Abstract P323: Sleep Debt and Type II Diabetes Mellitus in Middle Aged and Older Women

Background: Sleep disturbances can be both a cause and consequence of circadian disruption resulting in cardiometabolic dysregulation. However, little is known about sleep debt, defined as the average sleep duration difference >=2 hours between weekend versus weekday and type II diabetes (T2D) mellitus particularly in older women. Methods and Results: We analyzed 25,335 women free of cardiovascular disease (CVD) in the ongoing follow-up cohort from the Women’s Health Study (WHS). Utilizing the WHS stress questionnaire (2012-13) that assessed sleep duration among other chronic and acute stress measures, we computed sleep debt as the average sleep duration difference >=2 hours between weekend versus weekday. Of the 2539 women with physician confirmed T2D at the time of questionnaire administration, 216 women had sleep debt. Mean age for women with sleep debt and T2D versus no sleep debt and diabetes were 69.3 ± 4.4 and 72.7 +/- 6.1 years old respectively. Women with sleep debt and T2D were younger, more likely to have hypertension and hypercholesterolemia, use alcohol, be current smokers, had higher body mass index and be anxious or depressed. In logistic regression analyses, women with sleep debt had a 47% higher odds of T2D independent of age, race/ethnicity, and socioeconomic status (income and education) [odds ratio (OR): 1.47, 95% confidence interval (CI): 1.25 to 1.72, P<0.0001]. Adjustment for CVD risk factors, depression and anxiety symptoms resulted in attenuation of the relationship which maintained statistical significance [OR: 1.31, 95% CI: 1.10 to 1.55, P= 0.0002]. When cumulative psychological stress (combination of chronic and acute stressors: e.g., life events, job stress, discrimination) was accounted for, the observed relationship between sleep debt and T2D persisted [OR: 1.28, 95% CI 1.09 to 1.53, P= 0.004]. (Table 1) Conclusion: Sleep debt was associated with higher odds of type 2 diabetes prevalence in middle-aged and older women.

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Abstract P085: Extremes of Sleep Duration and Type II Diabetes in Older Women Participating in the Women’s Health Study

Circulation ◽

10.1161/circ.139.suppl_1.p085 ◽

2019 ◽

Vol 139 (Suppl_1) ◽

Author(s):

Jonathan Z Butler ◽

Natalie Slopen ◽

Susan Redline ◽

Mercedes Carnethon ◽

David R Williams ◽

...

Keyword(s):

Women’S Health ◽

Women's Health ◽

Older Women ◽

Sleep Duration ◽

Type Ii Diabetes ◽

Health Study ◽

Type Ii

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Sleep disorders interactions with obesity and type 2 diabetes

Obesity and metabolism ◽

10.14341/omet9963 ◽

2020 ◽

Vol 16 (4) ◽

pp. 25-30

Author(s):

Tatyana O. Brodovskaya ◽

Irina F. Grishina ◽

Genia G. Babykina ◽

Olga V. Nikolaenko ◽

Egor A. Kovin ◽

...

Keyword(s):

Sleep Disorders ◽

Sleep Duration ◽

Type Ii Diabetes ◽

Sleep Disturbances ◽

Metabolic Disorders ◽

Cardiovascular Complications ◽

Current Data ◽

Type Ii ◽

Obesity And Diabetes ◽

Modifiable Factors

Obesity and type II diabetes are 21st century pandemia. These metаbolic disorders are in the focus of attention of various specialties: cardiologists, endocrinologists, nutritionists, therapists, and others. The high incidence of obesity and type II diabetes cardiovascular complications, such as myocardial infarction, stroke, chronic heart failure, dementia, determine the call of risk factors search. Modifiable factors may include sleep disturbances. Recent studies have revealed a connection between changes in sleep duration and metabolic disorders. However, to date, the mechanisms underlying this association have not been established. The aim of the review is to summarize existing epidemiological and experimental observations, as well as an analysis of possible pathophysiological mechanisms linking sleep duration with obesity and type II diabetes. The article considers current data suggesting a bi-directional association of sleep disorders with obesity and diabetes. Sleep disturbances are significant determinant of developing metabolic disorders. Sleep duration correction as one of therapeutic targets for cardiovascular complications of obesity and type II diabetes prevention.

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Sleep debt: the impact of weekday sleep deprivation on cardiovascular health in older women

SLEEP ◽

10.1093/sleep/zsz149 ◽

2019 ◽

Cited By ~ 4

Author(s):

Tomás Cabeza de Baca ◽

Koharu Loulou Chayama ◽

Susan Redline ◽

Natalie Slopen ◽

Fumika Matsushita ◽

...

Keyword(s):

Cardiovascular Risk ◽

Older Women ◽

Sleep Duration ◽

Sleep Disturbances ◽

Cardiovascular Health ◽

Linear Regression Models ◽

Cvd Risk ◽

Sleep Debt ◽

The Impact ◽

The Relationship

Abstract Study Objectives Short sleep duration is associated with increased cardiovascular disease (CVD) risk. However, it is uncertain whether sleep debt, a measure of sleep deficiency during the week compared to the weekend, confers increased cardiovascular risk. Because sleep disturbances increase with age particularly in women, we examined the relationship between sleep debt and ideal cardiovascular health (ICH) in older women. Methods Sleep debt is defined as the difference between self-reported total weekday and weekend sleep hours of at least 2 hours among women without apparent CVD and cancer participating in the Women’s Health Stress Study follow-up cohort of female health professionals (N = 22 082). The ICH consisted of seven health factors and behaviors as defined by the American Heart Association Strategic 2020 goals including body mass index, smoking, physical activity, diet, blood pressure, total cholesterol, and glucose. Results Mean age was 72.1 ± 6.0 years. Compared to women with no sleep debt, women with sleep debt were more likely to be obese and have hypertension (pall < .05). Linear regression models adjusted for age and race/ethnicity revealed that sleep debt was significantly associated with poorer ICH (B = –0.13 [95% CI = –0.18 to –0.08]). The relationship was attenuated but remained significant after adjustment for education, income, depression/anxiety, cumulative stress, and snoring. Conclusion Sleep debt was associated with poorer ICH, despite taking into account socioeconomic status and psychosocial factors. These results suggest that weekly sleep duration variation, possibly leading to circadian misalignment, may be associated with cardiovascular risk in older women.

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Abstract P196: Insomnia Symptoms And Ideal Cardiovascular Health In Older Women: Data From The Women’S Health Study

Circulation ◽

10.1161/circ.143.suppl_1.p196 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Cameron Hicks ◽

Jonathan Butler ◽

Natalie B Slopen ◽

David Williams ◽

Dayna A Johnson ◽

...

Keyword(s):

Women’S Health ◽

Women's Health ◽

Older Women ◽

Sleep Duration ◽

Cardiovascular Health ◽

Health Study ◽

Lower Odds ◽

Ideal Cardiovascular Health ◽

The Relationship ◽

Insomnia Symptoms

Introduction: While insomnia is associated with an increased risk of incident cardiovascular disease (CVD), its relationship with ideal cardiovascular health (ICH) is less certain. Given that sleep disturbances increase with age, we examined the relationship between insomnia symptoms and ICH in older women. Methods: Among women participating in the ongoing Women’s Health Study stress cohort with no apparent history of CVD [N= 2588; Mean age= 72.5 ± 6.3], insomnia symptoms were characterized as self-reported difficulty falling asleep or waking up multiple times a night, three or more times per week. Ideal cardiovascular health, as defined by the American Heart Association’s 2020 Impact goals, included standard optimal targets for blood pressure, total cholesterol, glucose, body mass index, physical activity, diet, and smoking. We examined the relationship between insomnia symptoms and ICH using logistic regression, adjusting for clinical and demographic variables. Results: Of the 26588 participants, 52% reported insomnia symptoms, and 38% had ICH. Women with insomnia symptoms had significantly lower odds of ICH after full adjustment for age, race/ethnicity, education, income, depression/anxiety, marital status, and sleep duration (OR [95% CI]: 0.73 [0.64-0.83]). Moreover, compared to women without insomnia symptoms, those with insomnia symptoms were significantly more likely to have hypertension, diabetes, hypercholesterolemia, depression, anxiety, currently smoke, drink one or more alcoholic beverages per day, have a BMI >30, or exercise less frequently. Conclusion: In older women, insomnia symptoms were significantly associated with lower odds of ideal cardiovascular health even after adjusting for socioeconomic status, psychosocial factors, and sleep duration. These results suggest insomnia screening may be an important component of cardiovascular health promotion in this patient population. Further research is needed to evaluate the effects of sleep behavioral interventions on improving ICH.

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The effectiveness of health literacy oriented programs on physical activity behaviour in middle aged and older adults with type 2 diabetes: a systematic review

Health Psychology Research ◽

10.4081/hpr.2016.5595 ◽

2016 ◽

Vol 4 (1) ◽

Cited By ~ 4

Author(s):

Michael Huen Sum Lam ◽

Angela Yee Man Leung

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Older Adults ◽

Health Literacy ◽

Type Ii Diabetes ◽

Physical Activity Behavior ◽

Type Ii Diabetes Mellitus ◽

Type Ii ◽

Middle Aged ◽

Activity Behavior

Health literacy is the first step to self-management of type II diabetes mellitus, of which physical activity is the least compliant behavior. However, no reviews have summarized the effect and the process of interventions of health literacy oriented programs on physical activity behavior among middle aged and older adults with type II diabetes mellitus. This article is the first to examine the effectiveness of health literacy oriented programs on physical activity behavior among middle aged and older adults with type II diabetes mellitus. This systematic review extracted articles from nine electronic databases between 1990 and 2013. Six interventional studies were extracted and reported in accordance with the guidance of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Findings demonstrated that health literacy oriented programs increased the frequency and duration of physical activity among patients with high health literacy. Although some studies effectively improved the health literacy of physical activity, gap in literature remains open for the indistinct and unreliable measurement of physical activity within self-management programs of type II diabetes mellitus, and the questionable cross-culture generalizability of findings. Further studies with well-knit theorybased intervention with respect to patients’ cultural background, duration of intervention and objective measurements are encouraged to elucidate the relationship between health literacy oriented programs and physical activity behavior.

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The Effects of an Exercise and Lifestyle Intervention Program on Cardiovascular, Metabolic Factors and Cognitive Performance in Middle-Aged Adults with Type II Diabetes: A Pilot Study

Canadian Journal of Diabetes ◽

10.1016/j.jcjd.2013.03.369 ◽

2013 ◽

Vol 37 (4) ◽

pp. 214-219 ◽

Cited By ~ 18

Author(s):

Alexandra Jasmine Fiocco ◽

Sabrina Scarcello ◽

Susan Marzolini ◽

Alan Chan ◽

Paul Oh ◽

...

Keyword(s):

Pilot Study ◽

Cognitive Performance ◽

Lifestyle Intervention ◽

Type Ii Diabetes ◽

Intervention Program ◽

Type Ii ◽

Metabolic Factors ◽

Middle Aged ◽

Lifestyle Intervention Program ◽

Middle Aged Adults

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Macroangiopathy in type II diabetes

Acta Endocrinologica ◽

10.1530/acta.0.104s075 ◽

1983 ◽

Vol 104 (4_Suppl) ◽

pp. S75-S78

Author(s):

Antti Aro

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Vascular Disease ◽

Peripheral Vascular Disease ◽

Type Ii Diabetes ◽

Clinical Manifestations ◽

Diabetic Patients ◽

Type Ii ◽

Peripheral Vascular ◽

Middle Aged

ABSTRACT. Macroangiopathy is the most important cause of mortality and morbidity in type II diabetes. The atherosclerotic process in diabetes is similar to that found in non-diabetic subjects, but the laesions are more extensive and the clinical manifestations are more common in diabetic subjects than in the non-diabetic population. In diabetic patients from different populations, the prevalence of macroangiopathy is variable, and the relative frequency follows the pattern found in the respective non-diabetic populations. The relative risk of large vessel disease is in most populations higher for female than for male diabetics. Coronary heart disease is the most important manifestation of macroangiopathy while cerebrovascular disease and peripheral vascular disease are less frequent, although all these manifestations occur at increased frequency among middle-aged diabetic subjects. The incidence of peripheral vascular disease seems to increase with increasing duration of diabetes in middle-aged subjects, whereas coronary heart disease is particularly frequent in type II diabetes already at the time of the diagnosis. Key words: atherosclerosis, complications, diabetes mellitus, macroangiopathy, mortality.

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