Reduced Sleep Duration Research Articles

Mutant neuropeptide S receptor reduces sleep duration with preserved memory consolidation.

Sleep is a crucial physiological process for our survival and cognitive performance, yet the factors controlling human sleep regulation remain poorly understood. Here, we identified a missense mutation in a G protein-coupled neuropeptide S receptor 1 (NPSR1) that is associated with a natural short sleep phenotype in humans. Mice carrying the homologous mutation exhibited less sleep time despite increased sleep pressure. These animals were also resistant to contextual memory deficits associated with sleep deprivation. In vivo, the mutant receptors showed increased sensitivity to neuropeptide S exogenous activation. These results suggest that the NPS/NPSR1 pathway might play a critical role in regulating human sleep duration and in the link between sleep homeostasis and memory consolidation.

The Association between Air Pollution and Sleep Duration: A Cohort Study of Freshmen at a University in Beijing, China.

Background: Rising levels of air pollution in Beijing, China have become a serious environmental issue affecting human health, and young adults are experiencing high rates of insufficient sleep duration or a lack of sleep. Gaps in previous research remain regarding the relationship between air pollution and sleep duration among young adults. The purpose of this study is to assess the associations between air pollution and sleep duration among college students living in Beijing, China. Methods: We conducted follow-up health surveys on 16,889 freshman students enrolled at Tsinghua University over a five-year study period (2013–2018). Sleep duration was measured using the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI), which has been validated in China to measure sleep duration. Corresponding levels of the average hourly air quality index (AQI), PM2.5 (µg/m3), PM10 (µg/m3), and NO2 (µg/m3) were gathered from data provided by the Beijing Municipal Ecological Environment Bureau in a closed site at Tsinghua University. Multilevel mixed-effects linear regression models were used to analyze the data. Results: One standard deviation increase in air pollution concentration in AQI, PM2.5, PM10, and NO2 was associated with a reduction in daily hours of sleep by 0.68 (95% confidence interval (CI) = 0.63, 0.73), 0.55 (95% CI = 0.51, 0.59), 0.70 (95% CI = 0.64, 0.76), and 0.51 (95% CI = 0.47, 0.54), respectively. Conclusions: Air pollution was associated with a reduction in sleep duration among freshman students living in Beijing, China. Replication of this study is warranted among various populations within China.

Effect of Ramadan on Cardiac Patients Attending Cardiology Department Of Chattogram Medical College Hospital

Background: During the Ramadan fast, among Muslims due to change in life-style, in terms of obtaining the daily calorie intake via two meals with alteration of medication schedule or reduction in sleep duration, might affect patients with cardiovascular diseases. The aim of this study was to determine the proportion of cardiac patients who fasted and factors associated with breaking fast. Methods and materials: This cross-sectional study was conducted during the month of Ramadan 2018 (17 May to 15 June) in the outdoor and indoor of Cardiology Department of Chattogram Medical College Hospital, Chattogram, Bangladesh. Muslim patient, age above 18 years was included. Pregnant lady lactating mother and Non-Muslims patients were excluded. Data regarding age, sex, comorbid conditions, fasting status and reason for breaking fast if applicable were collected through a case record form and cardio vascular condition was evaluated. Results: Out of 221 patients, 121 (54.8%) were admitted in indoor and 100 (45.2%) patients attended in outdoor. Male to female ratio was equal (Male 103 and female 118) and mean (±SD) age was 53.48±12.22 years. Of those, 76 (73.8%) male and 86 (72.9%) female were fasting. Significantly higher number of female broke fast than male [Male 41 (53.9%) versus female 65 (75.6%). One hundred and twenty fasted patients (78.4%) experienced symptom aggravation and most of them (91.7%) had to break their fast. Aggravating symptoms were chest pain, breathlessness and hypoglycemic attack present respectively in 68.1%, 16.3% and 12.5% patients. Besides symptoms aggravation, other causes of breaking fast were medication in 36 (22.1%) patients and diagnostic procedure in 4 (2.47%) patients. Conclusion: Ramadan fasting had significant effect on female cardiac patients than male. Findings should be investigated with a prospective study.
 JCMCTA 2019 ; 30 (1) : 27-30

Schizophrenia liability shares common molecular genetic risk factors with sleep duration and nightmares in childhood.

Background: Sleep abnormalities are common in schizophrenia, often appearing before psychosis onset; however, the mechanisms behind this are uncertain. We investigated whether genetic risk for schizophrenia is associated with sleep phenotypes. Methods: We used data from 6,058 children and 2,302 mothers from the Avon Longitudinal Study of Parents and Children (ALSPAC). We examined associations between a polygenic risk score for schizophrenia and sleep duration in both children and mothers, and nightmares in children, along with genetic covariances between these traits. Results: Polygenic risk for schizophrenia was associated with increased risk of nightmares (OR=1.07, 95% CI: 1.01, 1.14, p=0.02) in children, and also with less sleep (β=-44.52, 95% CI: -88.98, -0.07; p=0.05). We observed a similar relationship with sleep duration in mothers, although evidence was much weaker (p=0.38). Finally, we found evidence of genetic covariance between schizophrenia risk and reduced sleep duration in children and mothers, and between schizophrenia risk and nightmares in children. Conclusions: These molecular genetic results support recent findings from twin analysis that show genetic overlap between sleep disturbances and psychotic-like experiences. They also show, to our knowledge for the first time, a genetic correlation between schizophrenia liability and risk of nightmares in childhood.

Schizophrenia liability shares common molecular genetic risk factors with sleep duration and nightmares in childhood

Background: Sleep abnormalities are common in schizophrenia, often appearing before psychosis onset; however, the mechanisms behind this are uncertain. We investigated whether genetic risk for schizophrenia is associated with sleep phenotypes. Methods: We used data from 6,058 children and 2,302 mothers from the Avon Longitudinal Study of Parents and Children (ALSPAC). We examined associations between a polygenic risk score for schizophrenia and sleep duration in both children and mothers, and nightmares in children, along with genetic covariances between these traits. Results: Polygenic risk for schizophrenia was associated with increased risk of nightmares (OR=1.07, 95% CI: 1.01, 1.14, p=0.02) in children, and also with less sleep (β=-44.52, 95% CI: −88.98, −0.07; p=0.05). We observed a similar relationship with sleep duration in mothers, although evidence was much weaker (p=0.38). Finally, we found evidence of genetic covariance between schizophrenia risk and reduced sleep duration in children and mothers, and between schizophrenia risk and nightmares in children. Conclusions: These molecular genetic results support recent findings from twin analysis that show genetic overlap between sleep disturbances and psychotic-like experiences. They also show, to our knowledge for the first time, a genetic correlation between schizophrenia liability and risk of nightmares in childhood.

Electronic Media Use and Sleep: a Self-Control Perspective

There has been an exponential increase in publications on the effects of electronic media use on sleep. One of the fundamental questions on this topic concerns the underlying mechanisms: how or why are electronic media affecting sleep? This article aims to refine the existing theoretical framework by considering the role of self-control. Prior research identifies self-control processes as part of the answer: we give in to the instant gratification of entertainment media at the cost of sleep. Specifically, media-related self-control failure is likely to (1) delay bedtime and reduce sleep duration and (2) trigger negative cognitive-affective responses that may undermine sleep quality. This article will review the relationships between self-control, media, and sleep and clarify how media challenge adequate self-control. It argues that a self-control perspective on media and sleep exposes complex media effect processes that warrant different research methods and open up new areas of intervention.

Prolonged Mobile Phone Use Is Associated with Poor Academic Performance in a Large Sample of Adolescent Students in China

Background: Prolonged mobile phone use (MPU) is prevalent in adolescents. This study examined the cross-sectional and longitudinal associations between prolonged MPU and academic performance in Chinese adolescents. Methods: Participants were 11,831 adolescents who participated in the Shandong Adolescent Behavior and Health Cohort in 2015. We used a self-administered questionnaire to collect data on demographics, weekday and weekend MPU, sleep duration, insomnia, depression, and academic performance. We obtained a subsample's year-end achievement test scores for Chinese, Mathematics, and English, 3 months after baseline survey (n=856). Findings: The mean participant age was 15.0 (SD=1.5) and 51% were boys. Approximately 10% participants used mobile phone ≥ 2 hours/day on weekdays and 25% used mobile phone ≥ 4 hours/day on weekends. With prolonged MPU from ≥ 1 hour/day on weekdays and ≥ 2 hours/day on weekends, the prevalence of self-reported poor academic performance significantly increased, and the achievement test scores significantly decreased. After controlling for adolescent and family covariates, students who used mobile phone ≥ 2 hours/day on weekdays (OR =2.12, 95%CI =1.82-2.47) and ≥ 5 hours/day on weekends (OR =1.50, 95%CI = 1.31-1.72) were significantly more likely to report poor overall academic performance and scored significantly lower on Mathematics and English compared with those who used mobile phone <1 hour/day on weekdays and < 2 hours/day on weekends, respectively. The association between prolonged MPU and academic performance was partially mediated by reduced sleep duration, insomnia, and depression. Interpretations: Prolonged MPU is associated with poor academic performance as measured by self-reports and subject tests in Chinese adolescents. Our findings suggest that adolescents should be advised to limit time of MPU to minimize its harmful effects on sleep, mental health and academic performance. Funding Statement: This work was funded in part for data collection by National Natural Science Foundation of China (Grant number 81573233). Declaration of Interests: All authors have no financial relationships relevant to this article to disclose. All authors have no conflict of interest to disclosure. Ethics Approval Statement: The study was approved by the research ethics committee of Shandong University School of Public Health and target schools. Informed consent was obtained from participants and permission was obtained from parents before the survey.

The 8-Hour Challenge: Incentivizing Sleep during End-of-Term Assessments.

Sleep is critical to physical health, mental well-being, attention, and creativity. During the week of final exams, however, fewer than 10% of undergraduate students maintain the recommended average of 8 hours/night (or, even the recommended minimum of 7 hours/night). For students completing multifaceted projects in studio-based majors (e.g., interior design, architecture, graphic design, studio art), anecdotal and questionnaire data suggest that the end-of-semester reduction in sleep duration may be even worse. One potential solution is to offer students an incentive to maintain healthy sleep durations. We offered interior design students, who were enrolled in a freshman-level graphics studio course, an optional extra credit incentive to maintain optimal sleep durations for five nights leading up to the due date of their final project. If participants maintained an average sleep duration of ≥ 8.0 hours for five nights, they would earn extra credit. By contrast, if they slept an average of 7.0-7.9 hours, there would be no grade change, and if they slept an average of ≤ 6.9 hours, they were instructed that they would lose points (no points were actually deducted). Of the 28 students enrolled in the course, 22 students attempted the challenge (78.6%), and we monitored their sleep duration objectively using wristband actigraphy devices. We compared their sleep duration to that of a group of 22 non-incentivized students enrolled in the same program. In the non-incentivized comparison group, very few students averaged 8 hours (9%) or even 7 hours (14%) of sleep per night. In dramatic contrast, the eight-hour challenge increased the percentage of 8-hour and 7-hour sleepers to 59% and 86%, respectively. Participants who took the eight-hour challenge slept an average of 98 minutes more each night than non-incentivized students and 82 minutes more than they self-reported to sleeping during the semester. The substantial increase in nightly sleep duration did not come at a cost to project performance. Individuals who opted in to the sleep challenge performed as well on the final project as students who did not opt in, and students who showed more consistent sleep (i.e., fewer nights of poor sleep followed by rebound sleep) performed better than students who showed inconsistent sleep. Thus, even during highly stressful "deadline" weeks, students can maintain healthy sleeping patterns without exacting a cost on their project performance.

SAT-251 Acute Sleep Change, Laboratory Meal Energy Intake, and Insulin Sensitivity in Children

Background Many studies show a correlation between short sleep duration and obesity/insulin resistance. One hypothesis for this association is that shortened sleep causes increased energy intake (EI). In some studies, experimentally reduced sleep duration has been found to increase total EI. There are mixed findings about the effects of habitual and acute short sleep on the macronutrient content of consumed meals. Additionally, there are few pediatric studies with objectively measured sleep duration (e.g. using actigraphy). Therefore, we aimed to determine if an acute sleep change was associated with greater total EI, altered macronutrient intake, or altered insulin sensitivity in children. Methods Healthy weight and overweight volunteers (n=18, 44% male), aged 7-11 years wore ActiGraph activity monitors for six consecutive 24 hour periods to determine nightly sleep duration. Volunteers were given no direction regarding sleep for the week. On day six, children underwent a standardized oral glucose tolerance test (OGTT) (1.75g/kg, max 75g) after which total EI (kcal) and macronutrient composition (% of total EI) were measured during a lunchtime laboratory test meal (>10,000 kcal; ~12% protein, 32% fat, 56% CHO). Subjects were directed to eat as much as they wanted. Acute change in sleep was calculated by subtracting each participant’s average nightly total sleep time over the entire week from their total sleep time on the fifth night (i.e., night before the test meal). Linear regressions examined associations of acute change in sleep with insulin AUC during OGTT, total EI, % CHO, % fat, and ratio of %CHO to %fat intake. Results Controlling for daily predicted energy needs and physical activity level, acute change in sleep (mean of 27.5 minutes less than average) was not significantly associated with total EI (p=0.58). However, the %CHO trended toward a significant negative correlation (r=-0.47, p=0.05) and %fat was positively associated (r=0.50, p=0.036) with acute change in sleep such that the %CHO to %fat intake ratio was greater in those with greater sleep deficit (p=0.039). Additionally, controlling for BMI-z score, basal insulin, and age, greater sleep deficit was associated with increased insulin AUC during the OGTT (p=0.001). Discussion Contrary to some previous experimental data, acute sleep deficit had no significant association with total EI; however, acute sleep deficit was associated with increased relative carbohydrate intake. Acute sleep deficit was also associated with decreased relative fat intake, a known satiating macronutrient. These data also suggest an acute decrease in insulin sensitivity associated with sleep deficit. All three mechanisms could explain or exacerbate the increased prevalence of obesity and metabolic abnormalities in children with short sleep duration and therefore, provide support for sleep-associated adjunctive treatment for such children.

A study on assessment of sleep pattern among school-going adolescents in semi-urban Chennai

Adolescent sleep pattern exerts an influence on their physical and mental wellbeing. Several factors such as academic stress, biological and psychosocial factors contribute to adolescent sleep. Reduction in the quantity and quality of sleep can lead to increased daytime sleepiness, interfere with cognitive functioning, memory as well as can lead to behavioural problems.300 adolescent school children in semi-urban Chennai participated by filling a questionnaire which was based on self- reporting of sleep pattern and sleep hygiene. On an average, most adolescents obtained inadequate sleep during the weekdays. The adolescents commonly reported daytime sleepiness, difficulty in falling asleep after going to bed, anxiety, morning headache and feeling tired of waking up in the morning. About half of the participants reported that parents exerted an influence on waking up time. Many adolescents reported the use of social media while going to bed which can reduce sleep duration. Paediatricians can play an important role in promoting healthy sleep practices by providing anticipatory guidance to adolescents and their parents.

Sunset time and the economic effects of social jetlag: evidence from US time zone borders

The rapid evolution into a 24 h society challenges individuals’ ability to conciliate work schedules and biological needs. Epidemiological research suggests that social and biological time are increasingly drifting apart (“social jetlag”). This study uses a spatial regression discontinuity design to estimate the economic cost of the misalignment between social and biological rhythms arising at the border of a time-zone in the presence of relatively rigid social schedules (e.g., work and school schedules). Exploiting the discontinuity in the timing of natural light at a time-zone boundary, we find that an extra hour of natural light in the evening reduces sleep duration by an average of 19 minutes and increases the likelihood of reporting insufficient sleep. Using data drawn from the Centers for Disease Control and Prevention and the US Census, we find that the discontinuity in the timing of natural light has significant effects on health outcomes typically associated with circadian rhythms disruptions (e.g., obesity, diabetes, cardiovascular diseases, and breast cancer) and economic performance (per capita income). We provide a lower bound estimate of the health care costs and productivity losses associated with these effects.

0239 Excessive Daytime Sleepiness, Reduced Sleep Duration on Weekend and Social Jetlag are associated with Caffeine Consumption in Teenagers

0239 Excessive Daytime Sleepiness, Reduced Sleep Duration on Weekend and Social Jetlag are associated with Caffeine Consumption in Teenagers

0199 Chronic Sleep Debt In Soldiers Is Exacerbated By Mission Training: An Assessment Of Subjective Sleep Characteristics

Military operations require vigilance and performance under stressful conditions while functioning with little sleep. Performance impairments (i.e., marksmanship, vigilance, executive function) have been linked with reduced sleep duration and sleep quality, as well as perceived sleepiness and fatigue. This research assessed changes in the Soldier subjective sleep profile when conducting a 72-hour military exercise during a stateside period between deployments. Performance of forty-six Soldier volunteers [42 males (mean age 24.5±4.2)] was assessed during a company-wide mission exercise. Subjective sleep duration, quality, and sleepiness were collected two weeks prior to mission and immediately post-mission, utilizing a modified Pittsburg Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Sleep duration pre-mission (M=5.77 hours, SD=1.45) was significantly higher than post-mission (M=3.94 hours, SD=1.34) (p<.0001), and significantly different across platoon-group (p=.027). However, mean sleep duration pre-mission was lower than the Army-recommended 7-8 hours, indicating chronic sleep debt across platoons prior to mission commencement. Additionally, there were no differences in PSQI scores across pre- and post-mission, with 83% categorized as “poor sleepers” (PSQI > 5) pre-mission (M=7.85, SD=3.83) and ending with 98% “poor sleepers” post-mission (M=8.71, SD=2.45). Perceived sleepiness also significantly increased across the mission (p<.0001); however, ESS scores for both pre- and post-mission indicated clinically relevant levels of excessive daytime sleepiness (ESS > 10) (pre: M=10.61, SD=5.76; post: M=17.57, SD=7.48). The time between deployments is intended as a recovery period, where Soldiers can recharge, reconnect, and train. However, even when stateside, Soldiers may be at risk for chronic sleep restriction and poor sleep quality leading to excessive daytime sleepiness even before participating in mission training and future deployment. Further investigation of potential influencing factors is warranted (i.e., Unit type, command climate, training regimes, work-life balance). Furthermore, platoon characteristics may influence factors leading to sleepiness during mission activities. Further analysis will explore performance degradations associated with daytime sleepiness and individual platoon differences, such as leadership, qualifications, and group cohesion. Military Operational Medicine Research Program and Natick Soldier Research Development Engineering Center.

0905 Reduced Sleep Duration Moderates Alcohol Use in Risky Situations in a Treatment Seeking Sample

Increased alcohol consumption has been linked to insufficient sleep duration and insomnia in subjects with/without alcohol use disorder (AUD). However, little information exists on the underlying reasons for alcohol consumption in those with insufficient sleep duration and insomnia symptoms in those with AUD. The primary aim of this investigation was to evaluate the association between alcohol consumption situations and habitual sleep duration in patients with alcohol use disorder. We analyzed baseline cross-sectional data from a treatment study of AUD patients (N=182). The Inventory of Drug-Taking Situations (IDTS) was used to assess reasons for alcohol consumption over the past year. Habitual sleep duration over the last 4 weeks was assessed using questions 4 from the Pittsburgh Sleep Quality Index. Alcohol consumption was assessed using the Time Line Follow Back interview. Linear regression analyses were used to assess the relationships between the IDTS reasons and sleep-related variables. Significant associations were further assessed in multivariable models adjusted for alcohol consumption, age, race and gender. The mean age was 42.2 years (SD=11.2), 67.3% were male and 93.7% were Caucasian. The mean habitual sleep duration was 5.9 hours (SD=1.5) with 39.9% reporting short sleep duration (<6 hours/night). About 34.4% (N=64) subjects reported difficulty falling asleep within 30 minutes in the 4 weeks. They drank on 49% (SD=27) of the days at baseline and nearly all of these drinking days were heavy drinking days [mean of 45(SD=27.5)]. Bivariate analyses demonstrated significant associations between IDTS reason-2 (physical discomfort) (β=-3.3; p=0.004) as well as IDTS reason-4 (difficulty with personal control) and sleep duration (β=-3.4; p=0.01). In multivariable models adjusted for covariates, sleep duration remained a significant predictor for IDTS item 2 (β= -2.4, t=-2.0; p=0.04) and item 4 (β=-3.1; p=0.04). A significant proportion of treatment seeking patients with AUD report short sleep duration and difficulty initiating sleep. Insufficient sleep duration appears to moderate alcohol use in situations of loss of control and discomfort and may be a risk factor for maintaining alcohol consumption. None

The key role of insomnia and sleep loss in the dysregulation of multiple systems involved in mood disorders: A proposed model

Mood disorders are amongst the most prevalent and severe disorders worldwide, with a tendency to be recurrent and disabling. Although multiple mechanisms have been hypothesized to be involved in their pathogenesis, just a few integrative theoretical frameworks have been proposed and have yet to integrate comprehensively all available findings. As such, a comprehensive framework would be quite useful from a clinical and therapeutic point of view in order to identify elements to evaluate and target in the clinical practice. Because conditions of sleep loss, which include reduced sleep duration and insomnia, are constant alterations in mood disorders, the aim of this paper was to review the literature on their potential role in the pathogenesis of mood disorders and to propose a novel theoretical model. According to this hypothesis, sleep should be considered the main regulator of several systems and processes whose dysregulation is involved in the pathogenesis of mood disorders. The model may help explain why sleep disturbances are so strikingly linked to mood disorders, and underscores the need to evaluate, assess and target sleep disturbances in clinical practice, as a priority, in order to prevent and treat mood disorders.

Pannexin 1 and Pannexin 3 regulate body fat accumulation in mouse models of dietinduced obesity

Pannexins (Panx) are channel‐forming glycoproteins important in paracrine signaling and cellular development. Panx1 and Panx3 are expressed in adipocytes and adipose stromal cells. We discovered that mice globally lacking Panx1 (KO) have significantly greater total fat mass and reduced lean mass compared to wild type (WT) mice under a normal diet, while Panx3 KO mice have reduced total fat mass and weigh less than WT controls. Despite having higher fat content, Panx1 KO mice on a high fat diet exhibited no differences in weight gain but showed an increase in glucose and insulin levels compared to WT. However, metabolic cage data revealed that these Panx1 KO mice display significantly increased activity levels, higher ambulatory activity, and reduced sleep duration relative to their WT littermates on a high‐fat diet. To uncover the cellular mechanism responsible for the increased fat content in the Panx1 KO, we isolated primary cultures of adipose‐derived stromal cells (ASCs) from WT and KO fat pads. In WT ASCs we observed that Panx1 protein levels increase upon induction into an adipogenic lineage. ASCs isolated from Panx1 KO mice proliferate less but demonstrate enhanced adipogenic differentiation with increased intracellular lipid accumulation, glycerol‐3‐phosphate dehydrogenase (GPDH) enzyme activity, and adipokine secretion, as compared to WT ASCs. This was consistent with the increased adipocyte size (hypertrophy) and decreased adipocyte numbers observed in subcutaneous fat of the Panx1 KO mice compared to WT. Panx3 is also expressed in adipose stromal cells and Panx3 protein levels significantly increase in differentiated adipocytes. However, the effect of the Panx3 KO seems to be the opposite of the Panx1 KO, with decreased weight under a high fat diet and lower fat mass (even under a normal chow diet). We propose that Panx1 and Panx3 may play opposing roles in adipose stromal cells during the early stages of adipogenic proliferation and differentiation, regulating fat accumulation in vivo.Support or Funding InformationFunded by the Canadian Institutes of Health Research (CIHR) grants to SP and LFThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Social-biological influences on sleep duration among adult residents of Northeastern China

BackgroundCold climates traditionally have conferred long sleep duration in the residents in northeast China; however, modern lifestyle reduces sleep duration. In this study, we investigated social-biological factors influencing sleep duration in the adult residents in northeast China.MethodsThis study was performed using data from the Investigation of Chronic Disease Morbidity Rate and Risk Factors of Adults in Jilin Province, China. Associations between sleep duration and indices of demographic characteristics, health-related behaviors, and disease history in adult residents were analyzed using univariate analysis and multivariate logistic regression analysis.ResultsThe mean sleep duration was 7.24 h. Of the 21,435 participants, approximately 53.4% had short sleep duration (sleep duration per day < 7 h), and 10.5% had long sleep duration (sleep duration per day > 9 h). There were associations between short sleep duration and indices, including age, place of residence, marital status, educational level, alcohol drinking, dietary, obesity, and history of coronary heart disease (CHD) or myocardial infarction (MI). There existed associations of long sleep duration with indices, such as age, place of residence, occupation, educational level, average monthly earnings, and physical exercise.ConclusionShort sleep duration is common among residents in northeast China. Age, place of residence, and educational level are implicated in both short sleep duration and long sleep duration. Short sleep duration inclines to link with the indices (marital status, alcohol drinking, dietary, obesity, and history of CHD or MI). However, long sleep duration is relevant to the indices (occupation, average monthly earnings, and physical exercise).

Sleep duration is a significant predictor of cardiac autonomic neuropathy in type 2 diabetes mellitus

AimTo investigate the association between sleep quality outcomes and measures of cardiac autonomic function and to assess the predictive ability of sleep quality outcomes for cardiac autonomic neuropathy (CAN) in type 2 diabetes mellitus (T2DM). MethodsFifty patients with T2DM (age, 51.3±7.01years; glycemic control, 8.4±1.65%) completed the study. Patients were diagnosed for CAN using the standard clinical autonomic test battery and were also assessed for heart rate variability (HRV) under resting conditions. Sleep quality was examined using the Pittsburg Sleep Quality Index (PSQI). ResultsSleep duration, sleep onset latency, sleep efficiency, daytime dysfunction and global PSQI score showed significant correlations with measures of cardiac autonomic control (p<0.05). At an optimal cut-off of≤5.83h (area under the curve: 0.76, p=0.0003; sensitivity: 50%; specificity: 94.4%), sleep duration predicted occurrence of CAN (odds ratio, confidence interval: 0.18, 0.04–0.70; p=0.01) in T2DM after adjusting for various clinical confounders. ConclusionFindings of the present study suggest that subjective sleep outcomes such as sleep duration, sleep onset latency, sleep efficiency, daytime dysfunction and overall sleep quality are associated with the indices of cardiac autonomic function in T2DM. Moreover, short sleep duration may be considered a predictor in the occurrence of CAN in these patients. Considering the role of sleep in the pathophysiology of CAN, sleep should be routinely examined in patients with T2DM and appropriate therapeutic interventions should be implemented particularly in case of reduced sleep duration.

Association of Short Sleep Duration and Atrial Fibrillation

Short sleep may be a risk factor for atrial fibrillation. However, previous investigations have been limited by lack of objective sleep measurement and small sample size. We sought to determine the association between objectively measured sleep duration and atrial fibrillation. All 31,079 adult patients undergoing diagnostic polysomnography from 1999 to 2015 at multiple sites within a large hospital network were identified from electronic medical records. Prevalent atrial fibrillation was identified by continuous ECG during polysomnography. Incident atrial fibrillation was identified by diagnostic codes and 12-lead ECGs. Logistic regression and Cox proportional hazards modeling were used to examine the association of sleep duration and atrial fibrillation prevalence and incidence, respectively, adjusting for age, sex, BMI, hypertension, coronary artery disease, cerebrovascular disease, peripheral vascular disease, heart failure, and sleep apnea severity. We identified 404 cases of prevalent atrial fibrillation among 30,061 individuals (mean age ± SD, 51.0 ± 14.5 years; 51.6%women) undergoing polysomnography. After adjustment, each 1-h reduction in sleep duration was associated with a 1.17-fold (95%CI, 1.11-1.30) increased risk of prevalent atrial fibrillation. Among 27,589 patients without atrial fibrillation at baseline, we identified 1,820 cases of incident atrial fibrillation over 4.6 years median follow-up. After adjustment, each 1-h reduction in sleep duration was associated with a 1.09-fold (95%CI, 1.05-1.13) increased risk for incident atrial fibrillation. Short sleep duration is independently associated with prevalent and incident atrial fibrillation. Further research is needed to determine whether interventions to extend sleep can lower atrial fibrillation risk.

Pattern of sleep dysfunction in systemic lupus erythematosus: a cluster analysis.

To investigate how the different components of sleep dysfunction described in SLE patients combine together in sleep clusters. We conducted a cross-sectional study on a perspective cohort of 79 SLE patients (mean age 8.2 ± 14.3years). Sleep was evaluated using Pittsburgh Sleep Quality Index (PSQI). Clusters were defined using the single components of PSQI in a hierarchical clustering model. We used Beck Depression Inventory, Hamilton Anxiety Rating Scale, and Medical Outcomes Study Short Form 36 (SF36) to measure depressive symptoms, anxiety, and quality of life, respectively. Three sleep clusters were identified. The cluster 1 (N = 47) is characterized by the lowest values of PSQI total score. The cluster 2 (N = 21) presents higher values of sleep latency, but sleep duration similar to cluster 1. In cluster 3 (N = 11), we found sleep latency increased as in cluster 2, but the highest values of PSQI total score and reduced sleep duration. Scores of anxiety and sedentary time were higher in clusters 2 and 3 than in cluster 1. Cluster 3 presented the highest scores of depression and reduced mental and physical components of SF36. The combination of different sleep components in SLE patients allowed us to identify three patterns of dysfunction: a first cluster with better sleep latency and duration, a second with increased sleep latency but conserved duration, and a third with impairment of both latency and duration. The stratification of sleep disorders in clusters might be useful for the personalization of therapy in relation to sleep cluster membership.