Sleep epidemiology最新文献

Sleep disparities in the United States: Comparison of logistic and linear regression with stratification by race

Sleep epidemiology

Pub Date : 2025-01-10 DOI: 10.1016/j.sleepe.2025.100106

Irene A Doherty , Mary Ellen Wells

Background

Analyses of risk factors associated with poor sleep/deprivation often use nationally representative surveys of the United States such as the National Household and Nutrition Examination Survey (NHANES). Outcomes are dichotomized as <6, <7, or <8 h of sleep and modeled with logistic regression where race or ethnicity is treated as an independent variable. Converting a continuous variable (sleep hours) to a categorical compromises statistical power. Treating race as a confounder fails to uncover how sleep disparities affect minorities.

Methods

This analysis of NHANES from 2005 to 2008 of White and Black participants compares interpretations from logistic regression models using ≤6 h of self-reported sleep to linear regression models using number of sleep minutes as the outcome. The analysis includes bivariate and multivariable models of risk factors associated with poor sleep including race, markers of low socioeconomic status (SES), sleep difficulty measures, self-reported health, and clinical comorbidities (obesity, hypertension, diabetes). All models were generated for the complete sample and stratified by race.

Results

Linear regression models produced quantifiable, clinically meaningful results such as women slept ∼20 additional minutes than men for both Black and White strata or were OR=0.63 times as likely to sleep ≤6 h. Markers of low SES (education, poverty) and self-reported health were associated with sleep deprivation for Whites, but not for Blacks in both linear and logistic regression.

Conclusions

Stratified analyses by race using the amount of sleep as a continuous outcome in linear regression is more rigorous and informative than logistic regression for sleep research using US representative surveys.

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引用次数: 0

Heart rate variability, sleep quality and physical activity in medical students

Sleep epidemiology

Pub Date : 2024-12-30 DOI: 10.1016/j.sleepe.2024.100105

Samuel Filipe Lopes Alves , Thaísy Andressa Bastos Primo de Sousa Santos , Marianne Lucena da Silva , Katiane da Costa Cunha

Aims

The present study aims to investigate the sleep quality, levels of physical activity, and their relationship with heart rate variability (HRV) in medical students.

Methods

We conducted a cross-sectional study with 105 medical students from Brazil. Data were collected through sociodemographic questionnaires, Pittsburgh Sleep Quality Index (PSQI), International Physical Activity Questionnaire Short Form (IPAQ-SF), anthropometric measurements, and resting HRV. One-way ANOVA analysed sociodemographic variables, PSQI, and IPAQ scores. Spearman correlation assessed the relationship between anthropometric data and HRV parameters. Multiple Linear Regression examined the relationship between PSQI, IPAQ, and HRV, with a significance level of 5%.

Results

A predominance of poor sleep quality and high physical activity levels were observed in medical students. Multivariate analysis revealed a significant association between HRV, IPAQ, and sleep quality in the SDNN (F reg=3.08; p = 0.0486) and LF (F reg=2.95; p = 0.0553) components. However, when analysing each variable independently, the correlation was statistically relevant only for the PSQI. The correlation was inversely proportional, indicating poorer sleep quality associated with lower HRV values.

Conclusion

The results indicate that poor sleep quality is common among medical students and is correlated with a reduction in HRV, which may have an adverse impact on the cardiovascular health of this population.

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引用次数: 0

Prevalence of sleep disturbances and factors associated among school going children in Uganda, a cross-sectional study

Sleep epidemiology

Pub Date : 2024-12-09 DOI: 10.1016/j.sleepe.2024.100104

Baluku Reagan Innocent , Oriokot Lorraine , Elly Katabira , Martha Sajatovic , Abbo Catherine , Kaddumukasa Mark

Background

Sleep disturbances greatly impact children's academic performance and social well-being. This study set out to determine the prevalence of sleep disturbances and factors associated among school going children in Kawempe division, Kampala, Uganda.

Methods

In a community cross-sectional study, 548 study participants using random cluster sampling were enrolled. The children start lessons at 8am and end the days classes at 5pm. Random cluster sampling method was used to select participants from the 19 parishes in Kawempe district. Data was collected using a semi-structured questionnaire and Sleep Disturbance Scale for Children (SDSC). Descriptive statistics and multivariate binary logistic regression were performed with a p < 0.05 level of significance, and a 95 % confidence interval as a measure of association between the sleep disturbance.

Results

Abnormal total sleep score (T- score >70) was at 3.5 %, and overall, 21.7 % of the children had an abnormal score on at least one SDSC factor. Among the children with sleep disturbances, we noted the following factors; use of an electronic device before bed, sleeping <7 h at night, having unemployed parents and lack of regular parental interaction.

Conclusion

Better understanding of sleep disturbances in needed to address challenges associated with sleep among children in Uganda.

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引用次数: 0

Longitudinal study of chronic nausea and vomiting and its associations with sleep-related leg cramps in the US general population

Sleep epidemiology

Pub Date : 2024-12-09 DOI: 10.1016/j.sleepe.2024.100103

MM Ohayon , YJ Chen , R Fass , ML Cote

Introduction

Chronic nausea and vomiting (CNV) can have a long-term impact on people's health and quality of life. This study aims to investigate whether CNV is involved in the development of sleep-related leg cramps (SRLCs) in a longitudinal study involving 10,931 participants representative of the US general population.

Methods

Participants were interviewed three years apart over the telephone using the Sleep-EVAL expert system. It collected information on sleep habits/disturbances (International Classification of Sleep Disorders), mental disorders (DSM-IV-TR) and medical conditions. CNV was defined as episodes of nausea and vomiting occurring at least five times a month for at least one month (outside pregnancy) as per the ROME IV recommendations.

Results

At the initial interview, 3% (95%CI:2.7%-3.3%) of the participants reported CNV, and 2.5% (95%CI:2.2%-2.8%) at follow-up. The 3-year incidence for CNV was 1.4%. SRLCs was found in 12.4% (95%CI:11.9%-13.1%) of the sample at the first-interview and 11.5% (95%CI:10.1%-12.1%) at follow-up. Multivariate models show that individuals with CNV at both interviews had a relative risk 4.1 times higher (95%CI:2.7–6.2; p < 0.0001) to have SRLCs at follow-up compared to those without nausea or vomiting. Magnesium intake at the initial interview was a protective factor for SRLCs (RR 0.4; 95%CI: 0.2–0.7; p = 003).

Discussion

Symptoms of CNV lasting for years is highly predictive of SRLC based on this longitudinal survey. The link between the two pathologies could be partially explained by potential potassium/magnesium depletion from muscles as a result of CNV. The findings of this study call for physician awareness of the association between CNV and SRLC.

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引用次数: 0

Erratum to “Modeling and Feature Assessment of the Sleep Quality among Chronic Kidney Disease Patients” [Sleep Epidemiology Volume 2, December 2022, 100041] 对《慢性肾病患者睡眠质量的建模和特征评估》的勘误 [《睡眠流行病学》第 2 卷，2022 年 12 月，100041]

Sleep epidemiology

Pub Date : 2024-12-01 DOI: 10.1016/j.sleepe.2024.100072

Surani Matharaarachchi , Mike Domaratzki , Chamil Marasinghe , Saman Muthukumarana , Varuni Tennakoon

引用次数: 0

Corrigendum to “Obstructive Sleep Apnea (OSA) and contact sports: A systematic review and meta-analysis” [Sleep Epidemiology, 2C (2022) 100036]

Sleep epidemiology

Pub Date : 2024-12-01 DOI: 10.1016/j.sleepe.2024.100094

Nathan E. Howarth , Adam J. White , Alan J. Pearce , Chris Nowinski , Robert Cantu , Chen Ji , Michelle A Miller

引用次数: 0

Anxiety symptoms, sleep disturbance, and academic achievement among Afghan female school students: A cross-sectional study 阿富汗女学生的焦虑症状、睡眠障碍和学习成绩：横断面研究

Sleep epidemiology

Pub Date : 2024-11-15 DOI: 10.1016/j.sleepe.2024.100102

Ahmad Neyazi , Bilal Ahmad Rahimi , Abdul Qadim Mohammadi , Nosaibah Razaqi , Laila Qanawezi , Shaharah Sarem , Saida Said , Raz Mohammad Tabib , Habibah Afzali , Mehrab Neyazi , Mark D. Griffiths

Background

Anxiety is a common psychological disorder in school-aged children and adolescents. The present study aimed to assess the prevalence of anxiety symptoms and sleep disturbances and their relationship with academic achievement among female students in Herat, Afghanistan.

Methods

A cross-sectional survey of 737 female students (mean age 11.8 years old) was conducted across 10 randomly selected schools in Herat, Afghanistan, covering Grades 1 to 6. Students were randomly chosen within these schools. The Depression Anxiety Stress Scale for Youth (DASS-Y) and Pittsburgh Sleep Quality Index (PSQI) assessed anxiety and sleep disturbance, while academic achievement ratings were provided by schoolteachers.

Results

Using the DASS-Y and the PSQI, 65.5% reported anxiety symptoms and 46.4% reported sleep disturbance. Low academic achievement correlated significantly with anxiety (r = 0.228) and sleep issues (r = 0.161). Multiple logistic regression analysis identified predictors for anxiety and sleep disturbance. Predictors for anxiety included being aged 13–16 years, having lower class grade, being of low economic status, and having unemployed parents. Predictors for sleep disturbance included being aged 13–16 years, having lower class grade, having an uneducated father, being of low economic status, and having unemployed parents.

Conclusion

There is a high prevalence of anxiety symptoms and sleep disturbances among female school students in Herat, Afghanistan. Significant correlations exist between students' academic achievement, anxiety, and sleep disturbances. Addressing anxiety and sleep disturbances among Afghan female school students could be facilitated by revising current government policies concerning students' health. Educational campaigns focused on sleep hygiene and anxiety management for both students and their parents may also prove beneficial.

背景焦虑是学龄儿童和青少年常见的心理障碍。本研究旨在评估阿富汗赫拉特市女学生中焦虑症状和睡眠障碍的发生率及其与学业成绩的关系。方法在阿富汗赫拉特市随机抽取了 10 所学校的 737 名女学生（平均年龄 11.8 岁）进行了横断面调查，调查范围涵盖一至六年级。学生在这些学校中随机抽取。青少年抑郁焦虑压力量表（DASS-Y）和匹兹堡睡眠质量指数（PSQI）对焦虑和睡眠障碍进行了评估，而学业成绩则由学校教师进行评分。结果使用 DASS-Y 和 PSQI，65.5% 的学生报告了焦虑症状，46.4% 的学生报告了睡眠障碍。学习成绩差与焦虑（r = 0.228）和睡眠问题（r = 0.161）有明显的相关性。多元逻辑回归分析确定了焦虑和睡眠障碍的预测因素。焦虑的预测因素包括 13-16 岁、年级较低、经济地位较低和父母失业。睡眠障碍的预测因素包括 13-16 岁、年级较低、父亲未受过教育、经济地位较低、父母失业。学生的学习成绩、焦虑和睡眠障碍之间存在明显的相关性。可以通过修订政府有关学生健康的现行政策来解决阿富汗女学生的焦虑和睡眠障碍问题。针对学生及其家长开展以睡眠卫生和焦虑管理为重点的教育活动也可能会有所裨益。

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引用次数: 0

Listening to patients: Incidence and distribution of sleep disorders in Prader-Willi syndrome 倾听患者的心声普拉德-威利综合征患者睡眠障碍的发生率和分布情况

Sleep epidemiology

Pub Date : 2024-10-20 DOI: 10.1016/j.sleepe.2024.100101

Amee Revana , E. Robert Wassman , Niva Haber , Lara C. Pullen , Terry Jo Bichell , Jessica Duis , Randy Bartlett , Christopher DeFelice , Maria Picone

While the medical community continues to recognize the contributions of disordered sleep to the burden of Prader-Willi syndrome (PWS), the medical literature lacks characterization of the patient burden of sleep disorders by people living with PWS and their caregivers. We developed and fielded a 72-question survey to the online PWS community, to query caregivers about their experiences with sleep symptoms. Respondents for all age groups reported sleep-disordered breathing (40 %), cataplexy-like symptoms (28.4 %), and insomnia (43.5 %). The presentation of cataplexy-like symptoms tended to change as children aged, presenting initially (ages 0–4 years) as head bobbing while eating, then transitioning to knee buckling between the ages of 5–12 years. Finally, loss of generalized tone associated with extreme emotions became more common in the teenage years. Frequent screening for potentially treatable sleep disorders should be considered the standard of care for individuals with PWS.

虽然医学界不断认识到睡眠障碍对普拉德-威利综合征（PWS）造成的负担，但医学文献中缺乏对普拉德-威利综合征患者及其照顾者的睡眠障碍患者负担的描述。我们开发并在网上PWS社区开展了一项包含72个问题的调查，以询问护理人员在睡眠症状方面的经验。所有年龄组的受访者均报告了睡眠呼吸障碍（40%）、类反射症状（28.4%）和失眠（43.5%）。随着儿童年龄的增长，反射样症状的表现形式也会发生变化，最初（0-4 岁）表现为进食时摇头晃脑，然后在 5-12 岁时转变为膝关节屈曲。最后，与极端情绪相关的全身失调在青少年时期变得更为常见。经常筛查潜在的可治疗睡眠障碍应被视为 PWS 患者的护理标准。

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引用次数: 0

Association between skin temperature and actigraphic sleep metrics in patients with Parkinson's disease: The PHASE study 帕金森病患者的皮肤温度与动觉睡眠指标之间的关系：PHASE 研究

Sleep epidemiology

Pub Date : 2024-10-16 DOI: 10.1016/j.sleepe.2024.100100

Yoshiaki Tai , Kenji Obayashi , Yuki Yamagami , Keigo Saeki , Kazuma Sugie , Hiroshi Kataoka

Introduction Sleep initiation and maintenance are linked to thermoregulation. In Parkinson's disease (PD), thermoregulatory dysfunction potentially worsens sleep disorders. However, the association between thermoregulation and sleep quality in patients with PD remains unclear. We aimed to examine the association between skin temperature, a measure of heat dissipation, and actigraphic sleep metrics in PD.

Methods In this cross-sectional study with 186 outpatients with PD and 580 non-PD controls, we measured wrist skin temperature (WST) and actigraphic sleep quality for seven days in PD and two days in controls in real-life settings. Linear mixed-effect models were used to examine the association between nighttime WST and sleep quality.

Results Nighttime WST in PD was significantly lower than that in controls (adjusted difference 0.39 [95 % confidence interval, 0.23–0.54] °C, P < 0.001). In patients with PD, changes in sleep efficiency, wake after sleep onset, total sleep time, and log-transformed fragmentation index per 1 °C increase in nighttime WST were 3.2 (95 % CI, 2.4–3.9) %, −10.3 (95 % CI, −13.6, −7.1) minutes, 13.4 (95 % CI, 9.1–17.8) minutes, and −0.09 (95 % CI: −0.12, −0.06), respectively, independent of potential confounders. Significant interactions were observed between nighttime WST and the presence of PD for sleep efficiency, wake after sleep onset, and total sleep time.

Conclusions: Within-individual changes in nighttime WST were significantly associated with changes in actigraphic sleep measures in PD. Interventional studies are necessary that address the limitations and potential biases of this study to elucidate whether cutaneous temperature modulation can enhance the quality of sleep in PD.

导言睡眠的开始和维持与体温调节有关。帕金森病（PD）患者的体温调节功能障碍可能会加重睡眠障碍。然而，帕金森病患者的体温调节与睡眠质量之间的关系仍不清楚。在这项横断面研究中，我们对 186 名帕金森病门诊患者和 580 名非帕金森病对照组患者进行了为期七天的腕部皮肤温度（WST）和睡眠质量的测量。我们使用线性混合效应模型来研究夜间腕部皮温与睡眠质量之间的关系。结果白内障患者的夜间腕部皮温明显低于对照组（调整后差异为 0.39 [95 % 置信区间，0.23-0.54] °C，P < 0.001）。在帕金森氏症患者中，夜间 WST 每升高 1 °C，睡眠效率、睡眠开始后唤醒、总睡眠时间和对数变换破碎指数的变化分别为 3.2 (95 % CI, 2.4-3.9) %、-10.3 (95 % CI, -13.6, -7.1)分钟、13.4 (95 % CI, 9.1-17.8) 分钟和-0.09 (95 % CI: -0.12, -0.06)，不受潜在混杂因素的影响。在睡眠效率、睡眠开始后唤醒和总睡眠时间方面，观察到夜间WST与PD存在显著的交互作用：结论：夜间WST的个体内部变化与帕金森病患者睡眠动图测量的变化有显著相关性。有必要进行干预性研究，解决本研究的局限性和潜在偏差，以阐明皮肤温度调节是否能提高帕金森病患者的睡眠质量。

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引用次数: 0

Characterization of sleep apnea among a sample of adults from Samoa 萨摩亚成年人睡眠呼吸暂停样本的特征

Sleep epidemiology

Pub Date : 2024-09-30 DOI: 10.1016/j.sleepe.2024.100099

Lacey W. Heinsberg , Alysa Pomer , Brian E. Cade , Jenna C. Carlson , Take Naseri , Muagututia Sefuiva Reupena , Satupa'itea Viali , Daniel E. Weeks , Stephen T. McGarvey , Susan Redline , Nicola L. Hawley

Sleep apnea is a global public health concern, but little research has examined this issue in low- and middle-income countries, including Samoa. The purpose of this study was to examine the sample prevalence and characteristics of sleep apnea using a validated home sleep apnea device (WatchPAT, Itamar) and explore factors that may influence sleep health in the Samoan setting. This study used data collected through the Soifua Manuia (“Good Health”) study, which investigated the impact of the body mass index (BMI)-associated genetic variant rs373863828 in CREBRF on metabolic traits in Samoan adults (sampled to overrepresent the obesity-risk allele of interest). A total of 330 participants had sleep data available. Participants (53.3 % female) had a mean (SD) age of 52.0 (9.9) years and BMI of 35.5 (7.5) kg/m², and 36.3 % of the sample had type 2 diabetes. Based on the 3 % and 4 % apnea hypopnea indices (AHI) and the 4 % oxygen desaturation index (ODI), descriptive analyses revealed moderate to severe sleep apnea (defined as

\geq

15 events/hr) in 54.9 %, 31.5 %, and 34.5 % of the sample, respectively. Sleep apnea was more severe in men (e.g., AHI 3 %

\geq

15 in 61.7 % of men and 48.9 % of women). Correction for non-representational sampling related to the CREBRF obesity-risk allele resulted in only slightly lower estimates. Multiple linear regression linked a higher number of events/hr to higher age, male sex, higher BMI, higher abdominal-hip circumference ratio, and geographic region of residence. Further research and an increased focus on equitable and affordable diagnosis and access to treatment are crucial to addressing sleep apnea in Samoa and globally.

睡眠呼吸暂停是一个全球性的公共健康问题，但很少有研究对包括萨摩亚在内的中低收入国家的这一问题进行研究。本研究的目的是使用经过验证的家用睡眠呼吸暂停装置（WatchPAT，伊塔玛尔）检查睡眠呼吸暂停的样本患病率和特征，并探讨可能影响萨摩亚人睡眠健康的因素。这项研究使用了 Soifua Manuia（"健康状况良好"）研究收集的数据，该研究调查了 CREBRF 中与体重指数 (BMI) 相关的基因变异 rs373863828 对萨摩亚成年人代谢特征的影响（取样时过度代表了感兴趣的肥胖风险等位基因）。共有 330 名参与者提供了睡眠数据。参与者（53.3% 为女性）的平均（标清）年龄为 52.0 (9.9)岁，体重指数为 35.5 (7.5) kg/m2，36.3% 的样本患有 2 型糖尿病。根据 3% 和 4% 的呼吸暂停低通气指数 (AHI) 和 4% 的血氧饱和度指数 (ODI)，描述性分析显示，54.9%、31.5% 和 34.5% 的样本分别患有中度至重度睡眠呼吸暂停（定义为≥15 次/小时）。男性的睡眠呼吸暂停更为严重（例如，61.7% 的男性和 48.9% 的女性 AHI 3% ≥15）。对与 CREBRF 肥胖风险等位基因有关的非代表性抽样进行校正后，估计值仅略有降低。多元线性回归将较高的事件/小时数与较高的年龄、男性性别、较高的体重指数、较高的腹围-臀围比率和居住的地理区域联系起来。在萨摩亚和全球解决睡眠呼吸暂停问题的关键在于进一步开展研究，并更加重视公平、可负担得起的诊断和治疗。

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引用次数: 0