Abstract P347: Association Between Sleep Patterns and the American Heart Association Life’s Simple 7 Among Women

Introduction: The American Heart Association’s Life’s Simple 7 (AHA LS7) is a measure of cardiovascular health that evaluates seven lifestyle behaviors and clinical risk factors to track the population’s progress towards the AHA 2020 strategic goals. Sleep is an emerging lifestyle risk factor for cardiovascular disease that is not currently included in the AHA LS7. Our aim was to assess the relation of sleep with the AHA LS7 within a diverse sample of women. Hypothesis: We hypothesized that a longer sleep duration, good sleep quality, low risk for obstructive sleep apnea (OSA), and absence of insomnia and snoring would be associated with a higher global AHA LS7 score and its component scores, as measures of compliance to overall and individual AHA LS7 guidelines. Methods: Baseline data from the AHA Go Red for Women Strategically Focused Research Network cohort at Columbia University Medical Center, an ongoing prospective study, were examined (n=323, >50% minority/Hispanic, mean age: 39y, range: 20-76y). Sleep was self-reported using validated questionnaires. A standardized scoring system was used to compute the global AHA LS7 score using criteria for smoking, diet, physical activity, body mass index (BMI), blood pressure (BP), total cholesterol, and fasting glucose. Women received a score of 2 (optimal), 1 (average), or 0 (poor) based on their compliance with each AHA LS7 guideline. The seven component scores were summed to create the global AHA LS7 score. T-tests, Fischer’s exact test and multivariable-adjusted regression models were used to evaluate associations between sleep and the global AHA LS7 score and its components. Results: The median global AHA LS7 score was 10; 31.3%, 33.3% and 35.3% of women had a score of 0-8 (poor), 9-10 (average), and 11-14 (optimal), respectively. Participants with sleep duration ≥7 hours, lack of insomnia and snoring, and low risk for OSA were more likely to meet ≥4 of the AHA LS7 metrics (p≤0.04). Those with sleep duration ≥7 hours, good sleep quality, no insomnia and snoring, and at low risk of OSA were more likely to meet the AHA LS7 optimal guideline for physical activity, BMI, BP, glucose, and cholesterol (p≤0.04). In multivariable-adjusted linear regression models, a lower global AHA LS7 score was associated with a higher Pittsburgh Sleep Quality Index, indicative of poorer sleep quality (β=-0.08, p=0.019), higher insomnia severity index (β=-0.05, p=0.027), and higher risk for OSA (β=-0.84, p=0.016). Conclusions: In this cohort of women, better sleep habits were associated with meeting the AHA LS7 guidelines. Our results warrant confirmation in larger prospective studies and within other population groups, but nonetheless highlight the potential importance of screening for sleep habits in conjunction with other lifestyle behaviors to identify those at risk of cardiovascular disease.

Download Full-text

Sleep Duration and Sleep Quality Are Associated with Physical Activity in Elderly People Living in Nursing Homes

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15112512 ◽

2018 ◽

Vol 15 (11) ◽

pp. 2512 ◽

Cited By ~ 6

Author(s):

Lovro Štefan ◽

Goran Vrgoč ◽

Tomislav Rupčić ◽

Goran Sporiš ◽

Damir Sekulić

Keyword(s):

Physical Activity ◽

Nursing Homes ◽

Sleep Quality ◽

Sleep Duration ◽

Short Sleep Duration ◽

Cross Sectional ◽

Elderly Individuals ◽

Short Sleep ◽

Long Sleep ◽

Good Sleep

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.

Download Full-text

Weight Status, Adherence to the Mediterranean Diet, Physical Activity Level, and Sleep Behavior of Italian Junior High School Adolescents

Nutrients ◽

10.3390/nu12020478 ◽

2020 ◽

Vol 12 (2) ◽

pp. 478 ◽

Cited By ~ 3

Author(s):

Alice Rosi ◽

Francesca Giopp ◽

Giulia Milioli ◽

Gabriele Melegari ◽

Matteo Goldoni ◽

...

Keyword(s):

Physical Activity ◽

Sleep Quality ◽

Mediterranean Diet ◽

Sleep Duration ◽

Physical Activity Level ◽

Vigorous Physical Activity ◽

Activity Level ◽

Sleep Habits ◽

Achievement Data ◽

The Mediterranean

Inadequate diet, physical activity, and sleep-related behaviors are potential risk factors for overweight and obese, therefore we investigated the relations between body mass index (BMI) and behavioral factors in a sample of Italian adolescents. Four hundred nine Italian secondary school students (46% females, 12.5 ± 0.6 y.o.) were enrolled in this cross-sectional study. Anthropometric measures, adherence to the Mediterranean Diet (KIDMED), physical activity level (PAQ-C), sleep duration, daytime sleepiness (PDSS), sleep quality, and school achievement data were collected through an online questionnaire. The percentage of overweight adolescents was slightly lower (14%) compared to the regional and the national figures. Approximately 88% of the sample reported a medium/high adherence to the Mediterranean Diet and 77% a moderate/vigorous physical activity level. The average sleep duration was in line with the international sleep recommendation for adolescents and 82% had a medium/high sleep quality. No differences were found between genders except for BMI (lower in females). Unexpectedly, no differences were found among the BMI groups (normal weight vs. overweight vs. obese) for lifestyle variables; in contrast, Mediterranean Diet adherence was associated with sleep habits. Further investigation is required to better explore the associations among behavioral variables involved in adolescents’ healthy development.

Download Full-text

Getting Enough Sleep: On the Importance of Collecting Longitudinal Data from Wearables to Assess Sleep Quality and Seasonal Effects on Variability in Daily Activity (Preprint)

10.2196/preprints.31807 ◽

2021 ◽

Author(s):

María Óskarsdóttir ◽

Anna Sigridur Islind ◽

Elias August ◽

Erna Sif Arnardóttir ◽

Francois Patou ◽

...

Keyword(s):

Physical Activity ◽

Heart Rate ◽

Data Collection ◽

Sleep Quality ◽

Daily Activity ◽

Hospital Environment ◽

Sensor Data ◽

Seasonal Patterns ◽

Sleep Patterns ◽

Sleep Habits

BACKGROUND The method considered the gold standard for recording sleep is a polysomnography, where the measurement is performed in a hospital environment for 1-3 nights. This requires subjects to sleep with a device and several sensors attached to their face, scalp, and body, which is both cumbersome and expensive. For longer studies with actigraphy, 3-14 days of data collection is typically used for both clinical and research studies. OBJECTIVE The primary goal of this paper is to investigate if the aforementioned timespan is sufficient for data collection, when performing sleep measurements at home using wearable and non-wearable sensors. Specifically, whether 3-14 days of data collection sufficient to capture an individual’s sleep habits and fluctuations in sleep patterns in a reliable way for research purposes. Our secondary goals are to investigate whether there is a relationship between sleep quality, physical activity, and heart rate, and whether individuals who exhibit similar activity and sleep patterns in general and in relation to seasonality can be clustered together. METHODS Data on sleep, physical activity, and heart rate was collected over a period of 6 months from 54 individuals in Denmark aged 52-86 years. The Withings Aura sleep tracker (non-wearable) and Withings Steel HR smartwatch (wearable) were used. At the individual level, we investigated the consistency of various physical activities and sleep metrics over different time spans to illustrate how sensor data from self-trackers can be used to illuminate trends. RESULTS Significant variability in standard metrics of sleep quality was found between different periods throughout the study. We show specifically that in order to get more robust individual assessment of sleep and physical activity patterns through wearable and non-wearable devices, a longer evaluation period than 3-14 days is necessary. Additionally, we found seasonal patterns in sleep data related to changing of the clock for Daylight Saving Time (DST). CONCLUSIONS We demonstrate that over two months worth of self-tracking data is needed to provide a representative summary of daily activity and sleep patterns. By doing so, we challenge the current standard of 3-14 days for sleep quality assessment and call for rethinking standards when collecting data for research purposes. Seasonal patterns and DST clock change are also important aspects that need to be taken into consideration, and designed for, when choosing a period for collecting data. Furthermore, we suggest using consumer-grade self-trackers (wearable and non-wearable ones) to support longer term evaluations of sleep and physical activity for research purposes and, possibly, clinical ones in the future.

Download Full-text

PO-236 Associations between sleep quality of college students and different measures of obesity: A cross-sectional study

Exercise Biochemistry Review ◽

10.14428/ebr.v1i5.10653 ◽

2018 ◽

Vol 1 (5) ◽

Author(s):

Guangyu Wang ◽

Mei Zhen Zhang

Keyword(s):

Physical Activity ◽

Waist Circumference ◽

Sleep Quality ◽

Sleep Duration ◽

Body Fat ◽

Positive Association ◽

Female Students ◽

Male Students ◽

Body Fat Percentage ◽

Fat Percentage

Objective The majority studies focused on obesity prevention on physical activity and eating behavior. However, epidemiological studies have shown that sleep duration and sleep quality could be an adjustable risk factor for obesity. The aim of this study was to examine the associations of sleep quality with different measurement of obesity in Chinese university students. Methods A total of 481 college students aged 18-25 years volunteered to participate in this study. Sleep quality was assessed by Pittsburgh Sleep Quality Index （PSQI）questionnaire. International Physical Activity Questionnaire （IPAQ）was used to determine the physical activity, Psychological status was assessed by Self-Rating Depression Scale （SDS） and Self-Rating Anxiety Scale (SAS). Body height, weight and waist circumference are measured by a trained researcher. Body composition was evaluated by a bio-impedance device (InBody 230, South Korea). Independent sample t test was applied to compare the sleep characteristics, physical activity, obesity, depression and anxiety in different gender students. The associations among the dependent variables BMI, body fat percentage, and the independent variables age, sleep quality and sleep durations was examined using Multiple linear regression models. SPSS 22.0 (IMB SPSS Inc) was used for all statistical. Results The BMI (22.9±3.4 vs 21.6±3.2, p＜0.001) of male students were significantly higher than that of female, but the percentage of body fat (18.7±6.9 vs 29.7±7.0, p＜0.001) was lower than that of female. We observed a positive association between sleep quality and body fat percentage (β = 0.166, P = 0.037), and a negative association with age (β = -0.166, P = 0.008) in female students. Sleep quality was associated positively with BMI (β = 0.360, P＜0.001), body fat percentage (β = 0.260, P＜0.001), and age (β = 0.215, P＜0.001) in male students; An inverse correlation between sleep duration and BMI (β = -0.141, P = 0.015), body fat percentage (β = -0.134, P = 0.022) was found, and a positive relationship with anxiety scores (β = 0.331, P＜0.001) in male students. while an inverse relationship was found with WHR (β = -0.236, P = 0.001), waist circumference (β = -0.169, P = 0.007), and a positive association between sleep duration with anxiety scores (β = 0.331, P＜0.001) and depression scores (β = 0.415, P＜0.001) in female students. Conclusions The obesity of male and female students goes up with the increase of total score of sleep quality, anxiety and depression, and goes down with the increase of sleep duration, physical activity time and energy consumption. Male obesity increases with age, but female obesity decreases with age. Among the importance of males' sleep duration and sleep quality in the obesity risk assessment, BMI and body fat percentages are more accurate, while for females, BMI and waist circumference is of no statistical significance.

Download Full-text

Association of physical activity with sleep health: A systematic review

Revista Brasileira de Atividade Física & Saúde ◽

10.12820/rbafs.23e0057 ◽

2019 ◽

Vol 23 ◽

pp. 1-26

Author(s):

Andrea Wendt ◽

Thaynã Ramos Flores ◽

Inácio Crochemore Mohnsam Silva ◽

Fernando César Wehrmeister

Keyword(s):

Physical Activity ◽

Sleep Quality ◽

Sleep Duration ◽

Undergraduate Students ◽

Data Extraction ◽

Activity Measurement ◽

Poor Sleep ◽

Long Term Effects ◽

Sleep Health ◽

Cross Sectional

The aim of this study was to systematically examine the literature on physical activity and sleep in non-clinical and population-based settings. The inclusion criteria were original studies testing the association between physical activity (as exposure) and sleep (as outcome) in representative samples of the general population, workers, or undergraduate students. Sleep health included sleep duration, sleep quality and insomnia. Studies evaluating samples including only individuals with some disease or a health condition were excluded. A search was performed in the PubMed, Scopus, Lilacs, CINAHL, and SPORTdiscus databases in March 2018. Data extraction was performed using the following items: year, author, country, population, age group, sample size, study design, sleep measurement/definition, physical activity measurement/definition, adjustment and main results. A total of 57 studies were selected, which markedly used heterogeneous instruments to measure physical activity and sleep. The majority were conducted in high-income countries and with cross-sectional design. Physical activity was associated with lower odds of insomnia (observed in 10 of 17 studies), poor sleep quality (observed in 12 of 19 studies) and long sleep duration (observed in 7 of 11 studies). The results about short sleep or continuous sleep duration remain unclear. Physical activity seems to be associated with sleep quality and insomnia, especially among adult and elderly populations in which these outcomes are more usually measured. The short- and long-term effects of physical activity intensities and dose-response on sleep should be better evaluated.

Download Full-text

Abstract P176: Moderate Physical Activity and Sleep Duration as Predictors of Cognitive Function in Older Adults With Hypertension: NHANES 2011-2014

Circulation ◽

10.1161/circ.137.suppl_1.p176 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Nicole Hoffmann ◽

Megan E Petrov

Keyword(s):

Physical Activity ◽

Cognitive Function ◽

Sleep Duration ◽

Cognitive Outcomes ◽

Moderate Physical Activity ◽

Digit Symbol Substitution Test ◽

Lifestyle Behaviors ◽

Hypertension Status ◽

Increased Risk ◽

Symbol Substitution

Introduction: Hypertension is associated with increased risk for cognitive decline. Lifestyle behaviors such as moderate physical activity (MPA) and adequate sleep duration may mitigate this decline, though limited research exists. The aim of the study was to examine the joint association of MPA and sleep duration on cognitive function by hypertension status. Methods: Adults (n=2976, ≥60yrs) from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) were assessed for their habitual sleep duration (<7, 7-8.9, ≥9hr) , self-reported participation in regular MPA (yes/no), reported physician-diagnosed hypertension (yes/no), and cognitive function (Digit Symbol Substitution Test [DSST]; Animal Fluency test). Weighted linear regression analyses were conducted to assess joint association of sleep duration and MPA on cognitive function, and test the modifying effect of hypertension status (alpha level set at 0.1) after adjustment for demographics. Results: See Table. There were significant main effects for combined MPA and sleep duration on DSST (Wald F (5,28)=5.33, p =.001) and Animal Fluency (Wald F (5,28)=2.58, p =.05). Participants who did not engage in MPA regardless of sleep duration had significantly worse cognitive function compared to participants who engaged in MPA and obtained 7-8.9hr sleep. There was a significant interaction between MPA-sleep duration groups and hypertension status on DSST (Wald F (5,28)=2.42, p =.06), but not on Animal Fluency. Stratified analyses indicated among individuals with hypertension the buffering effect of MPA regardless of sleep duration was maintained, but not for individuals without hypertension. Conclusions: In a sample of adults, regular MPA predicted better cognitive outcomes regardless of sleep duration. Among individuals with hypertension regular MPA regardless of sleep duration was significantly associated with better executive function, but no such association was found among individuals without hypertension.

Download Full-text

Sedentary Time, Physical Activity, and Sleep Duration: Associations with Body Composition in Fibromyalgia. The Al-Andalus Project

Journal of Clinical Medicine ◽

10.3390/jcm8081260 ◽

2019 ◽

Vol 8 (8) ◽

pp. 1260 ◽

Cited By ~ 2

Author(s):

Blanca Gavilán-Carrera ◽

Pedro Acosta-Manzano ◽

Alberto Soriano-Maldonado ◽

Milkana Borges-Cosic ◽

Virginia A. Aparicio ◽

...

Keyword(s):

Physical Activity ◽

Waist Circumference ◽

Physical Fitness ◽

Muscle Mass ◽

Sleep Duration ◽

Body Fat ◽

Regression Models ◽

Sedentary Time ◽

Body Fat Percentage ◽

Fat Percentage

To explore the individual–independent relationships of sedentary time (ST) and physical activity (PA) (light and moderate-to-vigorous intensity (MVPA)), with sleep duration and body composition (waist circumference, body mass index (BMI), body fat percentage, and muscle mass index) in women with fibromyalgia, and to determine whether these associations are independent of physical fitness. This cross-sectional study involved 385 women with fibromyalgia. ST and PA were assessed by triaxial accelerometry, sleep duration was self-reported. Waist circumference was measured using an anthropometric tape, and body weight, body fat percentage, and muscle mass were estimated using a bio-impedance analyzer. In individual regression models, ST and sleep were directly associated with waist circumference, BMI, and body fat percentage (β between 0.10 and 0.25; all p < 0.05). Light PA and MVPA were inversely associated with waist circumference, BMI, and body fat percentage (β between −0.23 and −0.12; all p < 0.05). In multiple linear regression models, ST (β between 0.17 and 0.23), light PA (β between −0.16 and −0.21), and sleep duration (β between 0.11 and 0.14) were independently associated with waist circumference, BMI, and body fat percentage (all p < 0.05). MVPA was associated with waist circumference independent of light physical activity (LPA) and sleep duration (β = −0.11; p < 0.05). Except for MVPA, these associations were independent of physical fitness. These results suggest that longer ST and sleep duration, and lower PA levels (especially light intensity PA), are independently associated with greater adiposity, but not muscle mass, in women with fibromyalgia. These associations are, overall, independent of physical fitness.

Download Full-text

Effect of exercise on sleep and bi-directional associations with accelerometer-assessed physical activity in men with obesity

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2020-0361 ◽

2020 ◽

Author(s):

Tatiana Plekhanova ◽

Alex V. Rowlands ◽

Melanie Davies ◽

Charlotte L. Edwardson ◽

Andrew Hall ◽

...

Keyword(s):

Physical Activity ◽

Sleep Quality ◽

Aerobic Exercise ◽

Sleep Duration ◽

Exercise Intervention ◽

Vigorous Physical Activity ◽

Sleep Onset ◽

Onset Time ◽

Post Intervention

This study examined the effect of exercise training on sleep duration and quality and bidirectional day-to-day relationships between physical activity (PA) and sleep. Fourteen inactive men with obesity (49.2±7.9 years, BMI 34.9±2.8 kg/m²) completed a baseline visit, eight-week aerobic exercise intervention, and one-month post-intervention follow-up. PA and sleep were assessed continuously throughout the study duration using wrist-worn accelerometry. Generalised estimating equations (GEE) were used to examine associations between PA and sleep. Sleep duration increased from 5.2h at baseline to 6.6h during the intervention period and 6.5h at one-month post-intervention follow-up (p<0.001). Bi-directional associations showed that higher overall activity volume and moderate-to-vigorous physical activity (MVPA) were associated with earlier sleep onset time (p<0.05). Later timing of sleep onset was associated with lower overall volume of activity, most active continuous 30 minutes (M30CONT), and MVPA (p<0.05). Higher overall activity volume, M30CONT, and MVPA predicted more wake after sleep onset (WASO) (p<0.001), whereas greater WASO was associated with higher overall volume of activity, M30CONT, and MVPA (p<0.001). An aerobic exercise intervention increased usual sleep duration. Day-to-day, more PA predicted earlier sleep onset, but worse sleep quality and vice versa. Novelty: • Greater levels of physical activity in the day were associated with an earlier sleep onset time that night, whereas a later timing of sleep onset was associated with lower physical activity the next day in men with obesity • Higher physical activity levels were associated with worse sleep quality, and vice versa

Download Full-text