Sleep duration associated with body mass index among Chinese adults

Short sleep duration is a significant risk factor of obesity: A multicenter observational study of healthy adults in Japan

This multicenter study aimed to elucidate the association between sleep duration and various lifestyle-related disorders in healthy adults in Japan. A total of 62,056 healthy participants (age: 49.4 ±  10.9 years) who received medical checkups from 2010 to 2020 were analyzed cross-sectionally and longitudinally. The mean sleep duration was 6.2 ±  1.0 h in men and 6.1 ±  1.0 h in women. The distribution of sleep duration showed that older people tended to sleep longer, which was clearly observed in men but not in women. Univariate analyses showed that older age, lower body mass index (BMI), habitual drinking, and habitual exercise were significantly associated with longer sleep duration. Multivariate analyses in men showed that sleep duration was positively associated with age, habitual exercise, serum triglyceride (TG), systolic blood pressure (SBP), and habitual drinking and negatively associated with BMI and hemoglobin A1c (HbA1c). Alternatively, in women, sleep duration was positively associated with habitual exercise and TG and negatively associated with BMI, high-density lipoprotein-cholesterol, HbA1c, and current smoking. During the follow-up period, 3,360 of 31,004 individuals (10.8%) developed obesity. The Cox proportional hazards model showed that shorter sleep duration was a significantly higher risk of obesity, and longer sleep duration might be a lower risk of obesity. On the other hand, 1,732 of 39,048 participants (4.4%) developed impaired glucose tolerance, and 6,405 of 33,537 participants (19.1%) developed hypertriglyceridemia. However, the Cox proportional hazards model did not show significant association between sleep duration and impaired glucose tolerance or hypertriglyceridemia. In conclusion, our large-scale cross-sectional study showed that sleep duration was positively associated with habitual exercise and TG and negatively associated with BMI and HbA1c, regardless of sex. Longitudinal analysis revealed that shorter sleep duration is a significant risk factor for obesity.

Economic cost of not meeting the 24-h movement guidelines in china: Research gaps and recommendations

It is well-known that not meeting the 24-hours (h) movement guidelines, including insufficient physical activity (PA), excessive sedentary behavior (SB), inadequate sleep duration, and their combinations, are independent risk factors for noncommunicable diseases (NCDs). The prevalence of not meeting the guidelines is high across the world, especially in China where has one of the largest population. Some studies have estimated the economic cost of insufficient PA in China, which is useful to guide policymakers to develop and implement effective health actions. However, several research gaps should be discussed and addressed for better evidence base and decision making. This commentary aims to provide a research insight into gaps and recommendations related to the analysis of economic cost of not meeting the 24-h movement guidelines. Some major research gaps can be indicated, including less research attention on excessive SB and inadequate sleep, limited evidence regarding NCDs associated with not meeting all 24-h movement guidelines considered in economic cost analysis, absence of evidence on estimated cost of not meeting the guidelines, and the adherence to methodological guide. Future research is required to address the gaps to guide effective health policy development in China. We hope that this commentary can play an important role in updating research evidence and advancing policy practice.

Association between sleep traits and biological aging risk: a Mendelian randomization study based on 157 227 cases and 179 332 controls

STUDY OBJECTIVES

To investigate whether sleep traits are associated with the risk of biological aging using a case-control design with Mendelian randomization (MR) analyses.

METHODS

We studied 336 559 participants in the UK Biobank cohort, including 157 227 cases of accelerated biological aging and 179 332 controls. PhenoAge, derived from clinical traits, estimated biological ages, and the discrepancies from chronological age were defined as age accelerations (PhenoAgeAccel). Sleep behaviors were assessed with a standardized questionnaire. propensity score matching matched control participants to age-accelerated participants, and a conditional multivariable logistic regression model estimated odds ratio (OR) and 95% confidence intervals (95% CI). Causal relationships between sleep traits and PhenoAgeAccel were explored using linear and nonlinear MR methods.

RESULTS

A U-shaped association was found between sleep duration and PhenoAgeAccel risk. Short sleepers had a 7% higher risk (OR = 1.07; 95% CI: 1.03 to 1.11), while long sleepers had an 18% higher risk (OR = 1.18; 95% CI: 1.15 to 1.22), compared to normal sleepers (6-8 hours/day). Evening chronotype was linked to higher PhenoAgeAccel risk than morning chronotype (OR = 1.14; 95% CI: 1.10 to 1.18), while no significant associations were found for insomnia or snoring. Morning chronotype had a protective effect on PhenoAgeAccel risk (OR = 0.87, 95% CI: 0.79 to 0.95) per linear MR analysis. Genetically predicted sleep duration showed a U-shaped relationship with PhenoAgeAccel, suggesting a nonlinear association (pnonlinear < 0.001).

CONCLUSIONS

The study suggests that improving sleep can slow biological aging, highlighting the importance of optimizing sleep as an intervention to mitigate aging's adverse effects.

Beneficial impacts of residential greenness on sleep deprivation in adults aged 19 or older living in South Korea: A nationwide community health survey in 2011-2018

BACKGROUND

Evidence of the relationship between greenness and sleep is limited, and, given the worsening sleep insufficiency worldwide, this relationship needs elucidation. In this study, we investigated the association of greenness with sleep deprivation using nationwide survey data.

METHODS

This study included 1,727,273 participants in the Korea Community Health Survey who resided in all 229 districts of South Korea from 2011 to 2018. Sleep deprivation variables were defined as strong deprivation or mild deprivation, based on average daily sleep duration of <5 or 5-6 h, respectively. District-specific annual average of satellite-derived enhanced vegetation index (EVI) was used as a green space exposure. A logistic regression with complex survey weights was used to estimate the association between greenness and sleep deprivation, and it was further examined by sex, age group, educational status, income level, and population density. The regression analysis was performed annually, and the annual estimates were pooled by a combined data analysis.

RESULTS

A higher level of greenness was associated (odds ratio [95 % confidence interval]) with strong and mild sleep deprivation (0.96 [0.93-0.99] and 0.96 [0.95-0.97]), respectively, and males and the younger age group (<65 years) showed a more prominent association with greenness than in females and the elderly group (65 years or older). In addition, only high-population-density areas showed evident associations of greenness with both strong and mild sleep deprivation.

CONCLUSIONS

This large population-based study provides important epidemiological evidence for improving sleep quantity through an increase in greenness exposure and supports policymakers in establishing strategies for urban planning.

Dietary insulinemic potential, sleep quality and quantity in Iranian adults: Yazd health study and TAMYZ study

BACKGROUND & AIMS

To examine the link between dietary insulin index (DII) and load (DIL) and sleep duration/quality for the first time.

METHODS

This cross-sectional study conducted on data from the recruitment phase of Yazd Health Study (YaHS)-Yazd Nutrition Study (TAMYZ), prospective study in Yazd, central Iran. Data on demographic characteristics, dietary intakes, sleep quantity and quality, and potential confounders were gathered by interview. Sleep quality and its components (insufficient sleep, delay in falling asleep, medication use for sleep, and sleep disorder) were assessed by a modified version of Pittsburgh questionnaire. The link between DII/DIL and low sleep quality and short/long sleep duration was studied using multivariable logistic regression.

RESULTS

In total, 5925 individuals aged 20 to 70 were eligible to take part in the current study. After adjustment for all potential confounders, participants in the highest DIL score tertile had a lower chance for sleep disorder (OR = 0.38; 95%CI: 0.17-0.85, Ptrend = 0.02) and delay in falling asleep (OR = 0.66; 95%CI: 0.42-1.03, Ptrend = 0.05) compared to those in the lowest tertile. The DII was also linked to a lower chance for sleep disorder (OR = 0.61; 95% CI: 0.39-0.93, P trend = 0.02). The DIL was inversely associated with sleep medication use and delay in falling sleep in men and women, respectively (P < 0.05). Moreover, DII was linked to a decreased odds of sleep disorder in women (P < 0.05). The associations were observed in those with overweight or obesity but not in those without overweight (P < 0.05).

CONCLUSION

Higher DIL and DII might be associated with sleep quality and its components. Prospective investigations are needed in the future to confirm these findings.

Onsite versus home-office: differences in sleep patterns according to workplace

Background and objective

This study aimed to evaluate the sleep patterns of students and employees working onsite versus those working from home during the COVID-19 pandemic using actigraphy.

Methods

A total of 75 students/employees (onsite: N = 40, home-office: N = 35; age range: 19-56 years; 32% male; 42.7% students, 49.3% employees) were studied between December 2020 and January 2022 using actigraphy, a sleep diary, and an online questionnaire assessing sociodemographics and morningness-eveningness. Independent-sample t-tests, paired-sample tests, and a multivariate general linear model adjusting for age (fixed factors: sex and work environment) were applied.

Results

Overall, onsite workers had significantly earlier rise times (7:05 [SD: 1:11] versus 7:44 [1:08] hours) and midpoints of sleep (2:57 [0:58] versus 3:33 [0:58] hours) on weekdays compared to home-office workers. Sleep efficiency, sleep duration, variability of sleep timing, and social jetlag did not differ between the groups.

Discussion

Home-office workers showed a delay in sleep timing that did not affect any other sleep parameters such as sleep efficiency or nighttime sleep duration. The work environment had only marginal impact on sleep patterns and thus sleep health in this sample. Sleep timing variability did not differ between groups.

Supplementary Information

The online version of this article (10.1007/s11818-023-00408-5) contains supplementary material 1 and 2, which is available to authorized users.

Sleep Duration, Body Mass Index, and Dietary Behaviour among KSU Students

BACKGROUND

Adolescents who receive an adequate amount of sleep benefit from a positive health status. Previous studies have documented several health consequences connected with obesity as well as short sleep duration among adolescents. Poor sleep quality with obesity and uncontrolled diet can lead to chronic diseases in the future. This study aimed to examine the link between eating habits, sleep duration, and body mass index (BMI) among King Saud University (KSU) students.

METHODS

The study was cross-sectional and conducted from February to May 2021 on 311 recruited students (male and female) of KSU premises. Pittsburgh Sleep Quality Index questionnaire was used to describe sleep duration linked with a dietary pattern that included fruit and vegetable intake. The questionnaire consists of two sections of 15 and 10 questions each. The questionnaire was created using the Google Forms tool and distributed through social media platforms like Twitter and WhatsApp. The obtained data was transferred into excel to perform the statistical analysis.

RESULTS

The mean total of students who participated in this study was 21.45 ± 23.11. Female students (72.3%) were actively involved in this study. About 30.2% of students were found to be overweight and obese. Around 67.8% of students had insufficient sleep, 32.2% had adequate sleep, and over 70% of students fell asleep within 30 min of going to bed. A total of 71.7% of students showed good sleep quality, whereas 28.3% reported poor sleep quality. BMI was categorized into four groups: 17.7% of individuals were underweight, 52.1% were of normal weight threshold, 20.6% were overweight, and 9.6% were obese. On a regular basis, 12.5% of students consume vegetables and 6.4% fruits daily. The results of this study show that only 8% of students eat breakfast, whereas 62.1% eat lunch, and 29.9% eat dinner.

CONCLUSION

This study concludes that short sleep duration was associated with obesity among KSU students. This association was also found between sleep duration and dietary factors, specifically in the consumption of fruits and vegetables in terms of eating behaviour.

Associations between perceived stress and BMI and waist circumference in Chinese adults: data from the 2015 China Health and Nutrition Survey

OBJECTIVES

To assess the association between perceived stress and adiposity among Chinese adults.

DESIGN

Cross-sectional study. Perceived stress was assessed using the 14-item perceived stress scale. Associations between quintiles of perceived stress and BMI and waist circumference were assessed using linear regression models and multinomial regression models. Estimates were adjusted for sociodemographic characteristics.

SETTING

2015 China Health and Nutrition Survey: 12 provinces covering a variety of geographic, economic development and health indicator situations.

PARTICIPANTS

A total of 8385 adults of both sexes, aged 18-99 years, were included.

RESULTS

Overall, the mean perceived stress score was 22·7 (6·2), mean BMI was 24·3 (3·6) kg/m2 and prevalence of obesity (BMI ≥ 30 kg/m2) was 6·0 %. There were inverse associations between perceived stress quintiles with continuous BMI (P < 0·001), BMI categories (P = 0·015) and waist circumference (P = 0·047). Compared to adults in the lowest quintile of perceived stress, adults in the highest quintile of perceived stress had 0·44 kg/m2 lower mean BMI (95 % CI: -0·67, -0·21), 0·72 times the prevalence of obesity (95 % CI: 0·55, 0·94) and 0·73 times the prevalence of abdominal obesity (95 % CI: 0·61, 0·88). Results were similar when using Chinese-specific cut-points.

CONCLUSION

Our results showed inverse associations between perceived stress quintiles and adiposity among Chinese adults. Future studies should aim to better understand the directionality of the observed associations and the potential biological and behavioural mechanisms underlying these associations in the Chinese population.

Prevalence and correlates of sleep problems among Chinese prisoners

PURPOSE

This study aimed to investigate the prevalence and correlates of sleep problems in a large prison in China.

METHODS

A total of 1491 incarcerated male adults (35.44 ± 9.67 years, range 18-69) were assessed by a self-administered structured questionnaire. Sleep duration, insomnia, sleep quality, substance abuse history, gambling history, traumatic life events, posttraumatic stress disorder (PTSD) and depressive symptoms were measured. Type of offense, history of incarceration, sentence length, and duration in prison were recorded. Multivariate logistic regression was used to examine correlated factors of sleep problems.

RESULTS

Overall, 17.4% (95% CI 15.6-19.5%) slept less than 6 h at night, 35.6% (95% CI 33.2-38.0%) slept 6-7 h, and 47.0% (95% CI 44.5-49.6%) slept 7 h or more. The prevalence rates were 26.2% (95% CI 24.0-28.5%) for insomnia and 45.9% (95% CI 43.4-48.4%) for poor sleep quality. Multiple models showed that older age, being divorced/widowed, poor physical health, long duration in prison, drug use before incarceration, PTSD and depression were associated with short sleep duration; while older age, poor physical health, PTSD, depression, and gambling before incarceration were associated with increased incidence of insomnia, and that being divorced/widowed, poor physical health, PTSD, depression, smoking before incarceration were related to poor sleep quality.

CONCLUSIONS

These findings indicate that sleep loss, insomnia, and poor sleep quality are common in prisoners, and that sleep problems are associated with multiple psychosocial factors.

The impact of sleep quality and duration on leptin, appetite, and obesity indices in adults

BACKGROUND Poor sleep duration and quality were previously reported to increase the risk of obesity. This study was aimed to evaluate the impact of sleep quality and duration on leptin, appetite, and adiposity in Indonesian adults. METHODS This cross-sectional study recruited adults in Yogyakarta, Indonesia, in 2016. Sleep quality was assessed using the Pittsburgh sleep quality index, appetite was evaluated using the community nutrition appetite questionnaire, and dietary intake was assessed by interviews using the semi-quantitative food frequency questionnaire. Sleep duration was also asked. Obesity indices were measured using the body mass index (BMI), waist-hip circumference, and percentage of body fat. Leptin was analyzed using the enzyme-linked immunosorbent assay. A Spearman analysis was done to evaluate the correlation between sleep quality, sleep duration, anthropometric measures, dietary intake, appetite, and leptin. RESULTS 244 adults participated in this study. This study showed that lower sleep quality and duration was significantly correlated with higher body weight (r = 0.129, p = 0.043 and r = −0.228, p<0.001), BMI (r = 0.176, p = 0.006 and r = −0.202, p = 0.001), and waist circumference (r = 0.179, p = 0.005 and r = −0.254, p<0.001). There was a correlation between poor sleep quality and higher leptin concentration (r = 0.186, p = 0.004). Sleep quality and duration were not associated with appetite (r = 0.109, p = 0.109 and r = −0.043, p = 0.500). CONCLUSIONS This study found that lower sleep quality was correlated with higher BMI, higher leptin concentration, but not appetite.

Relationship between sleep duration and sociodemographic characteristics, mental health and chronic diseases in individuals aged from 18 to 85 years old in Guangdong province in China: a population-based cross-sectional study

BACKGROUND

Sleep is vital for maintaining individual's physical and mental health. Prior studies have reported close relationships between sleep duration and chronic diseases. However, in China, the prevalence of aberrant sleep duration and the associations between sleep duration and chronic conditions still merit studying in Guangdong province. This study aimed at examining the relationship between sleep duration and multiple dimensions of sociodemographic characteristics, mental health and chronic diseases in Guangdong province in China, with a large population-based data of individuals aged from 18 to 85 years old.

METHODS

This study aimed at analyzing the sociodemographic and clinical characteristics of the population in Guangdong province. Multistage stratified cluster sampling was applied for this study. 13,768 participants from Guangdong province were interviewed with standardized assessment tools, including Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder (GAD-7). Basic socio-demographic information, mental health and chronic diseases information were collected. Self-reported sleep duration was classified as three types: short (< 7 h), normative (7-9 h) and long (≥9 h).

RESULTS

The mean sleep duration was 6.75 ± 1.11 h. Short sleepers had a higher prevalence of chronic diseases, including anemia (6.2%, p = 0.024), gout (2.8%, p = 0.010), hyperlipidemia (3.9%, p = 0.003) and low back pain (5.6%, p = 0.020) than other types of sleeper. Multinomial logistic regression analysis revealed that short sleepers were more likely to have low income level, have depressive symptoms, be ex- or current drinkers and be overweight. Anemia, hyperlipidemia and low back pain were all risk factors for short sleep, while malignant tumor was risky for long sleep.

CONCLUSIONS

Low income level, drinking status, being overweight, and chronic conditions may be associated with aberrant sleep duration in Guangdong province general population. Short sleepers have a higher risk of suffering from anemia, hyperlipidemia, and low back pain, while long sleepers are more likely to have malignant tumor. Health professionals should value the sleep patterns in general health care and attach importance to conduct further epidemiologic surveys to explore the relationship between sleep duration and health.

Sleep deprivation and its association with diseases- a review

Sleep deprivation, a consequence of multiple health problems or a cause of many major health risks, is a significant public health concern in this era. In the recent years, numerous reports have been added to the literature to provide explanation and to answer previously unanswered questions on this important topic but comprehensive updates and reviews in this aspect remain scarce. The present study identified 135 papers that investigated the association between sleep deprivation and health risks, including cardiovascular, respiratory, neurological, gastrointestinal, immunology, dermatology, endocrine, and reproductive health. In this review, we aimed to provide insight into the association between sleep deprivation and the development of diseases. We reviewed the latest updates available in the literature and particular attention was paid to reports that detailed all possible causal relationships involving both extrinsic and intrinsic factors that may be relevant to this topic. Various mechanisms by which sleep deprivation may affect health were presented and discussed, and this review hopes to serve as a platform for ideas generation for future research.

Parent-Child Relationships and Aging Parents' Sleep Quality: A Comparison of One-Child and Multiple-Children Families in China

Objectives: This study examined the associations between parent-child relationships and sleep difficulty among older parents in the context of Chinese multiple-children and one-child families. Methods: Using the 2014 China Longitudinal Aging Social Survey, this study analyzed older parents' (N = 8,450) reports of sleep quality and relationships with each of children. Results: Results from multivariate logistic regression models showed that living alone, greater variations in children's financial transfers and emotional closeness, and more instrumental support from children were associated with higher risks of sleep difficulty for Chinese older parents with multiple children. The maximum levels of financial transfers and emotional closeness from all children were related to lower risks of sleep difficulty for parents from multiple-children families, while greater instrumental support from children was associated with higher risks of sleep difficulty for parents from one-child families. Discussion: Findings have implications for support programs for Chinese aging population with sleep problems.

Sleep and suicidality in school-aged adolescents: A prospective study with 2-year follow-up

Current evidence about the association between sleep and suicide are conflicting. This study aimed to investigate the association between sleep duration and quality with suicidal behaviors in a group of school-aged adolescents in China. The baseline survey was conducted among Chinese adolescents aged 12-13 years in October 2016. All participants were asked to complete a self-administered questionnaire. After 2 years follow-up, a total of 1513 adolescents completed the follow-up. The multivariable logistic regression analysis showed that shorter sleep duration (<8 h per night) in baseline was associated with an increased likelihood of suicidality in boys [suicidal ideation, adjusted odds ratio (OR)=2.18, 95% confidence interval (CI)=1.97 to 3.98; suicide planning, OR=2.47, 95% CI=1.22 to 5.01; suicide attempt, OR=2.97, 95% CI=1.39 to 6.38]. Similarly, poor sleep quality [Pittsburgh Sleep Quality Index (PSQI) ≧ 5] was associated with an increased likelihood of suicidal ideation and suicide planning in boys (OR=2.14, 95% CI=1.15 to 3.99 and OR=2.47, 95% CI=1.16 to 5.25, respectively). This study indicates that school-aged boys are more likely to experience suicidality in exposure to short sleep or poor sleep quality.

DISTURBED SLEEP PATTERN (000198): CONTENT ANALYSIS IN PATIENTS WITH ACUTE CORONARY SYNDROME

ABSTRACT Objective: to analyze the content of the defining characteristics of the Disturbed Sleep Pattern Nursing Diagnosis (00198) in patients with Acute Coronary Syndrome. Method: content analysis performed by specialists who achieved a score equal to or greater than five, according to established criteria: clinical experience, teaching and/or research; participation in research groups; doctorate degree; master's degree; specialization and/or residency in cardiology and/or sleep and/or nursing classifications. Eight defining characteristics were evaluated for their relationship to population, relevance, clarity and accuracy. Descriptive statistics were performed to characterize the sample, binomial statistical test to establish if there is agreement between the experts and chi-square and Fisher's exact to establish associations between the evaluated items and the experts' variables. Results: 54 experts participated in the study. The defining characteristics validated by the experts were the following: dissatisfaction with sleep, feeling unrested, sleep deprivation, alteration in sleep pattern, unintentional awakening, difficulty initiating sleep and daytime sleepiness. There was a statistically significant association between evaluated items and the variables time of training, time of operation and punctuation. Conclusion: seven of the eight defining characteristics were considered valid after the application of binomial test. This study will contribute to the refinement of the Disturbed Sleep Pattern Nursing Diagnosis (000198) and may enable the improvement of the quality of care of patients hospitalized with Acute Coronary Syndrome regarding changes in sleep pattern. The content analysis stage will support the next stage of the validation process of the present diagnosis, the clinical validation.

Social-biological influences on sleep duration among adult residents of Northeastern China

Background

Cold climates traditionally have conferred long sleep duration in the residents in northeast China; however, modern lifestyle reduces sleep duration. In this study, we investigated social-biological factors influencing sleep duration in the adult residents in northeast China.

Methods

This study was performed using data from the Investigation of Chronic Disease Morbidity Rate and Risk Factors of Adults in Jilin Province, China. Associations between sleep duration and indices of demographic characteristics, health-related behaviors, and disease history in adult residents were analyzed using univariate analysis and multivariate logistic regression analysis.

Results

The mean sleep duration was 7.24 h. Of the 21,435 participants, approximately 53.4% had short sleep duration (sleep duration per day < 7 h), and 10.5% had long sleep duration (sleep duration per day > 9 h). There were associations between short sleep duration and indices, including age, place of residence, marital status, educational level, alcohol drinking, dietary, obesity, and history of coronary heart disease (CHD) or myocardial infarction (MI). There existed associations of long sleep duration with indices, such as age, place of residence, occupation, educational level, average monthly earnings, and physical exercise.

Conclusion

Short sleep duration is common among residents in northeast China. Age, place of residence, and educational level are implicated in both short sleep duration and long sleep duration. Short sleep duration inclines to link with the indices (marital status, alcohol drinking, dietary, obesity, and history of CHD or MI). However, long sleep duration is relevant to the indices (occupation, average monthly earnings, and physical exercise).

Sleep Patterns and Obesity: Hispanic Community Health Study/Study of Latinos Sueño Ancillar Study

BACKGROUND

The relationship of poor sleep patterns to the increased risk of obesity has been reported, but the results are variable. This study evaluated the association between objectively measured sleep patterns and obesity in a representative adult population of Hispanic/Latino subjects living in the United States.

METHODS

This cross-sectional study was an analysis of a multicenter, community-based cohort of 2,156 participants aged 18 to 64 years from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Recruitment was conducted in San Diego, California; Chicago, Illinois; Bronx, New York; and Miami, Florida. Models were controlled for age, sex, ethnic background, site, income, education, and apnea-hypopnea index. Seven days of wrist actigraphy data were collected. Obesity was defined as BMI ≥ 30 kg/m², and abdominal obesity was defined as waist circumference ≥ 88 cm in women and ≥ 102 cm in men. Napping was defined as more than one 15-min nap per week.

RESULTS

An inverse linear relationship was found between sleep duration and prevalence of obesity (P linear trend ≤ 0.01). A reduction of 1 h sleep increased obesity prevalence by 4.1% (95% CI, 1.6-6.6; P = .002) and abdominal obesity prevalence by 3.6% (95% CI, 1.1-6.1; P = .007). Daytime napping increased obesity prevalence by 10.4% (95% CI, 3.5-17.3; P = .004) and abdominal obesity prevalence by 7.1% (95% CI, 1.0-13.2; P = .02).

CONCLUSIONS

In a population of young to older adult Hispanic/Latino subjects, we found an inverse linear association between sleep duration and the prevalence of obesity. Daytime napping was strongly associated with greater adiposity. Interventional and longitudinal studies are needed to better understand how abnormal sleep patterns contribute to the obesity epidemic.

Association of Sleep Duration and Obesity According to Gender and Age in Korean Adults: Results from the Korea National Health and Nutrition Examination Survey 2007-2015

BACKGROUND

This study aimed to investigate associations between self-reported sleep duration and general and abdominal obesity in Korean adults stratified according to gender and age.

METHODS

Data from 41,805 adults, 18-110 years of age, collected by the Korea National Health and Nutrition Examination Survey (KNHANES) in 2007 and 2015, were analyzed. Multivariable logistic regression was used to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for obesity and abdominal obesity by sleep duration after controlling for sociodemographic and lifestyle variables.

RESULTS

Among individuals 30-49 years of age, there was an increased AOR for obesity only for sleep duration ≤ 5 hour/day compared with sleep duration 6 to 8 hour/day, both in men (OR, 1.25; 95% CI, 1.02-1.54) and women (OR, 1.56; 95% CI, 1.29-1.90), after controlling for covariates. Regarding women, there was increased AOR for abdominal obesity for sleep duration ≤ 5 hour/day (OR, 1.45; 95% CI, 1.18-1.78) and ≥ 9 hour/day (OR, 1.38; 95% CI, 1.09-1.76) compared with sleep duration 6 to 8 hour/day. However, for elderly individuals (≥ 65 years), there was a negative association between sleep duration ≤ 5 hour/day and obesity, but not with abdominal obesity, in both men and women.

CONCLUSION

This study demonstrated a significant association between sleep duration and obesity, which varied according to gender and age.

25-Hydroxyvitamin D Status and Its Association with Sleep Duration in Chinese Schoolchildren

OBJECTIVE

To examine the association between 25-Hydroxyvitamin D (25(OH)D) levels and sleep duration among Chinese adolescents.

SUBJECTS AND METHODS

A school-based cross-sectional study was conducted among Chinese adolescents in 2017. Data on a total of 800 adolescents aged 8⁻14 years was used for this study. Anthropometric measurements such as height and weight were measured by trained research staff. Serum 25(OH)D and lipids were measured in the laboratory. Sleep habits and other health-related behaviors were tested by questionnaire.

RESULTS

25(OH)D levels were significantly positively correlated with sleep duration (r = 0.11, p < 0.05). In multivariate logistic regression analyses, insufficiency/deficiency of vitamin D (25(OH)D ≤ 20 ng/mL) was significantly associated with increased probability of short sleep (AOR = 1.67, 95% CI = 1.14⁻2.43).

CONCLUSIONS

Low 25(OH)D levels were independently associated with the risk of insufficient sleep in Chinese adolescents.

Insufficient Sleep Duration and Overweight/Obesity among Adolescents in a Chinese Population

OBJECTIVES

The objective of this study was to investigate the relationship between sleep duration and overweight/obesity among Chinese adolescents.

METHODS

A school-based cross-sectional study was conducted among Chinese adolescents in 2016. In total, 2795 school-aged Chinese children aged 12 to 13 years participated in this study. Participants were asked to complete self-administered surveys during a 45-min class period in their classroom. Details of the questionnaire about health-related behaviors included sleep habits, physical activity, screen time, cigarette use, and alcohol use. Height, weight, waist circumference and hip circumference were directly measured.

RESULTS

The mean sleep duration was 8.7 h/day. In total, 43.0% of the participants had a sleep duration of less than 9 h/day. Sleep duration was significantly inversely related to BMI, waist circumference, hip circumference and WHtR in multiple linear regression analyses in both genders. Logistic regression models showed that insufficient sleep (<9 h/day) was associated with high odds of overweight/obesity among both young boys and girls.

CONCLUSIONS

Insufficient sleep duration was associated with overweight/obesity in Chinese adolescents, and short sleep duration was probably associated with central adiposity, especially among boys.

Association of sleep duration with apolipoproteins and the apolipoprotein B/A1 ratio: the China health and nutrition survey

Background

Short sleep duration has been related to established cardiovascular risk factors, likely obesity, diabetes, hypertension and dyslipidaemia. However, to the best of our knowledge, the associations between sleep duration and apolipoprotein concentrations and their ratios have not been investigated to date. This study aimed to explore the independent relationship of sleep duration with apolipoprotein (apo) A1, apoB and the apoB/apoA1 ratio in a Chinese adult population.

Methods

Data from 7381 participants, aged 18 to 75 years, from the National Health and Nutrition Survey 2009 were analysed in this cross-sectional study. Participants were divided into 3 categories according to sleep duration: ≤6, 7-8, and ≥9 h. Logistic regression analysis with odds ratios was employed to assess the association between sleep duration and apo profile.

Results

Using 7-8 h of sleep as a reference, short sleep duration was associated with significantly increased odds of elevated apoB (OR =1.75, 95% CI 1.12-2.72), whereas long sleep duration was correlated with a decreased (but not statistically significant) risk for elevated apoB (OR =0.86, 95% CI 0.54-1.38) among females after controlling for covariates. Among males, long sleep duration was only marginally related to decreased odds ratios for elevated apoB/apoA1 ratio after adjustment for covariates (OR =0.78, 95% CI 0.6-0.99).

Conclusions

These results indicate that short sleep duration is strongly associated with an increased risk of elevated apoB levels in women and that long sleep duration is correlated with decreased apoB/apoA1 levels in men. Sleep hygiene management could serve to treat and prevent cardiovascular diseases by altering unfavourable apo profile.

Sex-Specific Difference in the Association Between Poor Sleep Quality and Abdominal Obesity in Rural Chinese: A Large Population-Based Study

STUDY OBJECTIVES

Existing studies on sleep quality and associated obesity are inconsistent, and few studies have prospectively evaluated the association between sleep quality and abdominal obesity among Chinese individuals. To fill this void, the current study aimed to assess the association between sleep quality and abdominal obesity in a rural Chinese population.

METHODS

A representative sample of 9,404 adults aged 20-93 years in northeastern China was selected between 2012 and 2013 by a multistage cluster and random sampling method. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI), where a score of 6 or higher indicated sleep disorder. Abdominal obesity was measured by waist circumference (WC), with abdominal obesity defined as WC > 90 cm for men and WC > 80 cm for women.

RESULTS

Male participants with abdominal obesity had higher global PSQI scores in addition to higher subscores in almost all of the elements compared to normal values. The odds ratios of abdominal obesity among participants with sleep disorders were 1.64 (95% confidence interval [CI]: 1.39-1.95) and 1.14 (95% CI: 0.98-1.32) for males and females compared to the reference group. The risk in all sleep elements was significantly increased, with odds ratios ranging from 1.28 (95% CI: 1.08-1.51) to 5.81 (95% CI: 3.54-9.53) for males. The risk only in four elements was significantly increased, from 1.28 (95% CI: 1.12-1.47) to 2.27 (95% CI: 1.36-3.80) for females.

CONCLUSIONS

Poor sleep quality was associated with abdominal obesity in Chinese. Furthermore, effects in males were larger than those in females.

Interrelationship between Sleep and Exercise: A Systematic Review

Although a substantial body of literature has explored the relationship between sleep and exercise, comprehensive reviews and definitive conclusions about the impact of exercise interventions on sleep are lacking. Electronic databases were searched for articles published between January 2013 and March 2017. Studies were included if they possessed either objective or subjective measures of sleep and an exercise intervention that followed the guidelines recommended by the American College of Sports Medicine. Thirty-four studies met these inclusion criteria. Twenty-nine studies concluded that exercise improved sleep quality or duration; however, four found no difference and one reported a negative impact of exercise on sleep. Study results varied most significantly due to participants' age, health status, and the mode and intensity of exercise intervention. Mixed findings were reported for children, adolescents, and young adults. Interventions conducted with middle-aged and elderly adults reported more robust results. In these cases, exercise promoted increased sleep efficiency and duration regardless of the mode and intensity of activity, especially in populations suffering from disease. Our review suggests that sleep and exercise exert substantial positive effects on one another; however, to reach a true consensus, the mechanisms behind these observations must first be elucidated.

Relationship of Sleep Duration with Sociodemographic Characteristics, Lifestyle, Mental Health, and Chronic Diseases in a Large Chinese Adult Population

STUDY OBJECTIVES

Pattern of sleep duration and its correlates have rarely been reported in China. This study examined the sleep duration and its relationship with sociodemographic variables, lifestyle, mental health, and chronic diseases in a large Chinese adult population.

METHODS

This cross-sectional study used multistage stratified cluster sampling. A total of 17,320 participants from Jilin province were selected and interviewed using standardized assessment tools. Basic socio-demographic and clinical data were collected. Sleep duration was classified as short (< 7 h per day), long (> 9 h per day) and medium sleep (7-9 h per day).

RESULTS

The mean age of the sample was 42.60 ± 10.60 y, with 51.4% being female. The mean sleep duration was 7.31 ± 1.44 h. Short and long sleepers accounted for 30.9% and 6.9% of the sample, respectively. Multinomial logistic regression analysis revealed that older age, current smoking, irregular meal pattern, lack of physical exercise, poor mental health, and chronic diseases or multimorbidity were positively associated with short sleep. Being married and living in rural areas were, however, negatively associated with short sleep. In addition, living in rural area, current smoking, current alcohol use and lack of physical exercise were positively associated with long sleep, while older age and lower education were negatively associated with long sleep.

CONCLUSION

Given the high frequency of short sleep and its negative effect on health, health professionals should pay more attention to sleep patterns in general health care. Nationwide epidemiologic surveys in China are needed to further explore the relationship between sleep duration and health.

Insomnia and obesity

PURPOSE OF REVIEW

Accumulating data suggest that short sleep plays a role in the development of obesity in general population. Insomnia disorder is characterized by short sleep and may persist for years. The question whether these patients have a higher risk of obesity is of socioeconomic as well as therapeutic interest.

RECENT FINDINGS

Numerous recently published cross-sectional and longitudinal studies show positive as well as negative associations between short sleep and overweight. Critical reviews note several methodological limitations that weaken the assumption of short sleep duration as the potential cause for obesity. From a sleep medical perspective, a basic methodological problem is the lack of a biological cut-off for short sleep duration. Therefore, recent findings on the relation between emotional stress in short sleepers and incident of obesity opens a more promising perspective on sleep quality as a possible factor. A few studies on patients with insomnia disorder, however, do not show higher BMIs adding data to a research puzzle.

SUMMARY

The relation of sleep duration and incident obesity so far has insufficient evidence base. Few data on patients with insomnia disorder do not confirm the association. Further research is necessary with focus on sleep quality instead of sleep duration.

Sleep Duration and Obesity in Adults: What Are the Connections?

Collectively, cross-sectional and longitudinal studies on self-reported sleep duration and obesity do not show a clear pattern of association with some showing a negative linear relationship, some showing a U-shaped relationship, and some showing no relationship. Associations between sleep duration and obesity seem stronger in younger adults. Cross-sectional studies using objectively measured sleep duration (actigraphy or polysomnography (PSG)) also show this mixed pattern whereas all longitudinal studies to date using actigraphy or PSG have failed to show a relationship with obesity/weight gain. It is still too early and a too easy solution to suggest that changing the sleep duration will cure the obesity epidemic. Given novel results on emotional stress and poor sleep as mediating factors in the relationship between sleep duration and obesity, detection and management of these should become the target of future clinical efforts as well as future research.

Prevalence of overweight and obesity and some associated factors among adult residents of northeast China: a cross-sectional study

OBJECTIVES

This study aims to estimate the prevalence of overweight and obesity and determine potential influencing factors among adults in northeast China.

METHODS

A cross-sectional survey was conducted in Jilin Province, northeast China, in 2012. A total of 9873 men and 10 966 women aged 18-79 years from the general population were included using a multistage stratified random cluster sampling design. Data were obtained from face-to-face interview and physical examination. After being weighted according to a complex sampling scheme, the sample was used to estimate the prevalence of overweight (body mass index (BMI) 24-27.9 kg/m(2)) and obesity (BMI >28 kg/m(2)) in Jilin Province, and analyse influencing factors through corresponding statistical methods based on complex sampling design behaviours.

RESULTS

The overall prevalence of overweight was 32.3% (male 34.3%; female 30.2%), and the prevalence of obesity was 14.6% (male 16.3%; female 12.8%) in Jilin Province. The prevalence of both overweight and obesity were higher in men than women (p<0.001). Influencing factors included sex, age, marriage status, occupation, smoking, drinking, diet and hours of sleep (p<0.05).

CONCLUSIONS

This study estimated that the prevalence of overweight and obesity among adult residents of Jilin Province, northeast China, were high. The results of this study will be submitted to the Health Department of Jilin Province and other relevant departments as a reference, which should inform policy makers in developing education and publicity to prevent and control the occurrence of overweight and obesity.

Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion

The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health.

Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion

The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health.