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Fischer AR, Doudell KR, Cundiff JM, Green SRM, Lavender CA, Gunn HE. Maternal Sleep Health, Social Support, and Distress: A Mixed-Methods Analysis of Mothers of Infants and Young Children in Rural US. Behav Sleep Med 2024:1-24. [PMID: 38600856 DOI: 10.1080/15402002.2024.2339818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
OBJECTIVES The purpose of this study was to explore sleep health in rural maternal populations through a social-ecological framework and identify risk and protective factors for this population. METHODS 39 individuals who are mothers of infants or children under the age of 5 years completed an online survey, 35 of which completed a subsequent semi-structured interview. Recruitment was limited to one rural community and was in partnership with community healthcare providers. Results were integrated using a convergent, parallel mixed-methods design. RESULTS Poor sleep health and high prevalence of insomnia symptoms in rural mothers were evident and associated with social support and maternal distress. Qualitative content from interviews indicated that well-established precipitating and perpetuating factors for insomnia may contribute to poor maternal sleep health. Results also revealed a gap in knowledge and language surrounding sleep health among rural mothers. CONCLUSIONS Sleep health is challenged during the transition to motherhood and rural mothers have less access to specialized perinatal and behavioral health care than their urban counterparts. In this sample, poor sleep was attributable to distress in addition to nocturnal infant and child sleep patterns which has implications for psychoeducation and promotion of sleep health in mothers. Sleep is a modifiable health indicator that is associated with several other maternal health outcomes and should be considered an element of a comprehensive maternal health for prevention and intervention across individual, interpersonal, and societal domains of the social-ecological model of sleep health.
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Affiliation(s)
| | - Kelly R Doudell
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | - Jenny M Cundiff
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | | | - Catherine A Lavender
- College of Community Health Sciences, University of Alabama, Tuscaloosa, AL, USA
| | - Heather E Gunn
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
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2
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Ahn S, Lobo JM, Davis EM, Howie-Esquivel J, Chung ML, Logan JG. Characterization of sleep efficiency transitions in family caregivers. J Behav Med 2024; 47:308-319. [PMID: 38017251 DOI: 10.1007/s10865-023-00461-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 10/25/2023] [Indexed: 11/30/2023]
Abstract
Family caregivers are at high risk of psychological distress and low sleep efficiency resulting from their caregiving responsibilities. Although psychological symptoms are associated with sleep efficiency, there is limited knowledge about the association of psychological distress with variations in sleep efficiency. We aimed to characterize the short- and long-term patterns of caregivers' sleep efficiency using Markov chain models and compare these patterns between groups with high and low psychological symptoms (i.e., depression, anxiety, and caregiving stress). Based on 7-day actigraphy data from 33 caregivers, we categorized sleep efficiency into three states, < 75% (S1), 75-84% (S2), and ≥ 85% (S3), and developed Markov chain models. Caregivers were likely to maintain a consistent sleep efficiency state from one night to the next without returning efficiently to a normal state. On average, it took 3.6-5.1 days to return to a night of normal sleep efficiency (S3) from lower states, and the long-term probability of achieving normal sleep was 42%. We observed lower probabilities of transitioning to or remaining in a normal sleep efficiency state (S3) in the high depression and anxiety groups compared to the low symptom groups. The differences in the time required to return to a normal state were inconsistent by symptom levels. The long-term probability of achieving normal sleep efficiency was significantly lower for caregivers with high depression and anxiety compared to the low symptom groups. Caregivers' sleep efficiency appears to remain relatively consistent over time and does not show rapid recovery. Caregivers with higher levels of depression and anxiety may be more vulnerable to sustained suboptimal sleep efficiency.
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Affiliation(s)
- Soojung Ahn
- School of Nursing, Vanderbilt University, Nashville, TN, USA.
| | - Jennifer M Lobo
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Eric M Davis
- Division of Pulmonary and Critical Care, Department of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Jill Howie-Esquivel
- School of Nursing, University of California San Francisco, San Francisco, CA, USA
| | - Misook L Chung
- College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Jeongok G Logan
- School of Nursing, University of Virginia, Charlottesville, VA, USA
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3
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Pu L, Zhang R, Wang H, Zhao T, Zeng J, Yang H, Han L, Fang J, Sun N. Association between sleep pattern and incidence of hypertension: A prospective cohort study of older adult participants in the Chinese longitudinal healthy longevity survey. Arch Gerontol Geriatr 2024; 119:105314. [PMID: 38176123 DOI: 10.1016/j.archger.2023.105314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 12/06/2023] [Accepted: 12/12/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND The relationship between sleep duration or sleep quality and the risk of hypertension has been previously examined. However, little is known regarding the association between sleep duration and quality and the risk of developing hypertension in the older adult Chinese population. METHODS The sleep patterns of 5683 participants without hypertension at baseline from the Chinese Longitudinal Healthy Longevity Survey were analyzed. Cox proportional hazard models were used to study the associations between sleep patterns and hypertension. RESULTS It was found that 1712 (30.12%) of the 5683 participants had an unhealthy sleep pattern. After an average follow-up of 3.31 years, 1350 of the participants had hypertension. Compared with participants with an unhealthy sleep pattern, those with a healthy sleep pattern had a 20% (hazard ratio = 0.80, 95% confidence interval = 0.67-0.94, P = = 0.008) lower risk of incident hypertension in the fully adjusted models. In addition, an approximately linear dose-response association was observed between sleep duration and the incidence of hypertension (P for non-linear =0.43). Subgroup analyses demonstrated significant interactions between age and sleep pattern concerning hypertension (P for interaction <0.05). Several sensitivity analyses were conducted, and the obtained findings were similar to the main results. CONCLUSIONS A healthy sleep pattern, comprising an adequate sleep duration and good sleep quality, can help reduce hypertension risk. Thus, a healthy sleep pattern is crucial to decreasing hypertension in older Chinese adults in a rapidly aging society.
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Affiliation(s)
- Liyuan Pu
- Health Examination Center, Ningbo No. 2 Hospital, Ningbo, Zhejiang, China; Center for Cardiovascular and Cerebrovascular Epidemiology and Translational Medicine, Guoke Ningbo Life Science and Health Industry Research Institute, Ningbo, Zhejiang, China
| | - Ruijie Zhang
- Health Examination Center, Ningbo No. 2 Hospital, Ningbo, Zhejiang, China; Center for Cardiovascular and Cerebrovascular Epidemiology and Translational Medicine, Guoke Ningbo Life Science and Health Industry Research Institute, Ningbo, Zhejiang, China
| | - Han Wang
- Health Examination Center, Ningbo No. 2 Hospital, Ningbo, Zhejiang, China; Center for Cardiovascular and Cerebrovascular Epidemiology and Translational Medicine, Guoke Ningbo Life Science and Health Industry Research Institute, Ningbo, Zhejiang, China
| | - Tian Zhao
- Health Examination Center, Ningbo No. 2 Hospital, Ningbo, Zhejiang, China; Center for Cardiovascular and Cerebrovascular Epidemiology and Translational Medicine, Guoke Ningbo Life Science and Health Industry Research Institute, Ningbo, Zhejiang, China
| | - Jingjing Zeng
- Health Examination Center, Ningbo No. 2 Hospital, Ningbo, Zhejiang, China; Center for Cardiovascular and Cerebrovascular Epidemiology and Translational Medicine, Guoke Ningbo Life Science and Health Industry Research Institute, Ningbo, Zhejiang, China
| | - Huiqun Yang
- Health Examination Center, Ningbo No. 2 Hospital, Ningbo, Zhejiang, China; Center for Cardiovascular and Cerebrovascular Epidemiology and Translational Medicine, Guoke Ningbo Life Science and Health Industry Research Institute, Ningbo, Zhejiang, China
| | - Liyuan Han
- Health Examination Center, Ningbo No. 2 Hospital, Ningbo, Zhejiang, China; Center for Cardiovascular and Cerebrovascular Epidemiology and Translational Medicine, Guoke Ningbo Life Science and Health Industry Research Institute, Ningbo, Zhejiang, China
| | - Jianfei Fang
- Health Examination Center, Ningbo No. 2 Hospital, Ningbo, Zhejiang, China.
| | - Ning Sun
- School of Nursing, Ningbo College of Health Sciences, Ningbo, Zhejiang, China.
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4
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Chang CS, Chang LY, Wu CC, Chang HY. Associations between social jetlag trajectories and body mass index among young adults. Sleep 2024; 47:zsad270. [PMID: 37855456 DOI: 10.1093/sleep/zsad270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 10/11/2023] [Indexed: 10/20/2023] Open
Abstract
STUDY OBJECTIVES This study employed longitudinal data collected repeatedly from individuals over the course of several years to examine the trajectories of social jetlag from ages 11 to 22 years and their associations with subsequent body mass index (BMI). Potential sex differences were also investigated. METHODS Data were obtained from two longitudinal studies conducted in Taiwan (N = 4287). Social jetlag was defined as ≥ 2 hours of absolute difference in sleep midpoint between weekdays and weekends. BMI was calculated using weight (kg)/height(m)2 and categorized as underweight (<18 kg/m2), normal weight (18 kg/m2 ≤ BMI < 24 kg/m2), overweight (24 kg/m2 ≤ BMI < 27 kg/m2), and obese (≥27 kg/m2). Group-based trajectory modeling and multinomial logistic regression were applied to investigate study objectives. RESULTS Four distinct trajectories of social jetlag throughout the adolescent years were identified, with corresponding proportions as follows: low-stable (42%), moderate-decreasing (19%), low-increasing (22%), and chronic (17%) trajectories. Among males, the risk of being underweight (aOR, 1.96; 95% CI: 1.35 to 2.84) or obese (aOR, 1.40; 95% CI: 1.02 to 1.92) was higher in individuals with a low-increasing trajectory than in those with a low-stable trajectory. Among females, those with a low-increasing (aOR, 1.61; 95% CI: 1.02 to 2.54) or chronic (aOR, 2.04; 95% CI: 1.27 to 3.25) trajectory were at a higher risk of being obese relative to those with a low-stable trajectory. CONCLUSIONS Addressing the development of increasing or chronic social jetlag during adolescence can help prevent abnormal BMI in young adulthood. Practitioners should consider sex differences in treatment or consultation.
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Affiliation(s)
- Chia-Shuan Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ling-Yin Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chi-Chen Wu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Hsing-Yi Chang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
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Charchar FJ, Prestes PR, Mills C, Ching SM, Neupane D, Marques FZ, Sharman JE, Vogt L, Burrell LM, Korostovtseva L, Zec M, Patil M, Schultz MG, Wallen MP, Renna NF, Islam SMS, Hiremath S, Gyeltshen T, Chia YC, Gupta A, Schutte AE, Klein B, Borghi C, Browning CJ, Czesnikiewicz-Guzik M, Lee HY, Itoh H, Miura K, Brunström M, Campbell NR, Akinnibossun OA, Veerabhadrappa P, Wainford RD, Kruger R, Thomas SA, Komori T, Ralapanawa U, Cornelissen VA, Kapil V, Li Y, Zhang Y, Jafar TH, Khan N, Williams B, Stergiou G, Tomaszewski M. Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension. J Hypertens 2024; 42:23-49. [PMID: 37712135 PMCID: PMC10713007 DOI: 10.1097/hjh.0000000000003563] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/12/2023] [Accepted: 08/22/2023] [Indexed: 09/16/2023]
Abstract
Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools.
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Affiliation(s)
- Fadi J. Charchar
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
- Department of Physiology, University of Melbourne, Melbourne, Australia
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Priscilla R. Prestes
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
| | - Charlotte Mills
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang
- Department of Medical Sciences, School of Medical and Live Sciences, Sunway University, Bandar Sunway, Selangor, Malaysia
| | - Dinesh Neupane
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - Francine Z. Marques
- Hypertension Research Laboratory, School of Biological Sciences, Monash University
- Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne
| | - James E. Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Liffert Vogt
- Department of Internal Medicine, Section Nephrology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Microcirculation, Amsterdam, The Netherlands
| | - Louise M. Burrell
- Department of Medicine, University of Melbourne, Austin Health, Melbourne, Australia
| | - Lyudmila Korostovtseva
- Department of Hypertension, Almazov National Medical Research Centre, St Petersburg, Russia
| | - Manja Zec
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, USA
- Colorado Program for Musculoskeletal Research, Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Mansi Patil
- Department of Nutrition and Dietetics, Asha Kiran JHC Hospital, Chinchwad
- Hypertension and Nutrition, Core Group of IAPEN India, India
| | - Martin G. Schultz
- Department of Internal Medicine, Section Nephrology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Microcirculation, Amsterdam, The Netherlands
| | | | - Nicolás F. Renna
- Unit of Hypertension, Hospital Español de Mendoza, School of Medicine, National University of Cuyo, IMBECU-CONICET, Mendoza, Argentina
| | | | - Swapnil Hiremath
- Department of Medicine, University of Ottawa and the Ottawa Hospital, Ottawa, Canada
| | - Tshewang Gyeltshen
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Yook-Chin Chia
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Selangor
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Abhinav Gupta
- Department of Medicine, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, India
| | - Aletta E. Schutte
- School of Population Health, University of New South Wales, The George Institute for Global Health, Sydney, New South Wales, Australia
- Hypertension in Africa Research Team, SAMRC Unit for Hypertension and Cardiovascular Disease, North-West University
- SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Britt Klein
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, Faculty of Medicine, University of Bologna, Bologna, Italy
| | - Colette J. Browning
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
| | - Marta Czesnikiewicz-Guzik
- School of Medicine, Dentistry and Nursing-Dental School, University of Glasgow, UK
- Department of Periodontology, Prophylaxis and Oral Medicine; Jagiellonian University, Krakow, Poland
| | - Hae-Young Lee
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hiroshi Itoh
- Department of Internal Medicine (Nephrology, Endocrinology and Metabolism), Keio University, Tokyo
| | - Katsuyuki Miura
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Mattias Brunström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Norm R.C. Campbell
- Libin Cardiovascular Institute, Department of Medicine, University of Calgary, Calgary, Canada
| | | | - Praveen Veerabhadrappa
- Kinesiology, Division of Science, The Pennsylvania State University, Reading, Pennsylvania
| | - Richard D. Wainford
- Department of Pharmacology and Experimental Therapeutics, The Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston
- Division of Cardiology, Emory University, Atlanta, USA
| | - Ruan Kruger
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Shane A. Thomas
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
| | - Takahiro Komori
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Udaya Ralapanawa
- Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | | | - Vikas Kapil
- William Harvey Research Institute, Centre for Cardiovascular Medicine and Devices, NIHR Barts Biomedical Research Centre, BRC, Faculty of Medicine and Dentistry, Queen Mary University London
- Barts BP Centre of Excellence, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Yan Li
- Department of Cardiovascular Medicine, Shanghai Institute of Hypertension, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai
| | - Yuqing Zhang
- Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Chinese Hypertension League, Beijing, China
| | - Tazeen H. Jafar
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Nadia Khan
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Bryan Williams
- University College London (UCL), Institute of Cardiovascular Science, National Institute for Health Research (NIHR), UCL Hospitals Biomedical Research Centre, London, UK
| | - George Stergiou
- Hypertension Centre STRIDE-7, School of Medicine, Third Department of Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maciej Tomaszewski
- Division of Cardiovascular Sciences, Faculty of Medicine, Biology and Health, University of Manchester
- Manchester Academic Health Science Centre, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
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6
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Hawkins MS, Pokutnaya DY, Duan D, Coughlin JW, Martin LM, Zhao D, Goheer A, Woolf TB, Holzhauer K, Lehmann HP, Lent MR, McTigue KM, Bennett WL. Associations between sleep health and obesity and weight change in adults: The Daily24 Multisite Cohort Study. Sleep Health 2023; 9:767-773. [PMID: 37268482 DOI: 10.1016/j.sleh.2023.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 03/22/2023] [Accepted: 03/26/2023] [Indexed: 06/04/2023]
Abstract
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.
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Affiliation(s)
- Marquis S Hawkins
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.
| | - Darya Y Pokutnaya
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Daisy Duan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Janelle W Coughlin
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Lindsay M Martin
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Di Zhao
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Attia Goheer
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thomas B Woolf
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; Department of Clinical Psychology, School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Katherine Holzhauer
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Harold P Lehmann
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Michelle R Lent
- Department of Clinical Psychology, School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Kathleen M McTigue
- Division of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Wendy L Bennett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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7
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Ding R, Ding P, Tian L, Kuang X, Huang L, Shi H. Sleep duration trajectories and all-cause mortality among Chinese elderly: A community-based cohort study. BMC Public Health 2023; 23:1095. [PMID: 37344863 DOI: 10.1186/s12889-023-15894-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/15/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND China is among the largest and fastest aging countries. The elderly population is more vulnerable, with higher proportion of inappropriate sleep duration and risk of mortality, compared with young and middle-aged adults. Single-measured sleep duration has been associated with mortality, but the health effects of long-term sleep duration trajectories remain unknown. This study aimed to explore the prospective associations between sleep duration trajectories and all-cause mortality among Chinese elderly. METHODS Participants (n = 3,895; median age: 82 years; females: 53.3%) who reported sleep duration in all three surveys (2005, 2008, and 2011) from the community-based Chinese Longitudinal Healthy Longevity Survey (CLHLS) were followed up until 2019 (about 8 years). We identified sleep duration trajectories by latent class mixed model and explored their association with all-cause mortality using Cox hazard proportional regression and Laplace regression models. Further, stratified analysis by demographic characteristics and lifestyles and sensitivity analysis by lag effect, health-related factors, and inverse probability weighting were used to verify the robustness of the association. In addition, we explored the threshold effect of baseline sleep duration on the risk of all-cause mortality. RESULTS We documented 1,881 all-cause deaths during 16,689 person-years of follow-up. Five sleep duration trajectories were identified: moderately increased trajectory (28.1%), rapidly increased trajectory (7.2%), persistent sleep trajectory of 7 h (33.7%), moderately decreased trajectory (21.3%), and rapidly decreased trajectory (9.7%). Compared with the persistent sleep trajectory of 7 h, the multivariable-adjusted HRs (95%CI) for moderately increased trajectory, rapidly increased trajectory, moderately decreased trajectory, and rapidly decreased trajectory were 1.21 (1.08, 1.36), 1.21 (1.01, 1.44), 0.95 (0.82, 1.10), and 0.93 (0.78, 1.11), respectively; and the corresponding difference in median survival time (95%CI) were -0.53 (-1.01, -0.05), -0.43 (0.16, -1.02), 0.26 (-0.34, 0.86), and 0.25 (-0.51, 1.02), respectively. Stratified and sensitivity analyses showed consistent results. Threshold analysis indicated a sharply increased risk of mortality in participants whose sleep exceeds 9 h (HR = 1.20, 95%CI: 1.11, 1.30). CONCLUSION Compared with the persistent sleep trajectory of 7 h, moderately and rapidly increased sleep duration trajectories were associated with higher subsequent mortality in Chinese elderly. Those who report sleep exceeding 9 h may be at high risk for all-cause mortality.
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Affiliation(s)
- Rongxiu Ding
- School and Hospital of Stomatology, Wenzhou Medical University, 325000, Wenzhou, Zhejiang, P.R. China
| | - Pan Ding
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, 325000, Wenzhou, China
| | - Liuhong Tian
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, 325000, Wenzhou, China
| | - Xiaodan Kuang
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, 325000, Wenzhou, China
| | - Li Huang
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, 325000, Wenzhou, China
| | - Hongying Shi
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, 325000, Wenzhou, China.
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8
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Guo J, Li A, Chen M, Wei D, Wu J, Wang T, Hu Y, Lin Y, Xu X, Yang L, Wen Y, Li H, Xie X, Wu S. Association of longitudinal patterns of nighttime sleep duration and daytime napping duration with risk of multimorbidity. Sleep Health 2023; 9:363-372. [PMID: 37076420 DOI: 10.1016/j.sleh.2023.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 01/14/2023] [Accepted: 02/15/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVES To determine whether longitudinal trajectories of nighttime sleep duration and daytime napping duration are related to subsequent multimorbidity risk. To explore whether daytime napping can compensate for negative effects of short nighttime sleep. METHODS The current study included 5262 participants from China Health and Retirement Longitudinal Study. Self-reported nighttime sleep duration and daytime napping duration were collected from 2011 to 2015. The 4-year sleep duration trajectories were conducted by group-based trajectory modeling. The 14 medical conditions were defined by self-reported physician diagnoses. Multimorbidity was diagnosed as participants with 2 or more of the 14 chronic diseases after 2015. Associations between sleep trajectories and multimorbidity were assessed by Cox regression models. RESULTS During 6.69 years of follow-up, we observed multimorbidity in 785 participants. Three nighttime sleep duration trajectories and three daytime napping duration trajectories were identified. Participants with persistent short nighttime sleep duration trajectory had the higher risk of multimorbidity (hazard ratio = 1.37, 95% confidence interval: 1.06-1.77), compared with those with persistent recommended nighttime sleep duration trajectory. Participants with persistent short nighttime sleep duration and persistent seldom daytime napping duration had the highest risk of multimorbidity (hazard ratio = 1.69, 95% confidence interval: 1.16-2.46). CONCLUSIONS In this study, persistent short nighttime sleep duration trajectory was associated with subsequent multimorbidity risk. Daytime napping could compensate for the risk of insufficient night sleep.
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Affiliation(s)
- Jianhui Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Aina Li
- Department of Cardiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350001, China
| | - Mingjun Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Donghong Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Jieyu Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Tinggui Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Yuduan Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Yawen Lin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Xingyan Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Le Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Yeying Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Huangyuan Li
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou 350122, China.
| | - Xiaoxu Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China.
| | - Siying Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China.
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Zheng Y, Zhou B, Gong N, Chen X. Dual trajectory of sleep and frail in elderly people. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2023; 48:621-627. [PMID: 37385626 PMCID: PMC10930250 DOI: 10.11817/j.issn.1672-7347.2023.220544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Indexed: 07/01/2023]
Abstract
The high incidence of dual sleep and frail disorders in the elderly people, often occurring together, seriously affects the physical and mental health of the older people, effective research on the dynamics of dual sleep and frail disorders is important for improving the quality of life for the older people and responding to global ageing trend. While trajectory studies provide a unique practical scientific perspective to grasp the dynamics of development, dual trajectories unite dual barriers provide an opportunity to study the dynamic dependence of both sleep and frailty simultaneously sleep trajectories and frailty trajectories in older people are interrelated and interacted through deeper mechanisms. Therefore, it is necessary for the study not only focus on the ongoing development of health problems, but also needs to consider multiple aspects and propose targeted intervention program.
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Affiliation(s)
- Yu Zheng
- Xiangya Nursing School, Central South University, Changsha 410013.
| | - Bingqian Zhou
- Xiangya Nursing School, Central South University, Changsha 410013
| | - Ni Gong
- Nursing Department, Third Xiangya Hospital, Central South University, Changsha 410013, China.
| | - Xingli Chen
- Xiangya Nursing School, Central South University, Changsha 410013
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10
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Ruan H, Zheng Y, Yang J, Li L, Zhang M, Wang Z, He S. Changes in daily sleep duration and subsequent risk of mortality among older people. Sleep Med 2023; 101:252-259. [PMID: 36455297 DOI: 10.1016/j.sleep.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/30/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Single self-reported measures of daily sleep duration are associated with adverse health outcomes; however, the association between changes in daily sleep duration and all-cause mortality has not been thoroughly evaluated among a large group of older people. METHODS Using data from the Chinese Longitudinal Healthy Longevity Surveys, a total of 8588 older participants were included in the present study. Changes in daily sleep duration were assessed using annual changes, and Cox regression analysis examined the association of the annual changes with mortality. RESULTS The median age of the study population was 82.00 (IQR: 72.00, 90.00) years, and 3974 (46.27%) participants were men. During a median follow-up period of 3.81 (IQR: 2.03, 6.74) years, 5100 (59.39%) deaths were recorded. After adjusting for initial daily sleep duration and other confounders, there was a non-linear relationship between annual changes in daily sleep duration and all-cause mortality. Annual changes were not associated with mortality before 0.0 h/year, and mortality risk increased after 0.0 h/year, specially after 1 h/year (adjusted HR: 1.32 per 1-hour/year increment, 95% CI: 1.18-1.47). Compared to the stable group (annual changes between -1 and 1 h), adjusted HRs for mortality were 0.98 (95% CI: 0.89-1.08) for the shorter group (annual decline more than 1 h) and 1.29 (95% CI: 1.19-1.41) for the longer group (annual increase greater than 1 h), respectively. Stratified and sensitivity analyses suggested robustness of the results. CONCLUSIONS The present study suggested there was a non-linear relationship between annual changes in daily sleep duration and all-cause mortality among older people: longer changes were associated with higher mortality; while, shorter changes were not associated with mortality. Specially, mortality risk increased significantly with longer than 1 h of annual changes. The findings highlight the importance of closely monitoring the changes in daily sleep duration among older people.
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Affiliation(s)
- Haiyan Ruan
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China; Department of Cardiology, Hospital of Traditional Chinese Medicine, Shuangliu District, Chengdu, China
| | - Yi Zheng
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Jing Yang
- Maternal and Child Health Hospital, Longquanyi District, Chengdu, China
| | - Liying Li
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Muxin Zhang
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China; Department of Cardiology, First People's Hospital, Longquanyi District, Chengdu, China
| | - Ziqiong Wang
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Sen He
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China.
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11
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Zhu B, Wang Y, Yuan J, Mu Y, Chen P, Srimoragot M, Li Y, Park CG, Reutrakul S. Associations between sleep variability and cardiometabolic health: A systematic review. Sleep Med Rev 2022; 66:101688. [PMID: 36081237 DOI: 10.1016/j.smrv.2022.101688] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 08/02/2022] [Accepted: 08/02/2022] [Indexed: 12/13/2022]
Abstract
This review explored the associations between sleep variability and cardiometabolic health. It was performed following PRISMA guidelines. We identified 63 studies. Forty-one studies examined the association between sleep variability and body composition, with 29 examined body mass index (BMI). Thirteen studies used social jet lag (SJL), n = 30,519, with nine reporting a null association. Eight studies used variability in sleep duration (n = 33,029), with five reporting a correlation with BMI. Fourteen studies (n = 133,403) focused on overweight/obesity; significant associations with sleep variability were found in 11 (n = 120,168). Sleep variability was associated with weight gain (seven studies; n = 79,522). Twenty-three studies examined glucose outcomes. The association with hemoglobin A1c (16 studies, n = 11,755) differed depending on populations, while associations with diabetes or glucose were mixed, and none were seen with insulin resistance (five studies; n = 6416). Sixteen studies examined cardiovascular-related outcomes, with inconsistent results. Overall significant associations were found in five studies focusing on metabolic syndrome (n = 7413). In summary, sleep variability was likely associated with obesity, weight gain, and metabolic syndrome. It might be associated with hemoglobin A1c in people with type 1 diabetes. The associations with other outcomes were mixed. This review highlighted the possible association between sleep variability and cardiometabolic health.
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Affiliation(s)
- Bingqian Zhu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Yueying Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Jinjin Yuan
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Yunping Mu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Pei Chen
- Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | | | - Yan Li
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Chang G Park
- College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Sirimon Reutrakul
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Illinois Chicago, Chicago, IL, USA.
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12
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Chen J, Ricardo AC, Reid KJ, Lash J, Chung J, Patel SR, Daviglus ML, Huang T, Liu L, Hernandez R, Li Q, Redline S. Sleep, cardiovascular risk factors, and kidney function: The Multi-Ethnic Study of Atherosclerosis (MESA). Sleep Health 2022; 8:648-653. [PMID: 36216749 PMCID: PMC9772248 DOI: 10.1016/j.sleh.2022.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 08/18/2022] [Accepted: 08/18/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Examine the associations of sleep measures with kidney function changes over time among individuals from a community-based study. METHODS The sample includes 1657 participants (287 with chronic kidney disease [CKD]) in the Multi-Ethnic Study of Atherosclerosis Sleep Cohort (mean age: 57.7 years, male: 46.0%). We examined associations between a large set of sleep variables (polysomnography, actigraphy, and questionnaires) and cardiovascular disease risk factors and changes in estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio over approximately 5 years using high-dimensional regression. We investigated the modifying effect of sleep on the associations between cardiovascular disease risk factors and kidney function. RESULTS Sleep metrics predicted kidney function decline only among individuals with baseline CKD. Among this group, eGFR decline was associated with decreased stage N3 sleep (0.32 mL/min/1.73 m2/y per 10% decrease in N3, p < .001); increased actigraphy napping frequency (beta: -0.20 [-0.30, -0.07]); and actigraphy sleep midpoint trajectory in early morning (ref: midnight, beta: -0.84 [-1.19, -0.50]). Urinary albumin-to-creatinine ratio increase was associated with high wake bouts trajectory (ref: low, beta: 0.97 [0.28, 1.67]) and increased sleep-related hypoxemia (oxygen saturation %time<90 [≥5%], beta: 2.17 [1.26, 3.08]). Sleep metrics--N3 sleep, naps, and midpoint trajectory--significantly modified associations between hemoglobin A1C and eGFR decline. CONCLUSIONS Reduced deep sleep, daytime napping, increased wake bouts, delayed sleep rhythms, and overnight hypoxemia are associated with longitudinal kidney function decline, with effects most apparent in individuals with CKD. Deep sleep, napping, and sleep timing modified the association between hemoglobin A1C and kidney function.
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Affiliation(s)
- Jinsong Chen
- School of Public Health, University of Nevada Reno, Reno, Nevada; College of Applied Health Sciences/College of Medicine, University of Illinois at Chicago, Chicago, Illinois; USA.
| | - Ana C Ricardo
- College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kathryn J Reid
- Department of Neurology, Northwestern University, Chicago, Illinois, USA
| | - James Lash
- College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Joon Chung
- Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Sanjay R Patel
- Center for Sleep and Cardiovascular Outcomes Research, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Martha L Daviglus
- College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Tianyi Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Lei Liu
- Division of Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Rosalba Hernandez
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois; School of Social Work, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Quefeng Li
- Departmet of Biostatistics, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Susan Redline
- Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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13
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Sun J, Ma C, Zhao M, Magnussen CG, Xi B. Daytime napping and cardiovascular risk factors, cardiovascular disease, and mortality: A systematic review. Sleep Med Rev 2022; 65:101682. [PMID: 36027794 DOI: 10.1016/j.smrv.2022.101682] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 07/20/2022] [Accepted: 07/26/2022] [Indexed: 10/15/2022]
Abstract
Associations between night sleep duration and cardiovascular risk factors in adults have been well documented. However, the associations for daytime napping remain unclear. In this review, six databases were searched for eligible publications to April 8, 2022. A total of 11 articles were identified for umbrella review on the association of daytime napping with diabetes, metabolic syndrome (MetS), cardiovascular disease (CVD), and mortality in adults, 97 for systematic review on the association with CVD and several CVD risk factors. Our umbrella review showed that the associations of daytime napping with diabetes, MetS, CVD, and mortality in most meta-analyses were mainly supported by weak or suggestive evidence. Our systematic review showed that long daytime napping (≥1 h/d) was associated with higher odds of several CVD risk factors, CVD, and mortality, but no significant association was found between short daytime napping and most of the abovementioned outcomes. Our dose-response meta-analyses showed that daytime napping <30 min/d was not significantly associated with higher odds of most CVD risk factors and CVD among young and middle-aged adults. However, among older adults aged >60 years, we observed significant dose-response associations of daytime napping with higher odds of diabetes, dyslipidemia, MetS, and mortality starting from 0 min/d.
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Affiliation(s)
- Jiahong Sun
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Chuanwei Ma
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Min Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Costan G Magnussen
- Baker Heart and Diabetes Institute, Melbourne, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
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14
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Roncoroni J, Okun M, Hudson A. Systematic review: sleep health in the US Latinx population. Sleep 2022; 45:zsac092. [PMID: 35460556 DOI: 10.1093/sleep/zsac092] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 04/10/2022] [Indexed: 09/19/2023] Open
Abstract
Sleep disturbances are a common and unmet health problem in Latinx. While Latinx report similar sleep disturbances as non-Hispanic Whites [NHW], Latinx suffer from these disturbances to a greater degree than their NHW counterparts. Sleep disturbances are associated with increased risk of chronic health conditions, which Latinx experience at high rates. Research also points to significant sleep differences within Latinx. Given that Latinx are a rapidly growing population in the United States, sleep disparities between Latinx and NHWs and sleep differences within Latinx warrant further investigation. While research on Latinx sleep is growing, the last narrative review on US Latinx sleep health was published by Loredo and colleagues in 2010. Our narrative review expands on Loredo et al.'s work, adding the literature on Latinx sleep published since 2010 (N = 70). A total of 78 peer-reviewed articles related to young to middle-aged (i.e., 18-65 years) healthy Latinx adult sleep were identified in three databases-PsycInfo, PubMed/Medline, and Web of Science. With the socioecological model as framework, this review (1) summarizes current evidence pertaining to sleep health in healthy, community dwelling, urban Latinx adults; (2) discusses measurement challenges related to investigating Latinx sleep disparities and differences; and (3) discusses potential contributors to Latinx sleep. The prevalence of short sleep duration, long sleep duration, and poor sleep quality is high among Latinx; there are differences by Latinx subgroup. Our review identifies several multi-level influences associated with poor sleep: SES, sexual minority status, racial discrimination, access to care, neighborhood environment, and shift work. N = 250/250.
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Affiliation(s)
- Julia Roncoroni
- Department of Counseling Psychology, University of Denver, Denver, CO, USA
| | - Michele Okun
- Psychology Department University of Colorado, Colorado Springs, CO, USA
| | - Amy Hudson
- Department of Counseling Psychology, University of Denver, Denver, CO, USA
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15
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Xue X, Hua S, Weber K, Qi Q, Kaplan R, Gustafson DR, Sharma A, French A, Burgess HJ. Jointly modeling of sleep variables that are objectively measured by wrist actigraphy. Stat Med 2022; 41:2804-2821. [PMID: 35417078 PMCID: PMC9942772 DOI: 10.1002/sim.9385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/27/2022] [Accepted: 03/07/2022] [Indexed: 02/01/2023]
Abstract
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.
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Affiliation(s)
- Xiaonan Xue
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Simin Hua
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Kathleen Weber
- Core Center of Cook County Health, Stroger Hospital of Cook County, Chicago, Illinois, USA
| | - Qibin Qi
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Robert Kaplan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Deborah R. Gustafson
- Department of Neurology, Section for Neuro Epidemiology, State University of New York Downstate Health Sciences University, Brooklyn, New York, USA
| | - Anjali Sharma
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Audrey French
- Core Center of Cook County Health, Stroger Hospital of Cook County, Chicago, Illinois, USA,Division of Infectious Diseases, Stroger Hospital of Cook County, Chicago, Illinois, USA
| | - Helen J. Burgess
- Sleep and Circadian Research Laboratory, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
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16
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Waking up to sleep's role in obesity and blood pressure among Black adolescent girls in low-income, US urban communities: A longitudinal analysis. Sleep Health 2022; 8:200-207. [DOI: 10.1016/j.sleh.2021.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/26/2021] [Accepted: 12/03/2021] [Indexed: 12/15/2022]
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17
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Li X, Haneuse S, Rueschman M, Kaplan ER, Yu X, Davison KK, Redline S, Taveras EM. Longitudinal association of actigraphy-assessed sleep with physical growth in the first 6 months of life. Sleep 2021; 45:6401902. [PMID: 34676870 DOI: 10.1093/sleep/zsab243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/16/2021] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES Suboptimal sleep is associated with obesity and its sequelae in children and adults. However, few studies have examined the association between sleep and physical growth in infants who experience rapid changes in sleep/wake patterns. We examined the longitudinal association of changes in objectively assessed sleep/wake patterns with changes in growth between ages 1 and 6 months. METHODS We studied 298 full-term infants in the longitudinal Rise & SHINE cohort study. Changes from 1 and 6 months in nighttime sleep duration, wake after sleep onset (WASO), and number of waking bouts ≥5 min were assessed using ankle actigraphy. Overweight was defined as age- and sex-specific weight for length ≥95th percentile. Generalized estimating equation analyses adjusted for infants' and mothers' characteristics. RESULTS The mean (SD) birth weight was 3.4 (0.4) kg; 48.7% were boys. In multivariable adjusted models, each 1-h increase in nighttime sleep duration between months 1 and 6 was associated with a 26% decrease in the odds of overweight from 1 to 6 months (odds ratio [OR] = 0.74; 95% confidence interval [CI, 0.56, 0.98]). Each 1-unit decrease in number of waking bouts was associated with a 16% decrease in the odds of overweight (OR = 0.84; 95% CI [0.72, 0.98]). Changes in WASO were not associated with the odds of overweight. CONCLUSIONS Greater increases in nighttime sleep duration and more consolidation of nighttime sleep were associated with lower odds of overweight from 1 to 6 months. Adverse sleep patterns as early as infancy may contribute to excess adiposity.
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Affiliation(s)
- Xiaoyu Li
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michael Rueschman
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Emily R Kaplan
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Xinting Yu
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,School of Social Work, Boston College, Boston, MA, USA
| | | | - Susan Redline
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Elsie M Taveras
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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18
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The association of sleep duration and feeling rested with health in U.S. Hispanic women. Sleep Med 2021; 83:54-62. [PMID: 33990067 DOI: 10.1016/j.sleep.2021.03.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/11/2021] [Accepted: 03/30/2021] [Indexed: 02/05/2023]
Abstract
This study aims to understand the health correlates of sleep deficiencies in non-elderly U.S. Hispanic1 women. Data from a sample of U.S. Hispanic women (n = 1531; ages 18-65 [M = 39.98; SD = 12.85]) who completed the 2017 National Health Interview Survey were analyzed to understand (1) sleep duration and quality; (2) the association of sleep patterns with key health indicators; and (3) whether these relationships are mediated by health behaviors (ie, healthy eating and physical activity). Shorter sleep duration was associated with a higher likelihood of often feeling anxious and having hypertension. Worse sleep quality was associated with a higher likelihood of being overweight, having fair or poor health status, often feeling depressed, often feeling anxious, having high cholesterol, and having asthma. Doctor's recommendation to engage in physical activity and to decrease calorie intake served as mediators in some of these relationships. Results indicate that among Hispanic women: (1) sleep is an important determinant of a variety of health outcomes and (2) the association of sleep and many health outcomes are mediated by healthy eating and physical activity. Further research on the association of sleep and risk of chronic disease among Hispanic women is needed.
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19
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Fatima Y, Bucks RS, Mamun AA, Skinner I, Rosenzweig I, Leschziner G, Skinner TC. Sleep trajectories and mediators of poor sleep: findings from the longitudinal analysis of 41,094 participants of the UK Biobank cohort. Sleep Med 2020; 76:120-127. [PMID: 33157426 DOI: 10.1016/j.sleep.2020.10.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/29/2020] [Accepted: 10/19/2020] [Indexed: 01/19/2023]
Abstract
STUDY OBJECTIVES To explore sleep trajectories and identify the risk factors and mediators of poor sleep in middle-aged adults. METHODS Group-based multi-trajectory modelling was applied to the three waves of sleep data the from UK Biobank cohort to identify latent trajectories of sleep and group characteristics. Self-reported sleep duration, sleep problems (based on insomnia symptoms, snoring and trouble waking up) and daytime sleepiness (based on daytime tiredness and sleepiness) were included in the trajectory analyses. Multinomial logistic regression and mediation analysis were used to identify the main factors associated with poor sleep. RESULTS Analysis of sleep data from 41,094 participants (51.9% females) with a median age of 57 years (interquartile range 50-62 years) identified three distinct trajectories of sleep: healthy sleepers (40.8%); borderline poor sleepers (31.6%); and poor sleepers (27.6%). Socio-economic disadvantage, ethnic minority background, shift work, unhealthy lifestyle, poor health, depressive symptoms and obesity were the main risk factors associated with poor sleep. Around a third of the total effect of socio-economic deprivation on poor sleep was mediated through depressive symptoms. CONCLUSIONS The distinct groups with differential risk for developing sleep issues and stable sleep trajectories highlight the non-transient nature of sleep issues. Early management of depressive symptoms can help in reducing the future burden of poor sleep. Due to the increased risk of poor sleep, people from socio-economically deprived groups, particularly females from ethnic minorities, should be the highest priority for interventions aiming to improve population sleep health.
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Affiliation(s)
- Yaqoot Fatima
- Institute for Social Science Research, University of Queensland, Brisbane, Australia; Centre for Rural and Remote Health, James Cook University, Mount Isa, Australia.
| | - Romola S Bucks
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Abdullah A Mamun
- Institute for Social Science Research, University of Queensland, Brisbane, Australia
| | - Isabelle Skinner
- Centre for Rural and Remote Health, James Cook University, Mount Isa, Australia
| | - Ivana Rosenzweig
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Guy Leschziner
- Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, London, United Kingdom; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Timothy C Skinner
- Centre for Rural and Remote Health, James Cook University, Mount Isa, Australia; University Department of Rural Health, La Trobe University, Bendigo, Australia; Institut for Psykologi, Center for Sundhed of Samfund, Københavns Universitet, Øster Farimagsgade, København K, Denmark
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20
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Wang YH, Wang J, Chen SH, Li JQ, Lu QD, Vitiello MV, Wang F, Tang XD, Shi J, Lu L, Wu SL, Bao YP. Association of Longitudinal Patterns of Habitual Sleep Duration With Risk of Cardiovascular Events and All-Cause Mortality. JAMA Netw Open 2020; 3:e205246. [PMID: 32442289 PMCID: PMC7244989 DOI: 10.1001/jamanetworkopen.2020.5246] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
IMPORTANCE Single self-reported measures of sleep duration are associated with adverse health outcomes; however, long-term patterns of self-reported sleep duration and their association with cardiovascular events (CVEs) and all-cause mortality remain unknown. OBJECTIVE To determine whether trajectories of long-term vs single-measure sleep duration are associated with subsequent risk of CVEs and all-cause mortality. DESIGN, SETTING, AND PARTICIPANTS The Kailuan study is a prospective, population-based cohort study that began in 2006. The present cohort included 52 599 Chinese adults without atrial fibrillation, myocardial infarction, stroke, or cancer to 2010. Trajectories in sleep duration from January 1, 2006, to December 31, 2010, were identified to investigate the association with risk of CVEs and all-cause mortality from January 1, 2010, to December 31, 2017. Data analysis was conducted from July 1 to October 31, 2019. EXPOSURES Habitual self-reported nocturnal sleep durations were collected in 2006, 2008, and 2010. Trajectories in sleep duration for 4 years were identified by latent mixture modeling. MAIN OUTCOMES AND MEASURES All-cause mortality and first incident CVEs (atrial fibrillation, myocardial infarction, and stroke) from 2010 to 2017 were confirmed by medical records. Based on the baseline sleep duration and patterns over time, 4 trajectories were categorized (normal stable, normal decreasing, low increasing, and low stable). RESULTS Of the 52 599 adults included in the study (mean [SD] age at baseline, 52.5 [11.8] years), 40 087 (76.2%) were male and 12 512 (23.8%) were female. Four distinct 4-year sleep duration trajectory patterns were identified: normal stable (range, 7.4 to 7.5 hours [n = 40 262]), normal decreasing (mean decrease from 7.0 to 5.5 hours [n = 8074]), low increasing (mean increase from 4.9 to 6.9 hours [n = 3384]), and low stable (range, 4.2 to 4.9 hours [n = 879]). During a mean (SD) follow-up of 6.7 (1.1) years, 2361 individuals died and 2406 had a CVE. Compared with the normal-stable pattern and adjusting for potential confounders, a low-increasing pattern was associated with increased risk of first CVEs (hazard ratio [HR], 1.22; 95% CI, 1.04-1.43), a normal-decreasing pattern was associated with increased risk of all-cause mortality (HR, 1.34; 95% CI, 1.15-1.57), and the low-stable pattern was associated with the highest risk of CVEs (HR, 1.47; 95% CI, 1.05-2.05) and death (HR, 1.50; 95% CI, 1.07-2.10). CONCLUSIONS AND RELEVANCE In this study, sleep duration trajectories with lower or unstable patterns were significantly associated with increased risk of subsequent first CVEs and all-cause mortality. Longitudinal sleep duration patterns may assist in more precise identification of different at-risk groups for possible intervention. People reporting consistently sleeping less than 5 hours per night should be regarded as a population at higher risk for CVE and mortality.
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Affiliation(s)
- Yun-He Wang
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Jing Wang
- Peking University Medical Informatics Center, Peking University, Beijing, China
| | - Shuo-Hua Chen
- Health Care Center, Kailuan Medical Group, Tangshan, China
| | - Jin-Qiao Li
- Health Care Center, Kailuan Medical Group, Tangshan, China
| | - Qing-Dong Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Michael V. Vitiello
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle
| | - Feng Wang
- Chinese Center for Health Education, Beijing, China
| | - Xiang-Dong Tang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center and Translational Neuroscience Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Lin Lu
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, China
- Peking-Tsinghua Center for Life Sciences and International Data Group/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Shou-Ling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
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21
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Herring SJ, Yu D, Spaeth A, Pien G, Darden N, Riis V, Bersani V, Wallen J, Davey A, Foster GD. Influence of Sleep Duration on Postpartum Weight Change in Black and Hispanic Women. Obesity (Silver Spring) 2019; 27:295-303. [PMID: 30597751 PMCID: PMC6345591 DOI: 10.1002/oby.22364] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 10/14/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The primary purpose of this study was to examine associations of objectively measured sleep duration with weight changes in black and Hispanic mothers over the first postpartum year. METHODS Data were from 159 mothers (69% black, 32% Hispanic). Nocturnal sleep duration was assessed using wrist actigraphy at 6 weeks and 5 months post partum, examined as a continuous variable and in categories (< 7 vs. ≥ 7 hours/night, consistent with American Academy of Sleep Medicine recommendations). Body weights were abstracted from medical records in pregnancy and measured at 6 weeks, 5 months, and 12 months post partum. Outcomes included early postpartum (6 weeks to 5 months) and late postpartum (5 to 12 months) weight changes. RESULTS The majority of participants slept < 7 hours/night at 6 weeks (75%) and 5 months (63%) post partum. Early postpartum weight change did not differ by 6-week sleep duration category. By contrast, adjusted average late postpartum weight gain (SE) was 1.8 (0.7) kg higher in participants sleeping < 7 hours/night at 5 months post partum compared with those sleeping ≥ 7 hours/night (P = 0.02). Results did not show statistically significant associations of continuous measures of sleep duration, nor of measures of sleep quality, with postpartum weight changes. CONCLUSIONS Sleeping < 7 hours/night was associated with late postpartum weight gain in minority mothers.
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Affiliation(s)
- Sharon J. Herring
- Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
- Department of Clinical Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Daohai Yu
- Department of Clinical Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Andrea Spaeth
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA
| | - Grace Pien
- Department of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD
| | - Niesha Darden
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA
- Department of Clinical Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Valerie Riis
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA
| | - Veronica Bersani
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA
- Department of Clinical Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Jessica Wallen
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA
- Department of Clinical Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Adam Davey
- College of Health Sciences, University of Delaware, Newark, DE
| | - Gary D. Foster
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA
- Weight Watchers International, New York, NY
- Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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