Association between reduced sleep and weight gain in women

Sleep deprivation in development of obesity, effects on appetite regulation, energy metabolism, and dietary choices

Sleep deprivation, which is a decrease in duration and quality of sleep, is a common problem in today's life. Epidemiological and interventional investigations have suggested a link between sleep deprivation and overweight/obesity. Sleep deprivation affects homeostatic and non-homoeostatic regulation of appetite, with the food reward system playing a dominant role. Factors such as sex and weight status affect this regulation; men and individuals with excess weight seem to be more sensitive to reward-driven and hedonistic regulation of food intake. Sleep deprivation may also affect weight through affecting physical activity and energy expenditure. In addition, sleep deprivation influences food selection and eating behaviours, which are mainly managed by the food reward system. Sleep-deprived individuals mostly crave for palatable energy-dense foods and have low desire for fruit and vegetables. Consumption of meals may not change but energy intake from snacks increases. The individuals have more desire for snacks with high sugar and saturated fat content. The relationship between sleep and the diet is mutual, implying that diet and eating behaviours also affect sleep duration and quality. Consuming healthy diets containing fruit and vegetables and food sources of protein and unsaturated fats and low quantities of saturated fat and sugar may be used as a diet strategy to improve sleep. Since the effects of sleep deficiency differ between animals and humans, only evidence from human subject studies has been included, controversies are discussed and the need for future investigations is highlighted.

[Screening for sleep disorders in internal medicine as potential comorbidities of systemic autoimmune diseases and improving patients' quality of life]

Sleep medicine and internal medicine share a global and transdisciplinary vision of human physiology and illnesses, with an approach guided by the complaint and semiology. In France, approximately 13 to 18 million individuals suffer from a sleep disorder: these disorders therefore represent a public health problem. Their comorbidities with systemic autoimmune diseases are frequent. As such, this article suggests an approach to screening for sleep disorders in daily clinical practice of internal medicine leading, when appropriate, to request specialized diagnostic and/or therapeutic care in sleep medicine to substantially improve patients' quality of life.

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.

Elucidating the chrononutrition patterns and sleep quality among subfertile patients with different vitamin D levels

Subfertility affects about 10-15% of Malaysians, characterized by difficulty conceiving after 12 months of unprotected intercourse. Emerging research suggests that vitamin D deficiency, influenced by dietary intake and sleep patterns, may contribute to fertility. This study examines the relationship between chrononutrition patterns, sleep quality and vitamin D deficiency in subfertile patients. A cross-sectional study was conducted at two hospitals in Selangor, Malaysia, involving 140 subfertile individuals who fit the inclusion and exclusion criteria. Data were collected through self-administered questionnaires, including food frequency questionnaires (FFQ), the Chrononutrition Profile Questionnaire (CPQ), and the Pittsburgh Sleep Quality Index (PSQI). Serum vitamin D levels were measured through 25-hydroxyvitamin D blood test. Statistical analyses were performed using SPSS version 29. Results revealed a significant difference in mean serum vitamin D levels between male and female participants (p < 0.001), with 76.7% of the females being vitamin D deficient. Most parameters were not significant in males compared to females. Notably, a negative correlation was found between vitamin D levels and both energy and fat intake in females (p < 0.05). Female gender was identified as a significant determinant of vitamin D deficiency (OR 5.186, p < 0.001), while poor evening eating habits were strongly associated with deficiency (AOR 10.553, p < 0.05). These findings highlight the importance of gender and dietary patterns in vitamin D deficiency among subfertile patients. Hence, there is a need for targeted nutritional and lifestyle interventions.

Relationship Between Poor Sleep Quality and Body Mass Index Among University Students at Imam Mohammad Ibn Saud Islamic University

Introduction A chronic lack of sleep can lead to physical exhaustion, negatively affecting university students' academic performance. The relationship between insufficient sleep and increased body mass index (BMI) has garnered significant attention. Obesity, weight fluctuations, and cognitive conditions contribute to poor sleep quality. Aim The aim of this study was to investigate the correlation between poor sleep quality and BMI, which may negatively impact academic performance among university students at Imam Mohammad Ibn Saud Islamic University (IMSIU) in Riyadh, Saudi Arabia. The study also explores whether changes in weight and cognitive status are linked to poor sleep quality. Subject and methods This cross-sectional study was conducted among 1297 university students from IMSIU. A self-administered questionnaire was distributed among students using an online survey. The questionnaire included sociodemographic questions, sleep quality assessed through the Pittsburgh Sleep Quality Index (PSQI), and four subjective questions regarding weight and cognitive status changes over the last month. The study spanned from September 2021 to May 2023. The study utilized the chi-square test and a subsequent multivariate analysis to examine the correlation between poor sleep quality and high BMI, weight changes, and cognitive effects among students. Results The 1297 students were from various disciplines under science and humanities; 70.8% were females, and 48% were aged between 17 and 20 years old. Around 13.6% of students were obese, and 85.3% had sleep problems. In univariate analysis, the factors that influence poor sleep quality were high BMI, experiencing weight loss or weight gain, and experiencing cognitive effects like difficulty concentrating. In a multivariate regression model, experienced weight loss, weight gain, and cognitive effects were identified as the significant independent predictors of poor sleep. Conclusion The incidence of poor sleep among university students was high. The study identified increased BMI, weight loss, weight gain, and cognitive dysfunction due to lack of sleep as the influential factors in poor sleep quality. This study highlights the need for targeted interventions to improve sleep hygiene and promote physical well-being programs in this population.

Weight-adjusted-waist index is associated with increased risk of sleep disturbances in the U.S. adult population: an analysis of NHANES 2007-2012

OBJECTIVE

The weight-adjusted-waist index (WWI) is a novel measure of central adiposity, potentially linked to various sleep disturbances. This study explores the relationship between WWI and sleep outcomes, such as trouble sleeping, sleep disorder, and sleep duration.

METHODS

Data from the National Health and Nutrition Examination Survey 2007-2012 were analyzed, including 13,494 participants. The analysis focused on individuals aged 20 years and older who provided information on WWI and sleep. Sleep status was determined based on responses to the following questions: (1) "How many hours do you sleep?"; (2) if they reported trouble sleeping; and (3) if they had physician-diagnosed sleep disorders. Regression models assessed the association between WWI and sleep outcomes across the entire population and within subgroups. Restricted cubic spline (RCS) analysis was conducted to examine potential non-linear relationships between WWI and sleep outcomes.

RESULTS

A higher WWI was significantly correlated with an increased likelihood of trouble sleeping (OR = 1.26, 95% CI: 1.16, 1.36; p < 0.001) and sleep disorder (OR = 1.71, 95% CI: 1.50, 1.95; p < 0.001) in the overall population. RCS analysis indicated a linear relationship between WWI and these sleep outcomes. Subgroup analysis identified that the connection between WWI and trouble sleeping was most pronounced among Non-Hispanic Blacks and individuals with lower educational levels. For sleep disorder, the association was stronger in males and Non-Hispanic Blacks. A slight negative association between WWI and sleep duration was found, especially among non-drinkers (β = - 0.13, 95% CI: - 0.24, - 0.02; p = 0.028).

CONCLUSION

The findings highlight a significant and linear relationship between elevated WWI and an increased likelihood of experiencing trouble sleeping and sleep disorder, with variations observed across different demographic and lifestyle subgroups. These results imply that central adiposity, as measured by WWI, plays an important role in sleep health.

LEVEL OF EVIDENCE

Level III: Evidence obtained from well-designed cohort or case-control analytic studies.

The Effect of Sleep Disruption on Cardiometabolic Health

Sleep disruption has emerged as a significant public health concern with profound implications for metabolic health. This review synthesizes current evidence demonstrating the intricate relationships between sleep disturbances and cardiometabolic dysfunction. Epidemiological studies have consistently demonstrated that insufficient sleep duration (<7 h) and poor sleep quality are associated with increased risks of obesity, type 2 diabetes, and cardiovascular disease. The underlying mechanisms are multifaceted, involving the disruption of circadian clock genes, alterations in glucose and lipid metabolism, the activation of inflammatory pathways, and the modulation of the gut microbiome. Sleep loss affects key metabolic regulators, including AMPK signaling and disrupts the secretion of metabolic hormones such as leptin and ghrelin. The latest evidence points to the role of sleep-induced changes in the composition and function of gut microbiota, which may contribute to metabolic dysfunction through modifications in the intestinal barrier and inflammatory responses. The NLRP3 inflammasome and NF-κB signaling pathways have been identified as crucial mediators linking sleep disruption to metabolic inflammation. An understanding of these mechanisms has significant implications for public health and clinical practice, suggesting that improving sleep quality could be an effective strategy for preventing and treating cardiometabolic disorders in modern society.

Sleep Deficiency: Epidemiology and Effects

Adequate sleep is an important pillar of physical and mental health. Sleep deficiency, resulting from short sleep or suboptimal sleep quality, is highly prevalent in modern society. Occupation, social demands, psychiatric disorders, physical disorders, and sleep disorders are some of the contributing factors to sleep deficiency. Some populations are at increased risk of sleep deficiency based on ethnicity, age, marital status, sex, and hospitalization. Sleep deficiency influences cognition, alertness, mood, behavior, diabetes, cardiovascular health, renal function, immune system, and respiratory physiology. This review summarizes the epidemiology and effects of sleep deficiency.

Extent, range, and nature of studies examining sleep in nurses: a scoping review protocol

OBJECTIVE

This scoping review aims to comprehensively map the extent, range, and nature of studies that examine the various dimensions of nurses' sleep across all health care settings or countries.

INTRODUCTION

Over the past 2 decades, the importance of sleep for nurses has gained increasing attention from health care administrators, researchers, and policymakers. Despite growing research in the area, it remains unclear as to how research on sleep in nurses aligns with emerging concepts in sleep medicine more broadly, particularly in terms of how outcomes and predictors are associated with different dimensions of sleep.

INCLUSION CRITERIA

This review will consider sources of evidence reporting on nurses who hold professional accreditation, such as a registered nurse or equivalent, regardless of career stage or specialty. This review will include primary studies that examine nurses' sleep. All dimensions of sleep (eg, duration, timing, variability, quality, common disorders) reported objectively or subjectively will be considered for inclusion.

METHODS

This review will follow a modified version of the JBI methodology for scoping reviews and will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Databases to be searched include MEDLINE (Ovid), Emcare (Ovid), Embase (Ovid), PsycINFO (Ovid), and Scopus. A 3-step search strategy will be undertaken to identify primary studies published in English, with no date limit. Both double-screening and single-screening of titles and abstract records and of full-text reports will be used, with discussion to resolve any conflicts prior to single-screening. Data extraction will similarly involve duplicate extraction, followed by single extraction, with discrepancies resolved in a group meeting as needed. The data extracted will include specific details about the nursing population, sleep dimension, outcome measures, methodology, and key findings. Figurative, tabular, and accompanying narrative synthesis will be used to present the results in line with the review questions.

REVIEW REGISTRATION

Open Science Framework https://osf.io/rzc4m.

Association of cardiometabolic index with sleep quality in adults: a population‑based study

The Cardiometabolic Index (CMI) represents an innovative metric that encompasses abdominal obesity and lipid levels, offering a comprehensive assessment of cardiometabolic health. It is derived through the multiplication of the waist-to-height ratio by the triglyceride-to-high-density lipoprotein cholesterol ratio. Although obesity and blood lipid levels are known factors affecting sleep quality, the direct correlation between CMI and sleep quality has yet to be elucidated. This study uses NHANES data to explore the potential correlation between CMI and sleep quality. Our research employed a cross-sectional design, utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning 2011 to 2014. CMI was used as the exposure variable, with sleep quality assessed through three self-reported measures: trouble sleeping, sleep disorders, and sleep duration. We employed multivariate logistic regression models and linear regression model as well as subgroup analyses to explore the independent relationship between CMI and sleep quality. Additionally, interaction tests were conducted to examine differences across various subgroups. The study included 4298 participants, comprising 2134 males and 2164 females. There was a positive correlation between CMI and trouble sleeping (OR = 1.63, 95% CI 1.28-2.08) and sleep disorders (OR = 1.96, 95% CI 1.43-2.67), while there was a negative correlation between CMI and sleep duration (β = - 0.17, 95% CI - 0.31 to - 0.03), indicating that a higher CMI was associated with shorter sleep duration. Subgroup analyses and interaction tests revealed a consistently positive association between CMI and sleep difficulty across various populations, including gender, age, hypertension, diabetes, and cardiovascular disease history. However, the relationship between CMI and sleep disorders was more prominent among participants aged 50 and above. In American adults, a higher CMI is linked to an increased prevalence of sleep disturbances. In clinical practice, CMI can be considered as a supplementary factor in the assessment and management of sleep problems. Our study also provided new insights for improving sleep quality.

New Insights into Health Conditions Related to Malfunctions in Clock Genes

Chronotypes play a crucial role in regulating sleep-wake cycles and overall health. The aim of this study was to investigate chronotype, sleep quality, polymorphisms of clock genes and the level of leptin in serum. We used standardized questionnaires to assess chronotype and sleep quality. Genetic analysis was performed to determine the selected clock gene polymorphism. Serum leptin level was measured by the Elisa method. The results showed that serum leptin concentration was elevated in women, as well as in men who had a high waist-to-hip ratio (WHR) and body mass index (BMI). The evidence indicated that younger students (<22 years old) were most likely to experience poor sleep quality. Nevertheless, our multivariate analysis revealed that young age and a morning-oriented chronotype were associated with better sleep quality. We noted that clock gene polymorphisms were present in 28.6% of the participants. Moreover, polymorphisms of PER1 c.2247C>T (rs2735611) and PER2 c.-12C>G (rs2304672) genes were associated with serum leptin level and chronotype, respectively. These findings provide insights into the relationships between chronotype, sleep quality, clock gene polymorphisms and obesity risk in biomedical students. Understanding these factors can contribute to better sleep management and potential interventions to improve health outcomes in humans.

Demographic, socioconomic, and health correlates of sleep quality and sleep duration among community-dwelling older adults in India

BACKGROUND

Recent research has revealed that today's older adults report more sleep problems than their predecessors, a trend compounded by expanding social stratification. As such, this study examined the demographic, socioeconomic, and health correlates of sleep quality and sleep duration among community-dwelling older adults in India.

METHODS

The current study sample draws on data from 7118 respondents aged 50 years and over participating in the World Health Organization's Study on global AGEing and adult health (WHO-SAGE) wave-2 dataset. Sleep quality (good, moderate, and poor) and sleep duration (in hours and minutes) were self-reported. Adjusted multivariable logistic regression models were employed to examine the associations between sleep quality and sleep duration and several demographic, socioeconomic, and health indicators.

RESULTS

A total of 12.84% and 36.1% of older adults reported long (> 8 h) and short (< 7 h) sleep, respectively. Older adults with primary education had lower odds of poor sleep [aOR: 0.85, CI: 0.73-0.99] than peers with no formal education. The odds of poor sleep were lower among those in higher wealth quintiles than those in the poorest quintile. Older adults with higher education had higher odds of short sleep [aOR: 1.36, CI: 1.06-1.74], and those with primary education had lower odds of long sleep [aOR: 0.70, CI: 0.54-0.91] than those without formal education (base category: age-appropriate sleep, i.e., 7-8 h). Older adults who were widowed had lower odds of both short [aOR: 0.82, CI: 0.68-0.98] and long sleep [aOR:0.74, CI: 0.58-0.95] compared to those who were currently married. Older individuals with adequate nutritional intake reported lower odds of short [aOR:0.59, CI: 0.49-0.72] and higher odds of long sleep [aOR:1.52, CI: 1.20-1.93] relative to their counterparts. Older adults who reported chronic conditions and body pain had higher odds of poor sleep and short sleep than their counterparts.

CONCLUSIONS

We identified significant associations between several unmodifiable factors, including age, education, and marital status, and modifiable factors such as dietary intake, body pain, and pre-existing chronic ailments, and sleep quality and sleep duration. Our findings can assist health care providers and practitioners in developing a more holistic and empathic approach to care. Moreover, that several demographic, socioeconomic, and health-related factors are consequential for older adults' sleep health suggests that early detection through screening programs and community-based interventions is vital to improving sleep among older Indians who are most susceptible to sleep problems.

Associations of meal timing and sleep duration with incidence of obesity: a prospective cohort study

OBJECTIVES

Late mealtime and short sleep are known to be associated with obesity risk due to a misaligned circadian rhythm. This study aimed to investigate the relationship between obesity and mealtime and sleep duration using the Korean Genome and Epidemiology Study (KoGES) data.

DESIGN

Longitudinally prospective cohort study.

SETTING

Population-based.

PARTICIPANTS

KoGES analysed data from 9,474 Korean adults with an average age of 54- years old at baseline.

MEASUREMENTS

Meal timing was defined as the eating occasions of the day reported by the participant eating a 24-h dietary recall method. Sleep duration was categorized as <6, 6-7, 7-8, and ≥8 h. The Cox proportional hazard model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident obesity according to meal timing, sleep duration, and nightly fasting duration.

RESULTS

During a mean follow-up of 3.5 years, 826 participants developed obesity. In the multivariable-adjusted analysis, midnight snack eating (HR, 1.20; 95% CI, 1.02-1.41) and higher energy intake from midnight snacks (HR, 1.26; 95% CI, 1.06-1.49) were associated with a higher risk of obesity. Sleeping 8 h or more (HR, 0.67; 95% CI, 0.53-0.85) was associated with a lower risk of obesity.

CONCLUSIONS

Our findings highlight the importance of meal and sleep times and suggest that healthy eating habits related to the time of day.

Potential Therapeutic Targets in Obesity, Sleep Apnea, Diabetes, and Fatty Liver Disease

Obesity and metabolic syndrome affect the majority of the US population. Patients with obesity are at increased risk of developing type 2 diabetes (T2DM), obstructive sleep apnea (OSA), and metabolic dysfunction-associated steatotic liver disease (MASLD), each of which carry the risk of further complications if left untreated and lead to adverse outcomes. The rising prevalence of obesity and its comorbidities has led to increased mortality, decreased quality of life, and rising healthcare expenditures. This phenomenon has resulted in the intensive investigation of exciting therapies for obesity over the past decade, including more treatments that are still in the pipeline. In our present report, we aim to solidify the relationships among obesity, T2DM, OSA, and MASLD through a comprehensive review of current research. We also provide an overview of the surgical and pharmacologic treatment classes that target these relationships, namely bariatric surgery, the glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), and glucagon receptor agonists.

The effects of sleep disruption on metabolism, hunger, and satiety, and the influence of psychosocial stress and exercise: A narrative review

Sleep deficiency is a ubiquitous phenomenon among Americans. In fact, in the United States, ∼78% of teens and 35% of adults currently get less sleep than recommended for their age-group, and the quality of sleep appears to be getting worse for many. The consequences of sleep disruption manifest in a myriad of ways, including insulin resistance and disrupted nutrient metabolism, dysregulation of hunger and satiety, and potentially increased body weight and adiposity. Consequently, inadequate sleep is related to an increased risk of various cardiometabolic diseases, including obesity, diabetes, and heart disease. Exercise has the potential to be an effective therapeutic to counteract the deleterious effects of sleep disruption listed above, whereas chronic psychosocial stress may causally promote sleep disruption and cardiometabolic risk. Here, we provide a narrative review of the current evidence on the consequences of short sleep duration and poor sleep quality on substrate metabolism, circulating appetite hormones, hunger and satiety, and weight gain. Secondly, we provide a brief overview of chronic psychosocial stress and its impact on sleep and metabolic health. Finally, we summarise the current evidence regarding the ability of exercise to counteract the adverse metabolic health effects of sleep disruption. Throughout the review, we highlight areas where additional interrogation and future exploration are necessary.

Distress, multimorbidity, and complex multimorbidity among Chinese and Korean American older adults

BACKGROUND

Studies suggest that distress is associated with various health conditions such as hypertension, asthma, diabetes, and coronary heart disease. However, only few studies focused on Asian Americans and little is known about the association with multiple comorbidity.

METHODS

We conducted a cross-sectional analysis among 400 Chinese and Korean American participants (aged 50-75 years) of the STOP CRC randomized controlled trial. Perceived distress was assessed using the distress thermometer scale (range 0-10). Disease diagnosis was self-reported by the participants. Multimorbidity (MM) was defined as having ≥2 chronic conditions. Complex multimorbidity (CMM) was defined as having ≥3 of the following body system disorders: circulation disorder, endocrine-metabolic disorder, cancer, anxiety or depression, breathing problem, and other health problems. We performed logistic regression for CMM and Poisson regression with robust error variance for MM to estimate associations with distress, adjusting for potential confounders.

RESULTS

The mean age was 58.4 years and mean distress score was 3.65. One-unit increase in distress score was associated with a 1.22-fold increase in the odds of having CMM (95% CI: 1.04-1.42). The magnitude of association slightly increased after additional adjustment for socioeconomic factors and health insurance status (OR: 1.29; 95% CI: 1.10-1.52). Higher distress score was positively associated with MM but the association was only marginally significant (PR: 1.04; 95% CI: 0.99-1.10), adjusting for socioeconomic factors and health insurance status.

CONCLUSION

Our data suggest that higher perceived distress may be associated with simultaneous dysfunction of multiple distinct body systems among Chinese and Korean American older adults.

Relationships between sleep duration and health among U.S. adults with a history of household incarceration during childhood

The rate of incarceration in the United States has increased at an alarming rate in the past 30 years and thus so has the number of children having a household member incarcerated (referred to as household incarceration). Associations between experiencing household incarceration in childhood and later negative health and developmental outcomes are well-documented; however, the underlying mechanisms linking this childhood stressor and adult outcomes have been less well studied. Using state Behavioral Risk Factor Surveillance System survey data (N = 145,102), this study examines how experiencing household incarceration during childhood is associated with mental and physical health in adulthood and mediational pathways through suboptimal sleep (short or long sleep). Results indicate there were significant indirect effects of household incarceration to physical and mental distress through short sleep (≤ 6 hr per 24 hr) and long sleep (≥ 10 hr per 24 hr), and a significant indirect effect of household incarceration to body mass index through short sleep. Findings from the present study highlight indirect pathways through which household incarceration in childhood is linked with sleep health in adulthood and, in turn, to negative mental and physical health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

An Update on Sleep Duration, Obesity, and Mortality Risk in Women

Sleep health is an essential component to overall health. Because of numerous societal, economic, and biological factors, obtaining adequate sleep poses a unique challenge to aging women. Yet, women have been traditionally understudied in sleep research. An increasing body of research supports abnormal sleep duration as a risk factor for obesity, cardiovascular disease, and mortality. This review focuses specifically on 3 areas of the discussion of insufficient sleep in women: (1) the mysterious poor health of long sleepers, (2) the potential underlying mechanisms linking abnormal sleep duration and cardiometabolic health, and (3) the need to investigate multiple levels of social determinants driving sleep disparities.

Sex Differences Associated with Weekend Catch-Up Sleep and Waist-to-Height-Ratio among South Korean Adults Using Korea National Health and Nutrition Examination Survey 2016-2021 Data

The global surge in obesity rates is closely linked to the rise in sleep deprivation and prevalence of sleep disorders. This study aimed to investigate the association between weekend catch-up sleep (CUS) and obesity among Korean adults. Using multiple logistic regression analysis, we analyzed the data of 6790 adults aged >19 years obtained from the Korea National Health and Nutrition Examination Survey 2016-2021. In the subgroup analysis, we conducted multiple logistic regression analysis to determine the association between weekend CUS and obesity, stratified by sex. Women were significantly more likely to be obese than men (odds ratio (OR) = 0.53, 95% confidence interval (CI) = 0.46-0.61). Obesity was associated with 1 ≤ weekend CUS < 2 (OR = 0.86, 95% CI = 0.75-0.99) but not with weekend CUS ≤ 0. Compared to men, women had a lower obesity risk when engaging in weekend supplementary sleep that was 1 ≤ weekend CUS < 2 (OR = 0.78, 95% CI = 0.63-0.97). Our findings revealed that weekend CUS was associated with obesity. Our findings suggest that weekend CUS may offer a form of biological protection against obesity, and they contribute to a better understanding of this association and may serve as a basis for better obesity management.

Developmental Trajectory of Body Weight in Youths at Risk for Major Mood Disorders

Importance

Mood disorders are associated with increased body weight, especially in females, but it remains unknown when the weight increase starts.

Objectives

To examine sex-specific weight trajectories associated with familial mood disorder risk and determine the age at which youth at familial risk for mood disorders begin to diverge in weight from controls.

Design, Setting, and Participants

This community-based, single-center, acceleration cohort study of youth at familial risk for mood disorders and controls with yearly follow-ups (mean [SD], 5 [2.1] years) from January 1, 2014, to December 31, 2022, assessed 394 unaffected female and male offspring (aged 3 to 20 years) of parents with or without a mood disorder. Parents with mood (depressive or bipolar) disorders were recruited through adult mental health services. Parents of control participants were matched on age and socioeconomic factors and recruited through acquaintance referrals or schools.

Exposures

The youth in the familial mood risk group had at least 1 parent with a major mood disorder, whereas control youth did not have a parent with a mood disorder.

Main Outcomes and Measures

Body mass indexes (BMIs) were calculated as weight in kilograms divided by height in meters squared from measured weight and height at annual assessments and then converted to age- and sex-adjusted z scores (zBMIs). Repeated-measure regressions examined the association between zBMI and age in youth at familial risk of mood disorders and controls while accounting for sex. Sensitivity analyses accounted for socioeconomic status, prematurity, and birth weight.

Results

Of 394 participants (mean [SD] age, 11.5 [3.6] years; 203 [51.5%] female), youths at familial risk for mood disorders showed overall no difference in body weight (β = 0.12; 95% CI, 0.01-0.24) from controls. A sex-specific difference was detected, with females at familial risk showing a rapid peripubertal increase in body weight, leading to significantly increased zBMIs at 12 years and older compared with controls (β = 0.57; 95% CI, 0.31-0.82) independent of socioeconomic status, prematurity, or birth weight. Males did not differ from controls at any age.

Conclusions and Relevance

In this cohort study, females with a family history of mood disorders were prone to weight gain starting around puberty and predating mood disorder onset. Early interventions aiming to prevent adverse mental and physical outcomes in this vulnerable group need to start in childhood.

Associations between sleep health and obesity and weight change in adults: The Daily24 Multisite Cohort Study

OBJECTIVES

To examine cross-sectional and longitudinal associations of individual sleep domains and multidimensional sleep health with current overweight or obesity and 5-year weight change in adults.

METHODS

We estimated sleep regularity, quality, timing, onset latency, sleep interruptions, duration, and napping using validated questionnaires. We calculated multidimensional sleep health using a composite score (total number of "good" sleep health indicators) and sleep phenotypes derived from latent class analysis. Logistic regression was used to examine associations between sleep and overweight or obesity. Multinomial regression was used to examine associations between sleep and weight change (gain, loss, or maintenance) over a median of 1.66 years.

RESULTS

The sample included 1016 participants with a median age of 52 (IQR = 37-65), who primarily identified as female (78%), White (79%), and college-educated (74%). We identified 3 phenotypes: good, moderate, and poor sleep. More regularity of sleep, sleep quality, and shorter sleep onset latency were associated with 37%, 38%, and 45% lower odds of overweight or obesity, respectively. The addition of each good sleep health dimension was associated with 16% lower adjusted odds of having overweight or obesity. The adjusted odds of overweight or obesity were similar between sleep phenotypes. Sleep, individual or multidimensional sleep health, was not associated with weight change.

CONCLUSIONS

Multidimensional sleep health showed cross-sectional, but not longitudinal, associations with overweight or obesity. Future research should advance our understanding of how to assess multidimensional sleep health to understand the relationship between all aspects of sleep health and weight over time.

Association between Sleep Duration and Metabolic Disorders among Filipino Immigrant Women: The Filipino Women's Diet and Health Study (FiLWHEL)

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.

Sleep-Body Composition Relationship: Roles of Sleep Behaviors in General and Abdominal Obesity in Chinese Adolescents Aged 17-22 Years

This study aimed to investigate the association between sleep behaviors and body composition, which was measured by bioelectrical impedance analysis (BIA) among Chinese adolescents. Overall, 444 students (65.3% females, 19.12 ± 1.177 years) completed questionnaires describing sleep characteristics. Sleep characteristics were derived from subjective means. Body composition was obtained from BIA by InBody 720 (Biospace Co. Ltd., Seoul, Republic of Korea). Regression models tested relationships between sleep and body composition after adjustment for covariates. Students with weekday nap duration (>30 min/d) exerted higher waist-height ratio (WHtR) (B = 0.013, FDR-corrected p = 0.080). Average sleep duration (≤7 h/d) was linked to more WHtR (B = 0.016, FDR-corrected p = 0.080). People with high social jetlag showed gained visceral fat area (B = 7.475), WHtR (B = 0.015), waist to hip ratio (B = 0.012), fat mass index (B = 0.663) and body fat percentage (B = 1.703) (all FDR-corrected p < 0.1). Individuals with screen time before sleep (>0.5 h) exhibited higher visceral fat area (B = 7.934, FDR-corrected p = 0.064), WHtR (B = 0.017, FDR-corrected p = 0.080), waist to hip ratio (B = 0.016, FDR-corrected p = 0.090), fat mass index (B = 0.902, FDR-corrected p = 0.069) and body fat percentage (B = 2.892, FDR-corrected p = 0.018). We found poor sleep characteristics were closely related to general and abdominal obesity.

Well-being predictors of body composition and associated behavioral risk factors in midlife/older women participating in a meditative movement intervention: an exploratory analysis

Introduction

Greater than 40% of women are obese, a key risk factor for cardiometabolic, neurocognitive disease, mood disorders, and certain cancers. Obesity and unfavorable body composition can compromise physical and psychological health and well-being. Preliminary evidence demonstrates Meditative Movement (i.e., Tai Chi Easy) improves health outcomes and body composition among midlife/older women. This single-group pilot study explored relationships between well-being predictors related to body composition and associated behavioral risk factors in midlife/older women pre-to-post Tai Chi Easy intervention.

Methods

Eligible women 45-75 years old, participated in once-weekly 30-minute Tai Chi Easy classes over 8-weeks. Pre/post-intervention data included self-report surveys and on-site body composition. Multivariate linear regression models were fitted with putative predictor variables having correlations p-values of 0.20 or less with sleep quality and eating behaviors.

Results

Participants (N = 36) (M age = 53.7) were White (80.4%) and attended ≥ 4 years of college (70.6%). Analyses resulted in one independent variable per model as a predictor of the dependent variables of sleep quality and emotional eating. Results indicated: (1) stress explained 13.4% sleep quality variance (F (2, 20) = 2.71, p = 0.09) and (2) self-compassion explained 42.1% emotional eating variance (F (2, 31) = 12.54, p < .01).

Conclusion

Findings suggest stress and self-compassion partially explain variance in the dependent variables of sleep quality and emotional eating, both associated behavioral risk factors of body composition. Additional research may guide interventions to test efficacy and examine mediators to improve well-being predictors, body composition, and associated behavioral risk factors among midlife/older women.

Effect of insomnia and excessive daytime sleepiness on cardiac functions in older adults

BACKGROUND

We investigated the potential harmful effect in older adults of insomnia and excessive daytime sleepiness (EDS) on myocardial functions and electrophysiologic changes of the heart in terms of heart rate and QT intervals corrected for heart rate (QTc).

METHODS

The study included 32 insomnia patients and 30 control subjects. An Insomnia Severity Index score of ≥15 indicated insomnia, while a score of <8 was accepted as the control group. The Epworth Sleepiness Scale was used to assess EDS, with a score of ≥11/24 points indicating EDS. Diastolic and systolic functions were evaluated in each patient by transthoracic two-dimensional, conventional and tissue Doppler echocardiography. Heart rate and QTc were calculated for electrophysiologic changes.

RESULTS

The mean age was 73.2 ± 7.9 years, with 59.7% being female. Biventricular systolic and diastolic functions were impaired in the insomnia patients. The E' value for diastolic function was lower in the patients with insomnia than the controls (5.99 ± 1.59 vs. 6.88 ± 0.97, P = 0.053). Furthermore, values for the systolic function parameters Lateral-S (7.41 ± 1.92 vs. 9.37 ± 1.83, P < 0.001), Septal-S (6.69 ± 1.40 vs. 8.10 ± 1.30, P = 0.001), and Tricuspid-S (12.25 ± 2.00 vs. 14.37 ± 3.13, P = 0.004) were lower for insomnia patients than for controls. In the case of EDS coexistence, the heart rate and QTc values were higher than the controls (76.47 ± 7.18 vs. 71.03 ± 10.95, P = 0.001, and 413.72 ± 28.24 vs. 394.67 ± 24.47, P = 0.015, respectively).

CONCLUSION

Insomnia is associated with impaired systolic-diastolic functions, independent of EDS. The co-existence of insomnia and EDS may lead to electrophysiological changes in older adults, including increased heart rate and longer QTc.

Fat mass, weight and body shape changes at menopause - causes and consequences: a narrative review

In addition to age-related weight gain, menopause adds additional challenges for women with the occurrence of significant metabolic alterations and central and visceral fat redistribution. The changes in body composition then influence risks of cardiovascular disease, metabolic disruption, cancer, fracture, lung disease, sexual dysfunction, mental health disorders and dementia. They may also heighten the severity of vasomotor symptoms. Treatment of these changes requires a flexible long-term strategy. This narrative review explores the pathogenesis of the metabolic changes at menopause and effective management options.

Sleep and cancer recurrence and survival in patients with resected Stage III colon cancer: findings from CALGB/SWOG 80702 (Alliance)

BACKGROUND

We sought to assess the influences of sleep duration, sleep adequacy, and daytime sleepiness on survival outcomes among Stage III colon cancer patients.

METHODS

We conducted a prospective observational study of 1175 Stage III colon cancer patients enrolled in the CALGB/SWOG 80702 randomised adjuvant chemotherapy trial who completed a self-reported questionnaire on dietary and lifestyle habits 14-16 months post-randomisation. The primary endpoint was disease-free survival (DFS), and secondary was overall survival (OS). Multivariate analyses were adjusted for baseline sociodemographic, clinical, dietary and lifestyle factors.

RESULTS

Patients sleeping ≥9 h-relative to 7 h-experienced a worse hazard ratio (HR) of 1.62 (95% confidence interval (CI), 1.01-2.58) for DFS. In addition, those sleeping the least (≤5 h) or the most (≥ 9 h) experienced worse HRs for OS of 2.14 (95% CI, 1.14-4.03) and 2.34 (95% CI, 1.26-4.33), respectively. Self-reported sleep adequacy and daytime sleepiness showed no significant correlations with outcomes.

CONCLUSIONS

Among resected Stage III colon cancer patients who received uniform treatment and follow-up within a nationwide randomised clinical trial, very long and very short sleep durations were significantly associated with increased mortality. Interventions targeting optimising sleep health among indicated colon cancer patients may be an important method by which more comprehensive care can be delivered.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT01150045.

Combined effect of work from home and work during nonwork time on sleep disturbance

Background

Owing to the coronavirus disease 2019 pandemic, being exposed to work from home and work during nonwork time simultaneously can lead to sleep disturbance; however, their combined effect is unclear. We aimed to investigate the combined effect of work from home and work during nonwork time on sleep disturbance.

Methods

This study used data from the Sixth Korean Working Condition Survey and included 27,473 paid workers. Logistic regression analysis was conducted to investigate the relationship between work from home, work during nonwork time, and sleep disturbance according to sex. We re-classified participants into 4 groups based on their working from home (No/Yes) and working during nonwork time (No/Yes). The relative excess risk due to interaction was calculated to examine the effect of exposure to both telecommuting and non-regular work hours on sleep disturbance.

Results

Workers exposed to work from home and work during nonwork time had significantly higher risks of sleep disturbance for all, men, and women workers (OR [95% CI]: 1.71 [1.46-2.02], 1.79 [1.43-2.23], and 1.64 [1.29-2.08] for work from home and 3.04 [2.70-3.42], 3.61 [3.09-4.22], and 2.41 [2.01-2.90] for work during nonwork time, respectively). Compared to those who were not exposed to both factors, when workers had both job factors, the ORs (95% CI) of sleep disturbance for all, men, and women were 3.93 (2.80-5.53), 5.08 (3.21-8.03), and 2.91 (1.74-4.87), respectively. The relative excess risk due to interaction of work from home and work during nonwork time was not significant for sleep disturbance.

Conclusions

Work from home and work during nonwork time were each associated with sleep disturbance, but the interaction between the two factors on sleep disturbance was not observed in both men and women.

Sleep Patterns, Eating Behavior and the Risk of Noncommunicable Diseases

Sleep is extremely important for the homeostasis of the organism. In recent years, various studies have been carried out to address factors related to sleep patterns and their influence on food choices, as well as on the onset of chronic noncommunicable diseases. The aim of this article is to provide a scientific literature review on the possible role of sleep patterns on eating behavior and the risk of noncommunicable diseases. A search was performed on Medline (PubMed interface) using several keywords (e.g., "Factors Influencing Sleep" OR "Sleep and Chronic Diseases"). Articles published between 2000 and the present date that relate sleep to cyclic metabolic processes and changes in eating behavior were selected. Changes in sleep patterns are increasingly detected today, and these modifications are mainly caused by work and lifestyle conditions as well as a growing dependence on electronic devices. Sleep deprivation and the resultant short sleep duration lead to an increased appetite via an increase in the hunger hormone (ghrelin) and a decrease in the satiety hormone (leptin). Nowadays, sleep is undervalued, and thus often impaired, with consequences for the performance of various body systems. Sleep deprivation alters physiological homeostasis and influences eating behavior as well as the onset of chronic diseases.

Impact of Body Composition on Sleep and Its Relationship with Sleep Disorders: Current Insights

Sleep is involved in many physiological processes and is essential for both physical and mental health. Obesity and sleep deprivation due to sleep disorders are major public health issues. Their incidence is increasing, and they have a wide range of adverse health-related consequences, including life-threatening cardiovascular disease. The impact of sleep on obesity and body composition is well-known, and many studies have shown an association between insufficient or excessive sleep duration and obesity, body fat percentage, and weight gain. However, there is growing evidence of the effects of body composition on sleep and sleep disorders (particularly sleep disordered breathing) through anatomical and physiological mechanisms (nocturnal fluid shift, core body temperature, or diet). Although some research has been conducted on the bidirectional effects of sleep-disordered breathing and body composition, the specific effects of obesity and body composition on sleep and the underlying mechanisms that explain these effects remain unclear. Therefore, this review summarizes the findings on the effects of body composition on sleep and draws conclusions and proposals for future research in this field.

Sleep Apnea, Obesity, and Diabetes - an Intertwined Trio

PURPOSE OF REVIEW

To synthesize the existing literature regarding the complex interplay between sleep disturbance, obesity, and diabetes. The review emphasizes the three pillars of health being diet, exercise, and sleep, with the notion that if one is ignored, then the other two could suffer.

RECENT FINDINGS

Sleep deprivation is associated with incident obesity, perhaps mediated by dysregulation in leptin and ghrelin - hormones important in regulation of appetite. Sleep apnea is very common particularly among obese people with type 2 diabetes mellitus. Treatment of sleep apnea has clear symptomatic benefits although its impact on long-term cardiometabolic health is less clear. Sleep disturbance may be an important modifiable risk for patients at risk of cardiometabolic disease. An assessment of sleep health may be an important component of the comprehensive care of patients with obesity and diabetes mellitus.

Menopause, weight, and metabolic health - considerations for a patient centered, multidisciplinary approach

PURPOSE OF REVIEW

To examine the complexity of weight and metabolic changes during the menopausal transition and propose a multidisciplinary care approach to support long-term metabolic health.

RECENT FINDINGS

Menopause, weight and metabolic health changes are influenced by many interplaying factors, and therefore, require a multipronged, multidisciplinary patient centered approach. This approach should start with a medical history and examination. Additional key components include: behavior change principles, mental health evaluation, gynecological care, nutrition, exercise recommendations and sleep care. In addition, when appropriate, weight loss pharmacotherapy and surgical options should be considered. Metabolic health is a long-term chronic process and improvement requires a chronic management approach.

SUMMARY

Applying the framework of chronic disease prevention and treatment to optimizing metabolic health and body weight in peri and postmenopausal women offers an approach that works with the dynamic nature of metabolism changes that occur during aging and the menopausal transition. Using patient-centered care and behavior change principles with this multidisciplinary approach can strengthen its long-term effect.

Understanding changes in eating behavior during the transition to university from a self-determination theory perspective: a systematic review

Objective: The objective of this systematic review was to understand how and why eating behavior changes during the transition to university, and interpret findings from a self-determination theory perspective (Ryan & Deci, 2000). Methods: We searched six databases and identified 51 articles with findings involving changes in eating behavior during the transition to university. Results: During this transition, students eat less food, less healthy, and less regularly. These changes are mostly among students who move into a university residence or off-campus housing, with few changes in eating behavior among students who continue living at home. Yet, incoming students with food skills and experience living independently seem less likely to experience these changes. Conclusions: The university context offers challenges to eating healthy. Students' satisfaction of psychological needs may explain observed changes in habits, self-regulation, and motivation.

The EASO New Investigator Award in Clinical Research 2021: Role of Chronotype in Obesity

BACKGROUND

Chronotype is the expression of the timing of circadian rhythmicity of a subject, and three categories of chronotype have been identified: morning, evening, and intermediate chronotype. Subjects with morning chronotype prefer to carry out most of their daily activities in the morning, while subjects with evening chronotype perform most of their daily activities in the second half of the day. Intermediate chronotype is in an intermediate position between the above reported categories. Recently, evening chronotype has been associated with an increased risk of developing chronic diseases. Thus, the aim of this manuscript was to review the current evidence on the role of chronotype categories on the risk of developing obesity and the most common obesity-related comorbidities (cardiometabolic and neoplastic complications).

SUMMARY

Subjects with evening chronotype have been reported to be at high risk of developing obesity, and this was mostly due to the tendency of these subjects to follow unhealthy lifestyle mostly characterized by sedentary behavior and high intake of unhealthy food. In addition, sleep disturbances are a common finding in subjects with evening chronotype that in turn could further contribute to the risk of obesity. The impairment of insulin sensitivity, melatonin, adiponectin, and clock genes function along with increase of leptin secretion detected in subjects with evening chronotype could also represent a favorable milieu for the onset of obesity-related cancer. The current evidence is limited to breast, prostate, and endometrial cancer.

KEY MESSAGES

The chronotype categories could be easy assessed in subjects with obesity and at the same time provide an important information on an additional risk factor predisposing to the onset of obesity-related comorbidities. Since chronotype could be potentially modified through a behavioral-driven approach thus potentiating the efficacy of anti-obesity treatment, the assessment of chronotype categories should be included in the management of obesity.

Limited evidence of a threshold effect for increasing adiposity on risk of symptoms at midlife

OBJECTIVE

To assess the nature of relationships between increasing body mass index (BMI) and the prevalence of midlife symptoms in a population with high adiposity.

METHODS

In the cross-sectional Study of Women's Health in Qatar, 841 participants aged 40 to 60 years were recruited from nine primary health centers in Doha. Face-to-face interviews collected demographic, menopause, and symptom information. BMI (kg/m 2 ) was categorized as healthy, overweight, or class I, II, or III obesity. Multivariate logistic regression models were used to examine aches/stiffness in joints, trouble sleeping, shortness of breath, urinary incontinence, and hot flashes with BMI categories. Restricted cubic splines (RCSs) were used to estimate relationships between continuous BMI and each symptom and to conduct formal tests of nonlinearity.

RESULTS

Mean BMI was 34.3 kg/m 2 (SD, 6.0 kg/m 2 ). Women with class II and III obesity had higher odds of reporting aches/stiffness than women with a healthy BMI, and the odds of reporting urinary incontinence were three times higher among women with class III obesity (odds ratio, 3.08; 95% confidence interval, 1.17-8.14). Using restricted cubic spline models, a significant nonlinear association ( P = 0.002) was observed between aches/stiffness and BMI with an apparent threshold of 38 kg/m 2 . Linear relationships were observed with BMI for urinary incontinence ( P < 0.001 for linear trend) and shortness of breath ( P = 0.005 for linear trend). Trouble sleeping and hot flashes were not associated with BMI.

CONCLUSIONS

Even at very high levels of BMI, likelihood of urinary incontinence and shortness of breath increases with BMI. In contrast, likelihood of aches/stiffness has a nonlinear relationship with BMI, increasing to a threshold level.

Sleep pattern, healthy lifestyle and colorectal cancer incidence

Researchers have identified an association between lifestyle factors and colorectal cancer (CRC) risk. This study examined the relationship between sleep patterns and CRC events. 392,252 individuals were sampled from the UK Biobank. Chronotype, sleep duration, insomnia, snoring, and excessive daytime sleepiness were combined to measure a healthy sleep score. A number of healthy sleep factors were defined, along with factors for healthy lifestyle scores. Using Cox proportional hazards regression, computed hazard ratios (HRs) were used to examine the associations between sleep patterns, healthy lifestyles, and the incidence of CRC. Healthy sleep scores were inversely associated with CRC events. The HRs for CRC were 0.90 (95% CI, 0.88-0.92) and 0.95 (95% CI, 0.92-0.98) for a 1-point healthy sleep score increase among males and females. When analyzing sleep components, sleeping 7-8 h/day, no frequent insomnia, no snoring, and no frequent daytime sleepiness were independently associated with a 9%, 14%, 8%, and 14% lower risk of CRC, respectively, whilst healthy lifestyle scores were inversely associated with CRC incidence across all models. Sleep pattern and lifestyle are significantly correlated with CRC risk. The healthier the subject's lifestyle and sleep pattern, the lower their CRC risk.

The association between sleeping behavior, obesity, psychological depression, and eating habits among adolescents in the emirate of Abu Dhabi–United Arab Emirates

Objective

The study aimed to investigate the association between sleeping behavior (specifically sleep duration), body mass index (BMI), eating habits, and psychological mood depression among adolescents in the Emirate of Abu Dhabi- UAE.

Methods and materials

A subsample of three hundred and ninety-five participants (209 females and 186 males) from middle and high schools (aged 12–18 years) in the emirate of Abu Dhabi completed the surveys in the presence of their parents and two research assistants. Measures of daytime sleepiness and other sleep parameters (sleep duration on weekdays and weekends), eating habits, and mood depression questionnaires were reported.

Results

Differences in BMI between males and females were statistically significant (26.12 ± 4.5 vs. 24.4 ± 4.3; p < 0.01). There was a negative linear association (p < 0.01) between the students’ BMI and the weekday/ weekend sleep duration. The average weekday and weekend sleep duration ranged from 5.7 hours (weekdays) to 9.3 hours(weekend). The study showed that an increase in BMI was correlated to mood depression (r = 0.396, p<0.01). In terms of eating habits, there was a significant association between eating unhealthy food and sleep duration; 72.6% of students who slept less than 6 hours reported unhealthy eating habits (p <0.05).

Conclusion

The study showed a clear association between short sleep duration and obesity among adolescents in the UAE. This relationship between sleep duration and obesity is less studied and less understandable. Future research about exploring how sleeping behaviors can affect obesity during adolescence can support understanding this association and create an effective intervention.

Changes in health behaviours in adults at-risk of chronic disease: primary outcomes from the My health for life program

Background

Chronic disease is the leading cause of premature death globally, and many of these deaths are preventable by modifying some key behavioural and metabolic risk factors. This study examines changes in health behaviours among men and women at risk of diabetes or cardiovascular disease (CVD) who participated in a 6-month lifestyle intervention called the My health for life program.

Methods

The My health for life program is a Queensland Government-funded multi-component program designed to reduce chronic disease risk factors amongst at-risk adults in Queensland, Australia. The intervention comprises six sessions over a 6-month period, delivered by a trained facilitator or telephone health coach. The analysis presented in this paper stems from 9,372 participants who participated in the program between July 2017 and December 2019. Primary outcomes included fruit and vegetable intake, consumption of sugar-sweetened drinks and take-away, alcohol consumption, tobacco smoking, and physical activity. Variables were summed to form a single Healthy Lifestyle Index (HLI) ranging from 0 to 13, with higher scores denoting healthier behaviours. Longitudinal associations between lifestyle indices, program characteristics and socio-demographic characteristics were assessed using Gaussian Generalized Estimating Equations (GEE) models with an identity link and robust standard errors.

Results

Improvements in HLI scores were noted between baseline (Md = 8.8; IQR = 7.0, 10.0) and 26-weeks (Md = 10.0; IQR = 9.0, 11.0) which corresponded with increases in fruit and vegetable consumption and decreases in takeaway frequency (p < .001 for all) but not risky alcohol intake. Modelling showed higher average HLI among those aged 45 or older (β = 1.00, 95% CI = 0.90, 1.10, p < .001) with vocational educational qualifications (certificate/diploma: β = 0.32, 95% CI = 0.14, 0.50, p < .001; bachelor/post-graduate degree β = 0.79, 95% CI = 0.61, 0.98, p < .001) while being male, Aboriginal or Torres Strait Islander background, or not currently working conferred lower average HLI scores (p < .001 for all).

Conclusions

While participants showed improvements in dietary indicators, changes in alcohol consumption and physical activity were less amenable to the program. Additional research is needed to help understand the multi-level barriers and facilitators of behaviour change in this context to further tailor the intervention for priority groups.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14056-1.

Healthy Sleep Every Day Keeps the Doctor Away

When one considers the big picture of their health, sufficient sleep may often go overlooked as a keystone element in this picture. Insufficient sleep in either quality or duration is a growing problem for our modern society. It is essential to look at what this means for our health because insufficient sleep increases our risks of innumerable lifechanging diseases. Beyond increasing the risk of developing these diseases, it also makes the symptoms and pathogenesis of many diseases worse. Additionally, consistent quality sleep can not only improve our physical health but has also been shown to improve mental health and overall quality of life. Substandard sleep health could be a root cause for numerous issues individuals may be facing in their lives. It is essential that physicians take the time to learn about how to educate their patients on sleep health and try to work with them on an individual level to help motivate lifestyle changes. Facilitating access to sleep education for their patients is one way in which physicians can help provide patients with the tools to improve their sleep health. Throughout this paper, we will review the mechanisms behind the relationship between insufficient sleep health and chronic disease and what the science says about how inadequate sleep health negatively impacts the overall health and the quality of our lives. We will also explain the lifechanging effects of sufficient sleep and how we can help patients get there.

Jointly modeling of sleep variables that are objectively measured by wrist actigraphy

Recently developed actigraphy devices have made it possible for continuous and objective monitoring of sleep over multiple nights. Sleep variables captured by wrist actigraphy devices include sleep onset, sleep end, total sleep time, wake time after sleep onset, number of awakenings, etc. Currently available statistical methods to analyze such actigraphy data have limitations. First, averages over multiple nights are used to summarize sleep activities, ignoring variability over multiple nights from the same subject. Second, sleep variables are often analyzed independently. However, sleep variables tend to be correlated with each other. For example, how long a subject sleeps at night can be correlated with how long and how frequent he/she wakes up during that night. It is important to understand these inter-relationships. We therefore propose a joint mixed effect model on total sleep time, number of awakenings, and wake time. We develop an estimating procedure based upon a sequence of generalized linear mixed effects models, which can be implemented using existing software. The use of these models not only avoids computational intensity and instability that may occur by directly applying a numerical algorithm on a complicated joint likelihood function, but also provides additional insights on sleep activities. We demonstrated in simulation studies that the proposed estimating procedure performed well in estimating both fixed and random effects' parameters. We applied the proposed model to data from the Women's Interagency HIV Sleep Study to examine the association of employment status and age with overall sleep quality assessed by several actigraphy measured sleep variables.

Analysis on the Change of College Students' Life Pattern and its Impact during the COVID-19 Outbreak in China

Objectives: Our objective was to analyze changes in lifestyle patterns of Chinese college students at home during the COVID-19 outbreak. Methods: According to a structured online questionnaire covering socio- demographic information, anthropometric data, and changes in food intake, physical activity, and sleep during the COVID-19 outbreak, the relationships between the above data before and during the outbreak were analyzed. Results: Among the 781 participants, 38.5% had significantly increased their total food intake and 29.1% had significantly decreased their physical activity. Overall, 44% of participants reported weight gain. The average weight gain was 0.7±2.5 kg. The main causes of weight gain were increased food intake (p < .001), decreased physical activity (p < .01), and an excessive increase or reduction in sleep duration (p < .024). Conclusion: During the COVID-19 outbreak, college students' food intake was found to be increased and physical activity decreased; sleep duration was irregular, and all these factors influenced weight gain.

Sleep Deficiency: Epidemiology and Effects

Adequate sleep is an important pillar of physical and mental health. Sleep deficiency, resulting from short sleep or suboptimal sleep quality, is highly prevalent in modern society. Occupation, social demands, psychiatric disorders, physical disorders, and sleep disorders are some of the contributing factors to sleep deficiency. Some populations are at increased risk of sleep deficiency based on ethnicity, age, marital status, sex, and hospitalization. Sleep deficiency influences cognition, alertness, mood, behavior, diabetes, cardiovascular health, renal function, immune system, and respiratory physiology. This review summarizes the epidemiology and effects of sleep deficiency.

Nightly Variation in Sleep Influences Self-efficacy for Adhering to a Healthy Lifestyle: A Prospective Study

BACKGROUND

Self-efficacy, or the perceived capability to engage in a behavior, has been shown to play an important role in adhering to weight loss treatment. Given that adherence is extremely important for successful weight loss outcomes and that sleep and self-efficacy are modifiable factors in this relationship, we examined the association between sleep and self-efficacy for adhering to the daily plan. Investigators examined whether various dimensions of sleep were associated with self-efficacy for adhering to the daily recommended lifestyle plan among participants (N = 150) in a 12-month weight loss study.

METHOD

This study was a secondary analysis of data from a 12-month prospective observational study that included a standard behavioral weight loss intervention. Daily assessments at the beginning of day (BOD) of self-efficacy and the previous night's sleep were collected in real-time using ecological momentary assessment.

RESULTS

The analysis included 44,613 BOD assessments. On average, participants reported sleeping for 6.93 ± 1.28 h, reported 1.56 ± 3.54 awakenings, and gave low ratings for trouble sleeping (3.11 ± 2.58; 0: no trouble; 10: a lot of trouble) and mid-high ratings for sleep quality (6.45 ± 2.09; 0: poor; 10: excellent). Participants woke up feeling tired 41.7% of the time. Using linear mixed effects modeling, a better rating in each sleep dimension was associated with higher self-efficacy the following day (all p values < .001).

CONCLUSION

Our findings supported the hypothesis that better sleep would be associated with higher levels of reported self-efficacy for adhering to the healthy lifestyle plan.

The relationship between sleep and weight change among women diagnosed with breast cancer participating in the Women's Health Initiative

PURPOSE

Short and long sleep duration and poor sleep quality are risk factors for weight gain and cancer mortality. The purpose of this study is to investigate the relationship between sleep and weight change among postmenopausal breast cancer survivors.

METHODS

Women participating in the Women's Health Initiative who were diagnosed with incident breast cancer between year one and year three were included. Self-reported sleep duration was categorized as ≤ 5 h (short), 6 h, 7-8 h (optimal), and ≥ 9 h (long). Self-reported sleep quality was categorized as poor, average, and above average. Post-diagnosis weight change was the difference of weight closest to, but preceding diagnosis, and year 3 weight. We used linear regression to evaluate sleep duration and sleep quality associations with post-diagnosis weight change adjusted for potential confounders.

RESULTS

Among 1156 participants, 63% were weight stable after diagnosis; average weight gain post cancer diagnosis was 3.2 kg. Six percent of women reported sleeping ≤ 5 h, 26% reported 6 h, 64% reported 7-8 h, and 4% reported ≥ 9 h. There were no differences in adjusted estimates of weight change among participants with short duration (0.37 kg; 95% CI - 0.88, 1.63), or long duration (- 0.56 kg; 95% CI - 2.03, 0.90) compared to optimal duration, nor was there a difference among poor quality (- 0.51 kg; 95% CI - 1.42, 0.41) compared to above average quality.

CONCLUSION

Among postmenopausal breast cancer survivors, sleep duration and quality were not associated with weight change after breast cancer diagnosis. Future studies should consider capturing change in adiposity and to expand beyond self-reported sleep.

Recent Epidemiology and Risk Factors of Nonalcoholic Fatty Liver Disease

Because of the global obesity epidemic, the incidence and prevalence of nonalcoholic fatty liver disease (NAFLD) have increased worldwide, including among Koreans. Recently, the incidence rate of NAFLD in Korea was reported to be 45.1 per 1,000 person-years, and the prevalence as approximately 30% depending on the diagnostic methods used. The incidence of advanced fibrosis and hepatocellular carcinoma, as well as all-cause and liver-related mortality in NAFLD patients has increased substantially, imposing considerable public health costs in Korea. Genetic, demographic, environmental, and clinical factors are involved in the pathogenesis of NAFLD. Some genetic variants, such as patatin-like phospholipase domain-containing 3 (PNPLA-3) and sorting and assembly machinery component 50 (SAMM-50), play a major role in the occurrence of NAFLD. The risk of NAFLD and fibrosis increases with advancing age and in men. Nutritional factors, inadequate exercise, and sleep duration are also associated with increased risk of NAFLD. Obesity is a major risk factor for NAFLD; however, NAFLD in lean individuals has been noted in recent studies. Insulin resistance, type 2 diabetes, and metabolic syndrome and its components are closely associated with NAFLD development and liver fibrosis with various underlying mechanisms. Sarcopenia likely shares a common pathophysiology with NAFLD. The rapidly increasing incidence and prevalence of NAFLD and its complications, as well as the associated healthcare burden, warrant early assessment of NAFLD and its risk factors to prevent NAFLD-related complications in high risk groups.

Self-Reported Sleeping Time Effects on Physical Performance and Body Composition Among Spanish Older Adults: EXERNET-Elder 3.0 study

Objective: To determine the link between physical fitness and body composition with nocturnal and nap time in Spanish older adults. Methods: Eight hundred thirty older adults underwent several tests. Sleep was measured using Jenkins Sleep Scale. Nocturnal sleep was categorized (<7, 7-9, and >9 hours), and nap time (no nap, 1-30 minutes, and >30 minutes).Physical fitness was evaluated using validated tests, and body composition by electric bioimpedance. Results: 75.1% of participants were female, mean age 77.7 ± 5.1 years. Mean nocturnal sleep and nap time was 6.7 hours and 23.3 minutes, respectively. Models showed nocturnal sleep >9 hours was significant and positively associated with body shape index (Odds ratio[OR] = 4.07 (p = .011)) and waist circumference OR = 1.04 (p = .024) in females. Males' waist and hip circumference were positively significantly related to nap time between 1 and 30 minutes, OR = 1.08, p = .009 and OR = 1.08, p = .048, respectively. In females, nap time >30 minutes was associated with greater fat mass and body shape index OR = 1.22, p = .032 and OR = 3.95, p = .027, respectively. Physical fitness showed no associations with sleep outcomes. Conclusions: Sleep patterns do not influence physical fitness but body composition, being more related to female body composition as nocturnal and nap sleep were associated with higher fat mass, waist circumference and body shape index, while only short nap times were related to higher waist and hip circumference in males.