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Eirene O, Bubu OM, Donley T, Blanc J, Madera C, Turner A, Mbah AK, Williams NJ, Youngstedt S, Shochat T, Seixas AA, Osorio RS, Jean-Louis G. 0864 Race/ethnicity And Sex-dependent Effects Of Metabolic Burden Across Different Age-categories On Trends In Self-reported Sleep Duration: Findings From The National Health Interview Survey, 2004-2013. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
We examined race and sex-dependent effects of metabolic burden across different age-categories on trends in self-reported sleep duration for the U.S. non-institutionalized civilian population.
Methods
We analyzed data from the National Health Interview Survey (NHIS) adults aged 18-85 from 2004 to 2013 (N=258,158). Metabolic burden was characterized by obesity (BMI>30), dyslipidemia, diabetes, and hypertension morbidity burden levels. Racial/ethnic categories included non-Hispanic Whites (NHW), Blacks/African Americans (AAs) and Hispanics. Sleep duration within a 24-hour period on average was categorized as short sleep (≤ 6hrs), adequate sleep (7-8 hrs.), and long sleep (≥ 9hrs). Age was categorized as 18 - <26, 26 - <65 and 65 - 85. Adjusted multinomial logistic regression models stratified by race, sex and age-categories examined effects of metabolic burden on trends in self-reported sleep duration.
Results
The prevalence of short sleep duration was relatively stable from 2004-2012 for NHW and all females. However, AA and Hispanic males showed consistent increase in the rates of short sleepers beginning in 2007 through 2013 especially for ages 18 - <26, and 26 - <65 (P <.001 for trend). For all racial/ethnic categories, compared to individuals aged 18 - <26, individuals aged 26 - <65 were more likely to report short sleep (aOR: 1.55, 95% CI: 1.50-1.61) and individuals aged 65 - 85 were more likely to be long sleepers (aOR: 1.95, 95% CI: 1.86-2.05). Interestingly, the rate of short sleep increased as the metabolic burden increased (P <.001 for trend). This trend was more pronounced among AA and Hispanic males aged 65 - 85 with ≥ 2 metabolic conditions who were more likely to report short sleep (aOR: 1.77, 95% CI: 1.44-2.19 and aOR: 1.45, 95% CI: 1.17-1.93 respectively), compared to NHW males.
Conclusion
Increased metabolic burden among minority populations and especially in the elderly male, affect sleep and may have consequences for treating these populations.
Support
NIH/NIA/NHLBI (L30-AG064670, CIRAD P30AG059303 Pilot, T32HL129953, R01AG056531, R25HL105444, R25NS094093, K07AG05268503, R01HL142066, K23HL125939)
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Affiliation(s)
- O Eirene
- NYU School of Medicine, New York, NY
| | - O M Bubu
- NYU School of Medicine, New York, NY
| | - T Donley
- NYU School of Medicine, New York, NY
| | - J Blanc
- NYU School of Medicine, New York, NY
| | - C Madera
- NYU School of Medicine, New York, NY
| | - A Turner
- NYU School of Medicine, New York, NY
| | - A K Mbah
- University of South Florida, Tampa, FL
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Christina M, Bubu OM, Donley T, Blanc J, Oji E, Turner AD, Mbah AK, Williams NJ, Youngstedt S, Shochat T, Azizi SA, Osorio RS, Jean-Louis G. 0863 Age-categorized Trends In Self-reported Sleep Duration For The Non-institutionalized U.s. Civilian Population From 2004-2013: Considerations Of Racial/ethnic Variations. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
We examined age-categorized trends in self-reported sleep duration using data from the National Health Interview Survey (NHIS) 2004-2013 and explored how these trends may vary based on individuals’ race/ethnicity.
Methods
Study participants were aged 18-85 (N=258,158). Sleep duration within a 24-hour period on average was categorized as ≤ 6hrs (short-sleep), 7-8 hours (adequate-sleep), and ≥ 9hrs (long-sleep). Age was categorized as 18 - <26, 26 - <65 and 65 - 85. Racial categories included non-Hispanic Whites (NHW), Blacks/African Americans (AAs) and Hispanics. Adjusted multinomial logistic regression models examined trends in self-reported sleep duration across age-categories and assessed race/ethnic differences in these trends.
Results
Mean sleep duration (hrs.) across all years was 7.4, 7.0, and 7.5, for ages 18 - <26, 26 - <65 and 65 - 85, respectively and was relatively stable from 2004-2013. However, compared to individuals ages 18 - <26, those categorized as ages 26 - <65 were 55% more likely to be short sleepers while those ages 65 - 85 were 20% less likely to be short sleepers (P < .001 for all). Mean sleep duration was 7.2hrs, for NHW and 7.1hrs for AAs and Hispanics, and showed increasing trend toward short sleep beginning in 2007 through 2013 (P <.01 for trend). In the age 18 - <26 category, compared to whites, blacks and Hispanics were 35% and 29% more likely to be short sleepers, respectively. In the age 26 - <65 category, compared to whites, blacks and Hispanics were 35% and 21% more likely to be short sleepers, respectively. In the age 65 - 85 category, compared to whites, blacks were 19% more likely to be short sleepers (P < .001 for all).
Conclusion
Continued surveillance of population-level sleep trends among minority populations is essential as growing race/ethnic (age specific) disparities in self-reported sleep duration may have consequences for racial/ethnic health disparities.
Support
NIH/NIA/NHLBI (L30-AG064670, CIRAD P30AG059303 Pilot, T32HL129953, R01AG056531, R25HL105444, R25NS094093, K07AG05268503, R01HL142066, K23HL125939)
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Affiliation(s)
| | - O M Bubu
- NYU School of Medicine, New York, NY
| | - T Donley
- NYU School of Medicine, New York, NY
| | - J Blanc
- NYU School of Medicine, New York, NY
| | - E Oji
- NYU School of Medicine, New York, NY
| | | | - A K Mbah
- University of South Florida, Tampa, FL
| | | | | | | | - S A Azizi
- NYU School of Medicine, New York, NY
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Bubu OM, Turner AD, Parekh A, Mullins A, Kam K, Umasabor-Bubu OQ, Mbah AK, Williams NJ, Varga AW, Rapoport DM, Ayappa I, Jean-Louis G, Osorio RS. 1150 Obstructive Sleep Apnea-dependent Racial/ethnic And Sex-specific Mechanisms Underlying Alzheimer’s Disease Risk: A Retrospective Cohort Analysis Of In-lab PSG Sleep Study Data. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
We examined race and sex-specific biologic mechanisms of the relationship between obstructive sleep apnea (OSA) and incident AD.
Methods
Retrospective cohort analysis utilizing in-lab PSG sleep study data conducted among older adults between 2001 and 2005. OSA was defined using AHI4%. Participants had no history of cognitive decline or AD at baseline and included 663 (284 Non-Hispanic White (NHW), 207 Black/African-American (AA) and 172 Hispanic) OSA-patients matched on age, sex, race, BMI, 1:1 ratio to 663 (unexposed cohort I from sleep clinic) and 1:4 ratio to 2652 (unexposed cohort II from non-sleep clinics) non-OSA individuals. Incident AD was assessed annually from 2001-2013 with ICD-9-CM code 331.0. Adjusted cox proportional hazard regression models examined race and sex-specific biologic mechanisms including hypoxia, fragmentation and duration measures of OSA and AD risk.
Results
Of the 3,978 participants, 2,148 (54%) were women. Mean age at baseline was 72.6 (7.3) years. Over a mean follow-up time of 8.6 (1.4) years, 358 (9%) individuals (212 female) developed AD (119 NHW, 134 AAs, and 105 Hispanics). Relative to non-OSA individuals, OSA-patients had a higher risk of incident AD, with AAs and females showing stronger risk estimates (aHR: 2.24, 1.83, and 1.73, P <.001 for all, for AAs, Hispanics and NHW respectively; and aHR: 2.38, and 1.37, P <.001 for all, for female and male respectively). Measures of hypoxia, sleep fragmentation and sleep duration were associated with increase AD risk (P <.01 for all). Relative to NHW, AAs and Hispanics demonstrated up to 20% stronger effects/estimates on hypoxia and sleep duration measures. Relative to males, females demonstrated up to 25% stronger effects/estimates on sleep fragmentation measures, and 15% weaker effects/estimates on hypoxia measures (P <.01 for all).
Conclusion
Among OSA-patients, mechanisms related to hypoxia, sleep fragmentation and duration measures increase AD risk and may underlie race/ethnicity and sex disparities in AD.
Support
NIH/NIA/NHLBI (L30-AG064670, CIRAD P30AG059303 Pilot, T32HL129953, R01HL118624, R21AG049348, R21AG055002, R01AG056031, R01AG022374, R21AG059179, R01AG056682, R01AG056531, K07AG05268503, K23HL125939)
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Affiliation(s)
- O M Bubu
- NYU School of Medicine, New York, NY
| | | | - A Parekh
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - A Mullins
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - K Kam
- Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - A K Mbah
- University of South Florida, Tampa, FL
| | | | - A W Varga
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - D M Rapoport
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - I Ayappa
- Icahn School of Medicine at Mount Sinai, New York, NY
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Bubu OM, Mbah AK, Williams NJ, Turner AD, Parekh A, Mullins AE, Kam K, Umasabor-Bubu OQ, Varga AW, Rapoport DM, Ayappa I, Jean-Louis G, Osorio RS. 1153 Association Of Nocturnal Sleep Disturbance And Prospective Cognitive Decline In Cognitive Normal Elderly: Findings From The National Alzheimer’s Coordinating Center Uniform Dataset. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
We determined whether nocturnal sleep disturbance (NSD) is associated with prospective cognitive decline in clinically normal older adults
Methods
Prospective longitudinal study utilizing data from the National Alzheimer’s Coordinating Center (NACC) Uniform Data set (UDS). NSD data, as characterized by the Neuropsychiatric Inventory Questionnaire (NPI-Q), were derived from 10,600 participants at baseline, with at least one UDS follow-up visit, from 32 National Institute of Aging Alzheimer’s Disease Research Centers (ADRC). Prospective cognitive decline was characterized as incident mild cognitive impairment (MCI) diagnosis during UDS follow-up. Logistic mixed-effects model with random intercept and slope examined associations between the NSD and longitudinal cognitive decline. All models included age at baseline, sex, years of education, APOE ε4 status and their interactions with time. Time was operationalized as years from baseline for each participant.
Results
Of the 10,600 cognitively normal participants at baseline, 1,017 (8.6%) had NSD. The proportion of males versus females with sleep problems was 10.1% vs. 9.3% respectively. For participants with NSD and no NSD, the mean (SD) age was 71 (7.3) and 70 (5.7) years and average follow-up time was 5.2 (2.6) and 4.9 (2.7) years, respectively. Participants with NSD were significantly more likely to develop incident MCI during UDS follow-up (OR: 1.42, p =.003). The interaction of NSD with time was significant (p< .001) suggesting an increase in the likelihood of conversion to MCI increased over time. Furthermore, there were significant differences in mean conversion rates to MCI in the NSD group when the previous time-point was compared to the next (p<01), with a time dependent dose response in the risk of conversion to MCI observed.
Conclusion
In elderly cognitive-normal individuals, nocturnal sleep disturbance is associated with a time-dependent progression risk to MCI. These findings are consistent with the role of disturbed sleep in the development of Alzheimer’s Disease.
Support
NIH/NIA/NHLBI (L30-AG064670, CIRAD P30AG059303 Pilot, T32HL129953, R01HL118624, R21AG049348, R21AG055002, R01AG056031, R01AG022374, R21AG059179, R01AG056682, R01AG056531, K07AG05268503, K23HL125939)
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Affiliation(s)
- O M Bubu
- NYU School of Medicine, New York, NY
| | - A K Mbah
- University of South Florida, Tampa, FL
| | | | | | - A Parekh
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - A E Mullins
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - K Kam
- Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - A W Varga
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - D M Rapoport
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - I Ayappa
- Icahn School of Medicine at Mount Sinai, New York, NY
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Salemi JL, Whiteman VE, August EM, Chandler K, Mbah AK, Salihu HM. Maternal hepatitis B and hepatitis C infection and neonatal neurological outcomes. J Viral Hepat 2014; 21:e144-53. [PMID: 24666386 DOI: 10.1111/jvh.12250] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 01/12/2014] [Indexed: 12/13/2022]
Abstract
To examine the associations between maternal hepatitis B (HBV) and hepatitis C (HCV) infection status and selected infant neurological outcomes diagnosed at birth, we conducted a population-based, retrospective cohort study on singleton live births in Florida from 1998 to 2009. Primary exposures included maternal HBV and HCV monoinfection. The neurological outcomes included brachial plexus injury, cephalhematoma, foetal distress, feeding difficulties, intraventricular h aemorrhage and neonatal seizures. Multivariable logistic regression models were used to generate odds ratios (OR) and 95% confidence intervals (CI) that were adjusted for socio-demographic characteristics, risky behaviours, pregnancy complications and pre-existing medical conditions, and timing of delivery. The risk of an adverse neurological outcome was higher in infants born to mothers with hepatitis viral infection (7.2% for HCV, 5.0% for HBV), compared with infants of hepatitis virus-free mothers (4.2%). After adjusting for potential confounders, women with HBV were twice as likely to have infants who suffered from brachial plexus injury (OR = 2.04, 95% CI = 1.15-3.60), while those with HCV had an elevated odds of having an infant with feeding difficulties (OR: 1.32, 95% CI = 1.06-1.64) and a borderline increased likelihood for neonatal seizures (OR = 1.74, 95% CI = 0.98-3.10). Additionally, HCV+ mothers had a 22% increased odds of having an infant with some type of adverse neurological outcome (OR: 1.22, 95% CI = 1.03-1.44). Our findings add to current understanding of the association between maternal HBV/HCV infections and infant neurological outcomes. Further research evaluating the role of maternal HBV and HCV infections (including viraemia, treatment) on pregnancy outcomes is warranted.
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Affiliation(s)
- J L Salemi
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL, USA
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August EM, Salihu HM, Weldeselasse H, Biroscak BJ, Mbah AK, Alio AP. Infant mortality and subsequent risk of stillbirth: a retrospective cohort study. BJOG 2011; 118:1636-45. [DOI: 10.1111/j.1471-0528.2011.03137.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mbah AK, Kornosky JL, Kristensen S, August EM, Alio AP, Marty PJ, Belogolovkin V, Bruder K, Salihu HM. Super-obesity and risk for early and late pre-eclampsia. BJOG 2010; 117:997-1004. [PMID: 20482533 DOI: 10.1111/j.1471-0528.2010.02593.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine the association between obesity subtypes and risk of early and late pre-eclampsia. DESIGN Population-based retrospective study. SETTING State of Missouri maternally linked birth cohort files. POPULATION All singleton live births in the state of Missouri from 1989 to 2005. METHODS The body mass index (BMI) was used to classify women as normal weight (BMI = 18.5-24.9 kg/m(2)), class I obesity (BMI = 30-34.9 kg/m(2)), class II obesity (BMI = 35-39.9 kg/m(2)), class III obesity (BMI = 40-49.9 kg/m(2)) or super-obesity (BMI > or = 50 kg/m(2)). Adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between obesity and the risk of pre-eclampsia were obtained from logistic regression models with adjustment for intracluster correlation. RESULTS The rate of pre-eclampsia increased with increasing BMI, with super-obese women having the highest incidence (13.4%). Compared with normal weight women, obese women (BMI > or = 30 kg/m(2)) had a higher risk for pre-eclampsia (OR = 2.59, 95% CI = 2.87-3.01). This risk remained approximately the same for late-onset pre-eclampsia (pre-eclampsia occurring at 34 weeks or more of gestation) and was slightly reduced for early-onset pre-eclampsia (pre-eclampsia occurring at 34 weeks or less of gestation). Within each BMI category, the risk of pre-eclampsia increased with the rate of weight gain. Compared with normal weight mothers with moderate weight gain, super-obese women with a high rate of weight gain had the greatest risk for pre-eclampsia (OR = 7.52, 95% CI = 2.70-21.0). CONCLUSION BMI and rate of weight gain are synergistic risk factors that amplify the burden of pre-eclampsia among super-obese women.
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Affiliation(s)
- A K Mbah
- Center for Research and Evaluation, The Chiles Center, University of South Florida, 3111 E. Fletcher Avenue, Tampa, FL 33613, USA
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Salihu HM, Mbah AK, Alio AP, Clayton HB, Lynch O. Low pre-pregnancy body mass index and risk of medically indicated versus spontaneous preterm singleton birth. Eur J Obstet Gynecol Reprod Biol 2009; 144:119-23. [PMID: 19328619 DOI: 10.1016/j.ejogrb.2009.02.047] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2008] [Revised: 10/01/2008] [Accepted: 02/22/2009] [Indexed: 11/30/2022]
Affiliation(s)
- H M Salihu
- Department of Obstetrics and Gynecology, University of South Florida, Tampa, FL 33613, USA.
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