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Hou Z, Chen Y, Sun Y, Song C, Deng H, Cheng N, Han X, Zhang J, Wang Q, Li Y, Yin J, Meng Q. Sleep Duration and Insomnia with Comorbid Depression and Anxiety Symptoms in Chinese Adults: A Cross-Sectional Study. Nat Sci Sleep 2023; 15:1079-1091. [PMID: 38146513 PMCID: PMC10749553 DOI: 10.2147/nss.s440584] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/13/2023] [Indexed: 12/27/2023] Open
Abstract
Purpose Depression and anxiety are two highly prevalent mental disorders that commonly coexist. However, little is known about the association between sleep and comorbid depressive and anxiety symptoms (CDAS). Therefore, this study aims to explore the relationship between sleep duration, insomnia and CDAS. Methods This is a cross-sectional study of 22,004 community adults who participated in the China Multi-Ethnic Cohort (CMEC) study. Chinese version of Patient Health Questionnaire-2 and Generalized Anxiety Disorder-2 were used to screen CDAS in community adults. A positive score on each scale was considered indicative of CDAS. All participants received face-to-face interviews, medical examinations, and biochemical examinations to assess sleep duration and insomnia and collect covariates. The self-reported sleep duration was divided into three groups: <7 hr, 7-9 hr and >9 hr groups. Logistic regression was used to analyze the association between sleep duration, insomnia and CDAS. A restricted cubic spline (RCS) was used to explore the dose-response relationship between sleep duration and CDAS. Stratified analysis based on gender and age was conducted. Results Overall, 2.8% (95% CI 2.6%~3.0%) of participants reported having CDAS. After adjusting the potential covariates, sleep duration <7 hr (OR=1.635, 95% CI=1.335~2.004) was significantly associated with CDAS, compared with sleep 7-9 hr. After RCS analysis, there was a nonlinear relationship between sleep duration and CDAS. The increase in the number of types of insomnia, the greater the likelihood of CDAS (p for trend<0.05). In sensitivity analysis, it was found that the results were consistent with those of the main analysis. After stratification by gender and age, the association between sleep duration and CDAS was only observed in female and young and middle-aged adults, not in men and older adults. Conclusion Both insufficient sleep duration and insomnia are associated with a higher prevalence of CDAS in Chinese adults.
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Affiliation(s)
- Zhongxin Hou
- School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Yang Chen
- School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
- Institute for Acute Communicable Disease Prevention and Control, Yunnan Provincial Center for Disease Control and Prevention, Kunming, Yunnan, People’s Republic of China
| | - Yunrui Sun
- School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Chongwei Song
- School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Haoyuan Deng
- Medical Department, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Nan Cheng
- Department of Hospital Infection, Wuhan Mental Health Center, Wuhan, Hubei, People’s Republic of China
| | - Xiaoyu Han
- Institute for Acute Communicable Disease Prevention and Control, Yunnan Provincial Center for Disease Control and Prevention, Kunming, Yunnan, People’s Republic of China
| | - Jianghui Zhang
- AIDS Care Center, Yunnan Provincial Hospital of Infectious Disease, Anning, Yunnan, People’s Republic of China
| | - Qian Wang
- School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Yi Li
- School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Jianzhong Yin
- School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
- Baoshan College of Traditional Chinese Medicine, Baoshan, Yunnan, People’s Republic of China
| | - Qiong Meng
- School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
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El-Solh AA, Lawson Y, Wilding GE. The risk of major adverse cardiovascular events associated with the use of hypnotics in patients with insomnia. Sleep Health 2023; 9:717-725. [PMID: 37393143 DOI: 10.1016/j.sleh.2023.05.006] [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: 03/08/2023] [Revised: 04/19/2023] [Accepted: 05/05/2023] [Indexed: 07/03/2023]
Abstract
OBJECTIVES To examine whether hypnotic use in patients with insomnia reduces major adverse cardiovascular events, including all-cause mortality and nonfatal major adverse cardiovascular events. METHODS Using the Veterans Affairs Corporate Data Warehouse, we conducted a retrospective cohort study of 16,064 patients who were newly diagnosed with insomnia between January 1, 2010, and December 31, 2019. A pair of 3912 hypnotic users and nonusers were selected based on a 1:1 propensity score methodology. The primary outcome was extended major adverse cardiovascular events, a composite of the first occurrence of all-cause mortality or nonfatal major adverse cardiovascular events. RESULTS During the median follow-up of 4.8 years, a total of 2791 composite events occurred, including 2033 deaths and 762 nonfatal major adverse cardiovascular events. Although the incidence rates of major adverse cardiovascular events were comparable between hypnotic users and nonusers in the propensity-matched cohort, users of benzodiazepines and Z-drugs had a higher risk of all-cause mortality (hazard ratio 1.47 [95% CI, 1.17-1.88] and 1.20 [95% CI, 1.03-1.39], respectively), while serotonin antagonist and reuptake inhibitors users had a survival advantage (hazard ratio 0.79 [95% CI, 0.69-0.91]) compared with nonusers. There were no differences in the risk of nonfatal major adverse cardiovascular events between all classes of hypnotics. Male patients and those aged 60 years or younger who were using benzodiazepines or Z-drugs experienced higher major adverse cardiovascular events than their counterparts. CONCLUSIONS In patients with newly diagnosed insomnia, treatment with hypnotics resulted in higher extended major adverse cardiovascular events but not nonfatal major adverse cardiovascular events with benzodiazepine and Z-drug users compared with nonusers. The use of serotonin antagonist and reuptake inhibitors agents had a protective effect against major adverse cardiovascular events warranting further investigation.
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Affiliation(s)
- Ali A El-Solh
- The Veterans Affairs Western New York Healthcare System, Western New York Respiratory Research Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Buffalo, NY, USA; Department of Medicine, Jacobs School of Medicine and Biomedical Sciences and School of Public Health and Health Professions, Buffalo, NY, USA; Department of Epidemiology and Environmental Health, Jacobs School of Medicine and Biomedical Sciences and School of Public Health and Health Professions, Buffalo, NY, USA.
| | - Yolanda Lawson
- The Veterans Affairs Western New York Healthcare System, Western New York Respiratory Research Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Buffalo, NY, USA.
| | - Gregory E Wilding
- Department of Biostatistics; Jacobs School of Medicine and Biomedical Sciences and School of Public Health and Health Professions, Buffalo, CY, USA.
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Chung J, Goodman M, Huang T, Wallace ML, Lutsey PL, Chen JT, Castro-Diehl C, Bertisch S, Redline S. Multi-dimensional sleep and mortality: The Multi-Ethnic Study of Atherosclerosis. Sleep 2023; 46:zsad048. [PMID: 37523657 PMCID: PMC10848217 DOI: 10.1093/sleep/zsad048] [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: 10/14/2022] [Revised: 01/30/2023] [Indexed: 08/02/2023] Open
Abstract
STUDY OBJECTIVES Multiple sleep characteristics are informative of health, sleep characteristics cluster, and sleep health can be described as a composite of positive sleep attributes. We assessed the association between a sleep score reflecting multiple sleep dimensions, and mortality. We tested the hypothesis that more favorable sleep (higher sleep scores) is associated with lower mortality. METHODS The Multi-Ethnic Study of Atherosclerosis (MESA) is a racially and ethnically-diverse multi-site, prospective cohort study of US adults. Sleep was measured using unattended polysomnography, 7-day wrist actigraphy, and validated questionnaires (2010-2013). 1726 participants were followed for a median of 6.9 years (Q1-Q3, 6.4-7.4 years) until death (171 deaths) or last contact. Survival models were used to estimate the association between the exposure of sleep scores and the outcome of all-cause mortality, adjusting for socio-demographics, lifestyle, and medical comorbidities; follow-up analyses examined associations between individual metrics and mortality. The exposure, a sleep score, was constructed by an empirically-based Principal Components Analysis on 13 sleep metrics, selected a priori. RESULTS After adjusting for multiple confounders, a 1 standard deviation (sd) higher sleep score was associated with 25% lower hazard of mortality (Hazard Ratio [HR]: 0.75; 95% Confidence interval: [0.65, 0.87]). The largest drivers of this association were: night-to-night sleep regularity, total sleep time, and the Apnea-Hypopnea Index. CONCLUSION More favorable sleep across multiple characteristics, operationalized by a sleep score, is associated with lower risk of death in a diverse US cohort of adults. Results suggest that interventions that address multiple dimensions may provide novel approaches for improving health.
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Affiliation(s)
- Joon Chung
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Matthew Goodman
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Tianyi Huang
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Pamela L Lutsey
- Division of Epidemiology and Community Health, School of Public Health, the University of Minnesota, Minneapolis, MN, USA
| | - Jarvis T Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Suzanne Bertisch
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Wan ZY, Xiao L, Wang GH. People with passive sleep delay have more severe depression and sleep problems than those with active sleep delays-a cross-sectional study after the COVID-19 pandemic. Heliyon 2022; 8:e11805. [PMID: 36506868 PMCID: PMC9721167 DOI: 10.1016/j.heliyon.2022.e11805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/31/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022] Open
Abstract
Objective This study was designed to investigate the effect of different types of sleep delay in depression and sleep characteristics after the pandemic. Meanwhile, risk factors for depression were also explored. Methods The survey was conducted in Wuhan from March 1 to May 30, 2021, and participants were recruited through a snowball process. A total of 1,583 people with sleep delays responded to the invitation, of which 1,296 were enrolled. Participants filled out a questionnaire including social demographics, sleep characteristics, Social Support Rating Scale (SSRS), Pittsburgh Sleep Quality Index (PSQI) and Patient Health Questionnaire-9 (PHQ-9). Results There were no significant differences in sex, social support and level of education between the two types of sleep delay (p = 0.961, p = 0.110, p = 0.090), but the average age of the passive sleep delay group was higher (p = 0.015). And most people with active sleep delay were caused by the use of electronic devices (73.6%), while most people with passive sleep delay were caused by work or study tasks (73.2%), with a significant difference between the two groups (p < 0.001). People who actively delayed sleep had more regular sleep (p < 0.001), better sleep quality and longer sleep duration (p < 0.001, p < 0.001). In addition, although they delayed sleep more frequently (p < 0.001), they had significantly lower depression degree than people who passively delayed sleep (p < 0.001). Conclusions Passive sleep delays, usually caused by work or study, has higher levels of depression and more adverse sleep behaviors than active sleep delay. The findings help further understand the effects of delayed sleep and provide insight for people with delayed sleep to evaluate their own condition. Future studies are required to standardize and accurately classify sleep delay and further explore it.
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Affiliation(s)
- Zhen-Yu Wan
- Department of Psychiatry, Renmin Hospital of Wuhan University, China,Institute of Neuropsychiatry, Renmin Hospital of Wuhan University, China
| | - Ling Xiao
- Department of Psychiatry, Renmin Hospital of Wuhan University, China,Institute of Neuropsychiatry, Renmin Hospital of Wuhan University, China
| | - Gao-Hua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, China,Institute of Neuropsychiatry, Renmin Hospital of Wuhan University, China,Corresponding author
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Sogawa R, Shimanoe C, Tanaka K, Hara M, Nishida Y, Furukawa T, Nagayoshi M, Hishida A, Kubo Y, Kato Y, Oze I, Ito H, Nakamura Y, Kusakabe M, Tanoue S, Koriyama C, Suzuki S, Otani T, Matsui D, Watanabe I, Kuriki K, Takashima N, Kadota A, Watanabe T, Arisawa K, Ikezaki H, Otonari J, Wakai K, Matsuo K. Sex- and age-specific all-cause mortality in insomnia with hypnotics: Findings from Japan multi-institutional Collaborative Cohort Study. Sleep Med 2022; 100:410-418. [PMID: 36240602 DOI: 10.1016/j.sleep.2022.09.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/07/2022] [Accepted: 09/21/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Findings on the increased mortality risk in individuals with insomnia are inconsistent across studies. Rather than improving insomnia by sleep control, hypnotic use may be one factor in the increased risk of death; however, the effects of hypnotics on mortality remains unclear. This study aimed to examine the association between all-cause mortality and hypnotic use in a large sample, while adjusting for the effects of comorbidities. METHODS Overall, 92,527 individuals aged 35-69 years were followed up for mortality in the Japan Multi-Institutional Collaborative Cohort Study. Regular use of hypnotics was assessed using a self-administered questionnaire. Since cancer history carries a substantial risk of death and is associated with the treatment of insomnia with hypnotics, participants with a cancer history were excluded. The hazard ratio (HR) and 95% confidence interval (CI) for all-cause mortality related to hypnotic use were estimated using a Cox proportional hazard model with adjustments for covariates including sleeping hours and comorbidities (body mass index, ischemic heart disease, stroke, and diabetes). RESULTS During the follow-up (mean, 8.4 ± 2.5 years), 1,492 mortalities were recorded, and the prevalence of taking hypnotics was 4.2%. Hypnotic use was associated with significantly greater risk of all-cause mortality, even after adjustment for the covariates (HR, 1.32; 95% CI, 1.07-1.63). The association between hypnotic use and all-cause mortality was robust in males (HR, 1.51; 95% CI, 1.15-1.96), and participants aged <60 years (HR, 1.75; 95% CI, 1.21-2.54). CONCLUSIONS Our study revealed sex-age specific associations between hypnotic use and all-cause mortality.
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Affiliation(s)
- Rintaro Sogawa
- Department of Pharmacy, Saga University Hospital, Saga, Japan
| | - Chisato Shimanoe
- Department of Pharmacy, Saga University Hospital, Saga, Japan; Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan.
| | - Keitaro Tanaka
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Megumi Hara
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Yuichiro Nishida
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Takuma Furukawa
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan; Clinical Research Center, Saga University Hospital, Saga, Japan
| | - Mako Nagayoshi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Asahi Hishida
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoko Kubo
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasufumi Kato
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Hidemi Ito
- Division of Cancer Information and Control, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Yohko Nakamura
- Cancer Prevention Center, Chiba Cancer Center Research Institute, Chiba, Japan
| | - Miho Kusakabe
- Cancer Prevention Center, Chiba Cancer Center Research Institute, Chiba, Japan
| | - Shiroh Tanoue
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Chihaya Koriyama
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takahiro Otani
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Daisuke Matsui
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Isao Watanabe
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kiyonori Kuriki
- Laboratory of Public Health, Division of Nutritional Sciences, School of Food and Nutritional Sciences, University of Shizuoka, Shizuoka, Japan
| | - Naoyuki Takashima
- Department of Public Health, Faculty of Medicine, Kindai University, Osaka, Japan; NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
| | - Aya Kadota
- NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
| | - Takeshi Watanabe
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Kokichi Arisawa
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Hiroaki Ikezaki
- Department of Comprehensive General Internal Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Jun Otonari
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan; Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Yang Y, Wang G, Zhang S, Wang H, Zhou W, Ren F, Liang H, Wu D, Ji X, Hashimoto M, Wei J. Efficacy and evaluation of therapeutic exercises on adults with Parkinson's disease: a systematic review and network meta-analysis. BMC Geriatr 2022; 22:813. [PMID: 36271367 PMCID: PMC9587576 DOI: 10.1186/s12877-022-03510-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 10/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Exercises are an effective treatment in Parkinson’s disease (PD), but there is still controversy over which types should be used. We aimed to compare and rank the types of exercise that improve PD symptoms by quantifying information from randomised controlled trials. Methods We performed a systematic review and network meta-analysis and searched PubMed, MEDLINE, Embase, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and China National Knowledge Infrastructure (CNKI) from their inception date to June 30, 2022. We included randomized controlled trials of 24 types of exercise for the interventional treatment of adults (≥ 50 years old) with PD. Effect size measures were standardized mean differences (SMDs) with 95% credible intervals (CrIs). The confidence of evidence was examined using Confidence in Network Meta-Analysis (CINeMA). Results We identified 10 474 citations and included 250 studies involving 13 011 participants. Results of NMA showed that power training (PT) had the best benefits for motor symptoms compared with the control group (CON), with SMDs (95% CrI) (-1.46, [-2.18 to -0.74]). Body weight support treadmill training (BWS_TT) showed the best improvement in balance (1.55, [0.72 to 2.37]), gait velocity (1.15 [0.57 to 1.31]) and walking distance (1.96, [1.18 to 2.73]), and robotic assisted gait training (RA_GT) had the most benefits for freezing of gait (-1.09, [-1.80 to -0.38]). For non-motor symptoms, Dance showed the best benefits for depression (-1.71, [-2.79 to -0.73]). Only Yoga significantly reduced anxiety symptom compared with CON (-0.53, [0.96 to -0.11]). Only resistance training (RT) significantly enhanced sleep quality and cognition (-1.42, [-2.60 to -0.23]; 0.51, [0.09 to 0.94]). For muscle strength, PT showed the best advance (1.04, [0.64 to 1.44]). For concern of falling, five types of exercise were more effective than CON. Conclusions There is low quality evidence that PT, Yoga, BWS_TT, Dance, and RT are the most effective treatments, pending outcome of interest, for adults with PD. Trial registration PROSPERO (CRD42021220052). Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03510-9.
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Affiliation(s)
- Yong Yang
- Institute for Brain Sciences Research, School of Life Sciences, Shunhe District, Henan University, 85 Minglun Rd, Kaifeng City, 475001, China.,Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Henan University, Kaifeng, 475001, China
| | - Guotuan Wang
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Henan University, Kaifeng, 475001, China
| | - Shikun Zhang
- Department of Police Physical Education, Jiangsu Police Institute, Nanjing, China
| | - Huan Wang
- Department of Orthopedics, the Second Affiliated Hospital of Air Force Medical University, Xi 'an, China
| | - Wensheng Zhou
- College of Physical Education, Nanjing Xiao-Zhuang University, Nanjing, China
| | - Feifei Ren
- Department of Physical Education, Beijing Language and Culture University, Beijing, China
| | - Huimin Liang
- Institute for Brain Sciences Research, School of Life Sciences, Shunhe District, Henan University, 85 Minglun Rd, Kaifeng City, 475001, China.,Henan Medical School, Parkinson's Disease Research Center, Henan University, Kaifeng, China
| | - Dongdong Wu
- Institute for Brain Sciences Research, School of Life Sciences, Shunhe District, Henan University, 85 Minglun Rd, Kaifeng City, 475001, China.,Henan International Joint Laboratory for Nuclear Protein Regulation, Henan Medical School, Henan University, Kaifeng, China
| | - Xinying Ji
- Institute for Brain Sciences Research, School of Life Sciences, Shunhe District, Henan University, 85 Minglun Rd, Kaifeng City, 475001, China.,Henan International Joint Laboratory for Nuclear Protein Regulation, Henan Medical School, Henan University, Kaifeng, China
| | - Makoto Hashimoto
- Tokyo Metropolitan Institute of Medical Science, Setagaya Ku, 2-1-6 Kamikitazawa, Tokyo, 1560057, Japan
| | - Jianshe Wei
- Institute for Brain Sciences Research, School of Life Sciences, Shunhe District, Henan University, 85 Minglun Rd, Kaifeng City, 475001, China. .,Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Henan University, Kaifeng, 475001, China. .,Henan Medical School, Parkinson's Disease Research Center, Henan University, Kaifeng, China. .,Henan International Joint Laboratory for Nuclear Protein Regulation, Henan Medical School, Henan University, Kaifeng, China.
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Chen LJ, Hamer M, Lai YJ, Huang BH, Ku PW, Stamatakis E. Can physical activity eliminate the mortality risk associated with poor sleep? A 15-year follow-up of 341,248 MJ Cohort participants. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:596-604. [PMID: 33713846 PMCID: PMC9532590 DOI: 10.1016/j.jshs.2021.03.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/27/2020] [Accepted: 11/16/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND This study examined the joint associations of sleep patterns and physical activity (PA) with all-cause, cardiovascular disease (CVD), and cancer mortality. METHODS A total of 341,248 adults (mean age = 39.7 years; men: 48.3%) were included in the study, with a 15-year follow-up. Participants reported sleep duration and disturbances (difficulty falling asleep, easily awakened, or use of sleeping medication). PA was classified into 4 levels: <7.5, 7.5-14.9, 15.0-29.9, and ≥30.0 metabolic equivalent hours per week (MET-h/week). To understand the joint associations of sleep patterns and PA with mortality, Cox proportional hazard models were conducted, with exposure variables combining sleep duration/disturbances and PA. RESULTS Compared with the reference group (sleeping 6-8 h/day), individuals who slept >8 h/day had higher risk for all-cause mortality (hazard ratio (HR) = 1.307, 95% confidence interval (95%CI): 1.248-1.369), CVD mortality (HR = 1.298, 95%CI: 1.165-1.445), and cancer mortality (HR = 1.128, 95%CI: 1.042-1.220). Short sleep duration was not associated with mortality risk. Increased risk of all-cause and CVD mortality was found in participants who had difficulty falling asleep (HR = 1.120, 95%CI: 1.068-1.175; HR = 1.163, 95%CI: 1.038-1.304, respectively), and used sleeping medication (HR = 1.261, 95%CI: 1.159-1.372; HR = 1.335, 95%CI: 1.102-1.618, respectively) compared with those who slept well. Long sleep duration and sleep disturbances were not associated with risk of all-cause and CVD mortality among individuals achieving a PA level of ≥15 MET-h/week, and in particular among those achieving ≥30 MET-h/week. CONCLUSION Long sleep duration, difficulty falling asleep, and use of sleeping medication were related to a higher risk of death. Being physically active at a moderate intensity for 25-65 min/day eliminated these detrimental associations.
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Affiliation(s)
- Li-Jung Chen
- Department of Exercise Health Science, (National) Taiwan University of Sport, Taichung 40404, China
| | - Mark Hamer
- Institute of Sport Exercise and Health, Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, WC1E 6BT, UK
| | - Yun-Ju Lai
- Department of Exercise Health Science, (National) Taiwan University of Sport, Taichung 40404, China; Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou 54552, China; School of Medicine, (National) Yang-Ming University, Taipei 11221, China
| | - Bo-Huei Huang
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Po-Wen Ku
- Graduate Institute of Sports and Health, (National) Changhua University of Education, Changhua 50007, China; Department of Kinesiology, (National) Tsing Hua University, Hsinchu 30013, China.
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
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Howard S. OLD IDEAS, NEW DIRECTIONS: RE-EXAMINING THE PREDICTIVE UTILITY OF THE HEMODYNAMIC PROFILE OF THE STRESS RESPONSE IN HEALTHY POPULATIONS. Health Psychol Rev 2022; 17:104-120. [PMID: 35452356 DOI: 10.1080/17437199.2022.2067210] [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: 11/04/2022]
Abstract
The 'reactivity hypothesis' has a long and fruitful history in health psychology and behavioural medicine, with elements of its thesis taken as core and others lost in the plethora of research on its utility as a theory of psychosomatic disease. One such thesis is that the underlying hemodynamic profile of the stress response may be particularly revealing when detailing the impact of psychological stress on the development of cardiovascular disease. This paper re-examines old ideas surrounding the hemodynamic profile of the stress response, asking why its health-predictive properties were never fully explored. Further, this paper reviews the evidence that a vascular profile of stress responding may be especially predictive of disease development, particularly in the case of hypertension. In addition, measurement of hemodynamic profile as well as its known psychosocial moderators are reviewed including how examination of patterns of cardiovascular-stress response adaptation may extend the field. This paper highlights that the extension of the reactivity hypothesis to include both hemodynamic profile and patterns of cardiovascular stress-response adaptation may hold much explanatory power in detailing the impact of how stress responding and stress tolerance promotes disease development.
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Affiliation(s)
- Siobhán Howard
- SASHLab, Centre for Social Issues Research, Department of Psychology, University of Limerick, Ireland.,Health Research Institute, University of Limerick, Ireland
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9
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Hoertel N, Sánchez-Rico M, Gulbins E, Kornhuber J, Vernet R, Beeker N, Neuraz A, Blanco C, Olfson M, Airagnes G, Lemogne C, Alvarado JM, Arnaout M, Cougoule C, Meneton P, Limosin F. Association between benzodiazepine receptor agonist use and mortality in patients hospitalised for COVID-19: a multicentre observational study. Epidemiol Psychiatr Sci 2022; 31:e18. [PMID: 35352674 PMCID: PMC8967698 DOI: 10.1017/s2045796021000743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 11/24/2021] [Accepted: 12/04/2021] [Indexed: 11/18/2022] Open
Abstract
AIMS To examine the association between benzodiazepine receptor agonist (BZRA) use and mortality in patients hospitalised for coronavirus disease 2019 (COVID-19). METHODS A multicentre observational study was performed at Greater Paris University hospitals. The sample involved 14 381 patients hospitalised for COVID-19. A total of 686 (4.8%) inpatients received a BZRA at hospital admission at a mean daily diazepam-equivalent dose of 19.7 mg (standard deviation (s.d.) = 25.4). The study baseline was the date of admission, and the primary endpoint was death. We compared this endpoint between patients who received BZRAs and those who did not in time-to-event analyses adjusted for sociodemographic characteristics, medical comorbidities and other medications. The primary analysis was a Cox regression model with inverse probability weighting (IPW). RESULTS Over a mean follow-up of 14.5 days (s.d. = 18.1), the primary endpoint occurred in 186 patients (27.1%) who received BZRAs and in 1134 patients (8.3%) who did not. There was a significant association between BZRA use and increased mortality both in the crude analysis (hazard ratio (HR) = 3.20; 95% confidence interval (CI) = 2.74-3.74; p < 0.01) and in the IPW analysis (HR = 1.61; 95% CI = 1.31-1.98, p < 0.01), with a significant dose-dependent relationship (HR = 1.55; 95% CI = 1.08-2.22; p = 0.02). This association remained significant in sensitivity analyses. Exploratory analyses indicate that most BZRAs may be associated with an increased mortality among patients hospitalised for COVID-19, except for diazepam, which may be associated with a reduced mortality compared with any other BZRA treatment. CONCLUSIONS BZRA use may be associated with an increased mortality among patients hospitalised for COVID-19, suggesting the potential benefit of decreasing dose or tapering off gradually these medications when possible.
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Affiliation(s)
- N. Hoertel
- Département de Psychiatrie, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Issy-les-Moulineaux, France
- Université de Paris, Paris, France
- INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| | - M. Sánchez-Rico
- Département de Psychiatrie, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Issy-les-Moulineaux, France
- Department of Psychobiology & Behavioural Sciences Methods, Faculty of Psychology, Universidad Complutense de Madrid, Campus de Somosaguas, Pozuelo de Alarcon, Spain
| | - E. Gulbins
- Institute for Molecular Biology, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - J. Kornhuber
- Department of Psychiatry and Psychotherapy, University Hospital Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany
| | - R. Vernet
- Medical Informatics, Biostatistics and Public Health Department, AP-HP, Centre-Université de Paris, Hôpital Européen Georges Pompidou, F-75015Paris, France
| | - N. Beeker
- Assistance Publique-Hôpitaux de Paris (AP-HP), Unité de Recherche Clinique, Hôpital Cochin, Paris, France
| | - A. Neuraz
- INSERM, UMR_S 1138, Cordeliers Research Center, Université de Paris, Paris, France
- Department of Medical Informatics, AP-HP, Centre-Université de Paris, Necker-Enfants Malades Hospital, Paris, France
| | - C. Blanco
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, 6001 Executive Boulevard, Bethesda, MD20852, USA
| | - M. Olfson
- Department of Psychiatry, Columbia University/New York State Psychiatric Institute, 1051 Riverside Drive, Unit 69, New York, NY10032, USA
| | - G. Airagnes
- Département de Psychiatrie, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Issy-les-Moulineaux, France
- Université de Paris, Paris, France
- INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
- INSERM, UMS 011, Population-based Epidemiologic Cohorts, Villejuif, France
| | - C. Lemogne
- Université de Paris, Paris, France
- INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
- AP-HP, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'adulte, Paris, France
| | - J. M. Alvarado
- Department of Psychobiology & Behavioural Sciences Methods, Faculty of Psychology, Universidad Complutense de Madrid, Campus de Somosaguas, Pozuelo de Alarcon, Spain
| | - M. Arnaout
- Anesthesia and Intensive Care Department, Hôpitaux Universitaires Paris Île-de-France Ouest, Boulogne-Billancourt, France
| | - C. Cougoule
- Institut de Pharmacologie et de Biologie Structurale, IPBS, Université de Toulouse, Toulouse, France
| | - P. Meneton
- INSERM U1142 LIMICS, UMRS 1142, Sorbonne Universities, UPMC University of Paris 06, University of Paris 13, Paris, France
| | - F. Limosin
- Département de Psychiatrie, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Issy-les-Moulineaux, France
- Université de Paris, Paris, France
- INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
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10
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Ding L, Zhang L, Cui Y, Gong Q, Ma J, Wang Y, Sang H. The association of sleep duration and quality with depressive symptoms in older Chinese women. PLoS One 2022; 17:e0262331. [PMID: 35290372 PMCID: PMC8923433 DOI: 10.1371/journal.pone.0262331] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 12/22/2021] [Indexed: 11/22/2022] Open
Abstract
Poor sleep quality or short and long sleep duration are associated with many negative health outcomes, such as diabetes, hypertension, and fatigue, which may directly or indirectly correlate with poor mental health. Although, the association between sleep duration and quality, and depressive symptoms has been examined, the results of these studies were inconsistent and evidence specifically on older women is lacking. Therefore, we designed a cross-sectional study to evaluate the association between sleep duration and quality, and depressive symptoms in a relatively large sample of older Chinese women. The data were collected from 1,429 older women aged ≥60 years during bone-health examinations in Shanghai. Information on sleep duration and quality were assessed using a self-reported questionnaire. Depressive symptoms were assessed using the Zung self-rating depression scale (SDS), and depressive symptoms were considered present for SDS scores ≥ 45. Logistic regression models were used to analyze the association between sleep and depressive symptoms. After adjusting for all potential confounding factors, a J-shaped association was found between sleep duration and depressive symptoms. When a sleep duration of 6–8 hours was set as a reference, the odds ratios and 95% confidential intervals of short and long sleep duration were 1.31 (0.99, 1.73) and 2.10 (1.40, 3.16), respectively. Moreover, sleep quality was inversely associated with the prevalence of depressive symptoms (p for trend = 0.040). When the SDS cut-off score defining depressive symptoms was changed to 40 and 50, these associations were somewhat weakened, but the trend did not change. This study replicated and extended prior research findings that sleep duration and quality may influence mental health in older women.
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Affiliation(s)
- Liang Ding
- Department of Physical Education, Southeast University, Nanjing, Jiangsu Province, People’s Republic of China
- Institute of Exercise Epidemiology and Department of Physical Education, Huaiyin Institute of Technology, Huaian, Jiangsu Province, People’s Republic of China
- * E-mail: (LD); (LZ)
| | - Luyao Zhang
- Institute of Exercise Epidemiology and Department of Physical Education, Huaiyin Institute of Technology, Huaian, Jiangsu Province, People’s Republic of China
- * E-mail: (LD); (LZ)
| | - Yufei Cui
- Institute of Exercise Epidemiology and Department of Physical Education, Huaiyin Institute of Technology, Huaian, Jiangsu Province, People’s Republic of China
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Qiang Gong
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jiameng Ma
- Faculty of Physical Education, Sendai University, Miyagi, Japan
| | - Yongxiang Wang
- Institute of Exercise Epidemiology and Department of Physical Education, Huaiyin Institute of Technology, Huaian, Jiangsu Province, People’s Republic of China
| | - Haiyun Sang
- Institute of Exercise Epidemiology and Department of Physical Education, Huaiyin Institute of Technology, Huaian, Jiangsu Province, People’s Republic of China
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11
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Murphy RA, Tintle N, Harris WS, Darvishian M, Marklund M, Virtanen JK, Hantunen S, de Mello VD, Tuomilehto J, Lindström J, Bolt MA, Brouwer IA, Wood AC, Senn M, Redline S, Tsai MY, Gudnason V, Eiriksdottir G, Lindberg E, Shadyab AH, Liu B, Carnethon M, Uusitupa M, Djousse L, Risérus U, Lind L, van Dam RM, Koh WP, Shi P, Siscovick D, Lemaitre RN, Mozaffarian D. PUFA ω-3 and ω-6 biomarkers and sleep: a pooled analysis of cohort studies on behalf of the Fatty Acids and Outcomes Research Consortium (FORCE). Am J Clin Nutr 2021; 115:864-876. [PMID: 34918026 PMCID: PMC8895226 DOI: 10.1093/ajcn/nqab408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/07/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND n-3 and n-6 PUFAs have physiologic roles in sleep processes, but little is known regarding circulating n-3 and n-6 PUFA and sleep parameters. OBJECTIVES We sought to assess associations between biomarkers of n-3 and n-6 PUFA intake with self-reported sleep duration and difficulty falling sleeping in the Fatty Acids and Outcome Research Consortium. METHODS Harmonized, de novo, individual-level analyses were performed and pooled across 12 cohorts. Participants were 35-96 y old and from 5 nations. Circulating measures included α-linolenic acid (ALA), EPA, docosapentaenoic acid (DPA), DHA, EPA + DPA + DHA, linoleic acid, and arachidonic acid. Sleep duration (10 cohorts, n = 18,791) was categorized as short (≤6 h), 7-8 h (reference), or long (≥9 h). Difficulty falling asleep (8 cohorts, n = 12,500) was categorized as yes or no. Associations between PUFAs, sleep duration, and difficulty falling sleeping were assessed by cross-sectional multinomial logistic regression using standardized protocols and covariates. Cohort-specific multivariable-adjusted ORs per quintile of PUFAs were pooled with inverse-variance weighted meta-analysis. RESULTS In pooled analysis adjusted for sociodemographic characteristics and health status, participants with higher very long-chain n-3 PUFAs were less likely to have long sleep duration. In the top compared with the bottom quintiles, the multivariable-adjusted ORs (95% CIs) for long sleep were 0.78 (95% CI: 0.65, 0.95) for DHA and 0.76 (95% CI: 0.63, 0.93) for EPA + DPA + DHA. Significant associations for ALA and n-6 PUFA with short sleep duration or difficulty falling sleeping were not identified. CONCLUSIONS Participants with higher concentrations of very long-chain n-3 PUFAs were less likely to have long sleep duration. While objective biomarkers reduce recall bias and misclassification, the cross-sectional design limits assessment of the temporal nature of this relation. These novel findings across 12 cohorts highlight the need for experimental and biological assessments of very long-chain n-3 PUFAs and sleep duration.
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Affiliation(s)
| | - Nathan Tintle
- Department of Mathematics and Statistics, Dordt College, Sioux Center, IA, USA,Fatty Acid Research Institute, Sioux Falls, SD, USA
| | - William S Harris
- Fatty Acid Research Institute, Sioux Falls, SD, USA,Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, USA
| | | | - Matti Marklund
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala, Sweden,Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jyrki K Virtanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Sari Hantunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Vanessa D de Mello
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jaakko Tuomilehto
- Public Health, University of Helsinki, Helsinki, Finland,National Institute for Health and Welfare, Helsinki, Finland,National School of Public Health, Madrid, Spain
| | | | - Matthew A Bolt
- Department of Mathematics and Statistics, Dordt College, Sioux Center, IA, USA
| | - Ingeborg A Brouwer
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, Netherlands,Amersterdam Public Health Research Institute, De Boelelaan, Amsterdam, Netherlands
| | - Alexis C Wood
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
| | - Mackenzie Senn
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
| | - Susan Redline
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA,Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Michael Y Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | | | | | - Eva Lindberg
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Sweden
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Buyun Liu
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Mercedes Carnethon
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Matti Uusitupa
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Luc Djousse
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Ulf Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala, Sweden
| | - Lars Lind
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala, Sweden
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A *STAR), Singapore
| | - Peilin Shi
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | | | - Rozenn N Lemaitre
- Department of Medicine, Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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12
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Svensson T, Saito E, Svensson AK, Melander O, Orho-Melander M, Mimura M, Rahman S, Sawada N, Koh WP, Shu XO, Tsuji I, Kanemura S, Park SK, Nagata C, Tsugane S, Cai H, Yuan JM, Matsuyama S, Sugawara Y, Wada K, Yoo KY, Chia KS, Boffetta P, Ahsan H, Zheng W, Kang D, Potter JD, Inoue M. Association of Sleep Duration With All- and Major-Cause Mortality Among Adults in Japan, China, Singapore, and Korea. JAMA Netw Open 2021; 4:e2122837. [PMID: 34477853 PMCID: PMC8417759 DOI: 10.1001/jamanetworkopen.2021.22837] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
IMPORTANCE The association between long sleep duration and mortality appears stronger in East Asian populations than in North American or European populations. OBJECTIVES To assess the sex-specific association between sleep duration and all-cause and major-cause mortality in a pooled longitudinal cohort and to stratify the association by age and body mass index. DESIGN, SETTING, AND PARTICIPANTS This cohort study of individual-level data from 9 cohorts in the Asia Cohort Consortium was performed from January 1, 1984, to December 31, 2002. The final population included participants from Japan, China, Singapore, and Korea. Mean (SD) follow-up time was 14.0 (5.0) years for men and 13.4 (5.3) years for women. Data analysis was performed from August 1, 2018, to May 31, 2021. EXPOSURES Self-reported sleep duration, with 7 hours as the reference category. MAIN OUTCOMES AND MEASURES Mortality, including deaths from all causes, cardiovascular disease, cancer, and other causes. Sex-specific hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards regression with shared frailty models adjusted for age and the key self-reported covariates of marital status, body mass index, smoking status, alcohol consumption, physical activity, history of diabetes and hypertension, and menopausal status (for women). RESULTS For 322 721 participants (mean [SD] age, 54.5 [9.2] years; 178 542 [55.3%] female), 19 419 deaths occurred among men (mean [SD] age of men, 53.6 [9.0] years) and 13 768 deaths among women (mean [SD] age of women, 55.3 [9.2] years). A sleep duration of 7 hours was the nadir for associations with all-cause, cardiovascular disease, and other-cause mortality in both men and women, whereas 8 hours was the mode sleep duration among men and the second most common sleep duration among women. The association between sleep duration and all-cause mortality was J-shaped for both men and women. The greatest association for all-cause mortality was with sleep durations of 10 hours or longer for both men (hazard ratio [HR], 1.34; 95% CI, 1.26-1.44) and women (HR, 1.48; 95% CI, 1.36-1.61). Sex was a significant modifier of the association between sleep duration and mortality from cardiovascular disease (χ25 = 13.47, P = .02), cancer (χ25 = 16.04, P = .007), and other causes (χ25 = 12.79, P = .03). Age was a significant modifier of the associations among men only (all-cause mortality: χ25 = 41.49, P < .001; cancer: χ25 = 27.94, P < .001; other-cause mortality: χ25 = 24.51, P < .001). CONCLUSIONS AND RELEVANCE The findings of this cohort study suggest that sleep duration is a behavioral risk factor for mortality in both men and women. Age was a modifier of the association between sleep duration in men but not in women. Sleep duration recommendations in these populations may need to be considered in the context of sex and age.
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Affiliation(s)
- Thomas Svensson
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tsukiji, Chuo-ku, Tokyo, Japan
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
- Kanagawa University of Human Services School of Health Innovation, Kawasaki-ku, Kawasaki-shi, Kanagawa, Japan
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Eiko Saito
- Center for Cancer Control and Information Services, Division of Cancer Statistics Integration, National Cancer Center, Tokyo, Japan
| | - Akiko Kishi Svensson
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
- Department of Diabetes and Metabolic Diseases, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Olle Melander
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Marju Orho-Melander
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Shafiur Rahman
- Center for Public Health Sciences, Division of Prevention, National Cancer Center, Tokyo, Japan
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tsukiji, Chuo-ku, Tokyo, Japan
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Xiao-Ou Shu
- Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Division of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ichiro Tsuji
- Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Seiki Kanemura
- Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Sue K. Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chisato Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tsukiji, Chuo-ku, Tokyo, Japan
| | - Hui Cai
- Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Division of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jian-Min Yuan
- UPMC Hillman Cancer Center, Division of Cancer Control and Population Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sanae Matsuyama
- Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Yumi Sugawara
- Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Keiko Wada
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Keun-Young Yoo
- Seoul National University College of Medicine, Seoul, South Korea
| | | | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Habibul Ahsan
- Department of Public Health Sciences, The University of Chicago, Chicago, Illinois
| | - Wei Zheng
- Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Division of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Daehee Kang
- Seoul National University College of Medicine, Seoul, South Korea
| | - John D. Potter
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand
| | - Manami Inoue
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tsukiji, Chuo-ku, Tokyo, Japan
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13
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Vargas-Garrido H, Moyano-Díaz E, Andrades K. Sleep problems are related to commuting accidents rather than to workplace accidents. BMC Public Health 2021; 21:652. [PMID: 33823824 PMCID: PMC8022368 DOI: 10.1186/s12889-021-10737-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 03/25/2021] [Indexed: 11/17/2022] Open
Abstract
Background This study aimed to verify the relationships between sleep problems and both commuting and workplace accidents in workers of both sexes. Methods The study was carried out with a sample of workers (n = 2993; 50.2% female) from the Chilean Quality of Life Survey (ENCAVI) 2015–2016, while the rates of both workplace and commuting accidents were extracted from the statistics of the Superintendence of Social Security (SUSESO 2015; 180,036 and 52,629 lost-time accidents, respectively). Results Chilean workers sleep less than the rest of the people in the country (MW = 7.14 vs. MO = 7.33; t (6789) = − 5.19; p < .001), while the Chilean people as a whole sleep less compared to those of other countries (7.24 h per day). Likewise, it was found that sleep problems are more strongly related to commuting than to workplace accidents. In this vein, sleep quantity can explain 24% of the variance in commuting accidents’ rates (Stepwise Method; R2 = .30, F (1.14) = 5.49, p < .05; β = −.55, p < .05), by using aggregated data with all types of commuting roles (driver of a vehicle, a passenger of public or private transport, or as a pedestrian). Conclusions Our findings show that sleep quantity has a more robust relationship with commuting than workplace accidents, a neglected issue so far. Future prevention programs should emphasize sleep hygiene and focus on commuting to and from work. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10737-5.
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Affiliation(s)
| | - Emilio Moyano-Díaz
- Faculty of Psychology, Psychology Department, University of Talca, Talca, Chile.
| | - Katherinne Andrades
- Faculty of Psychology, Psychology Department, University of Talca, Talca, Chile
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14
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Cohen AA, Legault V, Fülöp T. What if there’s no such thing as “aging”? Mech Ageing Dev 2020; 192:111344. [DOI: 10.1016/j.mad.2020.111344] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/17/2020] [Accepted: 08/26/2020] [Indexed: 12/14/2022]
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15
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Kaneko H, Itoh H, Kiriyama H, Kamon T, Fujiu K, Morita K, Michihata N, Jo T, Takeda N, Morita H, Yasunaga H, Komuro I. Restfulness from sleep and subsequent cardiovascular disease in the general population. Sci Rep 2020; 10:19674. [PMID: 33184438 PMCID: PMC7665021 DOI: 10.1038/s41598-020-76669-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/02/2020] [Indexed: 01/25/2023] Open
Abstract
We aimed to clarify the association between restfulness from sleep and subsequent risk of cardiovascular disease (CVD). Medical records of 1,980,476 individuals with neither prior history of CVD nor sleep disorders were extracted from the Japan Medical Data Center. Restfulness from sleep was subjectively assessed using information from the questionnaires at initial health check-ups. The mean age was 45 ± 11 years and 1,184,937 individuals were men. Overall, 1,197,720 individuals (60.5%) reported having good restfulness from sleep. The mean follow-up period was 1122 ± 827 days. Myocardial infarction, angina pectoris, stroke, heart failure, and atrial fibrillation occurred in 3673 (0.2%), 30,241 (1.5%), 13,546 (0.7%), 28,296 (1.4%), and 8116 (0.4%) individuals, respectively. Multivariable Cox regression analyses including age, sex, and other CVD risk factors after multiple imputation for missing values showed that good restfulness from sleep was associated with lower incidence of myocardial infarction (hazard ratio [HR] 0.89, 95% confidence interval [CI] 0.83-0.95), angina pectoris (HR 0.85, 95% CI 0.83-0.87), stroke (HR 0.85, 95% CI 0.82-0.88), heart failure (HR 0.86, 95% CI 0.84-0.88), and atrial fibrillation (HR 0.93, 95% CI 0.89-0.97). The association of restfulness from sleep with CVD events was pronounced in subjects with younger age and female sex. In conclusion, good restfulness from sleep may be associated with the lower risk of myocardial infarction, angina pectoris, stroke, heart failure, and atrial fibrillation. Further studies are required to clarify the underlying mechanism and to develop a novel preventive approach for CVD from the perspective of sleep.
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Affiliation(s)
- Hidehiro Kaneko
- The Department of Cardiovascular Medicine, The University of Tokyo Hospital, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
- The Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan.
| | - Hidetaka Itoh
- The Department of Cardiovascular Medicine, The University of Tokyo Hospital, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroyuki Kiriyama
- The Department of Cardiovascular Medicine, The University of Tokyo Hospital, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tatsuya Kamon
- The Department of Cardiovascular Medicine, The University of Tokyo Hospital, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Katsuhito Fujiu
- The Department of Cardiovascular Medicine, The University of Tokyo Hospital, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
- The Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan
| | - Kojiro Morita
- The Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
- The Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Nobuaki Michihata
- The Department of Health Services Research, The University of Tokyo, Tokyo, Japan
| | - Taisuke Jo
- The Department of Health Services Research, The University of Tokyo, Tokyo, Japan
| | - Norifumi Takeda
- The Department of Cardiovascular Medicine, The University of Tokyo Hospital, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroyuki Morita
- The Department of Cardiovascular Medicine, The University of Tokyo Hospital, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hideo Yasunaga
- The Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Issei Komuro
- The Department of Cardiovascular Medicine, The University of Tokyo Hospital, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Kwon S, Lee H, Lee JT, Shin MJ, Choi S, Oh H. Sleep duration and mortality in Korean adults: a population-based prospective cohort study. BMC Public Health 2020; 20:1623. [PMID: 33115463 PMCID: PMC7594310 DOI: 10.1186/s12889-020-09720-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 10/16/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Increasing evidence suggests that sleep duration is associated with risks of various diseases including type 2 diabetes, cardiovascular disease (CVD), and certain types of cancer. However, the relationship with mortality is not clear, particularly in non-European populations. In this study, we investigated the association between sleep duration and mortality in a population-based prospective cohort of Korean adults. METHODS This analysis included 34,264 participants (14,704 men and 19,560 women) of the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2013 who agreed to mortality follow-up through December 31, 2016. Sleep duration was self-reported at baseline and was categorized into four groups: ≤4, 5-6, 7-8, and ≥ 9 h/day. Cox proportional hazards models were performed to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the associations with mortality (all-cause as well as CVD- and cancer-specific), adjusting for potential confounders. RESULTS During up to 9.5 years of follow-up, we identified a total of 1028 deaths. We observed the lowest mortality at 5-6 h/day sleep. Compared with 7-8 h/day of sleep, short (≤4 h/day) and long (≥9 h/day) sleep were associated with a 1.05-fold (95% CI = 0.79-1.39) and 1.47-fold (95% CI = 1.15-1.87) higher all-cause mortality, respectively. After additional adjustment for self-rated health, the positive association with short sleep disappeared (HR = 0.99, 95% CI = 0.75-1.32) and the association with long sleep was slightly attenuated (HR = 1.38, 95% CI = 1.08-1.76). Long sleep was also nonsignificantly positively associated with both cancer-mortality (HR = 1.30, 95% CI = 0.86-1.98) and CVD-mortality (HR = 1.27, 95% CI = 0.73-2.21). There was no statistically significant evidence for nonlinearity in the relationships between sleep duration and mortality (all-cause as well as CVD- and cancer-specific). Effect modification by age, sex, education, and occupation were not statistically significant. CONCLUSIONS Our findings suggest that long sleep duration is associated with an increased all-cause mortality in Korean adults.
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Affiliation(s)
- Sohyeon Kwon
- Interdisciplinary Program in Precision Public Health, Department of Public Health Science, Graduate School of Korea University, 145 Anam-ro, Hana Science Building B, Seongbuk-gu, Seoul, Republic of Korea
| | - Hyeyoung Lee
- Department of Statistics, Graduate School of Korea University, 145 Anam-ro, Woodang Hall, Seongbuk-gu, Seoul, Republic of Korea
| | - Jong-Tae Lee
- Interdisciplinary Program in Precision Public Health, Department of Public Health Science, Graduate School of Korea University, 145 Anam-ro, Hana Science Building B, Seongbuk-gu, Seoul, Republic of Korea
- Department of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Min-Jeong Shin
- Interdisciplinary Program in Precision Public Health, Department of Public Health Science, Graduate School of Korea University, 145 Anam-ro, Hana Science Building B, Seongbuk-gu, Seoul, Republic of Korea
- Department of Biosystems and Biomedical Sciences, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Sangbum Choi
- Department of Statistics, Graduate School of Korea University, 145 Anam-ro, Woodang Hall, Seongbuk-gu, Seoul, Republic of Korea.
| | - Hannah Oh
- Interdisciplinary Program in Precision Public Health, Department of Public Health Science, Graduate School of Korea University, 145 Anam-ro, Hana Science Building B, Seongbuk-gu, Seoul, Republic of Korea.
- Department of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea.
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17
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Labrosciano C, Tavella R, Reynolds A, Air T, Beltrame JF, Ranasinghe I, Adams RJT. The Association between Sleep Duration and Quality with Readmissions: An Exploratory Pilot-Study among Cardiology Inpatients. Clocks Sleep 2020; 2:120-142. [PMID: 33089196 PMCID: PMC7445848 DOI: 10.3390/clockssleep2020011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/31/2020] [Indexed: 11/21/2022] Open
Abstract
Background: Readmissions within 30 days of discharge are prominent among patients with cardiovascular disease. Post hospital syndrome hypothesizes that sleep disturbance during the index admission contributes to an acquired transient vulnerability, leading to increased risk of readmission. This study evaluated the association of in-hospital sleep (a) duration and (b) quality with 30-day all-cause unplanned readmission. Methods: This prospective observational cohort study included patients admitted to the coronary care unit of a South Australian hospital between 2016–2018. Study participants were invited to wear an ActiGraph GT3X+ for the duration of their admission and for two weeks post-discharge. Validated sleep and quality of life questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), were administered. Readmission status and questionnaires were assessed at 30 days post-discharge via patient telephone interview and a review of hospital records. Results: The final cohort consisted of 75 patients (readmitted: n = 15, non-readmitted: n = 60), of which 72% were male with a mean age 66.9 ± 13.1 years. Total sleep time (TST), both in hospital (6.9 ± 1.3 vs. 6.8 ± 2.9 h, p = 0.96) and post-discharge (7.4 ± 1.3 h vs. 8.9 ± 12.6 h, p = 0.76), was similar in all patients. Patient’s perception of sleep, reflected by PSQI scores, was poorer in readmitted patients (9.13 ± 3.6 vs. 6.4 ± 4.1, p = 0.02). Conclusions: Although an association between total sleep time and 30-day readmission was not found, patients who reported poorer sleep quality were more likely to be readmitted within 30 days. This study also highlighted the importance of improving sleep, both in and out of the hospital, to improve the outcomes of cardiology inpatients.
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Affiliation(s)
- Clementine Labrosciano
- Adelaide Medical School, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, SA 5011, Australia; (R.T.); (T.A.); (J.F.B.); (I.R.)
- Basil Hetzel Institute for Translational Health Research, Adelaide, SA 5011, Australia;
| | - Rosanna Tavella
- Adelaide Medical School, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, SA 5011, Australia; (R.T.); (T.A.); (J.F.B.); (I.R.)
- Basil Hetzel Institute for Translational Health Research, Adelaide, SA 5011, Australia;
- Central Adelaide Local Health Network, Adelaide, SA 5000, Australia
| | - Amy Reynolds
- CQUniversity Australia, The Appleton Institute, Wayville, SA 5034, Australia;
- Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, SA 5042, Australia
| | - Tracy Air
- Adelaide Medical School, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, SA 5011, Australia; (R.T.); (T.A.); (J.F.B.); (I.R.)
- Basil Hetzel Institute for Translational Health Research, Adelaide, SA 5011, Australia;
| | - John F Beltrame
- Adelaide Medical School, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, SA 5011, Australia; (R.T.); (T.A.); (J.F.B.); (I.R.)
- Basil Hetzel Institute for Translational Health Research, Adelaide, SA 5011, Australia;
- Central Adelaide Local Health Network, Adelaide, SA 5000, Australia
| | - Isuru Ranasinghe
- Adelaide Medical School, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, SA 5011, Australia; (R.T.); (T.A.); (J.F.B.); (I.R.)
- Basil Hetzel Institute for Translational Health Research, Adelaide, SA 5011, Australia;
- Central Adelaide Local Health Network, Adelaide, SA 5000, Australia
| | - Robert J T Adams
- Basil Hetzel Institute for Translational Health Research, Adelaide, SA 5011, Australia;
- Central Adelaide Local Health Network, Adelaide, SA 5000, Australia
- Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, SA 5042, Australia
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18
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Li W, Yin J, Cai X, Cheng X, Wang Y. Association between sleep duration and quality and depressive symptoms among university students: A cross-sectional study. PLoS One 2020; 15:e0238811. [PMID: 32915844 PMCID: PMC7485879 DOI: 10.1371/journal.pone.0238811] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 08/23/2020] [Indexed: 01/09/2023] Open
Abstract
Sleep duration and quality have several effects on human health. Some previous studies have shown an association between sleep duration and quality and mental health, but the results of those studies were inconsistent. Additionally, studies on sleep duration and its impact on depressive symptoms specifically among young Chinese adults are limited. Hence, this study aimed to investigate the association between duration and quality of sleep and depressive symptoms among Chinese university students. We designed a cross-sectional study comprising 9,515 Chinese university students. Sleep duration and quality were assessed using a self-reported questionnaire. Depressive symptoms were assessed based on the Self-rating Depression Scale score. Logistic regression models were used to analyze the association between sleep duration and quality and depressive symptoms. The results showed that good sleep quality was associated with a lower prevalence of depressive symptoms. In the final adjusted model, the odds ratios and 95% confidence intervals for the prevalence of depressive symptoms in those with poor sleep quality compared with those with normal and good sleep quality were 0.88 (0.77, 1.01) and 0.82 (0.81, 0.96), respectively (p for trend = 0.014). Moreover, short sleep duration was associated with a higher prevalence of depressive symptoms based on the crude model and final adjusted model (p for trend = 0.048 and 0.042, respectively). Poor sleep quality and short sleep duration were associated with a higher prevalence of depressive symptoms in this study population. These results suggest that reduced sleep duration and quality may be risk factors for mental health disorders among university students.
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Affiliation(s)
- Wang Li
- Department of Physical Education, Huaiyin Institute of Technology, Huaian, People's Republic of China
| | - Jianjun Yin
- Department of Physical Education, Guangdong University of Finance & Economics, Guangzhou, People's Republic of China
| | - Xianfeng Cai
- Department of Physical Education, Huaiyin Institute of Technology, Huaian, People's Republic of China
| | - Xin Cheng
- Department of Physical Education, Huaiyin Institute of Technology, Huaian, People's Republic of China
| | - Yongxiang Wang
- Department of Physical Education, Huaiyin Institute of Technology, Huaian, People's Republic of China
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19
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Troxel WM, Haas A, Ghosh-Dastidar B, Holliday SB, Richardson AS, Schwartz H, Gary-Webb TL, Hale L, Buysse DJ, Buman MP, Dubowitz T. Broken Windows, Broken Zzs: Poor Housing and Neighborhood Conditions Are Associated with Objective Measures of Sleep Health. J Urban Health 2020; 97:230-238. [PMID: 31993870 PMCID: PMC7101456 DOI: 10.1007/s11524-019-00418-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
African Americans and socioeconomically disadvantaged individuals have higher rates of a variety of sleep disturbances, including short sleep duration, poor sleep quality, and fragmented sleep. Such sleep disturbances may contribute to pervasive and widening racial and socioeconomic (SES) disparities in health. A growing body of literature demonstrates that over and above individual-level SES, indicators of neighborhood disadvantage are associated with poor sleep. However, there has been scant investigation of the association between sleep and the most proximal environments, the home and residential block. This is the first study to examine the association between objective and self-reported measures of housing and block conditions and sleep. The sample included 634 adults (mean age = 58.7 years; 95% African American) from two low-income urban neighborhoods. Study participants reported whether they experienced problems with any of seven different housing problems (e.g., broken windows) and rated the overall condition of their home. Trained data collectors rated residential block quality. Seven days of wrist actigraphy were used to measure average sleep duration, efficiency, and wakefulness after sleep onset (WASO), and a sleep diary assessed sleep quality. Multivariate regression analyses were conducted for each sleep outcome with housing or block conditions as predictors in separate models. Participants reporting "fair" or "poor" housing conditions had an adjusted average sleep duration that was 15.4 min shorter than that of participants reporting "good" or "excellent" conditions. Those reporting any home distress had 15.9 min shorter sleep and .19 units lower mean sleep quality as compared with participants who did not report home distress. Poor objectively measured block quality was associated with 14.0 min shorter sleep duration, 1.95% lower sleep efficiency, and 10.7 additional minutes of WASO. Adverse housing and proximal neighborhood conditions are independently associated with poor sleep health. Findings highlight the importance of considering strategies that target upstream determinants of sleep health disparities.
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Affiliation(s)
- Wendy M Troxel
- Behavior and Policy Sciences, RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA.
| | - Ann Haas
- Economics, Sociology and Statistics, RAND Corporation, Pittsburgh, PA, 15213, USA
| | | | - Stephanie Brooks Holliday
- Behavior and Policy Sciences, RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA
| | - Andrea S Richardson
- Behavior and Policy Sciences, RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA
| | - Heather Schwartz
- Economics, Sociology and Statistics, RAND Corporation, Pittsburgh, PA, 15213, USA
| | - Tiffany L Gary-Webb
- Departments of Behavioral and Community Health Sciences and Epidemiology, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Lauren Hale
- Department of Family, Population, and Preventive Medicine, Program in Public Health, Stony Brook University, Stony Brook, NY, 11794-8338, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Matthew P Buman
- College of Health Solutions, Arizona State University, Phoenix, AZ, 85004, USA
| | - Tamara Dubowitz
- Behavior and Policy Sciences, RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA
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20
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Svensson T, Inoue M, Saito E, Sawada N, Iso H, Mizoue T, Goto A, Yamaji T, Shimazu T, Iwasaki M, Tsugane S. The Association Between Habitual Sleep Duration and Mortality According to Sex and Age: The Japan Public Health Center-based Prospective Study. J Epidemiol 2020; 31:109-118. [PMID: 32009104 PMCID: PMC7813766 DOI: 10.2188/jea.je20190210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Short and long sleep durations are associated with mortality outcomes. The association between sleep duration and mortality outcomes may differ according to sex and age. Methods Participants of the Japan Public Health Center-based prospective study (JPHC Study) were aged 40–69 years and had completed a detailed questionnaire on lifestyle factors. Sex- and age-stratified analyses on the association between habitual sleep duration and mortality from all-causes, cardiovascular diseases (CVD), cancer and other causes included 46,152 men and 53,708 women without a history of CVD or cancer. Cox proportional hazards regression models, adjusted for potential confounders, were used to determine hazard ratios and 95% confidence intervals. Results Mean follow-up time was 19.9 years for men and 21.0 years for women. In the multivariable sex-stratified models, some categories of sleep durations ≥8 hours were positively associated with mortality from all-causes, CVD, and other causes in men and women compared with 7 hours. The sex- and age-stratified analyses did not reveal any major differences in the association between sleep duration and mortality outcomes in groups younger and older than 50 years of age. The only exception was the significant interaction between sleep duration and age in women for mortality from other causes. Conclusions Sleep durations ≥8 hours are associated with mortality outcomes in men and women. Age may be an effect modifier for the association between sleep duration and mortality from other causes in women.
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Affiliation(s)
- Thomas Svensson
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center.,Department of Neuropsychiatry, Keio University School of Medicine.,Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo.,Department of Clinical Sciences, Lund University, Skåne University Hospital.,School of Health Innovation, Kanagawa University of Human Services
| | - Manami Inoue
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
| | - Eiko Saito
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center.,Division of Cancer Statistics Integration, Center for Cancer Control and Information Services, National Cancer Center
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
| | - Hiroyasu Iso
- Public Health, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine
| | - Atsushi Goto
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
| | - Taiki Yamaji
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
| | - Taichi Shimazu
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
| | - Motoki Iwasaki
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
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21
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Social Epidemiology of Sleep: Extant Evidence and Future Directions. CURR EPIDEMIOL REP 2019. [DOI: 10.1007/s40471-019-00219-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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22
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Abstract
AIMS To determine the association between the sleep duration and the risk of all-cause mortality in adults. METHODS A search strategy was conducted in the MEDLINE, CENTRAL, EMBASE and LILACS databases. Searches were also conducted in other databases and unpublished literature. Cohort studies were included without language, time or setting restrictions. The risk of bias was evaluated with a modified Cochrane Collaboration's tool. An analysis of random effects was conducted. The primary outcome was all-cause mortality. The measure of the effect was the risk difference (RD) with a 95% confidence interval (CI). The planned comparisons were 7-9 h of sleep v. <7 h and the same reference v. >9 h. RESULTS Thirty-nine studies were included in our qualitative analysis, regarding the quantitative analysis, 19 studies were included in <7 v. 7-9 h analysis, and 18 studies in the >9 v. 7-9 h. A low risk of bias was shown for most of the study items. The overall RD for all-cause mortality was 0.09 (95% CI 0.07-0.11) favouring the >9 h group compared with our reference. In contrast, no differences were found between the <7 h and the reference sleep duration groups (RD 0.00, 95% CI 0.00-0.01). CONCLUSION We found a probable association of long sleep duration and higher mortality; however, it could reflect an underlying systemic or neurological disease that cause sleep fragmentation, deterioration in quality and micro-awakenings.
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Minz S, Pati AK. Morningness–eveningness preference, sleep quality and behavioral sleep patterns in humans – a mini review. BIOL RHYTHM RES 2019. [DOI: 10.1080/09291016.2019.1616889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Sarojini Minz
- School of Zoology, Gangadhar Meher University, Sambalpur, India
| | - Atanu Kumar Pati
- School of Zoology, Gangadhar Meher University, Sambalpur, India
- School of Studies in Life Science, Pandit Ravishankar Shukla University, Raipur, India
- Center for Translational Chronobiology, Pandit Ravishankar Shukla University, Raipur, India
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24
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Fang HF, Lee TY, Hui KC, Yim HCH, Chi MJ, Chung MH. Association between Sedative-hypnotics and Subsequent Cancer in Patients with and without Insomnia: A 14-year Follow-up Study in Taiwan. J Cancer 2019; 10:2288-2298. [PMID: 31258732 PMCID: PMC6584417 DOI: 10.7150/jca.30680] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 03/21/2019] [Indexed: 12/17/2022] Open
Abstract
Background: The aim of this population-based 14-year historical and prospective study was to determine the relationships between the usage of sedative-hypnotics, including benzodiazepines and nonbenzodiazepines, and the risk of subsequent cancer in patients with or without insomnia among the Taiwanese population. Methods: A total of 43,585 patients were recruited, 21,330 of whom had been diagnosed with insomnia and 8,717 who had been prescribed sedative-hypnotics during this study's following period of 2002 to 2015. Information from the claims data, namely basic demographic details, drug prescriptions, comorbidities, and patients' survival, was extracted from the National Health Insurance Research Database for χ2 analysis. A Cox proportional hazards model was used to compute the 14-year cancer-free survival rates after adjustment for confounding factors. Results: Patients with insomnia who used sedative-hypnotics had an adjusted hazard ratio of 1.49 compared with patients with insomnia who did not use any sedative-hypnotics, and patients without insomnia who used sedative-hypnotics had an adjusted hazard ratio of 1.68 compared with patients without insomnia who did not use any sedative-hypnotics. Regarding site-specific risk, patients with insomnia who used sedative-hypnotics had an increased risk of oral and breast cancers, and patients without insomnia who received sedative-hypnotics prescriptions had an increased risk of liver and breast cancers. The cancer-free survival rate of patients who had used sedative-hypnotics was significantly lower than that of patients who had never used sedative-hypnotics. Conclusions: The use of sedative-hypnotics in patients either with or without insomnia was associated with subsequent cancer development in the Taiwanese population. Increased risks of oral, liver, and breast cancer were found in the patients with the use of sedative-hypnotics. The use of sedative-hypnotics should be discouraged for treating patients with or without insomnia in Taiwan.
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Affiliation(s)
- Hui-Fen Fang
- Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan
| | - Tzu-Yin Lee
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - King Cheung Hui
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Howard Chi Ho Yim
- Microbiome Research Centre, St George & Sutherland Clinical School, University of New South Wales, Sydney, Australia
| | - Mei-Ju Chi
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Min-Huey Chung
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
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25
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Abstract
Personality and sleep predict longevity; however, no investigation has tested whether sleep mediates this association. Thus, we tested this effect across a 20-year follow-up (N = 3,759) in the Midlife Development in the United States cohort (baseline M age = 47.15) using proportional hazards in a structural equation modeling framework. Lower conscientiousness predicted increased death risk via the direct, indirect, and total effect of quadratic sleep duration. Although there were no other direct personality-mortality effects, higher neuroticism and agreeableness and lower conscientiousness predicted increased death risk via the joint indirect effects of quadratic sleep duration and higher daytime dysfunction. Lower extraversion predicted increased mortality risk via the indirect effect of daytime dysfunction. Our findings have implications for personality-based health interventions.
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Garfield V, Joshi R, Garcia-Hernandez J, Tillin T, Chaturvedi N. The relationship between sleep quality and all-cause, CVD and cancer mortality: the Southall and Brent REvisited study (SABRE). Sleep Med 2019; 60:230-235. [PMID: 31182326 DOI: 10.1016/j.sleep.2019.03.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/12/2019] [Accepted: 03/18/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Both long and short sleep duration increase risk of mortality. Most previous studies have been performed in Europeans and have focused on sleep duration. Thus, we aimed to investigate the association between sleep quality and mortality across three different ethnic groups. METHODS We used data from the Southall and Brent REvisited Study (SABRE) cohort, which comprises first generation migrant South Asian and African Caribbean men and women, aged 40-69 years, recruited between 1988 and 1991. In sum, 4399 participants provided complete data at baseline and follow-up. Of those, 1656 died by December 2017. Our exposures (eg, difficulty falling asleep, early morning waking and waking up tired in the morning) were self-reported and our primary outcome was mortality. We used Cox proportional hazards models to analyse our data, adjusting for baseline-measured confounders. RESULTS None of the sleep measures were strongly associated with all-cause mortality in Europeans or African Caribbeans, whilst in South Asians difficulty falling asleep was related to an increased risk of all-cause mortality (HR = 1.28, 95%CI = 1.01; 1.61). In Europeans, early morning waking was associated with a moderately increased risk of cardiovascular death (HR = 1.31, 95%CI = 1.05; 1.63); alternately, this association was not as strong in the other groups. CONCLUSION Our findings suggest that the relationship between sleep quality and mortality may differ by ethnic group, but formal heterogeneity tests indicated that the strongest difference in HRs was observed for early morning waking and cardiovascular disease (CVD) mortality across the three groups (Cochran's Q test p = 0.036). As such, these results are novel and provide support for ethnic differences in sleep quality and mortality, and may have implications for precision medicine.
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Affiliation(s)
- Victoria Garfield
- Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Roshni Joshi
- Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
| | - Jorge Garcia-Hernandez
- Institute of Health Informatics, University College London, 222 Euston Road, London, NW1 2DA, UK
| | - Therese Tillin
- Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
| | - Nish Chaturvedi
- Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
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Miyahara LK, Stefanini R, Suguri VM, Wawginiak GH, Balsalobre RDA, Haddad FLM. Evaluation of sleep quality and risk of obstructive sleep apnea in patients referred for aesthetic rhinoplasty. ACTA ACUST UNITED AC 2019; 12:126-131. [PMID: 31890086 PMCID: PMC6932849 DOI: 10.5935/1984-0063.20190077] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Importance Aesthetic rhinoplasty is the fifth surgical procedure most performed worldwide by plastic surgeons. With the growing demand for rhinoplasty, there is an unmet need for research into the profile of patients who seek aesthetic nasal surgery in an attempt to improve not only cosmetic dissatisfactions, but also the manifestations of other, possibly interrelated disorders, especially sleep disturbances. Objective To evaluate the sleep quality and the risk of Obstructive Sleep Apnea in patients referred for aesthetic rhinoplasty, as well as the association of these conditions with nasal symptoms. Design: Cross-sectional study performed at the period of June/2016 to August/2017. Setting: Department of Otolaryngology and Head and Neck Surgery - Universidade Federal de São Paulo. Participants: Patients of both sexes, aged 18 to 65 years, who were referred for aesthetic rhinoplasty. We evaluated 46 patients, two of whom were excluded because they were outside the inclusion age criteria. Main Outcome(s) and Measure(s): Anterior rhinoscopy and the following validated surveys were used. Pittsburgh Sleep Quality Index; Epworth Sleepiness Scale; Nasal Obstruction Symptom Evaluation scale; Berlin Questionnaire. The visual analog scale for snoring was also used. Results Of the 44 participants, 18 (41%) were males and 26 (59%) were females. 82% had poor sleep quality. 46% presented excessive daytime sleepiness. There was a high risk for Obstructive Sleep Apnea in 27%. Regarding to nasal symptoms, the mean score in the Nasal Obstructive Symptoms Evaluation was 66.25±25.38. When comparing the groups with good and poor sleep quality, we observed a higher risk for Obstructive Sleep Apnea (p=0.05) in patients with poor sleep quality. Patients at high risk for Obstructive Sleep Apnea had higher scores on the Nasal Obstructive Symptoms Evaluation (p=0.001) and on the analogue snoring scale (p<0.001) compared to patients at low risk. Conclusions We observed a high occurrence of poor sleep quality in participants. All participants who were at high risk for obstructive sleep apnea were also classified as having poor sleep quality. An association was also observed between the presence of high risk for obstructive sleep apnea and presence of nasal symptoms.
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Affiliation(s)
- Lucas Kenzo Miyahara
- Universidade Federal de São Paulo, Department of Otolaryngology and Head and Neck Surgery - São Paulo - São Paulo - Brazil
| | - Renato Stefanini
- Universidade Federal de São Paulo, Department of Otolaryngology and Head and Neck Surgery - São Paulo - São Paulo - Brazil
| | - Vinicius Magalhães Suguri
- Universidade Federal de São Paulo, Department of Otolaryngology and Head and Neck Surgery - São Paulo - São Paulo - Brazil
| | - Guilherme Henrique Wawginiak
- Universidade Federal de São Paulo, Department of Otolaryngology and Head and Neck Surgery - São Paulo - São Paulo - Brazil
| | - Rafael de Andrade Balsalobre
- Universidade Federal de São Paulo, Department of Otolaryngology and Head and Neck Surgery - São Paulo - São Paulo - Brazil
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28
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Shulman R, Cohen DL, Grandner MA, Gislason T, Pack AI, Kuna ST, Townsend RR, Cohen JB. Sleep duration and 24-hour ambulatory blood pressure in adults not on antihypertensive medications. J Clin Hypertens (Greenwich) 2018; 20:1712-1720. [PMID: 30375723 DOI: 10.1111/jch.13416] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 08/29/2018] [Accepted: 09/07/2018] [Indexed: 11/29/2022]
Abstract
Short sleep duration has been widely linked to increased cardiovascular morbidity and mortality. We performed a post hoc analysis of 24-hour ambulatory blood pressure monitoring (ABPM) in the Lifestyle Modification in Blood Pressure Lowering Study (LIMBS) and Penn Icelandic Sleep Apnea (PISA) Study. The 24-hour mean systolic blood pressure (BP) was 12.7 mm Hg higher in LIMBS (P < 0.001; n = 66) and 4.7 mm Hg higher in PISA (P = 0.005; n = 153) among participants with shorter sleep duration (less than 7 hours) compared to those with longer sleep duration (at least 7 hours). In multivariable adjusted models, shorter sleep duration was strongly associated with higher systolic BP on 24-hour ABPM, independent of nocturnal BP and in-office BP. There was no effect modification by obstructive sleep apnea. Adults with shorter sleep duration may benefit from screening with 24-hour ABPM to promote earlier detection of hypertension and potentially mitigate their increased risk for future cardiovascular disease.
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Affiliation(s)
- Rachel Shulman
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Debbie L Cohen
- Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael A Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, Arizona
| | - Thorarinn Gislason
- Department of Sleep Medicine, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Allan I Pack
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania.,Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Samuel T Kuna
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania.,Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Medicine, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania
| | - Raymond R Townsend
- Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jordana B Cohen
- Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Choi JW, Lee J, Jung SJ, Shin A, Lee YJ. Use of Sedative-Hypnotics and Mortality: A Population-Based Retrospective Cohort Study. J Clin Sleep Med 2018; 14:1669-1677. [PMID: 30353805 DOI: 10.5664/jcsm.7370] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 06/19/2018] [Indexed: 12/14/2022]
Abstract
STUDY OBJECTIVES Researchers have previously reported a possible association between sedative-hypnotics and increased mortality. However, the relationship remains controversial. We investigated the association between sedative-hypnotics and mortality using a large population-based database from the Republic of Korea. METHODS We used a National Health Insurance Service database. The study population was a 5% random sample of the database from the years 2002- 2015. Individuals who were age 40 years and older were included in the analysis. The sedative-hypnotic users were defined as individuals prescribed 30 or more defined daily doses of sedative-hypnotics per year since January 2004. Sedative-hypnotics were classified based on type and total amount. We estimated the risk of mortality (death from January 2004 to December 2015) using time-dependent Cox regression model adjusted for age, sex, Charlson Comorbidity Index, and psychiatric comorbidity. RESULTS We identified 180,823 study participants who used sedative-hypnotics and 320,136 nonusers. In a multivariate model, study participants who used sedative-hypnotics had significantly higher mortality risk than nonusers (hazard ratio [HR] 1.14, 95% confidence interval [CI] 1.12-1.16). Specifically, study participants who used zolpidem had a higher mortality risk (HR 1.59, 95% CI 1.52-1.67) than nonusers. CONCLUSIONS Based on the current study results, sedative-hypnotics were associated with an increased risk of mortality, especially in study participants who used zolpidem.
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Affiliation(s)
- Jae-Won Choi
- Department of Neuropsychiatry, Eulji University School of Medicine, Eulji General Hospital, Seoul, Republic of Korea
| | - Joonki Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sun Jae Jung
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yu Jin Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
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Kwok CS, Kontopantelis E, Kuligowski G, Gray M, Muhyaldeen A, Gale CP, Peat GM, Cleator J, Chew‐Graham C, Loke YK, Mamas MA. Self-Reported Sleep Duration and Quality and Cardiovascular Disease and Mortality: A Dose-Response Meta-Analysis. J Am Heart Assoc 2018; 7:e008552. [PMID: 30371228 PMCID: PMC6201443 DOI: 10.1161/jaha.118.008552] [Citation(s) in RCA: 216] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 05/16/2018] [Indexed: 12/16/2022]
Abstract
Background There is growing evidence that sleep duration and quality may be associated with cardiovascular harm and mortality. Methods and Results We conducted a systematic review, meta-analysis, and spline analysis of prospective cohort studies that evaluate the association between sleep duration and quality and cardiovascular outcomes. We searched MEDLINE and EMBASE for these studies and extracted data from identified studies. We utilized linear and nonlinear dose-response meta-analysis models and used DerSimonian-Laird random-effects meta-analysis models of risk ratios, with inverse variance weighting, and the I2 statistic to quantify heterogeneity. Seventy-four studies including 3 340 684 participants with 242 240 deaths among 2 564 029 participants who reported death events were reviewed. Findings were broadly similar across both linear and nonlinear dose-response models in 30 studies with >1 000 000 participants, and we report results from the linear model. Self-reported duration of sleep >8 hours was associated with a moderate increased risk of all-cause mortality, with risk ratio , 1.14 (1.05-1.25) for 9 hours, risk ratio, 1.30 (1.19-1.42) for 10 hours, and risk ratio, 1.47 (1.33-1.64) for 11 hours. No significant difference was identified for periods of self-reported sleep <7 hours, whereas similar patterns were observed for stroke and cardiovascular disease mortality. Subjective poor sleep quality was associated with coronary heart disease (risk ratio , 1.44; 95% confidence interval, 1.09-1.90), but no difference in mortality and other outcomes. Conclusions Divergence from the recommended 7 to 8 hours of sleep is associated with a higher risk of mortality and cardiovascular events. Longer duration of sleep may be more associated with adverse outcomes compared with shorter sleep durations.
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Affiliation(s)
- Chun Shing Kwok
- Keele Cardiovascular Research GroupInstitute for Applied Clinical Science and Centre for Prognosis ResearchInstitute of Primary Care and Health SciencesUniversity of KeeleStoke‐on‐TrentUnited Kingdom
| | | | | | - Matthew Gray
- School of MedicineUniversity of ManchesterUnited Kingdom
| | | | - Christopher P. Gale
- Leeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsUnited Kingdom
| | - George M. Peat
- Research Institute for Primary Care & Health SciencesKeele UniversityStoke‐on‐TrentUnited Kingdom
| | - Jacqueline Cleator
- Division of NursingMidwifery and Social WorkSchool of Health SciencesUniversity of ManchesterManchesterUnited Kingdom
| | - Carolyn Chew‐Graham
- Research Institute for Primary Care & Health SciencesKeele UniversityStoke‐on‐TrentUnited Kingdom
| | - Yoon Kong Loke
- Norwich Medical SchoolUniversity of East AngliaNorwichUnited Kingdom
| | - Mamas Andreas Mamas
- Keele Cardiovascular Research GroupInstitute for Applied Clinical Science and Centre for Prognosis ResearchInstitute of Primary Care and Health SciencesUniversity of KeeleStoke‐on‐TrentUnited Kingdom
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31
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Liu F, Zhang H, Liu Y, Sun X, Yin Z, Li H, Deng K, Zhao Y, Wang B, Ren Y, Zhang L, Zhou J, Han C, Liu X, Zhang D, Chen G, Hong S, Wang C, Hu D, Zhang M. Sleep Duration Interacts With Lifestyle Risk Factors and Health Status to Alter Risk of All-Cause Mortality: The Rural Chinese Cohort Study. J Clin Sleep Med 2018; 14:857-865. [PMID: 29734984 DOI: 10.5664/jcsm.7124] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 02/16/2018] [Indexed: 12/23/2022]
Abstract
STUDY OBJECTIVES Many studies suggest an association of both short and long sleep duration with all-cause mortality, but the effect of co-occurrence of sleep duration and other lifestyle risk factors or health status remains unclear. METHODS A total of 17,184 participants aged 18 years or older from rural areas of China were examined at baseline from 2007 to 2008 and followed up from 2013 to 2014. Cox proportional hazard models were used to estimate the hazard ratio (HR) and 95% confidence interval (CI). RESULTS During 6-year follow-up, we identified 1,101 deaths. The multivariable-adjusted mortality risk was significantly higher with short-duration sleepers (< 6.5 hours) (HR = 1.37, 95% CI 1.01-1.86) and long-duration sleepers (≥ 9.5 hours) (HR = 1.35, 95% CI 1.05-1.74) versus 6.5-7.5 hours. The multiplicative interaction of long sleep duration with some lifestyle risk factors and health statuses increased the mortality risk in men (low level of physical activity: HR = 1.03, 95% CI 1.02-1.04; hypertension: HR = 1.06, 95% CI 1.04-1.09; type 2 diabetes mellitus [T2DM]: HR = 1.07, 95% CI 1.04-1.11). Similar results were found in women (low level of physical activity: HR = 1.03, 95% CI 1.02-1.05; T2DM: HR = 1.07, 95% CI 1.05-1.10). CONCLUSIONS Sleep duration could be a predictor of all-cause mortality and its interaction with physical activity, hypertension, and T2DM may increase the risk of mortality.
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Affiliation(s)
- Feiyan Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.,The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.,Guangdong Key Laboratory for Genome Stability and Disease Prevention, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Hongyan Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Yu Liu
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Xizhuo Sun
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Zhaoxia Yin
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Honghui Li
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Kunpeng Deng
- Yantian Entry-exit Inspection and Quarantine Bureau, Shenzhen, Guangdong, People's Republic of China
| | - Yang Zhao
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.,The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Bingyuan Wang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.,The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Yongcheng Ren
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.,The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Lu Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.,The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.,Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Junmei Zhou
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.,The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Chengyi Han
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.,The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Xuejiao Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.,The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Dongdong Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.,The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.,Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Guozhen Chen
- Department of Clinical Medicine, Shenzhen University, Shenzhen, Guangdong, People's Republic of China
| | - Shihao Hong
- Department of Clinical Medicine, Shenzhen University, Shenzhen, Guangdong, People's Republic of China
| | - Chongjian Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dongsheng Hu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.,The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.,Guangdong Key Laboratory for Genome Stability and Disease Prevention, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Ming Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.,The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
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Han K, Park JB. Evaluation of the association between sleep duration and tooth loss among Korean adults: data from the Korean National Health and Nutrition Examination Survey (KNHANES 2012-2014). BMJ Open 2018; 8:e018383. [PMID: 29730614 PMCID: PMC5942464 DOI: 10.1136/bmjopen-2017-018383] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES This study assessed the association between sleep duration and tooth loss using nationally representative data. In this study, a cross-sectional analysis was performed using multivariable logistic regression analysis models. SETTING The present study analysed data from the Korean National Health and Nutrition Examination Survey between 2012 and 2014. PARTICIPANTS A total of 14 675 respondents over 19 years old without missing values were included in this study. EXPOSURE AND PRIMARY OUTCOME MEASURES Sleep duration and tooth loss. RESULTS Participants with a sleep duration of 6-8 hours showed the lowest prevalence of diabetes mellitus, hypertension, metabolic syndrome, periodontitis and meeting the waist circumference criteria for metabolic syndrome. Adjusted OR and their 95% CI of male individuals with fewer than 25 natural teeth were 1.426 (1.113 to 1.827), 1.290 (1.074 to 1.548), 0.988 (0.853 to 1.145), 1 (reference), 1.058 (0.907 to 1.235) and 1.620 (1.287 to 2.038) for sleep duration of 4 hours or less, 5 hours, 6 hours, 7 hours, 8 hours and 9 hours or more, respectively (p<0.05), after adjustments for age, sex, smoking, drinking, walking, frequency of tooth brushing per day, body mass index and periodontitis. CONCLUSIONS Our findings showed the U-shaped association between sleep duration and tooth loss was suggested by multiple logistic regression analyses after adjusting for confounding factors. Moreover, subgroup analyses showed that short and long sleep duration were associated with greater tooth loss in participants without diabetes mellitus, those without hypertension and those without metabolic syndrome.
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Affiliation(s)
- Kyungdo Han
- Department of Biostatistics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Jun-Beom Park
- Department of Periodontics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
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Win T, Yamazaki T, Kanda K, Tajima K, Sokejima S. Neighborhood social capital and sleep duration: a population based cross-sectional study in a rural Japanese town. BMC Public Health 2018. [PMID: 29529998 PMCID: PMC5848537 DOI: 10.1186/s12889-018-5204-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background Studies on social capital and health outcomes have become common, but the relationship between neighborhood social capital and sleep duration by gender is still unclear. We examined the relationship between neighborhood social capital and sleep duration by gender in adults living in a rural community in Japan. Method We conducted a cross-sectional survey of 12,321 residents aged ≥20 years in a town in Mie Prefecture in January–March 2013. Self-completed questionnaires were collected from the residents (n = 7782; valid participation rate, 63.2%). We used five items to assess the neighborhood social capital (Cronbach’s α = 0.86). We summed up the scores of each item, and then divided the participants into four groups by quartile of total scores of neighborhood social capital (lowest, low, high, and highest). Sleep duration of < 7 h/day was defined as insufficient sleep duration according to previous studies. To adjust for potential confounders, we performed a multiple log-binominal regression analysis and estimated the prevalence ratios (PRs) and 95% confidence intervals (CIs) for insufficient sleep. Results Overall 42% of the men and 45% of the women had insufficient sleep. In the men, the lowest group of neighborhood social capital presented a 22% higher prevalence of insufficient sleep (PR 1.22; 95% CIs 1.08–1.38) compared to the highest group of neighborhood social capital. Similarly the low group of neighborhood social capital and the high group of neighborhood social capital had 20 and 19% higher prevalence of insufficient sleep (PR 1.20; 95% CIs 1.06–1.36; PR 1.19; 95% CIs 1.06–1.34, respectively) compared to the highest group of neighborhood social capital. For women there was no significant association between neighborhood social capital and insufficient sleep after controlling for all potential confounders. Conclusion Having lower neighborhood social capital was associated with insufficient sleep among Japanese adults, particularly in the men. This suggests that the context of neighborhood social capital by gender should be considered to promote healthier behaviors with regard to getting enough sleep. Electronic supplementary material The online version of this article (10.1186/s12889-018-5204-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Thida Win
- Department of Public Health and Occupational Medicine, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-shi, Mie, 514-8507, Japan
| | - Toru Yamazaki
- Department of Public Health and Occupational Medicine, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-shi, Mie, 514-8507, Japan.,Epidemiology Centre for Disease Control and Prevention, Mie University Hospital, Tsu, Mie, Japan
| | - Koji Kanda
- Japan International Cooperation Agency, Tokyo, Japan
| | - Kazuo Tajima
- Department of Public Health and Occupational Medicine, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-shi, Mie, 514-8507, Japan
| | - Shigeru Sokejima
- Department of Public Health and Occupational Medicine, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-shi, Mie, 514-8507, Japan. .,Epidemiology Centre for Disease Control and Prevention, Mie University Hospital, Tsu, Mie, Japan.
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Han K, Park YM, Park JB. Evaluation of an association between long sleep duration and periodontal disease among men and women using nationally representative data. GACETA SANITARIA 2018; 32:143-150. [DOI: 10.1016/j.gaceta.2017.01.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 01/10/2017] [Accepted: 01/23/2017] [Indexed: 02/08/2023]
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Abstract
Since World War II, Japan has achieved remarkable economic development and has become an advanced country. Particularly in the industrial field, a production system has been developed to reduce the loss of machining time by adopting a shiftwork in factories operating 24 hours a day, which contributes to the improvement of productivity. Nowadays, this shiftwork practice has spread from the industrial field to other businesses such as 24-hour entertainment facilities and convenience stores, which lead to sleep deprivation in Japanese society. Even at home, certain conditions adversely affect sleeping habits. We are concerned about the risks of physical and mental health, impairments posed by the use of tablets, PCs, smartphones, and other devices so popular in today's Japan, as they delay sleep. It is urgent to improve poor sleeping habits because their outcomes such as sleep disorders and deprivation may also lead to traffic and industrial accidents.
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Affiliation(s)
- Masumi Takada
- Faculty of Nursing and Rehabilitation, Chubu Gakuin University
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36
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37
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Yin J, Jin X, Shan Z, Li S, Huang H, Li P, Peng X, Peng Z, Yu K, Bao W, Yang W, Chen X, Liu L. Relationship of Sleep Duration With All-Cause Mortality and Cardiovascular Events: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. J Am Heart Assoc 2017; 6:JAHA.117.005947. [PMID: 28889101 PMCID: PMC5634263 DOI: 10.1161/jaha.117.005947] [Citation(s) in RCA: 311] [Impact Index Per Article: 44.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background Effects of extreme sleep duration on risk of mortality and cardiovascular outcomes remain controversial. We aimed to quantify the dose‐response relationships of sleep duration with risk of all‐cause mortality, total cardiovascular disease, coronary heart disease, and stroke. Methods and Results PubMed and Embase were systematically searched for prospective cohort studies published before December 1, 2016, that examined the associations between sleep duration and at least 1 of the 4 outcomes in generally healthy populations. U‐shaped associations were indicated between sleep duration and risk of all outcomes, with the lowest risk observed for ≈7‐hour sleep duration per day, which was varied little by sex. For all‐cause mortality, when sleep duration was <7 hours per day, the pooled relative risk (RR) was 1.06 (95% CI, 1.04–1.07) per 1‐hour reduction; when sleep duration was >7 hours per day, the pooled RR was 1.13 (95% CI, 1.11–1.15) per 1‐hour increment. For total cardiovascular disease, the pooled RR was 1.06 (95% CI, 1.03–1.08) per 1‐hour reduction and 1.12 (95% CI, 1.08–1.16) per 1‐hour increment of sleep duration. For coronary heart disease, the pooled RR was 1.07 (95% CI, 1.03–1.12) per 1‐hour reduction and 1.05 (95% CI, 1.00–1.10) per 1‐hour increment of sleep duration. For stroke, the pooled RR was 1.05 (95% CI, 1.01–1.09) per 1‐hour reduction and 1.18 (95% CI, 1.14–1.21) per 1‐hour increment of sleep duration. Conclusions Our findings indicate that both short and long sleep duration is associated with an increased risk of all‐cause mortality and cardiovascular events.
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Affiliation(s)
- Jiawei Yin
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.,MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Xiaoling Jin
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.,MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Zhilei Shan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.,MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.,Departments of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Shuzhen Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.,MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Hao Huang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.,MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Peiyun Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.,MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Xiaobo Peng
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.,MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Zhao Peng
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.,MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Kaifeng Yu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.,MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| | - Wei Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.,MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Xiaoyi Chen
- School of Public Health, Guangzhou Medical University, Xinzao, Panyu District, Guangzhou, China
| | - Liegang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China .,MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
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Wang YM, Song M, Wang R, Shi L, He J, Fan TT, Chen WH, Wang L, Yu LL, Gao YY, Zhao XC, Li N, Han Y, Liu MY, Lu L, Wang XY. Insomnia and Multimorbidity in the Community Elderly in China. J Clin Sleep Med 2017; 13:591-597. [PMID: 28212690 DOI: 10.5664/jcsm.6550] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 01/24/2017] [Indexed: 12/20/2022]
Abstract
STUDY OBJECTIVES To examine the comorbidity between insomnia and medical conditions. METHODS This cross-sectional study was conducted in community adults, aged ≥ 60 years, who resided in one of four major cities in northern China. Sociodemographic and clinical data were collected simultaneously. A total of 3,176 elderly adults (1,292 male, mean ± standard deviation age 70.2 ± 6.8 years; 1,884 female, 68.8 ± 6.7 years) were interviewed. RESULTS The prevalence of specific medical conditions in both people with insomnia and people without insomnia was detected. Significantly higher proportions of arrhythmia, hypertension, cerebral hemorrhage, migraine, and hyperlipidemia were observed in people with insomnia than in people without insomnia. Moreover, a significantly higher proportion of insomnia was seen in elderly people with arrhythmia and migraine. We also found that elderly people with insomnia who took sleep medications reported a higher prevalence of coexisting arrhythmia, hypertension, and migraine, even after adjusting for age, sex, and depression. CONCLUSIONS Our results indicate associations between insomnia and medical conditions in the community elderly in China. People who complained of insomnia had poorer physical health conditions. Sleep medication may not be a covariate that influences the comorbidity of some specific physical conditions. CLINICAL TRIAL REGISTRATION Trial name: The study of diagnosis and treatment of senile dementia in Hebei Province; URL: http://www.chictr.org.cn/showproj.aspx?proj=8194; Registration number: ChiCTR-RRC-11001345.
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Affiliation(s)
- Yu-Mei Wang
- Institute of Mental Health, Hebei Medical University, Shijiazhuang, China.,Department of Psychiatry, First Hospital of Hebei Medical University, Shijiazhuang, China.,Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Mei Song
- Institute of Mental Health, Hebei Medical University, Shijiazhuang, China.,Department of Psychiatry, First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ran Wang
- Institute of Mental Health, Hebei Medical University, Shijiazhuang, China.,Department of Psychiatry, First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jia He
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Teng-Teng Fan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Wen-Hao Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Lan Wang
- Institute of Mental Health, Hebei Medical University, Shijiazhuang, China.,Department of Psychiatry, First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lu-Lu Yu
- Institute of Mental Health, Hebei Medical University, Shijiazhuang, China.,Department of Psychiatry, First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yuan-Yuan Gao
- Institute of Mental Health, Hebei Medical University, Shijiazhuang, China.,Department of Psychiatry, First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiao-Chuang Zhao
- Institute of Mental Health, Hebei Medical University, Shijiazhuang, China.,Department of Psychiatry, First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Na Li
- Institute of Mental Health, Hebei Medical University, Shijiazhuang, China.,Department of Psychiatry, First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ying Han
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Mei-Yan Liu
- Department of Cardiology, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing, China
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Xue-Yi Wang
- Institute of Mental Health, Hebei Medical University, Shijiazhuang, China.,Department of Psychiatry, First Hospital of Hebei Medical University, Shijiazhuang, China
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Sleep disturbances in caregivers of patients with advanced cancer: A systematic review. Palliat Support Care 2017; 15:125-140. [PMID: 28095943 DOI: 10.1017/s1478951516001024] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Sleep disturbances are a common issue for those who provide informal care to someone with a life-limiting condition. The negative consequences of poor sleep are well documented. The purpose of the present study was to determine the sleep patterns of caregivers of patients with advanced cancer. METHOD An extensive systematic review of studies reporting empirical sleep data was undertaken in 2015 in accordance with the PRISMA Statement. A total of eight electronic databases were searched, with no date restrictions imposed. Additionally, a search of the bibliographies of the studies identified during the electronic search was conducted. Search terms included: "sleep," "insomnia," "sleep disturbance," "circadian rhythm," "caregiver," "carer," "advanced cancer," "palliative cancer," and MESH suggestions. The inclusion criteria required studies to be in English and to report primary qualitative and/or quantitative research that examined sleep in caregivers of patients with advanced cancer. Unpublished studies, conference papers, and dissertations were excluded. RESULTS Overall, 10 studies met the inclusion criteria and were included in the review. Two major findings emerged from the data synthesis. First, at least 72% of caregivers reported moderate to severe sleep disturbance as measured by the Pittsburgh Sleep Quality Index. Second, objective measurement of caregivers' sleep identified that some caregivers experienced up to a 44% reduction in their total sleep time compared to the recommended eight hours. SIGNIFICANCE OF RESULTS Reduction in total sleep time appears to be the biggest issue facing caregivers' sleep. Future studies need to explore the specific factors that cause these sleep disturbances and thus help to identify interventions to optimize sleep.
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40
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Fung CH, Vitiello MV, Alessi CA, Kuchel GA. Report and Research Agenda of the American Geriatrics Society and National Institute on Aging Bedside-to-Bench Conference on Sleep, Circadian Rhythms, and Aging: New Avenues for Improving Brain Health, Physical Health, and Functioning. J Am Geriatr Soc 2016; 64:e238-e247. [PMID: 27858974 PMCID: PMC5173456 DOI: 10.1111/jgs.14493] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The American Geriatrics Society, with support from the National Institute on Aging and other funders, held its eighth Bedside-to-Bench research conference, entitled "Sleep, Circadian Rhythms, and Aging: New Avenues for Improving Brain Health, Physical Health and Functioning," October 4 to 6, 2015, in Bethesda, Maryland. Part of a conference series addressing three common geriatric syndromes-delirium, sleep and circadian rhythm (SCR) disturbance, and voiding dysfunction-the series highlighted relationships and pertinent clinical and pathophysiological commonalities between these three geriatric syndromes. The conference provided a forum for discussing current sleep, circadian rhythm, and aging research; identifying gaps in knowledge; and developing a research agenda to inform future investigative efforts. The conference also promoted networking among developing researchers, leaders in the field of SCR and aging, and National Institutes of Health program personnel.
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Affiliation(s)
- Constance H Fung
- Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Michael V Vitiello
- Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Cathy A Alessi
- Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - George A Kuchel
- Center on Aging, University of Connecticut Health Center, Farmington, Connecticut
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41
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Aurora RN, Kim JS, Crainiceanu C, O'Hearn D, Punjabi NM. Habitual Sleep Duration and All-Cause Mortality in a General Community Sample. Sleep 2016; 39:1903-1909. [PMID: 27450684 DOI: 10.5665/sleep.6212] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 06/27/2016] [Indexed: 12/11/2022] Open
Abstract
STUDY OBJECTIVES The current study sought to determine whether sleep duration and change in sleep duration are associated with all-cause mortality in a community sample of middle-aged and older adults while accounting for several confounding factors including prevalent sleep-disordered breathing (SDB). METHODS Habitual sleep duration was assessed using self-report (< 7, 7-8, ≥ 9 h/night) at the baseline and at the follow-up visits of the Sleep Heart Health Study. Techniques of survival analysis were used to relate habitual sleep duration and change in sleep duration to all-cause mortality after adjusting for covariates such as age, sex, race, body mass index, smoking history, prevalent hypertension, diabetes, cardiovascular disease, antidepressant medication use, and SDB severity. RESULTS Compared to a sleep duration of 7-8 h/night, habitually long sleep duration (≥ 9 h/night), but not short sleep duration (< 7 h/night), was associated with all-cause mortality with an adjusted hazards ratio of 1.25 (95% confidence interval [CI]: 1.05, 1.47). Participants who progressed from short or normal sleep duration to long sleep duration had increased risk for all-cause mortality with adjusted hazard ratios of 1.75 (95% CI: 1.08, 2.78) and 1.63 (95% CI: 1.26, 2.13), respectively. Finally, a change from long to short sleep duration was also associated with all-cause mortality. CONCLUSION Long sleep duration or a shift from long to short sleep duration are independently associated with all-cause mortality.
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Affiliation(s)
- R Nisha Aurora
- Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - Ji Soo Kim
- Department of Biostatistics, Johns Hopkins University, Baltimore, MD
| | | | - Daniel O'Hearn
- Department of Medicine, Oregon Health Sciences University, Portland, Oregon
| | - Naresh M Punjabi
- Department of Medicine, Johns Hopkins University, Baltimore, MD.,Department of Epidemiology, Johns Hopkins University, Baltimore, MD
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42
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Horváth A, Montana X, Lanquart JP, Hubain P, Szűcs A, Linkowski P, Loas G. Effects of state and trait anxiety on sleep structure: A polysomnographic study in 1083 subjects. Psychiatry Res 2016; 244:279-83. [PMID: 27512915 DOI: 10.1016/j.psychres.2016.03.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 12/30/2015] [Accepted: 03/01/2016] [Indexed: 10/21/2022]
Abstract
Anxiety affects millions of people and has been shown to co-occur in combination with sleep disturbances, generating heavy medical costs and a huge socio-medico-economic burden. Sleep-studies in anxiety disorders are inconsistent and the effects of state and trait anxiety are unexplored. We selected 1083 patients from the database of a hospital sleep laboratory. The patients had polysomnography for different sleep disorders; their sleep initiation (sleep onset latency), sleep maintenance (total sleep time), non-rapid eye movement sleep-, and rapid eye movement sleep parameters; as well as their State-Trait Anxiety Inventory and Beck depression scale were measured. In order to be included in our study, individuals needed to score in the low or high range on the State and/or Trait Subscales of the State-Trait Anxiety Inventory. We found that both state and trait anxiety affected non-rapid eye movement sleep parameters. Sleep onset latency changes predominantly associated to state anxiety while rapid eye movement parameters related to trait anxiety.
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Affiliation(s)
- András Horváth
- Sleep Laboratory, Department of Psychiatry, Erasme Academic Hospital & Laboratory of Psychiatric Research (ULB 266) Université Libre de Bruxelles, 808 Route de Lennik, B-1070 Brussels, Belgium; Department of Neurology, National Institute of Clinical Neurosciences, 57 Amerikai út, 1145 Budapest, Hungary; Semmelweis University School of PhD Studies, János Szentágothai Doctoral School of Neurosciences, 26 Üllői út, 1085 Budapest, Hungary.
| | - Xavier Montana
- Sleep Laboratory, Department of Psychiatry, Erasme Academic Hospital & Laboratory of Psychiatric Research (ULB 266) Université Libre de Bruxelles, 808 Route de Lennik, B-1070 Brussels, Belgium
| | - Jean-Pol Lanquart
- Sleep Laboratory, Department of Psychiatry, Erasme Academic Hospital & Laboratory of Psychiatric Research (ULB 266) Université Libre de Bruxelles, 808 Route de Lennik, B-1070 Brussels, Belgium
| | - Philippe Hubain
- Sleep Laboratory, Department of Psychiatry, Erasme Academic Hospital & Laboratory of Psychiatric Research (ULB 266) Université Libre de Bruxelles, 808 Route de Lennik, B-1070 Brussels, Belgium
| | - Anna Szűcs
- Department of Neurology, National Institute of Clinical Neurosciences, 57 Amerikai út, 1145 Budapest, Hungary
| | - Paul Linkowski
- Sleep Laboratory, Department of Psychiatry, Erasme Academic Hospital & Laboratory of Psychiatric Research (ULB 266) Université Libre de Bruxelles, 808 Route de Lennik, B-1070 Brussels, Belgium
| | - Gwenolé Loas
- Sleep Laboratory, Department of Psychiatry, Erasme Academic Hospital & Laboratory of Psychiatric Research (ULB 266) Université Libre de Bruxelles, 808 Route de Lennik, B-1070 Brussels, Belgium
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Abstract
Sleeping pills, more formally defined as hypnotics, are sedatives used to induce and maintain sleep. In a review of publications for the past 30 years, descriptive epidemiologic studies were identified that examined the mortality risk of hypnotics and related sedative-anxiolytics. Of the 34 studies estimating risk ratios, odds ratios, or hazard ratios, excess mortality associated with hypnotics was significant (p < 0.05) in 24 studies including all 14 of the largest, contrasted with no studies at all suggesting that hypnotics ever prolong life. The studies had many limitations: possibly tending to overestimate risk, such as possible confounding by indication with other risk factors; confusing hypnotics with drugs having other indications; possible genetic confounders; and too much heterogeneity of studies for meta-analyses. There were balancing limitations possibly tending towards underestimates of risk such as limited power, excessive follow-up intervals with possible follow-up mixing of participants taking hypnotics with controls, missing dosage data for most studies, and over-adjustment of confounders. Epidemiologic association in itself is not adequate proof of causality, but there is proof that hypnotics cause death in overdoses; there is thorough understanding of how hypnotics euthanize animals and execute humans; and there is proof that hypnotics cause potentially lethal morbidities such as depression, infection, poor driving, suppressed respiration, and possibly cancer. Combining these proofs with consistent evidence of association, the great weight of evidence is that hypnotics cause huge risks of decreasing a patient's duration of survival.
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Affiliation(s)
- Daniel F Kripke
- UCSD, 8437 Sugarman Drive, La Jolla, CA, 92037-2226, USA. .,Scripps Clinic Viterbi Family Sleep Center, La Jolla, USA.
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Parsaik AK, Mascarenhas SS, Khosh-Chashm D, Hashmi A, John V, Okusaga O, Singh B. Mortality associated with anxiolytic and hypnotic drugs-A systematic review and meta-analysis. Aust N Z J Psychiatry 2016; 50:520-33. [PMID: 26590022 DOI: 10.1177/0004867415616695] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Use of hypnotics or anxiolytic drugs is common and various studies have reported increased mortality with hypnotics or anxiolytic use. OBJECTIVE To consolidate the evidence on mortality risk associated with hypnotics or anxiolytic use METHODS Major databases were searched through April 2014 for studies reporting mortality risk associated with hypnotics or anxiolytics use. A pooled hazard ratio with 95% confidence interval was estimated using random-effects model. RESULTS After screening 2188 articles, 25 studies (24 cohort, 1 case-control) enrolling 2,350,093 patients with 59% females (age 18-102 years) were included in the meta-analysis. Hypnotics or anxiolytic users had 43% higher risk of mortality than non-users (hazard ratio, 1.43; 95% confidence interval, [1.12, 1.84]). Eight studies reported risk estimates for each gender category and pooled results from these studies showed increased risk of mortality among men (hazard ratio = 1.60, 95% confidence interval = [1.29,1.99]) and women (hazard ratio = 1.68, 95% confidence interval = [1.38, 2.04]). Pooled results from 10 studies showed higher mortality among benzodiazepine users compared to non-users (hazard ratio = 1.60, 95% confidence interval = [1.03, 2.49]), while pooled results from five studies showed an increased risk of mortality with Z-drugs use although the effect could not reach statistical significance (hazard ratio = 1.73, 95% confidence interval = [0.95, 3.16]). Significant heterogeneity was observed in the analyses and the quality of included studies was good. CONCLUSION This meta-analysis suggests that hypnotics or anxiolytics drugs use is associated with increased mortality and hence should be used with caution. Future studies focused on underlying mechanism of increased mortality with hypnotics or anxiolytics use are required.
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Affiliation(s)
- Ajay K Parsaik
- Department of Psychiatry and Behavioral Sciences, The University of Texas Medical School at Houston, Houston, TX, USA
| | | | - Darrow Khosh-Chashm
- Department of Psychiatry and Behavioral Sciences, The University of Texas Medical School at Houston, Houston, TX, USA
| | | | - Vineeth John
- Department of Psychiatry and Behavioral Sciences, The University of Texas Medical School at Houston, Houston, TX, USA
| | - Olaoluwa Okusaga
- Department of Psychiatry and Behavioral Sciences, The University of Texas Medical School at Houston, Houston, TX, USA
| | - Balwinder Singh
- Department of Psychiatry and Behavioral Science, School of Medicine & Health Sciences, University of North Dakota, Fargo, ND, USA
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Nighttime sleep duration, 24-hour sleep duration and risk of all-cause mortality among adults: a meta-analysis of prospective cohort studies. Sci Rep 2016; 6:21480. [PMID: 26900147 PMCID: PMC4761879 DOI: 10.1038/srep21480] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 01/25/2016] [Indexed: 11/09/2022] Open
Abstract
A dose-response meta-analysis was conducted to summarize evidence from prospective cohort studies about the association of nighttime sleep duration and 24-hour sleep duration with risk of all-cause mortality among adults. Pertinent studies were identified by a search of Embase and PubMed databases to March 2015. A two-stage random-effects dose-response meta-analysis was used to combine study-specific relative risks and 95% confidence intervals [RRs (95% CIs)]. Thirty-five articles were included. Compared with 7 hours/day, the RRs (95% CIs) of all-cause mortality were 1.07 (1.03-1.13), 1.04 (1.01-1.07), 1.01 (1.00-1.02), 1.07 (1.06-1.09), 1.21 (1.18-1.24), 1.37 (1.32-1.42) and 1.55 (1.47-1.63) for 4, 5, 6, 8, 9, 10 and 11 hours/day of nighttime sleep, respectively (146,830 death cases among 1,526,609 participants), and the risks were 1.09 (1.04-1.14), 1.05 (1.02-1.09), 1.02 (1.00-1.03), 1.08 (1.05-1.10), 1.27 (1.20-1.36), 1.53 (1.38-1.70) and 1.84 (1.59-2.13) for 4, 5, 6, 8, 9, 10 and 11 hours/day of 24-hour sleep, respectively (101,641 death cases among 903,727 participants). The above relationships were also found in subjects without cardiovascular diseases and cancer at baseline, and other covariates did not influence the relationships substantially. The results suggested that 7 hours/day of sleep duration should be recommended to prevent premature death among adults.
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46
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Hossin MZ. From habitual sleep hours to morbidity and mortality: existing evidence, potential mechanisms, and future agenda. Sleep Health 2016; 2:146-153. [PMID: 28923258 DOI: 10.1016/j.sleh.2016.01.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 01/23/2016] [Accepted: 01/26/2016] [Indexed: 11/16/2022]
Abstract
Epidemiological studies consistently show a strong U-shaped association between sleep duration and health outcomes. That is, both short and long sleepers are exposed to greater risks of death and diseases than normal length sleepers. Moreover, long sleep is often demonstrated as a stronger predictor of mortality than short sleep. While there is some experimental evidence in favor of a causal connection between short sleep and health, no such evidence exists to explain why excessive sleep might be associated with poor health. One possible explanation is that long duration sleep, instead of being a real cause of illness, is merely a marker of poor sleep quality or some unmeasured risk factor that confounds the association of long habitual sleep with mortality and other health outcomes. As for short sleep, the effect is said to be mediated via the hormones that alters glucose metabolism and appetite regulation as well as via an overactivity of the stress systems that causes increased heart rate and blood pressure. The mechanisms, however, are still poorly understood and future investigations should take into account sleep quality, objective and longitudinal sleep measures, more confounding biases, and the broad social context that influences the length and quality of sleep.
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47
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Tareque MI, Ikeda N, Koshio A, Hasegawa T. Is adjustment for reporting heterogeneity necessary in sleep disorders? Results from the Japanese World Health Survey. BMC Psychiatry 2016; 16:25. [PMID: 26852225 PMCID: PMC4744451 DOI: 10.1186/s12888-016-0733-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 02/02/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anchoring vignettes are brief texts describing a hypothetical character who illustrates a certain fixed level of a trait under evaluation. This research uses vignettes to elucidate factors associated with sleep disorders in adult Japanese before and after adjustment for reporting heterogeneity in self-reports. This study also evaluates the need for adjusting for reporting heterogeneity in the management of sleep and energy related problems in Japan. METHODS We investigated a dataset of 1002 respondents aged 18 years and over from the Japanese World Health Survey, which collected information through face-to-face interview from 2002 to 2003. The ordered probit model and the Compound Hierarchical Ordered Probit (CHOPIT) model, which incorporated anchoring vignettes, were employed to estimate and compare associations of sleep and energy with socio-demographic and life-style factors before and after adjustment for differences in response category cut-points for each individual. RESULTS The prevalence of self-reported problems with sleep and energy was 53 %. Without correction of cut-point shifts, age, sex, and the number of comorbidities were significantly associated with a greater severity of sleep-related problems. After correction, age, the number of comorbidities, and regular exercise were significantly associated with a greater severity of sleep-related problems; sex was no longer a significant factor. Compared to the ordered probit model, the CHOPIT model provided two changes with a subtle difference in the magnitude of regression coefficients after correction for reporting heterogeneity. CONCLUSION Sleep disorders are common in the general adult population of Japan. Correction for reporting heterogeneity using anchoring vignettes is not a necessary tool for proper management of sleep and energy related problems among Japanese adults. Older age, gender differences in communicating sleep-related problems, the presence of multiple morbidities, and regular exercise should be the focus of policies and clinical practice to improve sleep and energy management in Japan.
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Affiliation(s)
- Md. Ismail Tareque
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Nayu Ikeda
- Center for International Collaboration and Partnership, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.
| | | | - Toshihiko Hasegawa
- Department of Health Policy and Management, Nippon Medical School, Tokyo, Japan.
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Effect of leisure-time aerobic exercise and muscle strength activity on sleep duration: results from the 2012 National Health Interview Survey. J Public Health (Oxf) 2015. [DOI: 10.1007/s10389-015-0705-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Lan TY, Zeng YF, Tang GJ, Kao HC, Chiu HJ, Lan TH, Ho HF. The Use of Hypnotics and Mortality--A Population-Based Retrospective Cohort Study. PLoS One 2015; 10:e0145271. [PMID: 26709926 PMCID: PMC4692546 DOI: 10.1371/journal.pone.0145271] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 12/02/2015] [Indexed: 12/03/2022] Open
Abstract
Background Sleep disorders, especially chronic insomnia, have become major health problem worldwide and, as a result, the use of hypnotics is steadily increasing. However, few studies with a large sample size and long-term observation have been conducted to investigate the relationship between specific hypnotics and mortality. Methods We conducted this retrospective cohort study using data from the National Health Insurance Research Database in Taiwan. Information from claims data including basic characteristics, the use of hypnotics, and survival from 2000 to 2009 for 1,320,322 individuals were included. The use of hypnotics was divided into groups using the defined daily dose and the cumulative length of use. Hazard ratios (HRs) were calculated from a Cox proportional hazards model, with two different matching techniques to examine the associations. Results Compared to the non-users, both users of benzodiazepines (HR = 1.81; 95% confidence interval [CI] = 1.78–1.85) and mixed users (HR = 1.44; 95% CI = 1.42–1.47) had a higher risk of death, whereas the users of other non-benzodiazepines users showed no differences. Zolpidem users (HR = 0.73; 95% CI = 0.71–0.75) exhibited a lower risk of mortality in the adjusted models. This pattern remained similar in both matching techniques. Secondary analysis indicated that zolpidem users had a reduced risk of major cause-specific mortality except cancer, and that this protective effect was dose-responsive, with those using for more than 1 year having the lowest risk. Conclusions The effects of different types of hypnotics on mortality were diverse in this large cohort with long-term follow-up based on representative claims data in Taiwan. The use of zolpidem was associated with a reduced risk of mortality.
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Affiliation(s)
- Tzuo-Yun Lan
- Institute of Hospital & Health Care Administration, National Yang-Ming University, Taipei, Taiwan
- * E-mail:
| | - Ya-Fang Zeng
- Institute of Hospital & Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Gau-Jun Tang
- Institute of Hospital & Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Hui-Chuan Kao
- Department of Public Health, Tzu Chi University, Hualien, Taiwan
| | | | - Tsuo-Hung Lan
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Hsiao-Feng Ho
- National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan
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Araujo PABD, Sties SW, Wittkopf PG, Netto AS, Gonzáles AI, Lima DP, Guimarães SN, Aranha EE, Andrade A, Carvalho TD. ÍNDICE DA QUALIDADE DO SONO DE PITTSBURGH PARA USO NA REABILITAÇÃO CARDIOPULMONAR E METABÓLICA. REV BRAS MED ESPORTE 2015. [DOI: 10.1590/1517-869220152106147561] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introdução A qualidade do sono constitui-se em parâmetro relevante na avaliação da saúde em geral, sendo um fator relevante na determinação do risco das doenças cardiovasculares. Objetivo Validar a versão adaptada do questionário de avaliação do Índice de Qualidade do Sono de Pittsburgh (PSQI) para uso em programas de reabilitação cardiopulmonar e metabólica (RCPM). Métodos Estudo descritivo transversal realizado com 101 pacientes de ambos os sexos, com média de idade de 66,05 (± 13,9) anos. Para a análise estatística foi considerado intervalo de confiança de 95% e valor de significância p <0,05; para a análise de consistência interna foi utilizado o coeficiente de alfa de Cronbach e para a análise da relação entre componentes e itens com o escore total do questionário foi utilizado o coeficiente de correlação de Spearman. Resultados Todos os componentes do questionário apresentaram boa consistência interna com valor de 0,72. Os componentes que mais se relacionaram com o escore total foram "duração do sono" e "qualidade subjetiva do sono", sendo que o componente que menos se relacionou foi "alterações do sono". Dentre os itens a variação foi de 0,584 no item "durante a última semana, em geral, como você classificaria a qualidade do seu sono?", até -0,611 no item "durante a última semana, quantas horas você conseguia dormir durante a noite?". Foi possível observar que os itens "tossir ou roncar muito alto" e "frequência para dificuldades do sono por outras razões" não apresentaram correlação com o escore total do questionário. Conclusão A versão adaptada do PSQI mostrou-se válida para ser utilizada na avaliação do sono em programas de RCPM.
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