Abstract MP073: Sleep Patterns and Depression in a Diverse Sample of Women from the AHA Go Red for Women Strategically Focused Research Network (SFRN)

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.

Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Rosa Maria Bruno ◽  
Laura Palagini ◽  
Alessia Di Giulio ◽  
Angelo Gemignani ◽  
Stefano Taddei ◽  
...  

Purpose: Insomnia and short sleep duration have been associated with increased incidence of hypertension. However, the relationship between sleep loss and resistant hypertension (RH), has not been ascertained yet. Methods: 270 patients at first access to our Hypertension Outpatient Unit were enrolled. RH was defined according as office BP values >140/90 mmHg with 3 or more antihypertensive drugs, or controlled BP with 4 or more drugs, including a diuretic. Pittsburgh Sleep Quality Index (PSQI), and Beck Depression Inventory (BDI) were assessed. Poor sleep quality was defined as PSQI>5, mild-to-severe depressive symptoms as BDI score >10. Patients with self-reported sleep apneas or snoring were excluded (n=21). Results: Complete data were available for 234 patients (males 51%, mean age 58±13 years, BMI 26±5 kg/mq, antihypertensive treatment 84%, previous CV events 12%, diabetes 8%, smoking 15%, hypercholesterolemia 60%). Mean sleep duration was 6.4±1.6 hours, with a 49% prevalence of short sleep duration (<6 hours) and similar in both sexes. Conversely, women had higher PSQI scores (5.2 vs 3.6, p=0.03) and prevalence of poor sleep quality (46% vs 30% in men, p=0.01). Women showed also higher BDI scores (4.5 vs 1.8, p=0.006) and prevalence of depressive symptoms than men (20% vs 7%, p=0.003). RH patients (15%) had higher PSQI (5.8 vs 4.1, p=0.03), a difference shown in women (6.8 vs 4.8, p=0.04) but not in men (4.7 vs 3.5, p=0.37). The association between BDI score and RH showed a similar behavior (overall 3.6 vs 2.8, p=0.02; women 5.1 vs 3.7, p=0.03; men: 2.0 vs 1.9, p=0.53). In a multiple logistic regression analysis (including age, sex, obesity, diabetes, previous CV events, sleep duration, use of hypnotic drugs) poor sleep quality was independently associated with RH (OR 2.2, CI95% 1.1-5.3). However this relationship lost significance when also depressive symptoms were included in the model (p=0.12). Conclusions: Short sleep duration is highly prevalent in hypertensive patients. This condition is accompanied by poor sleep quality and depressive symptoms in women. Poor sleep quality is associated with a 2-fold higher probability of having RH. This association could be mediated by the presence of depressive symptoms.


BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e041995
Author(s):  
Yazan A Al-Ajlouni ◽  
Su Hyun Park ◽  
Jude Alawa ◽  
Ghaith Shamaileh ◽  
Aziz Bawab ◽  
...  

Background Jordan, a Middle Eastern country, declared a state of national emergency due to COVID-19 and a strict nationwide lockdown on 17 March 2020, banning all travel and movement around the country, potentially impacting mental health. This study sought to investigate the association between mental health (eg, anxiety and depressive symptoms) and sleep health among a sample of Jordanians living through a state of COVID-19-induced nationwide lockdown. Methods Using Facebook, participants (n=1240) in Jordan in March 2020 were recruited and direct to a web-based survey measuring anxiety (items from General Anxiety Disorder 7-item (GAD-7) scale instrument), depressive symptoms (items from Center for Epidemiologic Studies Depression Scale), sleep health (items from the Pittsburgh Sleep Quality Index) and sociodemographic. A modified Poisson regression model with robust error variance. Adjusted prevalence ratios (aPRs) and 95% CIs were estimated to examine how anxiety and depressive symptoms may affect different dimensions of sleep health: (1) poor sleep quality, (2) short sleep duration, (3) encountering sleep problems. Results The majority of participants reported having experienced mild (33.8%), moderate (12.9%) or severe (6.3%) levels of anxiety during lockdown, and nearly half of respondents reported depressive symptoms during lockdown. Similarly, over 60% of participants reported having experienced at least one sleep problem in the last week, and nearly half reported having had short sleep duration. Importantly, anxiety was associated with poor sleep health outcomes. For example, corresponding to the dose–response relationship between anxiety and sleep health outcomes, those reporting severe anxiety were the most likely to experience poor sleep quality (aPR =8.95; 95% CI=6.12 to 13.08), short sleep duration (aPR =2.23; 95% CI=1.91 to 2.61) and at least one problem sleep problem (aPR=1.73; 95% CI=1.54 to 1.95). Moreover, depressive symptoms were also associated with poor sleep health outcomes. As compared with scoring in the first quartile, scoring fourth quartile was associated with poor sleep quality (aPR=11.82; 95% CI=6.64 to 21.04), short sleep duration (aPR=1.87; 95% CI=1.58 to 2.22), and experiencing at least one sleep problem (aPR=1.90; 95% CI=1.66 to 2.18). Conclusions Increased levels of anxiety and depressive symptoms can negatively influence sleep health among a sample of Jordanian adults living in a state of COVID-19-induced nationwide lockdown.


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):  
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.


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 ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Loretta Cain ◽  
LáShauntá Glover ◽  
Dayna Johnson ◽  
Mario Sims

Introduction: Research shows that compared to non-Hispanic whites, African Americans (AAs) have poorer sleep quality, lower mean sleep duration, and a higher prevalence of sleep-disordered breathing. AAs also report more frequent exposures to certain stressors over the life course, which may impact physiological processes that may impair sleep. Goal-striving-stress (GSS), the discrepancy between aspiration and achievement, weighted by the subjective probability of success, and the level of disappointment experienced if goals are not reached, may be an important stressor among AA’s that may influence sleep; however this has yet to be explored. The objective of this study was to assess the relationship between GSS and sleep duration and sleep quality in AAs. Hypothesis: We assessed the hypothesis that high (versus low) GSS would be associated with short or long sleep duration and poor sleep quality. Methods: We utilized data from the baseline exam of the Jackson Heart Study (JHS; n=5306), an AA sample of women and men, 35-84 years old. There were a total of 5082 participants in the sample; 63.34% female with a mean age of 55.30 (± 12.75) and mean sleep duration of 6.43 hours (±1.51). The sample was categorized into GSS tertiles: low (n=2121), moderate (n=1716), high (n=1296). Participants self-reported sleep duration (hours) and rated their sleep quality. Sleep duration was categorized as short ( < 6 hours), normal (7 or 8 hours) and long ( > 9 hours). Sleep quality was categorized as high (good/very good/excellent) and low (fair/poor). Logistic regression models were used to obtain odds ratios (OR, 95% confidence interval-CI) to assess the associations of GSS levels with sleep duration and sleep quality categories. Models were adjusted for sex, age, socioeconomic status, health behaviors, discrimination, and health outcomes. Results: Significant results showed that participants who reported high (versus low) GSS had a 29% increased odds [1.29 (1.10, 1.52)] of short (versus normal) sleep after full adjustment. Participants who reported high (versus low) GSS had a 42% increased odds [1.42 (1.20, 1.67)] of low (versus high) sleep quality after full adjustment. Conclusion In conclusion, the deficit between goal aspiration and achievement is associated with short sleep duration and poor sleep quality. Potential interventions should consider the extent to which GSS may contribute to the development of short sleep duration and poor sleep quality.


SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A70-A70
Author(s):  
C E Kline ◽  
M J Lambiase ◽  
M B Conroy ◽  
M M Brooks ◽  
A M Kriska ◽  
...  

Abstract Introduction Short sleep duration and poor sleep quality have each been associated with obesity and weight gain. However, less is known regarding how sleep may impact attempted weight loss. The purpose of this study was to investigate the associations between sleep duration and sleep quality, both independently and in combination, with weight loss in a 12-month behavioral weight loss intervention. Methods Young to middle-aged adults who were overweight or obese (N=296) completed a 12-month behavioral weight loss intervention, with weight assessed at baseline, 6 and 12 months. Sleep duration and quality were derived from the Pittsburgh Sleep Quality Index. Analyses examined the change in sleep over time and the association between baseline sleep and changes in sleep with 6- and 12-month weight loss following adjustment for relevant covariates including age, gender, race, education, baseline body mass index, and baseline risk for sleep apnea. Results Participants (with an average baseline weight of 97.0±1.0 kg) lost 6.6±1.1 kg (6.8%) and 6.7±1.2 kg (6.9%) at 6 and 12 months relative to baseline, respectively. Global sleep quality significantly improved over the 12-month intervention (P=.03), but average sleep duration and the prevalence of short sleep duration (&lt;6 h) or poor sleep quality did not change significantly (each P≥.45). Adults with short sleep duration at baseline lost 3.3±0.9% less weight than those with ≥6 h sleep duration (P&lt;.001). Adults with poor sleep quality at baseline lost 1.6±0.8% less weight than those with good sleep quality (P=.04). When considered together, adults with both short sleep duration and poor sleep quality lost at least 5.0% less weight compared with all other sleep duration/quality group combinations (P&lt;.001). Conclusion Our findings highlight the importance of both sleep duration and sleep quality as predictors of behavioral weight loss and suggest that screening for sleep disturbance may be useful to determine who may benefit from additional counseling and resources. Support R01HL077525, K23HL118318


2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Tetsuji Azuma ◽  
Koichiro Irie ◽  
Kazutoshi Watanabe ◽  
Fumiko Deguchi ◽  
Takao Kojima ◽  
...  

An association between physical illness and sleep has been suggested. Disordered chewing might be a physical factor that is associated with sleep issues. This cross-sectional study aimed to determine whether chewing problems are associated with sleep in Japanese adults. Sleep and chewing issues were evaluated in 6,025 community residents using a self-reported questionnaire. The prevalence of poor sleep quality and sleeping for <6 h/day (short duration) were 15.6% and 29.4%, respectively. Multivariate logistic regression analyses showed that prevalence of poor sleep quality was significantly associated with self-reported medical history (odds ratio (OR), 1.30; p<0.001), self-reported symptoms (OR, 4.59; p<0.001), chewing problems (OR, 1.65; p<0.001), and poor glycemic control (OR, 1.43; p=0.035). The prevalence of short sleep duration was also significantly associated with female sex (OR, 1.23; p=0.001), self-reported symptoms (OR, 1.60; p<0.001), chewing problems (OR, 1.30; p=0.001), and being overweight (OR, 1.41; p<0.001). In conclusion, chewing problems were associated with poor sleep quality and short sleep duration among Japanese adults.


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