Does Weekend Catch-up Sleep Affect High-Sensitivity C-Reactive Protein Levels Among Korean Workers?: A Cross-Sectional Study Using KNHANES

Association between weekend catch-up sleep and depressive symptoms in American adults: Finding from NHANES 2017-2020

BACKGROUND

The effect of weekend catch-up sleep (WCS) on depressive symptoms is inconsistent among different populations, with limited evidence in Americans. Therefore, we aimed to investigate the association between WCS and depressive symptoms in American adults.

METHODS

We recruited 7719 participants from the National Health and Nutrition Examination Survey (NHANES) 2017-2020. Information on sleep duration and depressive symptoms were assessed by several self-reported questions and Patient Health Questionnaire-9 (PHQ-9), respectively. Then, WCS duration was calculated as weekend sleep duration minus weekday sleep duration, and WCS was further defined as WCS duration >0 h. Survey designed regression analyses were used to assess the association of WCS and depressive symptoms.

RESULTS

In fully adjusted multivariate logistic regression models, the odds ratio (95 % confidence interval) for depressive symptoms and the β (95 % confidence interval) for PHQ-9 score in response to WCS were 0.746 (0.462, 1.204; P = 0.218) and -0.429 (-0.900, 0.042; P = 0.073), respectively. Besides, the smooth relationship presented L-shaped, and only WCS duration of 0-2 h was statistically significantly associated with depressive symptoms or PHQ-9 score. Subgroup analyses showed that the negative associations were stronger among men, adults younger than 65 years, and those with short weekday sleep duration (P for interaction <0.05).

LIMITATIONS

The cross-sectional design limits the capability for causal relationship between WCS and depressive symptoms.

CONCLUSIONS

This study suggests that moderate WCS is associated with reduced odds of depressive symptoms, which provides additional epidemiological evidence for the effects of sleep on depressive symptoms.

Relationship between C-reactive protein level and periodontitis and systemic diseases

BACKGROUND

Periodontitis affects systemic disease risk, although the relationship thereof in the context of different C-reactive protein (CRP) levels is not clear. This study investigated the association of periodontitis with systemic diseases according to high-sensitivity CRP (hs-CRP) level and sought to identify the risk of systemic diseases in patients with periodontitis.

METHODS

We used data from the seventh (2016-2018) Korea National Health and Nutrition Examination Survey. In a total of 16,489 subjects, the hs-CRP group was classified into the hs-CRP low-risk group and the hs-CRP high-risk group. Propensity score matching (PSM) is used for 1:1 matching of confounding variables (e.g., age, gender, income, and education) between hs-CRP low-risk and hs-CRP at-risk groups to analyze the final 5316 subjects. The association between general characteristics and prevalence of systemic diseases was analyzed using descriptive statistics and the chi-squared test. The associations between hs-CRP level and systemic and periodontitis were analyzed using logistic regression analyses.

RESULTS

Within the hs-CRP group, the presence of periodontitis was associated with a significantly increased prevalence of hypertension, diabetes mellitus, and stroke. In the hs-CRP risk group, periodontitis significantly increased the risk of hypertension and diabetes mellitus by 2.1 and 2.4 times, respectively.

CONCLUSIONS

The presence of periodontitis significantly increases the prevalence of systemic diseases and more so in individuals with higher hs-CRP levels. This indicates the significance of maintaining oral health in reducing the risk of systemic diseases.

Joint associations of sedentary behavior and domain-specific physical activity on C-reactive protein in Korea

Sedentary behavior (SB) and physical activity (PA) exert opposing effects on inflammatory markers. This study examined the associations of a more subdivided combination of PA and SB with high-sensitivity C-reactive protein (hs-CRP). Using the 2014-2019 Korean National Health and Nutrition Examination Survey, this cross-sectional study analyzed 20,541 adults. The independent variables were SB, defined as ≥10 h of sitting per day, and three domains of PA: occupational PA (OPA) during work, leisure-time PA (LPA) during leisure time, and transportation PA (TPA) or active commuting. The dependent variable was hs-CRP ≥ 1.0 mg/L. Besides exploring the individual association of SB and each PA with hs-CRP, the combined association of SB and each PA with hs-CRP was also examined using multiple logistic regression. The analyses indicated that concurrent exposure to SB and OPA (odds ratio [OR] 1.36, 95% confidence interval [CI] 1.02-1.80) significantly raised the likelihood of increased hs-CRP, while SB without LPA (OR 1.26, 95% CI 1.11-1.41) or TPA (OR 1.19, 95% CI 1.08-1.31) significantly increased risk of higher hs-CRP, compared to their respective reference. The absence of non-occupational PA such as LPA or TPA combined with SB was associated with the increased hs-CRP risk, whereas OPA increased the risk when present concurrently with SB. Reducing SB and OPA while increasing LPA and TPA, is necessary to reduce inflammatory conditions.

The importance of sleep regularity: a consensus statement of the National Sleep Foundation sleep timing and variability panel

OBJECTIVE

To develop and present consensus findings of the National Sleep Foundation sleep timing and variability panel regarding the impact of sleep timing variability on health and performance.

METHODS

The National Sleep Foundation assembled a panel of sleep and circadian experts to evaluate the scientific evidence and conduct a formal consensus and voting procedure. A systematic literature review was conducted using the NIH National Library of Medicine PubMed database, and panelists voted on the appropriateness of 3 questions using a modified Delphi RAND/UCLA Appropriateness Method with 2 rounds of voting.

RESULTS

The literature search and panel review identified 63 full text publications to inform consensus voting. Panelists achieved consensus on each question: (1) is daily regularity in sleep timing important for (a) health or (b) performance? and (2) when sleep is of insufficient duration during the week (or work days), is catch-up sleep on weekends (or non-work days) important for health? Based on the evidence currently available, panelists agreed to an affirmative response to all 3 questions.

CONCLUSIONS

Consistency of sleep onset and offset timing is important for health, safety, and performance. Nonetheless, when insufficient sleep is obtained during the week/work days, weekend/non-work day catch-up sleep may be beneficial.

A prospective study of the association of weekend catch-up sleep and sleep duration with mortality in middle-aged adults

Health effects of weekend catch-up sleep (CUS) could differ depending on both the ability to obtain sufficient sleep during weekdays and amount of weekend CUS required to compensate for sleep lost during the week. Using data from 3128 middle-aged (40-64 years) participants of the Sleep Heart Health Study, we examined the longitudinal association of these two aspects of sleep with all-cause mortality. CUS was calculated as the difference in self-reported habitual sleep duration between weekends and weekdays, and classified into no, short (1 h), and long (2 h or more) CUS. Polysomnography-measured total sleep time, representing the ability to obtain sufficient sleep, was classified into short (< 360 min) or normal (≥ 360 min) sleep durations. We estimated multivariable-adjusted mortality hazard ratios (HRs) and 95% confidence intervals (CIs) for six groups divided by the extent of CUS and sleep duration. Participants were followed up for a median (interquartile range) of 12.3 (11.3-13.5) years. Short weekend CUS with normal sleep duration was associated with lower mortality compared to no CUS with normal sleep duration (HR, 0.48; 95% CI 0.27-0.83). When stricter cutoffs were applied for sleep durations, while the protective effect of short CUS with normal sleep duration (≥ 390 min) was strengthened (HR, 0.36; 95% CI 0.17-0.78), the harmful effect of short CUS with short sleep duration (< 330 min) emerged (HR, 1.84; 95% CI 1.08-3.14). Results highlight the importance of balancing sleep ability and CUS. Sufficient sleep may reduce weekday sleep debt and only a short CUS would be required on weekends, improving mortality in middle-aged adults.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41105-023-00460-6.

Association between weekend catch-up sleep and hyperuricemia with insufficient sleep in postmenopausal Korean women: a nationwide cross-sectional study

OBJECTIVE

Hyperuricemia is associated with metabolic and cardiovascular diseases and mortality. Efforts to lower the risk of hyperuricemia in various ways are needed as the prevalence of these diseases increases in postmenopausal women. Studies have shown that one of these methods is associated with adequate sleep duration, which is related to a low risk of hyperuricemia. Considering that it is difficult for people to get enough sleep in modern society, this study hypothesized that weekend catch-up sleep could be an alternative. To our knowledge, no past study has investigated the relation between weekend catch-up sleep and hyperuricemia in postmenopausal women. Hence, the aim of this research was to estimate the relation between weekend catch-up sleep and hyperuricemia with insufficient sleep in postmenopausal women during weekday or workday.

METHODS

This study included 1,877 participants extracted from the Korea National Health and Nutrition Examination Survey VII. The study population was divided into weekend catch-up sleep and non-weekend catch-up sleep groups. Odds ratios with 95% confidence intervals were derived using multiple logistic regression analysis.

RESULTS

Weekend catch-up sleep had a significantly lower prevalence of hyperuricemia after adjusting for confounders (odds ratio, 0.758 [95% confidence interval, 0.576-0.997]). In a subgroup analysis, weekend catch-up sleep of 1 to 2 hours was significantly correlated with a lower prevalence of hyperuricemia after adjusting for confounders (odds ratio: 0.522 [95% confidence interval, 0.323-0.845]).

CONCLUSIONS

Weekend catch-up sleep had a decreased prevalence of hyperuricemia in postmenopausal women with sleep deprivation.

Relationship Between Sleep Duration and Metabolic Health in Adolescents

Purpose: This study analyzed the gender differences in the cross-sectional relationship between sleep duration and metabolic health in Korean adolescents. Materials and Methods: Adolescents (1234 males, 1073 females) aged 12-19 years who provided their metabolic syndrome score (MetZscore) and sleep duration were included from the Korea National Health and Nutrition Examination Survey 2016-2020 data. Waist circumference (WC), blood pressure (BP), glucose, triglycerides (TGs), and high-density lipoprotein cholesterol (HDL) were combined to create a standardized MetZscore. Gender-specific linear or quadratic relationships between sleep durations (weekday or difference between weekend and weekday sleep) and MetZscore were analyzed after adjusting for age, family affluence, and self-rated health. Results: Male adolescents displayed an inverse linear relationship between weekday sleep duration and MetZscore [B, -0.037 (confidence interval, 95% CI: -0.054 to -0.019)], whereas females showed a nonsignificant relationship. In male adolescents, the standardized scores of WC, BP, and TG decreased linearly as weekday sleep duration increased. In females, weekday sleep duration had an inverse linear association with WC score and a positive quadratic association with glucose score. MetZscore declined linearly as the difference in sleep durations between weekends and weekdays increased [B, -0.078 (95% CI: -0.123 to -0.034) in males; B, -0.042 (95% CI: -0.080 to -0.005) in females]. Although the scores of WC and HDL in males and the scores of WC and glucose in females had inverse linear relationships with the difference in sleep durations, the BP score in males had a positive quadratic association. Conclusions: According to this study, metabolic health benefited from longer weekend sleep durations than weekdays in both male and female adolescents and longer weekdays sleep durations in male adolescents.

Wake-up ischemic stroke associated with short sleep duration and sleep behavior: A stratified analysis according to risk of obstructive sleep apnea

OBJECTIVE

Wake-up stroke (WUS) is an ischemic stroke occurring during nocturnal sleep with neurological deficits observed upon awakening. Our study aimed to investigate the association between WUS, sleep curtailment, and sleep behavior according to the obstructive sleep apnea (OSA) risk in patients with acute ischemic stroke.

METHODS

This single-centered, retrospective study included hospitalized subjects with acute ischemic stroke occurring within 30 days. A total of 250 participants were classified as WUS or not and enquired about their sleep habits concerning sleep time on weekdays and weekends, demographic factors, and assessed comorbid medical conditions. Weekend catch-up sleep (CUS) was defined as the extension of sleep duration during weekends. The average weekly sleep duration and chronotype were assessed. The association between WUS and sleep factors was analyzed.

RESULTS

WUS was observed in 70 patients (28.0%) with acute ischemic stroke. There were no significant differences in the demographic and stroke-related variables between the WUS and non-WUS (NWUS) groups. Upon stratified analysis based on risk of OSA, average weekly sleep duration (odds ratio, [OR] = 0.60, 95% confidence interval, [CI] = 0.41-0.89; p = 0.011), the presence of weekend CUS (OR = 0.07, 95% CI = 0.01-0.97; p = 0.047), and chronotype (OR = 0.62, 95% CI = 0.39-0.98; p = 0.041) were independently associated with WUS in low-risk group with OSA, but not in the high-risk group.

CONCLUSIONS

Short sleep duration and lack of compensation are significantly associated with WUS in low-risk OSA group. Insufficient sleep and sleep behaviors could play a different role in causing ischemic stroke during sleep when patients are stratified by their risk of sleep apnea.

Effect of weekend catch-up sleep on high-sensitivity C-reactive protein levels according to bedtime inconsistency: a population-based cross-sectional study

To investigate the associations of weekend catch-up sleep (WCS) and high-sensitivity C-reactive protein (hs-CRP) levels according to bedtime inconsistency in the Korean population. In this cross-sectional study using the Korea National Health and Nutrition Examination Survey (2016-2018) with 17,665 participants, four groups were defined: no-WCS (WCS within ± 1 h of weekday sleep time), moderate WCS (1 ≤ , < 3 h), severe WCS (≥ 3 h), and inverse WCS (≤ - 1 h). An inconsistent bedtime was defined as a > 2 h difference between weekend and weekday bedtimes. Outcomes were divided into quartiles based on the hs-CRP level: Lowest (< 0.34), Middle-low (≥ 0.34, < 0.55), Middle-high (≥ 0.55, < 1.10), Highest (≥ 1.10). Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated using multinomial logistic regression, controlling for relevant covariates. Moderate WCS was associated with a lower risk for the highest hs-CRP levels than no WCS (aOR = 0.87, 95% CI 0.78-0.97), and a similar association was observed only in participants with consistent bedtimes (aOR = 0.88, 95% CI 0.78-0.99). Significant interactions of those associations of WCS and hs-CRP levels with bedtime inconsistency were found. These findings provide evidence that people with inconsistent bedtimes would have limited protective effect of WCS on hs-CRP.

Sleep and Alcohol Use Patterns During Federal Holidays and Daylight Saving Time Transitions in the United States

We conducted a retrospective observational study using remote wearable and mobile application data to evaluate whether US public holidays or Daylight Saving Time transitions were associated with significant changes in sleep behaviors, including sleep duration, sleep onset and offset, and the consistency of sleep timing, as well as changes in the point prevalence of alcohol use. These metrics were analyzed using objective, high resolution sleep-wake data (10,350,760 sleep episodes) and 5,777,008 survey responses of 24,250 US subscribers (74.5% male; mean age of 37.6 ± 9.8 years) to the wrist-worn biometric device platform, WHOOP (Boston, Massachusetts, United States), who were active users during 1 May 2020, through 1 May 2021. Compared to baseline, statistically significant differences in sleep and alcohol measures were found on most DST transitions, US public holidays, and their eves. For example, New Year's Eve corresponded with a sleep consistency decrease of 13.8 ± 0.3%, a sleep onset delay of 88.9 ± 3.2 min (00:01 vs. 22:33 baseline) later, a sleep offset delay of 78.1 ± 3.1 min (07:56 vs. 06:39), and an increase in the prevalence of alcohol consumption, with more than twice as many participants having reported alcohol consumption [+138.0% ± 6.7 (74.2% vs. 31.2%)] compared to baseline. In this analysis of a non-random sample of mostly male subscribers conducted during the COVID-19 pandemic, the majority of US public holidays and holiday eves were associated with sample-level increases in sleep duration, decreases in sleep consistency, later sleep onset and offset, and increases in the prevalence of alcohol consumption. Future work would be warranted to explore the generalizability of these findings and their public health implications, including in more representative samples and over longer time intervals.

Evidence of sleep duration and weekend sleep recovery impact on suicidal ideation in adolescents with allergic rhinitis

STUDY OBJECTIVES

Sleep problems are common in allergic rhinitis (AR) and are a modifiable risk factor for suicidal ideation. However, the effect of sleep duration and weekend catch-up sleep (WCUS)-sleep time on weekends that exceeds sleep time on weekdays-on suicidal ideation for adolescents with AR is unknown. The objective of this study was to explore whether sleep duration and WCUS have an impact on suicidal ideation among adolescents with AR.

METHODS

From the annual Korean Youth Risk Behavior Web-Based Surveys (completed from 2013-2017), data were obtained from a stratified, multistage, clustered sample. Using self-reported questionnaires, students provided doctor-diagnosed AR and sleep time.

RESULTS

Among 134,417 and 262,653 adolescents with and without AR, respectively, those with AR compared with those without AR had more sleep dissatisfaction (46.6% vs 40.8%), slept less (sleep duration: 6.71 ± 1.37 hours vs 7.01 ± 1.48 hours), and had longer WCUS (3.46 ± 0.11 hours vs 2.11 ± 0.14 hours). After adjustment, the odds ratio of patients with sleep dissatisfaction was a 1.22 (95% confidence interval, 1.17-1.28) times higher risk of suicidal ideation than in those with sleep satisfaction. For average sleep duration (defining 7-8 hours as the reference), the odds ratio of short sleep (≤ 5 hours) was 1.45 (95% confidence interval, 1.32-1.53). Notably, long WCUS (≥ 2 hours) was significantly associated with decreased suicidal ideation (odds ratio, 0.85; 95% confidence interval, 0.81-0.92).

CONCLUSIONS

Although further research is needed to clarify this association, under the condition of sleep deprivation, WCUS at a certain extent may be associated with a low risk for suicidal ideation in adolescents with AR.

CITATION

Kim CW, Jeong SC, Hwang SW, Jo SH, Kim SH. Evidence of sleep duration and weekend sleep recovery impact on suicidal ideation in adolescents with allergic rhinitis. J Clin Sleep Med. 2021;17(8):1521-1532.

Beneficial effects of weekend catch-up sleep on metabolic syndrome in chronic short sleepers

OBJECTIVES

Short sleep duration has been known to be related to metabolic syndrome (MetS) . The aim of this study was to investigate the beneficial effects of weekend catch-up sleep (WCUS) on MetS in the Korean middle-aged population.

METHODS

For this cross-sectional study, 1,812 participants aged 35-60 years were selected from the 2016-2018 Korean National Health and Nutrition Examination Survey (mean age 46.94 years, 49% male). Short sleep duration was defined as <6hrs on weekdays, and participants were divided into two groups: WCUS group and no weekend catch-up sleep group. Multiple logistic regression was performed to determine the association between WCUS and MetS prevalence. The covariates included age, sex, education, income, occupation, smoking, alcohol consumption, and physical activity.

RESULTS

WCUS was significantly associated with lower MetS prevalence in the unadjusted model and in the model adjusted for socioeconomic and health behavior factors.

CONCLUSION

These results support the beneficial effects of WCUS on lowering the risk of MetS among middle-aged chronic short sleepers.

Sex differences in the association between self-rated health and high-sensitivity C-reactive protein levels in Koreans: a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey

BACKGROUND

No studies have investigated the association between self-rated health (SRH) and high-sensitivity C-reactive protein (hs-CRP) levels in South Koreans. We explored this association and analyzed differences between sexes.

METHODS

Using cross-sectional data from the 2015-2017 Korea National Health and Nutrition Examination Survey, we analyzed the association between SRH and high hs-CRP levels (> 1.0 mg/L) in 14,544 Koreans aged ≥ 19 years who responded to the SRH survey and had available hs-CRP test results. Differences in sociodemographic factors were analyzed using the Pearson's chi-square test for categorical variables or the Mann-Whitney U test for continuous variables. Multiple logistic regression analysis was used to measure the association between hs-CRP levels and SRH according to sex while adjusting for other possible confounders.

RESULTS

The percentage of very poor to poor SRH was higher in the high hs-CRP group (22.4%) than in the low hs-CRP group (17.66%). Among men, the risk of a high hs-CRP level increased with worse SRH (adjusted for confounders; P for trend < 0.001). After adjusting for all confounders, including chronic diseases, men with very poor SRH showed a higher odds ratio (OR) for high hs-CRP levels than those with very good SRH (fully adjusted OR, 1.74; 95% CI, 1.04-2.90). Significant correlations were absent among women.

CONCLUSIONS

Poor SRH was correlated with low-grade inflammation (high hs-CRP levels) among Korean male adults. These findings could be useful for developing health improvement programs and in goal setting at a national scale.

Association Between Weekend Catch-Up Sleep and Metabolic Syndrome with Sleep Restriction in Korean Adults: A Cross-Sectional Study Using KNHANES

BACKGROUND

Many researchers have identified that adequate sleep duration is linked to the quality of life and metabolic diseases. Nowadays, it is hard to take enough sleep, so weekend catch-up sleep (CUS) may be an alternative option in modern society. To our knowledge, no previous studies reported the association between weekend CUS and metabolic syndrome, especially in the Korean population.

OBJECTIVE

We investigated the association between weekend CUS and the prevalence of metabolic syndrome in Korean adults (≥20 years old) with less than 6 hours of average weekday sleep.

PATIENTS AND METHODS

A total of 1,453 individuals were selected from the Korean National Health and Nutrition Examination Survey. Weekend CUS was divided into four categories: ≤0 hour, 0-1 hour, 1-2 hours, and ≥2 hours. Odds ratios (ORs) with 95% confidence intervals (CIs) were derived by univariate and multivariate logistic regression analyses.

RESULTS

Participants with weekend CUS ≥1 hour had decreased risk of metabolic syndrome in univariate analysis (CUS 1-2 hours: OR: 0.413, 95% CI: 0.301-0.568; CUS ≥2 hours: OR: 0.382, 95% CI 0.296-0.493). Weekend CUS 1-2 hours reduced the risk of metabolic syndrome in multivariate logistic regression analysis (OR: 0.552, 95% CI: 0.369-0.823). Based on the age group analysis, weekend CUS ≥1 hour reduced the metabolic syndrome among those aged 20-39 and 40-65 (20-39: CUS 1-2 hours OR: 0.248, 95% CI: 0.078-0.783, CUS ≥2 hours OR: 0.374, 95% CI: 0.141-0.991; 40-65: CUS 1-2 hours OR: 0.507, 95% CI 0.309-0.832 CUS ≥2 hours OR: 0.638, 95% CI: 0.415-0.981).

CONCLUSION

Weekend CUS was associated with a low risk of metabolic syndrome among Korean adults with sleep restriction.