOD Nineteen participants were surveyed three times: at baseline, program completion (six weeks), and the six-month post-program timepoint. Sleep outcomes for quality, duration, insomnia symptoms, sleep hygiene behaviors, and excessive daytime sleepiness were assessed using validated surveys, including the Pittsburgh Sleep Quality Index (from which duration was also extracted), the Insomnia Severity Index, the Sleep Hygiene Index, and the Epworth Sleepiness Scale. RESULTS Longitudinal models adjusted for baseline sleep problems revealed the benefits achieved immediately after the program were retained at six months for sleep quality (estimate: -2.0 (95%CI: -2.7, -1.3)), sleep duration (estimate: 0.9 (95%CI: 0.6, 1.2)), insomnia symptoms (estimate: -3.5 95%CI: (-4.6, -2.3)), and sleep hygiene behaviors (estimate: -2.6 (-4.3, -0.9)). CONCLUSIONS These results suggest that a community-delivered sleep education intervention can produce sustained benefits for participants and should be considered as a tool to address uncomplicated sleep issues.
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Affiliation(s)
- Diana Haggerty
- Office of Research and Education, Spectrum Health West Michigan, Grand Rapids, Michigan
| | - Dawn A Contreras
- Michigan State University Extension. Michigan State University, East Lansing, Michigan
| | - Anita Carter
- Michigan State University Extension. Michigan State University, East Lansing, Michigan
| | - Christopher Drake
- Division of Sleep Medicine, Henry Ford Health System, Detroit, Michigan
| | - Robin M Tucker
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, Michigan
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Petersen MC, Gallop MR, Flores Ramos S, Zarrinpar A, Broussard JL, Chondronikola M, Chaix A, Klein S. Complex physiology and clinical implications of time-restricted eating. Physiol Rev 2022; 102:1991-2034. [PMID: 35834774 PMCID: PMC9423781 DOI: 10.1152/physrev.00006.2022] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/16/2022] [Accepted: 07/07/2022] [Indexed: 11/22/2022] Open
Abstract
Time-restricted eating (TRE) is a dietary intervention that limits food consumption to a specific time window each day. The effect of TRE on body weight and physiological functions has been extensively studied in rodent models, which have shown considerable therapeutic effects of TRE and important interactions among time of eating, circadian biology, and metabolic homeostasis. In contrast, it is difficult to make firm conclusions regarding the effect of TRE in people because of the heterogeneity in results, TRE regimens, and study populations. In this review, we 1) provide a background of the history of meal consumption in people and the normal physiology of eating and fasting; 2) discuss the interaction between circadian molecular metabolism and TRE; 3) integrate the results of preclinical and clinical studies that evaluated the effects of TRE on body weight and physiological functions; 4) summarize other time-related dietary interventions that have been studied in people; and 4) identify current gaps in knowledge and provide a framework for future research directions.
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Affiliation(s)
- Max C Petersen
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri
- Division of Endocrinology, Metabolism, and Lipid Research, Washington University School of Medicine, St. Louis, Missouri
| | - Molly R Gallop
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Stephany Flores Ramos
- Division of Gastroenterology, University of California, San Diego, La Jolla, California
| | - Amir Zarrinpar
- Division of Gastroenterology, University of California, San Diego, La Jolla, California
- Department of Veterans Affairs San Diego Health System, La Jolla, California
| | - Josiane L Broussard
- Division of Endocrinology, Metabolism, and Diabetes, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado
| | - Maria Chondronikola
- Departments of Nutrition and Radiology, University of California, Davis, California
- Departments of Nutrition and Dietetics, Harokopio University of Athens, Kallithea, Greece
| | - Amandine Chaix
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Samuel Klein
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri
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12
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Characteristic Sleep Patterns and Associated Obesity in Adolescents. Life (Basel) 2022; 12:life12091316. [PMID: 36143353 PMCID: PMC9500978 DOI: 10.3390/life12091316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/25/2022] [Accepted: 08/24/2022] [Indexed: 11/20/2022] Open
Abstract
Poor sleep adversely affects health and may cause obesity. Poor sleep includes short sleep duration, low quality of sleep, and sleep discrepancy. Although most studies have focused on the association between sleep duration and obesity, poor sleep is a significant risk factor for obesity. Adolescents have characteristic sleep patterns which correspond to poor sleep. Adolescents sleep late due to various biological and psychosocial factors; also, they wake up early to be on time for school. This causes them to sleep less. To make up for this sleep debt, adolescents sleep more on non-school days, which causes sleep discrepancies. Therefore, since adolescents have characteristic sleep patterns, an in-depth investigation is needed to identify whether poor sleep is a risk for obesity. This article presents an overview of the characteristic sleep patterns of adolescents, and reviews studies on the association of each sleep pattern with obesity.
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13
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Huang S, Si H, Liu J, Qi D, Pei X, Lu D, Zou S, Li Z. Sleep Loss Causes Dysfunction in Murine Extraorbital Lacrimal Glands. Invest Ophthalmol Vis Sci 2022; 63:19. [PMID: 35731510 PMCID: PMC9233287 DOI: 10.1167/iovs.63.6.19] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose Sleep loss markedly affects the structure and function of the lacrimal gland and may cause ocular surface disease as a common public health problem. This study aims to investigate the circadian disturbance caused by sleep loss leading to dysfunction of extraorbital lacrimal glands (ELGs). Methods A mouse sleep deprivation (SD) model for sleep loss studies was built in C57BL/6J male mice. After four weeks, the ELGs were collected at three-hour intervals during a 24-hour period. The Jonckheere-Terpstra-Kendall algorithm was used to determine the composition, phase, and rhythmicity of transcriptomic profiles in ELGs. Furthermore, we compared the non-sleep-deprived and SD-treated mouse ELG (i) reactive oxygen species (ROS) by fluorescein staining, (ii) DNA damage by immunostaining for γ-H2Ax, and (iii) circadian migration of immune cells by immunostaining for CD4, CD8, γδ-TCR, CD64, and CX3CR1. Finally, we also evaluated (i) the locomotor activity and core body temperature rhythm of mice and (ii) the mass, cell size, and tear secretion of the ELGs. Results SD dramatically altered the composition and phase-associated functional enrichment of the circadian transcriptome, immune cell trafficking, metabolism, cell differentiation, and neural secretory activities of mouse ELGs. Additionally, SD caused the ROS accumulation and consequent DNA damage in the ELGs, and the ELG dysfunction caused by SD was irreversible. Conclusions SD damages the structure, function, and diurnal oscillations of ELGs. These results highlight comprehensive characterization of insufficient sleep–affected ELG circadian transcriptome that may provide a new therapeutic approach to counteract the effects of SD on ELG function.
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Affiliation(s)
- Shenzhen Huang
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Henan University, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongli Si
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Henan University, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Jiangman Liu
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Henan University, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Di Qi
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Henan University, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoting Pei
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Henan University, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Dingli Lu
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Henan University, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Sen Zou
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Henan University, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhijie Li
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Henan University, People's Hospital of Zhengzhou University, Zhengzhou, China
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14
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Cheval B, Maltagliati S, Sieber S, Cullati S, Zou L, Ihle A, Kramer AF, Yu Q, Sander D, Boisgontier MP. Better Subjective Sleep Quality Partly Explains the Association Between Self-Reported Physical Activity and Better Cognitive Function. J Alzheimers Dis 2022; 87:919-931. [DOI: 10.3233/jad-215484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background: Physical activity has been associated with better cognitive function and better sleep quality. Yet, whether the beneficial effect of physical activity on cognitive function can be explained by an indirect pathway involving better sleep quality is unclear. Objective: To investigate whether sleep quality mediates the association between physical activity and cognitive function in adults 50 years of age or older. Methods: 86,541 community-dwelling European adults were included in the study. Physical activity and sleep quality were self-reported. Indicators of cognitive function (immediate recall, delayed recall, verbal fluency) were assessed using objective tests. All measures were collected six times between 2004 and 2017. The mediation was tested using multilevel mediation analyses. Results: Results showed that self-reported physical activity was associated with better self-reported sleep quality, which was associated with better performance in all three indicators of cognitive function, demonstrating an indirect effect of physical activity on cognitive function through sleep quality. The mediating effect of sleep quality accounted for 0.41%, 1.46%, and 8.88% of the total association of physical activity with verbal fluency, immediate recall, and delayed recall, respectively. Conclusion: These findings suggest that self-reported sleep quality partly mediates the association between self-reported physical activity and cognitive function. These results need to be confirmed by device-based data of physical activity and sleep quality.
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Affiliation(s)
- Boris Cheval
- Swiss Center for Affective Sciences, University of Geneva, Switzerland
- Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of Psychology, University of Geneva, Switzerland
| | | | - Stefan Sieber
- Swiss NCCR “LIVES – Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Switzerland
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Switzerland
| | - Stéphane Cullati
- Population Health Laboratory, University of Fribourg, Switzerland
- Department of Readaptation and Geriatrics, University of Geneva, Switzerland
| | - Liye Zou
- Institute of KEEP Collaborative Innovation, Shenzhen University, China
- Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, China
| | - Andreas Ihle
- Swiss NCCR “LIVES – Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Switzerland
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Switzerland
- Cognitive Aging Lab, Department of Psychology, University of Geneva, Geneva, Switzerland
| | - Arthur F. Kramer
- Center for Cognitive and Brain Health, Department of Psychology, Northeastern University, Boston, MA, USA
- Beckman Institute, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Qian Yu
- Institute of KEEP Collaborative Innovation, Shenzhen University, China
- Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, China
| | - David Sander
- Swiss Center for Affective Sciences, University of Geneva, Switzerland
- Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of Psychology, University of Geneva, Switzerland
| | - Matthieu P. Boisgontier
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Canada
- Bruyère Research Institute, Ottawa, Canada
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15
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Cook I, Mohlabe M. Objectively-measured sleep patterns and cardiometabolic health in a rural South African setting: a cross sectional analysis. SLEEP SCIENCE AND PRACTICE 2022. [DOI: 10.1186/s41606-022-00070-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To investigate the relationship between objectively-measured, free-living sleep patterns, and cardiometabolic health, in a rural South African health and demographic surveillance site.
Methods
Wrist-mounted actigraphy data was collected over nine days from 167 adults (≥ 40 years). Sleep patterns were constructed from tertiles of sleep quantity and quality parameters (TST: total sleep time, AC: activity counts during sleep) from valid minute-by-minute data. The reference category was Moderate TST/Low-to-Moderate AC. Self-reported data included behavioural, health and socio-demographic variables. Biological data included anthropometry, resting blood pressure and fasting blood glucose, insulin and lipids. Binary and ordinal logistic regression models were constructed to determine the association between TST and AC, the factors associated with sleeping patterns, and the association between sleeping patterns and Insulin resistance (HOMA-IR) and Metabolic Syndrome (MetS). HOMA-IR and MetS were also examined across sleep patterns using analysis of variance models.
Results
A total of 139 adults (71.2% female) had a complete dataset. In unadjusted analyses, females had poorer sleep quality, were more physically active, and displayed poorer cardiometabolc health and greater adiposity than males (p ≤ 0.017). There were no sex differences in TST or sleep pattern distribution (p ≤ 0.901). Not being classified as Low TST/High AC or exposed to ≥ 1 bout of Low TST/High AC sleep was associated with lower physical activity, longer sleep duration, better sleep quality and lower IR (p ≤ 0.0452). In multivariate analyses, there was no association between TST and AC (p = 0.921), while increasing age and people-to-bedroom density, and lower physical activity where significantly associated with increasing TST (p ≤ 0.027). Participants classified as Low TST/High AC had significantly higher HOMA-IR, but not MetS, compared with Moderate TST/Low AC (p = 0.021). Being exposed to ≥ 1 bout of Low TST/High AC sleep was significantly associated with hypertension (OR = 2.31, 95%CI: 1.00, 5.34), but not for HOMA-IR or MetS (p ≥ 0.227).
Conclusions
Long sleep was not associated with increased sleep fragmentation. Short, fragmented sleep was associated with insulin resistance. Exposure to at least one bout of short, fragmented sleep increased the likelihood of hypertension. Further studies are required to identify the factors associated with short, fragmented sleep in this setting.
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16
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Kiran HS, Gowthami T. Perceived sleep quality and quantity before acute myocardial infarction: A pilot study. JOURNAL OF THE PRACTICE OF CARDIOVASCULAR SCIENCES 2022. [DOI: 10.4103/jpcs.jpcs_43_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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17
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Moitra P, Madan J, Verma P. Independent and combined influences of physical activity, screen time, and sleep quality on adiposity indicators in Indian adolescents. BMC Public Health 2021; 21:2093. [PMID: 34781921 PMCID: PMC8591930 DOI: 10.1186/s12889-021-12183-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/09/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Inadequate physical activity (PA), excess screen time (ST), and sub-optimal sleep quality tend to co-occur during adolescence. Yet, little is known about the associations of these behaviors as a cluster with adiposity indicators in Indian adolescents. This study aimed to evaluate the independent and combined influences of PA, ST, and sleep quality on body mass index (BMI) and waist to height ratio (WHtR) in 10-15 years old adolescents in Mumbai, India. A secondary aim was to explore if these influences vary between sexes. METHODS Cross-sectional study. Adolescents (n = 772, mean age 13.2 (1.4) years) reported frequency and duration of moderate to vigorous PA (MVPA) and time spent using screens on a previously validated instrument. Sleep quality was estimated using the Pittsburg Sleep Quality Index (PSQI). Weight, height, and waist circumference were measured. Mixed effect logistic regression analyses were performed to explore associations between adiposity indicators (BMI z scores > +1SD and WHtR > 0.5) and unhealthy behaviors (PA < 60 min/d, ST > 120 min/d and PSQI scores > 5), stratified by sex. RESULTS The combined prevalence of overweight and obesity was 38.3%. Overall, 62.0 and 85.0% reported MVPA< 60 min/d and ST > 120 min/d respectively. Girls reported higher ST (218.21 (69.01) min/d) as compared to boys (165.3 (101.22) min/d, p < 0.001). Clustering of low PA and excess ST was observed in 69.2% and of all three unhealthy behaviors in 18.8%. Among girls, MVPA < 60 min/d (OR = 1.78, 95% CI 1.54-1.92, p < 0.001) and PSQI scores > 5 (OR = 2.01, 95% CI 1.78-2.25, p < 0.001) predicted increased BMI. The odds of overweight/obesity were 2.10 times higher in boys reporting low PA and 4.13 times higher in those with low PA+ ST > 120 min/d. Clustering of all three unhealthy behaviors increased prevalence of obesity in both sexes. CONCLUSIONS The results indicated a co-existence of multiple unhealthy lifestyle factors of obesity and that clustering of these behaviors can further aggravate obesity risk as compared to their independent effects. Integrated interventions that leverage the cumulative benefits of being active, less sedentary and sufficient sleep are warranted to facilitate greater improvements in obesity risk behaviors.
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Affiliation(s)
- Panchali Moitra
- Department of Food, Nutrition & Dietetics, Sir Vithaldas Thackersey College of Home Science (Autonomous), SNDT Women’s University, Santacruz West, Mumbai, Maharashtra 400049 India
| | - Jagmeet Madan
- Department of Food, Nutrition & Dietetics, Sir Vithaldas Thackersey College of Home Science (Autonomous), SNDT Women’s University, Santacruz West, Mumbai, Maharashtra 400049 India
| | - Preeti Verma
- Department of Special Education, Department of Interdisciplinary Studies, SNDT Women’s University, Santacruz West, Mumbai, Maharashtra 400049 India
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18
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Associations Between Sleep Quality and 10-Year Cardiovascular Disease Risk Among Female Nurses in Hong Kong: A Cross-sectional Study. J Cardiovasc Nurs 2021; 37:E22-E31. [PMID: 34581711 DOI: 10.1097/jcn.0000000000000857] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sleep problems are common among nurses compared with the general population. Poor sleep quality increases the risk of developing cardiovascular disease (CVD). The relationship between sleep quality and CVD risk has not been previously investigated among Hong Kong female nurses. OBJECTIVE The authors of this study explored the association between sleep quality and CVD risk among Hong Kong female nurses. METHODS Data were collected from the Hong Kong Women's Health Study cross-sectional survey between 2019 and 2020. Questionnaires were sent to female nurses (≥aged 30 years). Ten-year CVD risk was measured using the Framingham 10-year risk score, and the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Relationships were evaluated using adjusted multiple linear regression and binary logistic regression. RESULTS In 1344 respondents, the mean age was 46.12 ± 10.47 years, average PSQI score was 6.02 (3.35), and 52.4% reported poor sleeping quality (global PSQI score > 5). The mean 10-year CVD risk was 3.6% (3.3%). The 10-year CVD risk was significantly associated with sleep disturbance (β = 0.006) and daytime dysfunction (β = -0.002) (both Ps < .01). Participants who reported sleep disturbance had a higher CVD risk (odds ratio, 1.82; 95% confidence interval, 1.04-3.18). High daytime dysfunction decreased CVD risk (odds ratio, 0.63; 95% confidence interval, 0.46-0.85). Subgroup analysis showed stronger associations between sleep quality and Framingham 10-year risk score among those unemployed, undergoing postmenopause, or with a family history of CVDs. CONCLUSIONS Sleep disturbance and daytime dysfunction were associated with the 10-year CVD risk among Hong Kong female nurses. Nurses who were unemployed, were undergoing postmenopause, or with a family history of CVD were those with the highest risk.
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19
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Li B, Liu N, Guo D, Li B, Liang Y, Huang L, Wang X, Su Z, Zhang G, Wang P. Association between sleep quality and central obesity among southern Chinese reproductive-aged women. BMC WOMENS HEALTH 2021; 21:280. [PMID: 34348705 PMCID: PMC8336247 DOI: 10.1186/s12905-021-01407-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 06/28/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The connections between sleep quality and central obesity among reproductive-aged women are not clear. The study aimed to explore the association between sleep quality and central obesity among Chinese reproductive-aged women and identify the independent contributions of sociodemographic characteristics, health-related factors, and sleep quality to central obesity. METHODS In this cross-sectional survey, the minimal sample sizes were 2404 subjects; 2449 Chinese women aged 18-49 participated in this study. Sleep quality was assessed by the Chinese version of the Pittsburgh Sleep Quality Index (PSQI). Central obesity as the outcome of interest was a binary variable; women were categorized as with versus without central obesity measured by waist circumference (WC). The independent contribution of sociodemographic characteristics (Cluster 1), health-related variables (Cluster 2), and sleep quality (Cluster 3) to central obesity was derived from the corresponding R2 change (individual R2 change/total R2 × 100%), using clustered multiple logistic regression analyses. RESULTS The risk of central obesity increased significantly with poor sleep quality (assessed by global PSQI score) [adjusted odds ratio (OR) = 2.20 per SD increase; 95% confidence interval (CI) = 1.28-3.78; P = 0.004], increased sleep disturbance score (adjusted OR = 1.11 per SD increase; 95% CI = 1.01-1.22; P = 0.042) and decreased subjective sleep quality score (adjusted OR = 0.81 per SD increase; 95% CI = 0.73-0.90; P < 0.001). The independent contribution of sleep quality was 9.9%, less than those of sociodemographic (73.3%) and health-related (16.8%) variables. Among complaints related to sleep disturbance, the inability to breathe comfortably, and having bad dreams showed significant associations with central obesity. CONCLUSIONS There exists some degree of correlation between sleep quality and central obesity among Chinese reproductive-aged women. These findings underscore the need for future public health guidelines to formulate some detailed strategies to improve sleep quality, such as preventing and intervening risk factors that influence sleep quality and suggesting optimal sleep duration, which might effectively reduce the incidence of central obesity in this population group.
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Affiliation(s)
- Bingbing Li
- Institute of Chronic Disease Risks Assessment, School of Nursing and Health, Henan University, Kaifeng, 475004, China.,Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei Province, China
| | - Nan Liu
- Institute of Chronic Disease Risks Assessment, School of Nursing and Health, Henan University, Kaifeng, 475004, China
| | - Donghui Guo
- The People's Hospital of Longhua.Shenzhen, Shenzhen, 518109, China
| | - Bo Li
- Institute of Chronic Disease Risks Assessment, School of Nursing and Health, Henan University, Kaifeng, 475004, China
| | - Yan Liang
- The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221006, China
| | - Lingling Huang
- Institute of Nursing and Health, Shanghai Lida University, Shanghai, 201609, China
| | - Xiaoxiao Wang
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei Province, China
| | - Zhenzhen Su
- Institute of Chronic Disease Risks Assessment, School of Nursing and Health, Henan University, Kaifeng, 475004, China
| | - Guozeng Zhang
- Institute of Chronic Disease Risks Assessment, School of Nursing and Health, Henan University, Kaifeng, 475004, China.
| | - Peixi Wang
- Institute of Chronic Disease Risks Assessment, School of Nursing and Health, Henan University, Kaifeng, 475004, China. .,General Practice Center, The Seventh Affiliated Hospital, Southern Medical University, Foshan, PR China.
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20
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Weng Z, Ou W, Huang J, Singh M, Wang M, Zhu Y, Kumar R, Lin S. Circadian Misalignment Rather Than Sleep Duration is Associated with MAFLD: A Population-Based Propensity Score-Matched Study. Nat Sci Sleep 2021; 13:103-111. [PMID: 33542668 PMCID: PMC7853435 DOI: 10.2147/nss.s290465] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/15/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND AIMS Circadian misalignment (CM) leads to metabolic disorder. Metabolic (dysfunction) associated fatty liver disease (MAFLD) is a novel definition for fatty liver disease that requires the presence of metabolic dysfunction. As the association between CM and MAFLD remains unclear, this study is designed to explore whether there is an association between CM and MAFLD. METHODS NHANES 2017-2018 database was used in this study. Liver steatosis and fibrosis were diagnosed by Fibroscan®. CM was defined by the presence of mistimed sleep, late sleep or irregular chronotype. Propensity score matching (PSM) was used to match subjects for their age and gender. RESULTS A total of 4552 participants were included in the study, with 2089 (45.89%) identified as MAFLD and 894 (19.64%) as CM. Participants with CM were significantly younger than those without (46.06 ± 18.06 vs 50.93 ± 17.78, p<0.001). PSM for age and gender resulted in 894 participants with CM and 892 with non-CM. CM group had higher body mass index, liver enzymes, glucose and lipid levels. The prevalence of MAFLD was higher in the CM group than the non-CM group (45.41% vs 28.48%, p<0.001). The presence of CM increased the risk of MAFLD by more than twofold. Short sleep duration (<6 hours) was not independently associated with MAFLD or fibrosis if additionally adjusting for CM. CONCLUSION CM is independently associated with MAFLD, while short sleep duration (<6 hours) is not an independent risk factor for MAFLD or liver fibrosis after adjusting for CM.
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Affiliation(s)
- Zhiyuan Weng
- Cardiology Department, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian350001, People’s Republic of China
| | - Weijie Ou
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian350001, People’s Republic of China
| | - Jiaofeng Huang
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian350001, People’s Republic of China
| | - Medha Singh
- Department of General Medicine, Tan Tock Seng Hospital308433, Singapore
| | - Mingfang Wang
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian350001, People’s Republic of China
| | - Yueyong Zhu
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian350001, People’s Republic of China
| | - Rahul Kumar
- Department of Gastroenterology and Hepatology, Duke-NUS Academic Medical Centre, Changi General Hospital529889, Singapore
| | - Su Lin
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian350001, People’s Republic of China
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21
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Rasouli A, Mohiti S, Javadi M, Panjeshahin A, Kazemi M, Shiri-Shahsavar MR. The effect of daily fast food consumption, family size, weight-caused stress, and sleep quality on eating disorder risk in teenagers. Sleep Breath 2021; 25:1527-1533. [PMID: 33411190 DOI: 10.1007/s11325-020-02189-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/29/2020] [Accepted: 09/12/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Eating disorder (ED) is a common complication with disturbance of eating or eating-related behaviors that lead to physical and psychosocial disorders. The purpose of this study was to evaluate the association between eating disorders and daily fast food consumption, family size, weight-caused stress, and sleep quality in teenagers in Zanjan, Iran. METHODS Adolescent girl students aged 12-15 years (n = 370), selected in a cross-sectional study, completed the Eating Attitude Test-26 and Pittsburgh Sleep Quality Index questionnaires. The cluster random sampling method was used. Statistical analysis was performed using R software version 3.6.3. Logistic regression modeling was used for investigating the relationship between factors and odds of EDs. A p value of less than 0.05 was considered significant. RESULTS A significant relationship was found between family size (OR = 0.77, p = 0.049), fast food-daily consumption (OR = 5.42, p = 0.043), weight-caused stress (OR = 12.47, p < 0.001), and poor sleep quality (OR = 1.70, p = 0.024) and odds of eating disorder among teenage girls. CONCLUSION A significant positive association was found between a low number of family members, daily fast food consumption, stress status, poor sleep quality and odds of EDs. However more longitudinal studies are required to confirm the results.
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Affiliation(s)
- Ahmadreza Rasouli
- Department of Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran.,Student Research Committee, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Sara Mohiti
- Department of Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran.,Student Research Committee, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Maryam Javadi
- Department of Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran.,Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Asieh Panjeshahin
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Morteza Kazemi
- Department of Biostatistics and Epidemiology, School of Health Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mohammad Reza Shiri-Shahsavar
- Department of Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran. .,Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
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22
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Tucker RM, Contreras DA, Carlson BR, Carter A, Drake CL. Sleep Education for Elders Program (SLEEP): Promising Pilot Results of a Virtual, Health Educator-Led, Community-Delivered Sleep Behavior Change Intervention. Nat Sci Sleep 2021; 13:625-633. [PMID: 34040471 PMCID: PMC8141400 DOI: 10.2147/nss.s304035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/21/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Sleep problems pose serious public health concerns, and evidence suggests that the problem is worsening. Both sufficient sleep quantity and quality are needed for optimal health, particularly among older adults, but access to sleep care can be difficult. This study examined the efficacy of a six-week sleep behavior change program designed for older adults that was delivered virtually by health educators. PARTICIPANTS AND METHODS This quasi-experimental pilot study (intervention n = 22; control n = 31) explored the effects of the Sleep Education for Elders Program (SLEEP) on sleep outcomes, which included: 1) sleep quality, measured by the Pittsburgh Sleep Quality Index (PSQI); 2) sleep duration, extracted from the PSQI; 3) insomnia symptoms, measured by the Insomnia Severity Index; 4) sleep hygiene behaviors, obtained from the Sleep Hygiene Index; and 5) excessive daytime sleepiness, measured by the Epworth Sleepiness Scale. RESULTS After SLEEP, the intervention group experienced significantly improved sleep quality (p < 0.001), a reduction in maladaptive sleep hygiene behaviors (p = 0.007), and reduced daytime sleepiness (p < 0.027) compared to the control group. Effect sizes for all five sleep measures were medium or large. In the intervention group, all changes were judged to be clinically meaningful (≥ 0.5 SD) except for improvements in daytime sleepiness. CONCLUSION These data support the efficacy of a group-based, virtual behavior change intervention in improving sleep outcomes among older adults.
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Affiliation(s)
- Robin M Tucker
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, 48824, USA
| | - Dawn A Contreras
- Health and Nutrition Institute, Michigan State University Extension, Michigan State University, East Lansing, MI, 48824, USA
| | - Breanne R Carlson
- Health and Nutrition Institute, Michigan State University Extension, Michigan State University, East Lansing, MI, 48824, USA
| | - Anita Carter
- Health and Nutrition Institute, Michigan State University Extension, Michigan State University, East Lansing, MI, 48824, USA
| | - Christopher L Drake
- Division of Sleep Medicine, Henry Ford Health System, Detroit, MI, 48202, USA
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Takahashi A, Anzai Y, Kuroda M, Kokubun M, Kondo Y, Ogata T, Fujita M, Hayashi M, Imaizumi H, Abe K, Tanji N, Ohira H. Effects of sleep quality on non-alcoholic fatty liver disease: a cross-sectional survey. BMJ Open 2020; 10:e039947. [PMID: 33122322 PMCID: PMC7597499 DOI: 10.1136/bmjopen-2020-039947] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The effects of sleep quality on the risk of developing non-alcoholic fatty liver disease (NAFLD) remain uncertain. The purpose of this study was to clarify the association between sleep quality and NAFLD. METHODS The data of 4828 participants who underwent health check-ups at four hospitals were analysed. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI), which comprised seven elements scored from 0 to 3. The global PSQI score and the score for each element were compared between NAFLD and non-NAFLD groups separately by sex. Logistic regression analysis was performed to determine the association between NAFLD and each PSQI score. RESULTS In both men and women, the mean PSQI score for sleep medication use was significantly higher in non-NAFLD than in NAFLD. With regard to sleep medication use in men, the OR (95% CI) for NAFLD was lower with a score of 3 (OR 0.60, 95% CI 0.38-0.95) than with a score of 0 on multivariate logistic regression analysis adjusted for age, smoking habits and physical activity. The OR for NAFLD based on daytime dysfunction was also higher with a score of 3 than with a score of 0 in both men (OR 2.82, 95% CI 1.39-5.75) and women (OR 2.08, 95% CI 1.10-3.92). After adjustment for body mass index, the sleep latency scores in men and daytime dysfunction in women were associated with NAFLD. CONCLUSION Sleep quality was associated with NAFLD, and there were sex differences.
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Affiliation(s)
- Atsushi Takahashi
- Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yukio Anzai
- Gastroenterology, Watari Hospital, Fukushima, Japan
| | - Masahito Kuroda
- Gastroenterology, Fukushima Red Cross Hospital, Fukushima, Japan
| | - Masae Kokubun
- Total Medical Checkup, Jusendo Hospital, Koriyama, Fukushima, Japan
| | - Yuichiro Kondo
- Gastroenterology, Fujita General Hospital, Date-gun, Fukushima, Japan
| | - Takashi Ogata
- Gastroenterology, Masu Memorial Hospital, Nihonmatsu, Japan
| | - Masashi Fujita
- Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Manabu Hayashi
- Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hiromichi Imaizumi
- Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kazumichi Abe
- Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Nobuo Tanji
- Gastroenterology, Watari Hospital, Fukushima, Japan
| | - Hiromasa Ohira
- Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
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Lee SY, Ju YJ, Lee JE, Kim YT, Hong SC, Choi YJ, Song MK, Kim HY. Factors associated with poor sleep quality in the Korean general population: Providing information from the Korean version of the Pittsburgh Sleep Quality Index. J Affect Disord 2020; 271:49-58. [PMID: 32312697 DOI: 10.1016/j.jad.2020.03.069] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 01/16/2020] [Accepted: 03/22/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Recently, studies have been conducted to address the research gap in the understanding of poor-quality sleep and its relationship to health outcomes, through the evaluation of sleep quality. The aim of this study was to provide information regarding poor sleep quality based on a nationwide general population sample in Korea. METHODS We conducted a cross-sectional study using data from a nationwide sample of 165,193 individuals (males: 44%) aged 19 years or older from the 2018 Korea Community Health Survey. The age range of the participants was 19-107 years (mean: 55.3 ± 17.5). The Korean version of the Pittsburgh Sleep Quality Index (PSQI) was used for assessing sleep quality. Poor sleep quality was defined as a total PSQI score of >5. RESULTS The overall prevalence of poor sleepers was 41.0% (males: 35.6%; females: 46.2%). Poor sociodemographic status (illiteracy, low income, and unemployment), poor health behaviors (smoking, high-risk drinking, diabetes, hypertension, non-participation in walking, and obesity), and poor mental health (perceived poor health status, stress, depressive symptoms, and subjective cognitive decline) were all associated with poor sleep quality in both males and females. LIMITATIONS As this study relies on self-reported and cross-sectional data, causal inferences cannot be made. CONCLUSIONS Poor sleep quality is highly prevalent in females. In addition, poor socio-demographic status, poor health behaviors, and poor mental health were associated with poor sleep quality. The mechanisms underlying sex differences in sleep quality remain to be elucidated, and further studies are required to address this.
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Affiliation(s)
- Soon Young Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, 206 World cup-ro, Yeongtong-gu, Suwon-si Gyeonggi-do 16499, Republic of Korea; Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Yeong Jun Ju
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, 206 World cup-ro, Yeongtong-gu, Suwon-si Gyeonggi-do 16499, Republic of Korea; Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Joo Eun Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, 206 World cup-ro, Yeongtong-gu, Suwon-si Gyeonggi-do 16499, Republic of Korea; Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Taek Kim
- Public Health Medical Service Office, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Seung Chul Hong
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea
| | - Yun Jung Choi
- Division of Chronic Disease Control, Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea
| | - Min Kyoung Song
- Division of Chronic Disease Control, Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea
| | - Hye Yun Kim
- Division of Chronic Disease Control, Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea
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Hsu WC, Chiang CH. Effect of BMI and Perceived Importance of Health on the Health Behavior of College Students: Cross-Sectional Study. J Med Internet Res 2020; 22:e17640. [PMID: 32525487 PMCID: PMC7317634 DOI: 10.2196/17640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/17/2020] [Accepted: 03/26/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Both body mass index (BMI) and the perceived importance of health have received a lot of attention, but few studies have fully investigated the interaction of their effects on health behaviors. OBJECTIVE This study investigates the effects of BMI and the perceived importance of health on health behaviors (patterns of eating, sleeping, and exercising) among college students in Taiwan. METHODS A survey was conducted with 334 students to assess their perception of the importance of health (using indicators) and their health behavior (using the Health Behaviors Scale). Respondent BMI was calculated from self-reported body weight and height. Descriptive statistical analysis, independent t test analysis, two-way analysis of variance (ANOVA), and one-way ANOVA were conducted. RESULTS The results showed a significant difference between genders in health behaviors among college students (eating: t332=2.17, P=.03; exercise: t332=5.57, P<.001; sleep: t332=2.58, P=.01). Moreover, there was an interaction between BMI and perception (of the importance of health) for exercise behaviors (F2,328=3.50, P=.03), but not for eating behaviors (F2,328=0.12, P=.89) or sleep behaviors (F2,328=1.64, P=.20). CONCLUSIONS This study establishes, for the first time, the interaction of BMI and the perceived importance of health on health behaviors. The perception of health was found to have a significant effect on exercise behaviors. Thus, the perception of health plays a significant role in the exercise behaviors of college students in Taiwan. This finding provides researchers, policy makers, and practitioners with evidence, and consequently, opportunities for focusing on preventive actions. The findings suggest that increasing the importance of health in the perception of college students, should be the focus of efforts to help students exercise more regularly.
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Affiliation(s)
- Wan-Chen Hsu
- National Kaohsiung University of Sciences and Technology, Kaohsiung, Taiwan
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Muthukrishnan A, Muralidharan TR, Subash J, Lathamangeswari C. Association of poor sleep quality with risk factors after coronary artery bypass graft surgery—A prospective cohort study. JOURNAL OF VASCULAR NURSING 2020; 38:83-92. [DOI: 10.1016/j.jvn.2020.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 01/22/2020] [Accepted: 02/05/2020] [Indexed: 10/24/2022]
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Prospective relationships of mentally passive sedentary behaviors with depression: Mediation by sleep problems. J Affect Disord 2020; 265:538-544. [PMID: 31784118 DOI: 10.1016/j.jad.2019.11.088] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 09/13/2019] [Accepted: 11/12/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND As distinct from mentally-active sedentary behaviors (e.g. reading), passive sedentary behaviors (e.g. TV-viewing) have been linked to a higher risk of depression, but the underlying mechanisms are unclear. We examined the potential mediating role of sleep problems in prospective relationships of passive sedentary behaviors with major depressive disorder (MDD). METHOD In 1997, 43 863 adults were surveyed and responses linked to clinician diagnoses of MDD until 2010. The questionnaire included items on sedentary behavior and sleep problems (Karolinska Sleep Questionnaire). Cox proportional hazard models and the 'counterfactual approach' were used to identify potential mediating effects of sleep problems in the association of passive sedentary behavior and MDD. RESULTS Of the total sample, 3,065 (7.6%) were excluded for having indications of depression at baseline. Of 33,116 participants with complete data (mean age = 51.3 years, SD = 15.7, 64% female); 472 (1.4%) incident cases of MDD were identified during the 13-year follow-up. In Cox regression analyses, higher durations of passive sedentary behavior (≥3 h/day versus <3 h/day) were associated with greater hazards of developing MDD (HR = 1.27; 95% CI = 1.01, 1.58). This relationship remained after adjusting for confounders (HR = 1.29; 95% CI = 1.03, 1.63). Adding sleep problems into the analysis significantly attenuated these relationships (HR = 1.25; 95% CI = 0.99, 1.57). The excess MDD relative risk of passive sedentary behaviors due to sleep problems was statistically significant. LIMITATIONS Measures of sedentary behavior, physical activity and sleep were self-reported. CONCLUSION Sleep problems appear to mediate detrimental associations of passive sedentary behavior with depression. Findings require further confirmation using objective measures.
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Cohen A, Ben Abu N, Haimov I. The Interplay Between Tobacco Dependence and Sleep Quality Among Young Adults. Behav Sleep Med 2020; 18:163-176. [PMID: 30463440 DOI: 10.1080/15402002.2018.1546707] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective/Background: Sleep disturbances are considered among the negative consequences of smoking. However, the relationship between sleep quality and smoking among young adults, a population in which the prevalence of smoking is highest, has scarcely been examined. The current study aimed at examining differences in sleep indices, assessed by both subjective and objective (actigraphy) measures, between smokers and nonsmokers, and whether such differences are associated with levels of nicotine dependence. Participants: Eighty-six young (19-28 years old) volunteers, of them 46 nonsmokers (69.6% women) and 40 regular smokers (70.0% women) smoking at least 10 cigarettes a day. Methods: The participants completed the State-Trait Anxiety Inventory, Beck Depression Inventory, Brief Questionnaire on Smoking Urges, the Fagerstrom Test for Nicotine Dependence, and the Pittsburgh Sleep Quality Index. Their sleep was monitored objectively for one week using an actigraph. Results: Smokers' self-reported sleep quality was similar to that of nonsmokers. However, actigraphy data pointed to lower sleep continuity in smokers compared to nonsmokers as reflected by increased wake time after sleep onset (Mean ± SD: 18.56 ± 15.29 vs. 11.21 ± 11.19, p < .01) and decreased sleep efficiency (Mean ± SD: 95.63 ± 3.53 vs. 97.23 ± 2.62, p < .012). Total sleep time and sleep onset latency did not differ between the groups. Notably, severity of nicotine dependence was negatively associated with sleep efficiency (β = -.32; p < .05). Conclusion: Young adult smokers have lower sleep continuity without necessarily subjectively experiencing their sleep as poor. Nevertheless, their lower sleep continuity is related to their level of nicotine dependence.
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Affiliation(s)
- Ami Cohen
- Psychology Department, The Center for Psychobiological Research, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
| | - Natali Ben Abu
- Psychology Department, The Center for Psychobiological Research, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
| | - Iris Haimov
- Psychology Department, The Center for Psychobiological Research, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
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Jefferson T, Addison C, Sharma M, Payton M, Jenkins BC. Association Between Sleep and Obesity in African Americans in the Jackson Heart Study. THE JOURNAL OF THE AMERICAN OSTEOPATHIC ASSOCIATION 2019; 119:656-666. [PMID: 31566693 PMCID: PMC11119958 DOI: 10.7556/jaoa.2019.113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND In the United States, data from the National Health and Nutrition Examination Survey suggest that 68% of adults are overweight and obese. Obesity has been shown in previous cross-sectional and longitudinal studies to be influenced by short sleep duration, which can lead to unregulated appetite, excessive eating during awake time, and decreased energy expenditure. OBJECTIVE To examine the associations among sleep duration, sleep quality, body mass index (BMI), and waist circumference (WC) in African Americans. METHODS The sample included participants in the Jackson Heart Study. During a clinic visit, the sleep habits of participants were recorded via a sleep history questionnaire, and BMI and WC measurements were also recorded. Multivariate analysis was used to examine the associations among sleep duration, sleep quality, general obesity (measured by BMI), and abdominal obesity (measured by WC). RESULTS The authors studied participants who provided data for the variables of interest (N=3778; 1363 men and 2415 women). Of all participants, 3317 (87.8%) were overweight, and 2149 (56.9%) were obese. The mean (SD) BMI was 32.1 (7.2) kg/m2, and the mean (SD) WC was 103.3 (16.0) cm. Mean sleep duration was 6.3 (1.4) hours for men and 6.4 (1.5) hours for women. Among the men, a significant negative relationship was found between sleep duration and body composition: longer sleep was associated with lower BMI levels but negatively associated with WC in men (β=-1.06; P<.01)]. Sleep quality was positively associated with WC in men (β=1.20; P<.01) and women (β=0.61; P<.05). CONCLUSIONS This study's findings highlight the high rate of overweight and obesity among participants in the Jackson Heart Study. About one-fourth of the participants described themselves as enjoying ideal health. In men, longer sleep duration was associated with lower BMI levels and lower WC; in both men and women, good sleep quality was associated with lower WC. However, more research is needed to examine sleep and body composition as risk factors for disease development in African Americans.
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Lo K, Keung V, Cheung C, Tam W, Lee A. Associations between Sleep Pattern and Quality and Cardiovascular Risk Factors among Macao School Students. Child Obes 2019; 15:387-396. [PMID: 31140858 DOI: 10.1089/chi.2018.0319] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: Despite accumulating evidence showing that sleep duration and cardiometabolic health are correlated, the association of sleep regularity and quality with cardiovascular risk factors in children and adolescents remains inconclusive. Therefore, we examined the relationship between sleep regularity/quality and cardiovascular risk factors in children and adolescents in Macao, China. Methods: We conducted a cross-sectional study among primary and secondary school students (age range: 9-18 years) in Macao, China. Body weight, height, waist circumference (WC), and serum lipid levels were measured. Sleep regularity and sleep quality were assessed by using the Pittsburgh Sleep Quality Index. Multivariable logistic regression was conducted to examine the relationship of sleep variables with the increased likelihood of body mass index (BMI)-classified overweight/obesity, WC-classified obesity, and dyslipidemia. Results: A total of 1078 school students were included in the analysis. Differences of >2 hours between weekday and weekend bedtimes were associated with the increased risk of BMI-classified overweight/obesity (odds ratio = 2.58, 95% confidence interval = 1.55-4.31, p < 0.01) after being adjusted for sleep variables and lifestyle factors. No statistically significant association was found between poor sleep quality and any other outcome. Conclusions: Irregular bedtime was associated with elevated body weight regardless of sleep amount and quality. Thus, regular bedtimes are recommended as a simple but practical strategy for preventing obesity.
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Affiliation(s)
- Kenneth Lo
- 1Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guang Zhou, China.,2Department of Epidemiology, Center for Global Cardiometabolic Health, Brown University, Providence, RI.,3JC School of Public Health and Primary Care, Faculty of Medicine, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Vera Keung
- 3JC School of Public Health and Primary Care, Faculty of Medicine, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong.,4Center for Health Education and Health Promotion, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Calvin Cheung
- 3JC School of Public Health and Primary Care, Faculty of Medicine, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong.,4Center for Health Education and Health Promotion, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Wilson Tam
- 5Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Albert Lee
- 3JC School of Public Health and Primary Care, Faculty of Medicine, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong.,4Center for Health Education and Health Promotion, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong
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Pereira FH, Trevisan DD, Santos Lourenço D, da Silva JB, Lima MHM. Effect of Educational Strategies on the Sleep Quality of People with Diabetes: Randomized Clinical Trial. AQUICHAN 2019. [DOI: 10.5294/aqui.2019.19.3.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objective: To evaluate the effect of educational strategies on sleep quality and its relation to diabetes-related distress and glycemic control in people with type 2 diabetes mellitus (DM2). Materials and methods: Randomized clinical trial involving two groups. Group 1 (G1, n = 45) received verbal guidance and leaflets on sleep hygiene strategies and group 2 (G2, n = 46) received usual health care guidelines on self-care with the feet. Sleep was assessed by the Pittsburgh Sleep Quality Inventory and diabetes-related distress by the Diabetes Distress Scale. Linear mixed-effects models and linear regression model were used for the statistical analysis. Results: At the end of the follow-up, sleep quality improvement (p = 0.02) was verified in G1. Low diabetes-related distress score (p = 0.03), being male (p = 0.02), belonging to G1 (p = 0.002), and age (p = 0.04) contributed to better sleep quality. Conclusion: Educational guidelines on sleep hygiene in patients with DM2 were effective in improving sleep quality, measured by the PSQI instrument and emotional stress related to diabetes as assessed by the Diabetes Distress Scale.
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Guinhouya BC, Bisson M, Dubois L, Sériès F, Kimoff JR, Fraser WD, Marc I. Body Weight Status and Sleep Disturbances During Pregnancy: Does Adherence to Gestational Weight Gain Guidelines Matter? J Womens Health (Larchmt) 2019; 28:535-543. [DOI: 10.1089/jwh.2017.6892] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Benjamin C. Guinhouya
- Faculty of Health Sciences and Management and EA 2694, Public Health (Epidemiology and Healthcare Quality), University of Lille, Lille, France
- Department of Pediatrics, Research Center of CHUQ, Laval University, Quebec, Canada
| | - Michelle Bisson
- Department of Pediatrics, Research Center of CHUQ, Laval University, Quebec, Canada
| | - Lise Dubois
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada
| | - Frédéric Sériès
- Research Unit in Pneumology, Research Center, Laval University, Quebec, Canada
| | - John R. Kimoff
- Respiratory Division and Sleep Laboratory, McGill University Health Center, Montreal, Canada
| | - William D. Fraser
- Department of Obstetrics, Research Center of CHU de Sherbrooke, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Isabelle Marc
- Department of Pediatrics, Research Center of CHUQ, Laval University, Quebec, Canada
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Shiri-Shahsavar M, Rasouli A, Javadi M, Mohiti S, Shahsavari S, Kamali K. Eating disorder risk, sleep status, and anthropometric indices among teenage female students. SOCIAL HEALTH AND BEHAVIOR 2019. [DOI: 10.4103/shb.shb_37_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Role of the Circadian Clock in the Metabolic Syndrome and Nonalcoholic Fatty Liver Disease. Dig Dis Sci 2018; 63:3187-3206. [PMID: 30121811 DOI: 10.1007/s10620-018-5242-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 08/06/2018] [Indexed: 12/20/2022]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in industrialized nations and is strongly associated with the metabolic syndrome. The prevalence of NAFLD continues to rise along with the epidemic of the metabolic syndrome. Metabolic homeostasis is linked to the circadian clock (rhythm), with multiple signaling pathways in organs regulated by circadian clock genes, and recent studies of circadian clock gene functions suggest that disruption of the circadian rhythm is associated with significant morbidity and mortality, including the metabolic syndrome. In the industrialized world, various human behaviors and activities such as work and eating patterns, jet lag, and sleep deprivation interfere with the circadian rhythm, leading to perturbations in metabolism and development of the metabolic syndrome. In this review, we discuss how disruption of the circadian rhythm is associated with various metabolic conditions that comprise the metabolic syndrome and NAFLD.
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Hirota T, Morioka T, Yoda K, Toi N, Hayashi N, Maruo S, Yamazaki Y, Kurajoh M, Motoyama K, Yamada S, Shoji T, Emoto M, Inaba M. Positive association of plasma leptin with sleep quality in obese type 2 diabetes patients. J Diabetes Investig 2018; 9:1100-1105. [PMID: 29479862 PMCID: PMC6123027 DOI: 10.1111/jdi.12826] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 01/25/2018] [Accepted: 02/20/2018] [Indexed: 01/03/2023] Open
Abstract
AIMS/INTRODUCTION Poor sleep quality is associated with obesity and diabetes. The adipocyte-derived hormone, leptin, was recently shown to underlie the link between abnormal sleep and obesity. We aimed to investigate the association between leptin and sleep quality in type 2 diabetes patients. MATERIALS AND METHODS In the present cross-sectional study, we studied 182 type 2 diabetes patients, among whom 113 were diagnosed with obesity (body mass index ≥25 kg/m2 ). Fasting plasma leptin levels were measured, and sleep architecture was assessed using single-channel electroencephalography. RESULTS Using unadjusted analyses, the obese type 2 diabetes patients, but not their non-obese counterparts, showed a positive correlation between plasma leptin levels and a parameter for deep sleep assessed by delta power during the first sleep cycle. Multivariate analysis showed that plasma leptin levels were positively associated with delta power, but not with the total sleep time, after adjusting for potential confounders including age, body mass index and the apnea-hypopnea index, in the obesity group. However, neither delta power nor total sleep time was associated with leptin in the non-obesity group. CONCLUSIONS Plasma leptin levels are independently associated with sleep quality in obese, but not in non-obese, type 2 diabetes patients. The present study indicates a favorable relationship between leptin and sleep quality in obese type 2 diabetes patients.
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Affiliation(s)
- Tomoe Hirota
- Department of Metabolism, Endocrinology and Molecular MedicineOsaka City University Graduate School of MedicineOsakaJapan
| | - Tomoaki Morioka
- Department of Metabolism, Endocrinology and Molecular MedicineOsaka City University Graduate School of MedicineOsakaJapan
| | - Koichiro Yoda
- Department of Metabolism, Endocrinology and Molecular MedicineOsaka City University Graduate School of MedicineOsakaJapan
| | - Norikazu Toi
- Department of Metabolism, Endocrinology and Molecular MedicineOsaka City University Graduate School of MedicineOsakaJapan
| | - Noriyuki Hayashi
- Department of Metabolism, Endocrinology and Molecular MedicineOsaka City University Graduate School of MedicineOsakaJapan
| | - Saori Maruo
- Department of Metabolism, Endocrinology and Molecular MedicineOsaka City University Graduate School of MedicineOsakaJapan
| | - Yuko Yamazaki
- Department of Metabolism, Endocrinology and Molecular MedicineOsaka City University Graduate School of MedicineOsakaJapan
| | - Masafumi Kurajoh
- Department of Metabolism, Endocrinology and Molecular MedicineOsaka City University Graduate School of MedicineOsakaJapan
| | - Koka Motoyama
- Department of Metabolism, Endocrinology and Molecular MedicineOsaka City University Graduate School of MedicineOsakaJapan
| | - Shinsuke Yamada
- Department of Metabolism, Endocrinology and Molecular MedicineOsaka City University Graduate School of MedicineOsakaJapan
| | - Tetsuo Shoji
- Department of Vascular MedicineOsaka City University Graduate School of MedicineOsakaJapan
| | - Masanori Emoto
- Department of Metabolism, Endocrinology and Molecular MedicineOsaka City University Graduate School of MedicineOsakaJapan
| | - Masaaki Inaba
- Department of Metabolism, Endocrinology and Molecular MedicineOsaka City University Graduate School of MedicineOsakaJapan
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Krističević T, Štefan L, Sporiš G. The Associations between Sleep Duration and Sleep Quality with Body-Mass Index in a Large Sample of Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040758. [PMID: 29662031 PMCID: PMC5923800 DOI: 10.3390/ijerph15040758] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 04/02/2018] [Accepted: 04/11/2018] [Indexed: 01/05/2023]
Abstract
Background: The main aims of this study were to explore the associations between time spent in bed (as a proxy of sleep duration) and sleep quality with overweight/obesity status in a large sample of young adults. Methods: In this cross-sectional study, participants were 2100 university students (49.6% of women). We used Pittsburgh Sleep Quality Index (PSQI) questionnaire to assess time spent in bed and sleep quality. Body-mass index (BMI) was self-reported and dichotomized as normal (<25 kg/m2) vs. overweight/obesity (≥25 kg/m2) status. Results: In model 1, both short (<6 h/day, OR = 2.72; 95% CI 1.27 to 5.84) and long (>10 h/day, OR = 3.38; 95% CI 2.12 to 5.40) time spent in bed were associated with a greater likelihood of being overweight/obese. In model 2, poor sleep quality (>5 points, OR = 1.45; 95% CI 1.14 to 1.83) was associated with a greater likelihood of being overweight/obese. After entering time spent in bed and sleep quality simultaneously into the model 3, both short (OR = 2.64; 95% CI 1.23 to 5.66) and long (OR = 3.27; 95% CI 2.04 to 5.23) time spent in bed and poor sleep quality (OR = 1.40; 95% CI 1.10 to 1.78) were associated with overweight/obesity status. Conclusions: Our results show that both short and long time spent in bed and poor sleep quality are associated with overweight/obesity status in young adults. Special interventions and policies that use both sleep duration and sleep quality as protective factors against overweight/obesity are warranted.
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Affiliation(s)
| | - Lovro Štefan
- Faculty of Kinesiology, University of Zagreb, 10 000 Zagreb, Croatia.
| | - Goran Sporiš
- Faculty of Kinesiology, University of Zagreb, 10 000 Zagreb, Croatia.
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Vézina-Im LA, Nicklas TA, Baranowski T. Associations Among Sleep, Body Mass Index, Waist Circumference, and Risk of Type 2 Diabetes Among U.S. Childbearing-Age Women: National Health and Nutrition Examination Survey. J Womens Health (Larchmt) 2018; 27:1400-1407. [PMID: 29583069 DOI: 10.1089/jwh.2017.6534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Women of childbearing age (18-44 years) present an important group for understanding sleep, but few studies have focused on this population. No study has investigated the associations among sleep, overweight/obesity, and risk of type 2 diabetes among childbearing-age women in the National Health and Nutrition Examination Survey (NHANES). METHODS Data were from NHANES, 2005-2008. The study population consisted of 18-44 year old women. Pregnant women and those diagnosed with sleep disorders were excluded. Sleep duration and quality were self-reported. Body mass index (BMI), waist circumference (WC) measurements, and a 2-hour 75 g oral glucose tolerance test (OGTT) were performed by trained NHANES staff. An unadjusted linear regression analysis; a second adjusted for demographics only (partially adjusted model); and a third adjusted for demographics and variables associated with overweight/obesity and diabetes (fully adjusted model) were computed to assess associations among sleep duration/quality and BMI, WC, and 2-hour OGTT. RESULTS Total sample consisted of 2388 childbearing-age women. Only sleep duration was significantly associated with BMI and WC in the unadjusted and partially adjusted models, but was no longer significant in the fully adjusted model. Neither sleep duration nor quality was significantly associated with 2-hour OGTT in any of the models. CONCLUSIONS Targeting sleep duration and sleep quality alone would not likely contribute to significantly lower BMI, WC, or risk of type 2 diabetes in US childbearing-age women. Additional studies, especially longitudinal ones using objective measures of sleep, are needed to confirm these findings.
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Affiliation(s)
- Lydi-Anne Vézina-Im
- Children's Nutrition Research Center, Baylor College of Medicine , Houston, Texas
| | - Theresa A Nicklas
- Children's Nutrition Research Center, Baylor College of Medicine , Houston, Texas
| | - Tom Baranowski
- Children's Nutrition Research Center, Baylor College of Medicine , Houston, Texas
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Mello M, Vasques ACJ, Pareja JC, de Oliveira MDS, Novaes FS, Chaim ÉA, Geloneze B. Effect of biliopancreatic diversion on sleep quality and daytime sleepiness in patients with obesity and type 2 diabetes. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2017; 61:623-627. [PMID: 29412388 PMCID: PMC10522053 DOI: 10.1590/2359-3997000000314] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 08/09/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The poor quality of sleep and the deprivation thereof have been associated with disruption of metabolic homeostasis, favoring the development of obesity and type 2 diabetes (T2DM). We aimed to evaluate the influence of biliopancreatic diversion (BPD) surgery on sleep quality and excessive daytime sleepiness of obese patients with T2DM, comparing them with two control groups consisting of obese and normal weight individuals, both normal glucose tolerant. SUBJECTS AND METHODS Forty-two women were divided into three groups: LeanControl (n = 11), ObeseControl (n = 13), and ObeseT2DM (n = 18). The LeanC and ObeseC groups underwent all tests and evaluations once. The ObeseT2DM underwent BPD and were reassessed after 12 months. Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were applied before and 12 months after BPD. RESULTS Before surgery, there was less daytime sleepiness in LeanC group (p = 0.013) compared with ObeseC and T2DMObese groups. The two obese groups did not differ regarding daytime sleepiness, demonstrating that the presence of T2DM had no influence on daytime sleepiness. After surgery, the daytime sleepiness (p = 0.002) and the sleep quality (p = 0.033) improved. The score for daytime sleepiness of operated T2DMObese group became similar to LeanC and lower than ObeseC (p = 0.047). CONCLUSION BPD surgery has positively influenced daytime sleepiness and sleep quality of obese patients with T2DM, leading to normalization of daytime sleepiness 12 months after surgery. These results reinforce previously identified associations between sleep, obesity and T2DM in view of the importance of sleep in metabolic homeostasis, quality of life and health.
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Affiliation(s)
- Mayra Mello
- Universidade Estadual de CampinasLaboratório de Investigação em Metabolismo e Diabetes (LIMED)CampinasSPBrasilLaboratório de Investigação em Metabolismo e Diabetes (LIMED), Gastrocentro, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
| | - Ana Carolina J. Vasques
- Universidade Estadual de CampinasLaboratório de Investigação em Metabolismo e Diabetes (LIMED)CampinasSPBrasilLaboratório de Investigação em Metabolismo e Diabetes (LIMED), Gastrocentro, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
- Universidade Estadual de CampinasFaculdade de Ciências AplicadasLimeiraSPBrasilFaculdade de Ciências Aplicadas, Universidade Estadual de Campinas (FCA/Unicamp), Limeira, SP, Brasil
| | - José C. Pareja
- Universidade Estadual de CampinasLaboratório de Investigação em Metabolismo e Diabetes (LIMED)CampinasSPBrasilLaboratório de Investigação em Metabolismo e Diabetes (LIMED), Gastrocentro, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
- Universidade Estadual de CampinasUnidade de Cirurgia DiabéticaDepartamento de CirurgiaCampinasSPBrasilDepartamento de Cirurgia, Unidade de Cirurgia Diabética, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
| | - Maria da S. de Oliveira
- Universidade Estadual de CampinasLaboratório de Investigação em Metabolismo e Diabetes (LIMED)CampinasSPBrasilLaboratório de Investigação em Metabolismo e Diabetes (LIMED), Gastrocentro, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
| | - Fernanda S. Novaes
- Universidade Estadual de CampinasLaboratório de Investigação em Metabolismo e Diabetes (LIMED)CampinasSPBrasilLaboratório de Investigação em Metabolismo e Diabetes (LIMED), Gastrocentro, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
| | - Élinton A. Chaim
- Universidade Estadual de CampinasUnidade de Cirurgia DiabéticaDepartamento de CirurgiaCampinasSPBrasilDepartamento de Cirurgia, Unidade de Cirurgia Diabética, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
| | - Bruno Geloneze
- Universidade Estadual de CampinasLaboratório de Investigação em Metabolismo e Diabetes (LIMED)CampinasSPBrasilLaboratório de Investigação em Metabolismo e Diabetes (LIMED), Gastrocentro, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
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Öztürk ME, Yabancı Ayhan N. Associations between Poor Sleep Quality, Obesity, and the Anthropometric Measurements of Women in Turkey. Ecol Food Nutr 2017; 57:3-12. [PMID: 29182367 DOI: 10.1080/03670244.2017.1406351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Recent studies have shown that poor sleep quality is significantly associated with obesity. The aim of this study is to examine the association of sleep quality with obesity and specific anthropometric measurements. A total of 105 women aged 20-55 years with no chronic diseases participated in this study. They filled out the Pittsburgh Sleep Quality Index (PSQI), their anthropometric measurements were taken, and their dietary data were collected with a food frequency questionnaire (FFQ). There was no significant relationship between sleep quality and BMI, waist circumference, triceps skinfold thicknesses, body fat ratio (%), and body fat mass (p > .05), but high bread consumption was significantly associated with poor sleep quality (p < .05). The women with poor sleep quality consumed significantly more bread, but not other foods, than the women with good sleep quality. Sleep quality can thus be related to eating habits.
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Affiliation(s)
- Meryem Elif Öztürk
- a Ankara University Faculty of Health Sciences , Department of Nutrition and Dietetics , Ankara , Turkey
| | - Nurcan Yabancı Ayhan
- a Ankara University Faculty of Health Sciences , Department of Nutrition and Dietetics , Ankara , Turkey
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Zohal M, Ghorbani A, Esmailzadehha N, Ziaee A, Mohammadi Z. Association of sleep quality components and wake time with metabolic syndrome: The Qazvin Metabolic Diseases Study (QMDS), Iran. Diabetes Metab Syndr 2017; 11 Suppl 1:S377-S380. [PMID: 28284911 DOI: 10.1016/j.dsx.2017.03.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 03/03/2017] [Indexed: 12/31/2022]
Abstract
PURPOSE The aim of this study was to determine the association of sleep quality and sleep quantity with metabolic syndrome in Qazvin, Iran. METHODS this cross sectional study was conducted in 1079 residents of Qazvin selected by multistage cluster random sampling method in 2011. Metabolic syndrome was defined according to the criteria proposed by the national cholesterol education program third Adult treatment panel. Sleep was assessed using the Pittsburgh sleep quality index (PSQI). A logistic regression analysis was used to examine the association of sleep status and metabolic syndrome. RESULTS Mean age was 40.08±10.33years. Of 1079, 578 (52.2%) were female, and 30.6% had metabolic syndrome. The total global PSQI score in the subjects with metabolic syndrome was significantly higher than subjects without metabolic syndrome (6.30±3.20 vs. 5.83±2.76, P=0.013). In logistic regression analysis, sleep disturbances was associated with 1.388 fold increased risk of metabolic syndrome after adjustment for age, gender, and body mass index. CONCLUSION Sleep disturbances component was a predictor of metabolic syndrome in the present study. More longitudinal studies are necessary to understand the association of sleep quality and its components with metabolic syndrome.
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Affiliation(s)
- Mohammadali Zohal
- Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Azam Ghorbani
- Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran; School of Nursing & Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Neda Esmailzadehha
- Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Amir Ziaee
- Growth and Development Research Center, Iran University of Medical Sciences, Tehran, Iran; Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Zahrasadat Mohammadi
- Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
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Blumfield ML, Bei B, Zimberg IZ, Cain SW. Dietary disinhibition mediates the relationship between poor sleep quality and body weight. Appetite 2017; 120:602-608. [PMID: 29042189 DOI: 10.1016/j.appet.2017.10.022] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 10/03/2017] [Accepted: 10/13/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Inadequate sleep independently influences eating habits and weight status. However, the relationship between these three factors has not been well quantified. The objective of this study was to examine if eating behavior (i.e. dietary restraint, disinhibition and hunger) mediates the relationship between sleep and body mass index (BMI) in a large sample of American adults. METHOD Cross-sectional data from the Nathan Kline Institute Rockland sample were assessed (n = 602; 38.9 ± 14.5 years). Self-reported sleep and eating behavior were measured using the Pittsburgh Sleep Quality Index and Three Factor Eating Questionnaire, respectively. Path analysis was used to examine relationships amongst the construct, with mediation tested via bootstrapped confidence intervals. RESULTS Poorer sleep quality was associated with both greater hunger (P = 0.03) and higher disinhibited eating (overeating in the presence of palatable foods or other disinhibiting stimuli like emotional stress; P < 0.001) behaviors. Higher disinhibited eating behavior was also associated with higher BMI (P < 0.001). There was a significant indirect relationship between sleep quality and BMI via disinhibition (b [95% CI] = 0.13 [0.06, 0.21], P = 0.001). No significant effects were found when total sleep time or time in bed were replaced as predictors in the mediation model. CONCLUSION Disinhibited eating behavior mediated the relationship between sleep quality and weight status in both males and females. This mediation was due to aspects of sleep quality other than duration. These results suggest that improving sleep quality may benefit weight loss by helping to reduce an individuals' susceptibility to overeating.
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Affiliation(s)
- Michelle L Blumfield
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia.
| | - Bei Bei
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia; Centre for Women's Mental Health, Department of Psychiatry, University of Melbourne, Royal Women's Hospital, Victoria, Australia
| | - Iona Z Zimberg
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Sean W Cain
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia; Division of Sleep and Circadian Disorders, Department of Medicine and Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Division of Sleep and Circadian Disorders, Harvard Medical School, Boston, MA, USA
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Wang D, Zhou Y, Guo Y, Zhang R, Li W, He M, Zhang X, Guo H, Yuan J, Wu T, Chen W. The effect of sleep duration and sleep quality on hypertension in middle-aged and older Chinese: the Dongfeng-Tongji Cohort Study. Sleep Med 2017; 40:78-83. [PMID: 29221783 DOI: 10.1016/j.sleep.2017.09.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 09/12/2017] [Accepted: 09/14/2017] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To examine the independent and combined associations of sleep duration and sleep quality with hypertension in a middle-aged and older Chinese population. METHODS We included 21,912 individuals aged 62.2 years at baseline from September 2008 to June 2010, and they were followed until October 2013. Sleep duration was self-reported and sleep quality was evaluated with questions designed according to the Pittsburgh Sleep Quality Index. Hypertension was defined as blood pressure ≥140/90 mmHg, or self-reported physician diagnosis of hypertension, or self-reported current use of antihypertensive medication. RESULTS In the cross-sectional analyses, the odds ratio of hypertension prevalence was significantly elevated (OR = 1.13, 95% CI = 1.03-1.24) in those who slept less than 7 h after adjusting for sex, age, body mass index, midday napping, cigarette smoking and sleep quality. It was particularly evident among males (OR = 1.19, 95% CI = 1.01-1.40) and individuals who were thin (OR = 2.00, 95% CI = 1.01-3.93) with full adjustment. The association was also found for sleep duration of 9∼<10 h after adjusting various covariates (OR = 1.14, 95% CI = 1.04-1.27). In addition, impaired sleep quality was only associated with hypertension in obese individuals (OR = 1.25, 95% CI = 1.02-1.50), not in other subgroups. However, no significant association was detected in any category of sleep duration or sleep quality in all models in the prospective analyses, and the results remained unchanged in the subgroup analyses of sex, age and body mass index. CONCLUSIONS The results of this study provide limited support for association of sleep duration and sleep quality with hypertension in middle-aged and older Chinese. Further studies are needed to confirm the results.
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Affiliation(s)
- Dongming Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan, Hubei, China
| | - Yun Zhou
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yanjun Guo
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Runbo Zhang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wenzhen Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Meian He
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaomin Zhang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Huan Guo
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Yuan
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tangchun Wu
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Weihong Chen
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Shamshirgaran SM, Ataei J, Malek A, Iranparvar-Alamdari M, Aminisani N. Quality of sleep and its determinants among people with type 2 diabetes mellitus in Northwest of Iran. World J Diabetes 2017; 8:358-364. [PMID: 28751959 PMCID: PMC5507833 DOI: 10.4239/wjd.v8.i7.358] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 01/31/2017] [Accepted: 06/08/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To examine sleep quality and its determinants among people with type 2 diabetes mellitus (T2DM).
METHODS This is a cross-sectional study conducted among diabetic patients referring to Ardabil diabetes clinic in Northwest of Iran. Information on sleep quality was collected using Pittsburg Sleep Quality Index (PSQI). A questionnaire was used to collect data on sociodemographic lifestyle factors and psychological distress. This questionnaire was completed through an interview, and clinical information was extracted from patient’s record. Data analysis was done using SPSS software version 23 and univariate and multivariate analyses.
RESULTS Study participants consist of 256 people with T2DM the majority of whom were women (70%), and mean age of participants was 54.06 ± 9.09. The mean of total score of PSQI was 5.56 ± 3.34. Relative to younger age group, the middle-aged people with T2DM were twice more likely to be poor sleeper; the adjusted OR was 2.03 (95%CI: 1.01-4.08); and those with longer duration of diabetes were about 1.8 times more likely to report poor quality of sleep (ORadj = 1.77, 95%CI: 0.98-3.13). Participants with cholesterol level ≥ 240 mg/dL were about twice more likely to be poor sleeper (ORadj = 1.99, 95%CI: 1.01-3.94). The odds of being poor sleeper increased as the level of distress increased (1.84-4.09).
CONCLUSION As indicated by the results of the present study, some factors including age, duration of disease, psychological distress and high level of cholesterol were independently associated with poor sleep quality.
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Vézina-Im LA, Moreno JP, Nicklas TA, Baranowski T. Behavioral interventions to promote adequate sleep among women: protocol for a systematic review and meta-analysis. Syst Rev 2017; 6:95. [PMID: 28490370 PMCID: PMC5425988 DOI: 10.1186/s13643-017-0490-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 05/02/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Short and poor sleep have been associated with adverse health outcomes in adults, such as overweight/obesity and type 2 diabetes, especially among women. Women therefore represent an important target for interventions aimed at improving sleep and such interventions have been advocated to enhance maternal, fetal, and infant health. This systematic review will assess the efficacy or effectiveness of behavioral interventions aimed at promoting adequate sleep among women. The primary outcomes will be changes in sleep duration and/or sleep quality from baseline to post-intervention and to the last available follow-up measured either through self-reports or objectively. Secondary outcomes will be assessing the behavior change techniques that are responsible for the changes in sleep duration and quality among women. METHODS Behavioral interventions that are non-pharmacological and target either sleep directly or sleep hygiene behaviors will be included. Randomized controlled trials, quasi-experimental, and one-group pre-post studies will be included, but treated separately in the analyses, given that a limited number of studies on the topic of sleep is expected. MEDLINE/PubMed, PsycINFO, CINAHL, EMBASE, and Proquest Dissertations and Theses will be investigated. There will be no restriction on the year of publication of the articles, but we will include only the ones written in English or French. Two authors will independently assess articles for eligibility and will extract data using a standardized data extraction form that will have been previously pilot-tested. The quality of the studies will be assessed using the Effective Public Health Practice Project tool for quantitative study designs. The intervention procedures will be classified according to the latest validated taxonomy of behavior change techniques. If there is a sufficient number of studies (k > 5), a meta-analysis of the results will be performed with a random-effect model. If the heterogeneity is high (I 2 ≥ 75%), it will be investigated through sensitivity analyses and meta-regression. DISCUSSION This review will provide valuable information to those interested in promoting adequate sleep among women and, hopefully, encourage additional research in this important field to promote maternal, fetal, and infant health. SYSTEMATIC REVIEW REGISTRATION The study protocol was registered in PROSPERO in October 2016 (CRD42016049538).
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Affiliation(s)
- Lydi-Anne Vézina-Im
- Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX USA 77030
| | - Jennette Palcic Moreno
- Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX USA 77030
| | - Theresa A. Nicklas
- Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX USA 77030
| | - Tom Baranowski
- Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX USA 77030
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Liu RQ, Qian Z, Wang SQ, Vaughn MG, Geiger SD, Xian H, Lin S, Paul G, Zeng XW, Yang BY, Hu LW, Xu SL, Yang M, Dong GH. Sex-Specific Difference in the Association Between Poor Sleep Quality and Abdominal Obesity in Rural Chinese: A Large Population-Based Study. J Clin Sleep Med 2017; 13:565-574. [PMID: 28095972 DOI: 10.5664/jcsm.6544] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 11/28/2016] [Indexed: 01/26/2023]
Abstract
STUDY OBJECTIVES Existing studies on sleep quality and associated obesity are inconsistent, and few studies have prospectively evaluated the association between sleep quality and abdominal obesity among Chinese individuals. To fill this void, the current study aimed to assess the association between sleep quality and abdominal obesity in a rural Chinese population. METHODS A representative sample of 9,404 adults aged 20-93 years in northeastern China was selected between 2012 and 2013 by a multistage cluster and random sampling method. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI), where a score of 6 or higher indicated sleep disorder. Abdominal obesity was measured by waist circumference (WC), with abdominal obesity defined as WC > 90 cm for men and WC > 80 cm for women. RESULTS Male participants with abdominal obesity had higher global PSQI scores in addition to higher subscores in almost all of the elements compared to normal values. The odds ratios of abdominal obesity among participants with sleep disorders were 1.64 (95% confidence interval [CI]: 1.39-1.95) and 1.14 (95% CI: 0.98-1.32) for males and females compared to the reference group. The risk in all sleep elements was significantly increased, with odds ratios ranging from 1.28 (95% CI: 1.08-1.51) to 5.81 (95% CI: 3.54-9.53) for males. The risk only in four elements was significantly increased, from 1.28 (95% CI: 1.12-1.47) to 2.27 (95% CI: 1.36-3.80) for females. CONCLUSIONS Poor sleep quality was associated with abdominal obesity in Chinese. Furthermore, effects in males were larger than those in females.
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Affiliation(s)
- Ru-Qing Liu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhengmin Qian
- Department of Epidemiology, College of Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri
| | - Si-Quan Wang
- Department of Statistics and Operations Research, Hong Kong Baptist University, Hong Kong, China
| | - Michael G Vaughn
- School of Social Work, College of Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri
| | - Sarah Dee Geiger
- School of Nursing and Health Studies, Northern Illinois University, DeKalb, Illinois
| | - Hong Xian
- Department of Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri
| | - Shao Lin
- Department of Epidemiology and Biostatistics, School of Public Health, State University of New York, Albany, New York
| | - Gunther Paul
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Xiao-Wen Zeng
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Bo-Yi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Li-Wen Hu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shu-Li Xu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Mo Yang
- Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Guang-Hui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Madrid-Valero JJ, Martínez-Selva JM, Ordoñana JR. Sleep quality and body mass index: a co-twin study. J Sleep Res 2017; 26:461-467. [DOI: 10.1111/jsr.12493] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 12/02/2016] [Indexed: 12/31/2022]
Affiliation(s)
| | - José M. Martínez-Selva
- Department of Human Anatomy and Psychobiology; University of Murcia; Murcia Spain
- Murcia Institute of Biomedical Research; IMIB-Arrixaca; Murcia Spain
| | - Juan R. Ordoñana
- Department of Human Anatomy and Psychobiology; University of Murcia; Murcia Spain
- Murcia Institute of Biomedical Research; IMIB-Arrixaca; Murcia Spain
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47
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Schultes B, Hallschmid M, Oster H, Wilms B, Schmid SM. Hormone, Schlaf, zirkadiane Rhythmen und metabolische Gesundheit. GYNAKOLOGISCHE ENDOKRINOLOGIE 2016. [DOI: 10.1007/s10304-016-0081-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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48
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Hinz A, Glaesmer H, Brähler E, Löffler M, Engel C, Enzenbach C, Hegerl U, Sander C. Sleep quality in the general population: psychometric properties of the Pittsburgh Sleep Quality Index, derived from a German community sample of 9284 people. Sleep Med 2016; 30:57-63. [PMID: 28215264 DOI: 10.1016/j.sleep.2016.03.008] [Citation(s) in RCA: 268] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 03/03/2016] [Accepted: 03/14/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND The Pittsburgh Sleep Quality Index (PSQI) is frequently used to assess sleep problems in patients. The aim of this study was to provide reference values for this questionnaire, to test psychometric properties, and to analyze associations with psychological, sociodemographic, and behavioral factors. METHODS A German community sample comprising 9284 adult residents (aged 18-80 years) was surveyed using the PSQI and several other questionnaires. RESULTS According to the generally accepted cut-off (PSQI > 5), 36% of the general population slept badly. Females reported significantly more sleep problems than males (mean scores: M = 5.5 vs. M = 4.4, respectively; effect size d = 0.35), but there was no linear association between age and sleep quality. Sleep problems were correlated with fatigue, quality of life (physical as well as mental), physical complaints, anxiety, and lack of optimism. Sleep quality was also strongly associated with socioeconomic status, professional situation (poorest sleep quality in unemployed people), and obesity. In addition to the results of the PSQI total score, mean scores of specific components of sleep quality were presented (sleep latency, sleep duration, and use of sleep medication). CONCLUSION The PSQI proved to be a suitable instrument for measuring sleep quality. Gender differences, psychological factors, and obesity should be taken into account when groups of patients are compared with respect to sleep problems.
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Affiliation(s)
- Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Elmar Brähler
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany; Clinic for Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Markus Löffler
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Cornelia Enzenbach
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Ulrich Hegerl
- Department of Psychiatry, University of Leipzig, Leipzig, Germany
| | - Christian Sander
- Department of Psychiatry, University of Leipzig, Leipzig, Germany
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Abstract
The prevalence of obesity has increased dramatically over the past decade. Although an imbalance between caloric intake and physical activity is considered a key factor responsible for the increase, there is emerging evidence suggesting that other factors may be important contributors to weight gain, including inadequate sleep. Overall research evidence suggests that inadequate sleep is associated with obesity. Importantly, the strength and trajectory of the association seem to be influenced by multiple factors including age. Although limited, the emerging evidence suggests young adults might be at the center of a "perfect health storm," exposing them to the highest risk for obesity and inadequate sleep. Unfortunately, the methods necessary for elucidating the complex relationship between sleep and obesity are lacking. Uncovering the underlying factors and trajectories between inadequate sleep and weight gain in different populations may help to identify the windows of susceptibility and to design targeted interventions to prevent the negative impact of obesity and related diseases.
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Affiliation(s)
- Perla A Vargas
- New College of Liberal Arts and Sciences, School of Social and Behavioral Sciences, Arizona State University, 4701 W Thunderbird Rd, MC 3051, Glendale, AZ, 85306, USA.
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50
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Arora T, Chen MZ, Omar OM, Cooper AR, Andrews RC, Taheri S. An investigation of the associations among sleep duration and quality, body mass index and insulin resistance in newly diagnosed type 2 diabetes mellitus patients. Ther Adv Endocrinol Metab 2016; 7:3-11. [PMID: 26885358 PMCID: PMC4740940 DOI: 10.1177/2042018815616549] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES To examine direct and indirect associations of sleep duration and quality with insulin resistance, considering body mass index (BMI) as a potential mediator in newly diagnosed type 2 diabetes mellitus patients. METHODS Cross-sectional data from patients enrolled in the Early Activity in Diabetes study. We studied 522 newly diagnosed type 2 diabetes mellitus patients, 65.9% male, mean age 63.5 ± 10.1 years. Of the total sample 53% had a BMI of ⩾30 kg/m(2). Participants completed a 7-day sleep diary and sleep questionnaire. Average sleep duration (minutes), average nap duration (minutes) and average number of night awakenings were derived. Objective measures of height and body weight were obtained for the BMI calculation (kg/m(2)). Insulin resistance was obtained using the homeostatic model assessment - insulin resistance (HOMA2-IR) standardized technique. RESULTS Average number of night awakenings was positively correlated with BMI (r= 0.22, p < 0.001) and negatively associated with logged HOMA2-IR (r= -0.16, p = 0.04). Path analysis demonstrated night awakenings were directly associated with BMI and indirectly associated with insulin resistance, whilst considering BMI as a potential mediator (p < 0.05). Sleep duration was not associated with BMI or insulin resistance (p > 0.05). CONCLUSIONS Sleep quality, not sleep duration, plays an important role in insulin resistance in newly diagnosed type 2 diabetes mellitus patients. BMI may mediate the relationship between indicators of sleep quality and insulin resistance. There is a need to examine the impact of improving sleep quality on obesity and insulin resistance in patients with type 2 diabetes mellitus.
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Affiliation(s)
- Teresa Arora
- Weill Cornell Medicine in Qatar and New York, USA
| | - Mimi Z. Chen
- School of Clinical Sciences, University of Bristol, UK
- National Institute for Health Research, Bristol Biomedical Research Unit in Nutrition, Diet and Lifestyle, University of Bristol, UK
| | - Omar M. Omar
- Weill Cornell Medicine in Qatar and New York, USA
| | - Ashley R. Cooper
- National Institute for Health Research, Bristol Biomedical Research Unit in Nutrition, Diet and Lifestyle Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, UK
| | - Rob C. Andrews
- School of Clinical Sciences, University of Bristol, UK
- National Institute for Health Research, Bristol Biomedical Research Unit in Nutrition, Diet and Lifestyle, University of Bristol, UK
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