Associations of sleep phenotypes with severe intentional self-harm: a prospective analysis of the UK Biobank cohort

SLEEP ◽  
2021 ◽  
Author(s):  
Binbin Lei ◽  
Jihui Zhang ◽  
Sijing Chen ◽  
Jie Chen ◽  
Lulu Yang ◽  
...  

Abstract Study objectives We aimed to investigate the prospective associations of sleep phenotypes with severe intentional self-harm (ISH) in middle-aged and older adults. Methods A total of 499,159 participants (mean age: 56.55 ± 8.09 years; female: 54.4%) were recruited from the UK Biobank between 2006 and 2010 with follow-up until February 2016 in this population-based prospective study. Severe ISH was based on hospital inpatient records or a death cause of ICD-10 codes X60-X84. Patients with hospitalized diagnosis of severe ISH before the initial assessment were excluded. Sleep phenotypes, including sleep duration, chronotype, insomnia, sleepiness, and napping, were assessed at the initial assessments. Cox regression analysis was used to estimate temporal associations between sleep phenotypes and future risk of severe ISH. Results During a follow-up period of 7.04 years (SD: 0.88), 1,219 participants experienced the first hospitalization or death related to severe ISH. After adjusting for demographics, substance use, medical diseases, mental disorders, and other sleep phenotypes, short sleep duration (HR: 1.50, 95% CI: 1.23-1.83, P < .001), long sleep duration (HR: 1.56, 95% CI: 1.15-2.12, P = .004), and insomnia (usually: HR: 1.57, 95% CI: 1.31-1.89, P < .001) were significantly associated with severe ISH. Sensitivity analyses excluding participants with mental disorders preceding severe ISH yielded similar results. Conclusion The current study provides the empirical evidence of the independent prediction of sleep phenotypes, mainly insomnia, short and long sleep duration, for the future risk of severe ISH among middle-aged and older adults.

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A433-A433
Author(s):  
J Li ◽  
A J Alfini ◽  
F Yu ◽  
J A Schrack ◽  
V Cotter ◽  
...  

Abstract Introduction Lack of physical activity and disturbed sleep have been linked to older adult’s poor cognitive outcomes; however, little is unknown how they interact to affect cognition long-term. The purpose of this study was to examine the association of baseline sleep duration and physical activity (PA) with change in cognition independently and interactively over four years. Methods The sample included 1126 community-dwelling older adults aged 60+ (mean age 67.1±5.9 years, 51% female) from the 2011 baseline and 2015 follow-up data of the China Health and Retirement Longitudinal Study (CHARLS). All variables were assessed through interviews. Sleep duration was measured with hours per 30-minute interval and categorized as very-short (<5h), short (5-6.5h), normal (7-8.5h), and long (≥9h). PA was calculated based on PA intensity, duration, and number of days. Cognition was a composite score of mental capacity, episodic memory, and visuospatial abilities. Data were analyzed using multiple regression (primary outcome: change in cognition; main independent variables: baseline sleep, PA, and sleep PA interaction). Results At baseline, 19% of participants had very-short sleep duration, 34.4% had short sleep, 39.2% had normal sleep, and 7.2% had long sleep. At follow-up, 57.5% of participants experienced cognitive decline (-3.5±2.5). After controlling for age, gender, education, region, body mass index, smoking, drinking, number of chronic conditions, pain, depression, and cognition at baseline, compared to participants reporting 7-8.5h sleep, those with ≥9h sleep had significantly greater decline in cognition [β=-1.4, 95% CI=2.4, -0.4], while those with <5h sleep [β=-0.5, 95% CI=-1.2, 0.2] and 5-6.5h sleep did not [β=-0.1, 95% CI=-0.7, 0.5]. PA was neither associated with cognitive decline, nor moderated the relationship between sleep duration and cognitive decline. Conclusion Long sleep might be a marker of cognitive decline in older adults. Prospective analysis, using objectively measured PA and sleep should be conducted to further examine these associations. Support National Institute of Nursing Research R00NR016484


2018 ◽  
Vol 93 (7) ◽  
pp. 857-866 ◽  
Author(s):  
Dawit T. Zemedikun ◽  
Laura J. Gray ◽  
Kamlesh Khunti ◽  
Melanie J. Davies ◽  
Nafeesa N. Dhalwani
Keyword(s):  

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1848 ◽  
Author(s):  
Ahmad Syauqy ◽  
Chien-Yeh Hsu ◽  
Hsiao-Hsien Rau ◽  
Adi Lukas Kurniawan ◽  
Jane C-J Chao

The study determined the association of sleep duration and insomnia symptoms with the components of metabolic syndrome and inflammation in middle-aged and older adults with metabolic syndrome in Taiwan. This cross-sectional study used the database compiled in Taiwan between 2004–2013. A total of 26,016 volunteers aged 35 years and above were selected. Metabolic syndrome was defined according to the International Diabetes Federation. Compared with regular sleep duration (6–8 h/day), short (<6 h/day) or long sleep duration (>8 h/day) and insomnia symptoms significantly increased the odds ratios of high waist circumference, high blood pressure, low high-density lipoprotein-cholesterol, high triglycerides, high fasting blood glucose, and high C-reactive protein. Insomnia symptoms did not modify the effects of sleep duration on the components of metabolic syndrome and inflammation. Our study suggests that short or long sleep duration and insomnia symptoms may have an adverse effect on metabolic syndrome and inflammation.


2020 ◽  
pp. 1-9 ◽  
Author(s):  
Amy Ronaldson ◽  
Jorge Arias de la Torre ◽  
Fiona Gaughran ◽  
Ioannis Bakolis ◽  
Stephani L. Hatch ◽  
...  

Abstract Background A possible role of vitamin D in the pathophysiology of depression is currently speculative, with more rigorous research needed to assess this association in large adult populations. The current study assesses prospective associations between vitamin D status and depression in middle-aged adults enrolled in the UK Biobank. Methods We assessed prospective associations between vitamin D status at the baseline assessment (2006–2010) and depression measured at the follow-up assessment (2016) in 139 128 adults registered with the UK Biobank. Results Amongst participants with no depression at baseline (n = 127 244), logistic regression revealed that those with vitamin D insufficiency [adjusted odds ratio (aOR) = 1.14, 95% confidence interval (CI) = 1.07–1.22] and those with vitamin D deficiency (aOR = 1.24, 95% CI 1.13–1.36) were more likely to develop new-onset depression at follow-up compared with those with optimal vitamin D levels after adjustment for a wide range of relevant covariates. Similar prospective associations were reported for those with depression at baseline (n = 11 884) (insufficiency: aOR = 1.11, 95% CI 1.00–1.23; deficiency: aOR = 1.30, 95% CI 1.13–1.50). Conclusions The prospective associations found between vitamin D status and depression suggest that both vitamin D deficiency and insufficiency might be risk factors for the development of new-onset depression in middle-aged adults. Moreover, vitamin D deficiency (and to a lesser extent insufficiency) might be a predictor of sustained depressive symptoms in those who are already depressed. Vitamin D deficiency and insufficiency is very common, meaning that these findings have significant implications for public health.


2019 ◽  
Author(s):  
Richard J. Shaw ◽  
Breda Cullen ◽  
Nicholas Graham ◽  
Donald M. Lyall ◽  
Daniel Mackay ◽  
...  

AbstractBackgroundThe association between loneliness and suicide is complex, poorly understood, and there are no prior longitudinal studies. We aimed to investigate the relationship between living alone, loneliness and emotional support as predictors of death by suicide and self-harm.MethodsBetween 2006 and 2010 UK Biobank recruited over 0.5m people aged 37-73. This data was linked to prospective hospital admission and mortality records. Adjusted Cox regression models were used to investigate the relationship between self-reported measures of loneliness, emotional support and living arrangements and death by suicide and self-harm.ResultsFor women, there was no evidence that living arrangements, loneliness or lack of emotional support were associated with death by suicide. However, for men, both living alone (Hazard Ratio (HR) 2.19 95%CI 1.47-3.27) and with non-partners (HR 2.17 95%CI 1.28-3.69) were associated with death by suicide, independently of loneliness, which had a modest relationship with suicide in men (HR 1.45 95%CI 0.99-2.12). Associations between living alone and self-harm were explained by health for women, and by health, loneliness and emotional support for men. In fully adjusted models, loneliness was associated with hospital admissions for self-harm in both women (HR 1.90 95%CI 1.58-2.29) and men (HR 1.75 95%CI 1.41-2.18).ConclusionsFor men -but not for women- living alone or with a non-partner increased the risk of suicide, a finding not explained by loneliness. Loneliness may be more important as a risk factor for self-harm than for suicide, and appears to mitigate against any protective effect of cohabitation.


2021 ◽  
Vol 279 ◽  
pp. 316-323
Author(s):  
Richard J. Shaw ◽  
Breda Cullen ◽  
Nicholas Graham ◽  
Donald M. Lyall ◽  
Daniel Mackay ◽  
...  

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A273-A273
Author(s):  
Xi Zheng ◽  
Ma Cherrysse Ulsa ◽  
Peng Li ◽  
Lei Gao ◽  
Kun Hu

Abstract Introduction While there is emerging evidence for acute sleep disruption in the aftermath of coronavirus disease 2019 (COVID-19), it is unknown whether sleep traits contribute to mortality risk. In this study, we tested whether earlier-life sleep duration, chronotype, insomnia, napping or sleep apnea were associated with increased 30-day COVID-19 mortality. Methods We included 34,711 participants from the UK Biobank, who presented for COVID-19 testing between March and October 2020 (mean age at diagnosis: 69.4±8.3; range 50.2–84.6). Self-reported sleep duration (less than 6h/6-9h/more than 9h), chronotype (“morning”/”intermediate”/”evening”), daytime dozing (often/rarely), insomnia (often/rarely), napping (often/rarely) and presence of sleep apnea (ICD-10 or self-report) were obtained between 2006 and 2010. Multivariate logistic regression models were used to adjust for age, sex, education, socioeconomic status, and relevant risk factors (BMI, hypertension, diabetes, respiratory diseases, smoking, and alcohol). Results The mean time between sleep measures and COVID-19 testing was 11.6±0.9 years. Overall, 5,066 (14.6%) were positive. In those who were positive, 355 (7.0%) died within 30 days (median = 8) after diagnosis. Long sleepers (&gt;9h vs. 6-9h) [20/103 (19.4%) vs. 300/4,573 (6.6%); OR 2.09, 95% 1.19–3.64, p=0.009), often daytime dozers (OR 1.68, 95% 1.04–2.72, p=0.03), and nappers (OR 1.52, 95% 1.04–2.23, p=0.03) were at greater odds of mortality. Prior diagnosis of sleep apnea also saw a two-fold increased odds (OR 2.07, 95% CI: 1.25–3.44 p=0.005). No associations were seen for short sleepers, chronotype or insomnia with COVID-19 mortality. Conclusion Data across all current waves of infection show that prior sleep traits/disturbances, in particular long sleep duration, daytime dozing, napping and sleep apnea, are associated with increased 30-day mortality after COVID-19, independent of health-related risk factors. While sleep health traits may reflect unmeasured poor health, further work is warranted to examine the exact underlying mechanisms, and to test whether sleep health optimization offers resilience to severe illness from COVID-19. Support (if any) NIH [T32GM007592 and R03AG067985 to L.G. RF1AG059867, RF1AG064312, to K.H.], the BrightFocus Foundation A2020886S to P.L. and the Foundation of Anesthesia Education and Research MRTG-02-15-2020 to L.G.


2021 ◽  
pp. 1-9
Author(s):  
Janice L. Atkins ◽  
Luke C. Pilling ◽  
Christine J. Heales ◽  
Sharon Savage ◽  
Chia-Ling Kuo ◽  
...  

Background: Brain iron deposition occurs in dementia. In European ancestry populations, the HFE p.C282Y variant can cause iron overload and hemochromatosis, mostly in homozygous males. Objective: To estimated p.C282Y associations with brain MRI features plus incident dementia diagnoses during follow-up in a large community cohort. Methods: UK Biobank participants with follow-up hospitalization records (mean 10.5 years). MRI in 206 p.C282Y homozygotes versus 23,349 without variants, including T2 * measures (lower values indicating more iron). Results: European ancestry participants included 2,890 p.C282Y homozygotes. Male p.C282Y homozygotes had lower T2 * measures in areas including the putamen, thalamus, and hippocampus, compared to no HFE mutations. Incident dementia was more common in p.C282Y homozygous men (Hazard Ratio HR = 1.83; 95% CI 1.23 to 2.72, p = 0.003), as was delirium. There were no associations in homozygote women or in heterozygotes. Conclusion: Studies are needed of whether early iron reduction prevents or slows related brain pathologies in male HFE p.C282Y homozygotes.


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