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ABSTRACT: To assess characteristics of short sleepers and long sleepers and to assess association between sleep duration and central obesity in a population-based sample of women.
Non-pregnant women ≥20 years that were randomly selected from the population-registry of Uppsala, Sweden, answered a questionnaire (n=6461) including questions on sleeping habits and somatic disorders.
There was a U-shaped association between sleep duration and waist circumference. Short sleeping women (<5 h) had a waist circumference of 89.2±14.9 cm (mean±SD) decreasing to 82.9±11.9 cm for women sleeping 7-<8 h and increasing to 89.0±16.7 cm for women sleeping ≥10 h. Both short sleepers and long sleepers were more often physically inactive, smokers, ill or taking medication, and psychologically distressed than normal sleepers (6-<9 h). In women <50 years both short and long sleep duration were risk factors for central obesity. Short sleep duration remained a risk factor for central obesity, whereas the association with long sleep duration did not reach statistical significance after adjustments.
Short sleepers and long sleepers showed differences in characteristics compared to normal sleepers. Furthermore, we showed an independent association between short sleep duration and central obesity, which was strongest in younger women. It is important to identify short sleepers, especially in younger women.
Sleep Medicine 07/2012; 13(8):1079-85. · 3.40 Impact Factor
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ABSTRACT: Abstract BACKGROUND:It has been suggested that sleep-disordered breathing (SDB) is a risk factor for diabetes, but long-term follow-ups are lacking. The aim of this community-based study was to analyze the influence of SDB on glucose metabolism after more than 10 years. METHODS:Men without diabetes (n=141, mean age 57.5 years) were investigated at baseline, including whole-night respiratory monitoring. After a mean period of 11 years and 4 months, they were followed up with an interview, anthropometric measurements and blood sampling. Insulin resistance was quantified using the homeostasis model assessment (HOMA). ΔHOMA-IR was calculated as (HOMA-IR(follow-up) - HOMA-IR(baseline)). An oral glucose tolerance test was performed in 113 men to calculate the insulin sensitivity index (ISI). RESULTS:The mean apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) at baseline were 4.7 and 3.3, respectively. At the follow-up, 23 men had diabetes. An oxygen desaturation index (ODI) of >5 was a predictor of developing diabetes (adj. OR 4.4, 95% CI 1.1-18.1 after adjusting for age, BMI(baseline,) ΔBMI, hypertension and years with CPAP during the period). The ODI was inversely related to the ISI at the follow-up (r= -0.27, p=0.003). A deterioration in HOMA-IR was significantly related to all variables of sleep-disordered breathing (AHI, AHI>5, ODI, ODI>5 and MinSaO2) even when adjusting for confounders. When excluding the variable "years on CPAP" from the multivariate model, all associations weakened. CONCLUSIONS:SDB is independently related to the development of insulin resistance and thereby the risk of manifest diabetes mellitus.
Chest 04/2012; · 5.25 Impact Factor
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ABSTRACT: Obstructive sleep apnea (OSA) is associated with an increased risk of cardiovascular disease. One contributory factor may be hemodynamic stress due to the negative intrathoracic pressure during each episode of apnea. Type B natriuretic peptide (BNP) is secreted by the cardiac ventricles in response to volume expansion and pressure load and the authors hypothesized that there would be an association between indices of OSA during the night and levels of BNP in the morning.
Community-based in Uppsala, Sweden.
There were 349 women who participated.
Participants underwent full-night polysomnography and anthropometric measurements, and answered questionnaires about medical conditions and current medication. The morning after the polysomnography, blood samples were drawn for analysis of plasma BNP, C-reactive protein, creatinine, and hemoglobin. There was an increase in mean BNP as the severity of sleep apnea increased, increasing from a mean value of 8.5 ng/L among women with an apnea-hypopnea index (AHI) < 5 to 18.0 ng/L in women with an AHI ≥ 30. Elevated BNP levels (≥ 20 ng/L) were found in 29.8% of the women, whereas 70.2% had normal levels. The odds ratio was 2.2 for elevated BNP levels for women with an AHI of 5-14.9 in relation to women with an AHI < 5, 3.1 for women with an AHI of 15-29.9, and 4.6 for women with an AHI ≥ 30 after adjustment for age, body mass index, systolic blood pressure, antihypertensive drugs, and creatinine.
There is a dose-response relationship in women between the severity of sleep apnea during the night and the levels of BNP in the morning. CITATION: Ljunggren M; Lindahl B; Theorell-Haglöw J; Lindberg E. Association between obstructive sleep apnea and elevated levels of type B natriuretic peptide in a community-based sample of women. SLEEP 2012;35(11):1521-1527.
Sleep 01/2012; 35(11):1521-7. · 5.05 Impact Factor
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Sleep Medicine 12/2011; · 3.40 Impact Factor
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Sleep Medicine 12/2011; 13(2):213. · 3.40 Impact Factor
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ABSTRACT: The aim of this study was to assess associations between obstructive sleep apnea (OSA) and metabolic syndrome in a population-based sample of women.
Four hundred women aged 20-70 years underwent a full-night polysomnography, fasting blood sampling and measurement of anthropometric variables. Metabolic syndrome was defined according to the National Cholesterol Education Program (NCEP) criteria.
The NCEP criteria of metabolic syndrome were fulfilled by 104 (26.0%) of the women. The frequency of metabolic syndrome increased from 10.5% in women with apnea-hypopnea-index (AHI) <5 to 57.1% in women with AHI ≥30 (p for trend <0.0001). In the multivariate analysis, the severity of OSA measured as AHI, ODI (oxygen desaturation index), minimal saturation or T(90) (percentage of time during night with saturation <90%) were associated with metabolic syndrome after adjustment for age, level of physical activity, smoking and alcohol consumption. AHI (adj. OR 1.45; 95% CI 1.11-1.91), ODI (1.37; 1.09-1.73) and minimal saturation level (0.93; 0.87-0.99) remained significantly associated with metabolic syndrome also when adjusting for the waist-to-hip-ratio. The three markers of OSA were independently associated with central obesity, hypertriglyceridemia and reduced HDL cholesterol concentration.
Measures of OSA were closely associated with metabolic syndrome and its components in this population-based sample of women also after adjustments. Therefore, when the health consequences of sleep-disordered breathing are investigated it is important to consider metabolic syndrome. Sleep-disordered breathing should also be considered when treating patients with metabolic syndrome.
Sleep Medicine 02/2011; 12(4):329-34. · 3.40 Impact Factor
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ABSTRACT: The aim was to assess associations between sleep duration, sleep stages, and central obesity in women.
Cross-sectional study.
City of Uppsala, Sweden.
Population-based sample of 400 women (range 20-70 years).
Full-night polysomnography and measurement of anthropometric variables.
Sleep duration was inversely related to both waist circumference and sagittal abdominal diameter. Sleep duration remained inversely related to waist circumference (adj. beta = -1.22 cm/h; P = 0.016) and sagittal abdominal diameter (adj. beta = -0.46 cm/h; P = 0.001) after adjusting for potential confounders. Duration of slow wave sleep (SWS, adj. beta = -0.058 cm/min; P = 0.025) and REM sleep (adj. beta = -0.062 cm/min; P = 0.002) were both inversely related to waist circumference afteradjustments. Moreover,duration of REM sleep was inversely related to sagittal abdominal diameter (adj. beta = -0.021 cm/min; P < 0.0001). These associations were stronger in young women (age < 50 years).
An inverse relationship between short sleep duration and central obesity was found in women after adjusting for confounders. Loss of SWS and REM sleep may be important factors in the association between sleep loss and central obesity.
Sleep 05/2010; 33(5):593-8. · 5.05 Impact Factor
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ABSTRACT: The aim was to investigate the significance of snoring and sleep apnea on daytime symptoms in a population-based sample of women.
From the general population, 400 women aged 20 to 70 years were randomly selected, with oversampling of habitually snoring women. The women were investigated using full-night polysomnography and a questionnaire. The apnea-hypopnea index (AHI) was calculated, and women who acknowledged snoring loudly and disturbingly often or very often were considered habitual snorers.
Habitual snoring was independently related to excessive daytime sleepiness (odds ratio [OR], 2.28; 95% confidence interval [CI], 1.31 to 3.99), to falling asleep involuntarily during the day (OR, 2.11; 95% CI, 1.06 to 4.21), to waking up unrefreshed (OR, 2.14; 95% CI, 1.30 to 3.52), to daytime fatigue (OR, 2.77; 95% CI, 1.54 to 4.99), and to a dry mouth on awakening (OR, 2.00; 95% CI, 1.22 to 3.27) after adjustment for AHI, age, body mass index (BMI), smoking, total sleep time, percentage of slow-wave sleep, and percentage of rapid eye movement (REM) sleep. An AHI > or = 15/h was only related to a dry mouth on awakening after adjustment for snoring, age, BMI, smoking, total sleep time, percentage of slow-wave sleep, and percentage of REM sleep (OR, 2.24; 95% CI, 1.14 to 4.40). An AHI of 5 to 15/h was not related to any daytime symptom.
Excessive daytime sleepiness and daytime fatigue are related to habitual snoring independent of the apnea-hypopnea frequency, age, obesity, smoking, and sleep parameters in a population-based sample of women, but not to the AHI. This indicates that snoring is an independent cause of excess daytime sleepiness and not merely a proxy for sleep apnea.
Chest 09/2008; 134(5):919-24. · 5.25 Impact Factor
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ABSTRACT: To analyze the relation between different risk factors and excessive daytime sleepiness (EDS) and fatigue in women from a general-population sample.
Cross-sectional population study.
The municipality of Uppsala, Sweden.
Five thousand five hundred eight women (response rate 73.3%) aged 20 to 60 years.
EDS, fatigue, and potential risk factors were assessed in a self-administered questionnaire. Risk factors for EDS and fatigue were analyzed using a multiple logistic regression model. In the whole population, 16.1% of the women reported EDS and 14.3% fatigue. The risk of having EDS and fatigue decreased with increasing age: adjusted odds ratios (95% confidence interval) for EDS and fatigue were 0.73 (0.66-0.88) and 0.86 (0.77-0.96) per 10 years, respectively. The combination of anxiety and depression was highly related to both EDS and fatigue (4.51 [3.51-5.79] and 7.00 [5.39-9.10], respectively). Insomnia, somatic disease, snoring, being overweight, and being on sick leave were also independently related to both conditions, whereas lifestyle factors, such as physical inactivity and smoking, were related to fatigue but not to EDS. Having children did not influence the risk of either EDS or fatigue.
Psychological distress, insomnia, and somatic disease are the most important conditions in women reporting daytime sleepiness and fatigue. Because 1 in 5 (21%) of the women in this study reported sleepiness, fatigue, or both, interventions that improve psychiatric health and reduce insomnia are important in improving the quality of life in women with these sleep symptoms.
Sleep 07/2006; 29(6):751-7. · 5.05 Impact Factor
