Article

Inadequate sleep as a risk factor for obesity: Analyses of the NHANES I

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Abstract

Sleep deprivation has been hypothesized to contribute toward obesity by decreasing leptin, increasing ghrelin, and compromising insulin sensitivity. This study examines cross-sectional and longitudinal data from a large United States sample to determine whether sleep duration is associated with obesity and weight gain. Longitudinal analyses of the 1982-1984, 1987, and 1992 NHANES I Followup Studies and cross-sectional analysis of the 1982-1984 study. Probability sample of the civilian noninstitutionalized population of the United States. Sample sizes of 9,588 for the cross-sectional analyses, 8,073 for the 1987, and 6,981 for the 1992 longitudinal analyses. Measured weight in 1982-1984 and self-reported weights in 1987 and 1992. Subjects between the ages of 32 and 49 years with self-reported sleep durations at baseline less than 7 hours had higher average body mass indexes and were more likely to be obese than subjects with sleep durations of 7 hours. Sleep durations over 7 hours were not consistently associated with either an increased or decreased likelihood of obesity in the cross-sectional and longitudinal results. Each additional hour of sleep at baseline was negatively associated with change in body mass index over the follow-up period, but this association was small and statistically insignificant. These findings support the hypothesis that sleep duration is associated with obesity in a large longitudinally monitored United States sample. These observations support earlier experimental sleep studies and provide a basis for future studies on weight control interventions that increase the quantity and quality of sleep.

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... They found that the prevalence of obesity was high among shift workers while waist circumference was not significant. 8,9,10,11,12 On the contrary, a study conducted by Pasqua et al, concluded that there was no noteworthy difference in BMI among shift workers and day workers. 6 Amelsvoort et al, conducted a study and concluded that, subjects involved in rotational shift work for more than 5 years had appreciably higher BMI than those individuals with no shift work experience. ...
... 13 It was also suggested that, individuals who sleep less than 7 hours had an increased BMI and were more obese than those who sleep for 7 hours and more. 11 A recent study has stated that, there are at least three pathways i.e., alterations in pathways of glucose metabolism, up-regulation of appetite and decreased energy expenditure. 14 Various studies have established that the increase in adiposity found in sleep-deprived population is due to the alterations in the plasma Leptin and Ghrelin levels. ...
... 9, 26, 27 Gangwisch et al, concluded that, sleep duration of less than 5 hours is expected to be an augmented risk factor for hypertension among shift workers. 11 A study conducted by Cappuccio et al, suggested that, at baseline, there was no association between sleep duration and hypertension in men 7 ; but women who sleep ≤ 5 h/night had a higher risk of hypertension. 28 On the contrary, a population based Rotterdam study 29 conducted among individuals stated that there is no association found between sleep duration and hypertension in persons aged more than 58 years 30,31 while a prospective cohort study done in Spain proved that there was no connection found in prevalent or incident hypertension in older individuals , above 60 years. ...
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s: Background & Objectives: The cardiovascular disease is one of the major risk factors that account for mortality and morbidity worldwide, more so among the sleep deprived. The aim of this study is to assess cardio metabolic risk among shift working staff nurses at a medical college hospital. Methods: This hospital based cross sectional study was conducted to assess the cardio-metabolic risk among 100 rotational shift workers (staff nurses). A questionnaire was given to collect socio demographic details and sleep duration of the subjects. Anthropometric measurements and biochemical profile namely fasting blood sugar and lipid profile were assessed to identify the cardio-metabolic risk. Results: All the parameters showed significance (p < 0.05) in subjects with shorter sleep duration and increased shift work experience. Interpretation & Conclusion: As the cardio-metabolic risk among shift workers in India is underreported, this study may help in identifying the subjects at risk and provide them with adequate counseling on lifestyle modification.
... Past studies have examined the sex-based heterogeneity between short sleep and obesity (Suglia et al., 2014;Knutson, 2005;Xiao, Arem, Moore, Hollenbeck, & Matthews, 2013;Gangwisch, Malaspina, Boden-Albala, & Heymsfield, 2005). However, associations have not been consistently observed in either males or females. ...
... However, associations have not been consistently observed in either males or females. Some studies, for example, found an increased risk of obesity in females only (Li, 2021;Ning et al., 2020), others reported an J o u r n a l P r e -p r o o f 4 increased risk of obesity exclusively in males (Zhou et al., 2020;Nishiura & Hashimoto, 2010;Watanabe, Kikuchi, Tanaka, & Takahashi, 2010;Suglia, Kara, & Robinson, 2014), neither sex (Gangwisch, Malaspina, Boden-Albala, & Heymsfield, 2005;Stranges et al., 2008;Appelhans et al., 2013) or both (Magee, Iverson, & Caputi, 2010). In part, variability across study findings may reflect differences in the age distribution of study populations-for example, studies have restricted samples to children and adolescents (Suglia et al., 2014;Knutson, 2005;Xiao et al., 2013)-or the use of a non-generalizable US sample (Ning et al., 2020;Zhou et al., 2020;Nishiura & Hashimoto, 2010). ...
... [ Research on the sex-based association between reduced sleep duration and obesity has produced inconsistent results in the literature. Some studies reported an increased risk of obesity exclusively in males (Zhou et al., 2020;Nishiura & Hashimoto, 2010;Watanabe, Kikuchi, Tanaka, & Takahashi, 2010;Suglia, Kara, & Robinson, 2014); others found an increased risk in females only (Li, 2021;Ning et al., 2020); neither sex (Gangwisch, Malaspina, Boden-Albala, & Heymsfield, 2005;Stranges et al., 2008;Appelhans et al., 2013) or both (Magee, Iverson, & Caputi, 2010). A study of 21,958 Chinese adults aged 30-79 years found a significantly higher J o u r n a l P r e -p r o o f 8 risk of obesity among short sleepers (Ning et al., 2020). ...
Article
Background Obesity is an important public health problem in the United States. Identifying modifiable risk factors could guide public health intervention efforts. In this study, we leveraged a nationally representative sample of the US population to examine sex differences in the association between short sleep and obesity among US adults. Methods Publicly available cross-sectional national data were extracted from the National Health and Nutrition Examination Survey, 2015 through 2020. A multivariable survey logistic regression model was fitted for the association between short sleep (defined as less than 7 hours of sleep in 24 hours) and obesity, accounting for sample stratification, clustering, and weighing. Heterogeneity was assessed using interaction terms overall and by fitting a sex-stratified model. Results A total of 15,562 persons aged 18 years and older were included in the study. The majority were non-Hispanic whites, 18-44 years of age, with at most a high school education. Short sleepers tended to be female (55.9%; 95% CI: 53.9, 57.9) while long (59.6%; 95% CI: 57.4, 61.7) and normal sleepers (51.9%; 95% CI: 50.5, 53.2) tended to be male. As compared with normal sleep duration, 7-9 h, short sleep duration was not significantly associated with obesity in the study population overall (OR=0.95; 95% CI: 0.83-1.08) or among males (OR=0.98; 95% CI: 0.86-1.12). However, short sleep was associated with increased odds of obesity among females (OR=1.22; 95% CI: 1.01-1.49). Conclusions There is sex-based heterogeneity in the association between short sleep and obesity among US adults. Further research should explore the factors responsible, and investigate the underlying mechanism.
... Moreover, Smith (2007) examined whether physical activity individually or combined, coupled with weight loss has the potential to mitigate the signs of depression. Knutson et al. (2007), Taheri et al. (2004) and Gangwisch et al. (2005) observed that doing exercise routinely added up the quality and duration of sleep resulting in helping weight loss and control. Similarly, several studies have examined that the most commonly observed psychological hindrances to exercise were lack of will power, and support as well as misconception (Meetoo & Meetoo, 2005;Lawton et al., 2005;Greenhalgh, Helman, & Chowdhury, 1998). ...
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Exercise is a crucial strategy for diabetes management. However, the majority of patients with Type 2 diabetes seem reluctant to do physical activity. It increases the need of investigating the factors that are responsible for their non-exercising routine. This study aims to recognize the psychological and social barriers that prevent patients with diabetes mellitus to do exercise. A cross-sectional study was conducted with a total of 275 patients with type 2 diabetes attending family medicine outpatient clinics for the last six months. The questionnaire has been designed to collect data regarding psychological and social barriers to exercise. A comparison of social and psychological barriers with general characteristics was performed. The findings of the study reveal that all the general characteristics were significantly associated with psychological and social barriers. The patients reported that lack of interest, no willpower, a feeling of depression, unaffordability, and time barriers were the most frequent barriers among social and psychological barriers to exercise.
... The main cause of the obesity pandemic is the excessive intake of calories through daily eating while people keep burning less calories with decreasing physical activities over the past decades, i.e., less walking, cycling, sporting, etc. [2]. Besides that, medications' side effect, genetic traits, change of smoking habit or sleep-deprivation can also be another source of obesity [2][3][4]. Obesity in turns, is one of the main factors leading to several other health risks such as cardiovascular diseases, hypertension, or cancer [5]. Therefore, it is essential to keep monitoring health parameters in a daily routine to control the energy intake, the type of food, and balance with physical activities to reduce the obesity risks. ...
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With better quality of life, obesity is becoming a worldwide disease due to over-eating and sedentary lifestyle. Therefore, daily monitoring of the glucose and body fat percentage (%) is vital to keep track of one’s health. Currently, separated devices are required to monitor each parameter at home and some are still invasive to measure the glucose level. In this study, a portable band-shaped bioimpedance system is proposed to measure both parameters. The system is battery run with two main modules: the current source and the voltage recording, with minimal design to fit into a band of 150 mm x 40 mm in dimension. The impedance is measured at the frequency of 1 kHz at 30 kHz sampling frequency and in 1000 signal cycles to flatten noises. The final average impedance is calculated and evaluated in correlation with the body fat and the fasting glucose. The system was tested on 21 volunteers and 4 locations were picked for the impedance measurement: the arm under the triceps, the side of the belly, the back on one side and the thigh under the bicep femoris. The results show promising results with the arm being the best location for predicting the body fat (correlation coefficient: 0.89, 95% CI: 0.73-0.95), while the thigh impedance best correlated with the fasting glucose (correlation coefficient: 0.92, 95% CI: 0.81-0.97). These preliminary results indicate the feasibility and capacity of the proposed system as a home-based, portable and convenient system in monitoring the body fat and glucose. The system’s performance will be verified and replicated in a future larger study.
... However, existing research results are inconsistent. Some authors have reported a negative correlation between sleep duration and BMI [11,12], while others have indicated a U-shaped relationship [13,14] or no association at all [15,16]. Additionally, only few works have considered students. ...
Article
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Objectives: To examine associations between sleep duration as well as time of going to sleep and anthropometric indices related to the amount and distribution of adiposity. Material: A total of 969 female university students, aged 19-24 years. Methods: Participants self-reported their sleep duration. Body weight, height, and waist circumference were measured. BMI, WHR and WHtR were calculated. Statistical analyses of results involved logistic regression models. Socioeconomic status and level of stress were added as covariates. Results: In 15% of the sample, sleep was too short (<6 h), and 10% slept too long (>8 h). Compared to women who followed the recommended sleep duration, among short sleepers, both underweight and overweight were more frequent, while long sleepers were more likely to be overweight. A higher prevalence of abdominal obesity and increased risk of metabolic syndrome were observed in both short and long sleepers than in recommended sleepers. Irregular sleep times were connected with higher OR, both for BMI < 18.5 and BMI > 25, for WC > 80, and WHtR below 0.4 and above 0.5. Irregular sleep times also led to an increased risk of metabolic diseases prevalence. Conclusions: Both too long and too short sleep increases the risk of overweight, obesity and abdominal obesity and, as a consequence, the risk of metabolic syndrome in young women.
... Therefore, weight loss can improve sleep quality and duration [4]. Gangwicsh et al. (2005) investigated the National Health Examination Survey (NHANES) and indicated that participants with higher body mass index (BMI) had lower sleep duration than individuals with lower BMI [5]. ...
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Background: Sleep disturbances are common in nearly one-third of adults. Both low quality of sleep and sleep time could be related to increased obesity. An increase in visceral adipose tissue can result in the secretion of inflammatory cytokines. Inflammatory cytokines can lead to disturbance of the sleep-wake rhythm. Therefore, weight loss may improve sleep quality and duration. Intermittent fasting diet as a popular diet reduces body weight and improves anthropometric indices. This study is performed to further investigate the effect of a modified intermittent fasting diet on sleep quality and anthropometric indices. Methods: This is an open-label randomized controlled trial to evaluate the effect of daily calorie restriction (control) and modified intermittent fasting (intervention) on sleep quality and anthropometric indices in women with obesity or overweight for 8 weeks. 56 participants are classified using stratified randomization based on body mass index (BMI) and age. Then participants are assigned to one of the two groups of intervention or control using the random numbers table. The sleep quality, daytime sleepiness, and insomnia will be evaluated by using the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale, and the Insomnia Severity Index respectively. The primary outcomes are chosen for the study: the difference in sleep quality, daytime sleepiness, insomnia, BMI, fat-free mass (FFM), body fat mass, waist circumference, and waist-to-hip ratio from baseline to 8 weeks. Secondary outcomes are chosen for the study: the difference in hip circumference, the visceral fat area, percent body fat, soft lean mass, skeletal muscle mass, extracellular water ratio, and total body water from baseline to 8 weeks. Discussion: This study investigates the effect of intermittent fasting intervention compared with daily calorie restriction on sleep quality and anthropometric indices. The information gained will enhance our understanding of fasting interventions, which can be used to improve clinical dietary recommendations. The findings will help to disclose as yet the unknown relationship between diet and sleep quality. Trial registration: The protocol was registered at the Iranian Registry of Clinical Trials (IRCT20220522054958N3), date of registration: 2022/07/08, https://www.irct.ir/trial/64510
... Emotional problems, depression, anxiety, and obsessivecompulsive disorder are associated with an increase in childhood and adolescent obesity (Antwi et al., 2013). Shorter sleep times (< 7 hours) daily contribute for obesity by decreasing leptin, increasing ghrelin and impairing insulin sensitivity (Gangwisch et al., 2005). ...
Article
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Obesity is the accumulation of excess adipose tissue that affects a person's health and physical and psychosocial well-being. The classification is based on the body mass index, which makes it possible to compare prevalence rates worldwide. Obesity and overweight have become a global epidemic in both developed and developing countries. The objective of this study is to assess the prevalence of obesity and overweight in some countries. The results showed that in the last two decades, the prevalence of obesity and overweight in the world has more than doubled. The predominance of obesity and overweight is more pronounced in Western and Westernized countries, which are more developed, than in developing countries where malnutrition and obesity coexist. This global epidemic is seen in adults, adolescents and children without exception of gender. Obesity and overweight are one of the main factors in the increase of non-communicable diseases such as cardiovascular diseases, diabetes, musculoskeletal disorders and some types of cancer in the world. Poor diet is the main cause of the growing prevalence of obesity.
... El sobrepeso y la obesidad son fenómenos multifactoriales y complejos que involucran aspectos públicos, sociales e individuales. Específicamente en mujeres universitarias, el rápido aumento de la obesidad podría deberse a varios factores: a) la industria alimentaria promueve en mayor medida la comida rápida (definida como alimentos con bajo valor nutricional y a menudo altos en grasa, colesterol, azúcar y sodio), además este tipo de alimentos son más accesibles para los estudiantes en términos de conveniencia económica y disponibilidad (Schmidt et al., 2005); b) el estilo de vida sedentario (definido como actividades que no aumentan sustancialmente el gasto energético por encima del nivel de descanso) se está volviendo más común en la población adolescente y joven, ya que cada día se resuelven más actividades de la vida cotidiana desde la comodidad del asiento, por lo que los estudiantes no sólo se encuentran en mayor riesgo de desarrollar sobrepeso y obesidad, sino también enfermedades cardiovasculares y síndrome metabólico (Farinola y Bazán, 2011); c) la falta de sueño en las universitarias también es un factor de riesgo para la obesidad, y se ha demostrado que la privación del sueño (dormir menos de 7 horas) podría desempeñar un papel significativo en la etiología de la obesidad (Gangwisch, Malaspina, Boden-Albala y Heymsfield, 2005); y d) genética, aunque el efecto es menor, ya que las formas más comunes de obesidad son quizá el resultado de innumerables variaciones dentro de una gran cantidad de genes (Unikel, Vázquez y Kaufer-Horwitz, 2012). ...
Chapter
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En la actualidad, la comida es fuente tanto de placer como de conflicto para las personas. Gracias a la proliferación de redes comerciales y de transporte, la alimentación actual se rige por una diversidad en sus mercados. Aunque existen algunas diferencias, el cierre en la brecha de la variedad de platillos, sabores y olores que pueden disfrutarse ahora tanto en un restaurante como en casa es cada vez más notorio. Si bien la elaboración de platillos ha existido desde tiempos remotos, así como el uso de técnicas y métodos para preparar alimentos, cada cultura a lo largo de la historia de la humanidad ha elaborado una gama de platillos con características específicas, rigiéndose mayormente por la disponibilidad de ingredientes y el medio ambiente en el que habitaban (Goody, 1995; Fischler, 1995). El acto natural de “comer” transciende la idea básica de “alimentarse por sobrevivir” a lo que actualmente se le conoce como “experiencia gastronómica” (Goody, 1997). Consumir un alimento no se limita a la ingesta de nutrientes, incluye también sabores, aromas, texturas, colores, así como otros estímulos, tales como la atmósfera, decoración, pistas visuales y auditivas, sin dejar de lado el contexto social. A diferencia del tratamiento que se le daba a los alimentos en la antigüedad, el arte culinario o la gastronomía implican no sólo la preservación histórica de recetas o fórmulas para realizar un platillo, sino también la innovación del uso de esas técnicas con los ingredientes que son cada vez más disponibles y variados, así como una colaboración con otras disciplinas. La gastronomía, en un sentido general, suele vincularse con diversos conceptos, tales como: cocinas, productos, alimentos, técnicas culinarias, identidades y cosmovisiones (Goody, J. 1995). Asimismo, se le ha vinculado con la hotelería, e industria de la restauración, el arte, el catering, lo gourmet y los chefs. Como disciplina, ha evolucionado de ser un mero arte sin métodos ni guías, a colocarse en una posición de carácter incluso “científico” (Hegarty, 2005). Cabe mencionar que en la actualidad la gastronomía se ha ido dejando de considerar como una línea de investigación que pueda partir de disciplinas tanto químicas y en su mayoría sociales. En ese artículo se presenta una breve historia de cómo se fue consolidando la gastronomía como disciplina a lo largo de los dos últimos siglos, así como algunas actualidades respecto a los estudios gastronómicos consolidados y su relación con otras disciplinas concernientes al comportamiento alimentario y a la nutrición.
... Keeping the previous researches in mind, partial deprivation has been given the status of a categorical variable (e.g., Barnett & Cooper, 2008;Chen, Gill, & Prigerson, 2005;Gangwisch, Malaspina, Boden-Albala, & Heymsfield, 2005;Kripke, Garfinkel, Wingard, Klauber, &Marler, 2002). Here, the cutoff point was selected as 6 hours. ...
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Objectives: Present study intended to investigate the impact of parental personality traits on parenting patterns and parent child-relationships in Pakistan. Methods and Materials: This study included 342 parents aged between 31 and 57 years, with 159 fathers and 183 mothers, who were selected through purposive convenient sampling from different cities of Punjab, Pakistan. Parents having children of ages 3-14 years were selected as per requirement of the (PCRI) scale. In the present study we have demonstrated, the two Scales Neo-FFI Scale and PCRI scales to test the hypotheses. It was hypothesized that parental personality traits including openness to experience, conscientiousness, extraversion, agreeableness and neuroticism would predict parent child relationship i.e. parental support, satisfaction, communication, involvement and autonomy. Findings: The Cronbach's alpha coefficient was estimated for both the scale demonstrated reliable estimates for both scales. From the study through multiple regression analyses it is observed that among the predictors, openness to experience was significant positive predictor of parental support; agreeableness was significant positive predictor of satisfaction, and openness to experience and extraversion were significant positive predictors of communication. Implications: This study will be helpful for school and family counselors in understanding and dealing with issues related to parents and children.
... Keeping the previous researches in mind, partial deprivation has been given the status of a categorical variable (e.g., Barnett & Cooper, 2008;Chen, Gill, & Prigerson, 2005;Gangwisch, Malaspina, Boden-Albala, & Heymsfield, 2005;Kripke, Garfinkel, Wingard, Klauber, &Marler, 2002). Here, the cutoff point was selected as 6 hours. ...
... Smoking is linked to obesity-related illnesses (Manson et al., 1990;Sun et al., 2019). Sleep deprivation can play an important role in obesity in some persons (Gangwisch et al., 2005;Beccuti & Pannain, 2011). ...
Article
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The study tries to investigate the obesity and obesity related health implications of Colorado and Mississippi States to see the significant factors affecting obesity in each state to propose effective and doable policy suggestions to the states, especially to Mississippi state. The study follows logit analysis using Behavior Risk Factor Surveillance Systems (BRFSS) survey data of 2018. The individual data reported for the states were used for the analysis. The statistical package of STATA was used for the analysis. The analytical results show that physical exercise (EXER), number of sleeping hours (SLEP), and education (EDUC) play a major role in combatting obesity. Also, the impact of smoking (SMOK), alcohol consumption (DRNK), and obesity -related diseases ((DISE). The large differences in value between Colorado and Mississippi indicate the significance of these variables and how they could be used in Mississippi. Thus, Mississippi needs to go for efficient and effective policy implications to facilitate more for physical exercises, and education. Both states report that obesity-related illnesses have a significant impact on obesity. Thus, health programs on these diseases would be required to reduce obesity.
... Sleep deprivation or sleep loss is multifactorial, and has a variety of consequences [8]. The National Health and Nutrition Examination Survey (NHANES) showed significantly higher rates of obesity in adults who reported an average of less than 7 h a night of sleep [9]. Sleep loss has a negative impact on the process of thinking and on the learning, memory, and recall capacity, and thus on the ability to work efficiently and socialize freely, and results in a general feeling of being "disconnected" from the world [10]. ...
Article
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This narrative review presents the findings from intervention studies on the effects of sleep deprivation on eating habits, metabolic rate, and the hormones regulating metabolism, and discusses their relevance to weight loss efforts. Disturbed sleeping patterns lead to increased energy intake, partly from excessive snacking, mainly on foods high in fat and carbohydrates. The studies focused mainly on the effects of sleep duration, but also of sleep quality, on dietary intake during weight loss trials, and on weight loss maintenance. It is important to explore sleep routines that could enhance the efforts of obese and overweight people to lose weight, maintain their weight loss, and improve their overall health.
... [28] Another research conducted in accordance with NHANES I findings support the existence of the association between insufficient sleep duration and obesity. [29] In the study conducted on 5358 Turkish adolescents between the ages of 6 and 17, Ozturk et al. (2009) detected that sleep duration of both sexes increases as their BMIs decrease. [30] Girls who sleep for 10 or more hours have significantly higher BMIs than the ones sleeping for 8 or less hours. ...
... 51 The results of this study found support from the NHANES cohort, in which younger population, but not older than 50 years, showed an inverse association between reported short sleep duration and increased prevalence of overweight or obesity. 52 The current study has however some limitations. First, the sample size of the survey is moderate; secondly, due to the cross-sectional design of this research, it is not possible to assess the causal relationship between lifestyle behaviours, dietary habits and pre-and post-menopausal women. ...
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Objective: Menopause is the period when significant changes occur in women and influence their life quality. The aim of this study was to investigate lifestyle behaviours and dietary habits in an Italian sample of pre-menopausal and postmenopausal women. Materials and Methods: A cross-sectional online survey was conducted May to July 2021 by online platforms. A total of 250 women (130 pre-menopausal and 120 post-menopausal) completed a self-reported questionnaire, comprising questions on demographic characteristics, anthropometrics data, lifestyle behaviours and dietary habits. Results: Overweight/obesity prevalence was 22.4% with higher values of post-menopausal than pre-menopausal women (25.9% vs 19.2%). Pre-menopausal women were slightly more physically active (67.7% vs 65.8), but with significantly lower percentages when exercised for 60+ minutes (36.2% vs 54.7%; p=0.0130). As to sedentary activities, higher and significant percentage of pre-menopausal women was found compared to post-menopausal women (89.2% vs 67.5%; p <0.0001). Regarding the dietary habit of having breakfast regularly, a significantly higher percentage of post-menopausal than pre-menopausal women (90.0% vs 80.0%) emerged. Multiple logistic regression model showed that smoking, physical activity and sleep duration affected significantly the ponderal status, whereas age, marital status, alcohol consumption, breakfast habit, and sweet consumption were not significant. Conclusions: Not many differences in lifestyle and eating habits exist between pre-menopausal and post-menopausal women. The only significant differences relate to physical activity duration, sedentary behaviours and breakfast habit in favor of post-menopausal women. However, the prevalence of overweight/obesity was particularly linked to lifestyle behaviors such as smoking, sleep and physical activity in all participating women. Key words: Premenopausal women, postmenopausal women, lifestyle behaviours, dietary habits, overweight/obese.
... Data are expressed as median (range) or count (percentage).Abbreviation: BMI, body mass index; RWG, rapid weight gain. The significance level was set at 5%. of sleep has been reported in overweighed children and adolescents even without sleep breathing disturbances, 42 perhaps due to endocrine alterations such as decreased levels of leptin, increased levels of ghrelin, and compromised insulin sensitivity.43 However, we did not find significant differences in terms of sleep duration, sleep quality, or alteration of sleep architecture between groups with this limited sample.On the other hand, obesity could be also considered as a risk factor for sleep disturbance, as an increased BMI has been associated with a higher risk of obstructive sleep apnea (OSA).44 ...
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Objectif Caractériser la prise de poids rapide (PPR) associée à l’apparition de narcolepsie chez l’enfant et déterminer si elle constitue un marqueur de sévérité de la maladie. Méthodes Quatre-vingt-quatre enfants narcoleptiques, d’âge médian 12 ans au diagnostic : 60 % garçons, 91 % cataplexie, 99 % positivité HLA-DQB1*06 :02. La PPR est défini à l’aide de la pente du z-score de l’IMC rapportée à 1 an (> 0,67 SD) entre l’apparition des symptômes et le diagnostic. Nous avons comparé les caractéristiques cliniques, métaboliques et PSG entre les patients avec ou sans PPR avec suivi de la prise en charge thérapeutique, l’évolution anthropométrique et clinique. Résultats Les patients PPR étaient plus jeunes au diagnostic malgré un délai diagnostique plus court que les patients non-PPR. Ils avaient un IMC z-score et une prévalence d’obésité plus élevés au diagnostic, mais pas au début des symptômes. Ils avaient des scores plus élevés dans l’échelle d’Epworth et l’indice de sévérité de l’insomnie. Au suivi, les patients PPR avaient toujours un IMC z-score plus élevé et un pourcentage plus élevé d’obésité malgré la même prise en charge thérapeutique et l’amélioration de la somnolence et des difficultés scolaires. Conclusion Les patients narcoleptiques PPR étaient plus obèses et plus somnolents au diagnostic malgré un délai de diagnostic plus court que les patients non-PPR. Ils avaient un risque plus élevé de développer une obésité à long terme malgré une évolution positive de leurs symptômes. La PPR pourrait représenter un sous-groupe plus grave de narcolepsie infantile avec une charge d’obésité plus élevée à l’âge adulte.
... Sleep deprivation also has an impact on the immune system (10)(11)(12)(13)(14)(15)(16). SDs are considered an independent risk factor in the pathogenesis of several chronic diseases considered to be comorbidities of psoriasis, such as type 2 diabetes, hypertension (17), metabolic syndrome (18) and cardiovascular disease (8,(19)(20)(21)(22)(23)(24). The associations between psoriasis and SDs are wide and multidirectional. ...
Article
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Psoriasis alters patients’ quality of life. Among the disorders associated with psoriasis, sleep disorders are common, although they are not directly assessed by most quality-of-life scores. Thus, their specific evaluation with dedicated scores is necessary, especially because such disorders alter physical and psychological health. The relationship between psoriasis and sleep disorders has not yet been fully elucidated, but numerous studies in the literature show links between the two. Our study aims to update knowledge about sleep disorders in patients with psoriasis through a review of the scientific literature since 1980. This work covers several topics of interest, such as sleep assessment methods, the prevalence of sleep disorders in patients with psoriasis, factors predictive of sleep disorders in patients with psoriasis, the impact of sleep disorders on comorbidities and quality of life, pathogenic mechanisms, obstructive sleep apnoea and restless leg syndromes, and the impact of biotherapy treatments on sleep disorders in patients with psoriasis.
... Due to the importance of sleep in physical and mental wellbeing, significant attention has focused on the poor sleep patterns and insomnia among the public. For example, studies have shown that women [13], persons of minority ethnic groups [14,15], persons with obesity [16], and persons of lower socioeconomic status [17] were generally more likely to report poorer sleep patterns. ...
Article
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Given the importance of sleep for physical and mental wellbeing, it is crucial to understand the extent of insomnia among community dwellers. However, there is a paucity of population wide epidemiological studies to estimate the prevalence of poor sleep quality. This present study aimed to 1) characterize the sleep quality of a nationally representative sample (n=6126) of Singapore residents using Pittsburg Sleep Quality Index (PSQI) and 2) identify the sociodemographic correlates of poor sleep in our population. A total of 27.6% of respondents reported poor sleep quality (PSQI score ≥ 5). Sociodemographic correlates of poor sleep quality in our population included, but were not limited to, females (AOR = 1.44, 95% CI = 1.17 to 1.77, p-value = 0.001), Malays vs Chinese (AOR = 1.53, 95% CI = 1.23 to 1.9, p-value < 0.001), Indians vs Chinese (AOR = 1.22, 95% CI = 1.02 to 1.47, p-value = 0.03), ex-smokers vs non-smoker (AOR = 1.43, 95% CI = 1.07 to 1.92, p-value = 0.02), persons with comorbid mental health conditions vs no mental health conditions (AOR = 14.11, 95% CI = 6.52 to 30.54, p-value < 0.01), and persons with physical multimorbidity vs no physical conditions (AOR = 1.63, 95% CI = 1.24 to 2.15, p-value < 0.001). The prevalence of poor sleep in Singapore is comparable to that of other countries in the Asian region. Targeted public health campaigns to psycho-educate vulnerable groups on the importance of good sleep hygiene may improve the overall wellbeing of residents in Singapore.
... Data are expressed as median (range) or count (percentage).Abbreviation: BMI, body mass index; RWG, rapid weight gain. The significance level was set at 5%. of sleep has been reported in overweighed children and adolescents even without sleep breathing disturbances, 42 perhaps due to endocrine alterations such as decreased levels of leptin, increased levels of ghrelin, and compromised insulin sensitivity.43 However, we did not find significant differences in terms of sleep duration, sleep quality, or alteration of sleep architecture between groups with this limited sample.On the other hand, obesity could be also considered as a risk factor for sleep disturbance, as an increased BMI has been associated with a higher risk of obstructive sleep apnea (OSA).44 ...
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Objectives: To characterize the rapid weight gain (RWG) phenotype associated with the onset of childhood narcolepsy and to determine whether it could constitute a marker of severity of the disease. Methods: RWG was defined using the BMI z-score slope reported to one year (> 0.67 SD) from symptom onset to disease diagnosis. We compared the clinical, metabolic, and sleep characteristics between patients with or without RWG at diagnosis. Pharmacological management, anthropometric, and clinical progression were also evaluated during the follow-up. Results: A total of 84 de novo narcoleptic pediatric patients were included, their median age at diagnosis was 12.0 years, 59.5% boys, 90.5% cataplexy and 98.7% HLA-DQB1*06:02, 57% had RWG profile. RWG patients were younger at diagnosis compared to non-RWG patients, despite a shorter diagnostic delay. They had a higher BMI z-score and a higher prevalence of obesity at diagnosis, but not at symptom onset, and higher adapted Epworth Sleepiness Scale and Insomnia Severity Index scores than non-RWG patients. No differences on nocturnal polysomnography and multiple sleep latency test were found between groups at disease diagnosis. After a median follow-up of 5 years, RWG patients still had a higher BMI z-score and a higher prevalence of obesity despite benefiting from the same therapeutic management and displaying improvement in sleepiness and school difficulties. Conclusions: Narcoleptic RWG patients were younger, sleepier and the prevalence of obesity was higher at diagnosis despite a shorter diagnostic delay compared to non-RWG patients. These patients had also a higher risk of developing a long-term obesity despite a positive progression of their narcoleptic symptoms. RGW could then represent a maker of a more severe phenotype of childhood narcolepsy, which should inspire a prompt and more offensive management to prevent obesity and its complications.
... Current literature regarding the relationship of long sleep and weight are mixed, as some studies have observed a U-shaped relationship [8,32,33] and others an inverse relationship [3,21,34,35]. It has been proposed that [36]. ...
Article
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PurposeShort and long sleep duration and poor sleep quality are risk factors for weight gain and cancer mortality. The purpose of this study is to investigate the relationship between sleep and weight change among postmenopausal breast cancer survivors.Methods Women participating in the Women’s Health Initiative who were diagnosed with incident breast cancer between year one and year three were included. Self-reported sleep duration was categorized as ≤ 5 h (short), 6 h, 7–8 h (optimal), and ≥ 9 h (long). Self-reported sleep quality was categorized as poor, average, and above average. Post-diagnosis weight change was the difference of weight closest to, but preceding diagnosis, and year 3 weight. We used linear regression to evaluate sleep duration and sleep quality associations with post-diagnosis weight change adjusted for potential confounders.ResultsAmong 1156 participants, 63% were weight stable after diagnosis; average weight gain post cancer diagnosis was 3.2 kg. Six percent of women reported sleeping ≤ 5 h, 26% reported 6 h, 64% reported 7–8 h, and 4% reported ≥ 9 h. There were no differences in adjusted estimates of weight change among participants with short duration (0.37 kg; 95% CI − 0.88, 1.63), or long duration (− 0.56 kg; 95% CI − 2.03, 0.90) compared to optimal duration, nor was there a difference among poor quality (− 0.51 kg; 95% CI − 1.42, 0.41) compared to above average quality.Conclusion Among postmenopausal breast cancer survivors, sleep duration and quality were not associated with weight change after breast cancer diagnosis. Future studies should consider capturing change in adiposity and to expand beyond self-reported sleep.
... Inadequate sleep has been associated with obesity [67], and excessive work hours has been associated with a trade-off between exercise, social time, and sleep [68]. The average hours of sleep a night in a usual working week was asked with the possible responses of less than seven, seven to eight, and more than eight hours. ...
Article
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Obesity has become a public health challenge in every country on this planet, with a substantial contribution to global mortality and morbidity. Studies of the built environment have shown some promise in understanding the drivers of this obesity pandemic. This paper contributes to this knowledge, by focusing on one aspect of the urban environment and asking whether there is an association between commuting and obesity in residents of the Nepean Blue Mountains area on the fringes of Sydney. This is a cross-sectional study with obesity being the dependent variable, and commuting the independent variable, where 45 min or less was defined as local and distant commute was more than 45 min. In the sample of 158 respondents, the risk of obesity was twice as likely in the distant commuters than in the local commuters (OR 2.04, 95% CI 1.051 to 3.962, p = 0.034). Investigation of possible mediators of this association was limited by sample size; however, mode of transport was found to be a significant mediator. The results support the design of cities to provide health supporting environments for all residents, including equitable access to employment at a reasonable distance and effective public transport.
... 13 However, some questions remain open -for instance, the mediating role of age, with the deleterious association between short sleep duration and CVD risk factors such as obesity or hypertension potentially more marked in younger individuals. [14][15][16] There is also some controversy, with mixed results reported for the association between sleep duration and CVD risk factors -for instance, a reverse J-shaped relationship has been reported between sleep duration and risk of obesity, with the highest risk observed for short sleep duration, the lowest for 7-8 h and no differences for longer durations. 12 In turn, other authors have found long sleep to be associated with obesity and also with diabetes, 17 but not with hypertension. ...
Article
Background Sleep is known to affect cardiovascular health, but some controversy exists on the independent association between different sleep characteristics (duration, restfulness, difficulties falling asleep) and specific risk factors for cardiovascular disease (CVD). We aimed to assess the association between self-reported sleep characteristics and the likelihood of major CVD risk factors. Methods 521,364 Spanish workers (32% female, 44±9yrs [18-64]) insured by an occupational risk prevention company participated in this nationwide cross-sectional study. Participants’ sleep was considered ‘poor’ if they reported having ≥1 of the following conditions: excessively short (<6h/d) or long (>9h/d) sleep, unrestful sleep, or difficulties to fall asleep. We assessed the independent association between aforementioned sleep characteristics and the prevalence of hypertension, diabetes, hypercholesterolemia, obesity and physical inactivity. Results Poor sleep (reported by 33% of participants) was associated with a higher likelihood of presenting all CVD risk factors individually, particularly physical inactivity (which prevalence was ~3-fold higher in the poor sleep group compared with participants reporting no sleep abnormality). In separate analyses, all the different sleep characteristics were associated with the likelihood of ≥2 CVD risk factors. Participants with optimal sleep, normal sleep duration, no difficulties falling sleep and restful sleep showed a lower total CVD risk score than their peers with poor sleep, short sleep duration, difficulties falling sleep, and unrestful sleep, respectively (all p<0.001). Conclusions Poor sleep was associated with a higher likelihood of presenting major CVD risk factors. These findings might support the importance of monitoring and improving sleep patterns for primary CVD prevention.
... According to the Centers for Disease Control and Prevention (CDC), the prevalence of short sleep (<7 h/night) in adults by states in the United States ranged from 24.3% to 48.5% in 2014 [1]. Sleep disturbance is a major risk factor for chronic diseases such as obesity, diabetes, cardiovascular disease (CVD) and certain cancers [1][2][3] through interrupting glucose and insulin metabolism, and energy balance [4]. ...
Article
Study Objectives As an antagonist of calcium (Ca), magnesium (Mg) has been implicated in the regulation of sleep. We aimed to examine the longitudinal associations of Mg intake and Ca-to-Mg intake ratio (Ca:Mg) with sleep quality and duration. Methods The study sample consisted of 3,964 participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Dietary and supplementary intake of Mg were obtained using the CARDIA Dietary History at baseline (1985–1986), exam years 7 and 20. Self-reported sleep outcomes were measured at years 15 and 20. Sleep quality was rating from 1 (very good) to 5 (very bad). We categorized sleep duration to <7, 7–9, and >9 h. Generalized estimating equation was used to examine the associations of interest as repeated measures at the two time points. Results After adjustment for potential confounders, Mg intake was borderline associated with better sleep quality [highest quartile (Q4) vs. intake quartile (Q1): odds ratio (OR) = 1.23; 95% CI = 0.999, 1.50, ptrend = 0.051]. Participants in Q4 were also less likely to have short sleep (<7 h) compared to those in Q1 (OR = 0.64; 95% CI = 0.51, 0.81, ptrend = 0.012). The observed association with short sleep persisted among participants without depressive disorders (Q4 vs. Q1: OR = 0.64; 95% CI = 0.49, 0.82, ptrend < 0.001), but not among individuals with depressive disorder. Ca:Mg was not associated with either outcomes, regardless of depression status. Conclusions Mg intake was associated with both sleep outcomes in this longitudinal analysis. Randomized controlled trials with objective measures of sleep are warranted to establish the potential causal inference.
... 40 Another study indicated that BMI was significantly associated with inadequate sleep in 3682 younger participants (aged between 32 and 49 years) but not in older patients (>50 years). 41 The aforementioned results indicate that anthropometric parameters may more strongly affect OSAS severity in younger patients than in older patients. BMI was the most important in terms of OSA risk for the four groups, and waist circumference had the second-highest importance in terms of their effects on the AHI in men and older women, but their importance differed in younger women. ...
Article
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(a) Objective: Obstructive sleep apnea syndrome (OSAS) is typically diagnosed through polysomnography (PSG). However, PSG incurs high medical costs. This study developed new models for screening the risk of moderate-to-severe OSAS (apnea-hypopnea index, AHI ≥15) and severe OSAS (AHI ≥30) in various age groups and sexes by using anthropometric features in the Taiwan population. (b) Participants: Data were derived from 10,391 northern Taiwan patients who underwent PSG. (c) Methods: Patients’ characteristics – namely age, sex, body mass index (BMI), neck circumference, and waist circumference – was obtained. To develop an age- and sex-independent model, various approaches – namely logistic regression, k-nearest neighbor, naive Bayes, random forest (RF), and support vector machine – were trained for four groups based on sex and age (men or women; aged <50 or ≥50 years). Dataset was separated independently (training:70%; validation: 10%; testing: 20%) and Cross-validated grid search was applied for model optimization. Models demonstrating the highest overall accuracy in validation outcomes for the four groups were used to predict the testing dataset. (d) Results: The RF models showed the highest overall accuracy. BMI was the most influential parameter in both types of OSAS severity screening models. (e) Conclusion: The established models can be applied to screen OSAS risk in the Taiwan population and those with similar craniofacial features.
... Rest is just as important in achieving a balanced development. In adults, sleep deprivation has been linked to obesity by reducing circulating leptin and increasing ghrelin synthesis, thus increasing appetite and inducing insulin resistance [260,261]. The association of obesity with lack of sleep applies to children as well [262][263][264][265][266][267][268][269][270]. ...
Article
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The past few decades have shown a worrisome increase in the prevalence of obesity and its related illnesses. This increasing burden has a noteworthy impact on overall worldwide mortality and morbidity, with significant economic implications as well. The same trend is apparent regarding pediatric obesity. This is a particularly concerning aspect when considering the well-established link between cardiovascular disease and obesity, and the fact that childhood obesity frequently leads to adult obesity. Moreover, most obese adults have a history of excess weight starting in childhood. In addition, given the cumulative character of both time and severity of exposure to obesity as a risk factor for associated diseases, the repercussions of obesity prevalence and related morbidity could be exponential in time. The purpose of this review is to outline key aspects regarding the current knowledge on childhood and adolescent obesity as a cardiometabolic risk factor, as well as the most common etiological pathways involved in the development of weight excess and associated cardiovascular and metabolic diseases.
... Intestinal flora helps maintain host circadian rhythms as well as host metabolome rhythms. Numerous epidemiological studies have shown that sleep deprivation is closely related to obesity and metabolism, and abnormalities in the intestinal flora are closely related to metabolic and neurological diseases [7][8][9][10][11][12][13][14]. Whether the occurrence and development of insomnia are also related to the abnormalities in intestinal flora has become a research hotspot in this field. ...
Article
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Methods: The subjects included 13 PI patients from the Hubei Provincial Hospital of TCM, Hubei University of TCM, and Wuhan Traditional Chinese Medicine Hospital, and the corresponding noninsomniac spouses of the patients were selected as controls. TWBXG was continuously administered for 4 weeks. The feces of PI patients and their noninsomniac spouses before and after treatment with TWBXG were collected. The intestinal flora composition of each group was detected by metagenomic sequencing, and the efficacy of TWBXG was evaluated by the PSQI scale. Results: Compared with the control group, the model group showed an increase in the abundance of Roseburia faecis, Ruminococcus, Prevotella copri, Fusicatenibacter saccharivorans, and Blautia obeum, while those of Bacteroides, fecal Bacteroidetes, and Faecalibacterium prausnitzii were decreased. Compared with pretreatment, the PSQI score was significantly reduced (P < 0.05), the abundance of Bacteroides, fecal Bacteroidetes, and Faecalibacterium prausnitzii increased, and that of Roseburia faecis, Ruminococcus, Prevotella copri, Fusicatenibacter saccharivorans, and Blautia obeum decreased after treatment. However, there was still a certain gap in the abundance of related flora in the treatment group compared with the control. Conclusion: PI is associated with disturbances in the intestinal flora and is mainly related to the disorders of Roseburia faecis, Ruminococcus, Prevotella copri, Fusicatenibacter saccharivorans, Blautia obeum, Bacteroides, fecal Bacteroidetes, and Faecalibacterium prausnitzii. TWBXG can effectively treat PI, and its effect may be achieved by regulating the disordered intestinal flora. Clinical Trials. The study was registered in the Chinese clinical trial registry and approved by the World Health Organization clinical trial registration platform (Effects of the modified Tianwang Buxin granule and modified Tianwang Buxin decoction pieces on insomnia: a randomized, controlled trial, ChiCTR-IPR-17011549).
... Jong., et al.(2012) [14], in his study, used variables such as watching television and standing in front of the computer to study the relationship between sleep duration x childhood obesity. 4,072 children aged 4 to 13 years were evaluated, and it was found that there is a relationship between shorter sleep duration and excess weight, and among the determinants of sleep duration were watching television during the meal, permission to having sweets without asking, and sleeping late, being stronger the association with watching television and using the computer.In recent years, several lines of research have been developed that have deepened the understanding of the mechanisms regulating energy balance, the genetic basis that occurs or not the pathological accumulation of adipose tissue, as well as in the analysis of function, or endocrine dysfunction, of them[6].Overweight and obesity among children and adolescents are probably the result of complex interactions between genes, lifestyle behaviors, eating habits and socioeconomic factors[15]. ...
... Most of the studies have focused on the effect of short sleep duration on obesity [9][10][11][12][13]. A cohort study reported that shortening sleep causes obesogenic behaviors, lower physical activity, and desire for a carbohydrate-rich diet [14], and sleep deprivation may cause neurohormonal changes leading to increased caloric intake [8]. ...
Article
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Objectives: Obesity is a risk factor for several chronic conditions, including sleep disorders. We aimed to analyze the relationship between BMI, body fat percentage (FAT%), hip and waist circumference, and weight on the duration of nocturnal sleep. Methods: This study was part of the MASHAD cohort study. In all participants BMI and FAT% were measured. BMI was used to categorize individuals as obese, overweight, and normal subjects. FAT% was used to categorize individuals into tertile: tertile 1 (low) < 27.5, tertile 2 (medium) 27.5–41, and tertile 3 (high) > 41. The level of nightly sleep duration was categorized into three groups: <6, 6–8 (reference group), and >8 h. Results: There was a significant inverse association between body weight and duration of sleep ( p < 0.05). Obese and overweight participants had 1.152 OR (CI:1.083–1.225) and 1.126 OR (CI:1.063–1.194) for a short duration of nocturnal sleep, respectively, relative to those with a normal BMI. Conclusion: BMI was an independent determinant of nocturnal sleep duration; obesity and overweight may have negative consequences on sleep duration. Weight control should be considered as a factor in adjusting sleep quality.
... Current literature regarding the relationship of long sleep and weight are mixed, as some studies have observed a U-shaped relationship [8, 32,33] and others an inverse relationship [3,21,34,35]. It has been proposed that long sleep duration (generally ³ 9 hours) is associated with increased weight and BMI as long sleepers may engage in less physical activity [36]. ...
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Purpose: Short and long sleep duration and poor sleep quality are risk factors for weight gain and cancer mortality. The purpose of this study is to investigate the relationship between sleep and weight change among postmenopausal breast cancer survivors. Methods: Women participating in the Women’s Health Initiative who were diagnosed with incident breast cancer between year 1 and year 3 were included. Self-reported sleep duration was categorized as ≤5 hours (short), 6 hours, 7-8 hours (optimal), and ≥9 hours (long). Self-reported sleep quality was categorized as poor, average, and above average. Post-diagnosis weight change was the difference of weight closest to, but preceding diagnosis, and year 3 weight. We used linear regression to evaluate sleep duration and sleep quality associations with post-diagnosis weight change adjusted for potential confounders. Results: Among 1,156 participants, 63% were weight stable after diagnosis; average weight gain post cancer diagnosis was 3.2 kg. Six percent of women reported sleeping ≤5 hours, 26% reported 6 hours, 64% reported 7-8 hours, and 4% reported ≥9 hours. There were no differences in adjusted estimates of weight change among participants with short duration (0.37kg; 95%CI -0.88, 1.63), or long duration (-0.56kg; 95% CI -2.03, 0.90) compared to optimal duration, nor was there a difference among poor quality (-0.51kg; 95% CI -1.42, 0.41) compared to above average quality. Conclusion: Among postmenopausal breast cancer survivors, sleep duration and quality were not associated with weight change after breast cancer diagnosis. Future studies should consider capturing change in adiposity and to expand beyond self-reported sleep.
... However, the increasing pressure and speed of everyday life leads to lack of sleep and decreasing its quality. Insufficient sleep duration and poor sleep quality can result in heart disease [1,2], depression [3], obesity [4], diabetes mellitus [5], and neurodegenerative diseases [6,7]. Even one sleepless night might result in changes of immune responses [8]. ...
Chapter
There is an abundance of literature and evidence that supports the recent recognition of the importance of sleep over the past few years. Thankfully providers, researchers and public health specialists are all purporting the benefits of good quality sleep for both children and adults. Knowing that poor sleep can have telling consequences on the psychological, developmental and physical health and well-being of children, it is even more important for there to be a keen understanding of basic sleep physiology and pathophysiology. Sleep in young children is dynamic, with the character, pattern and rhythmicity changing as the child moves from infancy into young adulthood. Recognizing these changes can also help to better understand the pathophysiology that can be seen in young and older children alike. This article will review typical presentations of common pediatric sleep disorders, from sleep disordered breathing, sleep related movement disorders as well as parasomnias, insomnia and central disorders of hypersomnolence. Additionally, common diagnostic procedures will be reviewed with first line treatment options discussed. We will explore the behavioral and societal contributions to insomnia in young children and how we can work to counteract or mitigate these effects. Finally, we will touch upon the sleep needs of special populations and the consideration of using supplements and medications to treat sleep insomnia in this population.
Article
While prior studies have examined sleep across the lifecourse, few studies have investigated sleep around the birth of a child, one of the most important events to cause sleep deprivation. This study investigates changes in sleep hours and quality, paying attention to differences by gender and partnership status. Using the UK Household Longitudinal Study, we follow approximately 1,000 participants as they transition into parenthood in a three-year window. We use OLS and logistic regression to analyze changes in sleep hours and sleep quality. Results suggest that women’s sleep is reduced by an average of 0.7 hours (42 minutes) on becoming a mother. Whilst before parenthood women sleep more than men, after childbirth women and men sleep similar amounts. Cohabiting men experience a greater reduction in sleep by around 0.5 hours (30 minutes) than married men, to the level similar to women, suggesting that new cohabiting fathers may experience more sleep disturbances.
Article
Objective: To assess the nature of relationships between increasing body mass index (BMI) and the prevalence of midlife symptoms in a population with high adiposity. Methods: In the cross-sectional Study of Women's Health in Qatar, 841 participants aged 40 to 60 years were recruited from nine primary health centers in Doha. Face-to-face interviews collected demographic, menopause, and symptom information. BMI (kg/m2) was categorized as healthy, overweight, or class I, II, or III obesity. Multivariate logistic regression models were used to examine aches/stiffness in joints, trouble sleeping, shortness of breath, urinary incontinence, and hot flashes with BMI categories. Restricted cubic splines (RCSs) were used to estimate relationships between continuous BMI and each symptom and to conduct formal tests of nonlinearity. Results: Mean BMI was 34.3 kg/m2 (SD, 6.0 kg/m2). Women with class II and III obesity had higher odds of reporting aches/stiffness than women with a healthy BMI, and the odds of reporting urinary incontinence were three times higher among women with class III obesity (odds ratio, 3.08; 95% confidence interval, 1.17-8.14). Using restricted cubic spline models, a significant nonlinear association (P = 0.002) was observed between aches/stiffness and BMI with an apparent threshold of 38 kg/m2. Linear relationships were observed with BMI for urinary incontinence (P < 0.001 for linear trend) and shortness of breath (P = 0.005 for linear trend). Trouble sleeping and hot flashes were not associated with BMI. Conclusions: Even at very high levels of BMI, likelihood of urinary incontinence and shortness of breath increases with BMI. In contrast, likelihood of aches/stiffness has a nonlinear relationship with BMI, increasing to a threshold level.
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Objectives We evaluated an online Sleep Health and Wellness (SHAW) programme paired with dayzz, a personalised sleep training programme deployed via smartphone application (dayzz app) that promotes healthy sleep and treatment for sleep disorders, among employees at a large healthcare organisation. Design Open-label, randomised, parallel-group controlled trial. Setting A healthcare employer in the USA. Participants 1355 daytime workers. Intervention Participants were randomised to intervention (n=794) or control (n=561) on consent. Intervention participants received the SHAW educational programme at baseline plus access to the personalised dayzz app for up to 9 months. The control condition received the intervention at month 10. Primary and secondary outcome measures Our primary outcome measures were sleep-related behavioural changes (eg, consistent sleep schedule); sleep behaviour tracked on an electronic sleep diary and sleep quality. Our secondary outcome measures included employee absenteeism, performance and productivity; stress, mood, alertness and energy; and adverse health and safety outcomes (eg, accidents). Results At follow-up, employees in the intervention condition were more likely to report increased sleep duration on work (7.20 vs 6.99, p=0.01) and on free (8.26 vs 8.04, p=0.03) nights. At follow-up, the prevalence of poor sleep quality was lower in the intervention (n=160 of 321, 50%) compared with control (n=184 of 327, 56%) (p=0.04). The mean total dollars lost per person per month due to reduced workplace performance (presenteeism) was less in the intervention condition (US$1090 vs US$1321, p=0.001). Employees in the intervention reported fewer mental health visits (RR 0.72, 95% CI 0.56 to 0.94, p=0.01) and lower healthcare utilisation over the study interval (RR 0.81, 95% CI 0.67 to 0.98, p=0.03). We did not observe differences in stress (4.7 (95% CI 4.6 to 4.8) vs 4.7 (95% CI 4.6 to 4.8)), mood (4.5 (95% CI 4.4 to 4.6) vs 4.6 (95% CI 4.5 to 4.7)), alertness (4.9 (95% CI 4.8 to 5.0) vs 5.0 (95% CI 4.9 to 5.1)) or adverse health and safety outcomes (motor vehicle crashes: OR 0.82 (95% CI 0.34 to 1.9); near-miss crashes: OR=0.89 (95% CI 0.5 to 1.5) and injuries: 0.9 (95% CI 0.6 to 1.3)); energy was higher at follow-up in the intervention group (4.3 vs 4.5; p=0.03). Conclusions Results from this trial demonstrate that a SHAW programme followed by access to the digital dayzz app can be beneficial to both the employee and employer. Trial registration number NCT04224285
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Although a vibrant interdisciplinary literature has extensively documented the importance of quality sleep for health and longevity, many Americans struggle with sleep disorders. One factor which has received far less research attention to date in predicting sleep quality is religion/spirituality. The current study uses nationally representative data from the 2017 Baylor Religion Survey to assess how three dimensions of religion/spirituality, including religious attendance, divine control (the belief in God’s causal influence over daily life), and religious doubt (doubt in God’s existence), associate with sleep quality. Given that very few population-based studies have formally tested any underlying mechanisms of the association between religion/spirituality and sleep, we also consider the potential mediating influence of the sense of meaning and purpose in life. Results suggest that greater religious attendance and divine control were associated with better sleep quality, while doubt in God’s existence among religious believers was associated with lower sleep quality. The sense of meaning/purpose in life was found to mediate the relationship between religious attendance and divine control and sleep quality and confound the association between religious doubt and sleep quality. Taken together, our findings incorporate understudied measures of religion/spirituality and introduce the sense of meaning and purpose in life as a new mechanism.
Article
The thermal environment is an essential factor that affects sleep quality. In many circumstances, the bed microenvironment is more important than the ambient environment because of the large covered area of the human body and the close contact between the bedding system and the human body. The main objective of this research is to establish an effective method to determine bedding system insulation. A thermal manikin was used in the measurement of bedding system insulation. Three different types of quilts, which were filled with cotton, polyester and duvet respectively, were chosen to be tested. In total ten different quilts with different materials and weights were involved in the test. Four regular arrangements of covers were chosen with coverage rates of 94.1%, 85.9%, 70.6%, and 54.4% to test. A total of 64 bedding systems were tested to build an effective method to determine the bedding system insulation. On the basis of test data, the change of bedding system insulation with coverage was found to be nonlinear. Exponential fitting was applied to establish an insulation evaluation method for bedding system insulation. In addition, the effects of quilt cover and sleepwear on bedding system insulation were discussed and thermal insulation increment caused by quilt cover and sleepwear were estimated. The relationships between neutral indoor temperature and weight per unit area of the quilt for different coverage rates have been quantified based on existing subject experiments. This research provides an effective method to determine bedding system insulation, which can be widely used in thermal comfort research and HVAC system design.
Article
Objectives The central nervous system disorder in systemic lupus erythematosus (SLE), called neuropsychiatric lupus (NPSLE), is one of the most severe phenotypes with various clinical symptoms, including mood disorder, psychosis and delirium as diffuse neuropsychological manifestations (dNPSLE). Although stress is one of the aggravating factors for neuropsychiatric symptoms, its role in the pathogenesis of dNPSLE remains to be elucidated. We aimed to investigate stress effects on the neuropsychiatric pathophysiology in SLE using lupus-prone mice and patients’ data. Methods Sleep disturbance stress (SDS) for 2 weeks was placed on 6–8-week-old female MRL/ lpr and control mice. Behavioural phenotyping, histopathological analyses and gene and protein expression analyses were performed to assess SDS-induced neuroimmunological alterations. We also evaluated cytokines of the cerebrospinal fluid and brain regional volumes in patients with dNPSLE and patients with non-dNPSLE. Results SDS-subjected MRL/ lpr mice exhibited less anxiety-like behaviour, whereas stressed control mice showed increased anxiety. Furthermore, stress strongly activated the medial prefrontal cortex (mPFC) in SDS-subjected MRL/ lpr . A transcriptome analysis of the PFC revealed the upregulation of microglial activation-related genes, including Il12b . We confirmed that stress-induced microglial activation and the upregulation of interleukin (IL) 12/23p40 proteins and increased dendritic spines in the mPFC of stressed MRL/ lpr mice. IL-12/23p40 neutralisation and tyrosine kinase 2 inhibition mitigated the stress-induced neuropsychiatric phenotypes of MRL/ lpr mice. We also found a higher level of cerebrospinal fluid IL-12/23p40 and more atrophy in the mPFC of patients with dNPSLE than those with non-dNPSLE. Conclusions The microglial IL-12/23 axis in the mPFC might be associated with the pathogenesis and a promising therapeutic target for dNPSLE.
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Getting a good night's sleep seems a panacea for improving mood and cognition. These subjective impressions are supported by countless studies exploring the impacts of sleep (and sleep loss) on mental health, metabolism, and immune function. Similarly, being "out of phase" with local time, commonly experienced by shift workers of jet-lagged air travelers, demonstrates that there are both neural and physiologic effects of internal circadian (daily) time being misaligned with external environmental time. This article reviews these areas contextualized using the model of allostasis and allostatic load emphasizing the impact of this "wear and tear" on the brain and body.
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Behavioral plasticity refers to changes occurring due to external influences on an organism, including adaptation, learning, memory and enduring influences from early life experience. There are 2 types of behavioral plasticity: “developmental”, which refers to gene/environment interactions affecting a phenotype, and “activational” which refers to innate physiology and can involve structural physiological changes of the body. In this review, we focus on feeding behavior, and studies involving neuropeptides that influence behavioral plasticity - primarily opioids, orexin, neuropeptide Y, and oxytocin. In each section of the review, we include examples of behavioral plasticity as it relates to actions of these neuropeptides. It can be concluded from this review that eating behavior is influenced by a number of external factors, including time of day, type of food available, energy balance state, and stressors. The reviewed work underscores that environmental factors play a critical role in feeding behavior and energy balance, but changes in eating behavior also result from a multitude of non-environmental factors, such that there can be no single mechanism or variable that can explain ingestive behavior.
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Purpose To review the evidence of the potential mechanisms (behavioral, psychological/emotional, and physical factors) of prenatal yoga for preventing excessive gestational weight gain (GWG) in pregnant women to guide future research. Main body Prenatal yoga is a common form of physical activity during pregnancy and includes a combination of physical postures, breath control and meditation. This review theorizes how combining physical activity (i.e., prenatal yoga postures) with the add-ons brought by prenatal yoga (e.g., breath control, meditation), might provide a more comprehensive and effective strategy to prevent excessive GWG than physical activity alone. This article a) summarizes the literature on potential mechanisms of prenatal yoga to prevent excessive GWG specifically focusing on behavioral (diet, physical activity, and sleep), psychological/emotional (self-awareness, emotion regulation, stress, mood, mindfulness) and physical factors (pregnancy discomforts), b) highlights limitations of current studies, and c) provides suggestions for future research. The findings demonstrate there is insufficient evidence that prenatal yoga improves behavioral, psychological/emotional and physical factors in pregnant women and more research is needed. Though these factors have been more strongly linked to improved weight outcomes in non-pregnant populations, further testing in pregnant women is necessary to draw definitive conclusions for the efficacy of prenatal yoga to prevent excessive GWG. Conclusion Effective strategies are needed to prevent excessive GWG to encourage optimal maternal and child health outcomes. More research is warranted to evaluate the impact of prenatal yoga on weight outcomes during pregnancy and design studies to test the proposed mechanisms discussed in this review.
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Neuroendocrine systems together with the autonomic nervous system serve to synchronize physiological processes that keep the body in balance with the environment. Such a process, also called homeostasis, often is thought to keep the conditions in the body constant in a changing environment. The present paper discusses how the brain controls hormone secretion and how the suprachiasmatic nucleus(SCN), the brain’s biological clock, influences this process, illustrating that the internal conditions are far from stable but vary with a precise daily rhythm. As a result of this, hormone levels may vary by a factor 10 or more over the day–night cycle, but at a given hour may vary by less than 5% from 1 day to another. Clearly, the SCN influences a vast neuronal network within the hypothalamus, thus controlling a circadian rhythm in hormone secretion. These changing levels in circulating hormones need to be carefully tuned with the autonomic output to the organs to achieve the optimal physiological conditions needed at that time point. Particular emphasis will be paid to the rhythms of melatonin, corticosterone, and luteinizing hormone, of which the last one, even though in rats it only occurs once every 4–5 days, is also driven by the SCN. Finally, attention will also be given to the need of the SCN to be informed about the actual circulating concentration of the hormones, in order to adjust the hormonal levels to the levels appropriate to the time of the day.KeywordsSuprachiasmatic nucleusMelatoninCorticosteroneLuteinizing hormoneAutonomic nervous systemCircadian
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The COVID‐19 pandemic, an external stressor with multiple stressful sequelae, has fundamentally changed people's lives over multiple years. In this article, we first review research demonstrating that the pandemic has negatively impacted people's sense of belonging and health over time. Next, we draw upon decades of theoretical and empirical work demonstrating that threats to belonging and mental health problems are highly interrelated, with increases in the former driving increases in the latter. We then extend this discussion to physical health, drawing upon a wealth of theoretical and empirical work demonstrating that threats to belonging are a risk factor for longer term health problems and premature mortality. We also highlight potential mechanisms linking threats to belonging and health, with a focus on sleep and immune function. Throughout, we review how pre‐existing vulnerabilities may moderate these processes. We conclude with empirically supported recommendations for policymakers interested in addressing these issues.
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ABSTRACT Background and Aim: Previous research has shown that many factors can affect sportspersons’ quality of life. Sleep deprivation is one of these factors. Based on laboratory evidence, a number of possible mechanisms for the relationship between sleep deprivation and quality of life of sportspersons have been suggested. The aim of this study was to investigate the effect of sleep deprivation on the quality of life of sport science students. Materials and Methods: This was an experimental research study. The sample was 20 volunteer male sport science students selected by simple random sampling using a counterbalanced intragroup design. Data on the volunteer students were collected at two time points under controlled conditions in the university dormitory: 1. after twelve hours of fasting and eight hours of sufficient sleep, and 2. after twelve hours of fasting and thirty hours of full lack of sleep. The initial and final quality of life of the subjects were assessed and compared using the World Health Organization Quality of Life Questionnaire (WHOQOL_BREF). Changes in the dependent variable resulting from intervention were analyzed using the dependent t-test at p<0.05 with the SPSS softwarever.22. Results: Analysis of the data showed that 30 hours of sleep deprivation significantly reduced the quality of life scale, perception of physical health, mental health, social relationships, environmental health and the general health of the students (p=0.012). Conclusion: According to the results of this study, it is concluded that 30 hours of sleep deprivation can bring about a significant change in the quality of life of active male sport science students. Athletes need more sleep than inactive people because of exercise needs that affect the quality and quantity of sleep. Therefore, coaches and athletes are advised to identify the factors that cause sleep deprivation and, based on this, try to prevent athletes from falling asleep during training and competitions, and consequently reduce the negative effect of sleep deprivation on sports performance. Keywords: Sleep Deprivation, Insomnia, Quality of Life, Athletes' Performance
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Introduction: Sleep deprivation is one of those factors that affect the energy intake and appetite of individuals. It is reported that sleep deprivation affected by certain hormones (e.g. insulin, Leptin, ghrelin, and cholecystokinin, etc.) that are involved in energy balance may affect body weight through appetite. The aim of this study was to investigate the effect of sleep deprivation on appetite in active male students. Methodology: The research is experimental. Twenty volunteer's male sports science students selected and examined in two conditions with simple random selection in counter balanced intra-group pattern. Participants examined at two controlled situation; 1) after twelve hours fasting and eight hours enough sleep, and 2) after twelve hours fasting and thirty hours quiet sleeplessness. Appetite evaluated with Visual Analogue Scale. Changes in dependent variable due to intervention analyzed with dependent t test at p>.05 by SPSS software ver.22. Results: The findings of the present study showed that 30 hours of sleep deprivation significantly increased the tendency to food (p = 0.012) and consequently significantly reduced the feeling of satiety in male sports science students (p = 0.001). Conclusion: According to the results of the study, 30 sleep deprivation led to a significant change in students' appetite.
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The menopause transition is the time period encompassing the change from cyclical bleeding and fertility to decreased and subsequent cessation of fertility marked by 12 months absence of menses. With 3.763 billion of the world’s population female, at any given time there are approximately 1.2 billion women in the menopause transition and the postmenopause stage of life worldwide (https://data.worldbank.org/indicator/SP.POP.TOTL.FE.ZS). This is both a natural transition in reproductive phases for the individual woman and, with modern development allowing more women to survive both childhood and childbearing, a relatively recent expected life stage for the majority of women in social groups. With a typical median age of final menstrual period ranging from 45 years to 55 years, a woman in the United States will live 30–40% of her life after the menopause transition (El Khoudary, Menopause practice: a clinician’s guide, 2019). In low resource countries, the stage of life during and after menopause is still measured in decades (Blurton-Jones, Demography and evolutionary ecology of Hadza hunter-gatherers, 2016). This chapter looks at the evolutionary role of menopause among all mammals, what we know of the history and the development of the science of menopause, the staging of menopause, and how the menopause experience varies among populations and individuals worldwide.
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Global rates of obesity and Type 2 diabetes mellitus (T2DM) are increasing globally concomitant with a rising prevalence of sleep deprivation and sleep disorders. Understanding the links between sleep, obesity and T2DM might offer an opportunity to develop better prevention and treatment strategies for these epidemics. Experimental studies have shown that sleep restriction is associated with changes in energy homeostasis, insulin resistance and β-cell function. Epidemiological cohort studies established short sleep duration as a risk factor for developing obesity and T2DM. In addition, small studies suggested that short sleep duration was associated less weight loss following lifestyle interventions or bariatric surgery. In this article, we review the epidemiological evidence linking sleep duration to obesity and T2DM and plausible mechanisms. In addition, we review the impact of changes in sleep duration on obesity and T2DM.
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Background The effects of chronotype on dietary intake and weight gain during pregnancy has not been addressed by the literature. The aim of this study was to analyse the effect of chronotype on eating patterns, energy, and macronutrient intake and distribution, as well as weight gain during pregnancy. Methods Prospective cohort study carried out with 100 pregnant women in the first, second, and third gestational trimester. The dietary intake was assessed by three 24-hour dietary recalls in each trimester, totaling 9 recalls. Energy and macronutrient intake and distribution were evaluated at meals throughout the day. Chronotype was derived from mid-sleep time on free days and the obtained scores were categorized into tertiles. Recommendations from the Institute of Medicine were used to assess the adequacy of weight gain. Generalized Estimating Equation models were used to determine the effects of chronotype and gestational trimesters on eating patterns, daily energy, macronutrient distribution, and weight gain. Results Pregnant women with MSF values indicative of eveningness have breakfast later and also have a higher energy and carbohydrate intake at dinner when compared to those ‘morning’ women. Pregnant ‘morning’ women showed a better diet quality in terms of milk and dairy and saturated fat. Also, despite the tendency for all tertiles to gain excess weight during pregnancy, we found that pregnant women with a tendency to eveningness had worse adequacy of gestational weight gain in the third trimester when compared to those pregnant women with a tendency to ‘morning' (2,24 ± 0,25 versus 1,22 ± 0,14, p <0,001). Conclusions Pregnant women with a tendency to evening consume breakfast later in the day and present a greater consumption of energy and carbohydrates in the evening, as well as a worse standard of gestational weight gain in the third trimester. Our results emphasize the importance of considering chrononutrition variables in the nutritional antenatal guidelines to promote maternal-fetal health.
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Good sleep is vital for good health, and poor sleep, in particular insomnia, is associated with a range of poor health outcomes. Sleep disorders are common and a key reason why people self-medicate with cannabis. We have two key biological mechanisms which work together to regulate our sleep-wake cycle, the processes of sleep-wake homeostasis and our circadian rhythms. The endocannabinoid system is involved in the circadian sleep-wake cycle, including maintenance and promotion of sleep, and may provide the link between the circadian regulation systems and the physiological process of sleep. Cannabis has been used for centuries to treat sleep disorders. Preclinical and clinical evidence indicate that cannabidiol and tetrahydrocannabinol may have a role to play in the treatment of sleep disorders.
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Introduction Sleep quality and weight are inversely correlated in young adults (i.e., as weight increases, sleep quality decreases), but results are still inconsistent among older adults. Objective To examine the association between body mass index (BMI) and the waist-to-hip ratio (WHR) with sleep quality in older adults. Method 513 participants >60 years old were recruited. Data on BMI, WHR, age, gender, alcohol consumption, depression, comorbidities, and sleep (Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI)) were collected. Univariate and multivariate linear regression methods were used to evaluate the association between BMI, WHR and PSQI. Results 503 participants were included. There was a significant association between BMI (β = 0.10 95%CI: 0.04 to 0.15) and PSQI in the linear analysis, but not confirmed in the multivariate regression. No significant associations were observed between WHR and PSQI. Conclusion Neither BMI nor WHR were related to sleep quality in the older population.
Article
Study objectives: Since subjective sleep duration (SSD) is considered to be longer than objective sleep duration (OSD), results of SSD minus OSD (SSD-OSD) might always be thought to be positive. Some recent reports showed different results but exact results have not been obtained. The difference between SSD and OSD may change according to OSD. We investigated this difference and its association with sleep-disordered breathing (SDB) or nonrestorative sleep (NRS). Methods: This cross-sectional study evaluated 6908 community residents in Nagahama city, Japan. SSD was determined by self-administered questionnaire. OSD was measured by wrist actigraphy and sleep diary. SDB was assessed according to the 3% oxygen desaturation index adjusted for OSD. Results: Worthy of notice was that SSD was shorter than OSD longer than 6.98 hours in all participants, 7.36 hours in males and 6.80 hours in females. However, SSD was longer than OSD (mean±SD: 6.49±1.07 vs 6.01±0.96, P <0.001) overall, as SSD is considered to be longer than OSD. In patients with SDB, the difference between SSD-OSD was greater when OSD was shorter. The difference also depended on SDB severity. The degree of positivity between OSD and SSD was a significant factor in NRS (odds ratio: 2.691, P <0.001). Conclusions: When OSD was slightly <7 (6.98) hours, participants reported or perceived SSD>OSD. When OSD was >6.98 hours, participants reported or perceived SSD<OSD. Patients with SDB reported longer SSD than OSD according to severity of SDB. Evaluating SSD, OSD and their difference may be useful for managing sleep disturbances including NRS.
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Context The prevalence of obesity and overweight increased in the United States between 1978 and 1991. More recent reports have suggested continued increases but are based on self-reported data.Objective To examine trends and prevalences of overweight (body mass index [BMI] ≥25) and obesity (BMI ≥30), using measured height and weight data.Design, Setting, and Participants Survey of 4115 adult men and women conducted in 1999 and 2000 as part of the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the US population.Main Outcome Measure Age-adjusted prevalence of overweight, obesity, and extreme obesity compared with prior surveys, and sex-, age-, and race/ethnicity–specific estimates.Results The age-adjusted prevalence of obesity was 30.5% in 1999-2000 compared with 22.9% in NHANES III (1988-1994; P<.001). The prevalence of overweight also increased during this period from 55.9% to 64.5% (P<.001). Extreme obesity (BMI ≥40) also increased significantly in the population, from 2.9% to 4.7% (P = .002). Although not all changes were statistically significant, increases occurred for both men and women in all age groups and for non-Hispanic whites, non-Hispanic blacks, and Mexican Americans. Racial/ethnic groups did not differ significantly in the prevalence of obesity or overweight for men. Among women, obesity and overweight prevalences were highest among non-Hispanic black women. More than half of non-Hispanic black women aged 40 years or older were obese and more than 80% were overweight.Conclusions The increases in the prevalences of obesity and overweight previously observed continued in 1999-2000. The potential health benefits from reduction in overweight and obesity are of considerable public health importance.
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The increasing prevalence of obesity is a major public health concern, since obesity is associated with several chronic diseases. To monitor trends in state-specific data and to examine changes in the prevalence of obesity among adults. Cross-sectional random-digit telephone survey (Behavioral Risk Factor Surveillance System) of noninstitutionalized adults aged 18 years or older conducted by the Centers for Disease Control and Prevention and state health departments from 1991 to 1998. States that participated in the Behavioral Risk Factor Surveillance System. Body mass index calculated from self-reported weight and height. The prevalence of obesity (defined as a body mass index > or =30 kg/m2) increased from 12.0% in 1991 to 17.9% in 1998. A steady increase was observed in all states; in both sexes; across age groups, races, educational levels; and occurred regardless of smoking status. The greatest magnitude of increase was found in the following groups: 18- to 29-year-olds (7.1% to 12.1%), those with some college education (10.6% to 17.8%), and those of Hispanic ethnicity (11.6% to 20.8%). The magnitude of the increased prevalence varied by region (ranging from 31.9% for mid Atlantic to 67.2% for South Atlantic, the area with the greatest increases) and by state (ranging from 11.3% for Delaware to 101.8% for Georgia, the state with the greatest increases). Obesity continues to increase rapidly in the United States. To alter this trend, strategies and programs for weight maintenance as well as weight reduction must become a higher public health priority.
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To analyse the association of time watching television (TV) and physical activity with obesity in the Mediterranean area of Spain with the highest prevalence of obesity. Cross-sectional study. Valencia Region in Spain. A representative sample of 814 men and 958 women, aged 15 y and older, participating in a Health and Nutrition Survey conducted in 1994. Height and weight were directly measured during home interviews. The outcome measure was obesity, defined as a body mass index > or = 30 kg/m2. Covariates were self-reported hours of TV viewing, physical activity habits, sleeping duration, age, gender, educational level, smoking and marital status. Prevalence odds ratios (POR) estimated by logistic regression were used as effect measures. Obese people reported to spend more time watching TV (mean +/- s.d.: 3.6 +/- 1.5 h/day) than non-obese ones (3.0 +/- 1.4 h/day), and less sleeping time. In multivariate analysis, obesity was associated with TV viewing, sleeping time and physical activity at work. People watching TV > 4 h/day showed a higher adjusted prevalence odds ratio of obesity, POR = 2.38 (95% confidence interval, 1.54-3. 69), compared with those watching TV < or = 1 h/day. People who reported to sleep > or = 9 h/day presented a lower POR of obesity than those sleeping < or = 6 h/day, POR = 0.43 (0.27-0.67). Statistically significant dose-responses were observed for both associations, so that the prevalence odds ratio of obesity was 30% higher for each hour of increased TV viewing and 24% lower for each additional hour of sleeping time. In addition, the prevalence of obesity was lowest among single people, those more physically active at work, and those with a high educational level. Time spent watching television and a low physical activity at work were related to obesity in adults. The inverse association between obesity and sleep duration deserves further research.
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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.
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To assess the relationship between sleep duration and adiposity in 5- and 6-y-old Bavarian children. Cross-sectional study. A total of 6862 German children aged 5-6 y participating in the obligatory health examination in Bavaria, southern Germany. Routine data were collected on the height and weight of children at the time of school entry in six public health offices in 1999 and in another two in 2000. Body fat mass was estimated by BIA performed in three of those offices. An extensive questionnaire was given to all children's parents in order to assess risk factors for overweight and obesity. The main outcome measures were overweight, defined by a body mass index (BMI) above the 90th centile and obesity, defined by a BMI above the 97th centile for the German children in Bavaria. Excessive body fat was defined as fat mass above the 90th centile for all German children seen in this survey. The main exposure was usual sleeping hours on week days. The prevalence of obesity decreased by duration of sleep: < or =10 h, 5.4% (95% CI 4.1-7.0), 10.5-11.0 h, 2.8% (95% CI 2.3-3.3), and > or =11.5 h, 2.1% (95% CI 1.5-2.9). Similar relations were found with the prevalence of overweight and excessive body fat. These effects could not be explained by confounding due to a wide range of constitutional, sociodemographic and lifestyle factors. The adjusted odds ratio for obesity were: for sleeping 10.5-11.0 h, 0.52 (95% CI 0.34-0.78) and 0.46 (95% CI 0.28-0.75) for sleeping 11.5 h. The effect of sleep duration on obesity in children reflects a higher body fat composition and appears to be independent of other risk factors for childhood obesity.
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The prevalence of obesity and overweight increased in the United States between 1978 and 1991. More recent reports have suggested continued increases but are based on self-reported data. To examine trends and prevalences of overweight (body mass index [BMI] > or = 25) and obesity (BMI > or = 30), using measured height and weight data. Survey of 4115 adult men and women conducted in 1999 and 2000 as part of the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the US population. Age-adjusted prevalence of overweight, obesity, and extreme obesity compared with prior surveys, and sex-, age-, and race/ethnicity-specific estimates. The age-adjusted prevalence of obesity was 30.5% in 1999-2000 compared with 22.9% in NHANES III (1988-1994; P<.001). The prevalence of overweight also increased during this period from 55.9% to 64.5% (P<.001). Extreme obesity (BMI > or = 40) also increased significantly in the population, from 2.9% to 4.7% (P =.002). Although not all changes were statistically significant, increases occurred for both men and women in all age groups and for non-Hispanic whites, non-Hispanic blacks, and Mexican Americans. Racial/ethnic groups did not differ significantly in the prevalence of obesity or overweight for men. Among women, obesity and overweight prevalences were highest among non-Hispanic black women. More than half of non-Hispanic black women aged 40 years or older were obese and more than 80% were overweight. The increases in the prevalences of obesity and overweight previously observed continued in 1999-2000. The potential health benefits from reduction in overweight and obesity are of considerable public health importance.
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As the obesity epidemic spreads, concern about the significant health and economic consequences has also grown. Obesity has been linked to a variety of chronic diseases, almost 300,000 deaths each year, and 117 billion dollars in direct and indirect annual costs in the United States alone. In this article we review the recent trends in overweight and obesity, summarize the lifestyle factors that influence the increasing prevalence of obesity, and discuss the health and economic impact of the obesity epidemic.
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Obesity has become a major health problem with increasing prevalence. Given the limited availability of effective treatment of weight problems, the identification of potentially modifiable risk factors may lead to preventive approaches to obesity. The objective of this study was to test the hypothesis that short sleep duration is associated with obesity and weight gain during young adulthood. Prospective single-age cohort study of young adults. Information was derived from 4 interviews when participants were ages 27, 29, 34, and 40 years. Community setting. 496 young adults. Trained health professionals administered a semistructured interview for psychiatric and medical conditions and health habits. This study showed an association between short sleep duration and obesity (at age 27 years, odds ratio: 7.4, 95% confidence interval: 1.3-43.1) and a negative association between sleep duration and body mass index in young adults. These associations persisted after controlling for a variety of potentially confounding variables, including family history of weight problems, levels of physical activity, and demographic variables. Associations between sleep duration and obesity diminished after age 34 years. There was a trend (P = .08) for average change rate of weight gain to be negatively associated with average change rate of sleep duration. Because sleep duration is a potentially modifiable risk factor, these findings might have important clinical implications for the prevention and treatment of obesity.
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Total sleep deprivation in rodents and in humans has been associated with hyperphagia. Over the past 40 years, self-reported sleep duration in the United States has decreased by almost 2 hours. To determine whether partial sleep curtailment, an increasingly prevalent behavior, alters appetite regulation. Randomized, 2-period, 2-condition crossover clinical study. Clinical Research Center, University of Chicago, Chicago, Illinois. 12 healthy men (mean age [+/-SD], 22 +/- 2 years; mean body mass index [+/-SD], 23.6 +/- 2.0 kg/m2). Daytime profiles of plasma leptin and ghrelin levels and subjective ratings of hunger and appetite. 2 days of sleep restriction and 2 days of sleep extension under controlled conditions of caloric intake and physical activity. Sleep restriction was associated with average reductions in the anorexigenic hormone leptin (decrease, 18%; P = 0.04), elevations in the orexigenic factor ghrelin (increase, 28%; P < 0.04), and increased hunger (increase, 24%; P < 0.01) and appetite (increase, 23%; P = 0.01), especially for calorie-dense foods with high carbohydrate content (increase, 33% to 45%; P = 0.02). The study included only 12 young men and did not measure energy expenditure. Short sleep duration in young, healthy men is associated with decreased leptin levels, increased ghrelin levels, and increased hunger and appetite.
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Sleep duration may be an important regulator of body weight and metabolism. An association between short habitual sleep time and increased body mass index (BMI) has been reported in large population samples. The potential role of metabolic hormones in this association is unknown. Study participants were 1,024 volunteers from the Wisconsin Sleep Cohort Study, a population-based longitudinal study of sleep disorders. Participants underwent nocturnal polysomnography and reported on their sleep habits through questionnaires and sleep diaries. Following polysomnography, morning, fasted blood samples were evaluated for serum leptin and ghrelin (two key opposing hormones in appetite regulation), adiponectin, insulin, glucose, and lipid profile. Relationships among these measures, BMI, and sleep duration (habitual and immediately prior to blood sampling) were examined using multiple variable regressions with control for confounding factors. A U-shaped curvilinear association between sleep duration and BMI was observed. In persons sleeping less than 8 h (74.4% of the sample), increased BMI was proportional to decreased sleep. Short sleep was associated with low leptin (p for slope = 0.01), with a predicted 15.5% lower leptin for habitual sleep of 5 h versus 8 h, and high ghrelin (p for slope = 0.008), with a predicted 14.9% higher ghrelin for nocturnal (polysomnographic) sleep of 5 h versus 8 h, independent of BMI. Participants with short sleep had reduced leptin and elevated ghrelin. These differences in leptin and ghrelin are likely to increase appetite, possibly explaining the increased BMI observed with short sleep duration. In Western societies, where chronic sleep restriction is common and food is widely available, changes in appetite regulatory hormones with sleep curtailment may contribute to obesity.
Article
Context: The increasing prevalence of obesity is a major public health concern, since obesity is associated with several chronic diseases. Objective: To monitor trends in state-specific data and to examine changes in the prevalence of obesity among adults. Design: Cross-sectional random-digit telephone survey (Behavioral Risk Factor Surveillance System) of noninstitutionalized adults aged 18 years or older conducted by the Centers for Disease Control and Prevention and state health departments from 1991 to 1998. Setting: States that participated in the Behavioral Risk Factor Surveillance System. Main outcome measures: Body mass index calculated from self-reported weight and height. Results: The prevalence of obesity (defined as a body mass index > or =30 kg/m2) increased from 12.0% in 1991 to 17.9% in 1998. A steady increase was observed in all states; in both sexes; across age groups, races, educational levels; and occurred regardless of smoking status. The greatest magnitude of increase was found in the following groups: 18- to 29-year-olds (7.1% to 12.1%), those with some college education (10.6% to 17.8%), and those of Hispanic ethnicity (11.6% to 20.8%). The magnitude of the increased prevalence varied by region (ranging from 31.9% for mid Atlantic to 67.2% for South Atlantic, the area with the greatest increases) and by state (ranging from 11.3% for Delaware to 101.8% for Georgia, the state with the greatest increases). Conclusions: Obesity continues to increase rapidly in the United States. To alter this trend, strategies and programs for weight maintenance as well as weight reduction must become a higher public health priority.
Article
Sleep is often assessed in circadian rhythm studies and long-term monitoring is required to detect any changes in sleep over time. The present study aims to investigate the ability of the two most commonly employed methods, actigraphy and sleep logs, to identify circadian sleep/wake disorders and measure changes in sleep patterns over time. In addition, the study assesses whether sleep measured by both methods shows the same relationship with an established circadian phase marker, urinary 6-sulphatoxymelatonin. A total of 49 registered blind subjects with different types of circadian rhythms were studied daily for at least four weeks. Grouped analysis of all study days for all subjects was performed for all sleep parameters (1062–1150 days data per sleep parameter). Good correlations were observed when comparing the measurement of sleep timing and duration (sleep onset, sleep offset, night sleep duration, day-time nap duration). However, the methods were poorly correlated in their assessment of transitions between sleep and wake states (sleep latency, number and duration of night awakenings, number of day-time naps). There were also large and inconsistent differences in the measurement of the absolute sleep parameters. Overall, actigraphs recorded a shorter sleep latency, advanced onset time, increased number and duration of night awakenings, delayed offset, increased night sleep duration and increased number and duration of naps compared with the subjective sleep logs. Despite this, there was good agreement between the methods for measuring changes in sleep patterns over time. In particular, the methods agreed when assessing changes in sleep in relation to a circadian phase marker (the 6-sulphatoxymelatonin (aMT6s) rhythm) in both entrained (n= 30) and free-running (n= 4) subjects.
Article
To be more effective, the prevention of obesity in childhood should be focused on the population at risk. The purpose of the present study is firstly to find correlations between certain environmental factors and obesity in childhood, and secondly to measure the influence of the environmental factors after taking the parental history of obesity into account. This case controlled study includes 704 controls vs. 327 cases selected in a population of five year old school children. The anthropometric assessment was completed at school. Obesity was defined as a weight for height > or = 2 s.d. using the French weight charts for French children based on sex and height. Interviews of the parents recorded parental overweight and child birth overweight as 'constitutional' factors and family structure, socio-economic level and daily lifestyle (sleep, TV viewing, after school care, etc.) as 'environmental' factors. The results show that parental overweight and birth overweight are closely related to the child's obesity at five years of age (estimated relative risks 3.1 and 2.4 respectively). The environmental factors which contribute to child obesity are: southern European origin of the mother, snacks, excessive television viewing and, more importantly, short sleep duration (estimated relative risks = 1.9, 1.3, 2.1 and 4.9 respectively). A logistic regression model, after taking parental overweight into account, shows that the relationship between obesity and short sleep duration persists independently of television viewing. The hypotheses raised by these findings are discussed.
Article
To assess the use of actigraphy in evaluating insomnia, 36 patients with a serious complaint of insomnia slept 3 nights each in the laboratory, where the usual polysomnograms (PSGs) were obtained as well as actigraphic assessments of their sleep. Patients also wore actigraphs for 7 days at home, were extensively interviewed and filled out psychometric tests. Based on all this information, the patients were then diagnosed according to the International Classification of Sleep Disorders. Averaged over the 3 nights for each insomniac, the mean discrepancy between actigram and PSG was 49 minutes per night. In three-fourths of the cases, actigram and PSG agreed to within 1 hour on the total amount of sleep per night. Discrepancies, however, were not random: In patients with psychophysiologic insomnia and in insomnia associated with psychiatric disease, the actigram typically overestimated sleep when compared with the PSG. In patients with sleep-state misperception, the actigram was either quite accurate or it underestimated sleep when compared with the PSG. Comparing laboratory with home sleep, one-third of all insomniacs slept better in the laboratory and two-thirds slept better at home. In addition, night-by-night variability was higher at home than in the laboratory. Based on our study, we now recommend actigraphy as an additional tool in the clinical evaluation of insomnia, but we believe that in complex cases it should be combined with 1 PSG night in the sleep disorders center.
Article
The results of a series of studies on total and selective sleep deprivation in the rat are integrated and discussed. These studies showed that total sleep deprivation, paradoxical sleep deprivation, and disruption and/or deprivation of non-rapid eye movement (NREM) sleep produced a reliable syndrome that included death, debilitated appearance, skin lesions, increased food intake, weight loss, increased energy expenditure, decreased body temperature during the late stages of deprivation, increased plasma norepinephrine, and decreased plasma thyroxine. The significance of this syndrome for the function of sleep is not entirely clear, but several changes suggested that sleep may be necessary for effective thermoregulation.
Article
Within a wide range of individual differences, there are age-associated changes in the characteristics of sleep. There are shifts toward the extremities in sleep amounts, increased difficulties in initiating or maintaining sleep at night, and an emergence of naps. There are also changes in sleep structure. It is within these age-related changes that sleep disorders must be considered.
This report presents alternative strategies for analysis of data from the NHANES I Epidemiologic Followup Study (NHEFS) using Cox proportional hazards and person-time logistic regression models. Analytic issues related to the complex survey design of the NHANES I and the variable length of followup of NHEFS participants are discussed.
Article
Previous studies suggest that sleep deprivation (SD) decreases glucose tolerance in humans. The present study examined the ability of 10 males to process a glucose load during two conditions separated by at least 10 d. Condition I consisted of sedentary daily activity and sleep deprivation (SDS). Condition II consisted of daily physical activity and sleep deprivation (SDX). In both the SDS and SDX conditions, subjects were sleep deprived for 60 h followed by 7 h of normal sleep. An oral glucose tolerance test (OGTT) was administered at 10 and 60 h of SD, and after a night of recovery sleep in each condition, and plasma glucose and insulin concentrations were measured. No differences in the total plasma glucose response to the OGTT were observed over the total experimental period during Conditions I and II. However, the insulin response to the OGTT was elevated in the two conditions after 60 h of SD. Furthermore, the sedentary Condition I (SDS) resulted in higher insulin responses at all times compared to exercise Condition II (SDX). It is suggested that SD contributes to the development of an insulin resistance that can be partially reversed by physical activity. The results support the suggestion that SD results in decreased insulin sensitivity at peripheral receptor sites which can eventually lead to insulin exhaustion at pancreatic sites after longer periods of SD.
Article
At least one-third of Americans are obese, as defined by body mass indexes corresponding to body weight > or = 120% of ideal body weight, and this figure is rising steadily. Women and nonwhites have particularly high rates of obesity. Obesity greatly increases risks for many serious and morbid conditions, including diabetes mellitus, hypertension, dyslipidemia, coronary artery disease, and some cancers. Obesity is clearly associated with increased risk for mortality, but there has been controversy regarding optimal weight with respect to mortality risk. We review the literature concerning obesity and mortality, with reference to body fat distribution and weight gain, and consider potential effects of sex, age, and race on this relation. We conclude that when appropriate adjustments are made for effects of smoking and underlying disease, optimal weights are below average in both men and women; this appears to be true throughout the adult life span. Central obesity, most commonly approximated by the waist-to-hip ratio, may be particularly detrimental, although this requires further study. Weight gain in adulthood is also associated with increased mortality. These observations support public health measures to reduce obesity and weight gain, including recent recommendations to limit weight gain in the adult years to 4.5 kg (10 lb).
Article
Sleep is often assessed in circadian rhythm studies and long-term monitoring is required to detect any changes in sleep over time. The present study aims to investigate the ability of the two most commonly employed methods, actigraphy and sleep logs, to identify circadian sleep/wake disorders and measure changes in sleep patterns over time. In addition, the study assesses whether sleep measured by both methods shows the same relationship with an established circadian phase marker, urinary 6-sulphatoxymelatonin. A total of 49 registered blind subjects with different types of circadian rhythms were studied daily for at least four weeks. Grouped analysis of all study days for all subjects was performed for all sleep parameters (1062-1150 days data per sleep parameter). Good correlations were observed when comparing the measurement of sleep timing and duration (sleep onset, sleep offset, night sleep duration, day-time nap duration). However, the methods were poorly correlated in their assessment of transitions between sleep and wake states (sleep latency, number and duration of night awakenings, number of day-time naps). There were also large and inconsistent differences in the measurement of the absolute sleep parameters. Overall, actigraphs recorded a shorter sleep latency, advanced onset time, increased number and duration of night awakenings, delayed offset, increased night sleep duration and increased number and duration of naps compared with the subjective sleep logs. Despite this, there was good agreement between the methods for measuring changes in sleep patterns over time. In particular, the methods agreed when assessing changes in sleep in relation to a circadian phase marker (the 6-sulphatoxymelatonin (aMT6s) rhythm) in both entrained (n = 30) and free-running (n = 4) subjects.
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
Short sleeping hours could cause obesity through increased sympathetic activity, elevated cortisol secretion and decreased glucose tolerance. The aim of this study was to clarify parental and lifestyle factors, particularly sleeping habits, associated with obesity in Japanese children. Between June and July 1996, 8274 children (4194 males and 4080 females) aged 6-7 years living in Toyama prefecture, Japan, were investigated by questionnaire survey and the collection of anthropometric data. Subjects with a body mass index (BMI; weight in kg divided by square of height in m) greater than the age- and sex-specific cut-off points linked to adulthood overweight (BMI of 25 kg/m2 or more) were defined as obese subjects. Parental obesity was defined as a BMI of 25 kg/m2 or more. Logistic regression analysis was performed to evaluate the strength of the relationships between parental obesity or lifestyle factors and childhood obesity, adjusted for possible confounding factors. Parental obesity, long hours of TV watching and physical inactivity were significantly associated with childhood obesity. Although wake-up time was not related to obesity, there was a significant dose-response relationship between late bedtime or short sleeping hours and childhood obesity. Compared with children with 10 or more hours of sleep, the adjusted odds ratio was 1.49 (95% confidence interval 1.08-2.14) for those with 9-10 h sleep, 1.89 (1.34-2.73) for those with 8-9 h sleep and 2.87 (1.61-5.05) for those with <8 h sleep, after adjustment for age, sex, parental obesity and other lifestyle factors. A strong inverse association was observed in the relationship between sleeping hours and childhood obesity. Longitudinal research will be required to confirm this causality.
Article
Obstructive sleep apnoea is a disease of increasing importance because of its neurocognitive and cardiovascular sequelae. Abnormalities in the anatomy of the pharynx, the physiology of the upper airway muscle dilator, and the stability of ventilatory control are important causes of repetitive pharyngeal collapse during sleep. Obstructive sleep apnoea can be diagnosed on the basis of characteristic history (snoring, daytime sleepiness) and physical examination (increased neck circumference), but overnight polysomnography is needed to confirm presence of the disorder. Repetitive pharyngeal collapse causes recurrent arousals from sleep, leading to sleepiness and increased risk of motor vehicle and occupational accidents. The surges in hypoxaemia, hypercapnia, and catecholamine associated with this disorder have now been implicated in development of hypertension, but the association between obstructive sleep apnoea and myocardial infarction, stroke, and congestive heart failure is not proven. Continuous positive airway pressure, the treatment of choice for obstructive sleep apnoea, reduces sleepiness and improves hypertension.
Article
Obesity has reached epidemic proportions in the U.S. and more developed countries, particularly so among adolescents. A substantial impact on public health could be achieved if other factors causing obesity besides the conventional ones of diet and physical activity could be identified and acted upon. The present study investigates whether there is a link between low sleep quality and obesity in a tri-ethnic, cross-sectional sample (n = 383) of male and female adolescents ages 11-16 years old (Heartfelt Study). Sleep quality was expressed as two variables, total sleep time and sleep disturbance time obtained by 24-hour wrist actigraphy. Percent body fat and body mass index (BMI) were used together to define obesity. The potential influence of demographic and behavioral confounders were considered in models that described the relation of sleep to obesity occurrence. Obese adolescents experienced less sleep than nonobese adolescents (P < 0.01). For each hour of lost sleep, the odds of obesity increased by 80%. Sleep disturbance was not directly related to obesity in the sample, but influenced physical activity level (P < 0.01). Daytime physical activity diminished by 3% for every hour increase in sleep disturbance. The above observations were independent of potential confounding variables. Inadequate and poor sleep quality in adolescents may be important factors to consider in the prevention of childhood obesity.
Article
The hypothalamus integrates metabolic, neural and hormonal signals to evoke an intermittent appetitive drive in the daily management of energy homeostasis. Three major players identified recently in the feedback communication between the periphery and hypothalamus are leptin, ghrelin and neuropeptide Y (NPY). We propose that reciprocal circadian and ultradian rhythmicities in the afferent humoral signals, anorexigenic leptin from adipocytes and orexigenic ghrelin from stomach, encode a corresponding discharge pattern in the appetite-stimulating neuropeptide Y network in the hypothalamus. An exquisitely intricate temporal relationship among these signaling modalities with varied sites of origin is paramount in sustenance of weight control on a daily basis. Our model envisages that subtle and progressive derangements in temporal communication, imposed by environmental shifts in energy intake, impel a positive energy balance culminating in excessive weight gain and obesity. This conceptual advance provides a new target for designing pharmacologic or gene transfer therapies that would normalize the rhythmic patterns of afferent hormonal and efferent neurochemical messages.
Reduced risk for overweight and obesity in 5-and 6-year-old children by duration of sleep-a cross-sectional study
  • Von Kries
  • R Toschke
  • A M Wurmser
  • H Sauerwald
  • T Koletzko
Von Kries R, Toschke AM, Wurmser H, Sauerwald T, Koletzko B. Reduced risk for overweight and obesity in 5-and 6-year-old children by duration of sleep-a cross-sectional study. Int J Obesity 2002;26:710-6.
National Center for Health Statistics. National Health and Nutrition Examination Survey I: Epidemiologic Followup Study
U.S. Department of Health and Human Services, National Center for Health Statistics. National Health and Nutrition Examination Survey I: Epidemiologic Followup Study, 1982-1984 (computer file). 2 nd release. Hyattsville, MD: U.S. Department of Health and Human Services, National Center for Health Services (producer), 1992. Ann Arbor, MI: Inter-university Consortium for Political and Social Research (distributor), 1992.