Association between weekend catch-up sleep and cardiovascular disease: Evidence from the National Health and Nutrition Examination Surveys 2017-2018

Biomarkers of aging: from molecules and surrogates to physiology and function

Many countries face an unprecedented challenge in aging demographics. This has led to an exponential growth in research on aging, which, coupled to a massive financial influx of funding in the private and public sectors, has resulted in seminal insights into the underpinnings of this biological process. However, critical validation in humans has been hampered by the limited translatability of results obtained in model organisms, additionally confined by the need for extremely time-consuming clinical studies in the ostensible absence of robust biomarkers that would allow monitoring in shorter time frames. In the future, molecular parameters might hold great promise in this regard. In contrast, biomarkers centered on function, resilience, and frailty are available at the present time, with proven predictive value for morbidity and mortality. In this review, the current knowledge of molecular and physiological aspects of human aging, potential antiaging strategies, and the basis, evidence, and potential application of physiological biomarkers in human aging are discussed.

Relationship between multidimensional sleep health and depression during late pregnancy: a cross-sectional study

BACKGROUND

Depression is common among pregnant women and identifying modifiable risk factors is critical (e.g., sleep). Individual sleep dimensions, e.g., short sleep duration and poor sleep quality, were associated with a higher risk of depression, while whether the multidimensional construct of sleep health could be a protective or risk factor for prenatal depression remains unknown. This study aimed to examine the relationship between multidimensional sleep health and depression during late pregnancy.

METHODS

This study was conducted among women during late pregnancy (28-40 weeks). Sleep health was measured by self-report questionnaires. Each dimension (sleep quality, duration, efficiency, timing, regularity and daytime sleepiness) was categorized as "good" or "poor". A composite sleep health score was calculated. Depression was measured using the Edinburgh Postnatal Depression Scale. Logistic regression analyses were used to examine the associations between individual sleep health dimensions and depression. Restricted cubic spline analysis was used to explore the dose-response relationship between overall sleep health and depression.

RESULTS

A total of 329 women were included. Their mean age was 31.6 years and the mean gestational age was 34.7 weeks. Sixty (18.2%) had clinically elevated depression. There was a dose-response relationship between composite sleep health score and depression, with a higher sleep health score associated with a lower risk of depression (OR = 0.572, 95%CI = 0.423-0.774, p for linearity < 0.001). Controlling for covariates, poor sleep quality (OR = 3.485, 95%CI = 1.817-6.683, p < 0.001), short sleep duration (OR = 3.462, 95%CI = 1.513-7.924, p = 0.003), and excessive daytime sleepiness (OR = 3.409, 95%CI = 1.804-6.442, p < 0.001) were associated with a higher risk of depression.

CONCLUSION

Both overall sleep health and individual dimensions (sleep quality, short sleep duration, and daytime sleepiness) were associated with depression during late pregnancy. These findings highlight the potential benefits of maintaining sleep health to achieve mental wellbeing in pregnant women. Healthcare providers may consider adding the assessment and management of sleep health as part of routine prenatal care.

CLINICAL TRIAL NUMBER

Not applicable.

Investigating the associations between weekend catch-up sleep and insulin resistance: NHANES cross-sectional study

BACKGROUND

Insulin resistance (IR) is a precursor to metabolic syndrome. Weekend catch-up sleep (WCS) is practiced to compensate for insufficient weekday sleep, but its impact on IR remains unclear. This study investigated associations between WCS and severe IR risk.

METHODS

Data from 1,903 adults participating in the National Health and Nutrition Examination Survey 2017-2020 were analyzed. IR was assessed using the Homeostatic Model Assessment for IR (HOMA-IR) and Metabolic Score for IR (METS-IR), with severe IR defined as the highest quartile. WCS was calculated by subtracting weekday sleep duration from weekend sleep duration and was categorized into five groups. Weighted logistic regression and restricted cubic spline analyses were performed to examine associations between WCS patterns and severe IR risk. Percentages reported were weighted to account for sampling design and population distribution.

RESULTS

The majority of participants were under 60 yrs (75.2%, n = 1,344) and had a body mass index below 30 kg/m2 (59.2%, n = 1,082). Slightly more than half of the participants were female (51.3%, n = 990). A U-shaped relationship between WCS duration and severe IR risk was observed, with the lowest risk at approximately 0.7-1.0 h of WCS. Short WCS durations (0 < WCS ≤ 1 h) were associated with a significantly reduced risk of severe IR as defined by HOMA-IR (OR = 0.63, 95% CI: 0.41-0.97, P = 0.037) compared to stable sleep pattern (WCS = 0). Long WCS durations (WCS ≥ 2 h) were associated with an increased risk of severe IR as defined by METS-IR (OR = 1.88, 95% CI: 1.13-3.14, P = 0.018). Sensitivity analyses showed that the reduction in severe IR risk associated with short WCS durations was more significant in individuals with weekday sleep durations of seven hours or less.

CONCLUSIONS

WCS duration exhibits a U-shaped association with severe IR risk, with approximately 0.7-1.0 h of WCS linked to the lowest risk. Both insufficient and excessive WCS are associated with increased severe IR risk, emphasizing the importance of optimal sleep patterns for metabolic health.

Association of Sleep Duration, Bedtime Regularity, and Weekend Catch-Up Sleep with Age-Related Hearing Loss: A Population-Based Cross-Sectional Study

PURPOSE

Age-related hearing loss (ARHL) impacts quality of life and cognition in older adults, but its link to sleep patterns remains unclear. This study explores associations between ARHL and sleep duration, weekend catch-up sleep (WCS), and bedtime regularity in a Korean population.

METHODS

Data from 6,797 adults aged ≥40 years were analyzed using the Korea National Health and Nutrition Examination Survey (KNHANES, 2021-2022). Sleep patterns were assessed via self-reported questionnaires. ARHL was classified as mild (26-41 dB) or moderate and above (>41 dB) using audiometry. Poisson regression models examined associations between sleep characteristics and ARHL, adjusting for confounders.

RESULTS

WCS (≥1h) was significantly associated with a lower prevalence of both mild (adjusted prevalence ratio = 0.58, 95% CI: 0.44-0.76) and moderate ARHL (aPR = 0.79, 95% CI: 0.63-0.98). These associations remained robust in stratified analyses among middle-aged adults and men (p-interaction < 0.01). In contrast, sleep duration and bedtime regularity showed no significant associations with ARHL after adjustment.

CONCLUSION

Our findings indicate that WCS may be associated with a lower prevalence of ARHL, particularly in middle-aged adults and men, highlighting the potential role of sleep behavior in auditory health promotion.

The sleep paradox: The effect of weekend catch-up sleep on homeostasis and circadian misalignment

Weekend catch-up sleep involves not only changes in sleep duration between weekdays and weekends but also changes in sleep timing. When people sleep less during the weekdays, they accumulate sleep debt and extend their sleep duration on weekends to compensate, which is related with the homeostatic process. Thus, extend their sleep duration on weekends seems to be a protectively strategy of daytime function, mental and physical health. However, not all studies support this protective effect. Sleep duration changes with sleep timing. The difference in sleep timing between weekdays and weekends might bring social jet lag (SJL). Sleep duration changes with sleep timing. The difference in sleep timing between weekdays and weekends can lead to SJL, representing the discrepancy between the biological clock and the social clock. This makes SJL an indicator of circadian misalignment, which is associated with poor daytime function, reduced nighttime sleep quality, and an increased risk of depression, metabolic disturbances, and other diseases. Paradoxically, the protective effect of weekend catch-up sleep duration on the homeostatic process (compensating for sleep debt) and the potential impact of weekend catch-up sleep timing on the circadian process (circadian misalignment) contradict each other. A more comprehensive understanding of weekend catch-up sleep is essential to investigate its mechanisms using the two-process model and other influencing factors.

Sleep and Cardiovascular Health

Sleep is recognized as a foundational pillar of health, essential for maintaining nearly all vital processes, and a crucial component of cardiovascular function. In recent years, there has been a paradigm shift to conceptualize sleep health as a combination of multiple domains, including duration, timing, quality, variability/regularity, habits/behaviors, and disordered sleep. This review provides a comprehensive overview of the current evidence linking the multifaceted elements that contribute to healthy sleep with cardiovascular and blood pressure-related outcomes. The reviewed literature indicates a strong relationship between sleep and cardiovascular health. However, the specific pathophysiological mechanisms that bridge the various dimensions of sleep with cardiovascular outcomes remain elusive. Given the global burden of cardiovascular disease, understanding the interplay between sleep and cardiovascular health has important implications for both individual and population health. Sustained efforts to move beyond a focus on discrete domains of sleep are essential to fully understand this complex and potentially bidirectional relationship. Promoting healthy sleep patterns and optimizing the management and treatment of sleep disorders are key steps toward developing more comprehensive strategies for reducing cardiovascular risk. Integrating sleep health into routine clinical care is identified as a critical opportunity to enhance cardiovascular disease prevention and management, particularly among vulnerable and high-risk populations.

Weekend sleep extension, social jetlag, and incidence of coronary calcium score: the ELSA-Brasil study

STUDY OBJECTIVES

Insufficient/irregular sleep patterns are common conditions, but their cardiovascular consequences and strategies to minimize these risks are poorly explored. We aimed to determine whether weekend sleep extension (catch-up sleep) and social jetlag may impact the incidence of subclinical atherosclerosis.

METHODS

We performed a 7-day wrist actigraphy in this cohort study to monitor sleep parameters. Coronary artery calcium (CAC) was measured at two different time points. Catch-up-sleep was measured by calculating weekend minus weekday sleep duration. Social jetlag was calculated by the difference between the mean sleep midpoint on weekend days minus weekdays. The incidence of subclinical atherosclerosis was defined as baseline CAC = 0, followed by CAC > 0 at the follow-up. The association of incident CAC outcome was assessed using logistic regression adjusting for traditional confounders plus sleep apnea.

RESULTS

We analyzed 1832 participants (age: 48.8 ± 8.0 years; 57.8% women). Incidence of CAC among subjects with catch-up sleep >90 and ≤90 minutes were 19.1% vs. 31.7%, respectively (p < .001). In covariate-adjusted analyses (follow-up = 5.4 ± 0.90 years), we found a lower incidence of CAC in those participants with catch-up-sleep > 90 minutes (odds ratio [OR] = 0.62; 95% confidence interval [CI] 0.52-0.74). Interestingly, stratified analysis revealed that these results are modified by sleep duration (≤6.55 hours: OR = 0.42; 95% CI 0.33-0.54; > 6.55 hours: OR = 0.96; 95% CI 0.75-1.24). In contrast, social jet lag was weakly associated with incident CAC: 0.1% increasing risk/minute.

CONCLUSIONS

Extending sleep time during the weekend is independently associated with lower 5-year CAC incidence, providing relevant insights into the cardiovascular benefits of this common sleep habit Worldwide.

A narrative review of sleep and breast cancer: from epidemiology to mechanisms

Breast cancer is the leading cause of cancer-related death and the most common cancer among women worldwide. It is crucial to identify potentially modifiable risk factors to intervene and prevent breast cancer effectively. Sleep factors have emerged as a potentially novel risk factor for female breast cancer. Current epidemiologic studies suggest a significant impact of sleep factors on breast cancer. Exposure to abnormal sleep duration, poor sleep quality, sleep disorders, sleep medication use, or night shift work can increase the risk of breast cancer by decreasing melatonin secretion, disrupting circadian rhythm, compromising immune function, or altering hormone levels. However, there are still controversies regarding the epidemiologic association, and the underlying mechanisms have yet to be fully elucidated. This paper summarizes the epidemiologic evidence on the associations between sleep factors, including sleep duration, sleep quality, sleep disorders, sleep medication use, sleep habits, and night shift work, and the development of breast cancer. The potential mechanisms underlying these associations were also reviewed.

Weekend catch-up sleep and frailty in US adults: a cross-sectional study from NHANES 2017-2020

BACKGROUND

Frailty is an age-related condition characterized by vulnerability to adverse health outcomes. Adequate sleep may reduce frailty risk, many individuals rely on weekend catch-up sleep (WCS) to offset weekday deficits. However, the relationship between WCS and frailty remains poorly understood. This study aims to clarify the association between WCS and frailty.

METHODS

We conducted secondary data analyses using data from 7714 adult participants in the National Health and Nutrition Examination Survey (NHANES 2017-2020). Sleep duration was assessed through self-reported questions, while frailty was evaluated using the frailty index. WCS duration was then computed as the difference between weekend and weekday sleep durations, with WCS defined as WCS duration ≤ 0 h, 0-2 h, or ≥ 2 h. A frailty index of 0.25 or greater is considered frailty. Multivariate logistic regression analyses were conducted to explore the association between WCS and frailty.

RESULTS

In fully adjusted models, participants with 0-2 h of WCS had significantly lower odds of frailty (OR 0.709; 95% CI, 0.518-0.969; P = 0.035) compared to those with no WCS (≤ 0 h). However, the association was not significant for those with ≥ 2 h of WCS (OR 0.812; 95% CI, 0.550-1.200; P = 0.248). Subgroup analyses indicated no significant interaction across subgroups (P for interaction > 0.05).

LIMITATIONS

The cross-sectional design limits our ability to infer causality, and the reliance on self-reported sleep data may introduce measurement bias. Additionally, the frailty index, while validated, may not capture all dimensions of frailty. Future longitudinal studies with objective sleep measurements are needed to confirm these findings.

CONCLUSIONS

Our findings suggest that moderate WCS (0-2 h) may be associated with a lower prevalence of frailty, although the relationship is not linear and requires further investigation. These findings contribute to the emerging evidence base linking sleep patterns with frailty risk, warranting further prospective investigation.

Weekend catch-up sleep is associated with a decreased risk of kidney disease in American adults: an analysis of NHANES 2017-2020

BACKGROUND

In recent years, inadequate sleep duration has become a prominent concern all over the world, prompting investigations into its potential influences on various health conditions, including kidney disease. This study seeks to explore the association between weekend catch-up sleep (WCS) and kidney disease in American adults.

METHODS

A cross-sectional study was performed utilizing data from the National Health and Nutrition Examination Surveys (NHANES) spanning the years 2017-2020. The participants included who were 18 years old or older and clearly awareness of their sleep durations on weekdays and weekends. Sleep durations on weekdays and weekends were ascertained through questionnaires, and WCS was determined as the disparity between weekend and weekday sleep durations.

RESULTS

Participants with kidney disease exhibited notable variations in their weekday and weekend sleep durations in comparison to those without. The WCS of more than 2 h, irrespective of comorbidities such as hypertension and diabetes, was significantly linked to a lower prevalence of kidney disease, particularly in individuals who slept 6-8 h on weekdays. Furthermore, it was noted that there exists a non-linear correlation between WCS and the prevalence of kidney disease, with a distinct breakpoint identified at 3.5 h. The WCS of more than 2 h-possibly but not certainly-irrespective of comorbidities such as hypertension and diabetes, was significantly linked to a lower prevalence of kidney disease, particularly in individuals who slept 6-8 h on weekdays.

CONCLUSION

This research indicates that among adults with insufficient weekday sleep in the United States, participation in WCS, particularly exceeding 2 h is significantly linked to a decreased prevalence of kidney disease. These results offer new perspectives on the connection between sleep patterns and kidney disease, which could inform preventive measures for this prevalent chronic condition.

Association between weekend catch-up sleep and the systemic immune-inflammation index in adults: Evidence from the NHANES 2017-2020

BACKGROUND

Chronic sleep deprivation is widespread and associated with detrimental health outcomes, including inflammation. A common strategy to address weekday sleep deficits is weekend catch-up sleep (WCS). However, the relevance of the WCS on systemic inflammation, as quantified by the systemic immune-inflammation index (SII), remains inadequately understood.

METHODS

This cross-sectional analysis examined data from the National Health and Nutrition Examination Survey (NHANES) 2017-2020 cohort. To explore the relationship between the WCS and the SII, we employed univariate analysis, weighted linear regression, restricted cubic spline (RCS) techniques, and subgroup analyses.

RESULTS

The final sample included 4849 adults. Weighted linear regression confirmed a negative association between the WCS and the SII after adjusting for potential confounders (β = -16.72, 95 % CI: -34.29 to 0.85, P = 0.04). Subgroup analyses revealed that this association varied by obesity, gender, and age. Additionally, the association between the WCS duration and the SII was non-linear (P = 0.006) in adults with a weekday sleep duration of 7-8 h.

CONCLUSION

WCS can help mitigate the inflammatory burden associated with chronic sleep deprivation. WCS durations of 3 h and longer are particularly beneficial for adults who experience sleep deprivation on weekdays. The association between WCS and SII appears to be moderated by factors such as obesity, gender, and smoking status.

Optimized oxygen therapy improves sleep deprivation-induced cardiac dysfunction through gut microbiota

Adequate sleep is of paramount importance for relieving stress and restoring mental vigor. However, the adverse physiological and pathological responses resulting from sleep insufficiency or sleep deprivation (SD) are becoming increasingly prevalent. Currently, the impact of sleep deficiency on gut microbiota and microbiota-associated human diseases, especially cardiac diseases, remains controversial. Here, we employed the following methods: constructed an experimental sleep-deprivation model in mice; conducted 16S rRNA sequencing to investigate the changes in gut microbiota; through fecal microbiota transplantation (FMT) experiments, transplanted fecal microbiota from sleep-deprived mice to other mice; established an environment with a 30% oxygen concentration to explore the therapeutic effects of oxygen therapy on gut microbiota-associated cardiac fibrosis and dysfunction; and utilized transcriptome data to study the underlying mechanisms of oxygen therapy. The results revealed that: sleep-deprived mice exhibited weakness, depression-like behaviors, and dysfunction in multiple organs. Pathogenic cardiac hypertrophy and fibrosis occurred in sleep-deprived mice, accompanied by poor ejection fraction and fractional shortening. 16S rRNA sequencing indicated that sleep deprivation induced pathogenic effects on gut microbiota, and similar phenomena were also observed in mice that received fecal microbiota from sleep-deprived mice in the FMT experiments. The environment with a 30% oxygen concentration effectively alleviated the pathological impacts on cardiac function. Transcriptome data showed that oxygen therapy targeted several hypoxia-dependent pathways and inhibited the production of cardiac collagen. In conclusion, these results demonstrate the significance of sufficient sleep for gut microbiota and may represent a potential therapeutic strategy, where the oxygen environment exerts a protective effect on insomniacs through gut microbiota.

The prevalence and risk factors of sleep disturbances in community-dwelling older adults: a systematic review and meta-analysis

PURPOSE

Sleep disturbance is one of the most prevalent health issues among community-dwelling older adults. This systematic review aims to assess the prevalence of sleep disturbances among these adults living in the community and identify associated risk factors.

METHODS

A comprehensive literature search was performed using PubMed, Web of Science, Embase, and the Cochrane Library databases. We screened studies focusing on the prevalence of sleep disturbances in community-dwelling older adults (≥ 60 years). A random-effects model was used to calculate the pooled prevalence of sleep disturbances. Sensitivity and subgroup analyses were conducted to investigate sources of heterogeneity, and funnel plots were used to assess publication bias.

RESULTS

Our systematic review included 41 articles, encompassing a total sample of 71,607 participants from 13 countries. The pooled prevalence of sleep disturbances, measured by PSQI, was found to be 45% (95% CI: 40-50%). Notably, the prevalence of sleep disturbances was significantly higher among individuals aged 70 years and older (48%) compared to those aged 60 years and older (41%). Common risk factors for sleep disturbances included depression, advanced age, females, chronic diseases (hypertension, coronary heart disease, chronic obstructive pulmonary disease) and poor external support (poor social support and poor family relationships).

CONCLUSION

The findings highlight the necessity for comprehensive assessments and management strategies targeting this population with depression, advanced age, females, hypertension, coronary heart disease, chronic obstructive pulmonary disease, and poor external support while also underscoring the significance of healthcare planners and policymakers in enhancing sleep quality for older adults.

Association between weekend catch-up sleep and hypertension of the United States population from 2017 to 2020: a cross-sectional study

Background

Hypertension is a prevalent cardiovascular risk factor that significantly contributes to morbidity and mortality worldwide. Previous studies have highlighted the role of inadequate sleep during weekdays in the development of hypertension. However, the potential mitigative effects of weekend catch-up sleep (WCS) on hypertension have been less explored.

Methods

This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2017-2020, focusing on American adults. We assessed the association between WCS (defined as the difference in sleep duration between weekend and weekday) and the presence of hypertension. Participants were classified into two groups based on their WCS duration: none (below 1 hours), yes (over 1 hours). Multivariable logistic regression models adjusted for potential confounders such as age, gender, Body mass index (BMI), and lifestyle factors were utilized to explore this association. A Generalized Additive Model (GAM) was employed to generate smooth curves for a nuanced analysis of the nonlinear relationship.

Results

The findings indicated that moderate WCS (less than 4 hours) was significantly associated with a reduced risk of hypertension, while excessive WCS (greater than 4 hours) showed no significant protective benefits.

Conclusion

Moderate weekend catch-up sleep could serve as an effective intervention to mitigate hypertension risk, especially in populations with restricted weekday sleep. These results suggest the potential for integrating sleep management strategies into public health recommendations to address hypertension. Future longitudinal studies are needed to confirm these findings and clarify the mechanisms underlying the relationship between WCS and hypertension risk.

Association between weekend catch-up sleep and depression in US adults

BACKGROUND

Depression is one of the most prevalent mental disorders and causes a serious economic and medical burden on society. This research assessed the correlation between weekend catch-up sleep (WCS) and depression in US adults aged ≥ 20 years.

METHODS

Cross-sectional data were obtained from individuals with complete WCS and Patient Health Questionnaire (PHQ-9) data who participated in the 2017-2020 National Health and Nutrition Examination Survey (NHANES). A logistic regression analysis was conducted to evaluate the possible independent conjunction between depression and WCS. Subgroup analysis and interaction tests have been carried out.

RESULTS

A total of 7,795 individuals with an average PHQ-9 level of 3.27 ± 4.25 were analyzed. The prevalence of depression was 9.11% overall, and participants in the quartile 3 (WCS 1-2 h) tended to have lowest rates of depression (Quartile 1: 9.49%; Quartile 2: 9.95%; Quartile 3: 7.03%; Quartile 4: 8.75%; p = 0.014). The incidence of depression was found to be less correlated with 1-2 h of WCS (OR = 0.74, 95% CI: 0.55, 0.99). Individuals with less than one hour or more than two hours of WCS did not have a significantly different risk of depression than individuals without WCS.

CONCLUSIONS

Moderate catch-up sleep on weekends was linked to a decreased likelihood of depression.

Association between weekend catch-up outdoor duration and prevalence of myopia: evidence from a cross-sectional, multi-center study in China

BACKGROUND

This study aimed at investigating the relationship between the weekend catch-up outdoor duration (WCOD) and prevalence of myopia among students in China.

METHODS

This cross-sectional study recruited participants in 107 schools (six cities, 30 districts) from China from May to June 2021. Demographic characteristics (age, grade, sex, ethnicity, BMI, resident, and parents' myopia), optically habits (bad writing habits, working/studying time per day, continuous working/studying time per day, and screen time per day) and outdoor duration (weekday and weekend) were obtained from questionnaire. WCOD was defined as outdoor time 1 h longer on weekends than on weekdays. Spherical equivalent (SE) of refractive error were measured with non-cycloplegic refraction. Adjusted multivariate logistic regression analysis was performed to evaluate the relationship between WCOD and prevalence of myopia.

RESULTS

Students with myopia had shorter WCOD compared with those without myopia (P < 0.001). Adjusted multivariate logistic regression analyses showed negative associations between WCOD and prevalence of myopia in Chinese students, especially in students with WCOD of 2-3 h (OR = 0.577, P < 0.001) and 3-4 h (OR = 0.571, P = 0.004) when the weekday outdoor duration was 0.5-1 h, as well as students with WCOD of 2-3 h (OR = 0.614, P = 0.003) when the weekday outdoor duration was 1-2 h. Similar results were observed in students with high myopia. Students with high myopia had shorter WCOD compared with those without high myopia (P = 0.001). Negative associations between WCOD and prevalence of high myopia were significant in students with WCOD of 1-2 h when the weekday outdoor duration was < 0.5 h (OR = 0.585, P = 0.007) and 0.5-1 h (OR = 0.537, P = 0.018).

CONCLUSION

Our study, for the first time, reported that a WCOD have a potential to reduce the prevalence of myopia and high myopia in Chinese students.