Knutson KL. Sleep duration and cardiometabolic risk: a review of the epidemiologic evidence. Best Pract Res Clin Endocrinol Metab 24, 731-743

Section of Pulmonary/Critical Care, Department of Medicine, University of Chicago, 5841 S Maryland Ave MC 6076, Chicago, IL 60622, USA.
Best Practice & Research: Clinical Endocrinology & Metabolism (Impact Factor: 4.6). 10/2010; 24(5):731-43. DOI: 10.1016/j.beem.2010.07.001
Source: PubMed

ABSTRACT Laboratory studies have found that short-term sleep restriction is associated with impairments in glucose metabolism, appetite regulation and blood pressure regulation. This chapter reviews the epidemiologic evidence for an association between habitual sleep duration and quality and risk of cardiometabolic diseases including obesity, diabetes and hypertension. Multiple studies observed a cross-sectional association between short sleep duration (generally <6 h per night) and increased body mass index or obesity, prevalent diabetes and prevalent hypertension. Many studies also reported an association between self-reported long sleep duration (generally >8 h per night) and cardiometabolic disease. There have been a few prospective studies and several, but not all, have found an association between short sleep and incident diabetes, hypertension and markers of cardiovascular disease. Future prospective epidemiologic studies need to include objective measures of sleep, and intervention studies are needed in order to establish a causal link between impaired or insufficient sleep and cardiometabolic disease risk.

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Available from: Kristen L Knutson, Sep 26, 2015
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    • "Night or rotating shifts and other irregular schedules affect sleep quality and quantity, with important physiological and behavioral consequences: fatigue, chronic health problems, altered metabolism, increased risk of injury, and disruption of family and social routines. Insufficient sleep has been correlated with changes in appetite/satiety regulation, metabolism , and insulin sensitivity, as well as a reduction in available energy to engage in physical activity (Knutson, 2010). Epidemiologically, shiftwork has been linked to metabolic syndrome (Tucker, Marquié, Folkard, Ansiau, & Esquirol, 2012) and short sleep with overweight status (Gildner, Liebert, Kowal, Chatterji, & Snodgrass, 2014). "
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    ABSTRACT: The rising U.S. prevalence of obesity has generated significant concern and demonstrates striking socioeconomic and racial/ethnic disparities. Most interventions target individual behaviors, sometimes in combination with improving the physical environment in the community but rarely involving modifications of the work environment. With 3.6 million workers earning at or below the federal minimum wage, it is imperative to understand the impact of working conditions on health and weight for lower income workers. To investigate this question, a university-community partnership created a participatory research team and conducted eight focus groups, in English and Spanish, with people holding low-wage jobs in various industries. Analysis of transcripts identified four themes: physically demanding work (illnesses, injuries, leisure-time physical activity), psychosocial work stressors (high demands, low control, low social support, poor treatment), food environment at work (available food choices, kitchen equipment), and time pressure (scheduling, having multiple jobs and responsibilities). Physical and psychosocial features of work were identified as important antecedents for overweight. In particular, nontraditional work shifts and inflexible schedules limited participants' ability to adhere to public health recommendations for diet and physical activity. Workplace programs to address obesity in low-wage workers must include the effect of working conditions as a fundamental starting point. © 2015 Society for Public Health Education.
    Health Promotion Practice 09/2015; DOI:10.1177/1524839915602439 · 0.55 Impact Factor
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    • "Indeed there is increasing evidence that quantitative and qualitative sleep disturbances may play a role in the development of cardiometabolic disease. A number of cardiovascular risk factors and cardiovascular outcomes have been associated with disturbed sleep: coronary artery calcifications , atherogenic lipid profiles, atherosclerosis, obesity, type 2 diabetes, hypertension, cardiovascular events [19] [20]. "
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    ABSTRACT: Environmental noise, especially that caused by transportation means, is viewed as a significant cause of sleep disturbances. Poor sleep causes endocrine and metabolic measurable perturbations and is associated with a number of cardiometabolic, psychiatric and social negative outcomes both in adults and children. Nocturnal environmental noise also provokes measurable biological changes in the form of a stress response, and clearly affects sleep architecture, as well as subjective sleep quality. These sleep perturbations are similar in their nature to those observed in endogenous sleep disorders. Apart from these measurable effects and the subjective feeling of disturbed sleep, people who struggle with nocturnal environmental noise often also suffer the next day from daytime sleepiness and tiredness, annoyance, mood changes as well as decreased well-being and cognitive performance. But there is also emerging evidence that these short-term effects of environmental noise, particularly when the exposure is nocturnal, may be followed by long-term adverse cardiometabolic outcomes. Nocturnal environmental noise may be the most worrying form of noise pollution in terms of its health consequences because of its synergistic direct and indirect (through sleep disturbances acting as a mediator) influence on biological systems. Duration and quality of sleep should thus be regarded as risk factors or markers significantly influenced by the environment and possibly amenable to modification through both education and counseling as well as through measures of public health. One of the means that should be proposed is avoidance at all costs of sleep disruptions caused by environmental noise.
    Sleep Science 12/2014; 7(4):209-212. DOI:10.1016/j.slsci.2014.11.003
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    • "Due to the modern, around-the-clock lifestyles, many people form poor habitual sleep patterns and experience sleep disturbances and sleep deprivation. A number of epidemiological studies have demonstrated that sleep disturbance and short sleep duration are associated with adverse cardiovascular outcomes, such as hypertension , diabetes, and obesity [1] [2] [3] [4] [5] [6]. Additionally, a recently published meta-analysis in adults demonstrated that short sleep duration was associated with increased risk of coronary heart disease mortality [7]. "
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    ABSTRACT: Objective: To investigate the effects of objectively measured habitual sleep patterns on cardiac autonomic modulation (CAM) in a population-based sample of adolescents. Methods: We used data from 421 adolescents who completed the follow-up examination in the Penn State Children Cohort study. CAM was assessed by heart rate (HR) variability (HRV) analysis of beat-to-beat normal R-R intervals from a 39-h electrocardiogram, on a 30-min basis. The HRV indices included frequency domain (HF, LF, and LF/HF ratio), and time domain (SDNN, RMSSD, and heart rate or HR) variables. Actigraphy was used for seven consecutive nights to estimate nightly sleep duration and time in bed. The seven-night mean (SD) of sleep duration and sleep efficiency were used to represent sleep duration, duration variability, sleep efficiency, and efficiency variability, respectively. HF and LF were log-transformed for statistical analysis. Linear mixed-effect models were used to analyze the association between sleep patterns and CAM. Results: After adjusting for major confounders, increased sleep duration variability and efficiency variability were significantly associated with lower HRV and higher HR during the 39-h, as well as separated by daytime and nighttime. For instance, a 1-h increase in sleep duration variability is associated with -0.14(0.04), -0.12(0.06), and -0.16(0.05) ms(2) decrease in total, daytime, and nighttime HF, respectively. No associations were found between sleep duration, or sleep efficiency and HRV. Conclusion: Higher habitual sleep duration variability and efficiency variability are associated with lower HRV and higher HR, suggesting that an irregular sleep pattern has an adverse impact on CAM, even in healthy adolescents.
    Sleep Medicine 11/2014; 16(1):67-72. DOI:10.1016/j.sleep.2014.10.007 · 3.15 Impact Factor
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