Psychosocial Determinants of Sleep Behavior and Healthy Sleep Among Adolescents: A Two-Wave Panel Study

To date, it remains unknown which psychosocial determinants identified by several leading behavior change theories are associated with different sleep parameters among adolescents. Therefore, this study investigates whether changes in knowledge about healthy sleep, attitude toward healthy sleep and going to bed on time, self-efficacy to engage in healthy sleep behavior, perceived parental and peer norms, perceived barriers (e.g., worrying, fear of missing out), and perceived support (e.g., bedtime rules, encouragement) related to healthy sleep are associated with changes in adolescents' sleep duration on school days and free days and sleep quality over a period of 1 year. Two-wave data of 1648 Flemish adolescents (mean age = 15.01, SD = 0.65, 46.3% female) were analyzed using linear models. Increased levels of parental social support, positive attitude towards and perceived advantages of healthy sleep, norm-knowledge, and perceived peer behavior were associated with sleep duration, with parental social support having the strongest association. Increased levels of perceived barriers were associated with decreased levels of sleep quality parameters, and increased levels of self-efficacy, positive attitude, and parental modeling were associated with improved sleep quality parameters, with perceived barriers having the strongest association. The current results indicate that behavior change theories are useful in the context of adolescent sleep behavior and suggest that perceived parental support (i.e., bedtime rules) and perceived barriers are most strongly associated with adolescents' sleep duration and/or quality.

The Association Between Short Sleep Duration and Metabolic Syndrome: A Case-Control Study

Purpose

Short sleep duration and quality are increasingly common in the Middle East and North Africa (MENA) region and has been linked to metabolic syndrome, which increases the risk of cardiovascular disease and diabetes. This study aimed to examine the link between short sleep duration and metabolic syndrome.

Patients and Methods

We conducted a case-control study using data from Qatar Biobank, with 1000 participants categorized into two groups: less than 7 hours of sleep (n=500) and 7 or more hours of sleep (n=500). Metabolic syndrome was defined using WHO criteria, and logistic regression analysis adjusted for age and gender.

Results

There was a higher proportion of individuals with MetS in the short sleep duration group compared to the normal sleep duration group (22.8% vs 15.8%, respectively). The multivariable regression showed that short sleep duration was associated with metabolic syndrome (OR 1.91, 95% CI: 1.14-3.20, P=0.014) and having 1-2 components of metabolic syndrome (OR 1.91, 95% CI: 1.14-3.20, P=0.014), particularly in males (OR: 2.30, 95% CI: 1.07-4.94, P=0.032). Being overweight (OR 2.17, 95% CI: 1.30-3.63, P=0.003) was also associated with a shorter sleep duration. BMI was identified as the main contributor to the association between short sleep duration and metabolic syndrome, while diabetes played a minor role.

Conclusion

Short sleep duration was associated with metabolic syndrome in Qatar, particularly in males.

A Longitudinal Study of Stress During Pregnancy, Children's Sleep and Polygenic Risk for Poor Sleep in the General Pediatric Population

Early life stress is robustly associated with poor sleep across life. Preliminary studies suggest that these associations may begin already in utero. Here, we study the longitudinal associations of prenatal psychosocial stress with sleep across childhood, and assess whether prenatal stress interacts with genetic liability for poor sleep.The study is embedded in the Generation R population-based birth cohort. Caregivers reported on prenatal psychosocial stress (life events, contextual, parental or interpersonal stressors) and on children's sleep at ages 2 months, 1.5, 2, 3 and 6 years. The study sample consisted of 4,930 children; polygenic risk scores for sleep traits were available in 2,063.Prenatal stress was consistently associated with more sleep problems across assessments. Effect sizes ranged from small (B = 0.21, 95%CI: 0.14;0.27) at 2 months to medium (B = 0.45, 95%CI: 0.38;0.53) at 2 years. Prenatal stress was moreover associated with shorter sleep duration at 2 months (Bhrs = -0.22, 95%CI: -0.32;-0.12) and at 2 years (Bhrs = -0.04, 95%CI -0.07; -0.001), but not at 3 years (Bhrs = 0.02, 95%CI: -0.02;0.06). Prenatal negative life events interacted with polygenic risk for insomnia to exacerbate sleep problems at 6 years (Binteraction = 0.07, 95%CI: 0.02;0.13).Psychosocial stress during pregnancy has negative associations with children's sleep that persist across childhood, and are exacerbated by genetic liability for insomnia. Associations with sleep duration were more pronounced in infancy and seem to attenuate with age. These findings highlight the role of the prenatal environment for developing sleep regulation, and could inform early intervention programs targeting sleep in children from high-risk pregnancies.

Insomnia, Poor Sleep Quality and Sleep Duration and Risk for COVID-19 Infection and Hospitalization

BACKGROUND

Medical comorbidities increase the risk of severe acute COVID-19 illness. Although sleep problems are common after COVID-19 infection, it is unclear whether insomnia, poor sleep quality and extremely long or short sleep increase risk of developing COVID-19 infection or hospitalization.

METHODS

Cross-sectional survey of a diverse sample of 19,926 U.S. adults RESULTS: COVID-19 infection and hospitalization prevalence rates were 40.1% and 2.9% respectively. Insomnia and poor sleep quality were reported in 19.8% and 40.1% respectively. In logistic regression models adjusted for comorbid medical conditions and sleep duration but excluding participants who reported COVID-19 associated sleep problems, poor sleep quality but not insomnia was associated with COVID-19 infection (aOR: 1.16, 95%CI: 1.07-1.26) and COVID-19 hospitalization (aOR: 1.50, 95% CI: 1.18-1.91). In comparison to habitual sleep duration of 7-8 hours, sleep durations less than 7 hours (aOR: 1.14, 95% CI: 1.06-1.23) and sleep duration of 12 hours (aOR: 1.61, 95% CI: 1.12-2.31) were associated with increased odds of COVID-19 infection. Overall, the relationship between COVID-19 infection and hours of sleep followed a quadratic (U shaped) pattern. No association between sleep duration and COVID-19 hospitalization was observed.

CONCLUSION

In a general population sample, poor sleep quality and extremes of sleep duration are associated with greater odds of having had a COVID-19 infection; poor sleep quality was associated with an increased requirement of hospitalization for severe COVID-19 illness. These observations suggest that inclusion of healthy sleep practices in public health messaging may reduce the impact of the COVID-19 pandemic.

Association between Sleep Duration and Presbycusis in Korean Adults: Korea National Health and Nutrition Examination Survey

BACKGROUND

Sleep duration is associated with hearing loss, especially presbycusis, which is the most common type of hearing loss; however, there is limited evidence regarding this association among the Korean population. We aimed to determine the relationship between sleep duration and high-frequency hearing loss in Korean adults aged ≥40 years.

METHODS

We examined 5,547 Korean adults aged ≥40 years who completed audiometric tests and questionnaires regarding sleep duration during the 2010-2012 cycle of the Korea National Health and Nutrition Examination Survey. Mild presbycusis was defined as >25 decibels (dB) and <40 dB, whereas moderate-to-severe presbycusis was defined as >40 dB pure tone averages at high frequencies (3,000, 4,000, and 6,000 Hz) for both ears. Additionally, the sleep duration was divided into quartiles. Odds ratios and 95% confidence intervals were estimated using multivariable logistic regression after adjusting for covariates.

RESULTS

The prevalence of presbycusis in South Korean adults was 62.1%, of which 61.4% showed moderate to severe presbycusis. The incidence of moderate-to-severe, but not mild, presbycusis showed a significant positive correlation with sleep duration.

CONCLUSION

Our findings suggest that sleep duration is associated with the prevalence of presbycusis.

Association between sleep insufficiency and dyslipidemia: a cross-sectional study among Greek adults in the primary care setting

Objective

To investigate the potential association between sleep insufficiency and dyslipidemia (DL) in the primary care setting using self-reported questionnaires.

Material and Methods

957 adults aged between 19 and 86 years old from the rural area of Thrace, Greece were enrolled in this cross-sectional study. Multistage stratifed cluster sampling was used and the subjects were classifed into three groups according to sleep duration [short (<6h), normal (6-8h), and long (>8h) sleep duration]. DL was defined by a positive response to the question "Have you ever been told by a doctor or health professional that your blood cholesterol or triglyceride levels were high?", or if they were currently taking antilipidemic agents. Sleep quality, utilizing Epworth sleepiness scale, Athens insomnia scale, Pittsburgh sleep quality index and Berlin questionnaire, was also examined.

Results

DL prevalence was significantly associated with short sleep duration (aOR=2.18, p<0.001) and insomnia (aOR=1.43, p=0.050), while its relation with poor sleep quality (aOR=1.31, p=0.094) and risk for obstructive sleep apnea (aOR=1.32, p=0.097) were of marginal statistical significance. Concerning insomnia subtypes, DL was significantly associated with difficulties maintaining sleep (aOR=2.99, p<0.001) and early morning awakenings (aOR=1.38, p=0.050), but not difficulties initiating sleep (aOR=1.18, p=0.328).

Conclusion

This study reveals an association between sleep pathology and DL. Thus, early pharmacological and cognitive or behavioral interventions that improve sleep are deemed necessary in order to decrease DL burden.

Neural mechanisms that promote food consumption following sleep loss and social stress: An fMRI study in adolescent girls with overweight/obesity

STUDY OBJECTIVES

Insufficient sleep and social stress are associated with weight gain and obesity development in adolescent girls. Functional magnetic resonance imaging (fMRI) research suggests that altered engagement of emotion-related neural networks may explain overeating when under stress. The purpose of this study is to explore the effects of acute sleep restriction on female adolescents' neural responding during social evaluative stress and their subsequent eating behavior.

METHODS

Forty-two adolescent females (ages 15-18 years) with overweight or obesity completed a social stress induction task in which they were told they would be rated by peers based on their photograph and profile. Participants were randomly assigned to one night of sleep deprivation or 9 hours of sleep the night before undergoing fMRI while receiving positive and negative evaluations from their peers. After which, subjects participated in an ad libitum buffet.

RESULTS

Sleep deprived, relative to non-deprived girls had distinct patterns of neural engagement to positive and negative evaluation in anterior, mid, and posterior aspects of midline brain structures. Moreover, a sleep deprivation-by-evaluation valence-by-caloric intake interaction emerged in bilateral dorsal anterior cingulate. Among sleep deprived girls, greater engagement during negative, but not positive, feedback was associated with lower caloric intake. This was not observed for non-sleep deprived girls.

CONCLUSIONS

Results suggest an interaction between acute sleep loss and social evaluation that predicts emotion-related neural activation and caloric intake in adolescents. This research helps to elucidate the relationship between sleep loss, social stress, and weight status using a novel health neuroscience model.

Associations between everyday discrimination and sleep quality and duration among African Americans over time in the Jackson Heart Study

STUDY OBJECTIVES

African-Americans have a high burden of poor sleep, yet, psychosocial determinants (e.g., discrimination) are understudied. We investigated longitudinal associations between everyday discrimination and sleep quality and duration among African-Americans (N=3404) in the Jackson Heart Study.

METHODS

At Exam 1 (2000-2004) and Exam 3 (2008-2013), participants completed the Everyday Discrimination Scale, rated their sleep quality (1=poor to 5=excellent), and self-reported hours of sleep. A subset of participants (N=762) underwent 7-day actigraphy to objectively assess sleep duration (Sleep Exam 2012-2016). Changes in discrimination were defined as low stable (reference), increasing, decreasing, and stable high. Within-person changes in sleep from Exam 1-to-3 were regressed on change in discrimination from Exam 1-to-3 while adjusting for age, sex, education, income, employment, physical activity, smoking, body mass index, social support and stress.

RESULTS

At Exam 1, the mean age was 54.1 (12.0) years; 64% were female, mean sleep quality was 3.0 (1.1) and 54% were short sleepers. The distribution of the discrimination change trajectories, were 54.1% low stable, 13.5% increasing, 14.6% decreasing, and 17.7% were high stable. Participants who were in the increasing (vs. stable low) discrimination group had greater decrease in sleep quality. There was no association between change in discrimination and change in sleep duration. Among Sleep Exam participants, higher discrimination was cross-sectionally associated with shorter self-reported sleep duration, independent of stress.

CONCLUSION

Discrimination is a unique stressor for African-Americans; thus, future research should identify interventions to reduce the burden of discrimination on sleep quality.

Sleep insufficiency and incident diabetes mellitus among indigenous and minority populations in Greece

Objective

To investigate the potential association between sleep pathology and diabetes mellitus (DM) using self-reported questionnaires.

Material and Methods

957 adults aged between 19 and 86 years old were enrolled in this cross-sectional study. Multistage stratified cluster sampling was used and subjects were classified into three groups [short (<6h), normal (6-8h) and long (>8h) sleep duration]. Individuals were classified as diabetics if they responded positively to the questions: “Have you ever been told that you are diabetic or have high blood sugar by a health professional?” or “Are you on antidiabetic medication?”. Sleep quality, utilizing Epworth sleepiness scale, Athens insomnia scale, Pittsburgh sleep quality index and Berlin questionnaire, was also examined.

Results

DM prevalence was higher among expatriated and Muslim Greeks (23.1% and 18.7%, respectively) compared to indigenous Greek Christians (4.4%). DM prevalence was significantly associated with short sleep duration (aOR=2.82, p<0.001), excessive daytime sleepiness (aOR=2.09, p=0.019) and poor sleep quality (aOR=2.56, p<0.001), while its relation with insomnia (aOR=1.63, p=0.065) and risk for obstructive sleep apnea (aOR=1.53, p=0.080) were of marginal statistical significance.

Conclusion

This study indicates an association between sleep quantity, quality and DM and supports early pharmacological and cognitive behavioral interventions on sleep disturbances in order to reduce the burden of DM with increased focus on minority population needs.

How do adolescents with short sleep duration spend their extra waking hours? A device-based analysis of physical activity and sedentary behaviour in a Brazilian sample

Objectives

To compare sedentary behaviour and physical activity between short sleepers and adequate sleepers in a sample of Brazilian adolescents.

Material and Methods

688 adolescents wore accelerometers on the non-dominant wrist for seven days. Sleep duration, sedentary behaviour, light (LPA), moderate (MPA), and vigorous physical activity (VPA) were estimated. Participants were classified as short (<8h/night) or adequate sleepers (≥8h/night). The minutes and the percentage of time spent in each waking behaviour was compared between short and adequate sleepers.

Results

Participants were 16.3 years old, 50.4% were female, and 67.7% were short sleepers. Adequate sleepers engaged in less (min/day) sedentary behaviour (-53.46), LPA (-25.44), MPA (-4.27), and VPA (-0.63) compared to short sleepers. However, no differences were observed for the proportion of time (68% in sedentary behaviour, 28% in LPA, 3% in MPA, and <0.4% in VPA).

Conclusion

Patterns of waking behaviours are similar between short and adequate sleepers.

[The role of sleep and sleep disorder management in reducing cardiovascular- and cardiometabolic risk and improving treatment outcomes]

Despite extensive knowledge on the importance of quality sleep for health and wellbeing, sleep quality and sleep disorders are commonly overlooked in both prevention and treatment of chronic illnesses. The aim of this review is to draw attention to recently published literature focusing on how disrupted sleep contributes to the onset and progression of chronic diseases, with focus on cardiovascular- and -cardiometabolic diseases. Diagnosis and management of sleep disorders are an important part of prevention and chronic disease management to optimize outcomes and improve patients´ health and quality of life. Objective sleep disorder diagnosis is relevant to ensure appropriate therapy intervention, and for sleep disorders to be managed as other chronic diseases based on regular objective assessments of treatment efficacy. In light of the knowledge of how short sleep and/or low sleep quality negatively affects the cardiovascular system, including objective sleep evaluation in the -standard of care for risk assessment and management of cardiovascular diseases may improve cardiovascular risk prediction and improve outcomes.

Analysis of the Relationship between Sleep Duration and Body Mass Index among Korean Adolescents Using Data from the 2013-2015 Korea National Health and Nutrition Examination Survey

BACKGROUND

Obesity in adolescence can continue up to adulthood and lead to various complications. There has been a continuous increase in the obesity incidence among adolescents, which is an emerging social issue. Studies have reported that decreased sleep duration in adolescents can have negative effects on health, leading to obesity. Therefore, in the present study, we aimed to investigate the relationship between sleep duration and body mass index among South Korean middle and high school students aged 12-18 years.

METHODS

The participants of the Sixth National Health and Nutrition Survey conducted during 2013-2015 were screened. We selected 1,177 adolescents aged between 12 and 18 years who were enrolled in middle and high school or on leave of absence and had available data for sleep duration and body mass index (BMI) in the survey. Analyses of variance and covariance were performed after adjusting for confounding variables, including age, gender, waist circumference, and drinking experience, that showed significant correlations in univariate logistic regression.

RESULTS

The analysis of covariance revealed that an increase in sleep duration led to a corresponding decrease in the mean BMI among all students and middle school students.

CONCLUSION

Significant negative correlations were confirmed between sleep duration and BMI in all students and middle school students.

Sleep Patterns among US Latinos by Nativity and Country of Origin: Results from the National Health Interview Survey

Background

Sparse data exist to describe national population-level trends in short sleep duration among Latinos. Because short sleep duration is associated with several health conditions that are common in Latinos, such as obesity, diabetes, and hypertension, understanding sleep trends among this population may be key to reducing their disease burden. This study aimed to document Latino subgroup differences in self-reported sleep duration by nativity and country of origin relative to Whites.

Design and Setting

Pooled cross-sectional analysis of self-reported data from the National Health and Interview Survey (NHIS), 2004-2017.

Participants

303,244 respondents, aged 18 to 84 years, who self-identified as non-Latino US-born White, US-born Mexican, foreign-born Mexican, US-born Puerto Rican, island-born Puerto Rican, US-born Cuban, foreign-born Cuban, US-born Dominican, foreign-born Dominican, US-born Central/South American, foreign-born Central/South American, US-born "other" Latino, and foreign-born "other" Latino.

Methods

Multinomial logistic regression models were used to predict sleep duration controlling for demographics, acculturation, socioeconomic, and health-related factors.

Results

We found that all Latino subgroups (except US-born Cubans) were more likely to report poor sleep duration relative to non-Latino Whites, net of demographic, acculturation, socioeconomic, and health-related characteristics. However, the magnitude of disadvantage varies by Latino subgroup. We also found that poor sleep duration is concentrated among certain age groups for the various Latino subpopulations.

Conclusions

Given that Latinos in the United States are at higher risk for obesity, diabetes, and hypertension, understanding the patterns of sleep among this population can help identify strategies to improve sleep habits in order to reduce disease burden.

Association between sleep duration and hypertension: Isfahan Healthy Heart Program, Iran

BACKGROUND

Hypertension (HTN) is an important risk factor for atherosclerotic and non-atherosclerotic cardiovascular disease (CVD). HTN increases risk of stroke and diabetes complications and at the end stage renal disease. Sleep disorders including short sleep duration are involved in pathogenesis of HTN. This study aimed to examine the association between self-reported sleep duration and HTN in a group of adult population in Isfahan City, Iran.

METHODS

This cross-sectional survey was performed as part of the Isfahan Healthy Heart Program (IHHP). A total of 12492 individuals aged over 19 years (6110 men and 6382 women) entered the study. Sleep duration was recorded according to subjects' self-report. HTN was defined as a systolic blood pressure (SBP) of ≥ 140 mmHg, a diastolic blood pressure (DBP) of ≥ 90 mmHg, or use of antihypertensive medication. The relation between sleep hours and HTN was examined using multiple logistic regression in three models, unadjusted, adjusted according to age and sex, and adjusted according to age, sex, body mass index (BMI), and waist circumference (WC).

RESULTS

Sleeping time less than 5 hours, in comparison to sleep duration of 7-8 hours per night,was associated with a higher risk of HTN [odds ratio (OR) = 2.52, 95% confidence interval (CI): 2.17-2.93]. This association remained significant even after adjustment for age, sex, BMI, and WC (OR = 1.38, 95% CI: 1.16-1.64). Sleep duration over 9 hours had a negative association with risk of HTN among those under 60 years old (OR = 0.63, 95% CI: 0.47-0.86).

CONCLUSION

Sleep duration less than 5 hours is positively associated with HTN. It seems that sleep duration might affect HTN and atherosclerotic CVD.

Association of Sleep Duration and Obesity According to Gender and Age in Korean Adults: Results from the Korea National Health and Nutrition Examination Survey 2007-2015

BACKGROUND

This study aimed to investigate associations between self-reported sleep duration and general and abdominal obesity in Korean adults stratified according to gender and age.

METHODS

Data from 41,805 adults, 18-110 years of age, collected by the Korea National Health and Nutrition Examination Survey (KNHANES) in 2007 and 2015, were analyzed. Multivariable logistic regression was used to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for obesity and abdominal obesity by sleep duration after controlling for sociodemographic and lifestyle variables.

RESULTS

Among individuals 30-49 years of age, there was an increased AOR for obesity only for sleep duration ≤ 5 hour/day compared with sleep duration 6 to 8 hour/day, both in men (OR, 1.25; 95% CI, 1.02-1.54) and women (OR, 1.56; 95% CI, 1.29-1.90), after controlling for covariates. Regarding women, there was increased AOR for abdominal obesity for sleep duration ≤ 5 hour/day (OR, 1.45; 95% CI, 1.18-1.78) and ≥ 9 hour/day (OR, 1.38; 95% CI, 1.09-1.76) compared with sleep duration 6 to 8 hour/day. However, for elderly individuals (≥ 65 years), there was a negative association between sleep duration ≤ 5 hour/day and obesity, but not with abdominal obesity, in both men and women.

CONCLUSION

This study demonstrated a significant association between sleep duration and obesity, which varied according to gender and age.

Sleep Duration and Factors Related to Sleep Loss in 3-14-Year-Old Children in Beijing: A Cross-Sectional Survey

Background:

It is known that short sleep duration adversely affects children's behavior and physical development. This study aimed to investigate the status of sleep duration in 3–14-year-old children in Beijing and explore the related factors of sleep loss with them.

Methods:

In this study, a cross-sectional study of random stratified cluster sampling was conducted on 3–14-year-old children and adolescents in Beijing. According to the proportion of children in each district and school, the final cohort included a total of 11 kindergartens, 7 primary schools, and 8 junior high schools from 7 districts of Beijing. Children of sampled classes were included, and their parents were invited to fill a series of questionnaires including the simplified Chinese version of Pediatric Sleep Questionnaire, Sleep Questionnaire Scale, and Hong Kong-Children Sleep Questionnaire about the performance of the last 6 months.

Results:

Out of the total 11,420 questionnaires, 9198 questionnaires were valid and effective with the response rate of 80.54%. The age of the investigated children was 8.8 ± 3.8 years, including 4736 males and 4462 females. The daily sleep duration of children in Beijing was 9.7 ± 0.7 h. The prevalence of sleep loss (<9 h/day) of children in Beijing was 11.8%. The daily sleep duration of children aged <6, 6 ≤ age <11, and ≥11 years was 9.7 ± 0.6 h, 9.6 ± 0.6 h, and 9.5 ± 0.8 h, respectively. The sleep duration reduced significantly in children aged ≥11 years as compared to younger children in Beijing which was mainly contributed by the variation tendency of sleep duration on weekdays. The multivariate logistic regression analysis identified factors associated with sleep loss (P < 0.05): male (odds ratio [OR] = 1.32, 95% confidence interval [CI]: 1.15–1.51), age ≥11 years (OR = 2.37, 95% CI: 1.92–2.93), overweight (OR = 1.34, 95% CI: 1.17–1.54), family history of snoring (OR = 1.35, 95% CI: 1.13–1.61) and activities before bedtime with watching TV (OR = 1.24, 95% CI: 1.08–1.43), sports (OR = 1.22, 95% CI: 1.01–1.48), playing cellphone (OR = 1.91, 95% CI: 1.31–2.73) and surfing the Internet (OR = 1.27, 95% CI: 1.06–1.52) and among them age ≥11 years and playing cellphone before bedtime had greater impact on children's short sleep duration than that of other factors.

Conclusions:

Sleep loss was common among 3–14-year-old children in Beijing. Sleep duration decreased with age, especially among children over 11 years old. Factors associated with sleep loss covered sociodemographic characteristics, family sleep habits and routine activities before bedtime, and among those variables, age ≥11 years and playing with cellphones before bedtime had a greater impact on sleep duration, indicating that existing sleep loss in 3–14-year-old children could be, at least partly, improved by paying more attention to children aged of 11 years or entering Grade 5 and Grade 6 and to children with a family history of snoring; by reducing the use of electronic products before bedtime, especially cellphones; by managing weight and keeping fit; and by improving the bedtime routine.

Sleep Duration and Health-Related Quality of Life in Predialysis CKD

BACKGROUND AND OBJECTIVES

Sleep duration has been associated with cardiometabolic risk and mortality. The health-related quality of life represents a patient's comprehensive perception of health and is accepted as a health outcome. We examined the relationship between sleep duration and health-related quality of life in predialysis CKD.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

In this cross-sectional study, data from 1910 adults with CKD enrolled in the Korean Cohort Study for Outcome in Patients with CKD were analyzed. Health-related quality of life was assessed with the physical component summary and mental component summary of the Short Form-36 Health Survey. Low health-related quality of life was defined as a Short Form-36 Health Survey score >1 SD below the mean. Using a generalized additive model and multivariable logistic regression analysis, the relationship between self-reported sleep duration and health-related quality of life was examined.

RESULTS

Seven-hour sleepers showed the highest health-related quality of life. We found an inverted U-shaped relationship between sleep duration and health-related quality of life as analyzed by a generalized additive model. In multivariable logistic analysis, short sleepers (≤5 h/d) had lower health-related quality of life (odds ratio, 3.23; 95% confidence interval, 1.86 to 5.60 for the physical component summary; odds ratio, 2.37; 95% confidence interval, 1.43 to 3.94 for the mental component summary), and long sleepers (≥9 h/d) had lower health-related quality of life (odds ratio, 2.80; 95% confidence interval, 1.55 to 5.03 for the physical component summary; odds ratio, 2.08; 95% confidence interval, 1.20 to 3.60 for the mental component summary) compared with 7-hour sleepers. Sleep duration had a significant U-shaped association with low health-related quality of life.

CONCLUSIONS

These findings suggest that short or long sleep duration is independently associated with low health-related quality of life in adults with CKD.

Impact of Sleep Duration and Weekend Oversleep on Body Weight and Blood Pressure in Adolescents

Introduction

Weekend oversleep or catchup sleep is a frequent occurrence in children, but there are relatively little data concerning its impact on weight and blood pressure. The aim of this study was to assess the association between sleep duration and oversleep, and weight and blood pressure in adolescents.

Methods

Sleep duration, weight and blood pressure of 327 children (51.4% boys, mean age 13.3 ± 1.7 years) who had polysomnograms performed during both exam cycles of the Tucson Children's Assessment of Sleep Apnea study (TuCASA) were analyzed. Sleep duration on school nights and non-school nights was used to compute a weighted average of child and parent reported overall sleep duration respectively. Oversleep was defined as the difference between self and parent reported weekend sleep and weekday sleep separately. Simple correlations between overall sleep duration, sleep on school and non-school nights and oversleep, and blood pressure, standardized body mass index (BMI), snoring, respiratory disturbance index (RDI) and age were calculated. Significant bivariate associations then were used to develop multivariate partial correlation models.

Results

Unadjusted negative correlations with BMI were noted for parent reported total sleep duration at the 1^st exam cycle, parent and child reported total sleep and school night sleep duration, and parent reported non-school night sleep duration at the 2^nd exam cycle. Additionally, for BMI, positive correlations were observed for log RDI at both exam cycles and snoring at the 2^nd exam cycle. For blood pressure, there were positive associations with age, parent reported oversleep, caffeine consumption and snoring. Additionally, for blood pressure, negative relationships were observed with parent reported total sleep duration at the 1^st exam cycle, and parent and child reported total sleep and school night sleep durations at the 2^nd exam cycle. Partial correlations found that BMI was negatively correlated with parent reported total sleep duration at the 1^st exam cycle and parent reported total sleep duration at the 2^nd exam cycle, and positively correlated with snoring and log RDI at both exam cycles. Systolic blood pressure was only associated with age and snoring. Diastolic blood pressure was positively correlated with age and caffeine consumption, and negatively correlated with parent reported total and school night sleep duration. Oversleep and child reported sleep duration were not represented in any of these models.

Conclusion

Lower amounts of sleep especially on school nights is associated with higher body weight and blood pressure. Oversleep was not associated with either body weight or blood pressure.

Relationship between Mobile Phone Addiction and the Incidence of Poor and Short Sleep among Korean Adolescents: a Longitudinal Study of the Korean Children & Youth Panel Survey

Three of ten teenagers in Korea are addicted to mobile phones. The aim of this study was to examine the relationship between mobile phone addiction and the incidence of poor sleep quality and short sleep duration in adolescents. We used longitudinal data from the Korean Children & Youth Panel Survey conducted by the National Youth Policy Institute in Korea (2011-2013). A total of 1,125 students at baseline were included in this study after excluding those who already had poor sleep quality or short sleep duration in the previous year. A generalized estimating equation was used to analyze the data. High mobile phone addiction (mobile phone addiction score > 20) increased the risk of poor sleep quality but not short sleep duration. We suggest that consistent monitoring and effective intervention programs are required to prevent mobile phone addiction and improve adolescents' sleep quality.

The Association between Self-reported Sleep Duration and Body Mass Index among Korean Adolescents

Previous research has shown that lack of sleep is related to Body Mass Index (BMI) in adolescence. This study was designed to investigate the association between sleep duration and BMI among Korean adolescents. We conducted a school-based cross-sectional study of 3,785 adolescents (males: 58.2%, females: 41.8%) in middle and high school between the ages of 11 and 18 years (mean age 15.26 ± 1.45). Using a self-reported questionnaire, we obtained information regarding weekday sleep duration, weekend sleep duration, height, weight, time spent at private tutoring institutes, socioeconomic status and scores on the Beck Depression Inventory (BDI). We investigated the association between self-reported sleep duration and BMI. After adjusting for confounding factors including age, gender, time spent at private tutoring institutes, academic performance, economic status and BDI scores, longer sleep duration on both weekdays and weekends was associated with decreased BMI (P = 0.002 and P < 0.001, respectively) for both genders. Increased weekend catch-up sleep duration was associated with decreased BMI in females (P = 0.038), but not in males (P = 0.343). The results of the present study indicated that longer sleep duration on weekdays and weekends in adolescents was associated with lower BMI. Longer weekend catch-up sleep may compensate effects of insufficient sleep on BMI for female adolescents.

The impact of sleep on female sexual response and behavior: a pilot study

INTRODUCTION

The etiological role of sleep disturbance in sexual difficulties has been largely overlooked. Research suggests that short sleep duration and poor sleep quality lead to poor female sexual response. However, prior research consists of cross-sectional studies, and the influence of sleep on sexual functioning and behavior has not been prospectively examined.

AIM

We sought to examine the influence of nightly sleep duration, sleep quality, and sleep onset latency on daily female sexual response and activity.

METHODS

This study used a longitudinal design to study 171 women free of antidepressants and with reliable Internet access who were recruited from a university setting in the United States. Participants first completed baseline measures in a laboratory, and then completed web-delivered surveys at their habitual wake time for 14 consecutive days.

MAIN OUTCOME MEASURES

All outcome measures were modified for daily recall. Participants completed the Profile of Female Sexual Function's desire, subjective arousal, and orgasmic functioning scales and the Female Sexual Function Index's genital arousal scale, and indicated whether they engaged in partnered sexual activity or self-stimulation in response to dichotomous items.

RESULTS

Analyses revealed that longer sleep duration was related to greater next-day sexual desire (b = 0.32, P = 0.02), and that a 1-hour increase in sleep length corresponded to a 14% increase in odds of engaging in partnered sexual activity (odds ratio = 1.14, P < 0.05). In contrast, sleeping longer predicted poorer next-day genital arousal (b = -0.19, P < 0.01). However, results showed that women with longer average sleep duration reported better genital arousal than women with shorter average sleep length (b = 0.54, P = 0.03).

CONCLUSIONS

Obtaining sufficient sleep is important to the promotion of healthy sexual desire and genital response, as well as the likelihood of engaging in partnered sexual activity. These relationships were independent of daytime affect and fatigue. Future directions may investigate sleep disorders as risk factors for sexual dysfunction.

Association between Bone Mineral Density and Sleep Duration in the Korean Elderly Population

Background

An association between sleep duration and a wide spectrum of diseases has been reported, but little is known about its relationship with bone mineral density (BMD). Previously conducted studies in Korea and abroad have reported results that are controversial. The present study sought to assess whether sleep duration can be considered an independent risk factor of osteoporosis.

Methods

We included participants over the age of 60 years with data on self-reported habitual sleep duration and BMD measured with dual X-ray absorptiometry. Comprehensive data on the study sample was obtained from the Korea National Health and Nutritional Survey performed from 2008 to 2010. Sex-stratified multiple regression analyses were conducted with adjustments for possible confounding factors.

Results

There was a significant inverse dose-dependent association between sleep duration and BMD measured at total hip, femur neck, and lumbar spine for women and total hip and femur neck for men. Sex-stratified regression analyses adjusted for age and body mass index revealed that sleep duration had a negative correlation with BMD at total hip and femoral neck for both women (β = -0.0048; P = 0.0172 for total hip, β = -0.0037; P = 0.0303 for femur neck) and men (β = -0.0057; P = 0.0218 for total hip, β = -0.0057; P = 0.0143 for femur neck). For women, the significance remained after further adjustment of confounding variables.

Conclusion

Prolonged sleep duration appears to have a significant association with lower total hip and femur neck BMD in elderly women but not in elderly men.

Sleep duration and depressive symptoms: a gene-environment interaction

OBJECTIVE

We used quantitative genetic models to assess whether sleep duration modifies genetic and environmental influences on depressive symptoms.

METHOD

Participants were 1,788 adult twins from 894 same-sex twin pairs (192 male and 412 female monozygotic [MZ] pairs, and 81 male and 209 female dizygotic [DZ] pairs] from the University of Washington Twin Registry. Participants self-reported habitual sleep duration and depressive symptoms. Data were analyzed using quantitative genetic interaction models, which allowed the magnitude of additive genetic, shared environmental, and non-shared environmental influences on depressive symptoms to vary with sleep duration.

RESULTS

Within MZ twin pairs, the twin who reported longer sleep duration reported fewer depressive symptoms (ec = -0.17, SE = 0.06, P < 0.05). There was a significant gene × sleep duration interaction effect on depressive symptoms (a'c = 0.23, SE = 0.08, P < 0.05), with the interaction occurring on genetic influences that are common to both sleep duration and depressive symptoms. Among individuals with sleep duration within the normal range (7-8.9 h/night), the total heritability (h2) of depressive symptoms was approximately 27%. However, among individuals with sleep duration within the low (< 7 h/night) or high (≥ 9 h/night) range, increased genetic influence on depressive symptoms was observed, particularly at sleep duration extremes (5 h/night: h2 = 53%; 10 h/night: h2 = 49%).

CONCLUSION

Genetic contributions to depressive symptoms increase at both short and long sleep durations.