Sleep Duration Categories Research Articles

Association between sleep duration and risk of nonalcoholic fatty liver disease: A systematic review and meta-analysis.

Considering that both long and short sleep duration may have an association with nonalcoholic fatty liver disease (NAFLD), in this meta-analysis, we analyzed the dose-response association between sleep duration and NAFLD along with meta-analyses of the differences in mean sleep duration between NAFLD patients and healthy controls, and linear meta-analysis of the association between sleep duration and NAFLD. PubMed (665 articles), Scopus (442 articles), and Web of Sciences (200 articles) were searched from inception until November 2023. Observational studies were included if they assess the association between sleep duration and NAFLD or compare the mean sleep duration between patients with NAFLD and healthy population. All studies done in humans without restriction on sex, age, and language were included. The methological quality of studies was assessed by Joanna Briggs Institute (JBI) tools. The meta-analysis was conducted using STATA. Thirty-one studies that included 836,117 participants were included in this systematic review. The results indicated no significant differences between NAFLD patients and healthy controls regarding mean sleep duration [Mean difference: -7.08, 95% CI: -20.10, 5.94]. The subgroup meta-analysis did not show any significant differences between groups. The long versus short sleep duration meta-analysis showed a significant association between sleep duration and NAFLD (OR: 0.8 [95% CI, 0.74-0.91]). The results of the dose-response meta-analysis do not suggest a linear or nonlinear relationship between sleep duration and NAFLD (p-value=0.9). The highest category of sleep duration was associated with a lower risk of NAFLD. However, no dose-response association was observed.

Role of toxic and essential elements in sleep duration of patients with cardiovascular diseases

Sleep disorders are a common aspect of cardiovascular diseases (CVDs) that can negatively impact a patient’s quality of life, trigger coronary events, accelerate disease progression, and influence patient survival. This study aimed to investigate the relationship between essential and toxic elements with sleep duration among CVD patients. The study utilized cross-sectional data from 150 patients with CVDs (n = 150) from the Ravansar Non-Communicable Disease (RaNCD) Cohort Study. Serum concentrations of zinc (Zn), copper (Cu), Iron (Fe), arsenic (As), mercury (Hg), and nickel (Ni) were measured using a gas chromatography-mass spectrometry. The prevalence of short-sleep duration (< 7 h), normal sleep duration (7–8 h), and long-sleep duration (> 8 h) were 36%, 10.6%, and 53.3%, respectively. No significant differences were found among the three sleep duration categories in terms of serum concentrations of toxic and essential elements. The adjusted regression model showed that ORs for sleep duration across Zn quartiles Q1, Q2, Q3, and Q4 were 1.00 (reference), 0.32 (95% CI, 0.11–0.84), 0.31 (97.1% CI 0.11–0.81), and 0.33 (98.7% CI 0.12–0.88), respectively (p for trend = 0.006). Our findings suggest a significant relationship between serum zinc levels and sleep duration, with higher zinc concentrations being associated with optimal sleep duration.

Associations of sleep duration and weekend catch up sleep with cancer risk among US adults in the Cancer Prevention Study-3 cohort.

Our objective was to investigate the associations of sleep duration and weekend catch-up sleep with cancer risk among US adults in the Cancer Prevention Study-3. Cancer Prevention Study-3 is a prospective cohort of approximately 250,000 US adults aged 30-65years. At baseline (2006-2013), participants were asked to report their average daily sleep duration over the past year for weekdays and weekends separately. Using the midpoint of each sleep duration category, a 5:2 weekday:weekend weighted average was created. Weekend catch-up sleep was calculated using the difference of weekend and weekday sleep duration category midpoints and categorized as -4 or -2, 0, 2, and 4hours. Cancer incidence (overall and female breast) was determined via linkage to state registries; follow-up time ended at the time of cancer diagnosis, time of death, or end of follow-up (12/31/2018). We used multivariable Cox proportional hazards models to estimate adjusted hazard ratios and 95% confidence intervals for the associations of sleep duration and weekend catch-up sleep with cancer risk adjusted for sociodemographics, socioeconomic status, comorbidities, and lifestyle behaviors. A total of 10,256 incident cancer cases were reported among the 248,086 participants included in the study. We found no statistically significant associations between the examined sleep characteristics with overall or breast cancer-specific risk. Our research strengthens the existing null findings of the association between sleep duration and cancer risk. This was the first study to investigate the relationship of weekend catch-up sleep with cancer risk and more research is necessary to further elucidate this relationship.

Gender Identity Disparities in Early Adolescent Sleep: Findings from the Adolescent Brain Cognitive Development Study.

Purpose: Our aim was to examine associations between transgender identity and sleep disturbance in a demographically diverse, national sample of U.S. early adolescents. Methods: We conducted a cross-sectional analysis of the Adolescent Brain Cognitive Development Study from Year 3 (2019-2021, n = 10,277, 12-13 years) to investigate the association between transgender identity and caregiver-reported measures of their adolescent's sleep, assessed by the Sleep Disturbance Scale for Children. Results: Transgender adolescents had a higher risk of overall sleep disturbance and symptoms of insomnia and excessive sleepiness. Furthermore, per caregiver report, transgender adolescents were more likely to have shorter sleep duration categories; particularly concerning is the significant risk of <5 hours of sleep for transgender adolescents compared with their cisgender peers. Conclusion: These findings indicate that transgender adolescents had worse caregiver-reported sleep outcomes compared to cisgender peers. This study highlights the need for screenings and interventions targeted at improving sleep among transgender adolescents.

Objectively Measured Sleep Duration and Health-Related Quality of Life in Older Adults with Metabolic Syndrome: A One-Year Longitudinal Analysis of the PREDIMED-Plus Cohort.

The aim of our cross-sectional and longitudinal study is to assess the relationship between daytime and night-time sleep duration and health-related quality of life (HRQoL) in adults with metabolic syndrome after a 1-year healthy lifestyle intervention. Analysis of the data from 2119 Spanish adults aged 55-75 years from the PREDIMED-Plus study was performed. Sleep duration was assessed using a wrist-worn accelerometer. HRQoL was measured using the SF-36 questionnaire. Linear regression models adjusted for socioeconomic and lifestyle factors and morbidity were developed. In cross-sectional analyses, participants with extreme night-time sleep duration categories showed lower physical component summary scores in Models 1 and 2 [β-coefficient (95% confidence interval) <6 h vs. 7-9 h: -2, 3 (-3.8 to -0.8); p = 0.002. >9 h vs. 7-9 h: -1.1 (-2.0 to -0.3); p = 0.01]. Participants who sleep less than 7 h a night and take a nap are associated with higher mental component summary scores [β-coefficient (95% confidence interval) 6.3 (1.3 to 11.3); p = 0.01]. No differences between night-time sleep categories and 12-month changes in HRQoL were observed. In conclusion, in cross-sectional analyses, extremes in nocturnal sleep duration are related to lower physical component summary scores and napping is associated with higher mental component summary scores in older adults who sleep less than 7 h a night.

Consumption of fruits and vegetables and its association with sleep duration among Finnish adult population: a nationwide cross-sectional study.

Sleep and diet are crucial determinants of overall health and wellbeing, with the potential to mutually influence each other. This study examined the association between sleep duration and fruits and vegetables (FV) consumption among Finnish adults. The study analyzed data from the National FinHealth 2017 Study involving 5,043 adults aged 18 years and above. Participants reported their habitual sleep duration, and dietary consumption through a validated self-administered questionnaire. Confounders such as demographic, socio-economic factors, and chronotype were considered. A sensitivity analysis, which excluded energy under-reporters, was conducted to validate the findings. Mean dietary consumption was compared across three sleep duration categories (short, normal, long), revealing that short sleepers consumed 37 g/d fewer FV, and long sleepers consumed 73 g/d fewer FV than normal sleepers. Binary logistic regression analyses consistently demonstrated significant negative association between FV consumption and both short and long sleep duration across all models, even when adjusted for a range of covariates. Linear regression analyses revealed a positive but non-significant association between sleep duration and FV consumption that became significant when excluding energy under-reporters, particularly in model 1. This study suggests a consistent pattern where deviation from normal sleep duration was associated with decreased FV consumption, suggesting the need for considering sleep patterns in dietary intervention. The substantial role of accurate energy reporting in explaining these associations is highlighted. Further research, including longitudinal studies, is needed to better understand the mechanisms underlying these associations.

Association between sleep duration and psychological resilience in a population-based survey: A cross-sectional study.

The study aimed to find out the association between sleep duration and psychological resilience in a population-based survey. A cross-sectional survey was conducted in August 2022, employing a cluster random sampling method to recruit community residents at Futian District in Shenzhen, China. A total of 2,445 participants aged 18 years and over were included in the study. The Brief Resilience Scale (BRS) was utilized to measure psychological resilience, and sleep duration was classified according to the American Heart Association's sleep duration categories. Multivariable linear regression was used to analyze the relationship between psychological resilience and sleep duration after adjusting for gender, age, smoking status, physical exercise frequency, body mass index (BMI), and education level. The participants displayed moderate levels of psychological resilience, with a mean resilience score of 3.46 (standard deviation [SD] = 0.62) and a mean sleep duration of 7.04 h (SD = 1.10). After adjusting for covariates, longer sleep duration was associated with higher psychological resilience (β = 0.047, P < 0.05), indicating that participants with a long sleep duration had higher resilience scores than those with a short sleep duration. Longer sleep duration is positively associated with higher psychological resilience in community residents. These findings suggest that improving sleep duration may be a promising approach to enhancing psychological resilience, preventing psychological problems, and promoting overall physical and mental health development.

Correlation between sleep duration and prevalence of hypertension: the China Health and Nutrition Survey.

It is increasingly thought that sleep is a lifestyle factor that contributes to hypertension. However, the correlation between sleep duration and hypertension in the Chinese population remains largely unexplored. This study utilized data from the 2009 China Health and Nutrition Survey to investigate the correlation between sleep duration and hypertension. Average hours of sleep per day were grouped into following categories: ≤6, 7-9, and ≥10 h. The frequency of hypertension and odds ratio (OR) were computed across different sleep duration categories. Individuals sleeping 7-9 h per day were designated as the control group. Logistic regression was utilized for multivariate analysis. Among the 9435 participants, the mean sleep duration was 7.9±1.2 h. The prevalence of hypertension was 34.1, 21.7, and 29.3% for individuals sleeping ≤6, 7-9, and ≥10 h per day, respectively. Following adjustments for age, gender, body mass index, and diabetes, a significant association was observed between prolonged (≥10 h) sleep duration and hypertension. Compared to those sleeping 7-9 h per day, the OR for hypertension was 1.21 (95%CI: 1.02-1.43, P=0.03) for individuals sleeping ≥10 h per day. This study suggested that sleeping ≥10 h per day is associated with a higher risk of hypertension in adults.

Association of Sleep Duration and Change Over Time With Imaging Biomarkers of Cerebrovascular, Amyloid, Tau, and Neurodegenerative Pathology.

Both short and long sleep duration were previously associated with incident dementia, but underlying mechanisms remain unclear. We evaluated how self-reported sleep duration and its change over time associate with (A)myloid, (T)au, (N)eurodegeneration, and (V)ascular neuroimaging markers of Alzheimer disease. Two Framingham Heart Study overlapping samples were studied: participants who underwent 11C-Pittsburg Compound B amyloid and 18F-flortaucipir tau PET imaging and participants who underwent an MRI. MRI metrics estimated neurodegeneration (total brain volume) and cerebrovascular injuries (white matter hyperintensities [WMHs] volume, covert brain infarcts, free-water [FW] fraction). Self-reported sleep duration was assessed and split into categories both at the time of neuroimaging testing and approximately 13 years before: short ≤6 hours. average 7-8 hours, and long ≥9 hours. Logistic and linear regression models were used to examine sleep duration and neuroimaging metrics. The tested cohort was composed of 271 participants (age 53.6 ± 8.0 years; 51% male) in the PET imaging sample and 2,165 participants (age 61.3 ± 11.1 years; 45% male) in the MRI sample. No fully adjusted association was observed between cross-sectional sleep duration and neuroimaging metrics. In fully adjusted models compared with consistently sleeping 7-8 hours, groups transitioning to a longer sleep duration category over time had higher FW fraction (short to average β [SE] 0.0062 [0.0024], p = 0.009; short to long β [SE] 0.0164 [0.0076], p = 0.031; average to long β [SE] 0.0083 [0.0022], p = 0.002), and those specifically going from average to long sleep duration also had higher WMH burden (β [SE] 0.29 [0.11], p = 0.007). The opposite associations (lower WMH and FW) were observed in participants consistently sleeping ≥9 hours as compared with people consistently sleeping 7-8 hours in fully adjusted models (β [SE] -0.43 [0.20], p = 0.028; β [SE] -0.019 [0.004], p = 0.020). Each hour of increasing sleep (continuous, β [SE] 0.12 [0.04], p = 0.003; β [SE] 0.002 [0.001], p = 0.021) and extensive increase in sleep duration (≥2 hours vs 0 ± 1 hour change; β [SE] 0.24 [0.10], p = 0.019; β [SE] 0.0081 [0.0025], p = 0.001) over time was associated with higher WMH burden and FW fraction in fully adjusted models. Sleep duration change was not associated with PET amyloid or tau outcomes. Longer self-reported sleep duration over time was associated with neuroimaging biomarkers of cerebrovascular pathology as evidenced by higher WMH burden and FW fraction. A longer sleep duration extending over time may be an early change in the neurodegenerative trajectory.

The relationship between sleep duration and cortical sulcal width in midlife and older adults

AbstractBackgroundEmerging evidence suggests that poor sleep is associated with worse cognitive and structural brain health, and an increased risk of developing dementia (Bubu et al., 2016; Fjell et al., 2022; Tai et al., 2022). The present study investigated the influence of sleep duration on the cognition‐brain relationship in older adults using sulcal width (SW), a reliable measure of changes in the ageing brain (Bertoux et al., 2019). The influence of napping, depression likelihood, and genetic risk for dementia (APOE ε4 status) was also explored.MethodParticipants were 137 cognitively normal adults, aged 46‐72 from the Prospective Imaging Study of Ageing (PISA). Demographic information, sleep duration, and depressive symptoms were collected via online questionnaires. Cognition was assessed using the Cambridge Brain Systems battery. APOE genotype was determined from blood‐extracted DNA. Imaging data was acquired using a 3T Siemens PRISMA scanner. SW was extracted using the Morphologist pipeline (Borne et al., 2020).Canonical Partial Least Squares (PLS) were used to obtain latent variables of cognition and SW. ANCOVAs measured the effect of sleep duration categories (7‐7.5 hours versus {&lt;7 or ≥8 hours}) on the cognitive and SW components, with sex and age as covariates. Status of depression likelihood was added as a covariate of interest. The effect of napping, and APOE ɛ4 allele on these same components were measured by ANCOVAs, with sex and age as covariates.ResultWe observed a significant effect of sleep duration on SW (F(1, 133) = 4.17, p = 0.043, Fig. 1). This effect remained significant (F(1,132) = 4.89, p = 0.029) after including depression likelihood as a covariate, which was also significant in the model (F(1,132) = 4.62, p = 0.034). A significant interaction between APOE ε4 status and age (p = 0.050) on SW was also observed.ConclusionResults add weight to studies suggesting that not too much or too little sleep is needed to maintain brain health in later life (Li et al., 2022; Liang et al., 2019). Depression, a risk factor for dementia (Livingston et al., 2020), was also associated with poorer brain health. Results suggest that at approximately 60 years of age, the influence of a positive APOE ε4 status is associated with increasing age‐related brain atrophy.

0223 Associations of Pain Frequency and Severity with Excessive and Insufficient Sleep Duration in U.S. Adults

Abstract Introduction Pain and inadequate sleep duration are prevalent among adults in the United States. Both pain and inadequate sleep have been related to poorer quality of life and adverse health outcomes. However, the relationships of pain frequency and severity, modeled as predictors, to sleep duration have rarely been studied at the population level, particularly in the U.S. We aimed to investigate the relationships of both pain frequency and pain severity to sleep duration in a representative, population-based U.S. sample. Methods 2018 National Health Interview Survey data were analyzed. Self-reported sleep duration (on average) was categorized as short (6 hours or less), normal (7-9 hours), and long (10+ hours). Self-reported pain frequency (in the last three months) and pain severity (most recent event) were each categorized as “higher” and “lower or no”. Potential confounders/adjustment variables examined included age, sex, weight, chronic health conditions, race/ethnicity, depression, anxiety, and sleep medication use. For adjusted analyses, a multinomial logistic regression was fitted using stepwise selection using a sample of 10,173 U.S. adults. We estimated odds ratios (OR) and 95 percent (%) confidence intervals (CI) for three categories of sleep duration with regard to both pain frequency and severity in an adjusted multinomial model. Results In a multinomial model adjusted for age, anxiety, depression, and race/ethnicity, higher pain frequency, versus lower/no, was found to be associated with increased odds of short (OR=1.52, 95% CI, 1.38-1.66) and long (OR=1.85, 95% CI, 1.50-2.28) sleep duration versus normal sleep. In the same adjusted model, higher pain severity, versus lower/none, was found to be associated with an increased odds of short (OR=1.49, 95% CI, 1.33-1.68) and long (OR=1.77, 95% CI, 1.40-2.22) sleep duration versus normal sleep duration. Conclusion Higher pain frequency and higher pain severity, versus low or none, were both associated with an increased odds of insufficient (by 1.5-fold) and excessive (by 1.9 and 1.8-fold, respectively) sleep duration (vs. normal) in a large population-based U.S. sample. Results suggest that the prevention of pain, both its frequency and severity, should be considered to improve unhealthy sleep duration among US adults. Support (if any) None

Sleep duration and the onset of menopause in Japanese women.

Sleep characteristics may potentially affect the hormonal environment related to follicular degeneration. The present study aimed to examine the association between sleep duration and the onset of menopause in Japanese women. We conducted a prospective study among 3,090 premenopausal Japanese women aged 35 to 56 years derived from participants in the Takayama Study. Habitual sleep duration was determined by a self-administered questionnaire at the baseline. Menopausal status was defined as the absence of menstruation for 12 months or more. The Cox proportional hazard model was used to estimate the hazard ratio of the occurrence of menopause for each category of sleep duration (≤6, 8, and ≥9 h) as compared with 7 hours of sleep after controlling for age, parity, body mass index, smoking status, years of education, and lifelong irregular menstrual cycle. During the 10 follow-up years, 1,776 women experienced natural menopause. Sleep duration of ≤6 hours was significantly associated with decreased hazard ratio of menopause (0.88; 95% confidence interval, 0.78-0.99). The data suggest that short sleep duration is associated with later onset of menopause.

How did trends in sleep duration in 2020 compare to previous years and how did they vary by sex, race/ethnicity, and educational attainment?

Recent evidence utilizing online samples indicates that sleep patterns were significantly altered during the initial months of the SARS-CoV-2 (COVID-19) pandemic/lockdown. However, it remains less clear how sleep duration changed in population-based samples, in the later months of 2020, and across subpopulations. Here we used a population-based sample to document sleep duration trends for the entire year of 2020, compared these trends to the previous years of 2013, 2014, 2016, and 2018, and systematically analyzed whether self-reported sleep duration patterns in 2020 varied by sex, race/ethnicity, and educational attainment. Data were from the Behavioral Risk Factor Surveillance System (n = 2,203,861) and focused on Americans aged 18 years and older. Respondents self-reported the hours of sleep they got in a 24-h period. We fit multinomial and linear regression models to predict the category of sleep duration (six or fewer hours, seven to eight h (base), and nine or more hours) and the raw reports of sleep duration, net of demographic, socioeconomic, and behavioral health covariates. Results revealed significant increases in sleep duration during the months directly after the COVID-19 lockdown (March and April in particular). However, these increases were short lived; reports of sleep duration reverted to historical levels by the Fall of 2020. We also found that the changes in sleep duration trends in 2020 were similar by sex, race/ethnicity, and educational attainment, cumulatively leading to little impact to disparities in sleep duration. In a dramatic, but brief, alteration of population-level sleep duration patterns, disparities in self-reported sleep duration remained intractable.

Sleep quality traits correlate with inflammatory markers in the breast tissue of women.

Several mechanisms have been posited to play a role in the sleep and breast cancer association, including alterations in immune function, but evidence remains inconclusive. A closer look at how sleep quality traits affect the breast microenvironment may provide clues for molecular mechanisms underlying the link between sleep and breast cancer. We examined the association between sleep quality traits (sleep duration, sleep aids, and insomnia) and tissue-based protein levels and gene expression of several inflammatory markers associated with breast cancer. Breast tissues (normal n=165 and adipose n=74) were surgically obtained from women diagnosed with breast cancer. Protein levels by immunohistochemistry were determined using the quickscore method for 11 inflammatory markers in the normal epithelial breast tissue (interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), cyclooxygenase-2 (COX-2), leptin, serum amyloid A1 (SAA1), lactoferrin, transforming growth factor-beta (TGF-β), and signal transducer and activator of transcription 3 markers (STAT3). Relative quantification of 4 genes (COX-2, IL-6, TNF-α and LEP) in the adipose breast tissue was carried out using qPCR. Patient characteristics and sleep traits (average sleep duration per night, taking sleeping aids in the past year, and the average number of insomnia episodes per month) were determined by telephone interview. Associations were tested using Spearman's rank correlation (rs) coefficients adjusted (ars) for age at surgery, menopausal status and PCR batch when applicable. Sleep duration categories (<7, 7-9, >9h) and root- or log-transformed biomarker levels were examined with adjusted linear mixed models. TGF-β and CRP levels in normal epithelial breast tissue were positively correlated with sleep aids (ars=0.28, p=0.013), and insomnia (ars=0.23, p=0.044) in postmenopausal women, respectively. IL-6 in the adipose breast tissue was inversely correlated with sleep aids (ars=-0.26, p=0.029) in all women. None of the sleep traits significantly correlated with inflammatory markers in premenopausal women. Several markers tended to correlate at 0.05≥p≤0.10. Adjusted mean levels of inflammatory markers were significantly different across sleep duration categories (<7, 7-9, >9h). Higher mean levels of IL-6, CRP, IL-10, and IL-6 and COX-2 expression were noted in the breast tissues of women sleeping<7, and particularly, >9h per night (p<0.05). Our findings indicate that sleep duration, sleep aids, and insomnia may differently affect women's breast tissues depending on menopausal status. From a public health perspective, these results warrant further validation in larger studies. Since sleep is a modifiable factor, it may be an interesting approach for breast cancer prevention.

Short sleep duration is associated with a wide variety of medical conditions among United States military service members

ObjectivesThis cross-sectional study investigated self-reported sleep duration and its association with a comprehensive range of clinically-diagnosed medical condition categories (CDMCs), as well as the relationship between short sleep duration (≤6 h) and demographic/lifestyle factors, among United States military service members (SMs). MethodsA stratified random sample of SMs (n = 20,819) completed an online questionnaire on usual daily hours of sleep and demographic/lifestyle characteristics. CDMCs for a six-month period prior to questionnaire completion were obtained from a comprehensive military electronic medical surveillance system and grouped into 33 CDMCs covering both broad and specific medical conditions. Prevalence of CDMCs was compared among three sleep duration categories (≤4, 5–6 and ≥7 h). ResultsSMs reported a mean ± standard deviation of 6.3 ± 1.4 h of sleep per day. After adjustment for demographic/lifestyle characteristics, shorter sleep duration was associated with higher odds of a medical condition in 25 of 33 CDMCs, with most (n = 20) demonstrating a dose-response relationship. The five CDMCs with the largest differences between ≤4 vs ≥ 7 h sleep were: diseases of the nervous system (odds ratio [OR] = 2.9, 95% confidence interval [95%CI] = 2.4–3.4), mental/behavioral diseases (OR = 2.7, 95%CI = 2.3–3.2), diseases of the musculoskeletal system (OR = 1.9, 95%CI = 1.6–2.1), diseases of the circulatory system (OR = 1.7, 95%CI = 1.3–2.2), and diseases of the digestive system (OR = 1.6, 95%CI = 1.2–2.0). Six hours of sleep or less was independently associated with older age, less formal education, race, Hispanic ethnicity, higher body mass index, smoking, and military service branch. ConclusionsIn this young, physically active population, reporting shorter sleep duration was associated with a higher risk of multiple CDMCs.

Middle childhood and adolescence sleep duration and behavior problems in adolescence.

We examined the associations of middle childhood and adolescence nighttime sleep duration with adolescence internalizing and externalizing behavior problems per the Youth Self-Report (YSR) and the Child Behavior Checklist (CBCL) questionnaires, in a cohort of 889 Colombian schoolchildren. We estimated adjusted differences with 95% confidence intervals (CI) in mean behavior problem t-scores in standardized units between recommended sleep duration categories and as a continuous exposure using multiple linear regression and restricted cubic spline models, respectively. Compared with sleep duration within recommendations, middle childhood sleep above recommendations was related to 4.6 (95% CI: 1.6, 7.6; p = .004) and 5.4 (95% CI: 1.2, 9.7; p = .01) adjusted units higher YSR and CBCL externalizing problem scores, respectively. In continuous exposure analyses, this association seemed restricted to children aged ≥11 years. Longer sleep, both in categories and as a continuous exposure, was also associated with increased CBCL internalizing problems. Results did not differ by sex or weekend/weekday sleep. Sleeping under recommendations in middle childhood was not significantly related to behavior problems; nevertheless, shorter sleep in adolescence, in both categorical and continuous scales, was significantly related to behavior problems. In conclusion, behavior problems in adolescence are associated with longer sleep in middle childhood and shorter sleep in adolescence.

Napping and cognitive decline: a systematic review and meta-analysis of observational studies

BackgroundNo clear evidence is available for the influence of napping on cognitive function in older adults. This systematic review and meta-analysis aimed to elucidate the cross-sectional and longitudinal relationships between napping and cognitive function (global cognition and memory) and to explore whether some individual characteristics and sleep characteristics can modify this relationship.MethodsWe systematically searched Medline (via PubMed), Web of Science, and Scopus. DerSimonian and Lair and Hartung-Knapp-Sidik-Jonkman random effects methods were used to compute pooled estimates of odds ratios (ORs) and their respective 95% confidence intervals (95% CIs) for the association of global cognition and memory with napping. The mean age, the night sleep time (hours), and the percentage of women, no nappers, and people in the less night-time sleep duration category were used for meta-regressions.ResultsTwenty-five studies were included in this systematic review and meta-analysis, 18 cross-sectional and seven longitudinal studies, including 95,719 participants older than 60 years. The pooled ORs from the cross-sectional analyses were 1.03 (95% CI: 1.01 to 1.06) for global cognition and 1.06 (95%: 0.90 to 1.26) for memory. The pooled ORs from the longitudinal analyses were 1.00 (95% 0.85 to 1.18) for global cognition and 1.08 (95% 0.98 to 1.19) for memory. These associations were not modified by individual or sleep characteristics.ConclusionOur data confirm the absence of association between napping and global cognition and memory regardless of the characteristics of the population. This information might be considered when providing lifestyle recommendations to adults with and without cognitive complaints.

Sleep Late Impact on The Salivary pH Levels and Amylase Activity among Male Students who has Different BMI Category

The lack of sleep could damage the circadian rhythm, which has implications for health issues. Here we conduct a survey on Students from the Faculty of Social and Political using purposive random sampling, by targeting student who has sleep duration low than 8 hours. We are using a questionnaire to gain information about the sleeping duration and also the Body Mass Index (BMI). Moreover, we also collect saliva samples from the students. pH Universal Indicators are used to measure the pH levels of saliva. We predict the salivary amylase activity by measuring the decrease of the substrate. We found about 27 students have a sleep duration of fewer than 6 hours. Then 19 students have a sleep duration of about 8 - 6 hours. Finally, only 5 students have a sleep duration of more than 8 hours. Our study suggests there is no significant difference between the 3 categories of sleep duration on saliva pH levels and salivary amylase activity. The same for the BMI categories. Although there are small differences sleep duration and BMI is not the major factor influencing the pH levels and amylase activity in saliva

0496 Sleep and Behavior Problems in Children with Overweight and Obesity

Abstract Introduction Limited studies have examined sleep variability in children with overweight and obesity, nor do studies focused on its relation with behavior outcomes in this high risk pediatric population. The purpose of this study was to examine sleep duration and its variability in relation to behavior outcomes in school-age children with overweight and obesity. Methods Sleep in 246 children aged 6-9 years with overweight and obesity was assessed using actigraphy for 7 days and through the parent-report Children’s Sleep Habits Questionnaire (CSHQ). Children’s behaviors were assessed using parental responses on the Behavior Assessment for Children. Children were categorized into 4 groups based on the median split of the average daily sleep duration and its variability: sufficient-stable, sufficient-variable, insufficient-stable, and insufficient-variable. General linear model (GLM) analyses were performed with the 4 sleep groups as the primary predictor variable and child behavior outcomes as the dependent variable. Results Average daily sleep duration by actigraphy was 7.52 hours, with 84.6% of the children having clinically significant CSHQ sleep disturbance scores and 68.3% having a total behavior problem score in the clinical range. In the unadjusted and adjusted GLM analysis, children in the insufficient-stable sleep duration category had significantly higher emotion problem (p &amp;lt; 0.05), self-control problem (p &amp;lt; 0.01), and total behavior problem scores (p &amp;lt; 0.01) when compared with those in the sufficient-stable sleep duration (reference) category. Children in the insufficient-variable sleep duration category had significantly higher self-control problem scores when compared with those in the reference category (p &amp;lt; 0.05). Conclusion School-age children with overweight and obesity coexist with sleep and behavior problems, with those who have persistent short sleep at the greatest risk for the worst behavior outcomes. Support (If Any) This work was supported by Ministry of Science and Technology, Taiwan, MOST 107 - 2314 - B - 002 - 025 - MY3.

0588 Relationship Between Congestive Heart Failure and Poor Sleep Quality in the US Population

Abstract Introduction Few recent, population-level datasets have explored the relationship between congestive heart failure (CHF) and sleep difficulties. Methods The 2017 - March 2020 data from the National Health and Nutrition Examination Survey (NHANES) were used. Sleep difficulties were self-reported as difficulties “falling asleep, staying asleep, or sleeping too much” within the previous two weeks, categorized as “never,” “less than half the days,” “more than half the days,” and “nearly every day.” Sleep duration was self-reported and categorized as normal (6.5-8.5h), short (&amp;lt;6.5h), and long (&amp;gt;8.5h). A modified STOP-BANG score was created based on NHANES measures of snoring, daytime tiredness, snorting/gasping during sleep, hypertension, body mass index, age, and gender (no measure of neck circumference). Covariates included sex, age, race/ethnicity, education, and relationship status. Analyses were unweighted, with weighted results forthcoming. Results Those who reported sleep difficulties more than half the days (OR: 1.78, [1.20,2.65], p=0.004) and nearly every day (OR: 2.76, [2.01,3.78], p&amp;lt;0.001) were more likely to also report a history of CHF, relative to those without sleep difficulties. After adjusting for covariates these relationships were maintained for those who reported sleep difficulties more than half the days (OR: 1.71, [1.14,2.58], p=0.010) and nearly every day (OR: 2.45, [1.76,3.41] p&amp;lt;0.001). When adding sleep duration category as a covariate (normal, short, or long sleep), those diagnosed with CHF were more likely to have sleep problems nearly every day (OR: 2.21, [1.38,3.25], p&amp;lt;0.001). Those diagnosed with CHF are also likely to have a high risk for OSA (OR: 1.67, [1.39,1.95], p&amp;lt;0.001). Conclusion Poor sleep quality is associated with history of CHF, independent of sleep duration. CHF is also associated with population-level sleep apnea risk. Screening for sleep disorders (insomnia and/or sleep apnea) in CHF patients may improve outcomes. Support (If Any)