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Herth J, Sievi NA, Schmidt F, Kohler M. Effects of continuous positive airway pressure therapy on glucose metabolism in patients with obstructive sleep apnoea and type 2 diabetes: a systematic review and meta-analysis. Eur Respir Rev 2023; 32:230083. [PMID: 37673425 PMCID: PMC10481331 DOI: 10.1183/16000617.0083-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/27/2023] [Indexed: 09/08/2023] Open
Abstract
Obstructive sleep apnoea is a highly prevalent chronic disorder and has been shown to be associated with disturbed glucose metabolism and type 2 diabetes. However, the evidence from individual clinical trials on the effect of continuous positive airway pressure (CPAP) treatment on glycaemic control in patients with co-existing obstructive sleep apnoea and type 2 diabetes remains controversial. A systematic review of randomised controlled trials assessing the effect of CPAP on glycaemic control in patients with obstructive sleep apnoea and type 2 diabetes was conducted using the databases MEDLINE, Embase, Cochrane and Scopus up to December 2022. Meta-analysis using a random-effect model was performed for outcomes that were reported in at least two randomised controlled trials. From 3031 records screened, 11 RCTs with a total of 964 patients were included for analysis. CPAP treatment led to a significant reduction in haemoglobin A1c (HbA1c) (mean difference -0.24%, 95% CI -0.43- -0.06%, p=0.001) compared to inactive control groups. Meta-regression showed a significant association between reduction in HbA1c and hours of nightly CPAP usage. CPAP therapy seems to significantly improve HbA1c and thus long-term glycaemic control in patients with type 2 diabetes and obstructive sleep apnoea. The amount of improvement is dependent on the hours of usage of CPAP and thus optimal adherence to CPAP should be a primary goal in these patients.
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Affiliation(s)
- Jonas Herth
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | | | - Felix Schmidt
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Malcolm Kohler
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
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Abdu Y, Naja S, Mohamed Ibrahim MI, Abdou M, Ahmed R, Elhag S, Saleh AO, Yassin M, Bougmiza I. Sleep Quality Among People with Type 2 Diabetes Mellitus During COVID-19 Pandemic: Evidence from Qatar's National Diabetes Center. Diabetes Metab Syndr Obes 2023; 16:2803-2812. [PMID: 37727277 PMCID: PMC10506668 DOI: 10.2147/dmso.s421878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/23/2023] [Indexed: 09/21/2023] Open
Abstract
Purpose Sleep disturbance is suspected to increase during the COVID-19 pandemic, and people with type 2 DM are known to have a higher risk of sleep disturbance. We aimed to determine the prevalence and determinants of sleep disturbance through Pittsburgh Sleep Quality Index (PSQI) during the COVID-19 pandemic. Patients and Methods We randomly selected two hundred eighty-eight people with T2DM from the outpatient clinics of the National Diabetes Centre in Qatar. We used Chi-square, Mann-Whitney, Spearman, and Point Biserial correlation tests to examine the association between sleep quality and the independent variables. Finally, we conducted multiple logistics regression to identify the predictors of poor sleep quality and set the alpha level at 0.05. Results In our sample, the mean age (±SD) was 51.4 (± 9.5) years, and 64.3% of the study participants were males. The median (IQR) duration of diabetes was 10 (11) years. Additionally, 6.3% of the participants were on insulin. The median HbA1c was 7.6% (2.4). Three in ten patients reported poor sleep quality (PSQI>5); (n=103; 35.8%). Poor sleep quality was statistically associated with young age, previous history of sleep disturbance, prior diagnosis of sleep disorders, high depression score, and high perceived stress score. After adjusting for confounders, only high depressive symptoms score and previous history of sleep disorder were significant predictors of poor sleep quality (p < 0.001), with adjusted odd ratios of (aOR = 1.421; 95% CI: 1.242-1.625) and (aOR = 3.208; 95% CI: 1.574-6.537), respectively. Conclusion The prevalence of poor sleep quality among people with T2DM during the COVID-19 pandemic is high. Physicians must screen for depression, stress, and previous history of sleep disorder to tackle poor sleep among T2DM.
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Affiliation(s)
- Yasamin Abdu
- Community Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Sarah Naja
- Community Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Mariam Abdou
- Community Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Salma Elhag
- Wad Medani College of Medical Sciences and Technology, Jazeera, Sudan
| | - Ahmed O Saleh
- Department of Internal Medicine, Unity Hospital, Rochester, NY, USA
| | - Mohamed Yassin
- Hematology Department, Hamad Medical Corporation, Doha, Qatar
| | - Iheb Bougmiza
- Community Medicine Department, Primary Health Care Corporation, Doha, Qatar
- Community Medicine Department, College of Medicine, Sousse University, Sousse, Tunisia
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García-Hermoso A, López-Gil JF, Ezzatvar Y, Ramírez-Vélez R, Izquierdo M. Twenty-four-hour movement guidelines during middle adolescence and their association with glucose outcomes and type 2 diabetes mellitus in adulthood. J Sport Health Sci 2023; 12:167-174. [PMID: 35940532 PMCID: PMC10105017 DOI: 10.1016/j.jshs.2022.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/19/2022] [Accepted: 07/11/2022] [Indexed: 06/01/2023]
Abstract
PURPOSE The aim of the present study was to determine the association between adherence to the 24-h movement guidelines during middle adolescence and glucose outcomes (glycated hemoglobin and fasting glucose) and type 2 diabetes mellitus (T2DM) in adulthood, 14 and 22 years later. METHODS We analyzed data from apparently healthy adolescents aged 12-18 years who participated in Waves I and II (1994-1996, n = 14,738), Wave IV (2008-2009, n = 8913), and Wave V (2016-2018, n = 3457) of the National Longitudinal Study of Adolescent to Adult Health (Add Health) in the United States. Physical activity, screen time, and sleep duration were measured using questionnaires, and the 24-h guidelines were defined as: 5 or more times moderate-to-vigorous physical activity per week, ≤2 h per day of screen time, and 9-11 h of sleep for 12-13 years and 8-10 h for 14-17 years. Capillary and venous whole blood was collected and analyzed to determine glycated hemoglobin and fasting glucose for Waves IV and V, respectively. RESULTS Only 2.1% of the adolescents met all the 3 guidelines, and 37.8% met none of them. In both waves IV and V, adolescents who met physical activity and screen time guidelines had lower odds of T2DM in adulthood than those who did not meet any of these guidelines (Wave IV; prevalence ratio (PR) = 0.57, 95% confidence interval (95%CI): 0.21-0.89; Wave V: PR = 0.43, 95%CI: 0.32-0.74). Only for Wave V did adolescents who met all 3 guidelines have lower odds of T2DM at follow-up compared with those who did not meet any of these guidelines (PR = 0.47, 95%CI: 0.24-0.91). Also, for each increase in meeting one of the 24-h recommendations, the odds of T2DM decreased by 18% (PR = 0.82, 95%CI: 0.61-0.99) and 15% (PR = 0.85, 95%CI: 0.65-0.98) in adulthood for Waves IV and V, respectively. CONCLUSION Promoting all 24-h movement guidelines in adolescence, especially physical activity and screen time, is important for lowering the potential risk of T2DM in adulthood.
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Affiliation(s)
- Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona 31008, Spain.
| | | | - Yasmin Ezzatvar
- Department of Nursing, Universitat de València, Valencia 46010, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona 31008, Spain
| | - Mikel Izquierdo
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona 31008, Spain
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Botella-Serrano M, Velasco JM, Sánchez-Sánchez A, Garnica O, Hidalgo JI. Evaluating the influence of sleep quality and quantity on glycemic control in adults with type 1 diabetes. Front Endocrinol (Lausanne) 2023; 14:998881. [PMID: 36896174 PMCID: PMC9989462 DOI: 10.3389/fendo.2023.998881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 01/19/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Sleep quality disturbances are frequent in adults with type 1 diabetes. However, the possible influence of sleep problems on glycemic variability has yet to be studied in depth. This study aims to assess the influence of sleep quality on glycemic control. MATERIALS AND METHODS An observational study of 25 adults with type 1 diabetes, with simultaneous recording, for 14 days, of continuous glucose monitoring (Abbott FreeStyle Libre system) and a sleep study by wrist actigraphy (Fitbit Ionic device). The study analyzes, using artificial intelligence techniques, the relationship between the quality and structure of sleep with time in normo-, hypo-, and hyperglycemia ranges and with glycemic variability. The patients were also studied as a group, comparing patients with good and poor sleep quality. RESULTS A total of 243 days/nights were analyzed, of which 77% (n = 189) were categorized as poor quality and 33% (n = 54) as good quality. Linear regression methods were used to find a correlation (r =0.8) between the variability of sleep efficiency and the variability of mean blood glucose. With clustering techniques, patients were grouped according to their sleep structure (characterizing this structure by the number of transitions between the different sleep phases). These clusters showed a relationship between time in range and sleep structure. CONCLUSIONS This study suggests that poor sleep quality is associated with lower time in range and greater glycemic variability, so improving sleep quality in patients with type 1 diabetes could improve their glycemic control.
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Affiliation(s)
- Marta Botella-Serrano
- Endocrinology and Nutrition Service, Hospital Universitario Príncipe de Asturias, Madrid, Spain
- *Correspondence: Marta Botella-Serrano, ; Jose Manuel Velasco, ; J. Ignacio Hidalgo,
| | - Jose Manuel Velasco
- Computer Architecture and Automation Department, Universidad Complutense de Madrid, Madrid, Spain
- *Correspondence: Marta Botella-Serrano, ; Jose Manuel Velasco, ; J. Ignacio Hidalgo,
| | | | - Oscar Garnica
- Computer Architecture and Automation Department, Universidad Complutense de Madrid, Madrid, Spain
| | - J. Ignacio Hidalgo
- Computer Architecture and Automation Department, Universidad Complutense de Madrid, Madrid, Spain
- *Correspondence: Marta Botella-Serrano, ; Jose Manuel Velasco, ; J. Ignacio Hidalgo,
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Zhang K, Guhn M, Conklin AI. Association between social jetlag and sugar-sweetened beverages (SSBs) in adolescents in Western Canada. Eur J Public Health 2022; 33:287-292. [PMID: 36478224 PMCID: PMC10066488 DOI: 10.1093/eurpub/ckac177] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Abstract
Background
Sleep debt is linked to poor health behaviours, and adolescents may be especially vulnerable to deficit from the mismatch of their late chronotype with socially determined sleep timing. We aimed to investigate the potential association between social jetlag and sugar-sweetened beverages (SSBs) consumption among adolescents.
Methods
Cross-sectional data from 1031 adolescents (13–18 years) who participated in the population-based British Columbia Adolescent Substance Use Survey in 2012. Regression analysis using interaction terms estimated the associations between social jetlag (using self-reported weekday/weekends sleep times) and odds of SSB intake in girls and boys.
Results
On average, adolescents reported 1.59 (SD 0.73) hours of social jetlag, but girls had significantly more social jetlag (1.64) than boys (1.52). Most adolescents (84%) reported consuming SSBs, and significantly more boys (87%) than girls (81%); median SSB intake in boys was 1–2 times per week and in girls less than once per week. Significant differences in girls consuming any SSB were seen across levels of social jetlag. The odds of any SSB intake were significantly higher in adolescents with social jetlag between 1 and 2 h [odds ratio (OR): 1.6 (1.14–2.38)] and over 2 h [OR 1.87 (1.11–3.14)], compared with 1 h or less; associations were stronger and only significant in girls.
Conclusions
This study is the first to show social jetlag is a common sleep deficit that is associated with SSB intake in adolescents, particularly among teen girls.
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Affiliation(s)
- Kexin Zhang
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, University of British Columbia , Vancouver, BC, Canada
| | - Martin Guhn
- School of Population and Public Health, Faculty of Medicine, University of British Columbia , Vancouver, BC, Canada
| | - Annalijn I Conklin
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, University of British Columbia , Vancouver, BC, Canada
- Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia , Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, Providence Health Research Institute , Vancouver, BC, Canada
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Olivares MJ, Toledo C, Ortolani D, Ortiz FC, Díaz HS, Iturriaga R, Del Río R. Sleep dysregulation in sympathetic-mediated diseases: implications for disease progression. Sleep 2022; 45:6649852. [DOI: 10.1093/sleep/zsac166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/18/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
The autonomic nervous system (ANS) plays an important role in the coordination of several physiological functions including sleep/wake process. Significant changes in ANS activity occur during wake-to-sleep transition maintaining the adequate cardiorespiratory regulation and brain activity. Since sleep is a complex homeostatic function, partly regulated by the ANS, it is not surprising that sleep disruption trigger and/or evidence symptoms of ANS impairment. Indeed, several studies suggest a bidirectional relationship between impaired ANS function (i.e. enhanced sympathetic drive), and the emergence/development of sleep disorders. Furthermore, several epidemiological studies described a strong association between sympathetic-mediated diseases and the development and maintenance of sleep disorders resulting in a vicious cycle with adverse outcomes and increased mortality risk. However, which and how the sleep/wake control and ANS circuitry becomes affected during the progression of ANS-related diseases remains poorly understood. Thus, understanding the physiological mechanisms underpinning sleep/wake-dependent sympathetic modulation could provide insights into diseases involving autonomic dysfunction. The purpose of this review is to explore potential neural mechanisms involved in both the onset/maintenance of sympathetic-mediated diseases (Rett syndrome, congenital central hypoventilation syndrome, obstructive sleep apnoea, type 2 diabetes, obesity, heart failure, hypertension, and neurodegenerative diseases) and their plausible contribution to the generation of sleep disorders in order to review evidence that may serve to establish a causal link between sleep disorders and heightened sympathetic activity.
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Affiliation(s)
- María José Olivares
- Department of Physiology, Laboratory of Cardiorespiratory Control, Pontificia Universidad Católica de Chile , Santiago , Chile
| | - Camilo Toledo
- Department of Physiology, Laboratory of Cardiorespiratory Control, Pontificia Universidad Católica de Chile , Santiago , Chile
- Centro de Excelencia en Biomedicina de Magallanes (CEBIMA), Universidad de Magallanes , Punta Arenas , Chile
| | - Domiziana Ortolani
- Department of Physiology, Laboratory of Cardiorespiratory Control, Pontificia Universidad Católica de Chile , Santiago , Chile
| | - Fernando C Ortiz
- Mechanisms of Myelin Formation and Repair Laboratory, Instituto de Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile , Santiago , Chile
| | - Hugo S Díaz
- Department of Physiology, Laboratory of Cardiorespiratory Control, Pontificia Universidad Católica de Chile , Santiago , Chile
- Centro de Excelencia en Biomedicina de Magallanes (CEBIMA), Universidad de Magallanes , Punta Arenas , Chile
| | - Rodrigo Iturriaga
- Department of Physiology, Laboratory of Cardiorespiratory Control, Pontificia Universidad Católica de Chile , Santiago , Chile
- Centro de Excelencia en Biomedicina de Magallanes (CEBIMA), Universidad de Magallanes , Punta Arenas , Chile
| | - Rodrigo Del Río
- Department of Physiology, Laboratory of Cardiorespiratory Control, Pontificia Universidad Católica de Chile , Santiago , Chile
- Centro de Excelencia en Biomedicina de Magallanes (CEBIMA), Universidad de Magallanes , Punta Arenas , Chile
- Centro de Envejecimiento y Regeneración (CARE), Pontificia Universidad Católica de Chile , Santiago , Chile
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Kyprianidou M, Panagiotakos D, Makris KC, Kambanaros M, Christophi CA, Giannakou K. The Lifestyle Profile of Individuals with Cardiovascular and Endocrine Diseases in Cyprus: A Hierarchical, Classification Analysis. Nutrients 2022; 14:nu14081559. [PMID: 35458120 PMCID: PMC9027605 DOI: 10.3390/nu14081559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/01/2022] [Accepted: 04/05/2022] [Indexed: 02/01/2023] Open
Abstract
The study aims to explore the lifestyle profile of adult individuals with cardiovascular and endocrine diseases in Cyprus. Age and sex-specific analyses were applied. A representative sample of the general adult population was recruited during 2018–2019 using stratified sampling among the five government-controlled municipalities of the Republic of Cyprus. Data on Mediterranean diet adherence, quality of sleep, smoking status, physical activity, Body Mass Index, and the presence of cardiovascular and endocrine diseases were collected using a validated questionnaire. Diseases were classified according to the International Classification of Diseases, Tenth Revision (ICD-10). A total of 1140 men and women over 18 years old (range: 18–94) participated in the study. The prevalence of cardiovascular and endocrine diseases among the adult general population of Cyprus was 24.8% and 17.2%, respectively, with a higher prevalence of cardiovascular diseases in men, and a higher prevalence of endocrine diseases in women. Among individuals with cardiovascular disease, 23.3% were aged between 18–44 years old, while the corresponding percentage among endocrine disease individuals was 48%. The prevalence of smoking, physical activity, a low adherence to the Mediterranean diet, poor quality of sleep and obesity among the study population was 35.5%, 48.0%, 32.9%, 39.0% and 13.6%, respectively. Individuals with cardiovascular and endocrine diseases were characterized by poor quality of sleep, inadequate physical activity, and a higher BMI. This is the first study in Cyprus exploring the profile of individuals with cardiovascular and endocrine diseases in Cyprus. Health promotion and educational programs focusing on the importance of sleep quality, healthier dietary habits, physical activity, and lower BMIs among people with cardiovascular and endocrine diseases should be developed.
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Affiliation(s)
- Maria Kyprianidou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol 3036, Cyprus; (M.K.); (K.C.M.); (C.A.C.)
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia 1516, Cyprus
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676 Athens, Greece;
| | - Konstantinos C. Makris
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol 3036, Cyprus; (M.K.); (K.C.M.); (C.A.C.)
| | - Maria Kambanaros
- Department of Allied Health and Human Performance, University of South Australia, Adelaide, SA 5001, Australia;
| | - Costas A. Christophi
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol 3036, Cyprus; (M.K.); (K.C.M.); (C.A.C.)
| | - Konstantinos Giannakou
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia 1516, Cyprus
- Correspondence: ; Tel.: +357-2255-9656
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Kasahara T, Tsujiguchi H, Takeshita Y, Hara A, Suzuki K, Narukawa N, Hayashi K, Miyagi M, Asai A, Yamada Y, Nakamura H, Suzuki F, Pham KO, Hamagishi T, Nakamura M, Shibata A, Shimizu Y, Nguyen TTT, Miyagi S, Kambayashi Y, Kannon T, Tajima A, Tsuboi H, Konoshita T, Takamura T, Nakamura H. A retrospective cohort study on the association between poor sleep quality in junior high school students and high hemoglobin A1c level in early adults with higher body mass index values. BMC Endocr Disord 2022; 22:40. [PMID: 35164727 PMCID: PMC8845399 DOI: 10.1186/s12902-022-00951-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/31/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Few epidemiological studies have been performed to clarify the association between glucose metabolism disorders in early adults (20 years old) and physiological and environmental factors, including body mass index (BMI) in junior high school days. Therefore, we examined the association between hemoglobin A1c (HbA1c) level and body size (BMI) in early adulthood and lifestyles, including sleep habits and BMI in junior high school days in Shika town, a small town in Japan, by conducting a retrospective cohort study. METHODS We examined the HbA1c levels and body size (BMI) of 99 early adults who turned 20 years old between 2016 and 2020 and were residing in Shika town, Ishikawa Prefecture. We obtained the information on lifestyles and living environment factors, including BMI, from a questionnaire survey conducted among the subjects during their junior high school days (13-15 years old) from 2009 to 2013. RESULTS No correlations were observed between the HbA1c levels and the BMI values of the early adults. A two-way analysis of covariance (with the HbA1c levels and BMI values of the early adults as main factors) of the body size and lifestyle habits of the junior high school students revealed that "sleep quality in junior high school" was significantly poorer in the high HbA1c group than in the low HbA1c group in the early adults with high BMI values only. This result was also supported by the logistic regression analysis result. CONCLUSIONS The present results indicate that poor sleep quality in junior high school was associated with the high HbA1c levels of the early adults with higher BMI values, which suggests that good sleep quality in junior high school prevents the development of hyperglycemia. However, the present study did not find any relationship between early-adult BMI and HbA1c level.
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Affiliation(s)
- Tomoko Kasahara
- Department of Hygiene and Public Health, Graduate School of Advanced Preventive, Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan.
| | - Hiromasa Tsujiguchi
- Department of Hygiene and Public Health, Graduate School of Advanced Preventive, Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
- Kanazawa University Advanced Preventive Medical Sciences Research Center, Takara-Machi 13-1, Kanazawa, Ishikawa, 920-8640, Japan
| | - Yumie Takeshita
- Department of Endocrinology and Metabolism, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Akinori Hara
- Department of Hygiene and Public Health, Graduate School of Advanced Preventive, Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
- Kanazawa University Advanced Preventive Medical Sciences Research Center, Takara-Machi 13-1, Kanazawa, Ishikawa, 920-8640, Japan
| | - Keita Suzuki
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Nobuhiko Narukawa
- Department of Hygiene and Public Health, Graduate School of Advanced Preventive, Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Koichiro Hayashi
- Department of Hygiene and Public Health, Graduate School of Advanced Preventive, Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Masateru Miyagi
- Department of Hygiene and Public Health, Graduate School of Advanced Preventive, Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Atsushi Asai
- Department of Hygiene and Public Health, Graduate School of Advanced Preventive, Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Yohei Yamada
- Department of Hygiene and Public Health, Graduate School of Advanced Preventive, Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Haruki Nakamura
- Department of Hygiene and Public Health, Graduate School of Advanced Preventive, Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Fumihiko Suzuki
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
- Community Medicine Support Dentistry, Ohu University Hospital, Koriyama, Fukushima, 963-8611, Japan
| | - Kim-Oanh Pham
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Toshio Hamagishi
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Masaharu Nakamura
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Aki Shibata
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Yukari Shimizu
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
- Faculty of Health Sciences, Department of Nursing, Komatsu University, 14-1 Mukaimotoori-Machi, Komatsu, Ishikawa, 923-0961, Japan
| | - Thao Thi Thu Nguyen
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, 180000, Ngo Quyen, Hai Phong, Vietnam
| | - Sakae Miyagi
- Innovative Clinical Research Center, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Yasuhiro Kambayashi
- Department of Public Health, Faculty of Veterinary Medicine, Okayama University of Science, 1-3 Ikoinooka, Imabari, Ehime, 794-8555, Japan
| | - Takayuki Kannon
- Kanazawa University Advanced Preventive Medical Sciences Research Center, Takara-Machi 13-1, Kanazawa, Ishikawa, 920-8640, Japan
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive, Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Atsushi Tajima
- Kanazawa University Advanced Preventive Medical Sciences Research Center, Takara-Machi 13-1, Kanazawa, Ishikawa, 920-8640, Japan
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive, Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Hirohito Tsuboi
- Institute of Medical, Pharmaceutical & Health Sciences, Kanazawa University, Kanazawa, 920-1192, Japan
| | - Tadashi Konoshita
- Department of Endocrinology and Metabolism, University of Fukui Hospital, 23-3, Matsuokashimoaizuki, Eiheiji, Fukui, 910-1193, Japan
- Third Department of Internal Medicine, University of Fukui Faculty of Medical Sciences, 23-3, Matsuokashimoaizuki, Eiheiji, Fukui, 910-1193, Japan
| | - Toshinari Takamura
- Department of Endocrinology and Metabolism, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Hiroyuki Nakamura
- Department of Hygiene and Public Health, Graduate School of Advanced Preventive, Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
- Kanazawa University Advanced Preventive Medical Sciences Research Center, Takara-Machi 13-1, Kanazawa, Ishikawa, 920-8640, Japan
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9
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Agrawal R, Spiegelman AM, Bandi VD, Hirshkowitz M, Sharafkhaneh A. Obstructive sleep apnea in diabetic patients is associated with higher healthcare utilization. Sleep Breath 2022; 26:1817-1820. [DOI: 10.1007/s11325-021-02552-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 12/03/2021] [Accepted: 12/09/2021] [Indexed: 11/28/2022]
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10
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García-Aviles JE, Méndez-Hernández R, Guzmán-Ruiz MA, Cruz M, Guerrero-Vargas NN, Velázquez-Moctezuma J, Hurtado-Alvarado G. Metabolic Disturbances Induced by Sleep Restriction as Potential Triggers for Alzheimer's Disease. Front Integr Neurosci 2021; 15:722523. [PMID: 34539357 PMCID: PMC8447653 DOI: 10.3389/fnint.2021.722523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 07/26/2021] [Indexed: 01/15/2023] Open
Abstract
Sleep has a major role in learning, memory consolidation, and metabolic function. Although it is known that sleep restriction increases the accumulation of amyloid β peptide (Aβ) and the risk to develop Alzheimer's disease (AD), the mechanism behind these effects remains unknown. In this review, we discuss how chronic sleep restriction induces metabolic and cognitive impairments that could result in the development of AD in late life. Here, we integrate evidence regarding mechanisms whereby metabolic signaling becomes disturbed after short or chronic sleep restriction in the context of cognitive impairment, particularly in the accumulation of Aβ in the brain. We also discuss the role of the blood-brain barrier in sleep restriction with an emphasis on the transport of metabolic signals into the brain and Aβ clearance. This review presents the unexplored possibility that the alteration of peripheral metabolic signals induced by sleep restriction, especially insulin resistance, is responsible for cognitive deficit and, subsequently, implicated in AD development.
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Affiliation(s)
- Jesús Enrique García-Aviles
- Area of Neurosciences, Biology of Reproduction Department, Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Unidad Iztapalapa, Mexico City, Mexico.,Posgrado en Biología Experimental, Universidad Autónoma Metropolitana, Unidad Iztapalapa, Mexico City, Mexico
| | - Rebeca Méndez-Hernández
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico
| | - Mara A Guzmán-Ruiz
- Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Miguel Cruz
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades, Unidad de Investigación Médica en Bioquímica, Mexico City, Mexico
| | - Natalí N Guerrero-Vargas
- Departamento de Anatomía, Facultad de Medicina, Universidad Nacional Autónoma de México, México City, Mexico
| | - Javier Velázquez-Moctezuma
- Area of Neurosciences, Biology of Reproduction Department, Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Unidad Iztapalapa, Mexico City, Mexico
| | - Gabriela Hurtado-Alvarado
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico
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11
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Baker-Smith CM, Isaiah A, Melendres MC, Mahgerefteh J, Lasso-Pirot A, Mayo S, Gooding H, Zachariah J. Sleep-Disordered Breathing and Cardiovascular Disease in Children and Adolescents: A Scientific Statement From the American Heart Association. J Am Heart Assoc 2021; 10:e022427. [PMID: 34404224 PMCID: PMC8649512 DOI: 10.1161/jaha.121.022427] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Obstructive sleep apnea (OSA) is a known risk factor for cardiovascular disease in adults. It is associated with incident systemic hypertension, arrhythmia, stroke, coronary artery disease, and heart failure. OSA is common in children and adolescents, but there has been less focus on OSA as a primary risk factor for cardiovascular disease in children and adolescents. This scientific statement summarizes what is known regarding the impact of sleep‐disordered breathing and, in particular, OSA on the cardiovascular health of children and adolescents. This statement highlights what is known regarding the impact of OSA on the risk for hypertension, arrhythmia, abnormal ventricular morphology, impaired ventricular contractility, and elevated right heart pressure among children and adolescents. This scientific statement also summarizes current best practices for the diagnosis and evaluation of cardiovascular disease–related complications of OSA in children and adolescents with sleep apnea and highlights potential future research in the area of sleep‐disordered breathing and cardiovascular health during childhood and adolescence.
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Kaar JL, Bowen AE, Clark E, Ware M, Chandrasekhar JL, Gulley L, Studts CR, Shomaker L, Simon SL. School-based interventions to improve sleep duration: Lessons learned and future directions. Curr Psychol 2021. [DOI: 10.1007/s12144-021-02137-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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13
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Viswanathan V, Ramakrishnan N, Saboo B, Agarwal S. RSSDI clinical practice recommendations for screening, diagnosis, and treatment in type 2 diabetes mellitus with obstructive sleep apnea. Int J Diabetes Dev Ctries 2021; 41:4-21. [DOI: 10.1007/s13410-020-00909-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Abstract
We conducted a narrative review on the interaction between dietary patterns with demographic and lifestyle variables in relation to health status assessment. The food pattern has the advantage of taking into account the correlations that may exist between foods or groups of foods, but also between nutrients. It is an alternative and complementary approach in analysing the relationship between nutrition and the risk of chronic diseases. For the determination of dietary patterns one can use indices/scores that evaluate the conformity of the diet with the nutrition guidelines or the established patterns (a priori approach). The methods more commonly used are based on exploratory data (a posteriori): cluster analysis and factor analysis. Dietary patterns may vary according to sex, socio-economic status, ethnicity, culture and other factors, but more, they may vary depending on different associations between these factors. The dietary pattern exerts its effects on health in a synergistic way or even in conjunction with other lifestyle factors, and we can therefore refer to a 'pattern of lifestyle'.
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Affiliation(s)
- Andreea Gherasim
- ‘Grigore T. Popa’ University of Medicine and Pharmacy, Faculty of Medicine, 16 Universității street, Iași 700115, Romania
- ‘Sf. Spiridon’ Clinical Emergency Hospital, 1 Independenței boulevard, Iași 700111, Romania
| | - Lidia I. Arhire
- ‘Grigore T. Popa’ University of Medicine and Pharmacy, Faculty of Medicine, 16 Universității street, Iași 700115, Romania
- ‘Sf. Spiridon’ Clinical Emergency Hospital, 1 Independenței boulevard, Iași 700111, Romania
| | - Otilia Niță
- ‘Grigore T. Popa’ University of Medicine and Pharmacy, Faculty of Medicine, 16 Universității street, Iași 700115, Romania
- ‘Sf. Spiridon’ Clinical Emergency Hospital, 1 Independenței boulevard, Iași 700111, Romania
| | - Alina D. Popa
- ‘Grigore T. Popa’ University of Medicine and Pharmacy, Faculty of Medicine, 16 Universității street, Iași 700115, Romania
- ‘Sf. Spiridon’ Clinical Emergency Hospital, 1 Independenței boulevard, Iași 700111, Romania
| | - Mariana Graur
- ‘Grigore T. Popa’ University of Medicine and Pharmacy, Faculty of Medicine, 16 Universității street, Iași 700115, Romania
- ‘Sf. Spiridon’ Clinical Emergency Hospital, 1 Independenței boulevard, Iași 700111, Romania
| | - Laura Mihalache
- ‘Grigore T. Popa’ University of Medicine and Pharmacy, Faculty of Medicine, 16 Universității street, Iași 700115, Romania
- ‘Sf. Spiridon’ Clinical Emergency Hospital, 1 Independenței boulevard, Iași 700111, Romania
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Abstract
STUDY OBJECTIVES Because existing data investigating obstructive sleep apnea (OSA) and insulin resistance (IR) are inconsistent, we examine OSA and IR in a pediatric obesity clinic. METHODS Children (2-18 years) in the obesity clinic (2013-2017) undergoing polysomnography (PSG), anthropometric measurements, and fasting laboratory tests were included. Linear regression assessed OSA defined by the obstructive apnea-hypopnea index (oAHI) with the homeostatic model assessment of insulin resistance (HOMA-IR). Secondary aims assessed oxygen desaturation index (ODI) and age interactions with HOMA-IR. Logistic regression models and receiver operating characteristic analysis were performed to investigate optimal oAHI and ODI cutoffs relative to HOMA-IR ≥ 3. RESULTS Eighty children were included (mean age, 11.4 ± 4.0 years; 56% female; 46% Caucasian; median body mass index [BMI], 34.6 kg/m² [interquartile ratio, 29.9-40.1], median BMI z-score, 2.5 [interquartile ratio, 2.3-2.8); 46% with oAHI ≥ 5 events/h. HOMA-IR was higher in the OSA group (oAHI ≥ 5 events/h): 5 vs 3.8 (P = .034). After adjustment for sex, race, and BMI z-score, oAHI ≥ 5 events/h retained significance with HOMA-IR (P = .041). HOMA-IR increased in older children (age ≥ 12 years) when adjusting for waist circumference z-score and waist-height ratio (statistical interaction, P = .020 and .034, respectively). Receiver operating characteristic showed optimal cut points of oAHI and ODI for predicting significant IR 4.9 (area under the curve, 0.70; 95% confidence interval, 0.57-0.83; sensitivity, 0.76; specificity, 0.66) and 4.6 (area under the curve, 0.68; 95% confidence interval, 0.55-0.80; sensitivity, 0.70; specificity, 0.67), respectively. CONCLUSIONS In a clinic-based pediatric cohort with obesity, OSA is associated with increased IR even after adjusting for confounders including obesity defined by the BMI z-score. Age ≥ 12 years was associated with AHI relative to IR after adjustment for waist circumference z-score and waist-height ratio. Significant IR could be discriminated by oAHI ≥ 4.9 with moderate sensitivity/specificity. Future studies are needed to verify these findings.
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Affiliation(s)
| | - Lu Wang
- Sleep Disorders Center, Neurological Institute, Cleveland, Ohio
| | - Vaishal Shah
- Sleep Disorders Center, Neurological Institute, Cleveland, Ohio
| | - Reena Mehra
- Sleep Disorders Center, Neurological Institute, Cleveland, Ohio
| | - Sally Ibrahim
- Division of Pulmonary, Allergy and Sleep Medicine, Rainbow Babies and Children's Hospital of University Hospitals, Cleveland, Ohio
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16
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Toyoura M, Miike T, Tajima S, Matsuzawa S, Konishi Y. Inadequate sleep as a contributor to impaired glucose tolerance: A cross-sectional study in children, adolescents, and young adults with circadian rhythm sleep-wake disorder. Pediatr Diabetes 2020; 21:557-564. [PMID: 32134542 DOI: 10.1111/pedi.13003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 01/19/2020] [Accepted: 03/01/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Sleep deprivation and circadian disruption are associated with decreased insulin sensitivity and hyperglycemia. It is uncertain whether circadian sleep-wake disorder (CRSWD), which relates to both the homeostatic sleep system and the circadian timing system, affects glycemic regulation and insulin secretion. We aimed to examine the associations among sleep duration, sleep architecture or circadian rhythm of the sleep-wake cycle, and glucose metabolism in children, adolescents, and young adults with CRSWD. METHODS This cross-sectional observational study of 124 patients with CRSWD took place at Hyogo Children's Sleep and Development Medical Research Center in Hyogo, Japan. The patients underwent a 3-hour oral glucose tolerance test, anthropometric measurements, sleep-log analyses, and polysomnography. Analysis of covariance models were used to assess the association between sleep architecture or circadian rhythm of sleep-wake cycle and glucose/insulin homeostasis, adjusted for confounding variables such as age, gender, standardized body mass index, and sleep apnea index. RESULTS Impaired glucose tolerance was detected in 25.8% of all patients with CRSWD. After adjustment for confounding variables, we found a negative association between total sleep time (TST) and the 2-hour plasma glucose level. Stage N1 (%TST) was also a significant predictor of 3-hour glucose level. However, we did not detect an association between circadian rhythm of the sleep-wake cycle and glucose/insulin measures. CONCLUSIONS Decreased sleep duration and increased stage N1 (%TST) were associated with hyperglycemia in patients with CRSWD. Further research should elucidate how circadian misalignment in patients with CRSWD is associated with glucose and insulin homeostasis.
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Affiliation(s)
- Makiko Toyoura
- Department of Pediatrics, Hyogo Children's Sleep and Development Medical Research Center, Kobe, Japan
| | - Teruhisa Miike
- Department of Pediatrics, Hyogo Children's Sleep and Development Medical Research Center, Kobe, Japan
| | - Seiki Tajima
- Department of Pediatrics, Hyogo Children's Sleep and Development Medical Research Center, Kobe, Japan
| | | | - Yukuo Konishi
- Department of Pediatrics, Hyogo Children's Sleep and Development Medical Research Center, Kobe, Japan
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17
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Kaar JL, Schmiege SJ, Kalkwarf HJ, Woo JG, Daniels SR, Simon SL. Longitudinal Assessment of Sleep Trajectories during Early Childhood and Their Association with Obesity. Child Obes 2020; 16:211-217. [PMID: 31750742 PMCID: PMC7099424 DOI: 10.1089/chi.2019.0126] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introduction: To identify longitudinal sleep trajectories in early childhood and examine the influence of sleep duration on obesity risk via BMI percentile (BMIp). Methods: Sleep, physical activity, and television viewing were measured in a cohort of 301 children, starting in 2001-2002, when children were 3 years and followed them through age 6. Nighttime sleep, daytime naps, and sleep duration were calculated. A series of latent growth curve models were used to estimate predictors of rate of change in sleep duration and BMIp overtime. A parallel process latent growth model examined the longitudinal relationship between sleep duration and BMIp simultaneously. Results: Most children (>80%) slept >10 hours per night across ages 3 to 6 years, despite the majority of children (>66%) having bedtimes after 9 pm. Sleep duration decreased on average by 0.22 (95% CI 0.20-0.24) hours each year of age (p < 0.001), while BMIp increased on average by 1.76 (95% CI 1.18-2.34) each year of age (p < 0.001). Baseline sleep duration predicted the BMIp slope factor, over and above strong effects of baseline BMIp. This indicated that greater sleep duration at baseline was predictive of decreased BMIp over time (unstandardized coefficient = -1.52 (95% CI 0.34-2.71, p = 0.012). Conclusions: Longer sleep duration at age 3 predicted decreased BMIp from ages 3 to 6. These findings indicate that focusing on sleep behaviors in children before age 3 may be a priority for pediatric providers with a goal of decreasing obesity risk.
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Affiliation(s)
- Jill L. Kaar
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora, CO.,Address correspondence to: Jill L. Kaar, PhD, Children's Hospital Colorado, 13123 East 16th Avenue, Box 265, Aurora, CO 80045
| | - Sarah J. Schmiege
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Heidi J. Kalkwarf
- Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Jessica G. Woo
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.,Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Stephen R. Daniels
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora, CO
| | - Stacey L. Simon
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora, CO
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Wojujutari AK, Alabi OT, Emmanuel IE. Psychological resilience moderates influence of depression on sleep dysfunction of people living with diabetes. J Diabetes Metab Disord 2019; 18:429-436. [PMID: 31890668 PMCID: PMC6915166 DOI: 10.1007/s40200-019-00436-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 08/26/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The study examined the influence of depression on sleep dysfunction in people living with diabetes mellitus and investigated the moderating role of psychological resilience on the influence of depression on sleep dysfunction of patients. METHODS A cross-sectional survey was carried out among 380 (age 25-77 years; mean = 38.6; SD = 6.07) people living with diabetes who are registered patients and were attending the clinic in Department of Endocrinology, Ondo State Specialist Hospital, Akure. RESULTS Results showed that depression significantly influence sleep dysfunction of people living with diabetes, β = 0.3991, 95% CI (0.5393, 0.2588), t = 21.5010, p < 0.005. Results also showed significant moderating role of psychological resilience on the influence depression on sleep dysfunction of people living with diabetes, β = 0.7805, 95% CI (0.7091, 0.8519), t = 21.5010, p < 0.005. CONCLUSIONS Sleep dysfunction of individuals living with diabetes as result of their level of depression could be moderated by patient's level of psychological resilience. Along these lines, the study concludes that experts should focus more on diabetes patient's psychological resilience adequacy in their management, guidance and modification programs.
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Zou J, Xia Y, Xu H, Fu Y, Qian Y, Li X, Zhao X, Zou J, Meng L, Liu S, Zhu H, Yi H, Guan J, Chen B, Yin S. Independent relationships between cardinal features of obstructive sleep apnea and glycometabolism: a cross-sectional study. Metabolism 2018; 85:340-347. [PMID: 29382505 DOI: 10.1016/j.metabol.2017.11.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 11/15/2017] [Accepted: 11/21/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is associated with abnormal glycometabolism; however, the cardinal features of OSA, such as sleep fragmentation (SF) and intermittent hypoxia (IH), have yet to show clear, independent associations with glycometabolism. METHODS We enrolled 1834 participants with suspected OSA from July 2008 to July 2013 to participate in this study. Polysomnographic variables, biochemical indicators, and physical measurements were collected for each participant. Multiple linear regression analyses were used to evaluate independent associations between cardinal features of OSA and glycometabolism. Logistic regressions were used to determine the odds ratios (ORs) for abnormal glucose metabolism across microarousal index (MAI) and oxygen desaturation index (ODI) quartiles. The effect of the interaction between MAI and ODI on glycometabolism was also evaluated. RESULTS The MAI was independently associated with fasting insulin levels (β = 0.024, p = 0.001) and the homeostasis model assessment of insulin resistance (HOMA-IR; β = 0.006, p = 0.002) after multiple adjustments of confounding factors. In addition, the ORs for hyperinsulinemia across higher MAI quartiles were 1.081, 1.349, and 1.656, compared with the lowest quartile (p = 0.015 for a linear trend). Similarly, the ODI was independently associated with fasting glucose levels (β = 0.003, p < 0.001), fasting insulin levels (β = 0.037, p < 0.001), and the HOMA-IR (β = 0.010, p < 0.001) after adjusting for multiple factors. The ORs for hyperglycemia across higher ODI quartiles were 1.362, 1.231, and 2.184, compared with the lowest quartile (p < 0.05 for a linear trend). In addition, the ORs for hyperinsulinemia and abnormal HOMA-IR across ODI quartiles had the same trends. There was no interaction between MAI and ODI with respect to glycometabolism. CONCLUSION SF was independently associated with hyperinsulinemia, and IH was independently associated with hyperglycemia, hyperinsulinemia, and an abnormal HOMA-IR. We found no interaction between SF and IH with respect to OSA-related abnormal glycometabolism.
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Affiliation(s)
- Juanjuan Zou
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Yunyan Xia
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Huajun Xu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Yiqun Fu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Yingjun Qian
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Xinyi Li
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Xiaolong Zhao
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Jianyin Zou
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Lili Meng
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Suru Liu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Huaming Zhu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Hongliang Yi
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Jian Guan
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China.
| | - Bin Chen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China.
| | - Shankai Yin
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China.
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Makarem N, Aggarwal B. Gender Differences in Associations between Insufficient Sleep and Cardiovascular Disease Risk Factors and Endpoints: A Contemporary Review. Gender and the Genome 2018. [DOI: 10.1089/gg.2017.0001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Nour Makarem
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York
| | - Brooke Aggarwal
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York
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Guedes LG, Abreu GDA, Bloch KV. Self-reported nocturnal sleep duration and glycosylated hemoglobin A in the Study of Cardiovascular Risks in Adolescents (ERICA). Sleep Med 2018; 47:60-65. [PMID: 29758395 DOI: 10.1016/j.sleep.2018.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 03/06/2018] [Accepted: 03/12/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE At present, epidemiologic studies regarding the relationship between sleep duration and glucose metabolism in adolescents are scarce. The objective was to investigate the association between self-reported nocturnal sleep duration and glycosylated hemoglobin A in 12- to 17-year-old Brazilian adolescents. PATIENTS/METHODS A school-based multicenter cross-sectional study was carried out in private and public schools from 273 municipalities with more than 100,000 inhabitants. The final sample comprised 24,923 adolescents. A self-administered questionnaire was used. Blood tests included glucose, insulin, glycosylated hemoglobin A and serum lipids. Age, sex, skin color, school type, body mass index (BMI), physical activity, and Brazilian regions were studied as possible effect modifiers and/or confounders using linear regression. RESULTS A significant positive association was found between more than 12 h of nocturnal sleep and glycosylated hemoglobin A in two Brazilian regions: Southeast and South, even after adjustment for age, sex, skin color, and BMI (coefficients of 0.142 and 0.339, respectively). No association was found with nocturnal sleep duration <7 h. CONCLUSION Notably, a significant positive relationship was found between more than 12 h of nocturnal sleep duration and glycosylated hemoglobin A in two Brazilian regions. The specific pubertal sleep curtailment can be a compensatory mechanism for dealing with the insulin resistance during adolescence. Those that escape from this regulatory strategy and sleep longer than the adequate duration, break down this balance and tend to damage their glucose metabolism. To our knowledge, this is the first large scale study, of the association between sleep duration and glucose metabolism in adolescents.
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Affiliation(s)
- Luciane Gaspar Guedes
- Instituto de Puericultura e Pediatria Martagão Gesteira/Universidade Federal do Rio de Janeiro, Brazil.
| | | | - Katia Vergetti Bloch
- Instituto de Estudos em Saúde Coletiva/Universidade Federal do Rio de Janeiro, Brazil
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Garcia KA, Wohlgemuth WK, Ferrannini E, Mari A, Gonzalez A, Mendez AJ, Bizzotto R, Skyler JS, Schneiderman N, Hurwitz BE. Sleeping oxygen saturation, rapid eye movement sleep, and the adaptation of postprandial metabolic function in insulin sensitive and resistant individuals without diabetes. Physiol Behav 2018; 191:123-130. [PMID: 29655763 DOI: 10.1016/j.physbeh.2018.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 02/27/2018] [Accepted: 04/07/2018] [Indexed: 12/25/2022]
Abstract
AIMS Sleeping oxygen saturation (SaO2) and sleep stage duration have been linked with prediabetic alterations but the pathogenic pathways are not well understood. This study of insulin sensitive and resistant adults examined the effect on postprandial metabolic regulation of repeated mixed-meal challenges of different carbohydrate loading. The aim was to examine whether the relationship between lower sleeping oxygen saturation (SaO2) and poorer fasting and postprandial metabolic function may be linked with reduced slow wave sleep (SWS) and rapid eye movement (REM) duration, independent of age, sex and total adiposity. METHODS The 24 men and women, aged 25-54 years, had no diabetes or other diagnosed conditions, were evaluated with polysomnography to derive indices of SaO2 and sleep architecture. In addition, an OGTT and two 14-h serial mixed-meal tests were administered over 3 successive in-patient days. The carbohydrate content of the mixed-meals was manipulated to compare a standard-load day with a double-load day (300 vs. 600 kcal/meal). Quantitative modeling was applied to derive β-cell glucose sensitivity (β-GS), early insulin secretion rate sensitivity (ESRS), and total postprandial insulinemia (AUCINS). RESULTS Analyses showed that, for the 14-h tests, the SaO2 relationship with metabolic outcomes was associated significantly with percent time spent in REM but not SWS, independent of age, sex and total adiposity. Specifically, indirect pathways indicated that lower SaO2 was related to shorter REM duration, and shorter REM was respectively associated with higher β-GS, ESRS, and AUCINS for the 300- and 600-load days (300 kcal/meal: β = -8.68, p < .03, β = -8.54, p < .002, and β = -10.06, p < .008; 600 kcal/meal: β = -11.45, p < .003, β = -11.44, p < .001, and β = -11.00, p < .03). CONCLUSION Sleeping oxygen desaturation and diminished REM duration are associated with a metabolic pattern that reflects a compensatory adaptation of postprandial insulin metabolism accompanying preclinical diabetic risk.
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Affiliation(s)
- Karin A Garcia
- Behavioral Medicine Research Center, University of Miami, Miami, FL, USA; Department of Psychology, University of Miami, Coral Gables, FL, USA
| | | | - Ele Ferrannini
- National Research Council Institute of Clinical Physiology, Pisa, Italy
| | - Andrea Mari
- National Research Council Institute of Neurosciences, Padua, Italy
| | - Alex Gonzalez
- Behavioral Medicine Research Center, University of Miami, Miami, FL, USA
| | - Armando J Mendez
- Behavioral Medicine Research Center, University of Miami, Miami, FL, USA; Division of Endocrinology, Diabetes and Metabolism, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Roberto Bizzotto
- National Research Council Institute of Neurosciences, Padua, Italy
| | - Jay S Skyler
- Division of Endocrinology, Diabetes and Metabolism, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Neil Schneiderman
- Behavioral Medicine Research Center, University of Miami, Miami, FL, USA; Department of Psychology, University of Miami, Coral Gables, FL, USA; Division of Endocrinology, Diabetes and Metabolism, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Barry E Hurwitz
- Behavioral Medicine Research Center, University of Miami, Miami, FL, USA; Department of Psychology, University of Miami, Coral Gables, FL, USA; Division of Endocrinology, Diabetes and Metabolism, Miller School of Medicine, University of Miami, Miami, FL, USA.
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Pulido-Arjona L, Correa-Bautista JE, Agostinis-Sobrinho C, Mota J, Santos R, Correa-Rodríguez M, Garcia-Hermoso A, Ramírez-Vélez R. Role of sleep duration and sleep-related problems in the metabolic syndrome among children and adolescents. Ital J Pediatr 2018; 44:9. [PMID: 29334985 PMCID: PMC5769404 DOI: 10.1186/s13052-018-0451-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 01/08/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND There is increasing recognition that sleep is a risk factor for metabolic syndrome (MetS). The aim of the present study was to analyze the relationship between self-reported sleep duration, sleep-related problems and the presence of MetS in children and adolescents from Bogotá, D.C., Colombia. METHODS This is a cross-sectional analysis from the FUPRECOL study (2014-15). Participants included 2779 (54.2% girls) youth from Bogota (Colombia). MetS was defined as the presence of ≥3 of the metabolic abnormalities (hyperglycemia, hypertriglyceridemia, low high-density lipoprotein cholesterol [HDL-c], hypertension, and increased waist circumference) according to the criteria of de Ferranti/Magge and colleges. Self-reported sleep duration and sleep-related problems were assessed with the BEARS questionnaire. RESULTS Logistic regression analysis showed that boys who meet recommended duration of sleep had a decreased risk of elevated blood glucose levels (Odds Ratio [OR] = 0.71, 95%CI [0.40-0.94]; p = 0.031) compared to boys who have short-long sleep duration. Also, compared to young without sleep problems, excessive sleepiness during the day was related to low HDL-c levels in boys (OR = 1.36, 95%CI [1.02-1.83]; p = 0.036) and high triglyceride levels in girls (OR = 1.28, 95%CI [1.01-1.63]; p = 0.045). Girls with irregular sleep patterns had decreased HDL-c levels (OR = 0.71, 95%CI [0.55-0.91]; p = 0.009). CONCLUSIONS Recommended sleep duration was associated with a decreased risk of elevated fasting glucose levels in boys, and sleep problems was related to lower HDL-c in girls and higher triglyceride levels in boys. These findings suggested the clinical importance of improving sleep hygiene to reduce metabolic risk factors in children and adolescents.
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Affiliation(s)
- Leonardo Pulido-Arjona
- Center of Studies in Physical Activity Measurements, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá D.C, Colombia
| | - Jorge Enrique Correa-Bautista
- Center of Studies in Physical Activity Measurements, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá D.C, Colombia
| | - Cesar Agostinis-Sobrinho
- Research Center in Physical Activity, Health, and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Jorge Mota
- Research Center in Physical Activity, Health, and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Rute Santos
- Early Start Research Institute, Faculty of Social Sciences, School of Education, University of Wollongong, Wollongong, Australia
| | | | - Antonio Garcia-Hermoso
- Physical Activity, Sport and Health Sciences Laboratory, Faculty of Medical Sciences, Universidad de Santiago de Chile, USACH, Santiago, Chile
| | - Robinson Ramírez-Vélez
- Center of Studies in Physical Activity Measurements, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá D.C, Colombia
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24
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Abstract
Poor sleep and obesity are both extraordinarily common in the US adolescent population and often occur simultaneously. This review explores the links between obesity and sleep, outlining what is known about the relationships between sleep characteristics, obesity, and cardiometabolic risk factors in youth. Sleep duration is less than optimal in teens, and decreases as age increases. This is detrimental to overall well-being and is associated with obesity in children, adolescents, and young adults. Accordingly, inadequate sleep duration is associated with poor diet quality, decreased insulin sensitivity, hyperglycemia, and prevalent cardiometabolic risk factors. Evidence suggests that poor sleep quality and altered circadian timing characterized by a preferred later sleep onset, known as "adolescent chronotype," contributes to shortened sleep duration. Obstructive sleep apnea (OSA) occurs more frequently among youth with obesity, and is associated with autonomic nervous system activity promoting higher blood pressure, increased markers of cardiovascular disease risk, and insulin resistance. While there is a clear association between OSA and type 2 diabetes in adults, whether or not this association is prevalent in youth is unclear at this time. Interventions to improve both sleep duration and quality, and obesity in adolescents are scarce and more evidence is needed to determine if such interventions can improve obesity-related health outcomes.
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Affiliation(s)
- Anisha Gohil
- Pediatric Endocrinology Fellow, Section of Pediatric Endocrinology/Diabetology, Riley Hospital for Children at IU Health, Indiana University School of Medicine, Indianapolis, IN, United States
- *Correspondence: Anisha Gohil
| | - Tamara S. Hannon
- Section of Pediatric Endocrinology/Diabetology, Riley Hospital for Children at IU Health, Indiana University School of Medicine, Indianapolis, IN, United States
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25
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Abstract
The urban environment has changed vastly over past decades, which also has had an impact on our sleep and dietary patterns and possibly health outcomes. Some studies have shown that sleep duration and sleep quality has declined over past decades, especially in children. In parallel, our lifestyle and dietary patterns have also changed including more shift work, more meals outside the home or family setting and more irregular eating patterns, including breakfast skipping and late-night eating. This new area of research in nutritional sciences studying the impact of the timing of eating on health outcomes is called chrono-nutrition, and combines elements from nutritional research with chrono-biology. The objectives of this paper were to discuss secular trends in sleep patterns and related dietary patterns, introduce basic concepts and mechanisms of chrono-nutrition and discuss the evidence for the importance of sleep and chrono-nutrition in relation to health outcomes. Overall, chrono-nutrition could mediate the effects between sleep, diet and urbanisation, and more research is needed to elucidate the importance of chrono-nutrition for metabolic health and its impact on public health.
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Abstract
Background Some of the country's highest rates of morbidity and mortality from cardiovascular disease are found in lower‐income black communities in the rural Southeast. Research suggests these disparities originate in the early decades of life, and partly reflect the influence of broader socioeconomic forces acting on behavioral and biological processes that accelerate cardiovascular disease progression. However, this hypothesis has not been tested explicitly. Here, we examine metabolic syndrome (MetS) in rural black young adults as a function of their family's economic conditions before and after the Great Recession. Methods and Results In an ongoing prospective study, we followed 328 black youth from rural Georgia, who were 16 to 17 years old when the Great Recession began. When youth were 25, we assessed MetS prevalence using the International Diabetes Federation's guidelines. The sample's overall MetS prevalence was 18.6%, but rates varied depending on family economic trajectory from before to after the Great Recession. MetS prevalence was lowest (10.4%) among youth whose families maintained stable low‐income conditions across the Recession. It was intermediate (21.8%) among downwardly mobile youth (ie, those whose families were lower income before the Recession, but slipped into poverty). The highest MetS rates (27.5%) were among youth whose families began the Recession in poverty, and sank into more meager conditions afterwards. The same patterns were observed with 3 alternative MetS definitions. Conclusions These patterns suggest that broader economic forces shape cardiometabolic risk in young blacks, and may exacerbate disparities already present in this community.
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Affiliation(s)
- Gregory E Miller
- Institute for Policy Research and Department of Psychology, Northwestern University, Evanston, IL
| | - Edith Chen
- Institute for Policy Research and Department of Psychology, Northwestern University, Evanston, IL
| | - Tianyi Yu
- Center for Family Research, University of Georgia, Athens, GA
| | - Gene H Brody
- Center for Family Research, University of Georgia, Athens, GA
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27
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Abstract
Type 2 diabetes mellitus (T2DM) has shown to be associated with higher incidence of sleep disorders, which may be due to disease itself or because of secondary complications or associated comorbidities associated with diabetes. On the other hand, shorter sleep duration and erratic sleep behavior itself have been linked with higher incidence of obesity, metabolic syndrome, and T2DM. Assessment of sleep quality and sleep disorders as a part of the comprehensive medical evaluation is recommended based on emerging evidence suggesting a relationship between sleep quality and glycemic control in persons with T2DM. In this review, we attempt to summarize common sleep disorders associated with T2DM, their impacts on glycemic and other metabolic control, and various preventive and therapeutic strategies to tackle these problems.
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Affiliation(s)
- Deepak Khandelwal
- Department of Endocrinology, Maharaja Agrasen Hospital, New Delhi, India
| | - Deep Dutta
- Department of Endocrinology, Venkateshwar Hospital, New Delhi, India
| | - Sachin Chittawar
- Department of Medicine, Division of Endocrinology, Gandhi Medical College and Hamidia Hospital, Bhopal, Madhya Pradesh, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
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28
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Birnkrant DJ, Black JB, Tapia IE, Nicolai T, Gower WA, Noah TL. Pediatric Pulmonology year in review 2016: Part 1. Pediatr Pulmonol 2017; 52:1226-1233. [PMID: 28440921 DOI: 10.1002/ppul.23720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 04/04/2017] [Indexed: 11/07/2022]
Abstract
Pediatric Pulmonology continues to publish research and clinical topics related to the entire range of children's respiratory disorders. As we have done annually in recent years, we here summarize the past year's publications in our major topic areas, as well as selected literature in these areas from other core journals relevant to our discipline. This review (Part 1) covers selected articles on sleep, diagnostic testing/endoscopy, respiratory complications of neuromuscular disorders, and rare lung diseases.
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Affiliation(s)
- David J Birnkrant
- Metro Health Medical Center, Cleveland, Ohio.,Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Jane B Black
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Ignacio E Tapia
- Sleep Center, Division of Pulmonary Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - William A Gower
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Terry L Noah
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Abstract
PURPOSE OF REVIEW The review summarizes the current state of the artificial pancreas (AP) systems and introduces various new modules that should be included in future AP systems. RECENT FINDINGS A fully automated AP must be able to detect and mitigate the effects of meals, exercise, stress and sleep on blood glucose concentrations. This can only be achieved by using a multivariable approach that leverages information from wearable devices that provide real-time streaming data about various physiological variables that indicate imminent changes in blood glucose concentrations caused by meals, exercise, stress and sleep. The development of a fully automated AP will necessitate the design of multivariable and adaptive systems that use information from wearable devices in addition to glucose sensors and modify the models used in their model-predictive alarm and control systems to adapt to the changes in the metabolic state of the user. These AP systems will also integrate modules for controller performance assessment, fault detection and diagnosis, machine learning and classification to interpret various signals and achieve fault-tolerant control. Advances in wearable devices, computational power, and safe and secure communications are enabling the development of fully automated multivariable AP systems.
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Affiliation(s)
- Ali Cinar
- Department of Chemical and Biological Engineering and Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA.
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30
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Abstract
Obstructive sleep apnea (OSA) is a common chronic obstructive sleep disease in clinic. The purpose of our study was to use bioinformatics analysis to identify microRNAs (miRNAs) that are differentially expressed between OSA patients and healthy controls.Serum samples were collected from OSA patients and healthy controls. To better reveal the sample specificity of differentially expressed microRNAs, supervised hierarchical clustering was conducted. We used the microT-CDS and TargetScan databases to predict target genes of the differentially expressed microRNAs and selected the common genes. The Search Tool for the Retrieval of Interacting Genes (STRING) was used to evaluate many coexpression relationships. Moreover, we used these potential microRNA-target pairs and coexpression relationships to construct a regulatory coexpression network using Cytoscape software. Functional analysis of microRNA target genes was conducted with FunRich.A total of 104 microRNAs that were differentially expressed between OSA patients and healthy controls were identified. Supervised hierarchical clustering was conducted based on the expression of the 104 microRNAs in the OSA patients and healthy controls. Overall, 6621 potential target genes were predicted, and 119 target genes were screened based on coexpression coefficients in the STRING database. A regulatory coexpression network was constructed that included 23 differentially expressed microRNAs and 18 of the most related potential target genes. Metabolic signaling pathways were the most highly enriched category. Differentially expressed microRNAs, such as hsa-miR-485-5p, hsa-miR-107, hsa-miR-574-5p, and hsa-miR-199-3p, might participate in OSA. The target gene CAD might also be closely related to OSA.Our results may provide a basis for the pathogenesis of OSA and the study of disease diagnosis, prevention, and treatment. However, more experiments are needed to verify these predictions.
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31
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Nouwen A, Chambers A, Chechlacz M, Higgs S, Blissett J, Barrett TG, Allen HA. Microstructural abnormalities in white and gray matter in obese adolescents with and without type 2 diabetes. Neuroimage Clin 2017; 16:43-51. [PMID: 28752059 PMCID: PMC5514690 DOI: 10.1016/j.nicl.2017.07.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 06/24/2017] [Accepted: 07/03/2017] [Indexed: 01/15/2023]
Abstract
Aims/hypotheses In adults, type 2 diabetes and obesity have been associated with structural brain changes, even in the absence of dementia. Some evidence suggested similar changes in adolescents with type 2 diabetes but comparisons with a non-obese control group have been lacking. The aim of the current study was to examine differences in microstructure of gray and white matter between adolescents with type 2 diabetes, obese adolescents and healthy weight adolescents. Methods Magnetic resonance imaging data were collected from 15 adolescents with type 2 diabetes, 21 obese adolescents and 22 healthy weight controls. Volumetric differences in the gray matter between the three groups were examined using voxel based morphology, while tract based spatial statistics was used to examine differences in the microstructure of the white matter. Results Adolescents with type 2 diabetes and obese adolescents had reduced gray matter volume in the right hippocampus, left putamen and caudate, bilateral amygdala and left thalamus compared to healthy weight controls. Type 2 diabetes was also associated with significant regional changes in fractional anisotropy within the corpus callosum, fornix, left inferior fronto-occipital fasciculus, left uncinate, left internal and external capsule. Fractional anisotropy reductions within these tracts were explained by increased radial diffusivity, which may suggest demyelination of white matter tracts. Mean diffusivity and axial diffusivity did not differ between the groups. Conclusion/interpretation Our data shows that adolescent obesity alone results in reduced gray matter volume and that adolescent type 2 diabetes is associated with both white and gray matter abnormalities. Type 2 diabetes and obesity in adolescents is associated with reduced gray matter volume. Type 2 diabetes was associated with significant regional changes in FA. FA reductions within these tracts were explained by increased RD. Mean diffusivity and axial diffusivity did not differ between the groups.
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Affiliation(s)
- Arie Nouwen
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Alison Chambers
- School of Psychology, University of Birmingham, Birmingham, UK
| | | | - Suzanne Higgs
- School of Psychology, University of Birmingham, Birmingham, UK
| | | | | | - Harriet A Allen
- School of Psychology, University of Birmingham, Birmingham, UK
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32
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Abstract
Sleep is essential for children's learning, memory processes, school performance, and general well-being. The prevalence of sleepiness in children is approximately 4%. Reductions of sleep duration have daytime consequences, including sleepiness, behavior problems, cognitive deficits, poor school performance, inflammation, and metabolic dysfunction. Chronic pain, movement disorders, and sleep-disordered breathing also may lead to daytime somnolence, inattention, hyperactivity, oppositional behaviors, and mood dysregulation. Parent-report questionnaires are useful tools to assess subjective sleepiness in children. Sleepiness in children may be secondary to a sleep problem, such as narcolepsy, central hypersomnia, Kleine-Levin disease, or circadian rhythm disorder.
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Affiliation(s)
- Gustavo Antonio Moreira
- Department of Psychobiology, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo, São Paulo 04024-002, Brazil; Department of Pediatrics, Universidade Federal de São Paulo, Rua Botucatu, 598, São Paulo, São Paulo 04023-062, Brazil.
| | - Marcia Pradella-Hallinan
- Department of Psychobiology, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo, São Paulo 04024-002, Brazil
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Mameli C, Zuccotti GV, Carnovale C, Galli E, Nannini P, Cervia D, Perrotta C. An update on the assessment and management of metabolic syndrome, a growing medical emergency in paediatric populations. Pharmacol Res 2017; 119:99-117. [PMID: 28111263 DOI: 10.1016/j.phrs.2017.01.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/13/2017] [Accepted: 01/16/2017] [Indexed: 01/19/2023]
Abstract
In the last decades the increasing rate of obesity in children and adolescents worldwide has led to the onset in paediatric age of metabolic syndrome, a disease commonly associated to adulthood. Central obesity, dyslipidaemia, hyperglycaemia, and hypertension are typical features of metabolic syndrome that seem to hesitate often in type 2 diabetes, cardiovascular disease, non-alcoholic fatty liver disease, and many other clinical conditions. Thus preventing and curing metabolic syndrome in paediatric patients is becoming an urgent need for public health. While diagnostic criteria and therapy of metabolic syndrome in adults are very well defined, there is no consensus on the definition of metabolic syndrome in children and adolescents as well as on healing approaches. The aim of this review is to describe the recent advances on the pathogenesis and clinical outcomes of paediatric metabolic syndrome. We then detail the therapeutic strategies (i.e. dietary regimens, physical exercise, nutraceuticals, and medications) employed to manage the disease. Finally, we analyse the safety profile of the drugs used in children and adolescents by performing a retrospective review of paediatric adverse reactions reported in the FDA's Adverse Event Reporting System database.
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West C, Egger G. To Sleep, Perchance to … Get Everything Else Right. Lifestyle Medicine 2017. [DOI: 10.1016/b978-0-12-810401-9.00018-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Owens JA, Dearth-Wesley T, Lewin D, Gioia G, Whitaker RC. Self-Regulation and Sleep Duration, Sleepiness, and Chronotype in Adolescents. Pediatrics 2016; 138:peds.2016-1406. [PMID: 27940688 DOI: 10.1542/peds.2016-1406] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/01/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To determine whether shorter school-night sleep duration, greater daytime sleepiness, and greater eveningness chronotype were associated with lower self-regulation among adolescents. METHODS An online survey of 7th- to 12th-grade students in 19 schools in Fairfax County, Virginia Public Schools was conducted in 2015. Self-regulation was measured with the Behavior Rating Inventory of Executive Function, 2nd edition, Screening Self-Report Form. Sleep measures included school night-sleep duration (hours between usual bedtime and wake time), daytime sleepiness (Sleepiness Scale in the Sleep Habits Survey, tertiles), and chronotype (Morningness-Eveningness Scale for Children, continuous score and tertiles). Sociodemographic factors and mental health conditions were analyzed as potential confounders. RESULTS Among 2017 students surveyed, the mean age was 15.0 years (range, 12.1-18.9 years), and 21.7% slept <7 hours on school nights. In regression models adjusted for confounders, there was a significant independent association between self-regulation and both chronotype (P < .001) and daytime sleepiness (P < .001) but not sleep duration (P = .80). Compared with those in the lowest tertile of daytime sleepiness, those in the highest tertile had lower (0.59 SD units; 95% confidence interval, 0.48-0.71) self-regulation, as did those in the eveningness tertile of chronotype compared with those in the morningness tertile (0.35 SD units lower; 95% confidence interval, 0.24-0.46). CONCLUSIONS Among adolescents, greater daytime sleepiness and greater eveningness chronotype were independently associated with lower self-regulation, but shorter sleep duration was not. Aspects of sleep other than school-night sleep duration appear to be more strongly associated with self-regulation.
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Affiliation(s)
- Judith A Owens
- Division of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | | | - Gerard Gioia
- Neuropsychology, Children's National Medical Center, George Washington University School of Medicine, Washington, District of Columbia
| | - Robert C Whitaker
- Center for Obesity Research and Education and .,Departments of Epidemiology and Biostatistics and.,Pediatrics, Temple University, Philadelphia, Pennsylvania; and
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36
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Kelly NR, Shomaker LB, Radin RM, Thompson KA, Cassidy OL, Brady S, Mehari R, Courville AB, Chen KY, Galescu OA, Tanofsky-Kraff M, Yanovski JA. Associations of sleep duration and quality with disinhibited eating behaviors in adolescent girls at-risk for type 2 diabetes. Eat Behav 2016; 22:149-155. [PMID: 27289521 PMCID: PMC4983254 DOI: 10.1016/j.eatbeh.2016.06.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 04/28/2016] [Accepted: 06/01/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Short sleep duration and daytime sleepiness have been associated with an increased risk for the onset of type 2 diabetes in adults. There has been far less attention to the characterization of sleep in adolescents at-risk for diabetes or to the possible behavioral mechanisms, such as disinhibited eating, through which sleep may affect metabolic functioning. METHODS We evaluated the associations of sleep duration and daytime sleepiness with a multi-modal assessment of disinhibited eating in 119 adolescent girls at-risk for type 2 diabetes based upon being overweight/obese and having a family history of diabetes. Girls also endorsed mild-to-moderate depressive symptoms. Adolescents reported sleep duration and daytime sleepiness with the Sleep Habits Survey and Children's Sleep Habits Questionnaire. They were administered a series of successive test meals to measure total energy intake and eating in the absence of hunger (EAH). Adolescent binge eating was assessed with the Eating Disorder Examination interview. RESULTS Accounting for age, race, puberty, body composition, depressive symptoms, and perceived stress, reported sleep duration was positively related to test meal total energy intake (p=0.04), but not to EAH. Adjusting for the same covariates, daytime sleepiness was associated with a greater odds of objective binge eating in the previous month (p=0.009). CONCLUSIONS In adolescent girls at-risk for type 2 diabetes, reported sleep characteristics are associated with disinhibited eating behaviors that have been linked to excessive weight and adverse metabolic outcomes. Future studies are called for to evaluate these links using objective measures of sleep.
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Affiliation(s)
- Nichole R Kelly
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States; Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Department of Defense, 4301 Jones Bridge Road, Bethesda, MD 20814, United States
| | - Lauren B Shomaker
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States; Department of Human Development and Family Studies, Colorado State University, 410 Pitkin Street, Campus Delivery 1570, Fort Collins, CO 80523, United States.
| | - Rachel M Radin
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States; Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Department of Defense, 4301 Jones Bridge Road, Bethesda, MD 20814, United States
| | - Katherine A Thompson
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States
| | - Omni L Cassidy
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States; Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Department of Defense, 4301 Jones Bridge Road, Bethesda, MD 20814, United States
| | - Sheila Brady
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States
| | - Rim Mehari
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States
| | - Amber B Courville
- Nutrition Department, NIH Clinical Center, DHHS, 10 Center Drive, MSC 1078, Bethesda, MD 20892, United States
| | - Kong Y Chen
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, DHHS, 10 Center Drive, Bethesda, MD 20814, United States
| | - Ovidiu A Galescu
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States; Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Department of Defense, 4301 Jones Bridge Road, Bethesda, MD 20814, United States
| | - Jack A Yanovski
- Section on Growth and Obesity, National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, MSC 1103, Bethesda, MD 20892, United States
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Georges M, Mouillot T, Lombard S, Pénicaud L, Brondel L. La privation de sommeil fait grossir : mythe ou réalité ? NUTR CLIN METAB 2016. [DOI: 10.1016/j.nupar.2016.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Obstructive sleep apnoea (OSA) is a very common disorder that affects 10-25% of the general population. In the past two decades, OSA has emerged as a cardiometabolic risk factor in both paediatric and adult populations. OSA-induced metabolic perturbations include dyslipidaemia, atherogenesis, liver dysfunction and abnormal glucose metabolism. The mainstay of treatment for OSA is adenotonsillectomy in children and continuous positive airway pressure therapy in adults. Although these therapies are effective at resolving the sleep-disordered breathing component of OSA, they do not always produce beneficial effects on metabolic function. Thus, a deeper understanding of the underlying mechanisms by which OSA influences metabolic dysfunction might yield improved therapeutic approaches and outcomes. In this Review, we summarize the evidence obtained from animal models and studies of patients with OSA of potential mechanistic pathways linking the hallmarks of OSA (intermittent hypoxia and sleep fragmentation) with metabolic dysfunction. Special emphasis is given to adipose tissue dysfunction induced by sleep apnoea, which bears a striking resemblance to adipose dysfunction resulting from obesity. In addition, important gaps in current knowledge and promising lines of future investigation are identified.
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Affiliation(s)
- Alex Gileles-Hillel
- Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Knapp Center for Biomedical Discovery, Room 4100, 900 East 57th Street, Mailbox 4, Chicago, Illinois 60637-1470, USA
| | - Leila Kheirandish-Gozal
- Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Knapp Center for Biomedical Discovery, Room 4100, 900 East 57th Street, Mailbox 4, Chicago, Illinois 60637-1470, USA
| | - David Gozal
- Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Knapp Center for Biomedical Discovery, Room 4100, 900 East 57th Street, Mailbox 4, Chicago, Illinois 60637-1470, USA
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Shimizu I, Yoshida Y, Minamino T. A role for circadian clock in metabolic disease. Hypertens Res 2016; 39:483-91. [DOI: 10.1038/hr.2016.12] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 01/17/2016] [Accepted: 01/18/2016] [Indexed: 12/11/2022]
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Affiliation(s)
- Joshua J Gooley
- Center for Cognitive Neuroscience, Program in Neuroscience and Behavioral Disorders, Duke-NUS Graduate Medical School Singapore, Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
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Abstract
IN BRIEF Obstructive sleep apnea (OSA) alters glucose metabolism, promotes insulin resistance, and is associated with development of type 2 diabetes. Obesity is a key moderator of the effect of OSA on type 2 diabetes. However, chronic exposure to intermittent hypoxia and other pathophysiological effects of OSA affect glucose metabolism directly, and treatment of OSA can improve glucose homeostasis.
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Affiliation(s)
- Jimmy Doumit
- Jesse Brown VA Medical Center and University of Illinois at Chicago, Chicago, IL
| | - Bharati Prasad
- Jesse Brown VA Medical Center and University of Illinois at Chicago, Chicago, IL
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Abstract
OBJECTIVE To describe sleep in adolescents and young adults with type 1 diabetes and explore the association between sleep disturbances, diabetes management and glycemic control. METHODS Adolescents with type 1 diabetes (n = 159, mean age = 16.4, 43% female, 69% white, mean A1C = 9.3%) completed the Pittsburgh Sleep Quality Index to assess sleep quantity and quality and sleep disturbances. Frequency of blood glucose monitoring (meter downloads) was used as a measure of diabetes management. RESULTS Average sleep duration was 7.4 hours, below the recommended duration for this age. Adolescents using insulin pumps reported fewer sleep disturbances and longer sleep duration than those on injections, and older adolescents reported less sleep than younger adolescents. Poorer sleep duration was related to poorer diabetes management and better self-reported sleep quality was associated with better glycemic control for males but not for females. CONCLUSIONS Assessing for and treating sleep disturbances in adolescents may improve diabetes management.
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Jalilolghadr S, Yazdi Z, Mahram M, Babaei F, Esmailzadehha N, Nozari H, Saffari F. Sleep architecture and obstructive sleep apnea in obese children with and without metabolic syndrome: a case control study. Sleep Breath. 2016;20:845-851. [PMID: 26711131 DOI: 10.1007/s11325-015-1291-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Revised: 10/29/2015] [Accepted: 11/23/2015] [Indexed: 12/18/2022]
Abstract
PURPOSE Obesity and biochemical parameters of metabolic disorders are both closely related to obstructive sleep apnea (OSA). The aim of this study was to compare sleep architecture and OSA in obese children with and without metabolic syndrome. METHODS Forty-two children with metabolic syndrome were selected as case group and 38 children without metabolic syndrome were matched for age, sex, and BMI as control group. The standardized Persian version of bedtime problems, excessive daytime sleepiness, awakenings during the night, regularity and duration of sleep, snoring (BEARS) and Children's Sleep Habits Questionnaires were completed, and polysomnography (PSG) was performed for all study subjects. Scoring was performed using the manual of American Academy of Sleep Medicine for children. Data were analyzed using chi-square test, T test, Mann-Whitney U test, and logistic regression analysis. RESULTS Non-rapid eye movement (NREM) sleep and N1 stage in the case group were significantly longer than the control group, while REM sleep was significantly shorter. Waking after sleep onset (WASO) was significantly different between two groups. Severe OSA was more frequent in the control group. Multivariate logistic regression analysis showed that severe OSA (OR 21.478, 95 % CI 2.160-213.600; P = 0.009) and REM sleep (OR 0.856, 95 % CI 0.737-0.994; P = 0.041) had independent association with metabolic syndrome. CONCLUSIONS Obese children with metabolic syndrome had increased WASO, N1 sleep stage, and severe OSA. But the results regarding sleep architecture are most likely a direct result of OSA severity. More longitudinal studies are needed to confirm the association of metabolic syndrome and OSA.
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Hublin C, Lehtovirta M, Partinen M, Koskenvuo M, Kaprio J. Napping and the risk of type 2 diabetes: a population-based prospective study. Sleep Med 2015; 17:144-8. [PMID: 26847990 DOI: 10.1016/j.sleep.2015.11.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 10/27/2015] [Accepted: 11/02/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Some studies indicate an association between napping and increased risk of type 2 diabetes. We studied this prospectively in a sample representative of general population. METHODS A questionnaire was administered to the Finnish Twin Cohort in 1990 (response rate 77%, age 33-60 years). The study population included 12,244 subjects who replied to the question "Do you sleep during the daytime (take naps)?" with five response alternatives ranging from "no need" to "every or almost every day." Information on incident cases of diabetes was obtained by linkage to nationwide registers. Logistic regression models were used to obtain odds ratios (ORs) (95% confidence intervals) for incident type 2 diabetes risk in 1991-2004 by napping category. Adjustments were made for 11 socio-demographic and lifestyle covariates. For subjects aged 33-45 years at baseline, a questionnaire in 2011 provided information on prevalent diabetes. RESULTS Thirty-four per cent had no need for napping, and 15% did so on ≥3 days weekly. There were 356 incident type 2 diabetes cases during the follow-up. Using the 'no need' category as the reference, the risk of type 2 diabetes was significantly increased only among those napping most frequently [OR 1.86 (1.29-2.67), age- and sex-adjusted]. After adjusting for other covariates, the results were essentially the same, but when adjusted for body mass index, the association decreased (to about 1.3) and was statistically non-significant. Analysis of 2011 self-reported type 2 diabetes was in line with the register data. CONCLUSIONS Frequent napping is associated with future risk of type 2 diabetes. This association is largely explained by obesity.
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Affiliation(s)
- Christer Hublin
- Finnish Institute of Occupational Health, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland.
| | - Mikko Lehtovirta
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Markku Partinen
- Department of Public Health, University of Helsinki, Helsinki, Finland; Helsinki Sleep Clinic, Vitalmed Research Centre, Helsinki, Finland
| | - Markku Koskenvuo
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Helsinki, Finland; Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland
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Anothaisintawee T, Reutrakul S, Van Cauter E, Thakkinstian A. Sleep disturbances compared to traditional risk factors for diabetes development: Systematic review and meta-analysis. Sleep Med Rev 2015; 30:11-24. [PMID: 26687279 DOI: 10.1016/j.smrv.2015.10.002] [Citation(s) in RCA: 352] [Impact Index Per Article: 39.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 10/11/2015] [Accepted: 10/12/2015] [Indexed: 01/04/2023]
Abstract
Sleep disturbances [short (<6 h) and long (>8 h) sleeping time, insomnia (initiating or maintaining sleep), obstructive sleep apnea (OSA) and abnormal sleep timing] have been associated with increased diabetes risk but the effect size relative to that of traditional risk factors is unknown. We conducted a systematic review and meta-analysis to compare the risk associated with sleep disturbances to traditional risk factors. Studies were identified from Medline and Scopus. Cohort studies measuring the association between sleep disturbances and incident diabetes were eligible. For traditional risk factors (i.e., overweight, family history, and physical inactivity), systematic reviews with or without meta-analysis were included. Thirty-six studies (1,061,555 participants) were included. Pooled relative risks (RRs) of sleep variables were estimated using a random-effect model. Pooled RRs of sleeping ≤5 h, 6 h, and ≥9 h/d were respectively 1.48 (95%CI:1.25,1.76), 1.18 (1.10,1.26) and 1.36 (1.12,1.65). Poor sleep quality, OSA and shift work were associated with diabetes with a pooled RR of 1.40 (1.21,1.63), 2.02 (1.57, 2.61) and 1.40 (1.18,1.66), respectively. The pooled RRs of being overweight, having a family history of diabetes, and being physically inactive were 2.99 (2.42,3.72), 2.33 (1.79,2.79), and 1.20 (1.11,1.32), respectively. In conclusion, the risk of developing diabetes associated with sleep disturbances is comparable to that of traditional risk factors. Sleep disturbances should be considered in clinical guidelines for type 2 diabetes screening.
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Affiliation(s)
- Thunyarat Anothaisintawee
- Department of Family Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; Section for Clinical Epidemiology and Biostatistics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sirimon Reutrakul
- Division of Endocrinology and Metabolism, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Eve Van Cauter
- Section of Adult and Pediatric Endocrinology, Diabetes, and Metabolism, and Sleep, Metabolism and Health Center, Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Ammarin Thakkinstian
- Section for Clinical Epidemiology and Biostatistics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Abstract
Most living beings, including humans, must adapt to rhythmically occurring daily changes in their environment that are generated by the Earth's rotation. In the course of evolution, these organisms have acquired an internal circadian timing system that can anticipate environmental oscillations and thereby govern their rhythmic physiology in a proactive manner. In mammals, the circadian timing system coordinates virtually all physiological processes encompassing vigilance states, metabolism, endocrine functions and cardiovascular activity. Research performed during the past two decades has established that almost every cell in the body possesses its own circadian timekeeper. The resulting clock network is organized in a hierarchical manner. A master pacemaker, located in the suprachiasmatic nucleus (SCN) of the hypothalamus, is synchronized every day to the photoperiod. In turn, the SCN determines the phase of the cellular clocks in peripheral organs through a wide variety of signalling pathways dependent on feeding cycles, body temperature rhythms, oscillating bloodborne signals and, in some organs, inputs of the peripheral nervous system. A major purpose of circadian clocks in peripheral tissues is the temporal orchestration of key metabolic processes, including food processing (metabolism and xenobiotic detoxification). Here, we review some recent findings regarding the molecular and cellular composition of the circadian timing system and discuss its implications for the temporal coordination of metabolism in health and disease. We focus primarily on metabolic disorders such as obesity and type 2 diabetes, although circadian misalignments (shiftwork or 'social jet lag') have also been associated with the aetiology of human malignancies.
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Affiliation(s)
- C Dibner
- Department of Endocrinology, Diabetes, Nutrition and Hypertension, University Hospital of Geneva, Geneva, Switzerland
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Kheirandish-Gozal L, Gozal D, Pépin JL. Inflammation in sleep debt and sleep disorders. Mediators Inflamm 2015; 2015:343265. [PMID: 25883415 DOI: 10.1155/2015/343265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 03/01/2015] [Indexed: 12/31/2022] Open
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Abstract
Obstructive sleep apnea (OSA) is independently associated with cardiovascular and cardiometabolic risk in several large epidemiologic studies. OSA leads to several physiologic disturbances such as intermittent hypoxia, sleep fragmentation, and increase in autonomic tone. These disturbances have been associated with insulin resistance and type 2 diabetes mellitus (T2DM) in animal and human studies. Studies also suggest a bidirectional relationship between OSA and T2DM whereby T2DM itself might contribute to the features of OSA. Moreover, successful treatment of OSA may reduce these risks, although this is controversial. The purpose of this article is to review 1) the links and bidirectional associations between OSA and T2DM; 2) the pathogenic mechanisms that might link these two disease states; 3) the role of continuous positive airway pressure therapy in improving glucose tolerance, sensitivity, and resistance; and 4) the implications for clinical practice.
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Affiliation(s)
- Preethi Rajan
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Hofstra-North Shore LIJ School of Medicine, New Hyde Park, NY, USA
| | - Harly Greenberg
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Hofstra-North Shore LIJ School of Medicine, New Hyde Park, NY, USA
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Sathyanarayanan A, Benny E, Osborn J, Kumar S, Prabhu S, Mathew AC. Factors Associated with Poor Sleep Quality among Type 2 Diabetes Mellitus Patients on Insulin Therapy. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/jdm.2015.54025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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