Sleep epidemiology最新文献

Introduction

Research suggests that perceived neighborhood social environments (PNSE) may contribute to gender and race/ethnicity-based sleep disparities. Our study aimed to examine associations between PNSE factors and adolescents’ sleep patterns. As a secondary aim, we examined how gender and race/ethnic groups might moderate these associations.

Method

Data came from the National Longitudinal Study of Adolescent to Adult Health (n = 5158; mean age=15.34 years). Four self-reported sleep outcomes were created: 1) sleep duration (hours/night), 2) short sleep (≥8 h [reference] vs <8 h), 3) parental set bedtime (10:00PM/earlier [reference] vs by 11:00PM vs by/after 12:00AM), and 4) sleep satisfaction (enough sleep [reference] vs not enough sleep). PNSE included total scores for contentedness, social cohesion, and safety. Weighted linear and generalized logistic regressions were used to examine the relationships between each PNSE factor and sleep outcomes, adjusting for covariates. Associations were stratified by gender and race/ethnicity, separately.

Results

Neighborhood contentedness was associated with longer sleep duration and lower odds of short sleep, parental set bedtime by/after 12:00AM, and not enough sleep. Neighborhood social cohesion was related to lower odds of a parental set bedtime by/after 12:00AM. Neighborhood safety was related to lower odds of short sleep and not enough sleep. Gender and race/ethnic-specific results were mixed.

Conclusion

Positive perceptions of neighborhood social environments served as a protective factor against adverse sleep outcomes among adolescents. Efforts to improve adolescent sleep should consider the role of the neighborhood social context, gender, and racial and ethnic groups.

Introduction

Poor sleep health is frequent among people with three common diseases that may co-occur: asthma, allergic rhinitis (AR), and atopic dermatitis (AD). However, few studies have assessed sleep health in people with coexisting diseases. The aims of this review were to systematically summarise: the proportion of people with asthma, or AR or AD, who have sleep disorders; and the evidence on the association of sleep health with these diseases in general populations.

Methods

We searched three databases (Medline, Web of Science and Google Scholar) for population-based studies regarding the association between sleep health, asthma, AR, or AD published by May 2023. After a systematic review of the studies, we summarised the evidence including the most prevalent sleep outcomes according to four groups of exposure: 1) asthma; 2) AR; 3) AD and 4) coexisting diseases.

Results

A total of 20 studies were identified of which one used coexisting diseases as main exposure. The majority of the selected studies were of fair quality. The most frequently assessed outcomes were nocturnal sleep-related dysfunctions (e.g. insomnia) and daytime sleep-related dysfunctions (e.g. daytime sleepiness). High proportions of sleep disorders were found among people with asthma, AR or AD. We found significant evidence that people with asthma, allergic rhinitis, or atopic dermatitis had impaired sleep health.

Conclusion

This systematic review highlights the need for methodologically robust population-based studies focused on the assessment of sleep outcomes among people with three diseases that may co-occur.

Study objectives

The postpartum period is a unique time when sleep deficiency often occurs. Black and White adults are reported to have differences in sleep characteristics, but little is known if these differences exist in the postpartum period. Therefore, the purpose of this study was to examine sleep characteristics in a cohort of Black and White women from 6-8 weeks to 12 months postpartum.

Methods

Participants were 49 Black and 85 White women who gave birth to an infant at ≥37 weeks gestation. Participants were instructed to wear an Actiwatch for 7 days at 6-8 weeks, 4, 6, 9, and 12 months postpartum. Mixed-effects linear models with a race by time interaction were used to examine if characteristics differed between races over time.

Results

Only bedtime varied by race. White women had a later bedtime at 6-8 weeks compared to 6 months, but no significant change occurred for Black women. For the entire sample, average nighttime sleep duration increased from 385 min at 6-8 weeks to 404 min at 4 months postpartum. Percent sleep during the sleep interval and wake after sleep onset (WASO) improved by 6 and 9 months, respectively. However, average WASO remained >45 min and sleep efficiency <85 % at all timepoints for both Black and White women. Compared to White women, Black women had significantly shorter sleep duration (range: 40.6-59.9 min shorter across all timepoints, p < 0.0001) and time in bed (range: 17.5-67.6 minutes shorter, p = 0.0046), and lower percent sleep (range: 0.7-1.2 % lower, p = 0.0407) and sleep efficiency (range: 2.6-5.7 % lower, p = 0.0005). Sociodemographic factors were associated with sleep outcomes in Black and White women while behavioral factors were associated with sleep outcomes in White women only.

Conclusion

While there were improvements in nighttime sleep duration and quality, sleep duration remained suboptimal, and quality remained poor throughout the first year postpartum. In this sample, differences existed in factors associated with sleep outcomes between Black and White women.

Purpose

To identify sleep dimensions (characteristics) that co-occur in premenopausal women. The second aim was to examine associations between multiple dimensions of sleep and a set of demographic, lifestyle, and health correlates. The overarching goal was to uncover patterns of poor-sleep correlates that might inform interventions to improve sleep health of women in this age group.

Methods

The BioCycle Study included 259 healthy women aged 18–44y recruited between 2005 and 2007 from Western New York. Participants reported sleep data through daily diaries and questionnaires that were used to create five sleep health dimensions (duration, variability, timing, latency, and continuity). We used multivariate analysis – canonical correlation methods – to identify links among dimensions of sleep health and patterns of demographic, psychological, and occupational correlates.

Results

Two distinct combinations of sleep dimensions were identified. The first - primarily determined by low variability in nightly sleep duration, low variability in bedtime (timing), greater nocturnal awakening, and less sleep onset latency – was distinguished from the second – primarily determined by sleep duration.

The first combination of sleep dimensions was associated with older age and higher parity, fewer depressive symptoms, and higher stress level. The second combination of sleep dimensions was associated with perception of longer sleep duration as optimal, lower parity, not engaging in shift work, older age, lower stress level, higher prevalence of depressive symptoms, and White race.

Conclusion

Among premenopausal women, we demonstrated distinct patterns of sleep dimensions that co-occur and vary by demographic, health, and lifestyle correlates. These findings shed light on the correlates of sleep health vulnerabilities among young women.

Late chronotypes and early school start times are associated with unhealthy sleep habits during adolescence. Here we examine the impact of the relationship between school timing and chronotype on sleep quality in 349 Argentinian high-school students (age: 17-18 y.o., 49% females) randomly assigned to attend school in the morning, afternoon or evening. Students completed the Munich Chronotype Questionnaire and ranked their sleep quality using a Likert-like scale. We found higher sleep quality on free days than on weekdays. Importantly, morning-attending students showed lower sleep quality on weekdays. Finally, the interaction between school timing and chronotype was associated with sleep quality on weekdays: later chronotypes were associated with poorer sleep quality in morning- and afternoon-attending students, but not in the evening. Altogether, our results suggest that attending school in the morning is associated with shorter sleep duration and higher social jetlag, but also with lower sleep quality during adolescence.

Background

Risk factors for cardiovascular disease (CVD) and sleep health are well-known to be sex- and race-specific. To build on the established relationship between sleep duration and CVD risk, this cross-sectional study aimed to describe sex-specific associations between CVD risk and other sleep characteristics (sleep quality, sleep timing and sleep onset latency) in low-income adults of African descent.

Methods

Self-reported sleep (Pittsburgh Sleep Quality Index [PSQI], Epworth Sleepiness Scale [ESS], Insomnia Severity Index [ISI]), demographic and lifestyle data were collected in 412 adults (56 % women, 35.0 ± 7.6y, 40 % employed) living in an informal settlement in South Africa. CVD risk was determined using the BMI-modified Framingham 10-year CVD risk formula.

Results

Logistic regression analyses, adjusted for employment, alcohol use and physical activity, indicated that men reporting poor sleep quality (OR: 1.95[95 %CI: 1.07–3.51], p=0.025) and earlier bedtimes (0.54[0.39–0.74], p<0.001) were more likely to belong to a higher 10-year CVD risk score quintile. Women reporting earlier bedtimes (0.72[0.55–0.95], p=0.020) and wake-up times (0.30[0.13–0.73], p=0.007), longer sleep-onset latency (1.47[1.43–1.88], p=0.003), shorter total sleep times (0.84[0.72–0.98], p=0.029), higher PSQI global scores (1.93[1.29–2.90], p=0.001) and more moderate to severe symptoms of insomnia (ISI≥15)(3.24[1.04–10.04], p=0.016) were more likely to belong to higher 10-year CVD risk score quintile.

Conclusion

In addition to sleep duration, we found that sleep quality, sleep timing and sleep onset latency are additional risk factors for CVD in adults of African descent. Sex-specific differences in the sleep-CVD-risk relationship observed suggests that future studies and recommendations about sleep health in relation to CVD should take sex into account.

Background

Obstructive sleep apnea (OSA) and insomnia are both associated with suicidal ideation (SI), but it is not known if co-morbid insomnia and obstructive sleep apnea (COMISA) has a synergistic effect. We aim to study the association of symptoms of insomnia, OSA, and COMISA with self-reported risk of SI and/or self-harm.

Methods

Using cross-sectional data from the National Health and Nutrition Examination Survey (2005–2008) (n = 5,834), we examined the odds of self-reported risk of SI and/or self-harm (past 12-months) with insomnia symptoms, high-risk for OSA, and probable COMISA groups. Insomnia symptoms were identified as having trouble attaining sleep, awakening in between sleep, early awakening on more than 15 nights/month, or diagnosed by physician. High-risk for OSA was assessed by commonly used STOP-Bang questionnaire. Probable COMISA was identified if respondents had both insomnia symptoms and high-risk for OSA. Multiple logistic regression analyses examined the associations, both unadjusted and adjusted for demographics, health behaviors, and depressive symptoms.

Results

Self-reported risk of SI and/or self-harm was likely to be more common among respondents with probable COMISA (AOR 3.24, 95 % CI 1.78–5.87) relative to respondents with no sleep disorder symptoms. The increase in odds for self-reported risk of SI and/or self-harm with probable COMISA compared to insomnia symptoms or high-risk for OSA alone suggests an underlying synergistic effect (Synergy Factor = 2.38).

Conclusion

COMISA is associated with increased risk of SI and/or self-harm. Suicide prevention efforts should focus on multimorbidity (two or more physical/mental medical conditions) to identify high-risk groups.

This study aims to explore the intersection between immigrants' length of residence and visible minority status, examining how these factors influence the likelihood of obstructive sleep apnea (OSA) reported by a health professional. Utilizing data from the 2015–16 Canadian Community Health Survey and employing logistic regression analyses, we compare the prevalence of OSA reported by a health professional among distinct groups: white native-born, visible minority native-born, white recent immigrants, visible minority recent immigrants, white established immigrants, and visible minority established immigrants. At the unadjusted level, our findings indicate that visible minority native-born (cOR=0.57, p < 0.001) and recent immigrants (cOR=0.34, p < 0.001) are less likely to receive a sleep apnea diagnosis compared to white native-born individuals. However, when adjusting for demographic variables, particularly the age of respondents, the robustness of the significance diminishes for visible minority native-born (aOR=1.07, p > 0.05), while becoming significant for white established immigrants (aOR=0.79, p < 0.01). Despite remaining largely consistent after accounting for socioeconomic, behavioural, and health characteristics, the significance for visible minority recent immigrants (aOR=0.69, p > 0.05) and white established immigrants (aOR=0.82, p < 0.05) is substantially explained when considering BMI. Based on these findings, we discuss implications for policymakers and suggest avenues for future research.

Objective

The COVID-19 pandemic impactedro a people's physical and mental health and affected countless individuals globally. University students are a subgroup that might be sensitive to changes as they are experiencing major life transition entering adulthood. The aim of the study was to objectively investigate the free-living sleeping patterns, clock times and physical activity (PA) characteristics of Icelandic university students during the pandemic, including exploring gender differences and the association between sleep and PA.

Methods

Free-living sleep and PA were measured with wrist actigraphy (Actigraphy GT3X+) for one week in 76 first year (24.4 ± 3.5 years) students (females 43 %). Unpaired t-tests were used for gender comparisons and linear regression was used to evaluate the association between sleep and PA.

Results

On average students went to bed at 01:41 h (±78 min) and woke up at 09:05 h (±96 min). Females spent more time in bed, slept longer, and went to bed and rose earlier than males (all p's<0.05). No association was found between weekly PA counts and sleep duration, quality, variability, or social jetlag. However, a correlation between PA counts and bedtimes over the entire week was detected.

Conclusion

During the COVID-19 pandemic university students slept less than recommended and demonstrated a late sleep schedule. Among male and female students, differences in sleep and PA patterns were found. Earlier bedtimes correlated with higher PA counts could highlight the importance of good sleep hygiene, especially when considering future pandemics or personal hardship, since PA has many other positive effects on overall health.

Background

Sleep duration influences the dietary pattern and quality of life of adolescents and is associated with increased ultra-processed food (UPF) consumption among those with inadequate sleep duration, which may be related to the increased prevalence of obesity, insulin resistance, and high blood pressure in this age group. Thus, the study objective was to verify the association between sleep duration and UPF intake among Brazilian adolescents participating in the Study of Cardiovascular Risks in Adolescents (ERICA).

Methods

Cross-sectional study using ERICA data, conducted between March 2013 and December 2014 with adolescents aged 12 to 17 years from public and private schools in Brazilian cities with more than 100,000 inhabitants. UPF consumption was obtained by recording a 24-hour food diary and was used as the outcome variable (in grams). The sleep duration was obtained through a questionnaire, stratified into recommended sleep duration (eight to 10 h) and inadequate sleep duration (less than 8 h and more than 10 h). Linear regression was performed to verify the association between sleep duration and UPF consumption. The analyses were carried out using Stata.

Results

66,791 adolescents were included in the study, 55.94 % of whom had inadequate sleep duration. Regardless of sleep duration, male adolescents had a higher average UPF consumption, as did adolescents in the 14–15 age group, who belong to the high socioeconomic score. Adolescents who slept less than 8 or more than 10 h a night (inadequate sleep duration) showed an increase in UPF consumption compared to adolescents who complied with the recommended hours of sleep (37.20 (22.64 – 51.76).

Conclusion

The results show the importance of healthy lifestyle habits, such as adequate sleep duration and healthy eating, for health promotion. Food and Nutrition Education actions in schools are recommended to warn about the harm of inadequate sleep time and excessive UPF consumption.