Short Sleep Times Predict Obesity in Internal Medicine Clinic Patients

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

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

Association between ultra-processed foods consumption and micronutrient intake and diet quality in Iranian adults: a multicentric study

OBJECTIVE

To identify ultra-processed foods (UPF) contribution to daily energy and nutrient intake in Iranians and examine whether UPF intake is associated with nutrient profile and diet quality.

DESIGN

In this cross-sectional study, a validated FFQ was used to evaluate usual dietary intake over the preceding year. NOVA system was applied to categorise foods based on their levels of processing. Diet quality was evaluated using the nutrient adequacy ratio (NAR), Nutrient Rich Food Index (NRF) and hybrid nutrient density.

SETTING

The LIPOKAP study conducted in five cities of Iran (Isfahan, Birjand, Bandar Abbas, Kermanshah and Shahrekord).

PARTICIPANTS

A total of 1994 adults aged ≥18 years were recruited using stratified multistage random cluster sampling method.

RESULTS

UPF were responsible for 8·5 % of daily energy intake. In the adjusted model, UPF consumption was inversely associated with carbohydrate, protein, refined and whole grains, fibre, fruit and meat, but was positively linked to energy, total fat, saturated and trans fatty acids and cholesterol. Compared with those in the lowest tertile, individuals in the highest tertile of UPF had smaller NAR for Ca, Mg, Zn, Fe, phosphorus, thiamin, niacin, folate and vitamin C. Both NRF and hybrid nutrient density decreased when the share of daily energy intake from UPF increased.

CONCLUSION

The higher consumption of UPF is associated with poorer diet quality and lower nutrient intake. It is recommended that UPF be replaced with minimally processed foods to improve diet quality and nutrient profile.

Melatonin protects against body weight gain induced by sleep deprivation in mice

Sleep deprivation is an epidemic phenomenon in modern society. Lack of sleep has been shown to result in metabolic and endocrine disorders that predispose to obesity and other chronic metabolic diseases. Melatonin is a sleep-related neurohormone and affected by the circadian rhythm and light/dark cycles. Melatonin has recently been used to ameliorate diet-induced or night light-induced energy metabolic imbalance. However, the effect of melatonin on sleep deprivation-induced obesity has been poorly characterized. This study focuses on the protective effects of melatonin on lipid metabolism and body weight homeostasis in sleep-deprived mice. Mice subjected to sleep deprivation had significantly decreased plasma melatonin content and increased food intake and body weight gain compared to that of control. Meanwhile, the transcription factor PPARγ protein in liver increased, but there were no significant changes in hepatic circadian proteins BMAL1 and REV-ERBα after 10 consecutive days of sleep deprivation. Moreover, melatonin supplementation increased liver AMPKα/PPARα signaling pathway activity, which leads to lipid catabolism and reduced fat accumulation. These findings suggested that melatonin may be a potential agent for protecting against sleep deprivation-induced obesity.

Sleep Disorders and Psoriasis: An Update

Psoriasis alters patients’ quality of life. Among the disorders associated with psoriasis, sleep disorders are common, although they are not directly assessed by most quality-of-life scores. Thus, the specific evaluation of sleep disorders using dedicated scores is necessary, especially because such disorders alter patients;’ physical and psychological health. The relationship between psoriasis and sleep disorders has been shown in numerous studies, but has not yet been fully elucidated. The aim of this study was to update knowledge of sleep disorders in patients with psoriasis, through a review of the scientific literature since 1980. This work covers several topics of interest, such as sleep assessment methods, the prevalence of sleep disorders in patients with psoriasis, factors predictive of sleep disorders in patients with psoriasis, the impact of sleep disorders on comorbidities and quality of life, pathogenic mechanisms, obstructive sleep apnoea and restless leg syndromes, and the impact of biotherapy treatments on sleep disorders in patients with psoriasis.

Association of elevated glycated hemoglobin and obesity with afternoon napping for more than 1 h in young and middle-aged healthy adults

INTRODUCTION

Sleep has different patterns followed worldwide and can be influenced by social, cultural, and environmental factors. Daytime napping is commonly practiced in different parts of the world with controversial results of its effect on glucose metabolism. The current study aims to examine the association of afternoon napping and night sleep duration with metabolic derangements.

METHODS

This is a cross-sectional study involving young adults and middle-aged subjects. Anthropometric measurements were taken for height and weight and hip and waist ratio. Consented subjects were asked to wear actigraphy for 1 week and run their usual daily activities. Home sleep apnea testing was performed to exclude obstructive sleep apnea. Subjects had been asked to come fasting on day seven for blood collection to test for fasting glucose, glycated hemoglobin, lipid profile, and insulin.

RESULTS

A total of 405 subjects were involved to complete the study (52% male, 48% female). The mean age of participants was 32.8 ± 11.5 years. The study indicated that the duration of afternoon napping was significantly associated with abnormal glycated hemoglobin (HbA1c > 5.7%) (p = 0.01) and body mass index (p = 0.046) independent of age, gender, and nocturnal sleep duration. Nocturnal sleep duration was associated with increased insulin level (p = 0.04).

CONCLUSION

Afternoon napping is associated with an increased level of glycated hemoglobin and obesity and that may predispose to the development of type 2 diabetes mellitus.

Sleep duration is associated with protein biomarkers for cardiometabolic health: A large-scale population study

Sleep problems and short sleep duration have been linked to adverse health effects, such as cardiovascular disease and diabetes, but the mechanisms are not fully understood. Finding biomarkers could explain mechanistic pathways and help in understanding relationships between sleep and cardiometabolic health. The aim was to assess if sleep duration and sleep quality affect the cardiometabolic-related protein profile. In total, 242 proteins related to cardiometabolic health were measured in 2,430 plasma samples (male:female ratio 1:1, aged 45-75 years) from the population-based EpiHealth cohort, using a proximity extension assay. The association of self-reported sleep duration and sleep quality with each of the 242 proteins (primary outcome) was assessed with linear regression modelling, adjusting for confounders, and corrected for multiple testing using the false discovery rate (5%). Potential effect modification of age and sex was also tested using an interaction term. We identified U-shaped associations between sleep duration and the plasma levels of the proteins follistatin (more prominent in younger individuals), matrix metallopeptidase 9 (men only), urokinase receptor, adrenomedullin and kidney injury molecule, all previously known to be related to cardiovascular risk. There was no relationship between sleep quality and any of the proteins, after adjustment for confounders. These results give new leads to investigate the potential mechanistic pathways between sleep and cardiometabolic health.

Short Sleep Duration and Its Association with Obesity and Other Metabolic Risk Factors in Kuwaiti Urban Adults

BACKGROUND

Efficient sleep duration and its quality are increasingly recognized as important contributors for maintaining normal body weight. However, lifestyle and social structure within the Arab-gulf region differ compared to those in the western world. This study was specifically conducted in Kuwait's population to investigate the link between sleep quality (SQ) and obesity in the absence of sleep apnea (SA) onset.

METHODS

SQ was measured by the Pittsburgh Sleep Quality Index (PQSI) in 984 participants, then verified in 60 individuals including 20 lean (Body mass index/BMI: 18.5-24.9 kg/m²), 20 overweight (BMI: 25-29.9 kg/m²) and 20 obese (BMI: ≥30 kg/m²) through actigraph worn over the right-hip for 7 consecutive days to characterize their sleep-wake cycle, rest-activity, and physical activity. Blood samples were collected for metabolic markers.

RESULTS

59.6% of participants reported a PSQI score higher than 5, with 57.6% of the participants reporting less than 6 hours of sleep per day. The data show that both SQ and sleep duration are considered inadequate in comparison to the international SQ standards. We found a significant association between SQ and obesity independent of age and sex. Actigraph data further supported the independent association of sleep duration on BMI within the population (p < 0.001). Additionally, total sleep time (TST) was found to significantly correlate with several other metabolic factors including diastolic blood pressure, elevated resting heart rate (RHR), triglycerides, total cholesterol, homeostatic model assessment for insulin resistance (HOMA-IR), C-peptide, and C-Reactive Protein (CRP) secretion. Further multiple-regression analysis showed a significant independent association between blood pressure (p < 0.03), HOMA-IR (p < 0.04), and C-peptide (p < 0.3) and sleep duration.

CONCLUSION

These findings suggest that sleep deprivation and disturbance could be indirect factors involved in the development of not only obesity in Kuwait but also other metabolic syndromes such as type 2 diabetes.

Sleep duration is associated with healthy diet scores and meal patterns: results from the population-based EpiHealth study

STUDY OBJECTIVES

To investigate relationships between sleep duration and adherence to healthy diets, but also associations with meal patterns, in a large population-based cohort.

METHODS

Participants (n = 23,829, males and females, aged 45 to 75 years) from the Swedish EpiHealth cohort study were included in a cross-sectional analysis. The participants filled out an extensive Internet-based questionnaire, and also visited a test center for anthropometric measurements and blood sampling. Sleep duration was classified as short (< 6 h/night; n = 1,862), normal (6 to less fewer than 9 h/night; n = 19,907) and long sleep (≥ 9 h/night; n = 858). In addition, a combination variable of sleep duration (short/normal/long) and sleep quality (good/poor) was constructed, giving six categories. Adherence to a healthy diet was assessed using the modified Mediterranean diet (mMED) score and the Healthy Nordic Food Index (HNFI) score based on food groups from a food frequency questionnaire. A regular meal pattern was considered if the participant had breakfast, lunch and dinner on a daily basis.

RESULTS

Compared with normal sleepers, short sleepers displayed lower adherence to a healthy diet when using both the mMED score (adjusted odds ratio = 0.70; 95% confidence interval 0.56-0.88) and the HNFI score (0.70; 0.56-0.88). When combining sleep duration and sleep quality, short sleepers with poor sleep quality showed an independent relationship with low adherence to a healthy diet (0.67; 0.52-0.86) compared with normal sleepers with good sleep quality. In addition, both short sleepers (0.71; 0.62-0.82) and long sleepers (0.75; 0.62-0.91) showed low adherence to regular meal patterns, compared with normal sleepers. Furthermore, short sleepers with poor sleep quality had reduced odds of having a regular meal pattern (0.67; 0.57-0.79) as compared with normal sleepers with good sleep quality.

CONCLUSIONS

Short sleep duration combined with poor sleep quality is associated with low adherence to a healthy diet and regular meal patterns.

Work and Health Correlates of Sleep Quantity and Quality Among Correctional Nurses

BACKGROUND/OBJECTIVES

The correctional environment exposes nurses to unique physical and psychosocial work stressors, such as inmate violence and safety concerns. Nurses often experience short and poor sleep; however, the quantity and quality of sleep in this specialty practice group of nurses are underexplored. The study objective was to examine a wide range of work and health correlates of sleep quantity and quality in correctional nurses.

METHODS

A Web-based survey was administered to nurses within a Northeastern State Correctional Healthcare System, covering questions on sleep quantity and quality, working conditions, health outcomes, and work outcomes.

RESULTS

Among the 89 correctional nurses who participated, 56.2% reported short sleep duration (≤6 hours/day) and 31.8% reported poor sleep quality. Multivariate Poisson regression modeling suggested that night shift (prevalence ratio [PR] = 1.95, p < 0.05) and single marital status (PR = 2.25, p < 0.05) were significantly associated with increased prevalence of short sleep duration, whereas none of the work and health variables were significantly associated with increased prevalence of poor sleep quality, after adjustment for sociodemographics and other covariates.

CONCLUSION

Correctional nurses experience a high prevalence of short and poor sleep. Similar to previous studies, we found that short sleep duration was associated with night shift work. Interventions targeting work schedule remodeling (e.g., reduce the number of consecutive night shifts) and shift work coping mechanisms may promote sleep health of correctional nurses.

Work-Family Conflict, Sleep, and Mental Health of Nursing Assistants Working in Nursing Homes

Work-family conflict is challenging for workers and may lead to depression, anxiety, and overall poor health. Sleep plays an important role in the maintenance of mental health; however, the role of sleep in the association between work-family conflict and mental health is not well-studied. Questionnaires were collected from 650 nursing assistants in 15 nursing homes. Multivariate linear regression modeling demonstrated that increased work-family conflict was associated with lower mental health scores (β = -2.56, p < .01). More work-family conflict was correlated with more job demands, less job control, less social support, and longer work hours. Poor sleep quality, but not short sleep duration, mediated the association between work-family conflict and mental health. Workplace interventions to improve nursing assistants' mental health should increase their control over work schedules and responsibilities, provide support to meet their work and family needs, and address healthy sleep practices.

Sleep Disturbance in Psoriatic Disease: Prevalence and Associated Factors

OBJECTIVE

We aimed to determine the prevalence and quality of sleep in patients with psoriatic arthritis (PsA) and those with psoriasis without PsA (PsC) followed in the same center, to identify factors associated with sleep disturbance, and to compare findings to those of healthy controls (HC).

METHODS

The study included 113 PsA [ClASsification for Psoriatic ARthritis (CASPAR) criteria] and 62 PsC (PsA excluded by a rheumatologist) patients and 52 HC. Clinical variables were collected using a standard protocol. The sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Other patient-reported outcomes collected included the Health Assessment Questionnaire (HAQ), Dermatology Life Quality Index, EQ-5D, Medical Outcomes Study Short Form-36 survey, patient's global assessment, and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-fatigue) scale. Statistical analyses included descriptive statistics, Wilcoxon rank-sum test, and linear regression.

RESULTS

The prevalence of poor sleep quality was 84%, 69%, and 50% in PsA, PsC, and HC, respectively. Total PSQI score was higher in both patients with PsA and patients with PsC compared with HC (p < 0.01) and higher in patients with PsA compared to patients with PsC (p < 0.0001). EQ-5D anxiety component, EQ-5D final, and FACIT-fatigue were independently associated with worse PSQI in patients with PsC and those with PsA (p < 0.05). Actively inflamed (tender or swollen) joints are independently associated with worse PSQI in patients with PsA (p < 0.01).

CONCLUSION

Patients with psoriatic disease have poor sleep quality. Poor sleep is associated with fatigue, anxiety, and lower EQ-5D. In patients with PsA, poor sleep is associated with active joint inflammation.

Contributing influences of work environment on sleep quantity and quality of nursing assistants in long-term care facilities: A cross-sectional study

The effect of shift work on nurses' sleep is well-studied, but there are other challenging aspects of health care work that might also affect the sleep of direct caregivers. This study examined the influence of the long-term care work environment on sleep quantity and quality of nursing assistants. A cross-sectional survey collected data from 650 nursing assistants in 15 long-term care facilities; 46% reported short sleep duration and 23% reported poor sleep quality. A simple additive index of the number of beneficial work features (up to 7) was constructed for analysis with Poisson regression. With each unit increase of beneficial work features, nursing assistants were 7% less likely to report short sleep duration and 17% less likely to report poor sleep quality. These results suggest that effective workplace interventions should address a variety of work stressors, not only work schedule arrangements, in order to improve nursing assistants' sleep health.

Shiftwork, Sleep Habits, and Metabolic Disparities: Results from the Survey of the Health of Wisconsin

BACKGROUND

With the expanding demand for a 24-hour society, the prevalence of sleep deprivation and other sleep-related health problems is increasing. Shiftwork is an occupational health risk of growing significance because of its high prevalence and because of its potential role as a determinant of socioeconomic-related health disparities.

AIMS

The aim of this study was to examine the associations of shiftwork with overweight status and type 2 diabetes, and explore whether a history of sleep problems mediates or modifies these associations.

PARTICIPANTS AND METHODS

A cross-sectional study was conducted among 1,593 participants in the Survey of the Health of Wisconsin (2008-12) who were employed and reported work characteristics (traditional schedule or shiftwork) and sleep habits and history of sleep problems (insomnia, insufficient sleep, wake time sleepiness). Objective measures of body mass index (BMI) and type 2 diabetes were used.

RESULTS

Shiftworkers were more overweight than traditional-schedule workers (83% vs. 71% with BMI≥25) and reported more sleep problems, such as insomnia symptoms (24% vs. 16%), insufficient sleep (53% vs.43%), and sleepiness (32% vs. 24%). The associations between shiftwork and being overweight or diabetic were stronger among those reporting insufficient sleep, but the interaction was not statistically significant.

CONCLUSIONS

Shiftworkers face disparities in metabolic health, particularly those with insufficient sleep. Improved understanding of the relationship between sleep and metabolic states can inform healthcare providers' and employers' efforts to screen high-risk individuals and intervene with workplace wellness initiatives to address these disparities.

Relationship between habitual sleep duration, obesity and depressive symptoms in patients with sleep apnoea

OBJECTIVES

Short sleep duration has been linked with obesity in general population, but this issue has not been addressed in patients with obstructive sleep apnoea syndrome (OSAS) separately. Depressive symptoms are frequent in OSAS and may affect sleep and energy balance. Our purpose was to assess the association of habitual sleep duration, psychological distress, depressive symptoms, and excessive daytime sleepiness with measures of obesity in patients with OSAS.

METHODS

210 middle aged consecutive patients (111 men and 99 women) referred for evaluation of suspected OSAS were divided into subgroups based on apnoea-hypopnoea index (AHI) and treatment suggested by a sleep physician.

RESULTS

OSAS (AHI>5/h plus symptoms) was diagnosed in 75.7% of the patients. Their sleep duration correlated negatively with psychological distress (r=-0.22, p=0.043) and depressive symptoms (r=-0.27, p=0.013) in men. No association was found between self-reported habitual sleep duration and measures of obesity or subjective sleepiness. In patients considered for CPAP therapy, sleep duration associated inversely with depressive symptoms both in men (r=-0.28, p=0.024) and women (r=-0.33, p=0.037). After adjusting for age and Epworth Sleepiness Score, the results remained essentially similar.

CONCLUSIONS

Our results suggest that self-reported habitual sleep duration does not associate with obesity in patients with OSAS. Shorter habitual sleep duration seems to associate with higher scores of depressive symptoms and psychological distress.

[Medicine consumption in the adult population: Influence of self-medication]

Objetivo

El objetivo del estudio es conocer las características de la población que se asocian al consumo y autoconsumo de fármacos en Aragón.

Diseño

Estudio transversal a través de la Encuesta Nacional de Salud de 2006.

Emplazamiento

Comunidad autónoma de Aragón.

Participantes

Población adulta residente en Aragón.

Mediciones principales

Consumo y autoconsumo de fármacos, así como características sociodemográficas, de salud y de estilos de vida.

Resultados

El 65,1% de los adultos aragoneses habían consumido al menos un fármaco en las últimas 2 semanas, el 11,7% lo hizo sin receta médica. Se observó mayor consumo en las mujeres y en personas de mayor edad. El mal estado de salud percibido incrementaba de manera significativa el consumo de fármacos. Las personas con bajo nivel de estudios tenían mayor consumo, mientras que el autoconsumo fue más frecuente en el grupo de mayor nivel de estudios

Conclusiones

El consumo de fármacos en Aragón es elevado, así como la prevalencia de autoconsumo. Resulta de gran interés conocer el perfil de estos pacientes para poder realizar intervenciones dirigidas a reducir el consumo innecesario y mejorar la adecuación y seguridad de los fármacos utilizados

Oxidative stress, cancer, and sleep deprivation: is there a logical link in this association?

INTRODUCTION

Sleep disorders are associated with various human pathologies and interfere with biological processes essential for health and quality of life. On the other hand, cancer is one of the most common diseases worldwide with an average of 1,500 deaths per day in the USA. Is there a factor common to both sleep disorders and cancer that serves to link these conditions?

DISCUSSION

It is a normal process for cellular metabolism to produce reactive oxidant series (ROS). However, when the production of ROS overcomes the antioxidant capacity of the cell to eliminate these products, the resulting state is called oxidative stress. Oxidative DNA damage may participate in ROS-induced carcinogenesis. Moreover, ROS are also produced in the sleep deprivation process. The aim of this article is to review pathways and mechanisms that may point to oxidative stress as a link between sleep deprivation and cancer.

Sleep duration and central obesity in women - differences between short sleepers and long sleepers

OBJECTIVE

To assess characteristics of short sleepers and long sleepers and to assess association between sleep duration and central obesity in a population-based sample of women.

METHOD

Non-pregnant women ≥20 years that were randomly selected from the population-registry of Uppsala, Sweden, answered a questionnaire (n=6461) including questions on sleeping habits and somatic disorders.

RESULTS

There was a U-shaped association between sleep duration and waist circumference. Short sleeping women (<5 h) had a waist circumference of 89.2±14.9 cm (mean±SD) decreasing to 82.9±11.9 cm for women sleeping 7-<8 h and increasing to 89.0±16.7 cm for women sleeping ≥10 h. Both short sleepers and long sleepers were more often physically inactive, smokers, ill or taking medication, and psychologically distressed than normal sleepers (6-<9 h). In women <50 years both short and long sleep duration were risk factors for central obesity. Short sleep duration remained a risk factor for central obesity, whereas the association with long sleep duration did not reach statistical significance after adjustments.

CONCLUSIONS

Short sleepers and long sleepers showed differences in characteristics compared to normal sleepers. Furthermore, we showed an independent association between short sleep duration and central obesity, which was strongest in younger women. It is important to identify short sleepers, especially in younger women.

Sleep duration and biomarkers of metabolic function among police officers

OBJECTIVE

To investigate associations between sleep duration and biomarkers of metabolic function among police officers.

METHODS

Metabolic markers were measured using standardized methods and sleep duration was assessed from questionnaire data. Mean levels of leptin and adiponectin were assessed across five levels of sleep duration using ANCOVA and linear regression models.

RESULTS

Police officers (n = 443) who reported an average of less than 5 hours and at least 8 hours of sleep had higher levels of leptin compared to those who reported an average of 5 to 7 hours of sleep. These associations were stronger and statistically significant among women, officers with BMI of 24.9 kg/m or less and smaller abdominal height (< 20 cm), and officers who primarily worked on the day shift.

CONCLUSION

Short and long sleep duration were associated with higher leptin levels and may have implications for obesity-related conditions.

Psoriatic arthritis is a strong predictor of sleep interference in patients with psoriasis

OBJECTIVE

We sought to determine what clinical features of psoriasis predict sleep interference.

METHODS

Data were obtained from 420 respondents to the 2005 National Psoriasis Foundation telephone and e-mail surveys. Logistic regression was used to determine whether disease severity, body mass index, age of onset, psoriatic arthritis, income, ethnicity, sex, current therapy, and quality-of-life measures predicted reported sleep interference within the last month.

RESULTS

Psoriatic arthritis was the most significant predictor of sleep disturbance (odds ratio = 3.26). Itch, pain of lesions, and impact on emotional well-being were also significant predictors (odds ratio 1.26, 1.22, and 1.18, respectively). Body surface area covered with psoriasis, body mass index, and therapy were not significant predictors of sleep interference.

LIMITATIONS

All data were self-reported and not physician-assessed.

CONCLUSIONS

History of psoriatic arthritis, presence of itch and pain of psoriatic lesions, and impact of psoriasis on overall emotional well-being predict sleep interference.