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Kim HS, Lee H, Provido SMP, Chung GH, Hong S, Yu SH, Lee JE, Lee CB. Association between Sleep Duration and Metabolic Disorders among Filipino Immigrant Women: The Filipino Women's Diet and Health Study (FiLWHEL). J Obes Metab Syndr 2023; 32:224-235. [PMID: 37718118 PMCID: PMC10583772 DOI: 10.7570/jomes22032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 11/06/2022] [Accepted: 07/09/2023] [Indexed: 09/19/2023] Open
Abstract
Background Sleep plays a complex role in metabolic regulation, and the underlying linkage has not been clearly defined. We investigated the association between sleep duration and metabolic disorders in Filipino immigrants in Korea. Methods We analyzed 410 participants from the 2014 to 2016 baseline population of the Filipino Women's Diet and Health Study. Usual sleep duration was self-reported, and anthropometric parameters were measured directly. Blood glucose, lipid, and insulin levels were examined from fasting serum samples. We used general linear models to acquire least squares (LS) means and logistic regression models to calculate odds ratios to test the cross-sectional association between sleep duration and metabolic markers with 95% confidence intervals (CIs). Results We found a statistically significant linear association between increased sleep duration and elevated triglycerides, total cholesterol, and low-density lipoprotein cholesterol (LDL-C). LS means (95% CI) of <5, 5-6, 7-8, and >8 hours of sleep were 81.74 (71.43 to 93.54), 85.15 (76.65 to 94.59), 86.33 (77.84 to 95.75), and 105.22 (88.07 to 125.71), respectively, for triglycerides (P trend=0.049) and 174.52 (165.02 to 184.57), 180.50 (172.79 to 188.55), 182.51 (174.83 to 190.53), and 190.16 (176.61 to 204.74), respectively, for total cholesterol (P trend= 0.042). For LDL-C, the LS means (95% CI) were 97.34 (88.80 to 106.71), 100.69 (93.73 to 108.18), 104.47 (97.35 to 112.10), and 109.43 (96.94 to 123.54), respectively (P trend=0.047). Statistical significance persisted after additional adjustment for body mass index. The association with triglycerides was limited to current alcohol drinkers (P interaction=0.048). Conclusion Longer sleep duration was associated with increased triglyceride, total cholesterol, and LDL-C levels. The association with triglycerides was more pronounced among moderate alcohol drinkers.
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Affiliation(s)
- Hee Sun Kim
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Korea
| | - Heejin Lee
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Korea
| | | | - Grace H. Chung
- Research Institute of Human Ecology, Seoul National University, Seoul, Korea
- Department of Child Development and Family Studies, College of Human Ecology, Seoul National University, Seoul, Korea
| | - Sangmo Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Sung Hoon Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Jung Eun Lee
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Korea
- Research Institute of Human Ecology, Seoul National University, Seoul, Korea
| | - Chang Beom Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
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Zhu R, Yang J, Zhai Z, Zhao H, Jiang F, Sun C, Liu X, Hou J, Dou P, Wang C. The associations between sleep timing and night sleep duration with dyslipidemia in a rural population: The Henan Rural Cohort Study. Chronobiol Int 2023; 40:1261-1269. [PMID: 37781878 DOI: 10.1080/07420528.2023.2262565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 09/18/2023] [Indexed: 10/03/2023]
Abstract
Evidence linking sleep timing and night sleep duration to dyslipidemia was limited and inconclusive, especially among low- and middle-income adults. The aims were to evaluate the associations between sleep timing, night sleep duration and dyslipidemia in a rural population. Based on the Henan Rural Cohort Study, a total of 37 164 participants were included. The Pittsburgh Sleep Quality Index was used to collect sleep information. Logistic regression and restrictive cubic splines were conducted to explore the associations. Of the 37 164 enrolled participants, 13881 suffered from dyslipidemia. Compared to the reference groups, people who went to sleep after 23:00 or woke up after 7:30 had higher prevalence of dyslipidemia, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs)were 1.30 (1.20-1.41) and 1.34 (1.19-1.50). The adjusted OR (95%CI) of participants in the Late-sleep/Late-rise category compared to the Early-sleep/Early-rise category was 1.55 (1.08-1.23). Compared to the reference (7~≤8 h), the adjusted OR (95%CI) was 1.11 (1.03-1.20) for longer (>9 h) night sleep duration. Moreover, the combined effects of sleep duration (>9 h) with sleep time (22:00~) (OR = 1.46, 95%CI: 1.16-1.84), sleep duration (>9 h) with wake-up time (≥7:30) (OR = 1.28, 95%CI: 1.08-1.51), and sleep duration (>9 h) with the Late-sleep/Late-rise category (OR = 1.41, 95%CI: 1.14-1.75) increased the prevalence of dyslipidemia. Accordingly, our results indicate that delayed sleep timing and longer night sleep duration had independent and joint effects on higher risks of dyslipidemia in rural population.
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Affiliation(s)
- Ruifang Zhu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jing Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhihan Zhai
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Hongfei Zhao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Feng Jiang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Chunyang Sun
- Department of Preventive Medicine, School of Medicine, Henan University of Chinese Medicine, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ping Dou
- Department of Zhengzhou Center for Disease Control and Prevention, Zhengzhou, Henan, PR China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
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Badri M, Alkhaili M, Aldhaheri H, Yang G, Albahar M, Alrashdi A. From good sleep to health and to quality of life – a path analysis of determinants of sleep quality of working adults in Abu Dhabi. SLEEP SCIENCE AND PRACTICE 2023. [DOI: 10.1186/s41606-023-00083-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Abstract
Background
Sleep quality has significant impacts on many aspects of quality of life. Therefore, identifying the association of sleep quality with that quality of life domains could lead to deeper insights for social policymakers and professionals to enhance their understanding of the lives of Abu Dhabi working adults. This research focuses on sleep quality among working people in Abu Dhabi. The direct and indirect associations of sleep quality with various quality-of-life domains such as income and housing, physical and mental health, sport and activities, eating habits and obesity, work-life balance, online hours, and social connections are investigated and discussed.
Methods
Data were drawn from 36,515 full-time employees in both public, and private sectors, obtained from the third Abu Dhabi Quality of Life (QoL) survey aimed to cover all community members using online platforms. Informed by international research on sleep quality, preliminary investigation using correlation analysis and simple regression identified many well-being variables deemed necessary for inclusion in the path model. Path analysis was then performed.
Results
The final path model produced excellent fit measures. The significant variables directly associated with sleep quality included sleeping hours, social connection, satisfaction with income, satisfaction with residence, subjective physical and mental health, income satisfaction, satisfaction with the surrounding environment, frequency of eating healthy food, work-life balance, and online time. In addition, most variables recorded an indirect association to sleep quality through subjective health.
Conclusions
The importance of multidimensional linkages between many well-being factors influencing sleep quality and subjective health is underscored.
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Knapik JJ, Caldwell JA, Steelman RA, Trone DW, Farina EK, Lieberman HR. Short sleep duration is associated with a wide variety of medical conditions among United States military service members. Sleep Med 2023; 101:283-295. [PMID: 36470164 DOI: 10.1016/j.sleep.2022.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This cross-sectional study investigated self-reported sleep duration and its association with a comprehensive range of clinically-diagnosed medical condition categories (CDMCs), as well as the relationship between short sleep duration (≤6 h) and demographic/lifestyle factors, among United States military service members (SMs). METHODS A stratified random sample of SMs (n = 20,819) completed an online questionnaire on usual daily hours of sleep and demographic/lifestyle characteristics. CDMCs for a six-month period prior to questionnaire completion were obtained from a comprehensive military electronic medical surveillance system and grouped into 33 CDMCs covering both broad and specific medical conditions. Prevalence of CDMCs was compared among three sleep duration categories (≤4, 5-6 and ≥7 h). RESULTS SMs reported a mean ± standard deviation of 6.3 ± 1.4 h of sleep per day. After adjustment for demographic/lifestyle characteristics, shorter sleep duration was associated with higher odds of a medical condition in 25 of 33 CDMCs, with most (n = 20) demonstrating a dose-response relationship. The five CDMCs with the largest differences between ≤4 vs ≥ 7 h sleep were: diseases of the nervous system (odds ratio [OR] = 2.9, 95% confidence interval [95%CI] = 2.4-3.4), mental/behavioral diseases (OR = 2.7, 95%CI = 2.3-3.2), diseases of the musculoskeletal system (OR = 1.9, 95%CI = 1.6-2.1), diseases of the circulatory system (OR = 1.7, 95%CI = 1.3-2.2), and diseases of the digestive system (OR = 1.6, 95%CI = 1.2-2.0). Six hours of sleep or less was independently associated with older age, less formal education, race, Hispanic ethnicity, higher body mass index, smoking, and military service branch. CONCLUSIONS In this young, physically active population, reporting shorter sleep duration was associated with a higher risk of multiple CDMCs.
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Affiliation(s)
- Joseph J Knapik
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA.
| | - John A Caldwell
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA; Laulima Government Solutions, 5301 Buckystown Pike, STE 460, Frederick, MD, 21704, USA
| | - Ryan A Steelman
- U.S. Army Public Health Center, 8252 Blackhawk Rd, Aberdeen Proving Ground, MD, 21010, USA
| | - Daniel W Trone
- Naval Health Research Center, Building 329, Ryne Rd, San Diego, CA, 92152, USA
| | - Emily K Farina
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
| | - Harris R Lieberman
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
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Enderami A, Afshari M, Kheradmand M, Alizadeh-Navaei R, Hosseini SH, Moosazadeh M. Sleep profile status based on substance use, lipids and demographic variables in Tabari cohort study. Sleep Med X 2022; 4:100048. [PMID: 35592644 PMCID: PMC9112032 DOI: 10.1016/j.sleepx.2022.100048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 03/19/2022] [Accepted: 04/26/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND This study aims to investigate the situation of sleep profile and its related factors in the Tabari Cohort Tabari (TCS) population. METHODS The information of 10255 of the Tabari cohort population in the enrolment phase was used in this study. The sleep profile data was collected and recorded by trained questioners. The sleep duration in day & night, the time interval between going bed and falling asleep, continuous use of sedatives, involuntary nap, limb hypermobility during sleep and shift working were determined for each person. Data analysis was performed by independent T test and Pearson correlation coefficient. RESULTS Mean, standard deviation, median, minimum and maximum of sleep duration in this population were 7.6, 1.6, 7.5, 0.5 and 17 h. Frequency of sleeping less than 6 h, 6-10 h and more than 10 h were 1168(11.4%), 8463(82.5%) and 624(6.1%) respectively. Prevalence of sleeping more than 10 h among men and women were 5% and 6.8% respectively (P < 0.001). Prevalence of sedative routine use among men and women were 4.7% and 9.6% respectively (P < 0.001). There were significant relationships between sleep duration and area residence, age group (P < 0.001), education level (P < 0.001), socioeconomic level (P < 0.001), triglyceride (P = 0.002), HDL-cholesterol (P = 0.013) and Cholesterol total (P = 0.021). There was a negative correlation between age and sleep duration (r = -0.062, P < 0.001). CONCLUSION The results showed the association of the quality and quantity of sleep with personal, social, environmental and biological factors such as gender, age, economic status, educational status, and lipid profile. Therefore without proper intervention, the incidence of outcomes associated with these risk factors can be predicted in TCS In later years.
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Affiliation(s)
- Athena Enderami
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Afshari
- Pediatric Gastroenterology and Hepatology Research Center, Zabol University of Medical Sciences, Zabol, Iran
| | - Motahareh Kheradmand
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Hamzeh Hosseini
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Corresponding author.
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Akter S, Akhter H, Chaudhury HS, Rahman MH, Gorski A, Hasan MN, Shin Y, Rahman MA, Nguyen MN, Choi TG, Kim SS. Dietary carbohydrates: Pathogenesis and potential therapeutic targets to obesity-associated metabolic syndrome. Biofactors 2022; 48:1036-1059. [PMID: 36102254 DOI: 10.1002/biof.1886] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/01/2022] [Indexed: 02/06/2023]
Abstract
Metabolic syndrome (MetS) is a common feature in obesity, comprising a cluster of abnormalities including abdominal fat accumulation, hyperglycemia, hyperinsulinemia, dyslipidemia, and hypertension, leading to diabetes and cardiovascular diseases (CVD). Intake of carbohydrates (CHO), particularly a sugary diet that rapidly increases blood glucose, triglycerides, and blood pressure levels is the predominant determining factor of MetS. Complex CHO, on the other hand, are a stable source of energy taking a longer time to digest. In particular, resistant starch (RS) or soluble fiber is an excellent source of prebiotics, which alter the gut microbial composition, which in turn improves metabolic control. Altering maternal CHO intake during pregnancy may result in the child developing MetS. Furthermore, lifestyle factors such as physical inactivity in combination with dietary habits may synergistically influence gene expression by modulating genetic and epigenetic regulators transforming childhood obesity into adolescent metabolic disorders. This review summarizes the common pathophysiology of MetS in connection with the nature of CHO, intrauterine nutrition, genetic predisposition, lifestyle factors, and advanced treatment approaches; it also emphasizes how dietary CHO may act as a key element in the pathogenesis and future therapeutic targets of obesity and MetS.
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Affiliation(s)
- Salima Akter
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
- Department of Medical Biotechnology, Bangladesh University of Health Sciences, Dhaka 1216, Bangladesh
| | - Hajara Akhter
- Biomedical and Toxicological Research Institute, Bangladesh Council of Scientific and Industrial Research (BCSIR), Dhaka 1205, Bangladesh
| | - Habib Sadat Chaudhury
- Department of Biochemistry, International Medical College Hospital, Tongi 1711, Bangladesh
| | - Md Hasanur Rahman
- Department of Biotechnology and Genetic Engineering, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj 8100, Bangladesh
| | - Andrew Gorski
- Department of Philosophy in Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | | | - Yoonhwa Shin
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
- Biomedical Science Institute, Kyung Hee University, Seoul 02447, Republic of Korea
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Md Ataur Rahman
- Department of Pathology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
- Korean Medicine-Based Drug Repositioning Cancer Research Center, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
- Global Biotechnology & Biomedical Research Network (GBBRN), Department of Biotechnology and Genetic Engineering, Faculty of Biological Sciences, Islamic University, Kushtia 7003, Bangladesh
| | - Minh Nam Nguyen
- Research Center for Genetics and Reproductive Health, School of Medicine, Vietnam National University, Ho Chi Minh City, Vietnam
| | - Tae Gyu Choi
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Sung-Soo Kim
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
- Pristine Pharmaceuticals, Patuakhali 8600, Bangladesh
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
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Chen Z, Zhang X, Duan Y, Mo T, Liu W, Ma Y, Yin P. The Relationship Between Sleep Duration and Blood Lipids Among Chinese Middle-Aged and Older Adults: Cross-Lagged Path Analysis From CHARLS. Front Public Health 2022; 10:868059. [PMID: 35646780 PMCID: PMC9136093 DOI: 10.3389/fpubh.2022.868059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
This study used data from the China Health and Retirement Longitudinal Study to investigate the temporal relationship between blood lipids and sleep duration in Chinese middle-aged and older adults. We used medical examinations and questionnaire data of 5,016 Chinese middle-aged and older adults (age 45+) in 2011 and 2015. Cross-lagged path analysis was performed to examine the bidirectional relationships between blood lipids and sleep duration. Sleep duration and lipids data were analyzed as continuous variables. Temporal relationships between sleep duration and HDL-cholesterol, LDL-cholesterol, total cholesterol, and triglycerides were different. Sleep duration was negatively associated with HDL-cholesterol 4 year later (β1 = −0.171, P = 0.005), and HDL-cholesterol was negatively associated with sleep duration 4 year later (β2 = −0.006, P = 0.002). Longer sleep duration was associated lower levels of LDL-cholesterol (β1 = −0.275, P = 0.097) and total cholesterol (β1 = −0.329, P = 0.096) 4 year later. There was a positive correlation between triglycerides and sleep duration. The path coefficient from triglycerides to sleep duration 4 year later (β2 = 0.001, P = 0.018) was greater than that from sleep duration to triglycerides 4 year later (β1 = 0.109, P = 0.847), with P = 0.030 for the difference between β1 and β2. In stratified analysis, we found that the strength and direction of the relationships may be related to age and BMI. Effects of sleep duration on blood lipids were only observed among participants aged <60 years, while the effect in the opposite direction was observed in older adults (age 60+), and the cross-lagged path coefficients were more significant in adults with BMI > 25.
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Affiliation(s)
- Ziwei Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xia Zhang
- The First People's Hospital of Jingzhou, Jingzhou, China
| | - Yanran Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tingting Mo
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenli Liu
- Department of Statistics, East China Normal University, Shanghai, China
| | - Yilei Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Yilei Ma
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Ping Yin
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8
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Du J, Chen Y, Zhou N, Song Y, Wang W, Hong X. Associations between self-reported sleep duration and abnormal serum lipids in eastern China: a population-based cross-sectional survey. Sleep Med 2022; 95:1-8. [DOI: 10.1016/j.sleep.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/21/2022] [Accepted: 04/06/2022] [Indexed: 11/28/2022]
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9
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Meguro K, Svensson T, Chung UI, Svensson AK. Associations of work-related stress and total sleep time with cholesterol levels in an occupational cohort of Japanese office workers. J Occup Health 2021; 63:e12275. [PMID: 34679211 PMCID: PMC8535434 DOI: 10.1002/1348-9585.12275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 08/04/2021] [Accepted: 08/09/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE The aim of the study was to investigate the associations of total sleep time (TST) and occupational stress based on the Brief Job Stress Questionnaire (BJSQ) with cholesterol levels in an occupational cohort of Japanese office workers. METHODS The present study is a secondary analysis of a subset of participants from a randomized controlled trial. Participants were 179 employees from 5 companies in Tokyo who participated as the intervention group in a 3-month lifestyle intervention study among office workers with metabolic syndrome or at risk of metabolic syndrome. All intervention-group participants used a mobile app and a wearable device. The final population for analysis in the present study were 173 participants. Cholesterol measures were derived from participants' annual health check-up data in the fiscal year preceding their inclusion in the study. Multiple linear regression models were used to determine the association between exposures and outcome. RESULTS Overall, stress levels were significantly and inversely associated with LDL-C (-7.12 mg/dl; 95% CI: -11.78, -2.45) and LDL-C/HDL-C ratio (-0.16 mg/dl; 95% CI: -0.27, -0.04) per standard deviation increase. Compared to average TST 5.9-7.2 hours, average TST of 4.0-5.3 hours (-4.82 mg/dl; 95% CI: -9.22, -0.43) was inversely associated with HDL-C. CONCLUSION Incremental increases of stress were significantly and inversely associated with LDL-C and LDL-C/HDL-C ratio. The shortest average TST was inversely associated with HDL-C. The results should be interpreted with care given certain methodological limitations.
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Affiliation(s)
- Keiko Meguro
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Bunkyo, Japan.,School of Health Innovation, Kanagawa University of Human Services Graduate School, Kawasaki, Japan
| | - Thomas Svensson
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Bunkyo, Japan.,School of Health Innovation, Kanagawa University of Human Services Graduate School, Kawasaki, Japan.,Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ung-Il Chung
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Bunkyo, Japan.,School of Health Innovation, Kanagawa University of Human Services Graduate School, Kawasaki, Japan.,Clinical Biotechnology, Center for Disease Biology and Integrative Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo, Japan
| | - Akiko K Svensson
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Bunkyo, Japan.,Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.,Department of Diabetes and Metabolic Diseases, The University of Tokyo, Bunkyo, Japan
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Zhang J, Zhang J, Wu H, Wang R. Sleep duration and risk of hyperlipidemia: a systematic review and meta-analysis of prospective studies. Sleep Breath 2021; 26:997-1010. [PMID: 34618292 DOI: 10.1007/s11325-021-02504-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 09/28/2021] [Accepted: 09/30/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Current studies indicate that the association between sleep duration and risk of hyperlipidemia is uncertain. This systematic review aimed to evaluate relevant prospective studies and make a definite conclusion. METHODS Three databases were searched for prospective studies on the relationship between sleep duration and hyperlipidemia risk from their inception to October 2020. RESULTS We identified twelve studies involving 114,439 participants. Follow-up for incident hyperlipidemia ranged from 200 days to 10 years. Neither long (RR:1.00, 95%CI:0.90-1.11, P > 0.05) nor short (RR:0.99, 95%CI:0.94-1.05, P > 0.05) sleep duration had a significant association with increased hyperlipidemia risk in adults. However, long sleep duration was decidedly associated with low HDL-C (RR:0.19, 95%CI: - 0.03-0.40, P < 0.05) and high triglycerides (RR: - 0.20, 95%CI: - 0.43-0.03, P < 0.05) in children and adolescents. CONCLUSION Long sleep duration has strong associations with risks of low HDL-C and high triglycerides in children and adolescents. The mechanisms underlying this association deserves to be explored in future studies.
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Affiliation(s)
- Jinjia Zhang
- Department of General Practice, Second Hospital of Hebei Medical University, Heping Western Road No. 215, Shijiazhuang, 050000, Hebei, China
| | - Jinxin Zhang
- Department of Neurology, Weixian People's Hospital, Weixian, Xingtai, 054700, Hebei, China
| | - Huadong Wu
- Department of Gastrointestinal Surgery, Second Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei, China
| | - Rongying Wang
- Department of General Practice, Second Hospital of Hebei Medical University, Heping Western Road No. 215, Shijiazhuang, 050000, Hebei, China.
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11
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Contribution of sleep characteristics to the association between obstructive sleep apnea and dyslipidemia. Sleep Med 2021; 84:63-72. [PMID: 34111805 DOI: 10.1016/j.sleep.2021.05.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVES/BACKGROUND Little information is available about the association of obstructive sleep apnea (OSA) with atherogenic dyslipidemia and the contribution of sleep characteristics to lipid alterations. We compare dyslipidemia prevalence among non-apneic subjects and mild-severe OSA patients to identify the sleep characteristics that are independently associated with dyslipidemia and serum lipid levels in OSA patients. PATIENTS/METHODS We recruited 809 consecutive patients who had been referred for polysomnography study by OSA suspicion. Anthropometric characteristics, body composition and comorbidities were recorded. Spirometry and 24-h ambulatory blood pressure monitoring were performed the same day of the sleep study. The day after attended polysomnography, fasting blood samples were drawn to measure the lipid profile. RESULTS Dyslipidemia prevalence increased with the presence of OSA, from non-OSA subjects to mild, moderate and severe OSA patients (31%, 33%, 42% and 51%, respectively; p < 0.001). After adjusting for sex, age, body mass index and smoking habit, only severe OSA had an independent association with dyslipidemia when compared to non-OSA subjects (adjusted odds ratio 1.71, 95%CI 1.09 to 2.69, p = 0.019). In OSA patients, multivariate logistic regression identified active smoking, apnea-hypopnea index (AHI) and mean nocturnal saturation as variables independently associated with dyslipidemia. However, in these patients, arousal index, slow wave sleep duration and REM latency were also independently associated with cholesterol and low-density lipoprotein levels. CONCLUSIONS The association between dyslipidemia and OSA is limited to severe patients, with high AHI and nocturnal hypoxemia. However, sleep fragmentation and increased sympathetic activity could also contribute to OSA-related lipid dysregulation.
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Nie F, Wang Z, Zeng Q, Guan H, Yang J, Luo P, Du L, Wang J, Hong F. Health behaviors and metabolic risk factors are associated with dyslipidemia in ethnic Miao Chinese adults: the China multi-ethnic cohort study. BMC Public Health 2021; 21:851. [PMID: 33941138 PMCID: PMC8091723 DOI: 10.1186/s12889-021-10871-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/19/2021] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Cardiovascular risk factors in Chinese ethnic minority groups are rarely reported. OBJECTIVE To quantify the cardiovascular risk factors in Miao Chinese adults and to examine the association of health behaviors and metabolic risk factors with dyslipidemia. METHODS A cross-sectional analysis was conducted using baseline data from the China Multi-Ethnic Cohort (CMEC) study. A representative sample of 5559 Miao participants aged 30 to 79 years were surveyed and given physical and laboratory exams. The proportion of behavioral and metabolic risk factors were described in ethnic Miao adults. Logistic regression was utilized to evaluate the odds ratio (OR) and 95% confidence interval (CI) of the association between health behaviors and metabolic risk factors with dyslipidemia. RESULTS In Miao Chinese adults, the prevalence of dyslipidemia was 32.8%. After multivariate adjustment, subjects with poor waist-to-hip ratio (WHR), body mass index (BMI), fasting blood glucose (FBG) and blood pressure (BP) were more likely to have higher risk of triglycerides (TG) abnormality, regardless of gender and age. Furthermore, the strongly association was detected between poor WHR and low density lipoprotein cholesterol (LDL-C) abnormality (adjusted OR = 5.24, 95%CI: 2.42-11.34) in the older subgroup (≥ 60 years). Males who current smoking were an independent risk factor only for high density lipoprotein cholesterol (HDL-C) abnormality (adjusted OR = 1.44, 95%CI: 1.05-1.99). However, in the subgroup age, current smoker were at greater risk of high TG and low HDL-C. Males with regular drinking were less likely to be high LDL-C (adjusted OR = 0.51, 95%CI: 0.32-0.81). CONCLUSIONS The present findings indicated that Miao adults with metabolic risk factors were at greater risk of dyslipidemia.
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Affiliation(s)
- Fang Nie
- School of Public Health, The Key Laboratory Of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
- School of Public Health, Guizhou Medical University, Guiyang, 550025, China
| | - Ziyun Wang
- School of Public Health, The Key Laboratory Of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Qibing Zeng
- School of Public Health, The Key Laboratory Of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Han Guan
- School of Public Health, The Key Laboratory Of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Jingyuan Yang
- School of Public Health, The Key Laboratory Of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Peng Luo
- School of Public Health, The Key Laboratory Of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Lunwei Du
- School of Public Health, The Key Laboratory Of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
- School of Public Health, Guizhou Medical University, Guiyang, 550025, China
| | - Junhua Wang
- School of Public Health, The Key Laboratory Of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China.
| | - Feng Hong
- School of Public Health, The Key Laboratory Of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China.
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Xiao Q, Qian J, Evans DS, Redline S, Lane NE, Ancoli-Israel S, Scheer FAJL, Stone K. Cross-sectional and Prospective Associations of Rest-Activity Rhythms With Metabolic Markers and Type 2 Diabetes in Older Men. Diabetes Care 2020; 43:2702-2712. [PMID: 32887712 PMCID: PMC7576417 DOI: 10.2337/dc20-0557] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 08/15/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Disruption of rest-activity rhythms is cross-sectionally associated with metabolic disorders, including type 2 diabetes, yet it remains unclear whether it predicts impaired glucose metabolism and homeostasis. The aim of this study is to examine the cross-sectional and prospective associations between rest-activity rhythm characteristics and glycemic measures in a cohort of older men. RESEARCH DESIGN AND METHODS Baseline rest-activity rhythms were derived from actigraphy with use of extended cosine model analysis. With subjects fasting, glucose, insulin, and HOMA of insulin resistance (HOMA-IR) were measured from blood at baseline and after ∼3.5 years. Type 2 diabetes was defined based on self-report, medication use, and fasting glucose. RESULTS In the cross-sectional analysis (n = 2,450), lower 24-h amplitude-to-mesor ratio (i.e., mean activity-adjusted rhythm amplitude) and reduced overall rhythmicity were associated with higher fasting insulin and HOMA-IR (all P trend < 0.0001), indicating increased insulin resistance. The odds of baseline type 2 diabetes were significantly higher among those in the lowest quartile of amplitude (Q1) (odds ratio [OR]Q1 vs. Q4 1.63 [95% CI 1.14, 2.30]) and late acrophase group (ORlate vs. normal 1.46 [95% CI 1.04, 2.04]). In the prospective analysis (n = 861), multiple rest-activity characteristics predicted a two- to threefold increase in type 2 diabetes risk, including a lower amplitude (ORQ1 vs. Q4 3.81 [95% CI 1.45, 10.00]) and amplitude-to-mesor ratio (OR 2.79 [95% CI 1.10, 7.07]), reduced overall rhythmicity (OR 3.49 [95% CI 1.34, 9.10]), and a late acrophase (OR 2.44 [1.09, 5.47]). CONCLUSIONS Rest-activity rhythm characteristics are associated with impaired glycemic metabolism and homeostasis and higher risk of incident type 2 diabetes.
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Affiliation(s)
- Qian Xiao
- Department of Epidemiology, Human Genetics and Environmental Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX
| | - Jingyi Qian
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA .,Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA
| | - Daniel S Evans
- Research Institute, California Pacific Medical Center Research Institute, San Francisco, CA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Boston, MA
| | - Nancy E Lane
- Center for Musculoskeletal Health, Medicine and Rheumatology, University of California at Davis School of Medicine, Sacramento, CA
| | - Sonia Ancoli-Israel
- Departments of Psychiatry and Medicine, University of California, San Diego, La Jolla, CA.,Department of Veterans Affairs San Diego Center of Excellence for Stress and Mental Health, La Jolla, CA
| | - Frank A J L Scheer
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA
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Song Q, Liu X, Zhou W, Wu S, Wang X. Night sleep duration and risk of each lipid profile abnormality in a Chinese population: a prospective cohort study. Lipids Health Dis 2020; 19:185. [PMID: 32799877 PMCID: PMC7429803 DOI: 10.1186/s12944-020-01363-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 08/10/2020] [Indexed: 01/28/2023] Open
Abstract
Background To explore the associations between sleep duration and abnormalities in serum lipid levels in a Chinese population. Methods A prospective study was conducted with 34,260 participants from the general Chinese population. Sleep duration was categorized as ≤5, 6, 7, 8 or ≥ 9 h. Each lipid profile abnormality was defined according to the Chinese Guidelines for the Prevention and Treatment of Dyslipidemia in Adults (2016). The Cox proportional hazards model was used to assess the association between sleep duration and dyslipidemia. Results Compared with a 7 h sleep duration, long sleep duration (≥9 h) was significantly associated with low high-density lipoprotein cholesterol (HDL-C) levels (hazard ratio (HR): 1.24; 95% CI: 1.12–1.38). In subgroup analyses, the positive association between long sleep duration and low HDL-C level in men and in the different age groups was more pronounced than the association in women. No significant interactions were observed in the association between sleep duration and each abnormal serum lipid level by sex/age in the study population (P-interaction> 0.05). Conclusions These findings suggest that long sleep duration is associated with low HDL-C level among the Kailuan community population.
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Affiliation(s)
- Qiaofeng Song
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, No.65 Shengli Road, Lunan District, Tangshan, 063000, China
| | - Xiaoxue Liu
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, No.65 Shengli Road, Lunan District, Tangshan, 063000, China
| | - Wenhua Zhou
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, No.65 Shengli Road, Lunan District, Tangshan, 063000, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, 063000, China.
| | - Xizhu Wang
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, No.65 Shengli Road, Lunan District, Tangshan, 063000, China.
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Sleep Duration, Lipid Profile and Insulin Resistance: Potential Role of Lipoprotein(a). Int J Mol Sci 2020; 21:ijms21134680. [PMID: 32630105 PMCID: PMC7369827 DOI: 10.3390/ijms21134680] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/22/2020] [Accepted: 06/28/2020] [Indexed: 11/29/2022] Open
Abstract
Lipoprotein (a) (Lp(a)) is considered a genetic factor for cardiovascular disease playing an important role in atherogenesis and thrombosis, but the evidence about its association with sleep duration is controversial. We evaluated the relation between self-reported sleep duration and Lp(a). Among 1600 participants of the population-based sample, we selected 1427 subjects without previously known cardiovascular events, who answered the questions about their sleep duration; had valid lipid profile results (total cholesterol, low- and high-density lipoproteins, Lp(a), apolipoprotein AI (ApoAI), ApoB, and ApoB/ApoAI); and did not take lipid-lowering drugs (mean age 46 ± 12 years). We performed a structured interview, which included questions about lifestyle, medical history, complaints, and sleep duration (How long have you been sleeping per night during the last month?). Sleep duration was classified as follows: <6 h/night—short, 6–9 h/night—normal, and ≥10 h/night—long. Overall, 73 respondents (5.2%) were short-sleepers and 69 (4.8%) long-sleepers. Males were slightly more prevalent among short-sleepers. The groups matched by age, body mass index, blood pressure, diabetes mellitus, and hypertension rate. Short-sleepers had lower rates of high total cholesterol (≥5.0 mmol/L), lower Lp(a) levels and lower rates of increased Lp(a) ≥0.5 g/L, and higher insulin and insulin resistance (assessed by the homeostatic model assessment for insulin resistance (HOMA-IR)). ApoAI, ApoB, their ratio, and other lab tests were similar in the groups. The multinomial logistic regression demonstrated that only the short sleep duration was independently (odds ratio (OR) 0.29, 95% confidence interval (CI) (0.09–0.91), p = 0.033) associated with Lp(a) (χ2 = 41.58, p = 0.003). Other influencing factors were smoking and HOMA-IR. Such an association was not found for long-sleepers. In conclusion, a short-sleep duration is associated with Lp(a). The latter might mediate the higher insulin resistance and higher cardiometabolic risks in short-sleepers.
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Yang L, Ma L, Guo W, Fang Q, Lai X, Zhang X. Interaction of polymorphisms in APOA4-APOA5-ZPR1-BUD13 gene cluster and sleep duration on 5-year lipid changes in middle aged and older Chinese. Sleep 2020; 42:5513402. [PMID: 31181149 DOI: 10.1093/sleep/zsz115] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 03/24/2019] [Indexed: 12/31/2022] Open
Abstract
STUDY OBJECTIVES Lipid profiles are influenced by both genetic and environmental factors. Genetic variants in the APOA4-APOA5-ZPR1-BUD13 gene cluster and aberrant sleep duration were independently identified to be associated with lipids in previous studies. We aimed to investigate whether sleep duration modified the genetic associations with longitudinal lipids changes. METHODS Four single nucleotide polymorphisms (SNPs), rs17119975, rs651821, rs7396835, and rs964184 in the APOA4-APOA5-ZPR1-BUD13 gene cluster were genotyped among 8648 apparently healthy subjects from the Dongfeng-Tongji (DFTJ) cohort. Information on sleep duration was obtained by questionnaires. Changes in total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), were evaluated from baseline to 5-year follow-up. RESULTS After multivariate adjustments, we found that rs651821 and weighted genetic risk score (GRS) were significantly associated with increased triglyceride, and the genetic association with triglyceride change consistently strengthened across sleep duration categories. The differences in triglyceride changes per increment of risk allele for rs651821 were 0.028 (SE = 0.017, p = 0.112), 0.051 (SE = 0.009, p < 0.001), and 0.064 (SE = 0.016, p < 0.001) in individuals with sleep duration ≤7, >7-<9, and ≥9 h, respectively (p interaction = 0.031). The GRS also showed a significant interaction with sleep duration categories for triglyceride change (p interaction = 0.010). In addition, all of the four SNPs and GRS were inversely related to HDL-c changes. CONCLUSIONS Longer sleep duration might exacerbate the adverse effects of SNPs in APOA4-APOA5-ZPR1-BUD13 gene cluster on 5-year triglyceride changes.
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Affiliation(s)
- Liangle Yang
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lin Ma
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenting Guo
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qin Fang
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuefeng Lai
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Smiley A, King D, Harezlak J, Dinh P, Bidulescu A. The association between sleep duration and lipid profiles: the NHANES 2013-2014. J Diabetes Metab Disord 2019; 18:315-322. [PMID: 31890656 DOI: 10.1007/s40200-019-00415-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 05/27/2019] [Indexed: 12/21/2022]
Abstract
Background In the current literature, the association between sleep and different lipids is inconsistent. We aimed to assess the association of sleep with HDL cholesterol, triglyceride, and LDL cholesterol in the National Health and Nutrition Examination Survey (NHANES), 2013/2014. Methods We included 2705 participants from NHANES, 2013/2014. Cross-sectional information was measured on sleep duration and HDL cholesterol/triglyceride/LDL cholesterol. Generalized additive models (GAM) were constructed to assess the smooth relationship between the HDL cholesterol/triglyceride/LDL cholesterol, and the sleep duration. Models were adjusted for age, sex, race, marital status, household size, sitting time and physical activity. Effective degree of freedom (EDF) value in GAM indicated the amount of non-linearity of the smooth. EDF = 1 was indicative of a linear pattern of association. A value greater than 1 denoted a more complex association between outcome and sleep duration. Results The highest mean HDL cholesterol level was observed in participants sleeping 8 h/day. There was a significant non-linear association between sleep duration and HDL cholesterol in unadjusted GAM (EDF = 2.58, P = 0.002) and adjusted GAM (EDF = 1.85, P = 0.003). The lowest mean triglyceride level was observed in people sleeping 6 h/day. There was a significant non-linear association between sleep duration and triglyceride in unadjusted GAM (EDF = 3.05, P = 0.02) and adjusted GAM (EDF = 1.78, P = 0.02). There was no significant non-linear association between sleep duration and LDL cholesterol in either unadjusted GAM (EDF = 1.01, P = 0.2) or adjusted GAM (EDF = 1.01, P = 0.8). Conclusion Short sleep duration was associated with low HDL cholesterol/high triglyceride. Further longitudinal studies are warranted to shed extra light on this relationship.
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Affiliation(s)
- Abbas Smiley
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, 1025 E 7th St., Bloomington, IN 47405 USA
| | - David King
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, 1025 E 7th St., Bloomington, IN 47405 USA
| | - Jaroslaw Harezlak
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, 1025 E 7th St., Bloomington, IN 47405 USA
| | - Paul Dinh
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, 1025 E 7th St., Bloomington, IN 47405 USA
| | - Aurelian Bidulescu
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, 1025 E 7th St., Bloomington, IN 47405 USA
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Gordon-Dseagu VLZ, Derkach A, Xiao Q, Williams I, Sampson J, Stolzenberg-Solomon RZ. The association of sleep with metabolic pathways and metabolites: evidence from the Dietary Approaches to Stop Hypertension (DASH)-sodium feeding study. Metabolomics 2019; 15:48. [PMID: 30879189 PMCID: PMC8513072 DOI: 10.1007/s11306-019-1472-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 01/04/2019] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Sleep is increasingly being viewed as an issue of public health concern, yet few epidemiologic studies have explored associations between sleep habits and metabolomic profile. OBJECTIVES To assess the association between sleep and blood metabolites. METHODS We examined the association between sleep and 891 fasting plasma metabolites in a subgroup of 106 participants from the Dietary Approaches to Stop Hypertension (DASH)-Sodium feeding trial (1997-1999). We produced two sleep variables to analyze, sleep midpoint (median time between bedtime and waketime) and sleep duration, as well as bedtime and wake time. Metabolites were measured using liquid and gas chromatography, coupled with mass spectrometry. We assessed associations between sleep variables and log transformed metabolites using linear mixed-effects models. We combined the resulting p-values using Fisher's method to calculate associations between sleep and 38 metabolic pathways. RESULTS Sixteen pathways were associated (p < 0.05) with midpoint. Only the γ-glutamyl amino acid metabolism pathway reached Bonferroni-corrected threshold (0.0013). Eighty-three metabolites were associated with midpoint (FDR < 0.20). Similar associations were found for wake time. Neither bed time nor duration were strongly associated. The top metabolites (pathways given in brackets) associated with sleep were erythrulose (advanced glycation end-product) (positive association) and several γ-glutamyl pathway metabolites, including CMPF (fatty acid, dicarboxylate), isovalerate (valine, leucine and isoleucine and fatty acid metabolism) and HWESASXX (polypeptide) (inverse association). CONCLUSION Within our study, several metabolites that have previously been linked to inflammation and oxidative stress (processes involved in diseases such as cardiovascular disease and cancer) were found to be associated with sleep.
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Affiliation(s)
- Vanessa L Z Gordon-Dseagu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20850, USA.
| | - Andriy Derkach
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20850, USA
| | - Qian Xiao
- Department of Health and Human Physiology, College of Liberal Arts and Sciences, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Ishmael Williams
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20850, USA
| | - Joshua Sampson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20850, USA
| | - Rachael Z Stolzenberg-Solomon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20850, USA
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Cespedes Feliciano EM, Quante M, Rifas-Shiman SL, Redline S, Oken E, Taveras EM. Objective Sleep Characteristics and Cardiometabolic Health in Young Adolescents. Pediatrics 2018; 142:peds.2017-4085. [PMID: 29907703 PMCID: PMC6260972 DOI: 10.1542/peds.2017-4085] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/10/2018] [Indexed: 12/22/2022] Open
Abstract
UNLABELLED : media-1vid110.1542/5778442247001PEDS-VA_2017-4085Video Abstract BACKGROUND AND OBJECTIVES: Shorter sleep duration is associated with childhood obesity. Few studies measure sleep quantity and quality objectively or examine cardiometabolic biomarkers other than obesity. METHODS This cross-sectional study of 829 adolescents derived sleep duration, efficiency and moderate-to-vigorous physical activity from >5 days of wrist actigraphy recording for >10 hours/day. The main outcome was a metabolic risk score (mean of 5 sex-specific z-scores for waist circumference, systolic blood pressure, high-density lipoprotein cholesterol scaled inversely, and log-transformed triglycerides and homeostatic model assessment of insulin resistance), for which higher scores indicate greater metabolic risk. Secondary outcomes included score components and dual-energy radiograph absorptiometry fat mass. We measured socioeconomic status, race and/or ethnicity, pubertal status, and obesity-related behaviors (television-viewing and fast food and sugar-sweetened beverage consumption) using questionnaires. RESULTS The sample was 51.5% girls; mean (SD) age 13.2 (0.9) years, median (interquartile range) sleep duration was 441.1 (54.8) minutes per day and sleep efficiency was 84.0% (6.3). Longer sleep duration was associated with lower metabolic risk scores (-0.11 points; 95% CI: -0.19 to -0.02, per interquartile range). Associations with sleep efficiency were similar and persisted after adjustment for BMI z score and physical activity, television-viewing, and diet quality. Longer sleep duration and greater sleep efficiency were also favorably associated with waist circumference, systolic blood pressure, high-density lipoprotein cholesterol, and fat mass. CONCLUSIONS Longer sleep duration and higher sleep efficiency were associated with a more favorable cardiometabolic profile in early adolescence, independent of other obesity-related behaviors. These results support the need to assess the role of sleep quantity and quality interventions as strategies for improving cardiovascular risk profiles of adolescents.
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Affiliation(s)
| | - Mirja Quante
- Division of Sleep and Circadian Disorders, Department
of Medicine, Brigham and Women’s Hospital and Beth Israel Deaconess
Medical Center,,Department of Neonatology, University of
Tübingen, Tübingen, Germany; and
| | - Sheryl L. Rifas-Shiman
- Division of Chronic Disease Research Across the
Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care
Institute, Harvard Medical School, and
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Department
of Medicine, Brigham and Women’s Hospital and Beth Israel Deaconess
Medical Center
| | - Emily Oken
- Division of Chronic Disease Research Across the
Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care
Institute, Harvard Medical School, and
| | - Elsie M. Taveras
- Department of Nutrition, Harvard T. H. Chan School of
Public Health, Harvard University, Boston, Massachusetts;,Division of General Academic Pediatrics,
Massachusetts General Hospital for Children, Boston, Massachusetts
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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] [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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Kruisbrink M, Robertson W, Ji C, Miller MA, Geleijnse JM, Cappuccio FP. Association of sleep duration and quality with blood lipids: a systematic review and meta-analysis of prospective studies. BMJ Open 2017; 7:e018585. [PMID: 29247105 PMCID: PMC5735405 DOI: 10.1136/bmjopen-2017-018585] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 11/09/2017] [Accepted: 11/09/2017] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To assess the longitudinal evidence of the relationships between sleep disturbances (of quantity and quality) and dyslipidaemia in the general population and to quantify such relationships. SETTING Systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. METHODS We performed a systematic search of PubMed and Embase (up to 9 September 2017), complemented with manual searches, of prospective population studies describing the association between sleep duration and quality and the incidence of dyslipidaemias. Relative risks (95% CIs) were extracted and pooled using a random effects model. Subgroup analyses by lipid type were performed. Heterogeneity and publication bias were also assessed. Quality was assessed with Downs and Black score. PARTICIPANTS Studies were included if they were prospective, had measured sleep quantity and/or quality at baseline and either incident cases of dyslipidaemia or changes in blood lipid fractions assessed prospectively. PRIMARY OUTCOME MEASURES Incidence of dyslipidaemia and changes in lipid fractions. Dyslipidaemia was defined as a high total cholesterol, triglycerides, low-density lipoprotein cholesterol or low high-density lipoprotein cholesterol compared with the reference group. RESULTS Thirteen studies were identified (eight using sleep duration, four sleep quality and one both). There was heterogeneity in the sleep quality aspects and types of lipids assessed. Classification of sleep duration (per hour/groups) also varied widely. In the pooled analysis of sleep duration (6 studies, 16 cohort samples; 30 033 participants; follow-up 2.6-10 years), short sleep was associated with a risk of 1.01 (95% CI 0.93 to 1.10) of developing dyslipidaemia, with moderate heterogeneity (I2=56%, P=0.003) and publication bias (P=0.035). Long sleep was associated with a risk of 0.98 (95% CI 0.87 to 1.10) for dyslipidaemia, with heterogeneity (I2=63%, P<0.001) and no significant publication bias (P=0.248). CONCLUSION The present analysis was unable to find supportive evidence of a significant relationship between sleep duration and the development of dyslipidaemia. However, heterogeneity and small number of studies limit the interpretation. PROSPERO REGISTRATION NUMBER CRD42016045242.
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Affiliation(s)
- Marlot Kruisbrink
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Wendy Robertson
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Chen Ji
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Michelle A Miller
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Johanna M Geleijnse
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Francesco P Cappuccio
- ESH Centre of Excellence in Hypertension & Cardiometabolic Research, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
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Godin O, Henry C, Leboyer M, Azorin JM, Aubin V, Bellivier F, Polosan M, Courtet P, Gard S, Kahn JP, Loftus J, Passerieux C, Costagliola D, Etain B. Sleep quality, chronotype and metabolic syndrome components in bipolar disorders during the remission period: Results from the FACE-BD cohort. Chronobiol Int 2017; 34:1114-1124. [PMID: 28910540 DOI: 10.1080/07420528.2017.1332071] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Data on sleep or circadian abnormalities and metabolic disturbances in euthymic bipolar disorders are scarce and based on small sample sizes. The aim of this study was to explore the associations between sleep disturbances, chronotype and metabolic components in a large sample of euthymic patients with bipolar disorders (BD). From 2009 to 2015, 752 individuals with bipolar disorders from the FACE-BD cohort were included and assessed for sleep quality, chronotype and metabolic components. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) was used to confirm the diagnosis of BD. Subjective sleep quality was measured with the Pittsburgh Sleep Quality Index and chronotype with the Composite Scale of Morningness. Sociodemographic and clinical characteristics, psychotropic treatment, psychiatric comorbidities and blood samples were collected. In our sample, 22.4% of individuals with BD presented with a metabolic syndrome, 53.7% had sleep disturbances, 25.4% were considered as having an evening chronotype and 12.6% as having a morning chronotype. Independently of potential confounders, euthymic patients with sleep disturbances had a higher abdominal circumference, and patients with evening chronotype had a significantly higher level of triglycerides. There was an association between evening chronotype and an increased atherogenic index of plasma (OR = 4.8, 95%CI = 1.6-14.7). Our findings contribute the scant literature on the relationship between sleep quality, chronotype and cardiometabolic components in euthymic individuals with BD and highlight the need to improve quality of sleep and patient education about healthier sleep-hygiene practices.
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Affiliation(s)
- Ophélia Godin
- a Université Pierre et Marie Curie, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP UMRS , Paris , France.,b INSERM , UMRS, Paris , France.,e Fondation FondaMental, fondation de cooperation scientifique , Créteil , France
| | - Chantal Henry
- c INSERM , Equipe 15 Genetic Psychiatry, Creteil , France.,d University Paris-Est, UMR_S955, UPEC , Creteil , France.,e Fondation FondaMental, fondation de cooperation scientifique , Créteil , France.,f AP-HP, Hôpital H. Mondor - A. Chenevier, Pôle de psychiatrie , Créteil , France
| | - Marion Leboyer
- c INSERM , Equipe 15 Genetic Psychiatry, Creteil , France.,d University Paris-Est, UMR_S955, UPEC , Creteil , France.,e Fondation FondaMental, fondation de cooperation scientifique , Créteil , France.,f AP-HP, Hôpital H. Mondor - A. Chenevier, Pôle de psychiatrie , Créteil , France
| | - Jean-Michel Azorin
- e Fondation FondaMental, fondation de cooperation scientifique , Créteil , France.,g Psychiatric Department , Hôpital Sainte-Marguerite , Marseille , France
| | - Valerie Aubin
- e Fondation FondaMental, fondation de cooperation scientifique , Créteil , France.,h Psychiatric Department , Centre hospitalier Princess Grace , Monaco , France
| | - Frank Bellivier
- e Fondation FondaMental, fondation de cooperation scientifique , Créteil , France.,i AP-HP, GH Saint-Louis - Lariboisière - Fernand Widal, Pôle Neurosciences , Tête et Cou -; University Paris Diderot and INSERM UMR-S , Paris , France
| | - Mircea Polosan
- e Fondation FondaMental, fondation de cooperation scientifique , Créteil , France.,j University Joseph Fourier, Grenoble I , Grenoble , France.,k CHU de Grenoble , Grenoble , France.,l Grenoble Institut des Neurosciences (GIN) Inserm, Chemin Fortuné Ferrini , La Tronche , France
| | - Philippe Courtet
- e Fondation FondaMental, fondation de cooperation scientifique , Créteil , France.,m Psychiatric Emergency Department.,n INSERM, Montpellier Univsersity , Montpellier , France
| | - Sebastien Gard
- e Fondation FondaMental, fondation de cooperation scientifique , Créteil , France.,o Centre Expert Bipolaire, Pôle de Psychiatrie Générale Universitaire, Centre Hospitalier Charles Perrens , Bordeaux , France
| | - Jean-Pierre Kahn
- e Fondation FondaMental, fondation de cooperation scientifique , Créteil , France.,p Université de Lorraine, CHRU de Nancy et Pôle 6 de Psychiatrie et Psychologie Clinique - Centre Psychothérapique de Nancy, 1 rue du Docteur Archambault , Laxou Cedex , France
| | - Josephine Loftus
- e Fondation FondaMental, fondation de cooperation scientifique , Créteil , France.,h Psychiatric Department , Centre hospitalier Princess Grace , Monaco , France
| | - Christine Passerieux
- e Fondation FondaMental, fondation de cooperation scientifique , Créteil , France.,q Centre Hospitalier de Versailles -Le Chesnay , France.,r University Versailles-Saint-Quentin-en-Yvelines , Versailles , France
| | - Dominique Costagliola
- a Université Pierre et Marie Curie, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP UMRS , Paris , France.,b INSERM , UMRS, Paris , France
| | - Bruno Etain
- e Fondation FondaMental, fondation de cooperation scientifique , Créteil , France.,i AP-HP, GH Saint-Louis - Lariboisière - Fernand Widal, Pôle Neurosciences , Tête et Cou -; University Paris Diderot and INSERM UMR-S , Paris , France
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23
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Phua CS, Jayaram L, Wijeratne T. Relationship between Sleep Duration and Risk Factors for Stroke. Front Neurol 2017; 8:392. [PMID: 28848490 PMCID: PMC5550667 DOI: 10.3389/fneur.2017.00392] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 07/24/2017] [Indexed: 12/20/2022] Open
Abstract
Stroke is a leading cause of death and disability worldwide. While various risk factors have been identified, sleep has only been considered a risk factor more recently. Various epidemiologic studies have associated stroke with sleep such as sleep duration, and laboratory and clinical studies have proposed various underlying mechanisms. The pathophysiology is multifactorial, especially considering sleep affects many common risk factors for stroke. This review aims to provide an outline of the effect of sleep duration on common stroke risk factors. Appropriate sleep duration, especially in patients who have stroke risk factors, and increasing awareness and screening for sleep quality may contribute to primary prevention of stroke.
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Affiliation(s)
- Chun Seng Phua
- Department of Medicine, Melbourne Clinical School, University of Melbourne, Melbourne, VIC, Australia.,Department of Neurology, Western Health, St. Albans, VIC, Australia
| | - Lata Jayaram
- Department of Medicine, Melbourne Clinical School, University of Melbourne, Melbourne, VIC, Australia.,Department of Respiratory and Sleep Medicine, Western Health, St. Albans, VIC, Australia
| | - Tissa Wijeratne
- Department of Medicine, Melbourne Clinical School, University of Melbourne, Melbourne, VIC, Australia.,Department of Neurology, Western Health, St. Albans, VIC, Australia.,Department of Medicine, University of Rajarata, Saliyapura, Anuradhapura, Sri Lanka.,Department of Psychology and Counselling, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia
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25
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Doo H, Chun H, Doo M. Associations of daily sleep duration and dietary macronutrient consumption with obesity and dyslipidemia in Koreans: A cross-sectional study. Medicine (Baltimore) 2016; 95:e5360. [PMID: 27828860 PMCID: PMC5106066 DOI: 10.1097/md.0000000000005360] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Daily sleep duration is known to be associated with obesity and dyslipidemia.This study was performed to examine the interactions between daily sleep duration and the risks of obesity and dyslipidemia according to dietary macronutrient consumption in 14,680 Korean adults using the 5th Korean National Health and Nutrition Examination Survey.Sleep duration was inversely associated with body mass index (P < 0.001), waist circumference (P < 0.001), total cholesterol (P < 0.001), and low-density lipoprotein -cholesterol (P = 0.001). Participants with short sleep durations consumed less dietary protein (P < 0.001) and fat (P < 0.001), and consumed more dietary carbohydrates (P < 0.001). Among participants with the shortest sleep duration (≤5 hours a day), the odds ratio of obesity was found to increase in the high fat consumption group (1.393, 95% confidence interval 1.083-1.790) and decrease in the high carbohydrate consumption group (0.770, 95% confidence interval 0.604-0.983). High fat and low carbohydrate consumption were confirmed to be associated with the risk of obesity in the shortest sleep duration group (≤5 hours a day).These findings indicate that sleep duration was negatively associated with obesity and dyslipidemia-related indices in Korean adults. Additionally, the association of short sleep duration with the risk of obesity was potentially changed by dietary fat and carbohydrate consumption.
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Affiliation(s)
- Hyungie Doo
- Department of Natural and Forensic Sciences, Albany State University, Albany, GA, USA
| | - Hyejin Chun
- Department of Family Medicine, Bundang CHA Medical Center, CHA University, Yatap-ro, Gyeonggi-do
| | - Miae Doo
- Department of Nutritional Science and Food Management, Ewha Womans University, Ewhayeodae-gil, Seoul, Republic of Korea
- Correspondence: Miae Doo, Department of Nutritional Science and Food Management, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-Gu, Seoul 03760, Republic of Korea (e-mail: )
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26
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Bin YS. Is Sleep Quality More Important Than Sleep Duration for Public Health? Sleep 2016; 39:1629-1630. [PMID: 27568809 DOI: 10.5665/sleep.6078] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 08/04/2016] [Indexed: 11/03/2022] Open
Affiliation(s)
- Yu Sun Bin
- Clinical and Population Perinatal Health Research, Kolling Institute, University of Sydney, Sydney, Australia
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