Article

Self-reported sleep duration as a predictor of all-cause mortality: Results from the JACC Study, Japan

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

Epidemiologic studies have shown that habitual sleeping patterns are associated with all-cause mortality risk. However, sleep duration may be affected by physical, mental, or social conditions, and its impact on health may differ depending on the time or place. To examine the effects of sleep duration on all-cause mortality after adjusting for several covariates, mental condition in particular. A total of 104,010 subjects (43,852 men and 60,158 women), aged 40 to 79 years, who enrolled in the JACC Study (Japan Collaborative Cohort Study on Evaluation of Cancer Risk Sponsored by Monbusho) from 1988 to 1990 and were followed for an average of 9.9 years. Average sleep duration on weekdays and covariates, including perceived mental stress and depressive symptoms, were used in the analyses. Relative risks were calculated by Cox's proportional hazard model separately by sex. Men tended to sleep longer than women, and the elderly slept longer than younger subjects. Mean sleep duration was 7.5 hours for men and 7.1 hours for women; mode durations were 8 hours (range, 7.5-8.4 hours) and 7 hours (6.5-7.4), respectively. Sleep duration of shorter or longer than 7 hours was associated with a significantly elevated risk of all-cause mortality. However, the significant association with short sleep disappears when adjusted for some covariates among men. Sleep duration at night of 7 hours was found to show the lowest mortality risk.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... Anxiety, as a type of psychological stress, will set off a chain of physiological events that will reduce immunity (Singhal, 2020). Irregular or insufficient sleep may be linked to an increased risk of morbidity and mortality (World Health Organization [Internet], 2020; Tamakoshi et al., 2004;Leng et al., 2015;Youngstedt and Kripke, 2004;Whinnery et al., 2014;Pappa et al., 2020;. Documented studies confirmed both short and long sleeps are connected with increased morbidity and mortality (Tamakoshi et al., 2004;Leng et al., 2015;Youngstedt and Kripke, 2004). ...
... Irregular or insufficient sleep may be linked to an increased risk of morbidity and mortality (World Health Organization [Internet], 2020; Tamakoshi et al., 2004;Leng et al., 2015;Youngstedt and Kripke, 2004;Whinnery et al., 2014;Pappa et al., 2020;. Documented studies confirmed both short and long sleeps are connected with increased morbidity and mortality (Tamakoshi et al., 2004;Leng et al., 2015;Youngstedt and Kripke, 2004). Different studies reported that age; mental health status; and income were significantly associated with short sleep duration in favour of older age; experiencing depression or anxiety symptoms, working night shifts and being separated from partner. ...
Article
Full-text available
Aim The purpose of this study was to investigate into mental health outcomes such as stress, anxiety, and depression, as well as sleep quality in suspected COVID-19 quarantined cases. Methods This is a cross-sectional study that used an online survey to target suspected COVID-19 cases in quarantine facilities. Data were collected on several aspects of participants' sociodemographic characteristics, sleep disturbance, and mental health status. Depression, anxiety, stress scale and Pittsburgh Sleep Quality Index were used to measure both the psychological impact and mental health status. Results Of the 362 people who took the survey, 234 (64.6%) were men, and 148 were between the ages of 26-35. Poor sleep was found to be prevalent in 65% of study participants. The rates of individuals reporting severe depression, anxiety, and stress symptoms were 14.6%, 15%, and 15%, respectively. According to the findings, there were significant gender differences in depression and anxiety (p=0.001). When compared to the other age groups, participants aged 26-35 reported the highest level of stress (p=0.001). Being male [OR = -1.23, 95% CI (-2.75 - 1.95) P = 0.050], single [OR = 0.98, CI (0.15 - 4.20), P = 0.001], and a healthcare worker [OR = -2.20, 95% CI (-2.59 - 1.82), P = 0.001] were all associated with poor sleep quality. Conclusion Approximately one-third of quarantine COVID-19 patients had poor sleep quality with mild-moderate depression. Both anxiety and stress scales were prevalent in nearly half of the studied samples.
... A number of epidemiologic studies show that short sleep (≤6 h/d) is associated with a variety of physical impairments (1) and increased risk of all-cause mortality (2)(3)(4)(5), cardiovascular disease (6,7), and incident diabetes (8,9). In addition, similar and even stronger chronic disease and mortality risk relations have been observed among people who report long sleep duration (≥9 h/d) (2,3,5,10). ...
... A number of epidemiologic studies show that short sleep (≤6 h/d) is associated with a variety of physical impairments (1) and increased risk of all-cause mortality (2)(3)(4)(5), cardiovascular disease (6,7), and incident diabetes (8,9). In addition, similar and even stronger chronic disease and mortality risk relations have been observed among people who report long sleep duration (≥9 h/d) (2,3,5,10). Independent of duration, as a parameter of sleep quality, difficulty sleeping has been linked to angina (11) and is a feature of insomnia that is associated with increased risk of cardiovascular disease and mortality (12,13). ...
Article
Full-text available
Background: n-3 and n-6 PUFAs have physiologic roles in sleep processes, but little is known regarding circulating n-3 and n-6 PUFA and sleep parameters. Objectives: We sought to assess associations between biomarkers of n-3 and n-6 PUFA intake with self-reported sleep duration and difficulty falling sleeping in the Fatty Acids and Outcome Research Consortium. Methods: Harmonized, de novo, individual-level analyses were performed and pooled across 12 cohorts. Participants were 35-96 y old and from 5 nations. Circulating measures included α-linolenic acid (ALA), EPA, docosapentaenoic acid (DPA), DHA, EPA + DPA + DHA, linoleic acid, and arachidonic acid. Sleep duration (10 cohorts, n = 18,791) was categorized as short (≤6 h), 7-8 h (reference), or long (≥9 h). Difficulty falling asleep (8 cohorts, n = 12,500) was categorized as yes or no. Associations between PUFAs, sleep duration, and difficulty falling sleeping were assessed by cross-sectional multinomial logistic regression using standardized protocols and covariates. Cohort-specific multivariable-adjusted ORs per quintile of PUFAs were pooled with inverse-variance weighted meta-analysis. Results: In pooled analysis adjusted for sociodemographic characteristics and health status, participants with higher very long-chain n-3 PUFAs were less likely to have long sleep duration. In the top compared with the bottom quintiles, the multivariable-adjusted ORs (95% CIs) for long sleep were 0.78 (95% CI: 0.65, 0.95) for DHA and 0.76 (95% CI: 0.63, 0.93) for EPA + DPA + DHA. Significant associations for ALA and n-6 PUFA with short sleep duration or difficulty falling sleeping were not identified. Conclusions: Participants with higher concentrations of very long-chain n-3 PUFAs were less likely to have long sleep duration. While objective biomarkers reduce recall bias and misclassification, the cross-sectional design limits assessment of the temporal nature of this relation. These novel findings across 12 cohorts highlight the need for experimental and biological assessments of very long-chain n-3 PUFAs and sleep duration.
... 2022; 17(1): [21][22][23][24][25][26][27][28] prevention and improvement of frailty 9,10) . Thus, inadequate sleep has been shown to increase the total number of deaths and other disorders 11) . In a previous study that included 1,726 community-dwelling older adults, poor quality of sleep and shortened sleep periods (< 6 h) were associated with the severity of pre-frailty and frailty. ...
... Several studies have reported the importance of exercise and sleep in the prevention or improvement of frailty in community-dwelling older adults [5][6][7][8][9][10][11] . There is a relationship between exercise and sleep. ...
Article
Objectives: This study examined the effects of the interaction between exercise and sleep on frailty severity in community-dwelling older adults. Materials and Methods: This was a cross-sectional study. Data were collected in July 2019. In total, 2021 adults participated who responded to a questionnaire. Among them, 672 participants (317 men and 355 women) with valid responses were included in the analysis. Ordinal logistic regression analysis was performed to examine the association between frailty severity and the interaction between exercise and sleep. The dependent variable represents three different levels of frailty. The independent variables included basic information and interaction between exercise and sleep. Results: The results of ordinal logistic regression analysis (odds ratio [OR]) showed that the period from the start of exercise (OR=0.96), age (OR=1.00 for participants in their 60 s, OR=1.65 for those in their 70s, and OR=3.13 for those aged >80 years), poor subjective health perception (OR=2.12), poor quality of sleep (OR=1.88), stress (OR=1.62), and exercise–sleep interaction (OR=1.00 based on good-exercise–good-sleep interaction, OR=3.09 poor-exercise–good-sleep interaction, and OR=3.50 poor-exercise–poor-sleep interaction) significantly contributed to the model. The Nagelkerke coefficient of determination adjusted for degrees-of-freedom (R²), which represents the contribution rate of the regression equation, was 0.334. Conclusions: Our results suggest that a combination of good exercise and good sleep is needed to prevent frailty progression in community-dwelling older adults.
... The increase of sleep durations in the elderly is one of the distinguishing results of this study. Although population-based research in Japan remains limited, several questionnaire-based studies support our results [12][13][14][15][16]44 . For instance, a survey on insomnia, which enrolled outpatients of general hospitals, reported that the elderly slept longer than younger people 12 . ...
... This international survey supports our finding, while it reported the shorter gender difference of 16 min than our result. Also, shorter sleep in Japanese women was reported in several studies [12][13][14][15][16] , although these studies adopted the subjective assessment method. The overall gender differences reported by these studies varied between 8-24 min, whereas some epidemiological studies showed that sleep durations were shorter in men until the age of 40 years 13,15 . ...
Article
Full-text available
Using large-scale objective sleep data derived from body acceleration signals of 68,604 Japanese residents ranging from adolescents to the elderly (10–89 years old), we found significant age- and gender-related differences in sleep properties (timing, duration, and quality) in real-life settings. Time-in-bed and total sleep time (TST) showed a U-shaped association with age, indicating their decrease in adulthood following their increase in the elderly. There was a remarkable shift in sleep phase toward earlier bedtime and earlier wake time with increasing age (> 20 years), together with worsening of sleep quality, which is estimated by sleep efficiency (SE) and wake time after sleep onset. Gender comparisons showed that TST was shorter in women than in similarly aged men, which is much evident after the age of 30 years. This was associated with later bedtimes and greater age-related deterioration of sleep quality in women. Compared to men in the same age group, women over age 50 demonstrated a greater reduction in SE with aging, due mainly to increasing durations of nighttime awakening. These differences can be attributed to several intricately intertwined causes, including biological aging as well as socio-cultural and socio-familial factors in Japan. In conclusion, our findings provide valuable insights on the characteristics of Japanese sleep habits.
... In Japan, a major research study investigating the relationship between sleep time and mortality commenced in 1988, and it was reported in 2004 that sleep deprivation was related to increased risk of mortality [8]. It was also reported that approximately 2.5-15% of the population experience drowsiness during the day as a result of sleep deprivation, and 23% are aware of their own sleep deprivation [9]. ...
Article
Full-text available
Background: Sleep is one of the most important health-related factors. This cross-sectional study focused on sleep quality relates to systemic symptoms, including dental symptoms. Methods: Resource data were compiled from 7995 men and women aged 30 to 69 years, which is the core of the Japanese working population. The subjects were divided into four groups based on their answers to two questions, one on sleep time and one on sleep sufficiency, and groups were compared with other items in the questionnaire by means of a contingency table analysis (χ2 test). Results: Relationships were found between the sleep groups and basic attributes, the presence of subjective symptoms, and the presence of hospital visits. The items with significant relationships included 14 symptoms, such as lower back pain (p < 0.01) and four diseases, including high blood pressure (p < 0.01). A multinomial logistic regression was conducted with the sleep groups as objective variables. In the poor sleep group, significant odds ratios were found for four items, including hours of work (odds ratio: 2.53) and feeling listless (2.01). Conclusions: The results allowed multiple symptoms and diseases related to sleep quality to be identified, and different trends in the response rates of the groups were found. These results suggest that the useful classification of sleep quality groups according to health problems contributes to understanding the effects of different symptoms.
... So, the study subjects will experiencenew problems in their next sleeping time againsuch as difficult falling asleep and frequent awakening during sleep. The current study result supported by another research finding (34) .The current study finding indicates that suitable sleep environment which characterized by proper ventilation, adequate natural light and sunrays, and minimal levels of noise is significantly associated with lower levels of sleep disturbance (table 12). This may be justified by that, proper ventilation means absence of bad odors and having suitable bedroom temperature. ...
... 3. Depression: Assessed using questions used to elicit depressive symptoms in a study by Tamakoshi and Ohno. [13] Cronbach's alpha for the Bengali version was 0.73. ...
Article
Full-text available
Context: Multimorbidity is considered as a priority for global health research. It is defined as the coexistence of two or more chronic health conditions in an individual. It is increasingly being recognized as a major concern for primary care physicians due to its huge impact on individual, family, and societal level. Aim: The aim of this study was to find the quantum of gender-related inequalities and determinants of multimorbidity among the elderly people in a rural part of West Bengal. Materials and Methods: This is a cross-sectional study carried out among 246 elderly people (60 years and above) in a community setting from Oct 2017 to Sep 2018. Logistic regression analysis was done to find out the predictors of multimorbidity. Data were analyzed using the SPSS software (version 16.0. Chicago, SPSS Inc.). Results: Approximately 82% of the study subjects were suffering from multi-morbidity with a significant difference between males (80.9%) and females (88.5%). In binary logistics, people of both the genders aged >70 years, who had less than primary level education, had more than three children, whose source of income was from their children (sons/daughters), were dependent on others for daily routine were at high risk of being multimorbid; whereas depression was a significant predictor of multimorbidity in females and not in males. In multivariable analysis, age remained the only significant predictor for both the gender and for females; depression remained significant after adjusting with significant variables in binary logistics. Conclusion: Morbidity screening at each visit, individual as well as family counseling and lifestyle modifications help to cope with the rising burden of multimorbidity at the primary care level. More insight into the epidemiology of multi-morbidity is necessary to take steps to prevent it, lower its burden and align health-care services as per needs.
... 1,2 Sleep parameters, such as duration and quality, play an important role in the pathogenesis and progression of CVD, as well as in all-cause morbidity and mortality, especially among older adults. [3][4][5][6][7] These sleep parameters, duration and quality, are influenced by biological (age), social (gender, lifestyle), behavioral (bedtime and wake-up times), pathophysiological (insulin resistance, hypertension, hypercholesterolemia, type 2 diabetes or increased inflammatory markers) and environmental factors (light, noise and temperature). [5][6][7] Sleep is an important modulator of cardiovascular function and thus of CVD development, both in physiological conditions and in disease conditions. ...
Article
Background Altered sleep parameters, such as duration and quality, play an important role in the pathogenesis and progression of cardiovascular diseases, as well as in all-cause morbidity and mortality. It has been suggested that the specific mechanisms underlying this association could be through the influence of sleep parameters on vascular markers, such as arterial stiffness (AS), although this remains unclear. Thus, in this meta-analysis, we aimed to assess the association between sleep duration and sleep quality with AS in adults. Methods PubMed, Scopus, Web of Science and Cochrane Library databases were searched from inception to July 30, 2021. The DerSimonian and Laird method was used to compute pooled effect size estimates and their respective 95% confidence intervals (95% CIs) of the association of sleep duration and sleep quality with AS. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies from the United States National Institute of Health National Heart, Lung, and Blood Institute was used to assess the risk of bias. Results Finally, 14 studies (8 cross-sectional studies and baseline data from 6 prospective longitudinal studies) involving 97,837 individuals between 18 and 92 years of age were included. Our results showed that increased sleep duration, as continuous values, does not influence AS (effect size [ES]: 0.00; 95% CIs: -0.15, 0.15) in the general population. However, when sleep duration was longer than 8 hours (ES: 0.21; 95% CIs: 0.06, 0.36), according to sleep categories, a significant increase in pulse wave velocity was shown. Poor sleep quality was associated with increased AS (ES: 0.13; 95% CIs: 0.04, 0.21) in the general population. The overall risk of bias for studies examining sleep duration was fair in 77.8% of the included studies and the overall risk of bias for studies examining sleep quality was fair in 55.6%. Conclusions Our findings showed that both long sleep duration and poor sleep quality were associated with AS in adults. These findings underscore the influence of sleep on vascular health markers, specifically AS, as a possible pathway to explain the increased cardiovascular morbidity and mortality associated with sleep disorders.
... Long sleep of 9 h or greater (risk ratio ∼2) is actually the more problematic of the two ( Jike et al. 2018). This optimal middle range of sleep duration has also been observed for cross-sectional cognition (Xu et al. 2011), longitudinal cognitive change (Ferrie et al. 2011), and overall mortality (Tamakoshi et al. 2004). ...
Article
Full-text available
The restorative function of sleep is shaped by its duration, timing, continuity, subjective quality, and efficiency. Current sleep recommendations specify only nocturnal duration and have been largely derived from sleep self-reports that can be imprecise and miss relevant details. Sleep duration, preferred timing, and ability to withstand sleep deprivation are heritable traits whose expression may change with age and affect the optimal sleep prescription for an individual. Prevailing societal norms and circumstances related to work and relationships interact to influence sleep opportunity and quality. The value of allocating time for sleep is revealed by the impact of its restriction on behavior, functional brain imaging, sleep macrostructure, and late-life cognition. Augmentation of sleep slow oscillations and spindles have been proposed for enhancing sleep quality, but they inconsistently achieve their goal. Crafting bespoke sleep recommendations could benefit from large-scale, longitudinal collection of objective sleep data integrated with behavioral and self-reported data. Expected final online publication date for the Annual Review of Psychology, Volume 74 is January 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
... Long sleep of 9h or greater (RR ~2) is actually the more problematic of the two (Jike et al 2018). This optimal 'middle range' of sleep duration has also been observed for cross-sectional cognition (Xu et al 2011), longitudinal cognitive change (Ferrie et al 2011) and overall mortality (Tamakoshi et al 2004). ...
... which remained significant in the sensitivity analysis (Table 4; Fig. 2A www.nature.com/scientificreports/ findings contrast sharply with those from many reports linking subjective long sleep duration to increased mortality 1,[27][28][29] . Kripke et al. associated actigraphic long sleep duration with higher mortality; however, their supplemental analysis showed that TIB was a stronger risk factor for mortality than TST, indicating the possibility that the association between the two stems from other factors 5 . ...
Article
Full-text available
Associations of sleep duration with human health could differ depending on whether sleep is restorative. Using data from 5804 participants of the Sleep Heart Health Study, we examined the longitudinal association of sleep restfulness combined with polysomnography-measured total sleep time (TST) or time in bed (TIB), representing different sleeping behaviors, with all-cause mortality. Among middle-aged adults, compared with restful intermediate TST quartile, the lowest TST quartile with feeling unrested was associated with higher mortality (hazard ratio [HR], 1.54; 95% confidence interval [CI] 1.01–2.33); the highest TST quartile with feeling rested was associated with lower mortality (HR, 0.55; 95% CI 0.32–0.97). Among older adults, the highest TIB quartile with feeling unrested was associated with higher mortality, compared with restful intermediate TIB quartile (HR, 1.57; 95% CI 1.23–2.01). Results suggest a role of restorative sleep in differentiating the effects of sleep duration on health outcomes in midlife and beyond.
... Зменшення тривалості сну асоційоване з несприятливими наслідками для здоров'я та супроводжується підвищенням загальної смертності [11][12][13], частоти розвитку серцево-судинних захворювань [14,15], цукрового діабету 2 типу [11], дисліпідемії та ожиріння у дорослих і дітей [16, 17] та є маловивченим питанням у хворих діалізної популяції [20]. ...
Article
Full-text available
The researcheddemonstrated the relationship between functional state of the pineal gland and sleepdeterioration. However, impaired melatonin-producing function of the pineal gland (MFE) in patients with chronic kidney disease (CKD), treated with hemodialysis (HD), and its association with sleep disturbance in this cohort of patients required further investigations.Aim — to assess the quality of sleepin patients with stage 5 CKD treated with HD and investigate itsrelationship with the pineal dysfunction.Materials and methods. Examinations involved 130 patients (50 % of men) with stage 5 CKD, treated with hemodialysis, with the mean age 58.5 [43; 66]. The day and night melatoninlevels (MT) in saliva were determined and based on the results the patients were divided into two groups: group I — 110 patients with impaired MFE, group II — 20 patients with normal MFE. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. All patients underwent clinical and laboratory tests: general and biochemical blood tests, office blood pressure (BP) measurements, Holter blood pressure monitoring.Results. Analysis of the insomniastructure in patients with stage 5 CKD, treated with HD, according to the PSQI questionnaire, demonstrated the problems with falling asleep in 96.2 % of patients, feeling of heat in 56.8 %, frequent awakenings in 52.9 %, daytime dysfunction in 40.8 %, breathing problems in 40.5 %, sleep problems due to coughing or snoring in 37.8 %, having bad dreams in 18.9 %, the use of sleeping meds in 8 % of patients. The total PSQI score in patients with impaired MFE was higher by 71.4 % (p < 0.001) compared to the value obtained in the group with preserved pineal gland function, demonstrating the effects of MFE on sleep quality.The component of «sleep delay» and «sleep duration» in patients with pineal gland dysfunction was 66.7 % higher than in the group with preserved MFE (p < 0.001). Comparative analysis of the number of minutes required for patients to fall asleep in the study groups demonstrateda greater sleep delay in HD-treated patients with impaired MFE. From them, the majority of subjects (71.8 %) needed more than 60 minutes to fall asleep, while in the group with preserved MFE such patients were not identified (p < 0.05). The number of patients with the period of falling asleep of 31 to 60 minutes in the group with pineal gland dysfunction was 30 % less than in patients with preserved MFE (p < 0.05). The number of patients in whom it took 16—30 minutes to fall asleep in the group with preserved MFE was 92.5 % (p < 0.05) more than in patients with pineal gland dysfunction, and patientswith the period of falling asleep of less than 15 minutes was by 62 % higher than patients with impaired MFE (p < 0.05). The decreased sleep duration was established in all patients treated with HD, however the most worsening of the sleep quality was revealed in the groupof MFE disorders. Thus, thenumber of patients with sleep duration < 5 hourswas by 90.8 % (р < 0.05) higher in the groupof impairedMFEvs group with the preserved MFE, with sleep duration of 5—6 hours by 81.7 % (р < 0.05), the number of subjects with duration of 6—7 hours by 76.4 % lower (р < 0.05), and those who slept > 7 hours by 84.0 % (р < 0.05).Conclusions. Patients with stage 5 CKD, treated with HD, were characterized with combination of MFE impairment (84.6 %) with poor sleep quality (86.2 %), including problems withfalling asleep, felling hot, frequent waking up, and daytime dysfunction. The low quality of sleep was determined bylow melatonin levels in saliva, the presence of hypoalbuminemia and arterial hypertension, hypertension duration and HDtreatment
... Another large-scale meta-analysis reported that short sleep time correlated with greater risk of coronary disease and stroke [2]. Although the exact time of short sleep had not been defined, in a study targeting the Japanese race, which indicated higher all-cause mortality of short sleep time, sleep less than 7 h correlated with higher all-cause mortality [3]. Sympathetic nerve activation, a pro-inflammatory state, and insulin resistance develop in short sleepers [4]. ...
Article
Full-text available
PurposeSleep architecture consists of rapid eye movement (REM) sleep and non-REM sleep time. Non-REM sleep time is further classified into three stages by depth (stage N1–N3). Some studies have reported that short sleep time predicts all-cause mortality. Short sleep time can have characteristics of sleep architecture which contribute to poor prognosis. Obstructive sleep apnea (OSA) is a disease which causes cessation or decline of ventilation during sleep due to upper airway stenosis and affects sleep architecture. Few studies have reported on the sleep architecture of short sleep time in patients with OSA. Therefore, we aimed to observe this phenomenon.Methods From May 2008 to September 2021, patients diagnosed with OSA at our facility were assessed for clinical history and underwent full-night polysomnography (PSG). These patients were classified into two groups: total sleep time (TST) recorded on PSG consisting of a short TST (< 7 h) group and a not short TST (≥ 7 h) group.ResultsOf 266 patients with OSA, compared to the not short TST group (n = 131), the short TST group (n = 135) had a lower REM sleep time (%) and a higher stage N1 sleep time (%). There was a significant difference in age between the two groups, so sub-analyses classified the patients by age: non-elderly patients (< 65 years) and elderly patients (≥ 65 years) to adjust for age. Both sub-analyses showed similar results to the analysis for the combined ages regarding sleep architecture.Conclusion Patients with OSA who had short sleep time had disordered sleep architecture with a lower REM sleep time (%) and more stage N1 sleep time.
... There are higher risks of mortality associated with both long and short sleep (Patel et al, 2004, Yin et al, 2017Kronholm et al, 2011). In some studies, the association is even stronger in long than short sleep (Tamakoshi andOhno, 2004, Kwok et al, 2018). Magee, Iverson and Caputi (2009) in a study of Australian adults found that short sleep was associated with long working hours and obesity while long sleep was associated with recent treatment for cancer, heart attack and angina. ...
Article
Using data for over 2.5 million individuals in the United States over the period 2006-2019 from the Behavioral Risk Factor Surveillance System (BRFSS) survey series we show the unemployed suffer sleep disruption. The unemployed suffer more short and long sleep than the employed and are more likely to suffer from disturbed sleep. These are especially problematic for the long-term unemployed and for the jobless who say they are unable to work. Similar findings on unemployment and poor sleep quality are found in European data. Increases in the unemployment rate raise the incidence of short sleep and lower sleep durations.
... 9 Evidence also suggests that people with longer sleep duration (>8 hours/night) have an increased risk of all-cause mortality. 5,10,11 Risk of coronary heart disease increases in people with a sleep duration of >9 hours/night. 7 A longitudinal study carried out amongst the Chinese adult population found that a sleep duration ≥9 hours/night is associated with increased odds of metabolic syndrome incidence 5 years later comparing to those who sleep 7-8 hours/night. ...
Article
Full-text available
Purpose: Short and long sleep durations have adverse effects on physical and mental health. However, most studies are based on self-reported sleep duration and health status. Therefore, this longitudinal study aims to investigate objectively measured sleep duration and subsequent primary health care records in older adults to investigate the impact of sleep duration and fragmentation on physical and mental health. Methods: Data on objective sleep duration were measured using accelerometry. Primary care health records were then obtained from the UK Biobank (n=84,404). Participants (mean age, 62.4 years) were divided into five groups according to their sleep duration derived from the accelerometry data: <5 hours, 5-6 hours, 6-7 hours, 7-8 hours and >8 hours. ICD-10 codes were used for the analysis of primary care data. Wake after sleep onset, activity level during the least active 5 hours and episodes of movement during sleep were analysed as an indication for sleep fragmentation. Binary regression models were adjusted for age, gender and Townsend deprivation score. Results: A "U-shaped" relationship was found between sleep duration and diseases including diabetes, hypertension and heart disease and depression. Short and long sleep durations and fragmented sleep were associated with increased odds of disease. Conclusion: Six to eight hours of sleep, as well as less fragmented sleep, predicted better long-term metabolic and mental health.
... Diabetes and early mortality have both been associated with inadequate sleep, including insufficient duration or poor quality of sleep (e.g., Akerstedt et al., 2017;Anothaisintawee, Reutrakul, Van Cauter, & Thakkinstian, 2016;Heslop, Smith, Metcalfe, Macleod, & Hart, 2002;Hublin, Partinen, Koskenvuo, & Kaprio, 2007;Kripke, Langer, Elliott, Klauber, & Rex, 2011;Tamakoshi & Ohno, 2004). A number of studies have examined sleep disturbances or insomnia complaints in relation to mortality risk, and some observed significantly increased risk of mortality associated with these sleep-related complaints (Li et al., 2014;Sivertsen et al., 2014); however, others did not (Althuis, Fredman, Langenberg, & Magaziner, 1998;Kripke, Garfinkel, Wingard, Klauber, & Marler, 2002;Lovato & Lack, 2019;Rockwood, Davis, Merry, Macknight, & Mcdowell, 2001). ...
Article
Full-text available
Non-communicable diseases, including diabetes, are partly responsible for the deceleration of improvements of life expectancy in many countries. Diabetes is also associated with sleep disturbances. Our aim was to determine whether sleep disturbances, particularly in people with diabetes, were associated with increased mortality risk. Data from the UK Biobank were analysed (n = 487,728, mean follow-up time = 8.9 years). The primary exposure was sleep disturbances, assessed through the question: Do you have trouble falling asleep at night or do you wake up in the middle of the night? The primary outcome was mortality. We also dichotomized sleep disturbances into “never/sometimes” versus “usually” (frequently), and combined with the presence/absence of diabetes: 24.2% of participants reported “never/rarely” experiencing sleep disturbances, 47.8% “sometimes” and 28.0% “usually”. In age- and sex-adjusted models, frequent sleep disturbances were associated with an increased risk of all-cause mortality (hazard ratio [HR], 1.31; 95% confidence interval [CI], 1.26–1.37), which remained significant in the fully adjusted model (HR 1.13, 95% CI 1.09–1.18). The presence of both diabetes and frequent sleep disturbances was associated with greater risk of all-cause mortality than either condition alone. In the fully adjusted model, the hazard ratio for all-cause mortality was 1.11 (95% CI, 1.07–1.15) for frequent sleep disturbances alone, 1.67 (95% CI, 1.57–1.76) for diabetes alone and 1.87 for both (95% CI, 1.75–2.01). Frequent sleep disturbances (experienced by more than one quarter of the sample) were associated with increased risk of all-cause mortality. Mortality risk was highest in those with both diabetes and frequent sleep disturbances. Complaints of difficulty falling or staying asleep merit attention by physicians.
... more likely to be affected by many factors, such as unhealthy lifestyles, menopausal status, chronic disease and mental health [9,10], thus the relationship of sleep duration with all-cause mortality may be more complex. In addition, several issues have not been fully addressed in previous studies. ...
Article
Full-text available
Background Although a U-shaped association between sleep duration and all-cause mortality has been found in general population, its association in the elderly adults, especially in the oldest-old, is rarely explored. Methods In present cohort study, we prospectively explore the association between sleep duration and all-cause mortality among 15,092 participants enrolled in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2005 to 2019. Sleep duration and death information was collected by using structured questionnaires. Cox regression model with sleep duration as a time-varying exposure was performed to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs). The dose-response association between them was explored via a restricted cubic spline function. Results During an average follow-up of 4.51 (standard deviation, SD: 3.62) years, 10,768 participants died during the follow-up period. The mean (SD) age of the participants was 89.26 (11.56) years old. Compared to individuals with moderate sleep duration (7–8 hours), individuals with long sleep duration (> 8 hours) had a significantly higher risk of all-cause mortality (HR: 1.13, 95%CI: 1.09–1.18), but not among individuals with short sleep duration (≤ 6 hours) (HR: 1.02, 95%CI: 0.96–1.09). Similar results were observed in subgroup analyses based on age and gender. In the dose-response analysis, a J-shaped association was observed. Conclusions Sleep duration was associated with all-cause mortality in a J-shaped pattern in the elderly population in China.
... Findings from NHANES have been used to determine the prevalence of and risk factors for major diseases [15]. Based on research regarding health risks associated with sleep duration [16,17] insufficient sleep was defined as sleep duration less than 6 h, long sleep as sleep duration longer than 8 h [2], and "normal sleep" as sleep duration lasting 7-8 h [18]. Analyses included participants within the age range of 20 and 85 years, excluding those with a missing value for age, gender, education, total household income, body mass index (BMI), systolic blood pressure (SBP), diabetes diagnosis, sleep disorder diagnosis, and sleep duration variables were excluded. ...
Article
Full-text available
This study explored the divergence in population-level estimates of insufficient sleep (<6 h) by examining the explanatory role of race/ethnicity and contrasting values derived from logistic and Poisson regression modeling techniques. We utilized National Health and Nutrition Examination Survey data to test our hypotheses among 20-85 year-old non-Hispanic Black and non-Hispanic White adults. We estimated the odds ratios using the transformed logistic regression and Poisson regression with robust variance relative risk and 95% confidence intervals (CI) of insufficient sleep. Comparing non-Hispanic White (10176) with non-Hispanic Black (4888) adults (mean age: 50.61 ± 18.03 years, female: 50.8%), we observed that the proportion of insufficient sleepers among non-Hispanic Blacks (19.2-26.1%) was higher than among non-Hispanic Whites (8.9-13.7%) across all age groupings. The converted estimated relative risk ranged from 2.12 (95% CI: 1.59, 2.84) to 2.59 (95% CI: 1.92, 3.50), while the estimated relative risks derived directly from Poisson regression analysis ranged from 1.84 (95% CI: 1.49, 2.26) to 2.12 (95% CI: 1.64, 2.73). All analyses indicated a higher risk of insufficient sleep among non-Hispanic Blacks. However, the estimates derived from logistic regression modeling were considerably higher, suggesting the direct estimates of relative risk ascertained from Poisson regression modeling may be a preferred method for estimating population-level risk of insufficient sleep.
... However, in epidemiological studies, a longer sleep duration was associated with an increased risk of heart disease and all-cause mortality [50]. The lowest mortality risk was found for those who sleep about 7 hours a night [51], while men who slept more than 8 hours per day had a tripled risk of heart disease [52]. This relationship was shown in our study sample where older adults who were nonfrail and older adults who were frail had significantly different total sleep durations (P=.01). ...
Article
Background Frailty has detrimental health impacts on older home care clients and is associated with increased hospitalization and long-term care admission. The prevalence of frailty among home care clients is poorly understood and ranges from 4.0% to 59.1%. Although frailty screening tools exist, their inconsistent use in practice calls for more innovative and easier-to-use tools. Owing to increases in the capacity of wearable devices, as well as in technology literacy and adoption in Canadian older adults, wearable devices are emerging as a viable tool to assess frailty in this population. Objective The objective of this study was to prove that using a wearable device for assessing frailty in older home care clients could be possible. Methods From June 2018 to September 2019, we recruited home care clients aged 55 years and older to be monitored over a minimum of 8 days using a wearable device. Detailed sociodemographic information and patient assessments including degree of comorbidity and activities of daily living were collected. Frailty was measured using the Fried Frailty Index. Data collected from the wearable device were used to derive variables including daily step count, total sleep time, deep sleep time, light sleep time, awake time, sleep quality, heart rate, and heart rate standard deviation. Using both wearable and conventional assessment data, multiple logistic regression models were fitted via a sequential stepwise feature selection to predict frailty. ResultsA total of 37 older home care clients completed the study. The mean age was 82.27 (SD 10.84) years, and 76% (28/37) were female; 13 participants were frail, significantly older (P
... We assessed the depressive tendency following the procedure established by Tamakoshi et al (16). Four psychological or behavioral items in the baseline questionnaire were used for convenience to assess depressive tendency, as follows: (i) "Do you think your life is meaningful?" (ii) "Do you think you make decisions quickly?" (iii) "Are you enjoying your life?" and (iv) "Do you feel others rely very much on you?" ...
Article
Full-text available
Objective The burden of death from pneumonia is expected to increase with the aging of the population, as has been observed in Japan. Depressive tendency, a common psychosocial sign, may be a risk factor for pneumonia due to its possible association with some immune dysfunction. This study aimed to clarify the association between depressive tendency and the risk of death from pneumonia. Methods A population-based cohort that consisted of 75,174 Japanese men and women was followed for a median of 19.1 years. Four psychological and behavioral symptoms (depressive symptoms) were used to evaluate depressive tendency. Results A total of 1,329 deaths from pneumonia were observed. Depressive symptoms were positively and dose-dependently associated with the risk of death from pneumonia (P<0.001 for trend), and subjects with ≥2 depressive symptoms showed a significantly elevated risk compared to those without any symptoms (multivariable hazard ratio [HR], 1.66; 95% confidence interval [CI], 1.39-1.99). This association was not significantly affected by sex or age at baseline. The elevated risk was still significant even when subjects were limited to those without any medical histories. The excess risk was observed not only for death occurring within the first 10 years of follow-up (multivariable HR, 2.05; 95% CI, 1.51-2.78) but also for that occurring in the longer follow-up period (multivariable HR, 1.48; 95% CI, 1.18-1.85). Conclusion Depressive tendency may be a risk factor for death from pneumonia. Further studies using a more reliable tool for the evaluation of depressive state are necessary to confirm this relationship.
... Our findings suggest that excessive or insufficient amounts of sleep may be risk factors for all-cause and CVD mortality in people with type 2 diabetes. Although the association between sleep duration and allcause mortality has been investigated in several studies among [25][26][27], few studies have explored this association in individuals with established diabetes. This study provides evidence that sleep duration is associated with higher mortality risk among people with type 2 diabetes and that the absolute mortality rate is higher in diabetic individuals with extreme sleep duration. ...
Article
Full-text available
Aims/hypothesisThis study aimed to investigate whether the effects of sleep duration interacted with the presence of diabetes. We specifically sought to examine the relationship between sleep duration and all-cause and cause-specific mortality in people with type 2 diabetes across sex, age at diagnosis, duration of diabetes and treatment type.Methods The sample consisted of 273,029 adults, including 248,817 without diabetes and 24,212 with type 2 diabetes, who participated in the National Health Interview Survey from 2004 to 2013 and whose data were linked to a mortality database up to 31 December 2015. Sleep duration was measured using self-report, whereby participants were asked ‘on average how long do you sleep each day (≤5, 6, 7, 8, 9 or ≥10 h/day)?’ The relationship between sleep duration and mortality risk was investigated using Cox proportional hazards regression model, with adjustments for demographics, BMI, lifestyle behaviours and clinical variables.ResultsAbsolute mortality rate was higher in adults with diabetes and extremes of sleep duration (≤5 h/day, 215.0 per 10,000 person-years; ≥10 h/day, 363.5 per 10,000 person-years). There was a non-significant interaction between sleep duration and the presence of diabetes (p for interaction = 0.08). A J-shaped relationship existed between sleep duration and all-cause mortality risk in people with type 2 diabetes. Compared with the reference group (7 h/day), both shorter and longer sleep durations were associated with increased risk of all-cause mortality (≤5 h/day, HR 1.24 [95% CI 1.09, 1.40]; 6 h/day, HR 1.13 [1.01, 1.28]; 8 h/day, HR 1.17 [1.06, 1.30]; ≥10 h/day, HR 1.83 [1.61, 2.08]). Similar associations were also observed for mortality risk from CVD, cancer, kidney disease, Alzheimer’s disease and chronic lower respiratory diseases. Longer sleep duration in those with a younger age at diabetes onset was associated with greater risks of all-cause and CVD mortality. Shorter sleep duration in individuals treated with both insulin and oral glucose-lowering medication was also associated with higher risks of all-cause and CVD mortality.Conclusions/interpretationThe associations between sleep duration and mortality risk may be different between diabetic and non-diabetic individuals. In people with type 2 diabetes, sleeping less or more than 7 h/day was associated with increased risk of all-cause and condition-specific mortality. The association was more prominent in those with a younger age at diabetes onset and receiving treatment with both oral glucose-lowering medication and insulin. This population may benefit from targeted sleep-related interventions to reduce the risks of adverse health outcomes. Graphical abstract
... This method of categorization fails to appreciate the U-shaped relationship between sleep and periodontitis. Long sleep duration of 9 hours or more has been shown, in several epidemiological studies to be related to an increased morbidity and mortality [32][33][34]. In addition, it was shown to be associated with a higher periodontitis prevalence among women and fewer remaining teeth among elderly [35,36]. ...
Article
Full-text available
This study was undertaken to investigate the potential association between sleep duration and periodontitis. The study population consisted of 10,291 individuals who participated in the United States National Health and Nutrition Examination Survey (NHANES) from the 2009–2014 cycles. Sleep duration was categorized into sleep deficient (< 7 hours), sleep adequate (7–8 hours), and sleep excessive (> 8 hours). We used the Center for Disease Control and Prevention (CDC) and the American Academy of Periodontology (AAP) periodontitis case definition. Descriptive statistics and logistic regression models were used for data analyses. The prevalence of periodontitis was 36% higher in individuals who reported sleep deficiency when compared to the sleep adequate group (odds Ratio (OR) = 1.36, 95% confidence interval (CI): 1.23–1.50). Those who reported excessive sleep had 41% higher odds of periodontitis (OR: 1.40, 95% CI: 1.16–1.71). After adjusting for confounding factors, sleep deficient individuals were 19% more likely to have periodontitis when compared to sleep adequate individuals (OR: 1.19, 95% CI: 1.06–1.38). Among sleep excessive individuals, the association was non-significant (OR: 1.16, 95% CI: 0.94–1.43). Sleep deficiency was associated with a higher prevalence of periodontitis in this study population. The association however needs to be confirmed in longitudinal studies.
... Bad sleep quality was indicated by a total score greater than 5. Diagnostic sensitivity was 89.6% and specificity was 86.5%. 12,13 The validity and reliability study of PSQI specific to Turkey was performed by Agargun et al. in 1996. 14 Beck's Depression Inventory: Beck's depression inventory (BDI) was developed in 1961 by Beck et al. to measure the severity of Depression and to monitor the treatment efficiency in adolescents and adults. ...
... however, in a recent study, it was concluded that sleep durations in Britain in 2003 were not very different from what they were in 1969 (Kripke et al., 2002). Data from other studies suggest that both short and long sleep durations are associated with increased mortality risk and sleep problems, compared with intermediate sleep durations (Tamakoshi & Ohno, (2004;Grandner & Kripke, (2004;Zvonic et al., 2007). ...
Article
Full-text available
The present study aims to assess nutritional status in adolescent’s girls in relation to sleeping patterns. A survey was conducted on 150 adolescent girls (15-19 years) from Dr.B.M.N college of Home Science, Matunga and from Virar. Anthropometric measurements, sleeping patterns and lifestyle patterns were assessed through a pre -tested questionnaire. Dietary pattern was assessed using a 24 hour recall method. Analysis was done using SPSS package. Samples were called in a group of 30 and the objectives of the study and their role were explained. A brief introduction of what questionnaire intends to collect was elaborated to the participants. Anthropometric measurements were recorded using standardised techniques. A highly significant correlation was seen between the hours of sleep that girls had and consumption of meals in the study. Girls having breakfast showed a positive and significant correlation with the no of hours of sleep that they get (6-8 hours and 8 & more). No significant correlation was seen among hours of sleep and kind of breakfast they had. Also increase in calcium and iron intake showed an increase in waist to hip ratio in adolescents (p=0.004) whereas other nutrients had no effect on anthropometric measurements. Keywords: Sleeping patterns, Meals, Nutrients, Waist to hip ratio
... Our findings differed from some of previous studies, which reported a U-shaped relationship between sleep duration and all-cause mortality in both genders [12,[58][59][60]. The reasons behind these inconsistent observations are manifold. ...
Preprint
Full-text available
Background: Short or long sleep duration is proposed as a potential risk factor for all-cause mortality in the older people, yet the results of published studies are not often reproducible. Objectives: We aimed to investigate whether short or long sleep duration was associated with an increased risk of all-cause mortality in the older people via a comprehensive meta-analysis. Methods: Literature retrieval, study selection and data extraction were completed independently and in duplicate. Effect-size estimates are expressed as relative risk (RR) and its 95% confidence interval (CI). Results: Summary data from 35 articles, involving a total of 106990 older people, were meta-analyzed. Overall analyses revealed a significant association between long sleep duration and all-cause mortality (RR=1.27, 95% CI: 1.19-1.35, P <.001), whereas marginal significance was observed for short sleep duration (RR=1.05; 95% CI: 1.00-1.09; P =.045). There was a low probability of publication bias as indicated by Egger’s test for the association between sleep duration and all-cause mortality. In subgroup analyses, the association between long sleep duration and all-cause mortality was relatively strong in women (RR=1.48, 95% CI: 1.18-1.85, P =.002) relative to men (RR=1.30, 95% CI: 1.10-1.50, P =.001) (Two-sample Z test P = .219). Further dose-response regression analyses showed that trend estimation was not obvious for short sleep duration ( P = .016) compared with long sleep duration ( P < .001), indicating a J-shaped relationship between sleep duration and all-cause mortality. Conclusions: Our findings indicate a J-shaped relationship between sleep duration and all-cause mortality in the older people, with long sleep duration significantly associating with all-cause mortality, especially in women.
... 11 4 Depression: assessed using questions from the study by Tamakohia and Ohno. 16 Four questions were asked for four major depressive symptoms of a major depressive episode according to the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition): (i) Do you think your life is meaningful? (ii) Do you think you make decisions quickly? ...
Article
Full-text available
Background Elder abuse is an important public health problem hidden from public view in spite of its detrimental effect on physical and mental health. In the last three decades, there is responsiveness toward abuse of children and spouses worldwide but even today abuse and neglect of aged people seem to be the matter of least concern. This study aims to reveal the magnitude of elder abuse and its predictors. Methods This is a cross‐sectional study carried out in a community setting among elderly people (60 years and older) from October 2015 to September 2017 in a rural area of West Bengal, eastern part of India. Elder abuse was elicited by questions adapted from the Actual Abuse Tool. Data were analysed using SPSS (version 16.0). Logistic regression analysis was performed to reveal the factors associated with elder abuse. Results The study found that 25.6% of the respondents had experienced abuse, psychological abuse being the commonest type. Disability was the most common perceived risk for abuse. Univariate logistic regression showed higher age (70 years and older), female gender, who were Scheduled caste, living in a nuclear family, having more than three children, financially and functionally dependent, who was suffering from depression and multimorbidity had increased odds of being abused. In multivariable logistic regression, people aged above 70 years, living in a nuclear family and dependent for instrumental activities of daily living remained significant predictors of abuse. Conclusion Around one in four of the respondents was abused in a 1 year duration which implies the urgent need for action. Routine screening for elder abuse at ground level and abuse prevention campaigns can be an important measure to alleviate this hidden problem. Also, there is a need to explore culturally specific forms of elder abuse to provide an age‐friendly environment.
... Short sleep durations were associated with lower BMI in a cohort study in Japan. [15] The Shanghai Women's Health Study found that high BMI, waist to hip ratio, and waist circumference were associated with long sleep durations after adjustment for energy intake and other confounders. [16] In this study, people with normal sleep durations had higher BMI than those with short or long sleep durations. ...
Article
Full-text available
This study aims to examine the association between sleep duration and cognitive impairment in community-dwelling Chinese older adults.The associations between sleep duration and cognitive function have been widely studied across various age ranges but are of particular importance among older adults. However, there are inconsistent findings regarding the relationship between sleep duration and cognitive function in the literature.This study is an observational cross-sectional study. We analyzed data from 1115 Chinese individuals aged 60 and older from 3 Chinese communities (Beijing, Hefei, and Lanzhou). Cognitive impairment was defined as a Mini-Mental State Examination total score less than 24 points. Odds ratios (ORs) of associations were calculated and adjusted for potential confounders in logistic regression models.The prevalence of cognitive impairment was 25.7% (n = 287). Controlling for all demographic, lifestyle factors, and coexisting conditions, the adjusted OR for cognitive impairment was 2.54 (95% CI = 1.70-3.80) with <6 hours sleep and 2.39 (95% CI = 1.41-4.06) with >8 hours sleep.Both short and long sleep durations were related to worse cognitive function among community-dwelling Chinese elderly adults.
... Some studies have shown a U-shaped association between sleep duration and all-cause mortality in men and women [12,[54][55][56]. Unlike these studies, we found that the sleep duration in the older people was a J-type relationship with all-cause mortality, which confirmed the results by Liu and colleagues [57], and there was a J-type relation between sleep duration and all-cause mortality. ...
Preprint
Full-text available
Background Short or long sleep duration is recognized as a potential risk factor for all-cause mortality in the older people, yet the results are not often reproducible. Objectives We aimed to investigate whether sleep duration was associated with an increased risk of all-cause mortality in the older people through a comprehensive meta-analysis. Methods Literature retrieval, research selection and data extraction were done independently and in duplicate. Effect-size estimates are expressed as odds ratio (OR) and 95% confidence interval (CI). Results Summary data from 35 articles, involving 11746 older people, were meta-analyzed. Overall analyses revealed a significant association between long sleep duration and all-cause mortality in the older people (OR=1.27, 95% CI: 1.19-1.35, P <.001), and short sleep duration was marginally related to the all-cause mortality in the older people (OR=1.05; 95% CI: 1.00-1.09; P =.045). The Egger’s test indicated no publication bias between sleep duration and all-cause mortality in the older people. In subgroup analyses, the association with all-cause mortality was reinforced in older people women with long sleep duration (OR=1.48, 95% CI: 1.18-1.85, P =.002) relative to older people men with long sleep duration (OR=1.3, 95% CI: 1.10-1.50, P =.001). Further dose-response analyses showed a J-shaped relationship between sleep duration and all-cause mortality in the older people. Conclusions Our meta-analytical findings demonstrated a J-shaped relationship between sleep duration and all-cause mortality in the older people. For long sleep duration, older people women had a higher mortality rate than older people men.
... Sleep is an essential factor for health promotion along with nutrition and exercise. It has been reported that poor sleep is a risk factor for metabolic syndrome, cancers, and mortality [7][8][9]. Although good sleep is necessary to maintain health and high performance, many workers experience sleep problems. ...
Article
Full-text available
Several priority characteristics of wood that have beneficial effects on human beings have been reported. However, the advantages of wood use in bedroom interiors for sleep have not been fully evaluated. The aim of this cross-sectional epidemiological study was to evaluate the association of wood use in housing and bedrooms with comfort in the bedroom and sleep among workers in Japan. The study methods included sleep measurements using actigraphy and a self-administered questionnaire survey. In total, 671 workers (298 men and 373 women; mean age ± standard deviation: 43.3 ± 11.2 years) were included in the analysis. The amount of wood used in bedrooms was significantly associated with comfort in bedrooms, inversely associated with suspicion of insomnia, partly inversely associated with self-rated poor sleep quality, but not associated with low sleep efficiency. On logistic regression analysis, the adjusted odds ratio (aOR) of the “large amount of wood” group relative to the “no wood” group was 3.25 [95% confidence interval (CI) 1.63–6.47] for comfort. The aOR of the “no wood” group relative to the “large amount of wood” group was 2.15 (95% CI 1.11–4.16) for suspicion of insomnia. Wood structure of housing, as well as wood use on either the floor, wall, or ceiling, were not significantly associated with comfort and sleep conditions. Our study suggested that the use of a large amount of wood used in the bedroom interior could be beneficial for comfort, sleep, and therefore, health of workers. Further studies are required to obtain generalizable results.
Article
Background: Sleep is fundamental to a healthy life, and sleep disorders are an important health issue in healthcare. Whole-body warm water bathing is a non-pharmacological, safe (non-invasive), and widely used method for comforting. Here, we explored the feasibility and preliminary effectiveness of sodium bicarbonate bath (SBB) on sleep quality. Methods: Healthy adults without sleep disturbances were randomly assigned to shower baths (SHB), tap-water baths (TWB, placebo tablets), or SBB. All participants took a bath (shower, tap-water, or SBB) once a day for 10 min, after dinner, for 7 days. Sleepscan-derived sleep parameters, including total sleep time (TST), symptom questionnaires, and salivary α-amylase concentration were evaluated as outcome measures. Results: Forty participants were enrolled (14, 13, and 13 in SHB, TWB, and SBB groups, respectively) and 38 participants completed the trial (13, 12, and 13, respectively). The recruitment, adherence, and completion rates were 90.9% (40/44), 95.0% (38/40), and 95.0% (38/40), respectively. The SBB group showed a significant increase (12.35 [mean]±10.07 [standard deviation] min) in the mean TST at 1-week post-intervention (p = 0.0041) than the SHB (-1.81 ± 14.58 min; p = 0.0231) and TWB (4.54 ± 10.97 min; p = 0.0377) groups. The TST scores at 1-week post-intervention, sleep onset latency, wake after sleep onset, and sleep efficiency were significantly different between the groups. Sleep satisfaction by questionnaire was significantly improved with intervention in the SBB group than that in the SHB and TWB groups. Salivary α-amylase levels significantly improved in the SBB and TWB groups than in the SHB group, with the change being greater in the SBB group. Conclusions: SBB for 7 days had positive effects that improved sleep quality of adults. Further studies are needed to examine the efficacy and safety of SBB for prolonged usage in people diagnosed with insomnia, using objective sleep measurements, and to investigate potential sleep-enhancing mechanisms of action.
Chapter
The respiratory system is particularly susceptible to complications of cancer and cancer therapy. This vulnerability arises from the stringent architectural requirements for gas exchange, the continuous exposure of the respiratory tract to the external environment, and the severe symptoms that can accompany respiratory compromise. Gas exchange requires patent airways, an effective musculoskeletal ventilatory pump, a thin alveolocapillary membrane, and adequate blood flow through the pulmonary circulation. In cancer patients, primary and metastatic tumors of the chest compromise major airways; pleural effusions externally compress the lungs and impair diaphragmatic function; direct, hematogenous or lymphangitic spread of tumor replaces functioning lung parenchyma; resectional surgery reduces parenchymal volume; nonresectional surgery can transiently impair lung function; radiotherapy, chemotherapy, stem cell therapy, and infection injure the vulnerable alveolocapillary membrane; tumors directly or indirectly compromise the musculoskeletal pump; venous thromboembolism and pulmonary vasculopathy obstruct pulmonary blood flow. The normal respiratory system contains considerable physiologic reserve, such that surgical loss of one lung is generally well tolerated. However, in cancer patients, insults to multiple components of the respiratory system may result in progressive loss of physiologic reserve and increasing dyspnea. Dyspnea, cough, wheezing, stridor, chest pain, and hemoptysis are common symptoms in the cancer setting that lead to pulmonary consultation. In this article, we will discuss the pathophysiology, diagnosis, and management of the major respiratory complications of cancer and its therapy. We begin with the direct effects of cancer and cancer therapies on the lungs, review major indirect effects of cancer on the lungs, and end with respiratory failure in the cancer patient.
Article
Objectives: Previous studies using objective parameters have shown that irregular sleep is associated with the disease incidence, progression, or mortality. This study aimed to determine the association between subjective sleep duration and sleep regularity, with mortality in a large population. Methods: Participants were from the Japan Multi-Institutional Collaborative Cohort study. We obtained information from each participant on sleep duration, sleep regularity, and demographics and overall lifestyle using self-administered questionnaires. We defined sleep regularity according to participants' subjective assessment of sleep/wake time regularity. Participants (n = 81,382, mean age: 58.1 ± 9.1years, males: 44.2%) were classified into 6 groups according to sleep duration and sleep regularity. Hazard ratios (HR) for time-to-event of death were calculated using the Cox proportional hazards model. Results: The mean follow-up period was 9.1 years and the mean sleep duration was 6.6 h/day. Irregular sleep significantly increased the risk of all-cause mortality in all models compared with regular sleep (HR 1.30, 95% confidence interval; CI, 1.18-1.44), regardless of sleep duration. Multivariable analysis of the 6 groups by sleep pattern (sleep regularity and duration) showed irregular sleep and sleep durations of <6 h/day, 6 to <8 h/day, or ≥8 h/day were associated with a 1.2-1.5-fold increases in mortality, compared to regular sleep and sleep duration of 6 to <8 h/day. Conclusions: Our study shows an association between sleep irregularity and all-cause mortality in a large Japanese population. Our findings provide further confirmation of the need to consider not only sleep duration, but also the regularity aspect of sleep schedules.
Preprint
Full-text available
Background: Previous studies examining the association of sleep duration with general obesity among adults are from western countries, where the patterns of adulthood sleep (shorter or longer sleep durations) and abdominal obesity may be different from Taiwan. Furthermore, the negative associations between sleep duration and abdominal obesity among adults in the existing literature remain controversial. The purpose of this study was to investigate the association between sleep duration and risk of abdominal obesity in Taiwanese adults. Methods: This was a cross-sectional study conducted on 58,238 adults who participated in Taiwan’s National Physical Fitness Survey 2014-2015. Data from a standardized structured questionnaire and anthropometric measures were analyzed. Individuals’ sleep durations were categorized as very short (≤5.0 h), short (5.1–6.0 h), optimal (6.1–7.0 h), long (7.1–8.0 h), or very long (>8.0 h). Abdominal obesity was classified according to waist circumference (WC) ≥ 90 cm for men and WC ≥ 80 cm for women. Multiple logistic regression analysis was performed to evaluate the risk factors for abdominal obesity. Results: The multiple logistic regression, using the optimal sleep duration as a baseline, indicated significant associations between very short (OR = 1.14, 95% CI: 1.02-1.27), short (OR = 1.11, 95% CI: 1.04-1.19) and very long (OR = 1.09, 95% CI: 1.02-1.18) sleep durations and abdominal obesity after adjusting for potential confounding factors. Conclusions: Our findings suggest that subjects with shorter or longer sleep durations have a much higher risk of abdominal obesity than those with optimal sleep durations. Shorter sleep durations may result in higher risk for abdominal obesity than longer sleep durations.
Article
Full-text available
The purpose of the study was to measure changes in sleep quality and perceived stress 28 and their interrelationships in a sample of healthcare workers two years post the COVID-19 pan-29 demic. Using a cohort design, data were collected from frontline healthcare workers (FLHCW, n = 30 70) and non-frontline healthcare workers (NFLHCW, n = 74) in April 2020 (T1) and in February 2022 31 (T2). The Pittsburgh Sleep Quality Index (PSQI) and the Perceived Stress Scale (PSS-10) were ad-32 ministered at both time points. There were no differences in sleep quality or perceived stress be-33 tween FLHCW and NFLHCW at either timepoint. For the entire sample, the PSQI scores at T2 were 34 significantly higher than at T1 (7.56 ± 3.26 and 7.25 ± 3.29, respectively) p = 0.03, Cohen's d = 0.18. 35 PSS-10 scores at T2 were significantly lower than at T1 (19.85 ± 7.73 and 21.13 ± 7.41, respectively) p 36 = 0.001, Cohen's d = 0.78. Baseline sleep quality PSQI (T1) was a significant predictor for changes in 37 sleep quality. During the initial months of the outbreak of the COVID-19 pandemic, poor sleep 38 quality and perceived stress were common for healthcare workers. Two years into the pandemic, 39 perceived stress was reduced, but sleep quality worsened. 40 41
Article
Full-text available
Background Inadequate sleep is associated with many detrimental health effects, including increased risk of developing insulin resistance and type 2 diabetes. These effects have been associated with changes to the skeletal muscle transcriptome, although this has not been characterised in response to a period of sleep restriction. Exercise induces a beneficial transcriptional response within skeletal muscle that may counteract some of the negative effects associated with sleep restriction. We hypothesised that sleep restriction would down-regulate transcriptional pathways associated with glucose metabolism, but that performing exercise would mitigate these effects. Methods 20 healthy young males were allocated to one of three experimental groups: a Normal Sleep (NS) group (8 h time in bed per night (TIB), for five nights (11 pm – 7 am)), a Sleep Restriction (SR) group (4 h TIB, for five nights (3 am – 7 am)), and a Sleep Restriction and Exercise group (SR+EX) (4 h TIB, for five nights (3 am – 7 am) and three high-intensity interval exercise (HIIE) sessions (performed at 10 am)). RNA sequencing was performed on muscle samples collected pre- and post-intervention. Our data was then compared to skeletal muscle transcriptomic data previously reported following sleep deprivation (24 h without sleep). Results Gene set enrichment analysis (GSEA) indicated there was an increased enrichment of inflammatory and immune response related pathways in the SR group post-intervention. However, in the SR+EX group the direction of enrichment in these same pathways occurred in the opposite directions. Despite this, there were no significant changes at the individual gene level from pre- to post-intervention. A set of genes previously shown to be decreased with sleep deprivation was also decreased in the SR group, but increased in the SR+EX group. Conclusion The alterations to inflammatory and immune related pathways in skeletal muscle, following five nights of sleep restriction, provide insight regarding the transcriptional changes that underpin the detrimental effects associated with sleep loss. Performing three sessions of HIIE during sleep restriction attenuated some of these transcriptional changes. Overall, the transcriptional alterations observed with a moderate period of sleep restriction were less evident than previously reported changes following a period of sleep deprivation.
Article
Epidemiologic studies have demonstrated that short sleep duration is associated with an increased risk of cardio-metabolic health outcomes including cardiovascular disease mortality, coronary heart disease, type 2 diabetes mellitus, hypertension, and metabolic syndrome. Experimental sleep restriction studies have sought to explain these findings. This review describes the main evidence of these associations and possible mechanisms explaining them. Whether sleep extension reverses these now widely acknowledged adverse health effects and the feasibility of implementing such strategies on a public health level is discussed.
Article
Importance: Historically marginalized racial and ethnic groups are generally more likely to experience sleep deficiencies. It is unclear how these sleep duration disparities have changed during recent years. Objective: To evaluate 15-year trends in racial and ethnic differences in self-reported sleep duration among adults in the US. Design, setting, and participants: This serial cross-sectional study used US population-based National Health Interview Survey data collected from 2004 to 2018. A total of 429 195 noninstitutionalized adults were included in the analysis, which was performed from July 26, 2021, to February 10, 2022. Exposures: Self-reported race, ethnicity, household income, and sex. Main outcomes and measures: Temporal trends and racial and ethnic differences in short (<7 hours in 24 hours) and long (>9 hours in 24 hours) sleep duration and racial and ethnic differences in the association between sleep duration and age. Results: The study sample consisted of 429 195 individuals (median [IQR] age, 46 [31-60] years; 51.7% women), of whom 5.1% identified as Asian, 11.8% identified as Black, 14.7% identified as Hispanic or Latino, and 68.5% identified as White. In 2004, the adjusted estimated prevalence of short and long sleep duration were 31.4% and 2.5%, respectively, among Asian individuals; 35.3% and 6.4%, respectively, among Black individuals; 27.0% and 4.6%, respectively, among Hispanic or Latino individuals; and 27.8% and 3.5%, respectively, among White individuals. During the study period, there was a significant increase in short sleep prevalence among Black (6.39 [95% CI, 3.32-9.46] percentage points), Hispanic or Latino (6.61 [95% CI, 4.03-9.20] percentage points), and White (3.22 [95% CI, 2.06-4.38] percentage points) individuals (P < .001 for each), whereas prevalence of long sleep changed significantly only among Hispanic or Latino individuals (-1.42 [95% CI, -2.52 to -0.32] percentage points; P = .01). In 2018, compared with White individuals, short sleep prevalence among Black and Hispanic or Latino individuals was higher by 10.68 (95% CI, 8.12-13.24; P < .001) and 2.44 (95% CI, 0.23-4.65; P = .03) percentage points, respectively, and long sleep prevalence was higher only among Black individuals (1.44 [95% CI, 0.39-2.48] percentage points; P = .007). The short sleep disparities were greatest among women and among those with middle or high household income. In addition, across age groups, Black individuals had a higher short and long sleep duration prevalence compared with White individuals of the same age. Conclusions and relevance: The findings of this cross-sectional study suggest that from 2004 to 2018, the prevalence of short and long sleep duration was persistently higher among Black individuals in the US. The disparities in short sleep duration appear to be highest among women, individuals who had middle or high income, and young or middle-aged adults, which may be associated with health disparities.
Article
Full-text available
This study examined a cross-sectional association between self-reported low back pain (LBP) and unemployment among working-age people, and estimated the impact of self-reported LBP on unemployment. We used anonymized data from a nationally representative survey (24,854 men and 26,549 women aged 20-64 years). The generalized estimating equations of the multivariable Poisson regression models stratified by gender were used to estimate the adjusted prevalence ratio (PR) and 95% confidence interval (CI) for unemployment. The population attributable fraction (PAF) was calculated using Levin's method, with the substitution method for 95% CI estimation. The prevalence of self-reported LBP was 9.0% in men and 11.1% in women. The prevalence of unemployment was 9.3% in men and 31.7% in women. After adjusting for age, socio-economic status, lifestyle habits, and comorbidities, the PR (95% CI) for the unemployment of the LBP group was 1.32 (1.19-1.47) in men and 1.01 (0.96-1.07) in women, compared with the respective non-LBP group. The PAF (95% CI) of unemployment associated with self-reported LBP was 2.8% (1.6%, 4.2%) in men. Because the total population of Japanese men aged 20-64 in 2013 was 36,851 thousand, it was estimated that unemployment in 1037 thousand of the Japanese male working population was LBP-related.
Article
Full-text available
Importance The association between long sleep duration and mortality appears stronger in East Asian populations than in North American or European populations. Objectives To assess the sex-specific association between sleep duration and all-cause and major-cause mortality in a pooled longitudinal cohort and to stratify the association by age and body mass index. Design, Setting, and Participants This cohort study of individual-level data from 9 cohorts in the Asia Cohort Consortium was performed from January 1, 1984, to December 31, 2002. The final population included participants from Japan, China, Singapore, and Korea. Mean (SD) follow-up time was 14.0 (5.0) years for men and 13.4 (5.3) years for women. Data analysis was performed from August 1, 2018, to May 31, 2021. Exposures Self-reported sleep duration, with 7 hours as the reference category. Main Outcomes and Measures Mortality, including deaths from all causes, cardiovascular disease, cancer, and other causes. Sex-specific hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards regression with shared frailty models adjusted for age and the key self-reported covariates of marital status, body mass index, smoking status, alcohol consumption, physical activity, history of diabetes and hypertension, and menopausal status (for women). Results For 322 721 participants (mean [SD] age, 54.5 [9.2] years; 178 542 [55.3%] female), 19 419 deaths occurred among men (mean [SD] age of men, 53.6 [9.0] years) and 13 768 deaths among women (mean [SD] age of women, 55.3 [9.2] years). A sleep duration of 7 hours was the nadir for associations with all-cause, cardiovascular disease, and other-cause mortality in both men and women, whereas 8 hours was the mode sleep duration among men and the second most common sleep duration among women. The association between sleep duration and all-cause mortality was J-shaped for both men and women. The greatest association for all-cause mortality was with sleep durations of 10 hours or longer for both men (hazard ratio [HR], 1.34; 95% CI, 1.26-1.44) and women (HR, 1.48; 95% CI, 1.36-1.61). Sex was a significant modifier of the association between sleep duration and mortality from cardiovascular disease (χ²5 = 13.47, P = .02), cancer (χ²5 = 16.04, P = .007), and other causes (χ²5 = 12.79, P = .03). Age was a significant modifier of the associations among men only (all-cause mortality: χ²5 = 41.49, P < .001; cancer: χ²5 = 27.94, P < .001; other-cause mortality: χ²5 = 24.51, P < .001). Conclusions and Relevance The findings of this cohort study suggest that sleep duration is a behavioral risk factor for mortality in both men and women. Age was a modifier of the association between sleep duration in men but not in women. Sleep duration recommendations in these populations may need to be considered in the context of sex and age.
Article
Objective: Nocturnal hypertension and nondipping systolic blood pressure (SBP) are associated with increased cardiovascular disease (CVD) risk. Short and long sleep duration (SSD and LSD) are also associated with increased CVD risk and may be risk factors for nocturnal hypertension and nondipping SBP. We examined the association between SSD and LSD with sleep BP, nocturnal hypertension, and nondipping SBP among 647 white and African American Coronary Artery Risk Development in Young Adults (CARDIA) study participants who completed 24-h ambulatory BP monitoring, wrist actigraphy, and sleep diaries in 2015-2016. Methods: The times when participants were asleep and awake were determined from actigraphy complemented by sleep diaries. Nocturnal hypertension was defined as sleep BP ≥120/70 mmHg and nondipping SBP as mean sleep-to-awake SBP ratio >0.90. Sleep duration was categorized as SSD (<6 h), normal sleep duration (NSD: 6-8.9 h), and LSD (≥9 h). Results: The prevalence of SSD and LSD were 13.9 and 21.1%, respectively. Compared to participants with NSD, participants with LSD had higher mean sleep SBP (2.1 mmHg, 95% confidence interval [CI] 0.2, 4.1 mmHg) and diastolic BP (1.7 mmHg, 95% CI 0.5, 3.0 mmHg). Participants with LSD had a higher prevalence of nocturnal hypertension (prevalence ratio [PR]: 1.26, 95% CI 1.03-1.54) and nondipping SBP (PR 1.33, 95% CI 1.03-1.72) compared to participants with NSD. There was no evidence of an association between SSD and sleep SBP or DBP, nocturnal hypertension, or nondipping SBP. Conclusions: These findings suggest that LSD may be associated with nocturnal hypertension and nondipping SBP.
Article
Using data for over 2.5 million individuals in the United States over the period 2006-2019 from the Behavioral Risk Factor Surveillance System (BRFSS) survey series we show the unemployed suffer sleep disruption. The unemployed suffer more short and long sleep than the employed and are more likely to suffer from disturbed sleep. These are especially problematic for the long-term unemployed and for the jobless who say they are unable to work. Similar findings on unemployment and poor sleep quality are found in European data. Increases in the unemployment rate raise the incidence of short sleep and lower sleep durations.
Chapter
In this study, we propose an agent that guides elderly people to bed and supports better sleep through visual, voice, and tactile sense presentation. The system is mainly based on the following: 1) a visual presentation part that shows a agent approaching to bed, and getting into bed, to guide the user go to bed and sleep; and 2) a tactile presentation part that imitates the arm and body of the person lying down and that is equipped in a blanket. To draw the user to the bed in order to sleep, the agent presents a voice-like sound to notify bedtime, guides the user to the bed, and gives the user a tactile sense, such as a hug or a light tap via our blanket-type device, as though someone who cares for the user is actually there. Mental stability and sleep are expected to be drawn by the system. According to the experimental results, both the visual expression and tactile representation of simulated hugs and patting have an effect on the user’s mental stability, whereas the tactile stimulation of patting gives the user a sense of healing and comfort. Therefore, the proposed agent is considered effective to make the user comfortable.
Article
Full-text available
Background The present study investigated the association between two domains of physical activity (occupational physical activity [OPA] and leisure-time physical activity [LTPA]) and sleep duration. Methods We investigated 3,421 paid workers from the Korea National Health and Nutrition Examination Survey, 2014–2015. Sleep duration was categorized into three categories (short for less than 5 h, optimal for 5–9 h, and long for more than 9 h). OPA and LTPA were defined in terms of answers to relevant questions. Odds ratios were calculated for sleep duration according to each physical activity domain using multinomial logistic regression models. Results There were 464 subjects (13.6%) who showed short sleep duration, and 169 subjects (4.9%) who showed long sleep duration. Prevalence of OPA and LTPA was higher in male workers than in female workers (for OPA: 3.67% and 1.76%, respectively, p = 0.0108; for LTPA: 16.14% and 6.07%, respectively, p < 0.0001). The odds ratio of OPA for long sleep duration in female workers was 3.35 (95% confidence interval, 1.37–8.21). Otherwise, LTPA was not associated with sleep duration in female paid workers, nor both physical activity domains in male paid workers. Conclusion Female paid workers with work-related physical activity were at risk of oversleeping. These findings also suggested that physical activity has distinct associations with sleep duration according to the physical activity domains and sex.
Article
Full-text available
The circadian rhythm plays a fundamental role in regulating biological functions, including sleep-wake preference, body temperature, hormonal secretion, food intake, and cognitive and physical performance. Alterations in circadian rhythm can lead to chronic disease and impaired sleep. The circadian rhythmicity in human beings is represented by a complex phenotype. Indeed, over a 24-h period, a person's preferred time to be more active or to sleep can be expressed in the concept of morningness-eveningness. Three chronotypes are distinguished: Morning, Neither, and Evening-types. Interindividual differences in chronotypes need to be considered to reduce the negative effects of circadian disruptions on health. In the present review, we examine the bi-directional influences of the rest-activity circadian rhythm and sleep-wake cycle in chronic pathologies and disorders. We analyze the concept and the main characteristics of the three chronotypes.
Article
Objective: Sleep duration is an important health indicator. Our aim was to investigate the association between maternal sleep duration and infant birthweight. Methods: The study included 2,536 mother-infant pairs of a Spanish birth cohort (2004-2006, INMA project). The exposures were questionnaire-based measures of sleep duration before and during pregnancy. The primary outcome was infant birthweight score (g) standardized to 40 weeks of gestation. Results: In women sleeping less than 7 hours per day before pregnancy, each additional hour of sleep increased birthweight score by 44.7 g (p = 0.049) in the minimally-adjusted model, although findings were not statistically significant after considering other potential confounders (p > 0.05). However, increasing sleep duration for the group of mothers who slept more than 9 hours per day decreased birthweight score by 39.2 g per additional hour (p = 0.001). Findings were similar after adjusting for several socio-demographic confounders and maternal depression-anxiety clinical history as an intermediate factor. Similar but attenuated associations were observed with sleep duration in the second pregnancy trimester. Conclusion: The relationship between maternal sleep duration before and during pregnancy and infant birthweight is an inverse U-shaped curve. Excessive sleep duration may adversely affect infant health through its impact on birthweight.
Article
Résumé Un sommeil long est prédictif d’un surcroît de mortalité, avec une relation effet-dose, indépendamment de l’âge et du sexe, et en particulier de la mortalité d’origine cardiovasculaire. La définition d’un temps de sommeil long et ses modes d’évaluation sont assez variables selon les études. Plusieurs méta-analyses d’études prospectives ont montré l’augmentation du risque de coronaropathie, d’accident vasculaire cérébral, d’arythmie cardiaque. En revanche, concernant l’HTA ou la dyslipidémie les données sont peu probantes. Si le rôle des comorbidités cardiovasculaires à l’origine a pu être éliminé, il existe de nombreux facteurs confondants d’un temps de sommeil long et d’un surcroît de morbi-mortalité cardiovasculaire. C’est le cas pour les troubles de l’humeur et les traitements psychotropes, la sédentarité et certains facteurs socioéconomiques. Des facteurs biologiques (inflammation) ou génétiques peuvent également y contribuer. Les recommandations américaines de durée de sommeil pour l’adulte se situent entre 7 h et 9 h ou 7 h et 8 h selon la tranche d’âge. Limiter sa durée de sommeil pour les personnes qui ont un temps de sommeil long permettrait-il de baisser la mortalité, en particulier cardiovasculaire ? Cela reste à démontrer.
Chapter
Physical activity is a key determinant of metabolic control and is commonly recommended for people with non-alcoholic fatty liver disease (NAFLD), usually alongside weight loss and dietary change. Physical activity and exercise have both been shown to improve liver health in NAFLD and should be included as part of the clinical care of all patients, regardless of where they sit on the NAFLD disease spectrum [1]. Reducing or breaking up sedentary time should also be a key therapeutic target with these patients.
Article
Objectives Although hearing has been shown to interact with sleep, the underlying mechanisms for the interaction remain largely unclear. In the absence of knowledge about the neural pathways that are associated with hearing-sleep interaction, this study aimed to examine whether the auditory radiation, the final portion of the auditory pathway from the cochlea to the cerebral cortex, shows association with sleep duration. Methods Using Diffusion Tensor Imaging (DTI) data from enhanced Nathan Kline Institute-Rockland Sample (NKI-RS), we isolated the white matter tracts between the medial geniculate nucleus of the thalamus and Heschl’s gyrus in each individual subject (N = 465) using probabilistic tractography. As a measure of the white matter microstructure integrity, the mean fractional anisotropy (FA) of the whole auditory radiation was examined and tested for an association with sleep length in the Pittsburgh Sleep Assessment Index. Results A significant inverse-U shaped association was found between the auditory radiation FA and sleep duration. Discussion It is suggested that the auditory radiations are a part of the pathway mediating the sleep-hearing interaction. Although the current study does not resolve the causal relationship between hearing and sleep, it would be the first evidence that the auditory radiation is associated with sleep duration
Article
Full-text available
Objective: Sleep duration is an important predictor of cardiovascular health outcomes, but the role of sleep efficiency is less clear. This study investigated actigraphy-assessed sleep efficiency and sleep duration and their relationship with responses to mental and physical challenge tasks. Methods: To record sleep, actigraph devices were worn on the wrist continuously by 25 participants (age: 33.9±6.9, 60% female) for the duration of a seven-day period. Movement data were used to estimate sleep duration and efficiency. Mental (Stroop test) and physical (cold pressor) challenges were used to assess reactivity to and recovery from stress. During these tasks, heart rate, blood pressure, and emotional states were measured. Results: Significant findings from the mental challenge included a negative correlation between sleep efficiency and reaction time. There were no significant relationships between sleep efficiency and cardiovascular measures during the mental challenge, but sleep duration was related to cardiovascular reactivity. For the physical challenge, sleep efficiency was positively and significantly correlated with blood pressure recovery and sleep duration was not related to any outcome measures. Discussion: Previous literature has focused on sleep duration when assessing sleep and cardiovascular outcomes. However, sleep efficiency may be equally or more important when investigating reactivity to and recovery from stress.
Article
Objective This study aimed to examine the relationship between sleep duration and all-cause mortality, and to assess the role of cognitive impairment, physical disability, and chronic conditions on this association among very old adults. Design A prospective cohort study. Setting and Participants Within the Chinese Longitudinal Healthy Longevity Surveys, 17,637 oldest-old aged 80-105 years were followed up to 10 years (2005- 2014). Measures Data on sleep duration at baseline were based on self-report and were categorized as short (<7 hour), moderate (7-9 hours), and long sleep (>9 hours). Information on cognitive function using the Mini-Mental State Examination (MMSE), physical disability using Activities of Daily Living (ADL), and chronic conditions including diabetes, heart disease, stroke, asthma, and cancer were collected at baseline based on a structured questionnaire. Information about vital status was ascertained and confirmed by a close family member or village doctor of the participant during the follow-up. Data were analyzed using Cox proportional hazards models, with adjustment for potential confounders. Results During the follow-up of 10 years, 11,067 (62.7%) participants died. The multivariate-adjusted hazard ratios (HRs) with 95% confidence interval (CI) for mortality were 1.03 (0.98-1.09) for short sleep and 1.13 (1.08-1.18) for long sleep compared with moderate sleep duration. In stratified analysis by cognitive impairment, physical disability, and chronic conditions, the risk of morality was present only among people with MMSE scores ≤24 but did not differ much when stratified by physical disability and chronic conditions. There was a statistically significant interaction between long sleep and cognitive impairment on mortality (P for interaction = .002). Conclusions and Implications Long sleep duration is associated with higher risk of mortality in very old adults independently of health conditions. Cognitive impairment may enhance this association. These findings suggest that health practitioners and families should be aware of the potential adverse prognosis associated with long sleep.
Article
Full-text available
We studied the association between behavioral and demographic risk factors and 17-year mortality in members of the Alameda County (California) Study who were 60-94 years of age at baseline. In this age group, increased risk of death is associated with being male, smoking, having little leisure-time physical activity, deviating from moderate weight relative to height, and not regularly eating breakfast. These increased risks were independent of age, race, socioeconomic position (SEP), other behavioral risk factors, and baseline physical health status. Further examination of the group aged 70 or more revealed the same patterns of heightened risk.
Article
Full-text available
Patients often complain about insufficient sleep or chronic insomnia in the belief that they need 8 hours of sleep. Treatment strategies may be guided by what sleep durations predict optimal survival and whether insomnia might signal mortality risks. In 1982, the Cancer Prevention Study II of the American Cancer Society asked participants about their sleep duration and frequency of insomnia. Cox proportional hazards survival models were computed to determine whether sleep duration or frequency of insomnia was associated with excess mortality up to 1988, controlling simultaneously for demographics, habits, health factors, and use of various medications. Participants were more than 1.1 million men and women from 30 to 102 years of age. The best survival was found among those who slept 7 hours per night. Participants who reported sleeping 8 hours or more experienced significantly increased mortality hazard, as did those who slept 6 hours or less. The increased risk exceeded 15% for those reporting more than 8.5 hours sleep or less than 3.5 or 4.5 hours. In contrast, reports of "insomnia" were not associated with excess mortality hazard. As previously described, prescription sleeping pill use was associated with significantly increased mortality after control for reported sleep durations and insomnia. Patients can be reassured that short sleep and insomnia seem associated with little risk distinct from comorbidities. Slight risks associated with 8 or more hours of sleep and sleeping pill use need further study. Causality is unproven.
Article
The prevalence of sleep complaints and somatic diseases was estimated in a random sample of 4064 Swedish men aged 30-69 years. Great difficulty initiating sleep (DIS) was experienced by 6.9% and moderate problems in DIS by 14.3%. Complaints of major difficulty maintaining sleep (DMS) were reported by 7.5% of the men and of moderate DMS by 14.9%. DMS was more frequent with increasing age. Excessive daytime sleepiness (EDS) was reported by 5.7%. Altogether 879 men were attending regular medical examinations for somatic diseases. Among the 299 hypertensive men, major complaints of DMS (13.5%), DIS (8.4%) and EDS (8.8%) were more common, but the 167 men treated with beta-blockers rather showed a proportionally somewhat lower prevalence of sleep complaints. Men with obstructive pulmonary disease (n = 113) had a higher prevalence of DMS (18.8%) and EDS (12.4%). Diabetic men (n = 74) complained also more often of DMS (21.9%), DIS (21.1%) and EDS (12.2%). Men with rheumatic disease (n = 176) and obesity (n = 221) also had increased prevalence of sleep complaints.
Article
Prospective epidemiologic data of the American Cancer Society disclosed that reported usual sleep durations among groups who complained of insomnia and sleeping pill use "often" overlapped with those of groups who had no complaints. Reports of insomnia were not consistently associated with increased mortality when several factors were controlled; however, men who reported usually sleeping less than four hours were 2.80 times as likely to have died within six years as men who reported 7.0 to 7.9 hours of sleep. The ratio for women was 1.48. Men and women who reported sleeping ten hours or more had about 1.8 times the mortality of those who reported 7.0 to 7.9 hours of sleep. Those who reported using sleeping pills "often" had 1.5 times the mortality of those who "never" used sleeping pills. These results do not prove that mortality could be reduced by altering sleep durations or by reducing hypnotic prescribing. Rather, studies are needed to determine the causes of these mortality risk factors.
Article
To re-assess relationships between mortality, hypnotic use, subjective insomnia, and sleep duration. A prospective study examining 5-year mortality among hypnotic drug users and respondents with subjective insomnia identified in a longitudinal study of health, activity, and lifestyle (Nottingham Longitudinal Study of Activity and Ageing). General community. 1042 survey respondents, aged over 65 years, randomly selected from the community and stratified at age 75 years. Recorded mortality. During the 5-year period, 352 respondents died. The mortality rate was significantly greater among those taking some form of medication for sleep (n = 208) than for those not taking sleep medication (n = 812; chi-square = 4.91, df = 1, P = 0.027). When sleep medication users were categorized as either "hypnotic users" (ie, users of medication with recognized hypnotic or sedative actions) or "other users" (including analgesics and other over-the-counter medicines), only "other users" showed significant excess mortality (chi-square = 7.27, df = 1, P = 0.007). Logistic regression showed that "other users" were 2.5 times more likely to die than "non-users" even when gender, health risk, and usual sleep duration were controlled. There were no significant relationships between mortality and subjective insomnia or reported duration of sleep. Earlier reported relationships between excess mortality and use of medication for sleep are replicated in this study. Among elderly people, however, this relationship does not derive from the pharmacological characteristics of prescription hypnotics. Rather, it appears that reported self-medication to promote sleep, using a variety of non-sedative products, provides an epidemiological "marker" for a group within which levels of morbidity and mortality are particularly high. Excess mortality associated with very short or long sleep duration was not replicated in this study. Overall, these findings provide little epidemiological support for a wide-spread interaction between benzodiazepine hypnotic use and sleep disordered breathing in old age.
Article
In 1984–85, 1855 elderly residents of an urban community responded to a comprehensive baseline interview that included questions regarding an extensive set of sleep characteristics and problems. During the subsequent 3 1/2 years of follow-up, 16.7% of the respondents died and 3.5% were placed in nursing homes. The predictive significance of each sleep characteristic for mortality and for nursing home placement was determined separately for males and females, using Cox proportional hazards models. Selected demographic and psychosocial variables were also entered into the models. Age, problems with activities of daily living (ADL), self-assessed health, income, cognitive impairment, depression and whether respondents were living alone were controlled for statistically. Of the many variables analyzed, in males insomnia was the strongest predictor of both mortality and nursing home placement. For mortality, the relative hazard associated with insomnia exceeded the hazards associated with age, ADL problems, fair-poor health and low income. For nursing home placement, the hazard associated with insomnia exceeded that associated with cognitive impairment. The relationships of insomnia to mortality and nursing home placement were U-shaped, with a worse outcome if insomnia complaints over the preceding 2 weeks were either prominent (numerous or frequent) or absent. For females, insomnia was a borderline predictor of mortality and did not predict nursing home placement at all. Symptoms of the restless legs syndrome predicted mortality for females in some Cox regression models. Reported sleep duration, symptoms of sleep apnea and frequent use of hypnotic drugs did not predict mortality or nursing home placement in either sex.
Article
This paper continues the analysis previously reported of physical health status in an adult population and its relationship to various independent variables. Data for the study were gathered by questionnaires completed by a probability-based sample of adult residents of Alameda County, California, in 1965.Physical health is measured along a spectrum ranging from severe disability to high energy level with absence of chronic conditions or symptoms. The “ridit” which places each individual along the spectrum can be averaged for comparison of groups, and can be adjusted for differences due to age and sex.This paper examines the relation between common health practices, including hours of sleep, regularity of meals, physical activity, smoking and drinking, and physical health status. Good practices are shown to be associated with positive health, and the relationship of these activities was cumulative; those who followed all of the good practices being in better health, even though older, than those who failed to do so. This association was found to be independent of age, sex, and economic status.
Article
The mortality risk associated with different sleeping patterns was assessed by use of the 1965 Human Population Laboratory survey of a random sample of 6928 adults in Alameda County, CA and a subsequent 9-year mortality follow-up. The analysis indicates that mortality rates from ischemic heart disease, cancer, stroke, and all causes combined were lowest for individuals sleeping 7 or 8 h per night. Men sleeping 6 h or less or 9 h or more had 1.7 times the total age-adjusted death rate of men sleeping 7 or 8 h per night. The comparable relative risk for women was 1.6. The association between sleeping patterns and all causes of mortality was found to be independent of self-reported trouble sleeping and self-reported physical health status at the time of the 1965 survey. Simultaneous adjustment for age, sex, race, socioeconomic status, physical health status, smoking history, physical inactivity, alcohol consumption, weight status, use of health services, social networks, and life satisfaction reduced the relative mortality risk associated with sleeping patterns to 1.3 (p less than or equal to 0.04).
Article
Self-reported habitual sleep time is an important variable because short and long sleep times are associated with mortality. Speculation with regard to these results usually focuses on physical health, rather than psychological factors. We investigated the role of anxiety and depression in reports of habitual sleep times by examining the relative and absolute discrepancy between individuals' initial estimates of their sleep times and sleep diaries made over a 2-week period. Results indicated that depressed mood was associated not only with a tendency initially to underestimate length of sleep (relative discrepancy), but also to exaggerate reported sleep time regardless of direction (absolute discrepancy). These results imply that studies that examine relationships between reported sleep times and mortality should take mental health factors into account.
Article
Habitual sleep patterns may independently affect morbidity and mortality. However, the effect of habitual sleep patterns on the risk for stroke and coronary heart disease is unclear. We evaluated the association between sleep duration and daytime somnolence (often or almost always taking daytime naps) with the incidence of stroke and coronary heart disease in a national cohort of 7,844 adults who participated in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Cox proportional hazards analyses were used to examine these relationships during the 10-year follow-up. After adjusting for differences in age, race, gender, education, cigarette smoking, body mass index, serum cholesterol, systolic blood pressure, and diabetes mellitus, the risk for stroke was increased in persons who reported sleeping greater than 8 hours at night compared with persons who slept between 6 and 8 hours (relative risk [RR] = 1.5, 95% confidence interval [CI] = 1.1 to 2.0). Daytime somnolence was also associated with stroke incidence (RR = 1.4, 95% CI = 1.1 to 1.8). Persons who reported both greater than 8 hours of sleep and daytime somnolence were at the greatest risk for stroke (RR = 1.9, 95% CI = 1.2 to 3.1). Similar results were also found for coronary heart disease, although the results did not reach statistical significance in the multivariate adjusted model. Habitual sleep patterns have significant effects on the risk for stroke.
Article
Chronic sleep debt is becoming increasingly common and affects millions of people in more-developed countries. Sleep debt is currently believed to have no adverse effect on health. We investigated the effect of sleep debt on metabolic and endocrine functions. We assessed carbohydrate metabolism, thyrotropic function, activity of the hypothalamo-pituitary-adrenal axis, and sympathovagal balance in 11 young men after time in bed had been restricted to 4 h per night for 6 nights. We compared the sleep-debt condition with measurements taken at the end of a sleep-recovery period when participants were allowed 12 h in bed per night for 6 nights. Glucose tolerance was lower in the sleep-debt condition than in the fully rested condition (p<0.02), as were thyrotropin concentrations (p<0.01). Evening cortisol concentrations were raised (p=0.0001) and activity of the sympathetic nervous system was increased in the sleep-debt condition (p<0.02). Sleep debt has a harmful impact on carbohydrate metabolism and endocrine function. The effects are similar to those seen in normal ageing and, therefore, sleep debt may increase the severity of age-related chronic disorders.
Article
As part of the baseline examination in the Cardiovascular Health Study, sleep disturbance symptoms including snoring and daytime sleepiness, were assessed as potential risk factors or precipitants of cardiovascular disease (CVD). Because of the association of sleep disturbance with poorer health and the possible associations of sleep apnea with CVD, we hypothesized that those with poorer sleep or daytime sleepiness may be at increased risk of mortality or incident CVD. Participants (n = 5888) were recruited in 1989, with an additional minority cohort recruited in 1993, in four US communities for a cohort study designed to evaluate risk factors for cardiovascular disease. An interview-administered questionnaire regarding health and sleep habits with ongoing ascertainment of total mortality and cardiovascular disease morbidity and mortality, including total CVD morbidity and mortality, incident myocardial infarction, and congestive heart failure. Daytime sleepiness was the only sleep symptom that was significantly associated with mortality in both men and women. The unadjusted hazard ratio was 2.12 (1.66, 2.72) in women and 1.40 (1.12, 1.73) in men. Men who reported difficulty falling asleep also had an increased mortality rate (HR = 1.43 (1.14, 1.80)) which was not seen in women. The risks were attenuated with adjustment for age but remained significant for daytime sleepiness in women (HR = 1.82 (1.42, 2.34)) and for difficulty falling asleep in men. (HR = 1.29 (1.03, 1.63)). Frequent awakenings, early morning awakening, and snoring were not associated with a significantly increased risk of mortality in these older men and women. Crude event rates were evaluated for total incident cardiovascular morbidity and mortality, incident myocardial infarction, and incident congestive heart failure (CHF). Incident CVD rates were higher in both men and women with daytime sleepiness. The aged adjusted HR was 1.35 (95% CI = 1.03, 1.76) in men and was 1.66 (95% CI = 1.28, 2.16) in women. Incident CVD was not higher in those with any other sleep disturbance including snoring. The risk of CVD events associated with daytime sleepiness was attenuated but remained significant in women after adjustment for age. Incident myocardial infarction (MI) rates were also higher in women with daytime sleepiness but were not significantly higher in men. Incident CHF rates were increased in both men and women with daytime sleepiness. In men, the age adjusted HR was 1.49 (95% CI, 1.12- 1.98) and in women, was 2.21 (95% CI, 1.64-2.98). Women reporting both daytime sleepiness and frequent awakening had a hazard ratio of 2.34 (95% CI, 1.66-3.29) for incident CHF compared with those with daytime sleepiness but without frequent awakening. This interaction was not found in men. In this study, daytime sleepiness was the only sleep disturbance symptom that was associated with mortality, incident CVD morbidity and mortality, MI, and CHF. These findings were stronger in women than men, i.e., the associations persisted for mortality, CVD, and CHF in women after adjustment for age and other factors. Thus, a report of daytime sleepiness identifies older adults at increased risk for total and cardiovascular mortality, and is an independent risk factor in women.
Article
A population-based cohort study was conducted to assess the relationship between total mortality and self-reported sleep patterns as regards not only to sleep duration but also subjective sleep quality. A total of 5,322 inhabitants in Gifu Prefecture, Japan, completed a self-administered questionnaire on health status and lifestyles including habitual sleep patterns, and were followed-up for an average of 11.9 years. Relative risks were computed by using Cox proportional hazards models. Both longer and shorter sleep, compared to 7-8 hour-sleep, was related to significantly increased risk of total mortality in males (relative risk [RR] for > or = 10 hours = 1.94, and RR for < 7 hour = 1.90), but not in females. Females complaining of poor awakening state experienced a higher mortality risk compared to those who woke up normally (RR: 1.97). Males who usually fell asleep easily showed a marginally lower mortality risk compared to those who fell asleep normally (RR: 0.70). Female users of sleeping pills were at an elevated risk (RR: 1.89). These findings were almost unchanged after adjustment for sleep duration and other confounders. Poor self-reported quality of sleep seemed to be associated with an increased risk of mortality independently of sleep duration.
Article
Sleep disturbance is one of the major and unsolved problems in older people. Most of the previous sleep studies rely on self-reported documents, and memory disturbance in older people might bias sleep complaints and health status. Sleep disturbances were studied as a mortality risk. In 272 patients who were aged, infirmed and chronically institutionalized in a skilled-care geriatric hospital, the presence or absence of sleep disturbances were examined by hourly observations of patients over 2 weeks at baseline, and they were prospectively followed up for 2 years to assess mortality. Mortality after 2 years was significantly higher in the nighttime insomnia, daytime sleepiness, and sleep-onset delay groups. Further, adjusted for age, gender and activities of daily living status, the presence of nighttime insomnia and sleep-onset delay remained associated with a higher risk of mortality. Sleep disturbance may be one of the symptoms indicating poor health or functional deficits, and be an independent risk factor for survival.
Article
This paper primarily aimed to overview the rationale for initiating the Japan Collaborative Cohort Study for Evaluation of Cancer Risk Sponsored by Monbusho (Ministry of Education, Science, Sports and Culture of Japan) (JACC Study), by comparing socio-demographic and nutritional changes that were witnessed between 1965 and 1990 in Japan, and also to describe the study design, the follow-up conditions as of the end of 1997, and the frameworks for analyzing the data of the lung, stomach, pancreas and gallbladder/bile duct, based on the approximately 8-year follow-up data. For other major sites such as cancers of the large intestine and liver, an analysis will be started in the fiscal year of 2002. This paper secondarily aimed to be cited as the basic information on the JACC Study when several publications are to be based on.
Article
Only a few prospective surveys have been performed to investigate the relationship between sleep complaints and coronary artery disease (CAD) mortality. This study was conducted to determine whether sleep complaints in a middle-aged population predicted total mortality and CAD mortality. A population-based prospective study. Setting. The County of Dalarna, Sweden. In 1983, a random sample of 1870 subjects aged 45-65 years responded to a postal questionnaire (response rate 70.2%) including questions about sleep complaints and various diseases. Mortality data for the period 1983-95 were collected, and Cox proportional hazard analyses were used to examine the mortality risks. At 12-year follow-up 165 males (18.2%) and 101 females (10.5%) had died. After adjustment for a wide range of important putative risk factors, difficulties initiating sleep (DIS) were related to CAD death in males [relative risk (RR), 3.1; 95% confidence interval (CI), 1.5-6.3; P < 0.01], but not in females. Short or long sleep duration did not influence risk of CAD mortality or total mortality for either gender. Depression in males increased the risk of death attributed to CAD (RR, 3.0; 95% CI, 1.1-8.4; P < 0.05) and total mortality (RR, 2.2; 95% CI, 1.1-4.5; P < 0.05). These results provide evidence that there is an association between difficulties falling asleep and CAD mortality in males.
Article
Although sleep disturbance is a major public health problem in the elderly, few studies have examined the association between sleep disturbance and other related factors in Japan. We examined correlates of sleep disturbance among Japanese elderly. Participants in this cross-sectional study (255 men and 263 women) were those enrolled in a population-based health examination for 65 year-old residents in N City, Japan in 1996 and 1997. Epidemiological data were collected by a self-administered questionnaire. Sleep disturbances were assessed by three common symptoms: difficulty in falling asleep, frequent awakening at night and not feeling rested in the morning. The mean sleep duration was longer in men than in women (7.2 vs 6.8 h, P<0.01), and women reported difficulty in falling asleep more frequently than men (22.4 vs 15.3%, P<0.05). Sleep disturbances were associated with low educational attainment, retirement from work, higher body mass index (BMI), irregular bedtime, history of cardiovascular disease, arthritis or joint pain and prostatic hypertrophy, and lower subjective well-being in men, and the use of sleeping pills and depression in both genders, but not with marital status, residential status, smoking habits, exercise, limited instrumental activity of daily living, and past episode of such chronic diseases as hypertension and stroke. Our study suggests a close association of sleep disturbances among elderly Japanese with several medical/psychiatric health problems that are usually more prevalent in such an age group. Our findings emphasize the realistic need for clinicians to take underlying health problems into consideration when their patients complain of sleep-related symptoms.
Depression as a confounding variable in the estimation of habitual sleep time Sleep Duration as a Predictor of All-Cause Mortality—Tamakoshi et al SLEEP
  • Dl Bliwise
  • L Friedman
  • Yesavage
Bliwise DL, Friedman L, Yesavage JA. Depression as a confounding variable in the estimation of habitual sleep time. J Clin Psychol 1993;49:471-7. Sleep Duration as a Predictor of All-Cause Mortality—Tamakoshi et al SLEEP, Vol. 27, No. 1, 2004 54
Impact of sleep debt on metabolic and endocrine function
  • K Spiegel
  • R Leproult
  • E Van Cauter
Spiegel K. Leproult R, Van Cauter E. Impact of sleep debt on metabolic and endocrine function. Lancet. 1999;354:1435-9.