Abnormal Sleep Duration Research Articles

Association Between Abnormal Sleep Duration and Stroke in the United States.

The new American Heart Association Life's Essential 8 construct of ideal cardiovascular health now includes sleep duration. Little is known, however, about sleep duration in individuals with prior stroke. Our objective was to compare sleep duration among individuals with and without prior stroke. Using the National Health and Nutrition Examination Surveys (NHANES) database (2005-2018), individuals 18 years or older were identified (n = 37,987 without self-reported stroke; n = 1,572 with self-reported stroke). Prevalence of normal sleep duration (7-8 or 6-8 hours/night because of multiple definitions in the literature) was compared between persons with and without self-reported history of stroke using the Rao-Scott χ2 test. Multinomial logistic regression analysis was used to evaluate the relationship between prior stroke and abnormal sleep before and after adjusting for demographic and clinical variables. Compared with individuals without stroke, those with prior stroke were more likely to report >8 hours/night (unadjusted odds ratio (OR) 2.03, 95% confidence interval (CI) 1.64-2.51), <7 hours/night (1.29, 1.08-1.53), and <6 hours/night (1.87, 1.53-2.29). After adjustment, these associations were attenuated (adjusted OR 1.54, 95% CI 1.22-1.94 and 1.15, 0.96-1.38 and 1.50, 1.21-1.85). US stroke survivors are more likely to have abnormal sleep duration than those without prior stroke. Limitations of this study include the cross-sectional and self-reported nature of the data.

Assessing the Relationship Between Sleep Duration and the Prevalence of Chronic Kidney Disease Among Veterans in the United States: A 2022 Behavior Risk Factor Surveillance System (BRFSS) Cross-Sectional Study.

Chronic kidney disease (CKD) is more prevalent among veterans in the United States than in the general population. Similarly, veterans also exhibit higher rates of abnormal sleep duration compared to the general population. The aim of this study was to investigate the association between self-reported length of sleep and the prevalence of CKD among veterans in the United States using responses from the 2022 Behavioral Risk Factor Surveillance System (BRFSS). For this cross-sectional study, a total of 53,211 veterans who responded to the 2022 BRFSS survey were analyzed. Measures include the outcome variable which is self-reported CKD diagnosis and a major independent variable sleep duration. Sleep duration was recategorized into ≤ 5 hours (short sleep duration), 6-10 hours (normal sleep duration), and >10 hours (long sleep duration). Covariates included gender, age, race, residence, insurance, alcohol consumption, diabetes comorbidity, coronary artery disease (CAD) comorbidity, and stroke comorbidity. Descriptive, bivariate, and multivariate logistic regressions were conducted using the SAS software (SAS Institute Inc., Cary, North Carolina, United States). Results: The prevalence of CKD among veterans in the United States is 3332 (6.29%). Veterans with sleep duration of 6-10 hours had 17.5% lower odds of CKD than veterans who slept for ≤5 hours (adjusted OR (AOR)= 0.825, 95%CI= 0.821-0.830; P=<0.0001). Veterans who slept for more than 10 hours had 68.2% higher odds of having CKD (AOR=1.682, 95%CI= 1.662-1.702; P=<0.0001). Additionally, veterans diagnosed with diabetes, stroke, and coronary artery disease had 2.447-2.103, and 2.838, respectively, higher odds of developing CKD (AOR=2.447, 95%CI= 2.435-2.459; p=<0.0001). Veterans who were 65 years and older had higher odds of developing CKD compared to those aged 35-44 years (AOR= 5.743, 95%CI= 5.669-5.818; P<0.001). The odds of having CKD were also higher among veterans who identified as Black (AOR 1.397, 95%CI =1.388-1.405; P<0.01) or as Hispanic (AOR =1.318, 95%CI = 1.307-1.329; P<0.01) compared to non-Hispanic White veterans. Those who identified as Asian had lower odds of CKD (AOR= 0.87, 95%CI=0.853-0.888; P<0.01). Furthermore, veterans who consumed alcohol had 7.8% lower odds of having CKD as compared to individuals who did not consume alcohol (AOR= 0.922, 95%CI =0.918-0.927; p=<0.0001). Male veterans had 24.7% lower odds of having CKD as compared to female veterans (AOR = 0.753, 95%CI= 0.747-0.758; P<0.001). Conclusion: This research provides evidence of a greater prevalence of CKD among veterans with short sleep duration (≤ 5 hours) and long sleep duration (> 10 hours). Sleep hygiene education and sleep optimization programs can improve sleep and boost overall kidney health among veterans.

Exploring Sleep Duration and Insomnia Among Prospective University Students: A Study with Geographical Data and Machine Learning Techniques.

Sleep disruptions among prospective university students are increasingly recognized for their potential ramifications on academic achievement and psychological well-being. But, information regarding sleep issues among students preparing for university entrance exams is unknown. Thus, this study aimed to investigate the prevalence and factors associated with sleep duration and insomnia among university entrance test-takers in Bangladesh, utilizing both traditional statistical analyses and advanced geographic information system and machine learning techniques for enhanced predictive capability. A cross-sectional study was conducted in June 2023 among 1496 entrance test-takers at Jahangirnagar University, Dhaka. Structured questionnaires collected data on demographics, academic information, and mental health assessments. Statistical analyses, including chi-square tests and logistic regression, were performed using SPSS, while machine learning models were applied using Python and Google Colab. Approximately 62.9% of participants reported abnormal sleep duration (<7 hours/night or >9 hours/night), with 25.5% experiencing insomnia. Females and those dissatisfied with mock tests were more likely to report abnormal sleep duration, while repeat test-takers, those with unsatisfactory mock test results, or anxiety symptoms had a higher risk of insomnia. Machine learning identified satisfaction with previous mock tests as the most significant predictor of sleep disturbances, while higher secondary school certificate GPA had the least influence. The CatBoost model achieved maximum accuracy rates of 61.27% and 73.46%, respectively, for predicting sleep duration and insomnia, with low log loss values indicating robust predictive performance. Geographic analysis revealed regional variations in sleep disturbances, with higher insomnia prevalence in some southern districts and abnormal sleep duration in northern and eastern districts. Sleep disturbances are prevalent among prospective university students and are associated with various factors including gender, test-taking status, mock test satisfaction, and anxiety. Targeted interventions, including sleep education and psychological support, hold promise in ameliorating sleep health and overall well-being among students, potentially enhancing entrance test performance.

Associations of exposure to volatile organic compounds with sleep health and potential mediators: analysis of NHANES data.

The effect of environmental pollution on sleep has been widely studied, yet the relationship between exposure to volatile organic compounds (VOCs) and sleep health requires further exploration. We aimed to investigate the single and mixed effect of urinary VOC metabolites on sleep health and identify potential mediators. Data for this cross-sectional study was collected from the National Health and Nutrition Examination Surveys (NHANES) (2005-2006, 2011-2014). A weighted multivariate logistic regression was established to explore the associations of 16 VOCs with four sleep outcomes. Following the selection of important VOCs through the least absolute shrinkage and selection operator (LASSO) regression, principal component analyses (PCA), weight quantile sum (WQS), and Bayesian kernel machine regression (BKMR) analyses were conducted to explore the associations between exposure to single and mixed VOCs and sleep outcomes, as well as identify the most contributing components. A mediation analysis was performed to explore the potential effect of depression scores. Of the 3,473 participants included in the study, a total of 618 were diagnosed with poor sleep patterns. In logistic regression analyses, 7, 10, 1, and 5 VOCs were significantly positively correlated with poor sleep patterns, abnormal sleep duration, trouble sleeping, and sleep disorders, respectively. The PCA analysis showed that PC1 was substantially linked to a higher risk of poor sleep patterns and its components. The WQS model revealed a positive association between VOC mixture of increased concentrations and poor sleep patterns [OR (95% CI): 1.285 (1.107, 1.493)], abnormal sleep duration [OR (95% CI): 1.154 (1.030, 1.295)], trouble sleeping [OR (95% CI): 1.236 (1.090, 1.403)] and sleep disorders [OR (95% CI): 1.378 (1.118, 1.705)]. The BKMR model found positive associations of the overall VOC exposure with poor sleep patterns, trouble sleeping, and sleep disorders. PCA, WQS, and BKMR models all confirmed the significant role of N-acetyl-S-(N-methylcarbamoyl)-l-cysteine (AMCC) in poor sleep patterns and its components. The depression score was a mediator between the positive VOC mixture index and the four sleep outcomes. Exposure to single and mixed VOCs negatively affected the sleep health of American population, with AMCC playing a significant role. The depression score was shown to mediate the associations of VOC mixtures with poor sleep patterns and its components.

Pre-existing sleep disturbances and risk of COVID-19: a meta-analysis

Sleep disturbances are widespread but usually overlooked health risk factors for coronavirus disease 2019 (COVID-19). We aimed to investigate the influence of pre-existing sleep disturbances on the susceptibility, severity, and long-term effects of COVID-19. We searched PubMed, Web of Science, and Embase for relevant articles from inception to October 27, 2023 and updated at May 8, 2024. Sleep disturbances included obstructive sleep apnea (OSA), insomnia, abnormal sleep duration, night-shift work, and any other sleep disturbances. Outcomes were COVID-19 susceptibility, hospitalization, mortality, and long COVID. The effect sizes were pooled odds ratios (ORs) and 95% confidence intervals (95% CIs). This study is registered with PROSPERO (CRD42024503518). A total of 48 observational studies (n=8,664,026) were included. Pre-existing sleep disturbances increased the risk of COVID-19 susceptibility (OR=1.12, 95% CI 1.07-1.18), hospitalization (OR=1.25, 95% CI 1.15-1.36), mortality (OR=1.45, 95% CI 1.19-1.78), and long COVID (OR=1.36 95% CI 1.17-1.57). Subgroup analysis showed that younger individuals with sleep disturbances were associated with higher susceptibility and hospitalization and a lower risk of mortality than older individuals. Males with sleep disturbances were associated with higher mortality. For specific sleep disturbances, the susceptibility and hospitalization of COVID-19 were associated with OSA, abnormal sleep duration, and night-shift work; mortality of COVID-19 was linked to OSA; risk of long COVID was related to OSA, abnormal sleep duration and insomnia. Pre-existing sleep disturbances, especially OSA, increased the risk of COVID-19 susceptibility, hospitalization, mortality, and long COVID. Age and sex played important roles in the effect of sleep disturbances on COVID-19. The National Natural Science Foundation of China and the Key Laboratory of Respiratory Diseases of Liaoning Province.

Abnormal sleep duration is associated with sarcopenia in older Chinese people: A large retrospective cross-sectional study.

Abnormalities in sleep patterns are a common health problem for the older adults. The relationship between sarcopenia and sleep duration in older people is controversial. This research is to examine the association between sleep duration and sarcopenia. We drew 21,095 adults from the China Health and Retirement Longitudinal Survey (CHARLS). Not only we explore the relationship between sleep duration and sarcopenia, but also compare sleep duration to three sarcopenia subcomponents. Moreover, the sensitivity analysis was conducted by the gender and residence area to ascertain the discrepancy, separately. Finally, using restricted cubic spline to find the non-linear association between them. Among 7,342 community older adults engaged by CHARLS in 2015, the incidence of possible sarcopenia and sarcopenia was 23.14 and 11.30%, separately. Sleep duration (≤6 h) [OR(95%CI) = 1.30(1.03-1.65), p < 0.05] and (≥8 h) [OR(95%CI) = 1.33(1.05-1.69), p < 0.05] were significantly linked with possible sarcopenia, while long sleep duration (≥8 h) [OR(95%CI) = 1.41(1.01-2.02), p < 0.05] was correlated strongly with sarcopenia. A non-linear relationship (U-shaped) between sarcopenia risk and sleep duration was found (p for non-linear = 0.009). Our findings highlight the importance of sleep duration in the onset of sarcopenia and might assist older persons to maintain good sleeping habits.

Prevalence of Depression Among Older Adults Visiting the Primary Healthcare Centers in Jizan City, Saudi Arabia: An Analytical Cross-Sectional Study.

Background and objective Older adults are susceptible to various disorders, including depression. Depression manifests as a disorder characterized by a persistent depressed mood, feelings of sadness and loneliness, sleep disturbances, and loss of interest lasting for two weeks or more. This condition can significantly affect the quality of life for older adults, resulting in adverse outcomes that have a negative impact on their overall well-being. In this study, our objective was to assess the prevalence of depression and identify associated risk factors among individuals aged 60 years and above who attended Primary Healthcare Centers (PHCCs) in Jizan City. Methodology We conducted an analytical cross-sectional study among older people attending PHCCs in Jizan City between May and December 2022. In this study, we interviewed 300 participants using the Patient Health Questionnaire-9 (PHQ-9) to assess depression. IBM SPSS Statistics for Windows, Version 25.0 (IBM Corp., Armonk, NY) was used for data entry and analysis. We used the chi-square test and binary logistic regression model to detect the associations and predictors of depression among older adults. Results One-third of the study participants experienced depression, with 49 (16%) exhibiting mild depression, 33 (11%) reporting moderate depression, and 17 (6%) individuals indicating moderately severe depression. Depression was more common among females (158, 52.7%) than males (142, 47.3%). The predictors of depression among the study participants were the dependency to perform daily tasks and abnormal sleep duration. Conclusions Depression is a prevalent health problem among older people in Jizan City, particularly among females, those who are divorced or widowed, individuals dependent on others for daily tasks, and those with abnormal sleep duration. We concludethat we need more research on older adults to assess their mental problems and fill in the literature gap.

Associations between sleep-behavioral traits and healthspan: A one-sample Mendelian randomization study based on 388,909 participants of the UK-Biobank

BackgroundAlthough the association between sleep behavior and morbidity and mortality risk has been reported before, there is still uncertainty whether the observed associations are causal or confounding. Therefore, we investigated the causal relationships between sleep-behavioral traits and terminated healthspan risk using Mendelian randomization (MR). MethodsWe conducted a one-sample MR analysis to evaluate causality between six sleep-behavioral traits (sleep duration, chronotype/morningness, napping, sleeplessness/insomnia, and getting up from bed) and risk of healthspan termination among 388, 909 UK Biobank (UKB) participants. Instrumental variables for sleep behaviors (N = 590) were obtained from recent genome-wide association studies (GWAS). We defined healthspan based on eight predominant health-terminating events associated with longevity (congestive heart failure, myocardial infarction, chronic obstructive pulmonary disease, stroke, dementia, diabetes, cancer, and death). We further constructed a sleep score and a weighted genetic risk score to increase the predictive ability of the sleep-behavioral traits. Cox regression models and Inverse Probability Treatment Weighting (IPTW) were implemented, followed by MR to assess causation. We used inverse-variance-weighted MR to estimate causal effects, and weighted-median and MR-egger for sensitivity analysis to test the pleiotropic effects. ResultsIn IPTW, we observed a decreased risk of terminated healthspan for healthy sleep behaviors such as ‘sleep duration 7-8h/d’ (Hazard ratio, HR = 0.93; 95 % confidence interval, CI: 0.92–0.96; P < 0.001); ‘morningness’ (HR = 0.95; 95%CI: 0.93–0.98; P < 0.01); ‘napping’ (HR = 0.93; 95%CI: 0.91–0.94; P < 0.001); ‘easy getting up from bed’ (HR = 0.91; 95%CI: 0.88–0.93; P < 0.001); and, ‘never/rarely experience sleeplessness/insomnia’ (HR = 0.94; 95%CI: 0.92–0.96; P < 0.001). MR results further indicated causal associations between healthy sleep duration (OR = 0.98; 95%CI: 0.97–1.00; P = 0.036) and insomnia (OR = 1.02; 95%CI: 1.01–1.03; P < 0.001) with terminated healthspan. MR-egger did not suggest any potential pleiotropy. ConclusionThis study supports abnormal sleep duration and insomnia as potential causal risk factors for terminated healthspan. Thus, healthy sleep behavior is valuable for the extension of healthspan, and well-designed and tailored sleep health interventions are warranted.

Association between personality characteristics and sleep quality among Chinese middle-aged and older adults: evidence from China family panel studies

BackgroundPoor sleep quality will have adverse effects on physical and mental health, quality of life and other aspects of middle-aged and older adults. Sleep quality is affected by many factors. Whether the sleep quality measures of the participants had changed in the previous or subsequent time period is not easily taken into account. Moreover, there have been no studies on this topic in Chinese middle-aged and older adults. The objective of this study was to mitigate the bias of sleep quality assessment, and analyze the association between personality traits and sleep quality in Chinese middle-aged and older adults.MethodsThe data came from the China Family Panel Studies (CFPS). A total of 6031 participants aged ≥ 45 years were included in this study. Personality characteristics were evaluated based on the scores of each dimension of Big Five personality traits. Sleep duration and sleep perception were used as indicators to measure sleep quality. Logistic models were used to analyze the relationship between personality traits and sleep duration or sleep perception, respectively.Results4.5% of the participants had abnormal sleep duration, and 14.4% had a pessimistic sleep perception. Conscientiousness was rated the highest among the personality traits (3.97 ± 0.6). Participants with higher scores for extraversion personality traits had more normal sleep duration (OR = 0.77, 95% CI: 0.64–0.93) and more optimistic sleep perception (OR = 0.86, 95% CI: 0.76–0.96). Using the Internet and feeling unwell in the past week have a moderating effect on the impact of conscientiousness personality characteristics on sleep duration or sleep perception, respectively (but not overall sleep quality). In addition, participants with a spouse or no recent physical discomfort tended to have a normal sleep duration and a more optimistic sleep perception.ConclusionsThe higher the score of extraversion personality traits, the better the overall sleep quality of middle-aged and older adults. Having a spouse and feeling unwell were the important factors affecting their sleep quality. Specific personality traits intervention should be carried out for middle-aged and older adults with poor sleep quality to make their personality traits are closer to extraversion. In addition, middle-aged and older adults without spouses should be encouraged to marry or remarry. We will strengthen health management and medical expenditures for middle-aged and older adults.

Sleep health and subjective cognitive decline in the Vanderbilt Memory and Aging Project

AbstractBackgroundIdentifying modifiable risk factors for Alzheimer’s disease (AD) and related dementias (ADRD) may reveal critical evidence for early prevention. It is commonly believed that poor sleep is an early symptom of neurodegeneration and ADRD. However, distinct neurobiological processes occur during sleep, and dysfunction of these processes may also contribute to AD pathogenesis. Less is known about poor sleep and associations with subjective cognitive decline (SCD), a clinical symptom occurring before overt cognitive impairment due to early pathological AD. This study investigated associations between objective and self‐reported measures of sleep health and SCD in a community‐based cohort of older adults.MethodParticipants from the Vanderbilt Memory and Aging Project (n = 220; 74±7 years; 34% female) completed 7‐days of wrist actigraphy and self‐report measures for SCD [Everyday Cognition Scale (ECog)] and sleep quality [Pittsburgh Sleep Quality Index (PSQI)]. Actigraphy data was processed to estimate average nightly sleep duration, sleep efficiency, and wake after sleep onset. Linear regressions related objective and self‐report sleep health measures with total ECog score adjusting for age, sex, race/ethnicity, education, body mass index, depressive symptoms, Framingham cardiovascular risk score, and apolipoprotein E‐e4 carrier status.ResultIn main effect models, longer sleep duration was associated with greater SCD (b = 0.05, p&lt;0.01). In models adjusted for age, sex, race/ethnicity, and education, higher PSQI (indicative of poorer sleep quality) was associated with greater SCD (b = 1.06, p = 0.01); however, the association was no longer statistically significant in the fully adjusted model. No associations were observed between sleep efficiency or wake after sleep onset and SCD.ConclusionIn this community cohort of older adults, longer nightly sleep duration and self‐reported poor sleep quality were linked with higher SCD. Findings could suggest that abnormal sleep duration and poor sleep quality increase the earliest clinical symptoms of AD. Further investigations are needed to evaluate the potential pathways connecting sleep health to ADRD development.

Association of Abnormal Sleep Duration and Sleep Disturbance with Physical Activity in Older Adults: Between- and within-Person Effects

ObjectivesSleep is associated with physical activity (PA), yet the nature and directions of this association are less understood. This study aimed to disentangle the long-term temporal sequences between sleep duration/disturbance and PA in older adults, distinguishing between- and within-person effects. DesignLongitudinal panel study. Setting and ParticipantsWe conducted a longitudinal study using 3 waves of data collected in 2008/09 (T1), 2012/13 (T2), and 2016/17(T3) from adults aged ≥50 years in the English Longitudinal Study of Ageing (N = 10,749 individuals). MeasuresSleep duration, sleep disturbance, and PA were assessed by self-reported questionnaires. We used cross-lagged panel models (CLPMs) to examine between-person effects and random intercept cross-lagged panel models (RI-CLPMs) to examine within-person effects. ResultsOur analyses revealed a reciprocal relationship between abnormal sleep duration and low PA levels at between-person level (abnormal sleep duration to PA: βT1-T2 = −0.053, βT2-T3 = −0.058, all P < .001; PA to abnormal sleep duration: βT1-T2 = −0.040, βT2-T3 = −0.045, all P < .05), with abnormal sleep duration being the driving force in the dynamic association. In addition, there was a unidirectional effect of more severe sleep disturbance on lower levels of PA at both between- and within-person levels (between-person level: βT1-T2 = −0.032, βT2-T3 = −0.028, all P < .001; within-person level: βT1-T2 and T2-T3 = −0.031, all P = .011). Conclusions and ImplicationsThis study adds novel insights into the temporal directionality of sleep and PA among community-dwelling older adults and highlights poor sleep as a potential risk factor for PA. Intervention strategies should aim to improve sleep to promote PA levels and successful aging.

Sleep duration and risk of stroke and coronary heart disease: a 9-year community-based prospective study of 0.5 million Chinese adults

BackgroundThere is uncertainty about the optimum sleep duration for risk of different subtypes of stroke and ischaemic heart disease.MethodsThe present analyses involved 409,156 adults in the China Kadoorie Biobank study without a prior history of coronary heart disease or stroke or insomnia symptoms. The mean age of study participants was 52 years and 59% were women. Self-reported sleep duration including daytime napping was recorded using a questionnaire. The adjusted hazard ratios (HRs) for disease outcomes associated with sleep duration were estimated by Cox proportional hazards after adjustment for confounding factors.ResultsThe overall mean (SD) sleep duration was 7.4 (1.4) hours. The associations of sleep duration with CVD types were U-shaped, with individuals reporting 7–8 h of sleep having the lowest risks. Compared with those who typically slept 7–8 h, individuals with very short sleep duration (≤ 5 h) had adjusted HRs of 1.10 (95% CI 1.04–1.16), 1.07 (1.01–1.13), 1.19 (1.06–1.33) and 1.23 (1.10–1.37) for total stroke, ischaemic stroke (IS), Intracerebral haemorrhage (ICH) and major coronary events (MCE), respectively. Likewise, individuals with very long sleep duration (≥ 10 h) had HRs of 1.12 (1.07–1.17), 1.08 (1.03–1.14), 1.23 (1.12–1.35) and 1.22 (1.10–1.34) for the same diseases, respectively, with little differences by sex and age. The patterns were similar for all-cause mortality.ConclusionsWhile abnormal sleep duration (≤ 6 h or ≥ 9 h) was associated with higher risks of CVD, the risks were more extreme for those reporting ≤ 5 or ≥ 10 h, respectively and such individuals should be prioritised for more intensive treatment for CVD prevention.

Association between Abnormal Sleep Duration and Sleepiness and Road Traffic Crashes in Urban Taxi Drivers

Association between Abnormal Sleep Duration and Sleepiness and Road Traffic Crashes in Urban Taxi Drivers

Validation of "Life's Essential 8" Metrics With Cardiovascular Structural Status in Children: The PROC Study in China.

Background Life's Essential 8 (LE8) metrics for cardiovascular health (CVH) aid primordial prevention in US populations. Methods and Results We conducted a child cohort study (PROC [Beijing Child Growth and Health Cohort]) with baseline (2018-2019) and follow-up (2020-2021) assessments, enrolling disease-free 6- to 10-year-old children from 6 elementary schools in Beijing. We collected LE8-assessed components via questionnaire surveys and 3 cardiovascular structural parameters by 2-dimensional M-mode echocardiography: left ventricular mass (LVM), LVM index, and carotid intima-media thickness. Compared with 1914 participants (mean age, 6.6 years) at baseline, we saw lower mean CVH scores at follow-up (n=1789; 8.5 years). Among LE8 components, diet presented the lowest perfect-score prevalence (5.1%). Only 18.6% of participants had physical activity ≥420 min/wk, 55.9% had nicotine exposure, and 25.2% had abnormal sleep duration. Prevalence of overweight/obesity was 26.8% at baseline and 38.2% at follow-up. We noted optimal blood lipid scores in 30.7%, while 12.9% of children had abnormal fasting glucose. Normal BP was 71.6% at baseline and 60.3% at follow-up. LVM (g), LVM index (g/m2.7), and carotid intima-media thickness (mm) were significantly lower in children with high (56.8, 33.2, 0.35) or moderate CVH scores (60.6, 34.6, 0.36), compared with children with low CVH scores (67.9, 37.1, 0.37). Adjusting for age/sex, LVM (β=11.8 [95% CI, 3.5-20.0]; P=0.005), LVM index (β=4.4 [95% CI, 0.5-8.3]; P=0.027), and carotid intima-media thickness (β=0.016 [95% CI, 0.002-0.030]; P=0.028) were higher in the low-CVH group. Conclusions CVH scores were suboptimal, declining with age. LE8 metrics indicated worse CVH in children with abnormal cardiovascular structural measurements, suggesting the validity of LE8 in assessing child CVH. Registration URL: https://www.chictr.org.cn/index.html; Unique identifier: ChiCTR2100044027.

Predictors of Abnormal Sleep Duration in Older Adults With Hip Fracture and Diabetes

Abnormal sleep duration affects recovery in older adults with hip fracture and diabetes mellitus (DM) negatively. However, the predictors of abnormal sleep duration in this population remain unknown. This study was designed to explore the predictors of abnormal sleep duration among older adults with hip fracture and DM within 6 months of hospital discharge. A longitudinal study using secondary data from a randomized controlled trial was implemented. Data on fracture-related factors (diagnosis, surgical methods) were collected from medical charts. Information on the duration of DM, methods of DM control, and diabetes-related peripheral vascular disease was collected by asking simple questions. Diabetic peripheral neuropathy was assessed using the Michigan Neuropathy Screening Instrument. Sleep duration outcomes were determined using data collected from a SenseWear armband. Having more comorbidities (OR = 3.14, p = .04), having undergone open reduction (OR = 2.65, p = .005), having undergone closed reduction with internal fixation (OR = 1.39, p = .04), and having DM (OR = 1.18, p = .01), diabetic peripheral neuropathy (OR = 9.60, p = .02), or diabetic peripheral vascular disease for a longer duration (OR = 15.62, p = .006) were all associated with a higher risk of abnormal sleep duration. The findings indicate that patients with more comorbidities or who had undergone internal fixation, had a long DM history, or had complications are more likely to have abnormal sleep duration. Thus, greater attention should be focused on the sleep duration of diabetic older adults with hip fracture who are affected by these factors to achieve better postoperative recovery.

The impact of high-risk lifestyle factors on all-cause mortality in the US non-communicable disease population

BackgroundPrevious studies have suggested that lifestyle factors are associated with mortality in different population. However, little is known about the impact of lifestyle factors on all-cause mortality in non-communicable disease (NCD) population.MethodsThis study included 10,111 NCD patients from the National Health Interview Survey. The potential high-risk lifestyle factors were defined as smoking, excessive drinking, abnormal body mass index, abnormal sleep duration, insufficient physical activity (PA), overlong sedentary behavior (SB), high dietary inflammatory index (DII) and low diet quality. Cox proportional hazard model was used to evaluate the impact of the lifestyle factors and the combination on all-cause mortality. The interaction effects and all combinations of lifestyle factors were also analyzed.ResultsDuring 49,972 person-years of follow-up, 1040 deaths (10.3%) were identified. Among eight potential high-risk lifestyle factors, smoking (HR = 1.25, 95% CI 1.09–1.43), insufficient PA (HR = 1.86, 95% CI 1.61–2.14), overlong SB (HR = 1.33, 95% CI 1.17–1.51) and high DII (HR = 1.24, 95% CI 1.07–1.44) were risk factors for all-cause mortality in the multivariable Cox proportional regression. The risk of all-cause mortality was increased linearly as the high-risk lifestyle score increased (P for trend < 0.01). The interaction analysis showed that lifestyle had stronger impact on all-cause mortality among patients with higher education and income level. The combinations of lifestyle factors involving insufficient PA and overlong SB had stronger associations with all-cause mortality than those with same number of factors.ConclusionSmoking, PA, SB, DII and their combination had significant impact on all-cause mortality of NCD patients. The synergistic effects of these factors were observed, suggesting some combinations of high-risk lifestyle factor may be more harmful than others.

Sleep duration, hypnotic drug use, and risk factors: cross- sectional study

Both short sleep duration (SSD) and long sleep duration (LSD) are associated with an increased risk of morbidity and mortality. Here, we aimed to assess the prevalence of sleep duration disturbances among adults in association with demographic, medication use, personal habits, and chronic diseases, while also considering the impact of hypnotic drug use. We performed a cross-sectional study of 9991 adult participants of the Rafsanjan Cohort Study (RCS), as part of the Prospective epidemiological research studies in Iran (PERSIAN). Multivariate logistic regression analyses were conducted to assess the association between short (< 6 h) and long (> 9 h) sleep duration with demographic and lifestyle parameters and common non-communicable diseases. Additionally, we performed stratified analysis to investigate the association of sleep duration with the abovementioned factors and diseases, in groups with and without hypnotic drug use. We found higher odds of SSD significantly associated with age (P < 0.001), BMI (P < 0.001), physical activity (P < 0.001), and depression (P = 0.023). LSD displayed a positive association with the female sex (P < 0.001), opium consumption (P < 0.001), and history of MI (P = 0.045), and a reverse connection with education (P = 0.007), physical activity (P < 0.001) and alcohol consumption (P = 0.027). Stratifying for the hypnotic drug use, our sensitivity analyses indicated that in hypnotic drug users, education (P = 0.034) and physical activity (P < 0.001) were associated with LSD, in this group, significantly increased odds ratio of LSD were associated with opium consumption (P = 0.046) and thyroid dysfunction (P = 0.037). Our findings demonstrated the demographic and lifestyle factors and diseases associated with long and short sleep duration in the population of the RCS. Additionally, after stratifying for hypnotic drug use, our results indicated that some diseases are only associated with abnormal sleep duration upon using hypnotic drugs.

Abstract WP203: Stroke Occurrence Is Associated With Abnormal Sleep Duration In The United States

Background and Purpose: Inappropriate sleep duration (&lt;7 or &gt;8 hours/night) is associated with cardiovascular events. Given its importance, the new American Heart Association Life’s Essential 8 construct of ideal cardiovascular health includes sleep duration. Yet, studies of sleep duration in relation to stroke are scarce. Our objective was to compare sleep duration among individuals with and without prior stroke in a nationally representative U.S. sample. Methods: Using the National Health and Nutrition Examination Surveys database (2005-2018), individuals &gt;=18 years were identified (n=37,987 without self-reported stroke; n=1,572 with self-reported stroke). Prevalence of normal sleep duration (7-8 hours/night) was compared between persons with and without self-reported history of stroke using the Rao-Scott χ; 2 test. Multinomial logistic regression analysis was used to evaluate the relationship between prior stroke and abnormal sleep before and after adjusting for demographic and clinical variables. Results: Compared to individuals without prior stroke, prevalence of normal sleep duration was lower in individuals with prior stroke (18-44 years: 32% vs 54%; 45-64 years: 47% vs 55%; &gt;=65 years: 45% vs 54%). Factors associated with &gt;8 hours/night sleep included female sex, older age, non-White race, lower education, poverty, and obesity. Factors associated with &lt;7 hours/night sleep were male sex, younger age, Black race, lower education, poverty, and obesity. Compared to individuals without stroke, those with prior stroke were more likely to report &gt;8 hours/night (unadjusted OR 2.03, 95% CI 1.64-2.51) and &lt;7 hours/night (1.29, 1.08-1.53). These associations were respectively attenuated after adjustment for demographic and clinical variables (adjusted OR 1.54, 95% CI 1.22-1.94 and 1.15, 0.96-1.38). Conclusion: Stroke survivors in the United States are more likely to have abnormal sleep duration compared to those without a prior stroke. Future research should explore the causal links between stroke by type and duration of sleep.

Triglyceride glucose index and poor sleep patterns in non-diabetic adults: Evidence from NHANES 2005-2016.

Sleep disorders are commonly encountered in modern populations. This cross-sectional study aimed to investigate the associations between triglyceride glucose (TyG) index and poor sleep patterns in non-diabetic adults. Data of non-diabetic adults aged 20-70 years were extracted from the US National Health and Nutrition Examination Survey database 2005-2016. Pregnant women, individuals with diabetes and cancer history, and individuals lacking complete data on sleep patterns or parameters for calculating TyG index were excluded. Poor sleep pattern was defined as having two or more following conditions: (1) abnormal sleep duration, defined as less than 7 h or longer than 9 h; (2) self-reported trouble sleeping; and (3) physician-confirmed sleep disorders. Associations between poor sleep patterns, TyG index, and an additional index incorporating body mass index (BMI), TyGBMI, and other study variables were determined by univariable and multivariable logistic regression analysis. Among 9,390 included participants, 1,422 had poor sleep patterns and 7,968 did not. The individuals with poor sleep patterns had a higher mean TyG index, were older, had higher BMI, and had higher proportions of hypertension and history of CVD than those without poor sleep pattern (all p < 0.001). Multivariable analysis showed no significant association between poor sleep pattern and TyG index. However, among the components of poor sleep pattern, TyG index in the highest quartile (Q4) was significantly associated with trouble sleeping [adjusted OR (aOR): 1.46, 95%CI: 1.04-2.03) as compared with the lowest TyG quartile (Q1). In addition, TyG-BMI in Q4 was indepently associated with increased likelihood for poor sleep patterns (aOR: 2.18, 95%CI: 1.61-2.95), trouble sleeping (aOR: 1.76, 95%CI: 1.30-2.39), abnormal sleep duration (aOR: 1.41, 95%CI: 1.12-1.78), and sleep disorders (aOR: 3.11, 95%CI: 2.08-4.64) as compared to Q1. Among US adults without diabetes, elevated TyG index is correlated with self-reported trouble sleeping, independent of BMI. Future studies should build upon this preliminary work and examine these associations longitudinally and through treatment trials.

Sleep Characteristics and Cancer-Related Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses of Observational Studies.

Sleep is closely related to various diseases. Several meta-analyses have provided evidence of sleep and cancer, and yet the credibility of this evidence has not been comprehensively quantified. Thus, we conducted an umbrella review to quantify the evidence for systematic reviews and meta-analyses of observational studies on sleep characteristics (sleep duration, sleep quality, napping, bedtime, and wake-up time) and cancer-related outcomes. PubMed, Web of Science (Core Collection), and Embase databases were searched from inception until 29 July 2022. Assessment of Multiple Systematic Reviews, version 1, was used to evaluate the methodological quality of each eligible systematic review or meta-analysis. For each association, the summary effect with a 95% confidence interval was evaluated by fixed and random effects models. The 95% prediction interval, heterogeneity, small-study effects, and excess significance bias were also evaluated. Evidence of the associations from systematic reviews and meta-analyses was ranked based on the established criteria of published literature as convincing, highly suggestive, suggestive, weak, or non-significant. The umbrella review identified thirty meta-analyses on the aforementioned associations from six articles. The methodological quality of five articles was high or moderate. Suggestive evidence was found for associations between long sleep duration and a 21% increased risk of colorectal cancer, a 9% increased all-cancer mortality and a 65% increased mortality of lung cancer, and associations between short sleep duration and a 21% increased mortality of lung cancer. Additionally, the evidence of associations between short sleep duration and lung cancer mortality was upgraded to convincing, and between long sleep duration and lung cancer mortality was upgraded to highly suggestive, among the population reporting 24 h sleep duration. Abnormal sleep duration might be linked to several adverse cancer-related outcomes.