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Strandberg TE, Pitkälä KH, Kivimäki M. Sleep duration in midlife and old age and risk of mortality over a 48-year follow-up: The Helsinki businessmen study (HBS) cohort. Maturitas 2024; 184:107964. [PMID: 38471293 DOI: 10.1016/j.maturitas.2024.107964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/19/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVES Both short and long sleep duration have been associated with increased mortality, but there are few truly long-term studies. STUDY DESIGN This is a cohort study of 2504 men born between 1919 and 1934. In 1974-1975 (mean age 48), participants underwent baseline clinical examinations and sleep duration assessments. A follow-up examination took place 35 years later, in 2010 (mean age 82). MAIN OUTCOME MEASURE All-cause mortality data from baseline and from old age were collected through to December 31, 2022. RESULTS At baseline, short sleep duration (≤6 h per night), normal sleep duration (>6 and ≤ 8 h), and long sleep duration (>8 h) was reported by 266, 2019 and 219 men, respectively. Men with short sleep duration had higher levels of smoking, alcohol consumption, body mass index, and poorer self-rated health than those with normal sleep duration. During the 48-year follow-up, 2287 men died. The unadjusted hazard ratio for mortality was 1.20 (95 % confidence interval [CI] 1.05-1.37) for short compared with normal sleep duration, but this association vanished after adjustments (1.01, 95 % CI 0.87-1.17). In old age, the corresponding hazard ratios were 1.41 (1.16-1.72) and 1.19 (0.94-1.51) for short sleep duration and 1.33 (1.09-1.63) and 1.31 (1.02-1.67) for long sleep duration. CONCLUSIONS In a comprehensive lifespan follow-up, the modestly increased mortality among men with short sleep duration in midlife was attributed to unhealthy lifestyle factors. In old age both long and short sleep duration seemed to be associated with modestly increased mortality. CLINICALTRIALS gov identifier for the HBS: NCT02526082.
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Affiliation(s)
- Timo E Strandberg
- University of Helsinki and Helsinki University Hospital, PO Box 340, 00029 Helsinki, Finland.
| | - Kaisu H Pitkälä
- University of Helsinki and Helsinki University Hospital, PO Box 340, 00029 Helsinki, Finland.
| | - Mika Kivimäki
- University of Helsinki and Helsinki University Hospital, PO Box 340, 00029 Helsinki, Finland; UCL Brain Sciences, University College London, London, UK.
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2
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Jaspan VN, Greenberg GS, Parihar S, Park CM, Somers VK, Shapiro MD, Lavie CJ, Virani SS, Slipczuk L. The Role of Sleep in Cardiovascular Disease. Curr Atheroscler Rep 2024:10.1007/s11883-024-01207-5. [PMID: 38795275 DOI: 10.1007/s11883-024-01207-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2024] [Indexed: 05/27/2024]
Abstract
PURPOSE OF REVIEW Sleep is an important component of cardiovascular (CV) health. This review summarizes the complex relationship between sleep and CV disease (CVD). Additionally, we describe the data supporting the treatment of sleep disturbances in preventing and treating CVD. RECENT FINDINGS Recent guidelines recommend screening for obstructive sleep apnea in patients with atrial fibrillation. New data continues to demonstrate the importance of sleep quality and duration for CV health. There is a complex bidirectional relationship between sleep health and CVD. Sleep disturbances have systemic effects that contribute to the development of CVD, including hypertension, coronary artery disease, heart failure, and arrhythmias. Additionally, CVD contributes to the development of sleep disturbances. However, more data are needed to support the role of screening for and treatment of sleep disorders for the prevention of CVD.
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Affiliation(s)
- Vita N Jaspan
- Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Garred S Greenberg
- Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Siddhant Parihar
- Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Christine M Park
- Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Virend K Somers
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Michael D Shapiro
- Center for Preventive Cardiology, Section On Cardiovascular Medicine, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA
| | - Carl J Lavie
- Ochsner Clinical School, John Ochsner Heart and Vascular Institute, The University of Queensland School of Medicine, New Orleans, LA, USA
| | - Salim S Virani
- Office of the Vice Provost (Research), The Aga Khan University, Karachi, Pakistan
- Division of Cardiology, The Texas Heart Institute/Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX, USA
| | - Leandro Slipczuk
- Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, USA.
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3
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Eshera YM, Gavrilova L, Hughes JW. Sleep is Essential for Cardiovascular Health: An Analytic Review of the Relationship Between Sleep and Cardiovascular Mortality. Am J Lifestyle Med 2024; 18:340-350. [PMID: 38737888 PMCID: PMC11082862 DOI: 10.1177/15598276231211846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
The American Heart Association recently included sleep health as one of eight factors that define cardiovascular health. Restorative sleep is a pillar of lifestyle medicine influenced by sleep duration, quality, and disorders. Short and long sleep duration are associated with greater risk of cardiovascular disease. Short sleep appears causally related to cardiovascular risk. Long sleep is more strongly predictive of cardiovascular risk, which may be due to comorbidities and other risk factors. Good-quality sleep appears to protect against the increased risk and is independently associated with risk of cardiovascular disease (CVD). Insomnia, particularly difficulty falling asleep and non-restorative sleep, is associated with an increase in cardiac events. Obstructive sleep apnea (OSA) is associated with cardiac risk and outcomes, which is typically observed in the context of contributing comorbidities. However, treating OSA with continuous positive airway pressure (CPAP) may not improve prognosis. Further research is needed to understand the causal mechanisms connecting sleep health with CVD and whether modifying sleep can improve outcomes. Sleep health should be considered as part of a holistic approach to improving cardiovascular health, as reflected in the scoring of LE8 and as one of the interrelated components of lifestyle medicine.
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Affiliation(s)
- Yasmine M. Eshera
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Lyubov Gavrilova
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Joel W. Hughes
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
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4
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Wu L, Chen R, Zhang Y, Pan H, Wang Y, Wang X. Sleep duration and mortality in patients with chronic noncommunicable disease: a population-based cohort study. Environ Health Prev Med 2024; 29:9. [PMID: 38417886 PMCID: PMC10937247 DOI: 10.1265/ehpm.23-00249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/31/2024] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Inadequate sleep behaviors may confer a higher risk of premature death, however, evidence in patients with chronic noncommunicable disease (NCD) is scarce. To investigate the relationship between sleep duration and mortality from all-cause and heart diseases in NCD patients from a prospective cohort. METHODS Totally, 14,171 participants with at least one NCD, including 8275 with hypertension, 7547 with high cholesterol, 4065 with diabetes, and 5815 with chronic renal failure were enrolled from the National Health and Nutrition Examination Survey during 2005-2014. Cox proportional hazard models were performed to estimate the hazard ratio (HR) for sleep duration and mortality after adjusting for potential confounding factors. RESULTS After a median follow-up of 9 years, 2514 all-cause deaths were identified. Compared with sleeping 7-8 h/day, sleeping over 8 h/day was significantly associated with a higher risk of all-cause mortality, where the multivariable-HRs were 1.29 (1.11, 1.50) for hypertension, 1.23 (1.01, 1.51) for high cholesterol, 1.44 (1.13, 1.82) for diabetes, and 1.36 (1.10, 1.68) for chronic renal failure. Similar patterns were observed for heart disease mortality. A nonlinear association was detected between sleep duration and mortality in patients with NCD. Age modified the association in patients with hypertension (P-interaction: 0.036). Trouble sleeping modified the association in patients with diabetes (P-interaction: 0.042). CONCLUSIONS Long sleep duration was associated with higher risks of all-cause and heart disease mortality in patients with chronic NCD. Our findings highlight that improving sleep behaviors may decrease the risk of premature deaths and help to NCD tertiary prevention.
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Affiliation(s)
- Lin Wu
- School of Medicine, Jinhua Polytechnic College, Jinhua 321017, China
| | - Ruyi Chen
- School of Medicine, Jinhua Polytechnic College, Jinhua 321017, China
| | - Yuqin Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Huiying Pan
- School of Medicine, Jinhua Polytechnic College, Jinhua 321017, China
| | - Ying Wang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiaowen Wang
- Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing 100191, China
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5
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Berjaoui C, Tesfasilassie Kibrom B, Ghayyad M, Joumaa S, Talal Al Labban N, Nazir A, Kachouh C, Akanmu Moradeyo A, Wojtara M, Uwishema O. Unveiling the sleep-cardiovascular connection: Novel perspectives and interventions-A narrative review. Health Sci Rep 2023; 6:e1773. [PMID: 38107151 PMCID: PMC10723785 DOI: 10.1002/hsr2.1773] [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: 08/27/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Sleep is an important neurophysiological condition that is intricately linked to general health, laying the basis for both physiological and psychological well-being. A thorough examination of sleep disorders and cardiovascular health demonstrates their deep relationship, emphasizing the numerous diagnostic tools and treatment techniques available. Aim This study aims to examine the impact, mechanisms, diagnostic techniques, treatment strategies, implications, and healthcare interventions of the sleep-cardiovascular connection, to better understand the relationship between sleep disorders and cardiovascular health. Methods The paper reviews key studies conducted from 2015-till date, investigating the impact of sleep disorders on the cardiovascular system. It looked into data relating to cardiovascular outcomes based on the degree of sleep disorders, considered potential confounding factors, and addressed current research constraints. Results The findings highlight a strong link between sleep problems and poor cardiovascular outcomes. Emerging diagnostic tools, such as enhanced sleep-related technology and biomarkers, open up new avenues for determining the impact of sleep disturbances on cardiovascular health. In addition, the research discusses several treatment options, ranging from cognitive behavioral therapy to pharmaceutical therapies, and their potential benefits in addressing sleep-related cardiovascular risks. Conclusion The complex association between sleep disturbances and cardiovascular health emphasizes the need to recognize sleep as a critical component of overall well-being. Thus collaboration among medical disciplines, as well as individualized therapies, are critical to improving patient care. Moreover, Understanding and managing the consequences of sleep problems on cardiovascular health can lead to more effective interventions, better outcomes, and improved public health as research advances.
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Affiliation(s)
- Christin Berjaoui
- Department of MedicineOli Health Magazine Organization, Research, and EducationKigaliRwanda
- Department of Medicine, Faculty of MedicineBeirut Arab UniversityBeirutLebanon
| | - Bethlehem Tesfasilassie Kibrom
- Department of MedicineOli Health Magazine Organization, Research, and EducationKigaliRwanda
- Department of Medicine, College of Health SciencesAddis Ababa UniversityAddis AbabaEthiopia
| | - Mohammad Ghayyad
- Department of MedicineOli Health Magazine Organization, Research, and EducationKigaliRwanda
- Department of Medicine, Faculty of MedicineBeirut Arab UniversityBeirutLebanon
| | - Safaa Joumaa
- Department of MedicineOli Health Magazine Organization, Research, and EducationKigaliRwanda
- Department of Medicine, Faculty of Medical ScienceLebanese UniversityBeirutLebanon
| | - Nihal Talal Al Labban
- Department of MedicineOli Health Magazine Organization, Research, and EducationKigaliRwanda
- Department of Medicine, Faculty of MedicineBeirut Arab UniversityBeirutLebanon
| | - Abubakar Nazir
- Department of MedicineOli Health Magazine Organization, Research, and EducationKigaliRwanda
- Department of MedicineKing Edward Medical UniversityLahorePakistan
| | - Charbel Kachouh
- Department of MedicineOli Health Magazine Organization, Research, and EducationKigaliRwanda
- Department of MedicineSaint‐Joseph UniversityBeirutLebanon
| | - Abdulrahmon Akanmu Moradeyo
- Department of MedicineOli Health Magazine Organization, Research, and EducationKigaliRwanda
- Department of Medicine and SurgeryLadoke Akintola University of TechnologyOgbomoshoNigeria
| | - Magda Wojtara
- Department of MedicineOli Health Magazine Organization, Research, and EducationKigaliRwanda
| | - Olivier Uwishema
- Department of MedicineOli Health Magazine Organization, Research, and EducationKigaliRwanda
- Department of MedicineClinton Global Initiative UniversityNew YorkNew YorkUSA
- Department of MedicineKaradeniz Technical UniversityTrabzonTurkey
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6
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Tai BWS, Dawood T, Macefield VG, Yiallourou SR. The association between sleep duration and muscle sympathetic nerve activity. Clin Auton Res 2023; 33:647-657. [PMID: 37543558 PMCID: PMC10751264 DOI: 10.1007/s10286-023-00965-7] [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: 04/20/2023] [Accepted: 07/07/2023] [Indexed: 08/07/2023]
Abstract
PURPOSE Sleep duration is associated with risk of hypertension and cardiovascular diseases. It is thought that shorter sleep increases sympathetic activity. However, most studies are based on acute experimental sleep deprivation that have produced conflicting results. Furthermore, there are limited data available on habitual sleep duration and gold-standard measures of sympathetic activation. Hence, this study aimed to assess the association between habitual sleep duration and muscle sympathetic nerve activity. METHODS Twenty-four participants aged ≥ 18 years were included in the study. Sleep was assessed using at-home 7-day/night actigraphy (ActiGraph™ GT3X-BT) and sleep questionnaires (Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale). Microelectrode recordings of muscle sympathetic nerve activity were obtained from the common peroneal nerve. Participants were categorised into shorter or longer sleep duration groups using a median split of self-report and actigraphy sleep measures. RESULTS Compared to longer sleepers, shorter sleepers averaged 99 ± 40 min and 82 ± 40 min less sleep per night as assessed by self-report and objective measures, respectively. There were no differences in age (38 ± 18 vs 39 ± 21 years), sex (5 male, 7 female vs 6 male, 6 female), or body mass index (23 ± 3 vs 22 ± 3 kg/m2) between shorter and longer sleepers. Expressed as burst frequency, muscle sympathetic nerve activity was higher in shorter versus longer sleepers for both self-report (39.4 ± 12.9 vs 28.4 ± 8.5 bursts/min, p = 0.019) and objective (37.9 ± 12.4 vs 28.1 ± 8.8 bursts/min, p = 0.036) sleep duration. CONCLUSIONS Shorter sleep duration assessed in a home setting was associated with higher muscle sympathetic nerve activity. Sympathetic overactivity may underlie the association between short sleep and hypertension.
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Affiliation(s)
- Bryan W S Tai
- Human Autonomic Neurophysiology Lab, Baker Heart and Diabetes Institute, Melbourne, Australia
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
| | - Tye Dawood
- Human Autonomic Neurophysiology Lab, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Vaughan G Macefield
- Human Autonomic Neurophysiology Lab, Baker Heart and Diabetes Institute, Melbourne, Australia
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
| | - Stephanie R Yiallourou
- Human Autonomic Neurophysiology Lab, Baker Heart and Diabetes Institute, Melbourne, Australia.
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia.
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia.
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7
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Gökçe E, Arslan S, İşler A. Correlation of plasma metabolites and comorbid illnesses with poor sleep quality in patients with coronary heart disease. Sleep Breath 2023; 27:2249-2255. [PMID: 37103681 DOI: 10.1007/s11325-023-02835-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 04/08/2023] [Accepted: 04/14/2023] [Indexed: 04/28/2023]
Abstract
PURPOSE This study aimed to examine the relationship between plasma metabolites (biochemical parameters) and comorbid illnesses with sleep quality in individuals with coronary heart disease (CHD). METHODS This descriptive cross-sectional study was conducted between 2020 and 2021 at a university hospital. Hospitalized patients with a diagnosis of CHD were analyzed. The Personal Information Form' and Pittsburgh Sleep Quality Index (PSQI) were used to collect data. Laboratory findings including plasma metabolites were examined. RESULTS Of 60 hospitalized patients with CHD, 50 (83%) had poor sleep quality. A positive and statistically significant correlation was found between the plasma metabolite blood urea nitrogen and poor sleep quality (r = 0.399; p = 0.002). The presence of CHD and additional chronic diseases (especially diabetes mellitus, hypertension, and chronic kidney disease) are important parameters associated with the risk of poor sleep quality (p = 0.040 < 0.05). CONCLUSION Increases in blood urea nitrogen level in individuals with CHD are associated with worse sleep quality. Additional chronic diseases coexisting with CHD correlate with increased risk of poor sleep quality.
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Affiliation(s)
- Esma Gökçe
- Department of Vocational School of Health Services, Toros University, Mersin, Turkey.
| | - Sevban Arslan
- Department of Nurses, Faculty of Health Science, Çukurova University, Adana, Turkey
| | - Arzu İşler
- Department of Cardiology, Çukurova University, Adana, Turkey
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8
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Cheraghian B, Heybar H, Saki N, Raeisizadeh M, Hashemi SJ, Bitaraf S. Sleep duration and Framingham´s cardiovascular risk score: results from the Hoveyzeh Cohort Study (HCS). BMC Cardiovasc Disord 2023; 23:570. [PMID: 37986150 PMCID: PMC10662158 DOI: 10.1186/s12872-023-03611-2] [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: 01/09/2023] [Accepted: 11/13/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs) are the leading causes of global deaths. So, it is necessary to know the possible risk factors for each region. We aimed to assess the relationship between the risk of CVDs and sleep duration in the Iranian Arab population. METHODS In this cross-sectional study, data from 8362 participants aged between 35 and 70 from the Hoveyzeh Cohort Study enrollment phase between 2016 and 2018 was analyzed. This study evaluated the association between ten-year CVD risk using the Framingham risk score and sleep duration. Self-reported sleep duration was categorized as short duration (equal to or less than 5 h), standard duration (6-8 h), or prolonged duration (equal to or greater than 9 h). Multivariable logistic regression to adjust for conventional CVD risks was used. RESULTS Among the assessed participants, 4892 (58.50%) were female, and the mean age was 47.93 (9.01). The average sleep duration was 7.59 (1.56) hours. The low, intermediate-to-high, and high CVD risk individuals were 6461 (77.27%), 1185 (14.17%), and 716 (8.56%), respectively. There was a significant relationship between prolonged sleep duration and lower odds of intermediate-to-high CVD risk in males (OR 0.66, 95% CI: 0.49-0.87, P-value: 0.004). CONCLUSION The results of our study showed that longer sleep duration has a protective association with the intermediate to high risk of cardiovascular diseases in males. However, long and short sleep durations have no significant relationship with females' risk of cardiovascular disease.
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Affiliation(s)
- Bahman Cheraghian
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Habib Heybar
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nader Saki
- Hearing Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maedeh Raeisizadeh
- Department of Biostatistics and Epidemiology, School of Public Health, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Jalal Hashemi
- Department of Internal Medicine, School of Medicine, Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeid Bitaraf
- Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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9
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Kanki M, Nath AP, Xiang R, Yiallourou S, Fuller PJ, Cole TJ, Cánovas R, Young MJ. Poor sleep and shift work associate with increased blood pressure and inflammation in UK Biobank participants. Nat Commun 2023; 14:7096. [PMID: 37925459 PMCID: PMC10625529 DOI: 10.1038/s41467-023-42758-6] [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: 12/16/2022] [Accepted: 10/19/2023] [Indexed: 11/06/2023] Open
Abstract
Disrupted circadian rhythms have been linked to an increased risk of hypertension and cardiovascular disease. However, many studies show inconsistent findings and are not sufficiently powered for targeted subgroup analyses. Using the UK Biobank cohort, we evaluate the association between circadian rhythm-disrupting behaviours, blood pressure (SBP, DBP) and inflammatory markers in >350,000 adults with European white British ancestry. The independent U-shaped relationship between sleep length and SBP/DBP is most prominent with a low inflammatory status. Poor sleep quality and permanent night shift work are also positively associated with SBP/DBP. Although fully adjusting for BMI in the linear regression model attenuated effect sizes, these associations remain significant. Two-sample Mendelian Randomisation (MR) analyses support a potential causal effect of long sleep, short sleep, chronotype, daytime napping and sleep duration on SBP/DBP. Thus, in the current study, we present a positive association between circadian rhythm-disrupting behaviours and SBP/DBP regulation in males and females that is largely independent of age.
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Affiliation(s)
- Monica Kanki
- Cardiovascular Endocrinology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Department of Medicine (Alfred Health), Central Clinical School, Monash University, Clayton, VIC, Australia
| | - Artika P Nath
- Cambridge-Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Ruidong Xiang
- Cambridge-Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Stephanie Yiallourou
- Turner Institute for Brain and Mental Health, Department of Central Clinical School, Monash University, Clayton, VIC, Australia
| | - Peter J Fuller
- Centre of Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, VIC, Australia
| | - Timothy J Cole
- Department of Biochemistry and Molecular Biology, Monash University, Clayton, VIC, Australia
| | - Rodrigo Cánovas
- Cambridge-Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Health and Biosecurity, Australian e-Health Research Centre, CSIRO, Melbourne, VIC, Australia
| | - Morag J Young
- Cardiovascular Endocrinology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
- Department of Cardiometabolic Health, University of Melbourne, Melbourne, VIC, Australia.
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10
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Pan Y, Zhou Y, Shi X, He S, Lai W. The association between sleep deprivation and the risk of cardiovascular diseases: A systematic meta‑analysis. Biomed Rep 2023; 19:78. [PMID: 37829258 PMCID: PMC10565718 DOI: 10.3892/br.2023.1660] [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: 06/17/2023] [Accepted: 08/04/2023] [Indexed: 10/14/2023] Open
Abstract
Globally, sleep deprivation is a concerning health issue associated with an increased risk of cardiovascular diseases (CVDs). The present study aimed to explore the association between short-term sleep and the risk of CVDs, taking into consideration sex and age groups. A comprehensive review was conducted by assembling cohort studies that are available in the PubMed, Cochrane Library, and Embase databases. Individuals with ≤5 or ≤6 h of sleep per day were considered as sleep-deprived subjects. To minimize potential bias, two reviewers thoroughly evaluated the selected articles. Relevant data were extracted, and pooled odds ratios (ORs) or relative risks (RRs) were calculated using a random-effects model. In total, 18 cohort studies involving adult subjects were included in the present analysis. The pooled results strongly indicated that sleep deprivation was associated with a greater risk of CVDs [RR: 1.09, 95% confidence interval (CI): 1.02-1.16, P=0.009]. However, when the pooled analysis was stratified by sex and age, the following results were observed: short-term sleep women (RR: 1.06, 95% CI: 0.96-1.17, P=0.27), short-term sleep men (RR: 1.07, 95% CI: 0.97-1.17, P=0.17); ≥18 years-old sleep-deprived population (RR: 1.09, 95% CI: 1.00-1.17, P=0.04), ≥40 years-old sleep-deprived population (RR: 1.09, 95% CI: 0.98-1.22, P=0.11), and subjects with co-existing diseases, such as diabetes and hyperlipidemia (RR: 1.06, 95% CI: 0.94-1.20, P=0.32). In conclusion, short-term sleep is associated with the increased risk of CVDs. Among subjects who were aged ≥18 years-old, there was a strong association with the development of CVDs compared with those who were aged ≥40 years-old. Furthermore, men were at a higher risk of CVDs than women. Adequate sleep (7-8 h per day) may play a role in improving cardiac health. The results of the present study may provide valuable support for further research in public health, highlighting the correlation between sleep deprivation and the risk of CVDs.
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Affiliation(s)
- Yuan Pan
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510260, P.R. China
| | - Yantao Zhou
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510260, P.R. China
| | - Xianghua Shi
- Department of Urology, The First People's Hospital of Foshan, Foshan, Guangdong 528010, P.R. China
| | - Suifen He
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510260, P.R. China
| | - Weibo Lai
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510260, P.R. China
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11
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Liang YY, Ai S, Xue H, Chen Y, Zhou J, Shu X, Weng F, Zhou M, Ma H, Zhang J, Geng Q, Wing YK. Joint Associations of Device-Measured Sleep Duration and Efficiency With All-Cause and Cause-Specific Mortality: A Prospective Cohort Study of 90 398 UK Biobank Participants. J Gerontol A Biol Sci Med Sci 2023; 78:1717-1724. [PMID: 37186145 DOI: 10.1093/gerona/glad108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Both sleep duration and efficiency are essential for health outcomes. However, few studies have considered the effects of both sleep duration and efficiency on predicting the risks of mortality. This study investigated the independent and joint associations of accelerometer-measured sleep duration and efficiency with all-cause and cause-specific mortality. METHODS The UK Biobank is a cohort study of over 500 000 individuals recruited between 2006 and 2010. This study included participants wearing wrist accelerometers for 7 consecutive days between February 2013 and December 2015. Mortality was ascertained by the national death registries. RESULTS Of the 90 398 participants (age, 62.4 [7.8] years, 43.5% male) who were included, 2 685 deaths were reported within a median follow-up duration of 6.4 years. Both accelerometer-measured short (adjusted hazard ratios, 1.27; 95% confidence interval [CI]: 1.11-1.45) and long sleep duration (adjusted hazard ratios, 1.16; 95% CI: 1.06-1.28) were positively associated with the risks of all-cause mortality. Lower sleep efficiency was associated with an increased risk of all-cause and cause-specific mortality. Significant interaction existed between accelerometer-measured sleep duration and efficiency for the risk of all-cause mortality (Pinteraction = .001), participants with long sleep duration and lower sleep efficiency had a double mortality risk compared with those with higher sleep efficiency and normal sleep duration (adjusted hazard ratios = 2.11; 95% CI: 1.44-3.09). CONCLUSIONS Accelerometer-measured short/long sleep duration and lower sleep efficiency were associated with increased risks of mortality. Sleep efficiency modified the effects of long sleep duration on survival.
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Affiliation(s)
- Yannis Yan Liang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Institute of Psycho-neuroscience, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Sizhi Ai
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Cardiology, Heart Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan, China
| | - Huachen Xue
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yilin Chen
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jiajin Zhou
- The Affiliated Hospital of Kunming University of Science and Technology, The First People's Hospital of Yunnan Province. Kunming, Yunnan, China
| | - Xinyue Shu
- School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Foqian Weng
- School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Mingqing Zhou
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Huan Ma
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Jihui Zhang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Qingshan Geng
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China
| | - Yun-Kwok Wing
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
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Cimmino G, Natale F, Alfieri R, Cante L, Covino S, Franzese R, Limatola M, Marotta L, Molinari R, Mollo N, Loffredo FS, Golino P. Non-Conventional Risk Factors: "Fact" or "Fake" in Cardiovascular Disease Prevention? Biomedicines 2023; 11:2353. [PMID: 37760794 PMCID: PMC10525401 DOI: 10.3390/biomedicines11092353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
Cardiovascular diseases (CVDs), such as arterial hypertension, myocardial infarction, stroke, heart failure, atrial fibrillation, etc., still represent the main cause of morbidity and mortality worldwide. They significantly modify the patients' quality of life with a tremendous economic impact. It is well established that cardiovascular risk factors increase the probability of fatal and non-fatal cardiac events. These risk factors are classified into modifiable (smoking, arterial hypertension, hypercholesterolemia, low HDL cholesterol, diabetes, excessive alcohol consumption, high-fat and high-calorie diet, reduced physical activity) and non-modifiable (sex, age, family history, of previous cardiovascular disease). Hence, CVD prevention is based on early identification and management of modifiable risk factors whose impact on the CV outcome is now performed by the use of CV risk assessment models, such as the Framingham Risk Score, Pooled Cohort Equations, or the SCORE2. However, in recent years, emerging, non-traditional factors (metabolic and non-metabolic) seem to significantly affect this assessment. In this article, we aim at defining these emerging factors and describe the potential mechanisms by which they might contribute to the development of CVD.
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Affiliation(s)
- Giovanni Cimmino
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, 80138 Naples, Italy
| | - Francesco Natale
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Roberta Alfieri
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Luigi Cante
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Simona Covino
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Rosa Franzese
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Mirella Limatola
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Luigi Marotta
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Riccardo Molinari
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Noemi Mollo
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Francesco S Loffredo
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Paolo Golino
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
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Li J, Wu Q, Fan L, Yan Z, Shen D, Zhang M. Nonlinear associations between sleep duration and the risks of all-cause and cardiovascular mortality among the general adult population: a long-term cohort study. Front Cardiovasc Med 2023; 10:1109225. [PMID: 37388641 PMCID: PMC10301724 DOI: 10.3389/fcvm.2023.1109225] [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: 11/27/2022] [Accepted: 06/05/2023] [Indexed: 07/01/2023] Open
Abstract
Objective This study aims to investigate the correlation between sleep duration and all-cause and cardiovascular mortality in the general population. Methods A total of 26,977 participants aged ≥18 years were included in the analysis from the National Health and Nutrition Examination Survey (NHANES) database covering the period from 2005 to 2014. Data on cardiovascular and all-cause deaths were collected until December 2019. Sleep duration was assessed using a structured questionnaire, and participants were categorized into five groups based on their reported sleep duration (≤5, 6, 7, 8, or ≥9 h). Kaplan-Meier survival curves were employed to examine the mortality rates across different sleep duration groups. Multivariate Cox regression models were utilized to explore the association between sleep duration and mortality. Additionally, a restricted cubic spline regression model was employed to identify the non-linear relationship between sleep duration and all-cause and cardiovascular mortality. Results The average age of participants was 46.23 ± 18.48 years, with 49.9% of the subjects being male. Over a median follow-up period of 9.42 years, 3,153 (11.7%) participants died from all-cause mortality, among which 819 (3.0%) were attributed to cardiovascular causes. The groups with sleep durations of ≥9 and ≤5 h exhibited the lowest cumulative survival rates for all-cause mortality and cardiovascular mortality, respectively. When using a sleep duration of 7 h as the reference, the hazard ratios (with 95% confidence intervals) for all-cause mortality were 1.28 (1.14-1.44) for ≤5 h, 1.10 (0.98-1.23) for 6 h, 1.21 (1.10-1.34) for 8 h, and 1.53 (1.35-1.73) for ≥9 h. The hazard ratios (with 95% confidence intervals) for cardiovascular mortality were 1.32 (1.04-1.67) for ≤5 h, 1.22 (0.97-1.53) for 6 h, 1.29 (1.05-1.59) for 8 h, and 1.74 (1.37-2.21) for ≥9 h. A U-shaped non-linear relationship between sleep duration and all-cause and cardiovascular mortality was observed, with inflection point thresholds at 7.32 and 7.04 h, respectively. Conclusion The findings suggest that the risk of all-cause and cardiovascular mortality is minimized when sleep duration is approximately 7 h.
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Affiliation(s)
- Jie Li
- Department of Echocardiography, ChangZhou No.2 People’s Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Qiyong Wu
- Cardio-Thoracic Surgery, ChangZhou No.2 People's Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Li Fan
- Department of Echocardiography, ChangZhou No.2 People’s Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Zining Yan
- Department of Echocardiography, ChangZhou No.2 People’s Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Dan Shen
- Department of Echocardiography, ChangZhou No.2 People’s Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Ming Zhang
- Cardio-Thoracic Surgery, ChangZhou No.2 People's Hospital Affiliated to Nanjing Medical University, Changzhou, China
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Jalali N, Khalili P, Jamali Z, Jalali Z, Moghadam-Ahmadi A, Vakilian A, Ayoobi F. Sleep duration, hypnotic drug use, and risk factors: cross- sectional study. Sci Rep 2023; 13:3459. [PMID: 36859460 PMCID: PMC9977908 DOI: 10.1038/s41598-023-30501-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 02/24/2023] [Indexed: 03/03/2023] Open
Abstract
Both short sleep duration (SSD) and long sleep duration (LSD) are associated with an increased risk of morbidity and mortality. Here, we aimed to assess the prevalence of sleep duration disturbances among adults in association with demographic, medication use, personal habits, and chronic diseases, while also considering the impact of hypnotic drug use. We performed a cross-sectional study of 9991 adult participants of the Rafsanjan Cohort Study (RCS), as part of the Prospective epidemiological research studies in Iran (PERSIAN). Multivariate logistic regression analyses were conducted to assess the association between short (< 6 h) and long (> 9 h) sleep duration with demographic and lifestyle parameters and common non-communicable diseases. Additionally, we performed stratified analysis to investigate the association of sleep duration with the abovementioned factors and diseases, in groups with and without hypnotic drug use. We found higher odds of SSD significantly associated with age (P < 0.001), BMI (P < 0.001), physical activity (P < 0.001), and depression (P = 0.023). LSD displayed a positive association with the female sex (P < 0.001), opium consumption (P < 0.001), and history of MI (P = 0.045), and a reverse connection with education (P = 0.007), physical activity (P < 0.001) and alcohol consumption (P = 0.027). Stratifying for the hypnotic drug use, our sensitivity analyses indicated that in hypnotic drug users, education (P = 0.034) and physical activity (P < 0.001) were associated with LSD, in this group, significantly increased odds ratio of LSD were associated with opium consumption (P = 0.046) and thyroid dysfunction (P = 0.037). Our findings demonstrated the demographic and lifestyle factors and diseases associated with long and short sleep duration in the population of the RCS. Additionally, after stratifying for hypnotic drug use, our results indicated that some diseases are only associated with abnormal sleep duration upon using hypnotic drugs.
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Affiliation(s)
- Nazanin Jalali
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Neurology Department, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Parvin Khalili
- Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Epidemiology, School of Public Health, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Zahra Jamali
- Clinical Research Development Unit (CRDU), Niknafs Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Zahra Jalali
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Clinical Biochemistry, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Amir Moghadam-Ahmadi
- Neurology Department, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Neuro-Immunology Research Scholar, Neurological Research Laboratory, Jefferson Hospital for Neuroscience, Thomas Jefferson University, Philadelphia, PA, USA
| | - Alireza Vakilian
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Neurology Department, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Fatemeh Ayoobi
- Occupational Safety and Health Research Center, NICICO, World Safety Organization and Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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15
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Ma K, Song P, Liu Z, Yang L, Wang L, Zhou J, Chen J, Dong Q. Genetic evidence suggests that depression increases the risk of erectile dysfunction: A Mendelian randomization study. Front Genet 2022; 13:1026227. [PMID: 36313469 PMCID: PMC9614163 DOI: 10.3389/fgene.2022.1026227] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The causal relationship between depression and erectile dysfunction (ED) is still uncertain. Objectives: To identify the genetically predicted causality of depression on ED through Mendelian randomization (MR). Materials and methods: A comprehensive GWAS meta-analysis comprising 807,553 Europeans provided single-nucleotide polymorphism (SNP) information for depression, and another genome-wide association analysis involving 223,805 European ancestries measured SNPs for ED. The inverse variance weighted (IVW) method was used as the primary MR analysis method to evaluate causal effects. In addition, the maximum likelihood method, MR-Egger, weighted median, robust adjusted contour score (MR.RAPS), and MR pleiotropic residual and outlier (MR-PRESSO) methods were used as supplements for sensitivity analysis. Results: According to the IVW analysis, depression significantly increases the incidence of ED (odds ratio [OR] = 1.68, 95% confidence interval [CI] = 1.38–2.05, p < 0.001). In sensitivity analyses, the ORs for the maximum likelihood method, MR-Egger, weighted median, MR.RAPS, and MR-PRESSO are 1.70 (95% CI = 1.39–2.08, p < 0 .001), 1.94 (95% CI = 0.63–6.01, p > 0 .05), 1.59 (95% CI = 1.21–2.10, p < 0 .001), 1 .70 (95% CI = 1.39–2.08, p < 0 .001), and 1.68 (95% CI = 1.40–2.04, p < 0 .001). There is no clear indication of potential heterogeneity or pleiotropy (p for the MR-Egger intercept = 0.804; p for the global test = 0.594; and p for Cochran’s Q statistics >0.05). Conclusion: Genetically predicted depression plays a potentially causal role in the occurrence of ED.
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Sum-Ping O, Geng YJ. Impact of Sleep on Cardiovascular Health: A Narrative Review. HEART AND MIND 2022. [DOI: 10.4103/hm.hm_29_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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