Sleep duration, insomnia and cognitive performance in the Elsa-Brasil cohort: a cross-sectional analysis / Duração do sono, insônia e desempenho cognitivo na coorte Elsa-Brasil: uma análise transversal

ABSTRACT Objective: To investigate the single and combined associations between sleep disturbances (sleep duration, insomnia symptoms in the last 30 nights, and daytime tiredness) and performance in cognitive tests. Methods: Cross-sectional analysis of data from visit 2 (2012-2014) of the Longitudinal Study of Adult Health from a cohort of active and retired civil servants from six Brazilian capitals. Polynomial regression with quadratic term and multiple linear regression models were performed to assess single and combined associations between sleep disturbances and memory performance, fluency, executive functions, and global cognition. Results: A total of 7,248 participants were included, with a mean age of 62.7 years (standard deviation [SD]=5.9), and 55.2% were women. Inverted U-shaped associations were observed between sleep duration and performance on all cognitive abilities, suggesting that durations shorter or longer than seven hours are associated with worse performance, regardless of age. Reported insomnia was associated with worse executive function (β: -0.08; 95% confidence interval [CI]: -0.15 to -0.01), and the magnitudes of associations were higher for individuals with insomnia at two or more moments (β: -0.12; 95%CI -0.19 to -0.05) or, especially, insomnia combined with short sleep (β: -0.18; 95%CI -0.24 to -0.11). Insomnia in two or more periods was also associated with lower memory and global cognition. There was no association between any sleep disturbance tested and verbal fluency. Isolated daytime tiredness was not associated with performance in the evaluated tests. Conclusion: The results suggest that extreme sleep durations are detrimental to almost all cognitive abilities investigated, whereas insomnia appears to affect more severely the executive function.

RESUMO Objetivo: Investigar a associação isolada e combinada entre distúrbios do sono (duração do sono, sintomas de insônia nas últimas 30 noites e cansaço diurno) e desempenho em testes cognitivos. Métodos: Análise transversal dos dados da visita 2 (2012-2014) do Estudo Longitudinal de Saúde do Adulto de coorte de servidores públicos ativos e aposentados de seis capitais brasileiras. Regressão polinomial com termo quadrático e modelos de regressão linear múltipla foram realizados para avaliar associações isoladas e combinadas entre distúrbios do sono e desempenho na memória, fluência, funções executivas e cognição global. Resultados: Foram incluídos um total de 7.248 participantes, com média etária de 62,7 anos (desvio padrão [DP]=5,9), sendo 55,2% mulheres. Associações em forma de U invertido foram observadas entre duração do sono e desempenho em todas as habilidades cognitivas, sugerindo que durações menores ou maiores que sete horas estão associadas ao pior desempenho, independentemente da idade. O relato de insônia foi associado à pior função executiva (β: -0.08; IC95% -0.15 a -0.01), sendo as magnitudes das associações maiores para indivíduos com insônia em dois ou mais momentos (β: -0.12; intervalo de confiança [IC]95% -0.19 a -0.05) ou, especialmente, insônia combinada com sono curto (β: -0.18; IC95% -0.24 a -0.11). Insônia em dois ou mais períodos também foi associada à menor memória e cognição global. Não houve associação entre qualquer distúrbio do sono testado e fluência verbal. Cansaço diurno isolado não foi associado ao desempenho nos testes avaliados. Conclusão: Os resultados sugerem que a duração extrema do sono é prejudicial para quase todas as funções cognitivas investigadas, enquanto a insônia parece afetar mais fortemente a função executiva.

Association between sleep duration and depressive symptoms inthe elderly / 四川精神卫生

BackgroundDepression presents a significant risk to the physical and mental health of the elderly. The relationship between sleep and depressive symptoms has become a major research focus. However， previous research findings on this relationship have yielded inconsistent conclusions. ObjectiveTo explore the relationship between sleep duration and depressive symptoms in the elderly， in order to provide insights into the prevention of depressive symptoms and delaying their progression in the elderly. MethodsData analysis involved 8 210 adults aged 60 years or older， utilizing data from the 2018 China Health and Retirement Longitudinal Study （CHARLS） survey. Participants were categorized into two groups those with depressive symptoms and those without- based on the Center for Epidemiologic Studies Depression-10 Scale （CESD-10） criteria. Logistic regression and restricted cubic spline models were used to analyze the association between sleep duration and depressive symptoms. ResultsThe 318 people with depressive symptoms were detected among the 8 210 elderly participants， with an average sleep duration of （6.14±2.05） hours per night. Restricted cubic spline models showed a non-linear association between sleep duration and depressive symptoms （χ2=412.670，P<0.01）. After adjusting for confounding factors， compared to the elderly with a sleep duration 7~7.9 hours， the risk of depressive symptoms in the elderly was 2.971 times higher （95% CI： 2.560~3.449， P<0.01） in those with a sleep duration <6 hours， 1.372 times higher （95% CI： 1.161~1.621， P<0.01） in those with 6~6.9 hours， and 1 185 times higher （95% CI： 1.009~1.393， P<0.05） in those with ≥8 hours. Subgroup analysis showed no correlation between sleep duration ≥8 hours and the risk of depressive symptoms across genders and the 60~69 age group （P>0.05）. ConclusionThere was an approximately nonlinear association between sleep duration and depressive symptoms， with differences by gender and age.［Funded by Sichuan Applied Psychology Research Center， Chengdu Medical College （number， CSXL-22226）］

Genetically predicted insomnia causally increases the risk of erectile dysfunction / 亚洲男科学杂志(英文版)

Sleep has attracted extensive attention due to its significance in health. However, its association with erectile dysfunction (ED) is insufficiently investigated. To investigate the potential causal links between sleep traits (insomnia, sleep duration, and chronotype) and ED, this study was performed. The single-nucleotide polymorphisms (SNPs) associated with insomnia, sleep duration, and chronotype were retrieved from previous genome-wide association studies (GWAS). A conventional two-sample Mendelian randomization (MR) was used to estimate the causal links between sleep traits and ED. The summary statistics of ED were from individuals of European ancestry (6175 cases vs 217 630 controls). As shown by the random effect inverse-variance-weighting (IVW) estimator, genetically predicted insomnia was causally associated with a 1.15-fold risk of ED (95% confidence interval: 1.07-1.23, P < 0.001). Sleep duration and morningness were not causally associated with ED, as indicated by the IVW (all P > 0.05). These findings were consistent with the results of sensitivity analyses. Based on genetic data, this study provides causal evidence that genetically predicted insomnia increases the risk of ED, whereas sleep duration and chronotype do not.

Obesity: A mediator between cardiorespiratory fitness and self-reported sleep pattern among future physicians

Background: Obesity in relation to physical fitness is of major concern nowadays, as the prevalence of obesity is increasing rapidly worldwide and India is no exception to it. Lack of fitness results in stress as well as increased burnout, which ultimately contributes to mortality from cardiovascular disease. Physicians who are having poor exercise habits are also less likely to counsel patients about exercise. Aim and Objectives: Hence, in this study, we aim to evaluate the body mass index (BMI) as well as cardiorespiratory fitness and self-reported sleep pattern among the resident doctors of MMIMSR, Mullana, Ambala, Haryana. Materials and Methods: Data were collected for the cross-sectional study. Sleep pattern was determined using a validated Pittsburgh sleep quality index questionnaire. Body weight and height were measured and BMI was calculated using Quetelet index. Queen’s College Step Test method was used to estimate cardiorespiratory fitness by calculating VO2max. VO2max is internationally accepted parameter and is the first choice in measuring a person’s cardiopulmonary status. Results: The result of our study showed highly positive significant (P < 0.01) association and correlation between obesity and sleep patterns and highly significant (P < 0.01) correlation between obesity and cardiorespiratory fitness among the resident doctors. Residents with relatively disturbed sleep pattern and with shorter sleep durations were either overweight or obese. Preliminary findings are consistent with the hypothesis that disturbance in sleep pattern may be one of the factors which influences BMI and also influences long-term cardiorespiratory health. Residents attributed time constraints due to training as a key barrier to physical activity. Conclusion: Proper awareness at early stage is extremely important to impress the consequences disturbed sleep pattern and in prevention of the development of obesity and improvement in the cardiorespiratory fitness.

Relationship between sleep duration, sleep time and brachial-ankle pulse wave velocity / 中华内分泌代谢杂志

Objective:Explore the relationship between sleep duration, sleep time and brachial-ankle pulse wave velocity(baPWV) in community population.Methods:Questionnaire, physical examination, blood tests, and baPWV detection were applied to a community based population. Finally, 3 912 subjects with complete data were included in the study. The relationship between sleep duration, time to fall asleep and PWV was evaluated with binary logistic regression analysis. Results:Being adjusted for age, sex, prevalence of diabetes, sleep condition, body mass index, blood glucose, blood pressure, dyslipidemia, ankle-brachial index, sleep duration and time to fall asleep were correlated with PWV. The risk of PWV abnormalities was increased in the≥8 h group compared to the 6-8 h group( OR=1.155, 95% CI 0.995-1.367, P=0.037). The risk of abnormalities PWV was higher in the group with sleep time after 00: 00 than in the group -23: 00( OR=1.482, 95% CI 1.008-2.179, P=0.045). Conclusion:Long sleep duration(≥8 h) and late sleep time(after 00: 00) may be associated with higher risk of atherosclerosis.

Correlation between depressive symptoms and sleep quality among middle school students in Shanghai / 环境与职业医学

Background The correlation between depression and sleep quality is well established in adults, but similar evidence is lacking in adolescents. Objective To study the sleep quality, the positive rate of depressive symptoms, and their correlation among middle school students in Shanghai, so as to provide a basis for providing mental health and sleep management to this group of students. Methods From September to November 2020, using multi-stage stratified cluster random sampling method, a total of 7796 students from 32 middle schools in 16 districts of Shanghai were selected to conduct a questionnaire survey. The questionnaire for middle school students of the 2020 Shanghai Students’ Common Diseases and Health Influencing Factors Surveillance was used to collect students' demographic information, history of smoking, history of drinking, and history of chronic diseases; the Pittsburgh Sleep Quality Index was used to assess sleep quality; and the Center for Epidemiological Studies Depression Scale was used to evaluate depressive symptoms. χ2 test was used to compare qualitative data between groups. Binary logistic regression was used to analyze the correlation between sleep quality and depressive symptoms among middle school students in Shanghai. Results After excluding incomplete questionnaires, a total of 7160 valid questionnaires were collected. The average sleep time of middle school students in Shanghai was (7.54±1.15) h. Among them, 84.8% reported insufficient sleep time < 9 h, and only 15.2% reported sleep time ≥9 h. In addition, 9.2% of the students had poor sleep quality (Pittsburgh Sleep Quality Index ≥8 points). The sleep quality of urban students was worse than that of suburban students. The sleep quality of girls was worse than that of boys. The sleep quality of students in the third grade of middle school was worse than that of students in the first and second grades of middle school. Students with smoking history, drinking history, and chronic disease history had worse sleep quality than those without (P<0.05). The positive rate of depressive symptoms among middle school students in Shanghai was 22.2%, among which 7.0% reported possible depressive symptoms and 15.2% reported definite depressive symptoms. The positive rate of depressive symptoms in female students (26.1%) was higher than that in male students (18.5%); among different grades of middle school, the positive rate of depressive symptoms of the third grade middle school students was the highest (24.1%); the positive rates of depressive symptoms in students with smoking history, drinking history, and chronic disease history were higher than those without; the positive rate of depressive symptoms was higher in students with poor sleep quality (P<0.05). The results of logistic regression analysis indicated that the students with poor sleep quality showed higher risks of reporting depressive symptoms, and the OR (95%CI) was 17.064 (14.024-20.764). Conclusion The positive rates of poor sleep quality and depressive symptoms of middle school students in Shanghai are high, and there is a significant correlation between these two indicators. For students’ mental health and sleep management, more attention should be paid to the quality in addition to the quantity of sleep.

Associations of Daytime Napping with Incident Cardiovascular Diseases and Hypertension in Chinese Adults: A Nationwide Cohort Study / 生物医学与环境科学（英文）

OBJECTIVE@#This study aimed to examine the associations of daytime napping with incident risks of cardiovascular diseases (CVDs) and hypertension (HTN).@*METHODS@#Data for napping and CVD outcomes in 25 provinces were collected from baseline (2010) and three waves of follow-up (2012-2017) investigations of the China Family Panel Studies. Cox frailty models with random intercepts for the surveyed provinces were used to assess the longitudinal effects of daytime napping on CVD and HTN.@*RESULTS@#Compared with non-nappers, 30+ min nappers had higher risks of CVD and HTN, while no significant associations were observed among < 30 min nappers. Incident risks among 30- to < 60-min nappers increased by 22% [hazard ratio (HR) 1.22, 95% confidence interval ( CI) 1.08-1.39] for CVD and 21% (1.21, 1.04-1.41) for HTN, respectively, with corresponding HRs of CVD and HTN of 1.27 (1.09-1.47) and 1.38 (1.16-1.65) among ≥ 60 min nappers. Nap-associated CVD risks varied by subgroups, with stronger associations in participants with lower body mass index (< 24 kg/m 2), physically inactive persons, smokers, and participants with longer nighttime sleep (≥ 7 h/night). Significant effects of daytime napping were observed on rural and northern residents only, highlighting great regional variations in CVD risks associated with napping habits.@*CONCLUSIONS@#This cohort study revealed strong evidence that long daytime napping (≥ 30 min) is associated with an increased incidence of cardiovascular events.

Relación entre la duración del sueño y la presión arterial elevada en estudiantes universitarios / Relationship between sleep duration and high blood pressure in university students

RESUMEN Introducción: Los estudiantes universitarios presentan alteraciones en la duración del sueño. Estudios previos revelaron que la duración del sueño puede estar asociada a un aumento de la presión arterial (PA) Objetivo: Analizar la posible relación entre duración del sueño y la PA en estudiantes de Medicina. Material y métodos: Estudio analítico, de corte transversal en 728 estudiantes de Medicina. Se consideró PA elevada a la PA ≥ a la categoría de PA limítrofe (PA sistólica ≥130 mmHg y/o diastólica ≥85 mmHg). La duración del sueño se clasificó en: <6, 6-8 y >8 horas/día. Para determinar los riesgos asociados se realizaron comparaciones bivariadas (chi cuadrado) y multivariadas (regresión logística) ajustadas por factores de riesgo. Resultados: El 33,6% de los estudiantes presentó PA elevada. La duración media del sueño para los que presentaron PA elevada fue de 6,92 ± 0,92 horas, mientras que para los estudiantes con PA normal fue de 6,97 ± 0,95 horas. El 12,4% dormían <6 horas, el 74,6% entre 6-8 horas y 13,0% más de 8 horas. El análisis bivariado mostró que las horas de sueño no estuvieron asociados a PA elevada. El análisis multivariado ajustado no mostró asociación significativa entre las horas de sueño y la PA. Conclusión: La duración del sueño para los estudiantes con PA elevada fue la misma que para los estudiantes con PA normal. Hay un bajo porcentaje de estudiantes que duermen menos de 6 horas y más de 8 hs. No se encontró asociación significativa entre la duración del sueño corto o largo y la prevalencia de PA elevada.

ABSTRACT Background: University students present alterations in the duration of sleep. Previous studies revealed that the duration of sleep may be associated with an increase in blood pressure (BP). Objective: Analyze the possible relationship between sleep duration and BP in medical students. Methods: Analytical, cross-sectional study in medical students. High BP was considered to be BP ≥ to the borderline BP category (SBP ≥130 mmHg and / or DBP ≥85 mmHg). The duration of sleep was classified as: <6, 6-8 and >8 h / d. To determine the associated risks, bivariate (chi square) and multivariate (logistic regression) comparisons were made adjusted for risk factors. Results: 33.6% of the students presented high BP. The mean duration of sleep for those with high BP was 6.92 ± 0.92 hours, while for students with normal BP it was 6.97 ± 0.95. 12.4% slept <6 hours, 74.6% between 6-8 hours and 13.0% more than 8 hours. The bivariate analysis showed that hours of sleep were not associated with high BP. The adjusted multivariate analysis did not show a significant association between hours of sleep and BP. Conclusion: The duration of sleep for students with high BP was the same as for students with normal BP. There is a low percentage of students who sleep less than 6 hours and more than 8 hours. No significant association was found between the duration of short or long sleep and the prevalence of elevated BP.

Association between low vision and sleep duration among primary and middle school students / 预防医学

Objective @#To understand the relationship between sleep duration and low vision among primary and middle school students, so as to provide the reference for promoting eye health of primary and middle school students.@* Methods @#Using stratified cluster sampling method, the students were selected from four primary schools, four junior high schools and three senior high schools in Dinghai, Putuo, Daishan and Shengsi of Zhoushan. The questionnaire for the influencing factors of myopia in the national monitoring and intervention project of common diseases and influencing factors among students in 2019 was used to collect their demography, video display terminal use, outdoor activity, parents'myopia and sleep duration. The multivariate logistic regression model was established to analyze the relationship between sleep duration and low vision among the students. @*Results @#A total of 3 016 questionnaires were sent out, and 2 932 valid ones were returned. The effective rate was 97.21%. There were 1 537 ( 52.42% ) males and 1 395 females ( 47.58% ); 947 ( 32.30% ) primary school students and 1 985 ( 67.70% ) middle school students; 2 328 ( 79.40% ) students with low vision. There were 1 022 ( 34.85% ), 903 (30.80%), 697 ( 23.77% ) and 310 ( 10.57% ) students with the daily sleep duration of <8 hours, 8-<9 hours, 9-<10 hours and ≥10 hours, respectively. The multivariate logistic regression analysis showed that the risk of low vision was lower when the daily sleep duration of students was 8-<9 hours ( OR=0.735, 95%CI: 0.561-0.963 ) and 9-<10 hours ( OR=0.605, 95%CI: 0.446-0.825 ). @*Conclusion @#Adequate sleep duration is conducive to reduce the risk of low vision among primary and middle school students.

Relation between sleep duration and brachial-ankle pulse wave velocity in patients with type 2 diabetes mellitus / 中华内分泌代谢杂志

To explore the relationship between sleep duration and brachial-ankle pulse wave velocity(baPWV) in patients with type 2 diabetes mellitus(T2DM). A total of 1 755 patients with T2DM received standardized management of metabolic disease from March 1, 2018 to February 29, 2020 were included. All patients were classified into three groups according to the sleep duration: short(≤6 h), medium(>6 h to 8 h) and long(>8 h). Increased arterial stiffness was defined as baPWV≥1 600 cm/s. The prevalence of baPWV≥1 600 cm/s was 39.7%, 30.8% and 38.6% in short, medium and long sleep duration group, respectively( P<0.01). Multivariate logistic regression analysis showed that patients with long sleep duration( OR=1.317, P<0.05) but not short sleep duration( OR=1.169, P>0.05) had a higher risk for baPWV≥1 600 cm/s compared with the reference group with medium sleep duration. Stratified analyses by sex showed that the OR were 1.735( P<0.05) among female and 1.131( P>0.05) among male respectively for baPWV≥1 600 cm/s in long sleep duration group when compared with medium sleep duration group. Sleep duration>8 h was found to be associated with elevated baPWV in patients with T2DM. There were gender differences in the correlation between long sleep duration and baPWV.

Correlation between sleep duration and incident diabetes among residents of different ages in Xinjiang region / 中华内分泌代谢杂志

Objective:To explore the correlation between sleep duration and incident diabetes among residents of different ages in Xinjiang region.Methods:A total of 9 541 residents, aged 40 and over in Karamay, Xinjiang were identified by a cluster sampling method. Physical examinations and biochemical test were performed, and the data on sleep duration and lifestyle were obtained using standardized questionnaires. The population was divided into three categories according to sleep duration: insufficient sleep(<6 h), ideal sleep(6-8 h), and long sleep duration(>8 h). They were further divided into 2 subgroups based on age at survey. Those who were younger than 60 years old were defined as the middle-aged group, and the rest as the elderly. Multivariate logistic regression analysis was used to explore the correlation between sleep duration and the risk of diabetes in different age groups.Results:There existed an approximate U-shaped relationship between total sleep duration and fasting blood glucose as well as HbA 1C. Fasting blood glucose and HbA 1C were relatively lower among those with ideal sleep duration. After multivariable adjustment, residents with insufficient sleep revealed a 35% increased risk of diabetes( OR=1.35, 95% CI 1.06-1.71) compared with those with ideal sleep duration. However, the risk of diabetes was not significantly increased in those with long sleep duration( OR=1.04, 95% CI 0.94-1.14). Furthermore, the additive risk of insufficient sleep was only significant in the middle-aged group( OR=1.37, 95% CI 1.02-1.84). Conclusions:Among residents of different ages in Xinjiang region, insufficient sleep is associated with an increased risk of diabetes, which is only significant in the middle-aged group.

Predicted 10-year Cardiovascular Disease Risk and Its Association with Sleep Duration among Adults in Beijing-Tianjin-Hebei Region, China / 生物医学与环境科学（英文）

Objective@#The study aims to predict 10-year cardiovascular disease (CVD) risk and explore its association with sleep duration among Chinese urban adults.@*Methods@#We analyzed part of the baseline data of a cohort that recruited adults for health screening by cluster sampling. The simplified Pittsburgh Sleep Quality Index (PSQI) and Framingham 10-year risk score (FRS) were used to measure sleep duration and CVD risk. Demographic characteristics, personal history of chronic diseases, lifestyle factors were collected using a questionnaire. Height, weight, total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-C) were also measured. Multiple logistic regression models were performed to explore the association of sleep duration with the predicted CVD risk.@*Results@#We included 31, 135 participants (median age 44 years, 53.02% males) free of CVD, cerebral stroke, and not taking lipid-lowering agents. Overall, 14.05%, and 25.55% of participants were at medium and high predicted CVD risk, respectively. Short sleep was independently associated with increased odds of medium to high risk of predicted 10-year CVD among males ( @*Conclusion@#A substantial number of adults free of CVD were at high 10-year CVD risk. Short sleep was associated with increased odds of predicted CVD risk.

Effect of interaction between sleep and occupational stress on the prevalence of hypertension in petroleum workers / 中国职业医学

OBJECTIVE: To explore the influence of the interaction among occupational stress, sleep duration and sleep quality on the prevalence of hypertension in petroleum workers. METHODS: A total of 3 040 workers from six oil field bases in Karamay City were selected as study subjects by multi-stage random cluster sampling method. The Chinese version of Pittsburgh Sleep Quality Scale and the revised version of Occupational Stress Scale were used to evaluate their sleep quality and occupational stress status. Binary logistic regression was used to analyze the effect of interaction of occupational stress, sleep duration and sleep quality on hypertension. RESULTS: The prevalence of hypertension in the study subjects was 15.3%(466/3 040), and the detection rates of sleep deprivation, poor sleep quality and high occupational stress were 26.5%, 78.3% and 19.6% respectively. After adjusting for confounding factors such as gender, ethnicity, age, marital status, education level, length of service, professional title, shift work, smoking, alcohol consumption and body mass index, the interaction analysis results showed that the risk of hypertension was higher in the poor sleep quality groups with normal sleep duration, sleep deprivation or longer sleep duration than that in good sleep quality group with normal sleep duration(all P<0.05), respectively. The risk of hypertension was higher in the group with sleep deprivation and high occupational stress than that in the group with normal sleep duration and low occupational stress(P<0.01). In the group with poor sleep quality and high occupational stress the risk of hypertension was higher than that in the group with good sleep quality and low occupational stress(P<0.05). CONCLUSION: The interaction among occupational stress, sleep duration and sleep quality may increase the risk of hypertension in petroleum workers.

Effect Of Type Of Physical Activity On The Sleep Pattern Of Sport Players

Background: Physical activity has been identified as a significant adjuvant in improving quality of life and lowering the cost of medicine. A positive effect has been seen on the mental and physical health of an individual influenced by physical activity and sleep. There is a scarcity of studies that determined the correlation between sleep patterns and physical activity among sports players. The present study is aimed to assess the association between physical activity and sleep among sports players. Methods: The present study was carried in Faridabad with a sample size of 133 sports players with age criteria between 18-25 years. The subjects were runners, shooters, and archers. WHO Questionnaire for physical activity was used to assess the physical activity of sports players. The Sleep Pattern was evaluated by using the “Pittsburgh Sleep Quality Index.” Results: The study results revealed that all of the runners (100%) were having vigorous activity. 72.7% of archers had moderate activity, but 58.8% of shooters had sedentary activity. Most of the sports payers were having a fairly good quality of Sleep (P=0.65). No correlation was observed between the Global Physical Activity Questionnaire Score of the subjects with any Sleep Domain. Conclusion: The study concluded that among different sports players doing sedentary, moderate, or heavy physical activity were having good quality sleep. This means even a small amount of physical activity can contribute to good quality sleep.

Relationship between sleep duration on peak melatonin secretion and renal function injury in steel workers / 中国职业医学

OBJECTIVE: To investigate the relationship between the sleep duration on peak melatonin secretion and renal function injury in steel workers. METHODS: A judgment sampling method was used to select 7 655 steel workers in a steel production department for health examination and questionnaire survey, and the relationship between renal function injury and non-peak sleep time(equivalent to the reduction of sleep duration on peak melatonin secretion) was analyzed using restriction cubic spline(RCS) model and multi-factor logistic regression. RESULTS: The detection rate of renal injury in the study subjects was 14.5%(1 110/7 655). RCS model analysis results showed that there was a linear dose-response relationship between non-peak sleep time and renal injury(overall correlation test χ~2=16.85, P<0.01, nonlinear test χ~2=3.70, P>0.05). Multivariate logistic regression analysis results showed that the workers of non-peak sleep time more than or equal to 4 515-day had higher risk of renal function injury than the workers of non-peak sleep time less than 4 515-day(P<0.05), with odds ratio and 95% confidence interval of 1.4(1.2-1.7), after adjustment for the potential influencing factors such as individual factors and occupational factors. CONCLUSION: Reduction of peak melatonin secretion sleep duration is correlated with renal function injury in steel workers.

Correlation between sleep duration and ischemic stroke: A large community study / 西安交通大学学报(医学版)

Objective To investigate the relationship between sleep duration (SD) collected by polysomnography and ischemic stroke in community populations. Methods We recruited 2062 participants, including 724 males and 1338 females. The mean age of the all participants was 61.44 years. In this study, the subjects were divided into three groups according to SD: short SD (8 h), and normal SD (6-8 h). Logistic regression was used to analyze the independent association between the three different sleep durations and the occurrence of ischemic stroke. Results ① The three groups differed significantly in gender, age, BMI, prevalence of diabetes and serum triglyceride levels (P<0.05). ② The incidence of ischemic stroke was significantly higher in short SD group than in long SD group and normal SD group (the incidence rates were 5.9%, 2.7% and 1.6%, respectively; P=0.044, P<0.001). ③ Univariate logistic regression analysis suggested that short SD was associated with the occurrence of ischemic stroke (OR=3.845, 95% CI: 1.789-8.266, P=0.001). After adjusting potential factors such as gender, age, marital status, alcohol consumption, hypertension, diabetes and triglycerides, multivariate logistic regression analysis showed that short SD was still an independent risk factor for ischemic stroke (OR=2.629, 95% CI: 1.033-6.693, P=0.043). Conclusion The incidence of ischemic stroke differs in people with different SD. Among them, the incidence of ischemic stroke is higher in people with short SD.

Association of sleep with anxiety in the elderly aged 60 years and older in China / 中华流行病学杂志

Objective@#To investigate the relationship of sleep duration and sleep quality with anxiety in the elderly aged 60 years and older in China.@*Methods@#The elderly aged 60 years and older were selected from the China Short-term Health Effects of Air Pollution Study conducted between July 18, 2017 and February 7, 2018. Multivariate logistic regression models were used to analyze the association of sleep duration and sleep quality with anxiety.@*Results@#A total of 3 897 elderly aged 60 years and older were included in the study. The age of the elderly was (73.4±8.0) years old. Among the elderly surveyed, 6.5% were defined with anxiety, and 18.7% reported poor sleep quality. Multivariate logistic regression models showed shorter sleep duration was the risk factor for anxiety in the elderly that after adjusting for factors such as general demographics, socioeconomic factors, lifestyle, health status, social support and ambient fine particulates exposure. Compared with the elderly with 7 hours of sleep duration daily, the OR (95%CI) of anxiety for those with sleep duration ≤ 6 hours was 2.09 (1.49-2.93). Compared with those with good sleep quality, the OR (95%CI) of anxiety for those with poor sleep quality was 5.12 (3.88-6.77). We also found statistically significant correlations of the scores of subscales of Pittsburgh sleep quality index with anxiety, in which the effects of sleep disturbance, subjective sleep quality and daytime dysfunction scores were most obvious, the ORs (95%CI) were 4.63 (3.55-6.04), 2.75 (2.33-3.23) and 2.50 (2.19-2.86), respectively. Subgroup analysis showed that the association of sleep duration and sleep quality with anxiety was more obvious in males and in those aged <80 years.@*Conclusion@#Shorter sleep duration and poor sleep quality are associated with anxiety in the elderly in China.

Effect of sleep duration and quality on hypertension incidence in Chinese middle-aged and elderly people / 中华疾病控制杂志

Objective To investigate the incidence of hypertension among Chinese middle-aged and elderly people, and to explore the association of sleep duration and sleep quality with the incidence of hypertension. Methods Our data were collected from the 2011 and 2015 China health and retirement longitudinal study(CHARLS),a total of 6 047 middle-aged and elderly individuals aged 45 years and over were included in this study, sleep duration were measured as self-reported average sleep time in the past month. Sleep quality was evaluated using the self-made questionnaire. The association of sleep duration and sleep quality with the incidence of hypertension was analyzed using multivariate logistic regression analysis. Results After four years of follow-up,1 151 peoples developed hypertension, and the cumulative incidence rate was 19.03%. Logistic regression analysis showed that abnormal sleep time or poor sleep quality had no effect on the incidence of hypertension. The results remained unchanged in the subgroup analysis of sex and age. Further investigation of the association of different combinations of sleep duration and quality in relation to hypertension indicated that the combined effect of sleep time and sleep quality on hypertension was not statistically significant (all P>0.05). Conclusion There is no sufficient evidence supporting correlation between sleep time and sleep quality with the incidence of hypertension in the middle-aged and the elderly in China, and age and sex had no effect on the correlation.

The association between sleep duration, bedtimes, and early pubertal timing among Chinese adolescents: a cross-sectional study

BACKGROUND AND OBJECTIVE@#Early pubertal timing is associated with sleep among Western adolescents, but little is known about this association in Chinese adolescents, especially with regard to the association between bedtimes and early pubertal timing. This paper aimed to identify the association between sleep duration, bedtimes, and early pubertal timing in Chinese adolescents.@*METHODS@#An anonymous cross-sectional survey was conducted among primary and junior middle students (grades 3 to 9) from QiJiang District, ChongQing, China. Participants were recruited by applying stratified cluster sampling. Pubertal timing, sleep duration, and bedtimes were assessed using the Pubertal Development Scale and a self-designed sleep questionnaire. We utilized multivariable logistic linear regression (MLLR) to test the association between sleep duration, bedtimes, and pubertal timing.@*RESULTS@#A total of 5461 adolescents were evaluated, with mean age and BMI values of 11.41 ± 2.05 and 18.03 ± 3.03, respectively, of whom 1257 (23.02%) were in early pubertal timing. In MLLR controlling for age, BMI, family economic status, and other covariates, sufficient sleep (b = - 0.214, P = 0.032, OR = 0.808, 95% CI 0.664-0.982) was negatively related to early pubertal timing, and later bedtime (b = 0.195, P < 0.001, OR = 1.215, 95% CI 1.104-1.338) was positively associated with early pubertal timing.@*CONCLUSION@#Students with early pubertal timing had less sleep duration and later bedtimes, which may be the result of increased stress caused by physical and psychological changes. Therefore, more attention should be paid to pubertal health education for adolescents during puberty. Further longitudinal studies are needed to confirm the causality between sleep and early pubertal timing in Chinese adolescents.

Association of sleep with anxiety in the elderly aged 60 years and older in China / 中华流行病学杂志

To investigate the relationship of sleep duration and sleep quality with anxiety in the elderly aged 60 years and older in China. The elderly aged 60 years and older were selected from the China Short-term Health Effects of Air Pollution Study conducted between July 18, 2017 and February 7, 2018. Multivariate logistic regression models were used to analyze the association of sleep duration and sleep quality with anxiety. A total of 3 897 elderly aged 60 years and older were included in the study. The age of the elderly was (73.4±8.0) years old. Among the elderly surveyed, 6.5 were defined with anxiety, and 18.7 reported poor sleep quality. Multivariate logistic regression models showed shorter sleep duration was the risk factor for anxiety in the elderly that after adjusting for factors such as general demographics, socioeconomic factors, lifestyle, health status, social support and ambient fine particulates exposure. Compared with the elderly with 7 hours of sleep duration daily, the (95) of anxiety for those with sleep duration ≤ 6 hours was 2.09 (1.49-2.93). Compared with those with good sleep quality, the (95) of anxiety for those with poor sleep quality was 5.12 (3.88-6.77). We also found statistically significant correlations of the scores of subscales of Pittsburgh sleep quality index with anxiety, in which the effects of sleep disturbance, subjective sleep quality and daytime dysfunction scores were most obvious, the (95) were 4.63 (3.55-6.04), 2.75 (2.33-3.23) and 2.50 (2.19-2.86), respectively. Subgroup analysis showed that the association of sleep duration and sleep quality with anxiety was more obvious in males and in those aged <80 years. Shorter sleep duration and poor sleep quality are associated with anxiety in the elderly in China.