Abstract P108: Habitual Short Sleep Duration Associated with Self-Reported and Objectively-Determined Cardiovascular and Metabolic Disease Risk Factors: Data from NHANES

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Michael A Grandner ◽  
Subhajit Chakravorty ◽  
Michael Perlis ◽  
Linden Oliver ◽  
Indira Gurubhagavatula

Background: Self-reported short and long sleep duration have been associated with adverse cardiometabolic health outcomes in laboratory and epidemiologic studies, but interpretation of such data has been limited by methodological issues. Methods: We analyzed adult 2007-2008 US National Health and Nutrition Examination Survey (NHANES) data (N=5,649). Average self-reported nightly sleep duration was reported and categorized as either very short (<5h), short (5-6h), normal (7-8h), or long (≥9h). Self-reported as well as objective evidence of obesity, diabetes, hypertension, and hyperlipidemia were recorded. Univariate comparisons were conducted across sleep duration categories for all variables. Binary logistic regression analyses were performed using cardiometabolic factor as the outcome variable, and sleep duration category as the predictor variable, before and after adjusting for age, sex, race/ethnicity, acculturation, education, access to insurance, food security, home ownership, smoking, and caffeine use. Results: See table. In adjusted analyses, very short sleep was associated with self-reported hypertension, self-reported hyperlipidemia, objective hyperlipidemia, self-reported diabetes, and objective obesity. Regarding short sleep (5-6hrs), in adjusted analyses, elevated risk was seen for self-reported hypertension self-reported obesity and objective obesity. Regarding long sleep (≥9hrs), no elevated risk was found for any outcomes. Conclusions: Very short and short sleep duration are associated with self-reported and objectively-determined adverse cardiometabolic outcomes, even after adjustment for covariates. Table 1. Unadjusted and Adjusted Odds Ratios (OR) and 95% Confidence Intervals (95%CI) of Associations between Sleep Duration and Cardiometabolic Disease Outcomes *Adjusted analyses include age, sex, race/ethnicity, acculturation, education, insurance, home ownership, food security, smoking, and caffeine

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Brooke Aggarwal ◽  
Ming Liao

Background: Depression has been linked to increased risk of cardiovascular disease (CVD) through biological mechanisms and altered lifestyle behaviors, possibly including short and/or long sleep duration. However the relation between specific sleep components and depressive symptoms, and interaction by race/ethnicity has not been fully defined. The purpose of this study was to determine if sleep patterns including short sleep duration, poor sleep quality, and insomnia were associated with depressive symptoms in a free-living ethnically diverse population of adult women, and if they varied by racial/ethnic status. Methods: English or Spanish speaking females between the ages of 20-79 y, participating in an observational cohort study as part of the American Heart Association Go Red for Women SFRN, were included (n=50, 56% (28 of 50) non-white, mean age = 41 ±18y). Sleep patterns were assessed using the Pittsburgh Sleep Quality Index (PSQI), a validated instrument used to measure the quality and duration of sleep in adults. Presence of insomnia was measured using the Insomnia Severity Index (ISI). Depressive symptoms were assessed using the Beck Depression Inventory (BDI-II). Linear and logistic regression models were used to evaluate cross-sectional associations between sleep patterns and depression overall, and by race/ethnicity. Results: Overall, nearly one-fifth of participants had depressive symptoms (BDI II score ≤13), 18% (9 of 50) had short sleep duration (<6 hours per night), 38% (19 of 50) had poor quality sleep (PSQI score ≥5), and 40% (20 of 50) had some level of insomnia (ISI score ≥8). Mean BDI-II scores among women who slept <6 versus ≥6 hours were significantly greater (16 versus 5, p=.0003). Higher depression scores were associated with shorter sleep duration (p=.001), poorer sleep quality (p=.03), and higher insomnia severity (p<.0001) overall. There was no association between depression and long sleep (≥8 hours). When stratified by race/ethnicity, depression was significantly associated with poor sleep quality among minority women in multivariable models adjusted for demographic confounders (OR=1.42, 95% CI=1.03-1.95), but not among non-Hispanic white women. Depression was also significantly associated with insomnia severity (p<.001), and sleep duration (p=.03) among minority women only, in multivariable adjusted models stratified by race/ethnicity. Conclusions: In this diverse sample of women, sleep problems were highly prevalent. Poor sleep quality, insomnia, and short sleep duration (but not long sleep) were associated with greater depressive symptoms among minority women but not whites. These preliminary data suggest that minority women with short sleep duration may be at heightened CVD risk from depression. Future research should determine if interventions designed to improve sleep result in decreased depressive symptoms and reduced CVD risk.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Everlyne G. Ogugu ◽  
Sheryl L. Catz ◽  
Janice F. Bell ◽  
Christiana Drake ◽  
Julie T. Bidwell ◽  
...  

Abstract Background The relationship between inadequate sleep duration and hypertension risk has been established in the general population, but there is a gap in the literature on predictors of habitual sleep duration in adults with hypertension. This study examined factors associated with habitual sleep duration among adults with hypertension in the United States (US). Methods Data of 5660 adults with hypertension were obtained by combining the 2015–2018 cycles of the National Health and Nutrition Examination Survey (NHANES). Survey weighted multinomial logistic regression models were fit to examine factors associated with short (< 7 h) and long (> 9 h) sleep duration with adequate sleep duration (7–9 h) as the reference. Results The prevalence of self-reported adequate sleep duration was 65.7%, while short sleep duration was 23.6%, and long sleep duration 10.7%. Short sleep duration (compared to adequate sleep duration) was positively associated with history of seeking help for sleeping difficulties (relative risk ratio [RRR], 1.25; 95% confidence interval [CI], 1.02–1.53), Non-Hispanic Black race/ethnicity (RRR, 2.08; 95% CI, 1.61–2.67), working ≥45 h/week (RRR, 1.81; 95% CI, 1.32–2.48), and negatively associated with older age ≥ 65 years (RRR, 0.63; 95% CI, 0.45–0.91) and female gender (RRR, 0.70; 95% CI, 0.56–0.88). Long sleep duration was positively associated with female gender (RRR, 1.24; 95% CI, 1.001–1.54), chronic kidney disease (RRR, 1.48; 95% CI, 1.14–1.92), moderate depressive symptoms (RRR, 1.62; 95% CI, 1.08–2.44), moderately severe to severe depressive symptoms (RRR, 1.89; 95% CI, 1.05–3.43), being in retirement (RRR, 3.46; 95% CI, 2.18–5.49), and not working due to health reasons (RRR, 4.87; 95% CI, 2.89–8.22) or other reasons (RRR, 3.29; 95% CI, 1.84–5.88). Conclusion This population-based study identified factors independently associated with habitual sleep duration in adults with hypertension. These included help-seeking for sleeping difficulty, gender, age, chronic kidney disease, depressive symptoms, race/ethnicity, and employment status. These findings can help in the development of tailored approaches for promoting adequate sleep duration in adults with hypertension.


2021 ◽  
Author(s):  
Everlyne G. Ogugu ◽  
Sheryl L. Catz ◽  
Janice F. Bell ◽  
Christiana Drake ◽  
Julie T. Bidwell ◽  
...  

Abstract Background: The relationship between inadequate sleep duration and hypertension risk has been established in the general population, but there is a gap in the literature on predictors of habitual sleep duration in adults with hypertension. This study examined factors associated with habitual sleep duration among adults with hypertension in the United States (US).Methods: Data of 5,660 adults with hypertension were obtained by combining the 2015 – 2018 cycles of the National Health and Nutrition Examination Survey (NHANES). Survey weighted multinomial logistic regression models were fit to examine factors associated with short (<7 hours) and long (>9 hours) sleep duration with adequate sleep duration (7 – 9 hours) as the reference. Results: The prevalence of self-reported adequate sleep duration was 65.7%, while short sleep duration was 23.6%, and long sleep duration 10.7%. Short sleep duration (compared to adequate sleep duration) was positively associated with history of seeking help for sleeping difficulties (relative risk ratio [RRR], 1.25; 95% confidence interval [CI], 1.02 – 1.53), Non-Hispanic Black race/ethnicity (RRR, 2.08; 95% CI, 1.61 – 2.67), working ≥45 hours/week (RRR, 1.81; 95% CI, 1.32 – 2.48), and negatively associated with older age ≥ 65 years (RRR, 0.63; 95% CI, 0.45 – 0.91) and female gender (RRR, 0.70; 95% CI, 0.56 – 0.88). Long sleep duration was positively associated with female gender (RRR, 1.24; 95% CI, 1.001 – 1.54), chronic kidney disease (RRR, 1.48; 95% CI, 1.14-1.92), moderate depressive symptoms (RRR, 1.62; 95% CI, 1.08 – 2.44), moderately severe to severe depressive symptoms (RRR, 1.89; 95% CI, 1.05 – 3.43), being in retirement (RRR, 3.46; 95% CI, 2.18 – 5.49), and not working due to health reasons (RRR, 4.87; 95% CI, 2.89 – 8.22) or other reasons (RRR, 3.29; 95% CI, 1.84 – 5.88).Conclusion: This population-based study identified factors independently associated with habitual sleep duration in adults with hypertension. These included help-seeking for sleeping difficulty, gender, age, chronic kidney disease, depressive symptoms, race/ethnicity, and employment status. These findings can help in the development of tailored approaches for promoting adequate sleep duration in adults with hypertension.


Author(s):  
Sizhi Ai ◽  
Jihui Zhang ◽  
Guoan Zhao ◽  
Ningjian Wang ◽  
Guohua Li ◽  
...  

Abstract Aims Observational studies have suggested strong associations between sleep duration and many cardiovascular diseases (CVDs), but causal inferences have not been confirmed. We aimed to determine the causal associations between genetically predicted sleep duration and 12 CVDs using both linear and nonlinear Mendelian randomization (MR) designs. Methods and results Genetic variants associated with continuous, short (≤6 h) and long (≥9 h) sleep durations were used to examine the causal associations with 12 CVDs among 404 044 UK Biobank participants of White British ancestry. Linear MR analyses showed that genetically predicted sleep duration was negatively associated with arterial hypertension, atrial fibrillation, pulmonary embolism, and chronic ischaemic heart disease after correcting for multiple tests (P &lt; 0.001). Nonlinear MR analyses demonstrated nonlinearity (L-shaped associations) between genetically predicted sleep duration and four CVDs, including arterial hypertension, chronic ischaemic heart disease, coronary artery disease, and myocardial infarction. Complementary analyses provided confirmative evidence of the adverse effects of genetically predicted short sleep duration on the risks of 5 out of the 12 CVDs, including arterial hypertension, pulmonary embolism, coronary artery disease, myocardial infarction, and chronic ischaemic heart disease (P &lt; 0.001), and suggestive evidence for atrial fibrillation (P &lt; 0.05). However, genetically predicted long sleep duration was not associated with any CVD. Conclusion This study suggests that genetically predicted short sleep duration is a potential causal risk factor of several CVDs, while genetically predicted long sleep duration is unlikely to be a causal risk factor for most CVDs.


Author(s):  
Lovro Štefan ◽  
Goran Vrgoč ◽  
Tomislav Rupčić ◽  
Goran Sporiš ◽  
Damir Sekulić

The main purpose of the study was to explore the associations of sleep duration and sleep quality with physical activity (PA). In this cross-sectional study, participants were 894 elderly individuals (mean age 80 ± 3 years; 56.0% women) living in nursing homes. PA, sleep duration, and sleep quality (based on the Pittsburgh Sleep Quality Index (PSQI)) were self-reported. The associations of sleep duration and sleep quality with PA at the nursing home level were analyzed using generalized estimating equations with clustering. Participants reporting short sleep duration (<6 h; OR = 0.45; 95% CI 0.25–0.80) were less likely to report sufficient PA, yet those reporting long sleep duration (>9 h; OR = 2.61; 95% CI 1.35–5.02) and good sleep quality (<5 points; OR = 1.59; 95% CI 1.19–2.12) were more likely to report sufficient PA. When sleep duration and sleep quality were entered into the same model, the same associations remained. This study shows that elderly individuals who report short sleep duration are less likely to meet PA guidelines, while those who report long sleep duration and good sleep quality are more likely to meet PA guidelines. Strategies aiming to improve sleep duration and sleep quality are warranted.


2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Yohannes Adama Melaku ◽  
Sarah Appleton ◽  
Amy Reynolds ◽  
Tiffany Gills ◽  
Robert Adams

Abstract Background Evidence shows that habitual short and long sleep is associated with higher mortality risk in the general population. However, studies on the association between sleep duration and mortality in people with diabetes are scarce. Methods Data from the National Health Interview Survey (NHIS) of the United States (US) between 2004 and 2014 (N = 32,766) were used. Self-reported habitual sleep duration for those with self-reported doctor diagnosed diabetes was categorized as ≤ 6 hr (short sleep), 7-8 hr (adequate sleep), and ≥9 hr (long sleep). Mortality status and cause of death data were retrieved from the US National Death Index and linked. We used adjusted Cox proportional models to examine the association between sleep duration and mortality risk. Dose-response relationships were quantified. Sensitivity analysis was performed excluding cardiovascular and cancer cases. Results In the median follow-up time of 4.6 years (171,375.2 person-years), 5312 all-cause, 1129 cardiovascular, 1148 cancer and 494 diabetes deaths were recorded. Whereas short sleep duration (adjusted hazard ratio (aHR)=1.04; 95% confidence interval (CI): 0.97, 1.11) in diabetic patients was not associated with all-cause mortality, long sleep duration was positively (aHR=1.43; 95% CI: 1.30, 1.57) associated with increased mortality risk. A similar trend of association was found with cause-specific mortality and the dose-response analysis identified a “J” shape association. Similar results were found upon sensitivity analysis. Conclusions Long but not short sleep duration is associated with all-cause and cause-specific mortality in diabetic patients. Key messages Sleep should be part of behavioural intervention to prevent premature mortality in those with diabetics.


2021 ◽  
Author(s):  
Jianian Hua ◽  
Hongpeng Sun ◽  
Qi Fang

AbstractIMPORTANCEThe bidirectional association between sleep duration and cognitive function has not been conclusively demonstrated.OBJECTIVETo investigate the longitudinal association between sleep duration and cognitive function among middle-aged and elderly Chinese participants.Design, SETTING, AND PARTICIPANTSA national representative and prospective longitudinal study in China. 7984 participants aged 45 years and above were assessed at baseline between June 2011 and March 2012 (wave 1) and 2013 (wave 2), 2015 (wave 3) and 2018 (wave4).MAIN OUCOMES AND MEASURESSelf-reported nighttime sleep duration was evaluated by interview. Cognitive function was evaluated via assessments of global cognition, which reflected the ability of episodic memory, visuospatial construction, calculation, orientation and attention.ResultsRegarding the 7984 participants in wave 4, the mean (SD) age was 64.7 (8.4), 3862 (48.4) were male, and 6453 (80.7) lived in rural area. There were 14981, 11768 (78.6%), 10192 (68.0%), 7984 (53.3%) participants in the four waves of the study, respectively. Latent growth models showed both sleep duration and global cognition worsen over time. Cross-lagged models indicated that long or short sleep duration in the previous wave was associated lower global cognition in the next wave (standardized β=-0.066; 95%CI: −0.073, −0.059; P<0.001; Wave 1 to 2), and lower global cognition in the previous wave was associated with long or short sleep duration in the next wave (standardized β=-0.106; 95%CI: −0.116, −0.096; P<0.001; Wave 1 to 2). Global cognition was probably the major driver in this reciprocal associations.CONCLUSIONS AND REVELANCEThere were bidirectional associations between long or short sleep duration and cognitive function. Lower cognitive function had a stronger association with worse cognitive function than the reverse. A moderate sleep duration is always recommended. Moreover, attention should be paid on the declined cognition and cognitive therapy among older adults with short or long sleep duration.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Michael Grandner

Introduction: Many studies have shown that sleep duration is associated with obesity. It is unclear, though, whether this relationship exists equally across groups and whether it depends on demographics, socioeconomics, or aspects of health. Methods: Nationally-representative data from the 2016 BRFSS was used. Obesity was calculated as BMI≥30. Sleep duration was categorized as very short (≤4), short (5-6), normal (7-8), and long (≥9). Covariates included demographics (age, sex, race/ethnicity, education, marital status), socioeconomics (education, income, employment, # children), health risk factors (smoking, heavy drinking, sedentary lifestyle, access to a doctor, foregoing medical care due to cost), and health status (physical health, mental health, health-related limitations). Weighted logistic regression examined 5 models (unadjusted, demographics, add socioeconomics, add health behaviors, add health status). Whether relationships depended on covariates were evaluated with interaction terms and followed up by stratified analyses. Results: See Table for associations between sleep duration and obesity across all 5 models. In all models, very short, short, and long sleep were all associated with obesity, with very short sleep carrying the greatest risk. Note that as the number of covariates increased, the analytic samples were smaller. Interaction terms for all variables were statistically significant (p<0.001). Very short and short sleep effects were strongest in the youngest adults. Relationships were stronger in women. Sedentary individuals, heavy drinkers, and smokers demonstrated a weaker relationship. Lack of care was associated with a stronger relationship. Conclusions: Both short and long sleep are associated with obesity, even after accounting for many covariates. However, this relationship depends on factors such as age, sex, race/ethnicity, socioeconomic status, and health. This will help towards understanding risk and targeting interventions.


Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Ryan Saelee ◽  
Regine Haardörfer ◽  
Dayna A Johnson ◽  
Julie A Gazmararian ◽  
Shakira F Suglia

Background: Short sleep duration (e.g., <9 hours (hrs) for 6-12 years and <8 hrs for 13-18 years) is highly prevalent and associated with cardiometabolic risk among adolescents. Significant racial disparities in sleep duration among adolescents have been found. Investigating mechanisms driving sleep disparities is important for informing interventions to reduce disparities. Neighborhood and household stressors may contribute to racial disparities in sleep among adolescents as prior literature have found them to be patterned by race/ethnicity and associated with sleep duration. This study examined neighborhood and household context as mediators in the association between race/ethnicity (a proxy for sociocultural factors such as racism) and sleep duration among adolescents. Methods: Participants (n=13,019) were from Waves I and II of the National Longitudinal Study of Adolescent to Adult Health, a nationally representative multi-ethnic sample of adolescents and their health in adulthood. Sleep duration was self-reported in whole hours per day and categorized based on age-specific cut-offs for short sleep (6-12 years: <9 hrs, 13-18 years: <8 hrs, 19-25 years: <7 hrs) vs. recommended (6-13 years: 9-11 hrs, 14-17 years: 8-10 hrs, 18-25 years: 7-9 hrs). Neighborhood factors included neighborhood socioeconomic status (SES) (e.g. census tract measures: proportions of female-headed households, individuals below the poverty threshold, individuals receiving public assistance, adults with < high school education, and adults unemployed), perceived safety and social cohesion. Household factors included living in a single parent household and household SES (e.g. highest parental education, income, and occupation). Structural equation modeling (SEM) was used to simultaneously assess mediation of neighborhood and household context in the association between race/ethnicity and short sleep duration adjusting for age and sex. Results: The sample was 4% Asian, 15% African American (AA), 2% American Indian (AI), 12% Hispanic, and 66% non-Hispanic White (NHW) and mean age 15 years (SD=.1). In SEM, AAs (β=.055, p<.001) and Asians (β=.047, p=.047) were more likely to have short sleep duration than NHW. Higher household SES was associated with a greater probability for short sleep duration (β=.061, p=.004) in the total sample. Only household SES was a significant mediator, explaining 11.6%, 9.9%, and 42.4% of AA-NHW, AI-NHW, and Hispanic-NHW differences, respectively. Conclusion: Although household SES partially explained racial disparities, improving household SES conditions for racial/ethnic minority adolescents may not reduce disparities, given that higher household SES was positively associated with short sleep duration. Future studies should explore buffers for racial/ethnic minority adolescents in the context of SES to inform interventions and reduce disparities in sleep.


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