Sleep epidemiology最新文献

Background

Co-morbid insomnia and sleep apnoea (COMISA) is a highly prevalent condition associated with negative health outcomes. This population-based study aimed to investigate the association between COMISA and all-cause mortality.

Methods

Sleep data in 6,877 participants (Age median [IQR]=45 [33,57], 50.1% male) were drawn from the National Health and Nutrition Examination Survey (2005-2008). Insomnia was defined as difficulties initiating sleep, long awakenings, and/or early morning awakenings on ≥16 nights/month, with daytime impairment. The STOP-Bang questionnaire was used to identify participants at high risk of obstructive sleep apnoea (OSA). COMISA was defined if participants met criteria for insomnia and high risk OSA. The median (IQR) follow-up for mortality was 8.6 (7.8, 9.8) years. Cox regression models were used to determine the association between COMISA and all-cause mortality, controlling for socio-demographic characteristics, behavioural factors and chronic conditions.

Results

The prevalence of no insomnia/OSA, insomnia-alone, OSA-alone, and COMISA were 73.5, 3.0, 20.1, and 3.3%, respectively, and 6.7% of participants died by 11-year follow-up. Compared to participants with no insomnia/OSA, higher mortality risk was observed in participants with COMISA (HR=1.9; 95%CI=1.3-2.8) and insomnia alone (HR=1.5; 95%CI=1.0-2.3) after adjusting for socio-demographic characteristics, and behavioural factors. The relationship between COMISA and mortality persisted after additionally controlling for chronic conditions, sleep duration and sleeping pill use (HR=1.6; 95%CI=1.1-2.3), but the relationship between insomnia-alone and mortality did not (HR=1.4; 95%CI=0.9-2.3).

Conclusion

Co-morbid insomnia and high-risk OSA is associated with increased risk of all-cause mortality. More research is needed to identify effective treatments for COMISA.

Context

Parental socioeconomic status (SES) is increasingly understood to be a key contributor to sleep health, but the research in childhood has not been synthesized.

Objective

To examine the associations between indicators of child SES and child sleep (≤18 years old), we conducted a systematic review and meta-analyses.

Data sources

CINAHL with Full Text, PsycINFO, MEDLINE/PubMed, and Embase were searched using terms to define SES and childhood to ascertain all relevant, peer-reviewed articles from database inception to 27 December 2019.

Study selection

Studies were included if an association between an indicator of parental SES and a measure of child sleep (duration, quality, and problems) was reported.

Data extraction

Data was extracted from 46 studies (N = 72,915). Across these studies, total sample size across participants included in the meta-estimate was N = 69,373.

Results

Data was extracted from 46 studies (N = 72,915). Across these studies, total sample size across participants included in the meta-estimate was N = 69,373. Higher parental education was associated with longer childhood sleep duration (stronger in samples with a higher proportion of White children) (OR = 1.302, 95% CI [1.111, 1.526], p = .001) and better sleep quality (OR = 1.332, 95% CI [1.014, 1.751], p = .040). Parental education was not directly associated with child sleep problems (OR = 1.191, 95% CI [0.733, 1.935], p = .479); moderation occurred by continent and the relationship was more pronounced in the Asian meta-estimate. Higher household income was not directly associated with longer childhood sleep duration (OR = 0.570, 95% CI [0.167, 1.943], p = 0.369), but moderation occurred by higher quality studies and the proportion of White children in the sample. Higher household income was associated with fewer sleep problems (moderated by continent) (OR = 0.764 (95% CI [0.689, 0.848], p < .001) and higher sleep quality (OR = 1.558, 95% CI [1.036, 2.342], p = .033).

Limitations

This review was limited by the number and methods of available published studies meeting inclusion criteria.

Conclusions

Preventative programs that emphasize improvements in sleep of children and adolescents growing up in lower SES families are needed.

Objective

Sleep has been impacted by the COVID-19 pandemic around the world. Furthermore, screen time has been reported to influence sleep and has increased during pandemic quarantines. This systematic review searched databases to determine if screen time affected sleep during the COVID-19 pandemic.

Methods

PubMed, Nursing and Allied Health Proquest, and Science Direct Health and Lifescience college edition were searched for articles that fit the inclusion criteria. There were 2750 articles initially screened. Then, 119 articles were further assessed to determine eligibility, creating a final sample of 18 articles that explored whether screen time affected sleep.

Results

After reviewing the included articles (n = 18), the main theme revealed that screen time negatively affected sleep during the COVID-19 pandemic, specifically aspects such as sleep duration, sleep quality, sleep onset latency, and wake time. However, several articles countered this implication. Therefore, it is important to consider other factors that may influence the relationship between screen time and sleep.

Conclusions

Although the number of articles included is limited, the overall synthesis suggests that COVID-19-related lifestyle changes, such as increased screen time, may negatively affect sleep health. However, other unidentified factors may have contributed to these findings and warrant further research. Nonetheless, community leaders must consider the long-term consequences of the pandemic and implement initiatives to address sleep challenges due to the intricate connection between sleep and well-being.

Human sleep is fundamental for organic functions to occur properly. Therefore, lack of adequate sleep can impair cognitive function, which in turn causes emotional problems, memory changes and the onset of diseases. However, it is worth noting that sleep is influenced by external factors, such as tobacco usage. In this sense, our goal is to analyze studies that have the influence of tobacco consumption on the sleep quality of adults as the object of their research. A high-sensibility search was performed in databases (Virtual Health Library [Biblioteca Virtual em Saúde – BVS], Scielo, Medline via Pubmed, Cochrane, Embase, Web of Science, Scopus, PsycoInfo, Cinahl) using descriptors linked to tobacco consumption and sleep habits. 19 studies originating from 10 countries were included, with a total sample of 15245 participants; 10 studies were selected for the meta-analysis. It was identified that smoking tobacco affects sleep characteristics — such as quality, maintenance, and duration — with females and those who use tobacco more heavily having greater alterations.

Objective

Habitual insufficient sleep may contribute to cardiometabolic disease in the United States, particularly among racial and ethnic minorities. However, there is mixed evidence on secular trends in U.S. sleep duration.

Study design

Cross-sectional data from 413,417 individuals were acquired from the National Health Interview Survey from 2005–2018. Variables included self-reported sleep duration as well as lifetime diagnosis of hypertension, coronary heart disease, diabetes, and pre-diabetes, and obesity. Population-weighted robust Poisson models estimated annual trends in sleep duration and the prevalence risk ratios (PRR) of cardiometabolic disease as a function of sleep duration.

Setting

Population-based survey.

Results

Daily sleep duration decreased -0.62 min ([-0.71, 0.54], p < 0.01) annually from 2005–2018. However, this decline began only after 2010, when sleep duration fell by 1.04 min ([-1.21, -0.86], p < 0.01) each year. This trend varied by race (two-way ANOVA, p = 0.02), such that Mexican Hispanic individuals saw a greater decline (-1.83 [-2.37, -1.30] min per year, p < 0.01) than whites (-0.83 [-1.02, -0.64] min per year, p < 0.01). Additionally, a 1-h loss in daily sleep duration was linked to 4% greater prevalence of hypertension (PRR: 1.04, [1.04, 1.05]), 3% greater prevalence of diabetes (PRR: 1.03 [1.01, 1.05]), and 8% greater prevalence of obesity (PRR: 1.08 [1.07, 1.09]) after adjusting for age, sex, employment, marital status, and survey year.

Conclusions

There is a secular decline in U.S. daily sleep duration that is greater among Mexican Hispanic individuals. Moreover, reduced sleep duration is associated with more prevalent cardiometabolic disease.

Background

Sleep affects health. Sleep habits differ between population subgroups and may also differ between weekdays and weekends; however, these patterns are rarely described at the population level.

Purpose

To investigate age and racial/ethnic differences in sleep duration and timing between weekdays (workdays) and weekends (non-workdays).

Methods

A cross-sectional analysis of the US nationally representative data from the National Health and Nutrition Examination Survey among adolescents (16-19 years) and adults (≥20 years).

Results

Data on 10069 individuals were analyzed (51% female), including 959 adolescents and 9110 adults. The hours per night of sleep were shorter during weekdays (7.6, 95%CI: 7.6 to 7.7) than on weekends (8.3, 95% CI: 8.3 to 8.2). Females slept shorter hours than males on weekdays (7.7 [95%CI, 7.7 to 7.8] vs. 7.5 [95%CI, 7.4 to 7.5]) and on weekends (8.5, [95%CI, 8.4 to 8.5] vs. 8.2 [95% CI, 8.1 to 8.2]). Non-Hispanic blacks (7.4, 95% CI: 7.4 to 7.5) reported the shortest weekdays sleep. With respect to sleep timing, comparing to weekdays, males reported 30-min delayed weekends bedtime (23:30 [IQR, 22:30-00:30] vs. 23:00 [IQR, 22:00-00:00]), whereas both sexes reported 1.5-hour delayed weekends wake-up time (male: 07:30 [IQR, 06:30-09:00] vs. 06:00 [IQR, 05:30-07:30]; female: 08:00 [IQR, 06:30-09:00] vs. 06:30 [IQR, 05:30-07:30]). The delayed weekend bedtime and wake-up times were observed in all racial/ethnic groups.

Conclusions

In the US population, sleep habits differed between weekdays and weekends. Shorter sleep hours and delayed sleep timing were noted and more apparent among racial/ethnic minorities of both sexes.

The internet network continues to be a major source of health-related information. Our research provides insights into the online health-seeking behaviors of the general population, and evaluates the potential relationship between the COVID-19 pandemic and public interest and awareness of general sleep health, mental health and wellbeing.

Google Trends’ weekly relative search volumes (RSVs) were examined during 2020 for searches specifically related to COVID-19 symptoms, and for searches related to general health, sleep and wellbeing, in the United Kingdom, the United States of America, France, Italy and Japan. To obtain insight into the association between the initiation of public restrictions and online search trends, we assessed a six-week period; the ‘early pandemic period’ (EPP) (01 March 2020 – 11 April 2020). To provide a meaningful pre-pandemic comparison, a similar period during 2019 (03 March – 13 April 2019) was compared for RSV and median difference analysis.

The EPP was associated with increased online searches related to COVID-19 symptoms, as compared with those related to more general sleep health, mental health and wellbeing. The latter search terms frequently showed a decrease or minimal change in RSV during the EPP compared with the equivalent period in 2019. This finding illustrates the potential link between the COVID-19 pandemic and online search behavior and corroborates existing findings regarding internet searches during this period.

Proactive communication by healthcare professionals during future pandemics and as an ongoing measure could help prevent public neglect of general health and wellbeing symptoms, and encourage reporting and early intervention.

Purpose

Excessive daytime sleepiness (EDS) is a symptom experienced by patients with obstructive sleep apnea (OSA) that may persist despite primary CPAP therapy (residual EDS; rEDS). This study aimed to estimate the age- and gender-specific prevalence and incidence for CPAP-treated OSA patients that showed indicators of rEDS in health-related data.

Methods

This study used the InGef research database, an anonymized representative dataset of 4 million persons covered by statutory health insurance in Germany. OSA patients receiving CPAP therapy were analyzed and data indicators for rEDS, or with EDS not satisfactorily treated by primary OSA therapy, were identified using an expert-opinion based diagnostic scheme in two study cohorts: The objective of the first cohort was to estimate the 12-month prevalence and incidence of rEDS in OSA (study period: 2016). The second cohort investigates patient characteristics and health care utilization (study period: 2013–2018).

Results

1298 OSA patients with indicators of rEDS after initiation of CPAP therapy were identified, giving an overall prevalence estimate of 41.1 (95%-CI 38.9-43.4) per 100,000 persons in Germany. Of all CPAP-users, 6.4% were affected by rEDS. Annual incidence was estimated to be 6.4 (95%-CI 5.6-7.4) per 100,000 persons. In the year before CPAP treatment started, 46% received antidepressants, 45% were in psychotherapeutic treatment and 58% of employees were unable to work, on average for 71 days within one year.

Conclusion

Patients that were identified with indicators of residual EDS showed a high socioeconomic burden potentially leading to an increased demand of healthcare services and incapacity for work.

The present study sought to determine which subjective sleep assessment parameters were most strongly associated with university students’ grade point average (GPA) and level of satisfaction with their academic performance. One hundred and five students completed the Pittsburgh Sleep Quality Index and answered questions about their GPA and level of satisfaction with that average. Logistic regression analyses indicate that the parameters most strongly associated with students’ GPA are, in descending order, sleep efficiency, daytime dysfunction due to sleepiness, and total sleep time. Only one parameter was associated with dissatisfaction with the GPA: subjective sleep quality. This study highlights the importance of considering students’ expectations of their academic performance rather than focusing solely on their grades. It also advocates for promoting high sleep efficiency rather than focusing exclusively or primarily on sleep duration.