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Papadopoulos D, Sosso FAE. Socioeconomic status and sleep health: a narrative synthesis of 3 decades of empirical research. J Clin Sleep Med 2023; 19:605-620. [PMID: 36239056 PMCID: PMC9978435 DOI: 10.5664/jcsm.10336] [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: 05/17/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 12/24/2022]
Abstract
STUDY OBJECTIVES This review aims to assess the association between socioeconomic status (SES) and sleep health in the general population and the mediating effects of lifestyle and mental and physical health in this relationship. METHODS Observational studies testing the independent association between objective or subjective SES indicators and behavioral/physiological or clinical sleep health variables in the general population were included. PubMed/MEDLINE was searched for reports published from January 1990 to December 2019. The direction of effect was used as the primary effect measure, testing the hypothesis that low SES is associated with poor sleep health outcomes. Results are presented in the form of direction effect plots and synthesized as binomial proportions. RESULTS Overall, 336 studies were identified. A high proportion of effects at the expected direction was noted for measures of sleep continuity (100% for sleep latency, 50-100% for awakenings, 66.7-100% for sleep efficiency), symptoms of disturbed sleep (75-94.1% for insomnia, 66.7-100% for sleep-disordered breathing, 60-100% for hypersomnia), and general sleep satisfaction (62.5-100%), while the effect on sleep duration was inconsistent and depended on the specific SES variable (92.3% for subjective SES, 31.7% for employment status). Lifestyle habits, chronic illnesses, and psychological factors were identified as key mediators of the SES-sleep relationship. CONCLUSIONS Unhealthy behaviors, increased stress levels, and limited access to health care in low-SES individuals may explain the SES-sleep health gradient. However, the cross-sectional design of most studies and the high heterogeneity in employed measures of SES and sleep limit the quality of evidence. Further research is warranted due to important implications for health issues and policy changes. CITATION Papadopoulos D, Etindele Sosso FA. Socioeconomic status and sleep health: a narrative synthesis of 3 decades of empirical research. J Clin Sleep Med. 2023;19(3):605-620.
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GEORGIADI K, TSIPTSIOS D, FOTIADOU A, KALTSATOU A, VAFEIADIS I, LIALIARIS S, TRYPSIANI I, KITMERIDOU S, KARATZETZOU S, MANOLIS A, TSAMAKIS K, SERDARI A, NENA E, STEIROPOULOS P, TRIPSIANIS G. "How Do Greeks Sleep?" A Cross-Sectional Study among Indigenous and Minority Populations. MAEDICA 2022; 17:615-627. [PMID: 36540581 PMCID: PMC9720652 DOI: 10.26574/maedica.2022.17.3.615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Objective: To investigate sleep habits and their potential relationship with several sociodemographic, lifestyle and health related characteristics among indigenous and minority populations in Northeastern Greece. Materials and methods: Nine hundred fifty seven adults aged 19 to 86 years were enrolled in this cross-sectional study. Self-reported structured questionnaires were utilized. Results:The reported mean sleep duration on a weekly basis was 6:26±1:10 hours (range, 04:00 to 10:00 hours); sleep duration was 26 min longer on weekends (p < 0.001). In multivariate linear regression analysis, older age (β=-26.7 min, p=0.010), being divorced or widowed (β=-29.0 min, p < 0.001), high alcohol (β=-39.7 min, p < 0.001) or coffee (β=-36.9 min, p=0.006) consumption, screen exposure before bedtime for 1-2 hours (β=-18.9 min, p=0.004) or > one hour (β=-34.4 min, p < 0.001), having a child aged under six years (β=-62.3 min, p < 0.001), napping for > 30 min during the day (β=-35.2 min, p < 0.001) and morbidity (β=-21.5 min, p < 0.001) were independently associated with short sleep duration and lower sleep efficiency. Moreover, a tendency towards short sleep duration was associated with anxiety (β=-8.8 min, p=0.078) and depression (β=-12.8 min, p=0.029). Obesity (β=10.7 min, p=0.047), being a university student (β=41.0 min, p=0.002), high financial status (β=16.6 min, p=0.037) and high adherence to Mediterranean diet (β=15.4 min, p=0.002) were associated with long sleep duration. Conclusion:This study illustrates the association of sleep disturbances with several sociodemographic and health-related factors and dictates conduction of larger scale prospective studies to evaluate causality on the relationship between sleep patterns and lifestyle factors.
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Affiliation(s)
- Kyriaki GEORGIADI
- Neurology Department, Democritus University of Thrace, Alexandroupolis Greece
| | - Dimitrios TSIPTSIOS
- Neurology Department, Democritus University of Thrace, Alexandroupolis Greece
| | - Aggeliki FOTIADOU
- Neurology Department, Democritus University of Thrace, Alexandroupolis Greece
| | - Antonia KALTSATOU
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Greece
| | - Ioannis VAFEIADIS
- Laboratory of Medical Statistics, Democritus University of Thrace, Alexandroupolis, Greece
| | - Stergios LIALIARIS
- Department of Otorhinolaryngology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Ioanna TRYPSIANI
- Laboratory of Medical Statistics, Democritus University of Thrace, Alexandroupolis, Greece
| | - Sofia KITMERIDOU
- Neurology Department, Democritus University of Thrace, Alexandroupolis Greece
| | - Stella KARATZETZOU
- Neurology Department, Democritus University of Thrace, Alexandroupolis Greece
| | - Apostolos MANOLIS
- Laboratory of Medical Statistics, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Aspasia SERDARI
- Department of Child and Adolescent, Democritus University of Thrace, Alexandroupolis, Greece
| | - Evangelia NENA
- Laboratory of Hygiene and Environmental Protection, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Gregory TRIPSIANIS
- Laboratory of Medical Statistics, Democritus University of Thrace, Alexandroupolis, Greece
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Cao B, Zhao Y, Ren Z, McIntyre RS, Teopiz KM, Gao X, Ding L. Are Physical Activities Associated With Perceived Stress? The Evidence From the China Health and Nutrition Survey. Front Public Health 2021; 9:697484. [PMID: 34414158 PMCID: PMC8369204 DOI: 10.3389/fpubh.2021.697484] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/07/2021] [Indexed: 11/23/2022] Open
Abstract
Psychological stress is a negative affective state. The association between physical activity and psychological stress was commonly reported in previous researches. Few published studies with large sample sizes have explored such an association in Chinese population. The current research aims to assess the association between perceived stress and physical activity preferences, as well as the association between risk of high perceived stress and physical activity behaviors (e.g., sports-, transport-, occupational-related physical activity, sedentary activities and time in bed). The data were collected from the China Health and Nutrition Survey (CHNS) in 2015. Generalized linear models and logistic regression models were used to explore the association between perceived stress and physical activity. In total, 11,066 participants were included in the current analysis. For physical activity preferences, we found that “like” preference of all six mentioned domains of activities contributed to lower perceived stress (i.e., lower perceived stress scale −14 score, all β < 0 and p < 0.05). For physical activity behaviors, the results indicated that none/low intensity physical activity behaviors (e.g., sports-, occupational- related, sedentary) were associated with risk of high perceived stress, except that low intensity of transport-related activities seemed to be protective from high stress. However, the association between intensity of physical activity behaviors and perceived stress was not simply the higher the better. High intensity of all these physical activity behaviors was also associated with high perceived stress. Our findings suggest that positive preferences and moderate physical activity behaviors were associated with low perceived stress. The findings herein highlight the effect of regulating physical activity on perceived stress, as well as inform potential strategies to reduce psychological stress.
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Affiliation(s)
- Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China.,National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing, China
| | - Yuxiao Zhao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China
| | - Zhongyu Ren
- College of Physical Education, Southwest University, Chongqing, China
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Kayla M Teopiz
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Xiao Gao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China.,National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing, China
| | - Ling Ding
- Pharmacy Department, The Central Hospital of Jiangjin, Chongqing, China
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Gubelmann C, Heinzer R, Haba-Rubio J, Vollenweider P, Marques-Vidal P. Physical activity is associated with higher sleep efficiency in the general population: the CoLaus study. Sleep 2019; 41:4956778. [PMID: 29617980 DOI: 10.1093/sleep/zsy070] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Indexed: 11/15/2022] Open
Abstract
Study Objectives To evaluate the association of objective physical activity (PA) and sedentary behavior (SB) with sleep duration and quality. Methods Cross-sectional study including 2649 adults (53.5% women, 45-86 years) from the general population. Proportions of time spent in PA and SB were measured using 14 day accelerometry. Low PA and high SB statuses were defined as the lowest and highest tertile of each behavior. "Inactive," "Weekend warrior," and "Regularly active" weekly patterns were also defined. Sleep parameters were derived from the accelerometer and validated questionnaires. Results High PA, relative to low PA, was associated with higher sleep efficiency (76.6 vs. 73.8%, p < 0.01) and lower likelihood of evening chronotype [relative-risk ratio (RR) and 95% CI: 0.71 (0.52; 0.97)]. Similar associations were found for low SB relative to high SB. "Weekend warriors" relative to "Inactives," had higher sleep efficiency [76.4 vs. 73.9%, p < 0.01] and lower likelihood of evening chronotype [RR: 0.63 (0.43; 0.93)]. "Regularly actives," relative to "Inactives," had higher sleep efficiency [76.7 vs. 73.9%, p < 0.01] and tended to have less frequently an evening chronotype [RR: 0.75 (0.54; 1.04), p = 0.09]. No associations were found for PA and SB with sleep duration, daytime sleepiness, insomnia, and risk of sleep apnea (after adjustment for body mass index). Conclusions High PA and low SB individuals, even if they do not sleep longer, have higher sleep efficiency and have less frequently an evening chronotype.
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Affiliation(s)
- Cédric Gubelmann
- Department of Medicine, Internal Medicine, Lausanne University Hospital, Switzerland
| | - Raphael Heinzer
- Centre for Investigation and Research in Sleep, Lausanne University Hospital, Switzerland
| | - José Haba-Rubio
- Centre for Investigation and Research in Sleep, Lausanne University Hospital, Switzerland
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital, Switzerland
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Pettee Gabriel K, Sternfeld B, Shiroma EJ, Pérez A, Cheung J, Lee IM. Bidirectional associations of accelerometer-determined sedentary behavior and physical activity with reported time in bed: Women's Health Study. Sleep Health 2016; 3:49-55. [PMID: 28346151 DOI: 10.1016/j.sleh.2016.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 08/31/2016] [Accepted: 10/05/2016] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To examine the day-to-day, bidirectional associations of accelerometer-derived sedentary behavior and physical activity (PA) with reported time in bed in a large cohort of older women. METHODS Data are from 10086 Women's Health Study participants (aged 71.6 years; SD, 5.7) who agreed to wear an accelerometer and complete a diary for 7 consecutive days. Generalized linear (multilevel) models with repeated measures were used to examine the adjusted associations of the following: (1) reported time in bed with next-day accelerometer-determined counts and time spent sedentary and in light- and moderate-to-vigorous-intensity PA (MVPA) and (2) accelerometer estimates with reported time in bed that night, expressed as short (<7 hours), optimal (7-9 hours), and long (>9 hours) sleep. RESULTS Across days, short sleep was associated with an average of 5500 (SE, 1352) higher accelerometer counts the following day but was also related to higher average sedentary (46.5 [SE, 1.5] minutes) and light-intensity PA (11.9 [SE, 1.2] minutes) than optimal sleep (all P<.001). Long sleep was associated with lower accelerometer counts, time spent sedentary and in light-intensity PA, and a reduced likelihood of engaging in ≥20 minutes of MVPA (all P<.001) than optimal sleep. Higher PA during the day (higher accelerometer counts and ≥20 minutes of accumulated MVPA) was associated with a reduced likelihood of reporting short or long sleep that night (all P<.001). CONCLUSIONS Findings support the bidirectional associations of accelerometer-determined sedentary behavior and PA with reported time in bed in older women. Future studies are needed to confirm findings with sleep actigraphy in older women.
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Affiliation(s)
- Kelley Pettee Gabriel
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center in Houston, School of Public Health-Austin Campus, Austin, TX 78701.
| | - Barbara Sternfeld
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612
| | - Eric J Shiroma
- Division of Preventive Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA; National Institute on Aging, National Institutes of Health, Bethesda, MD
| | - Adriana Pérez
- Department of Biostatistics, University of Texas Health Science Center in Houston, School of Public Health-Austin Campus, Austin, TX 78701
| | - Joseph Cheung
- Stanford Center for Sleep Sciences and Medicine, Stanford University; Palo Alto, CA 94304
| | - I-Min Lee
- Division of Preventive Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA
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Hoyos C, Glozier N, Marshall NS. Recent Evidence on Worldwide Trends on Sleep Duration. CURRENT SLEEP MEDICINE REPORTS 2015. [DOI: 10.1007/s40675-015-0024-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Youngstedt SD, Goff EE, Reynolds AM, Kripke DF, Irwin MR, Bootzin RR, Khan N, Jean-Louis G. Has adult sleep duration declined over the last 50+ years? Sleep Med Rev 2015; 28:69-85. [PMID: 26478985 DOI: 10.1016/j.smrv.2015.08.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 08/09/2015] [Accepted: 08/13/2015] [Indexed: 01/01/2023]
Abstract
The common assumption that population sleep duration has declined in the past few decades has not been supported by recent reviews, which have been limited to self-reported data. The aim of this review was to assess whether there has been a reduction in objectively recorded sleep duration over the last 50+ years. The literature was searched for studies published from 1960 to 2013, which assessed objective sleep duration (total sleep time (TST)) in healthy normal-sleeping adults. The search found 168 studies that met inclusion criteria, with 257 data points representing 6052 individuals ages 18-88 y. Data were assessed by comparing the regression lines of age vs. TST in studies conducted between 1960 and 1989 vs. 1990-2013. Weighted regression analyses assessed the association of year of study with age-adjusted TST across all data points. Regression analyses also assessed the association of year of study with TST separately for 10-y age categories (e.g., ages 18-27 y), and separately for polysomnographic and actigraphic data, and for studies involving a fixed sleep schedule and participants' customary sleep schedules. Analyses revealed no significant association of sleep duration with study year. The results are consistent with recent reviews of subjective data, which have challenged the notion of a modern epidemic of insufficient sleep.
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Affiliation(s)
- Shawn D Youngstedt
- College of Nursing and Health Innovation, College of Health Solutions, Arizona State University, Phoenix, AZ, USA.
| | - Eric E Goff
- Department of Biological Sciences, University of South Carolina, USA
| | | | - Daniel F Kripke
- Scripps Clinic Viterbi Family Sleep Center, La Jolla, CA, USA
| | - Michael R Irwin
- Cousins Center for Psychoneuorimmunology, Semel Institute for Neuroscience, University of California, Los Angeles, USA
| | | | - Nidha Khan
- Department of Exercise Science, University of South Carolina, USA
| | - Girardin Jean-Louis
- Center for Healthful Behavior Change, Department of Population Health, NYU School of Medicine, USA
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