International Journal of Environmental Research and Public Health

Research

10 pages, 826 KiB

Open AccessArticle

Do Sleep Disorders Positively Correlate with Dry Eye Syndrome? Results of National Claim Data

by Kyu-Tae Han, Ji Hyung Nam and Eun-Cheol Park

Int. J. Environ. Res. Public Health 2019, 16(5), 878; https://doi.org/10.3390/ijerph16050878 - 11 Mar 2019

Cited by 14 | Viewed by 3502

Purpose: Dry eye syndrome (DES) is a common disease with an increasing occurrence. Although DES symptoms are considered mild, it can reduce quality of life for individuals. Many studies on DES have been conducted, but these focused on the use of electronic [...] Read more.

Purpose: Dry eye syndrome (DES) is a common disease with an increasing occurrence. Although DES symptoms are considered mild, it can reduce quality of life for individuals. Many studies on DES have been conducted, but these focused on the use of electronic devices. Here, we investigate an association between DES and sleep disorders in the context of emerging health issues. Methods: Our data came from the National Health Insurance Service (NHIS) National Sample Cohort, which included 44,366 patients and was based on a 1:1 matching method (sleep disorder patients vs. patients without sleep disorders) during 2012–2015. Using survival analysis with a Cox proportional hazard model, we identified an association of sleep disorders with DES. Results: About 16.7% of all patients were diagnosed with DES, and prevalence was higher in patients with sleep disorders (sleep disorders: 19.82%, no sleep disorders: 13.67%). Survival analysis showed that sleep disorders positively correlated with DES diagnosis (Hazard Ratio (HR): 1.320, 95% Confidence Interval (CI): 1.261–1.382, p-value < 0.0001). Positive trends were enhanced in males, younger patients, lower economic levels, and with higher severity of comorbid. Conclusions: Our findings suggest that sleep disorder was positively associated with DES. This correlation can be helpful in effective management of both sleep disorders and DES in South Koreans. Full article

(This article belongs to the Special Issue Sleep Health)

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11 pages, 1091 KiB

Open AccessArticle

Differences in Insomnia Symptoms between Immigrants and Non-Immigrants in Switzerland attributed to Emotional Distress: Analysis of the Swiss Health Survey

by Andres R. Schneeberger, Azizi Seixas, Nina Schweinfurth, Undine E. Lang, Christian Cajochen, Donald A. Bux, Shannique Richards, Girardin Jean-Louis and Christian G. Huber

Int. J. Environ. Res. Public Health 2019, 16(2), 289; https://doi.org/10.3390/ijerph16020289 - 21 Jan 2019

Cited by 10 | Viewed by 4533

Abstract

Migration can be a stressful experience and may lead to poor health and behavioral changes. The immigrant population in Switzerland is disproportionately burdened by several negative health outcomes, chief among these is mental health issues. The aim of the study was to investigate [...] Read more.

Migration can be a stressful experience and may lead to poor health and behavioral changes. The immigrant population in Switzerland is disproportionately burdened by several negative health outcomes, chief among these is mental health issues. The aim of the study was to investigate whether sleep disturbances are more prevalent among immigrants compared to non-immigrants and whether emotional distress might explain sleep differences. Based on the Swiss Health Survey 2012 dataset, we analyzed the data of 17,968 people, of which 3406 respondents were immigrants. We examined variables including insomnia symptoms, emotional distress and clinical and socio-demographic data using unadjusted and adjusted generalized linear models. Compared to non-immigrants, immigrants suffer significantly more often from insomnia symptoms. Immigrants also endured higher levels of emotional distress. Higher values of emotional distress are related to other symptoms of sleep disorders. Immigrants with emotional distress were at significant risk of sleep disturbances. Sleep disparities between immigrants and non-immigrants may be influenced by emotional distress. Migration health care should address emotional distress, a more proximal and modifiable factor, as a possible cause of insomnia symptoms in immigrants. Full article

(This article belongs to the Special Issue Sleep Health)

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8 pages, 637 KiB

Open AccessArticle

Relationship between Daytime Sleepiness and Health Utility in Patients after Cardiac Surgery: A Preliminary Study

by Kazuhiro P. Izawa, Yusuke Kasahara, Koji Hiraki, Yasuyuki Hirano, Koichiro Oka and Satoshi Watanabe

Int. J. Environ. Res. Public Health 2018, 15(12), 2716; https://doi.org/10.3390/ijerph15122716 - 2 Dec 2018

Cited by 3 | Viewed by 3025

Abstract

Background Daytime sleepiness can be assessed by the Epworth Sleepiness Scale (ESS), which is widely used in the field of sleep medicine as a subjective measure of a patient’s sleepiness. Also, health utility assessed by the mean Short-Form Six-Dimension (SF-6D) score, one of [...] Read more.

Background Daytime sleepiness can be assessed by the Epworth Sleepiness Scale (ESS), which is widely used in the field of sleep medicine as a subjective measure of a patient’s sleepiness. Also, health utility assessed by the mean Short-Form Six-Dimension (SF-6D) score, one of several preference-based utility measures, is an important measure in health care. We aimed to examine age-related differences in daytime sleepiness and health utility and their relationship in patients 5 months after cardiac surgery. Methods; This cross-sectional study assessed 51 consecutive cardiac surgery patients who were divided into a middle-aged (<65 years, n = 29) and older-age group (≥65 years, n = 22). The mean ESS and SF-6D utility scores were measured at 5 months after cardiac surgery and compared. In addition, the relationship between ESS and SF-6D utility scores were assessed. Results; There were no significant differences between the middle-aged and older-aged groups in either the mean ESS (5.14 ± 2.96 vs. 4.05 ± 3.23, p = 0.22) or SF-6D utility (0.72 ± 0.14 vs. 0.71 ± 0.10, p = 0.76) scores. However, there was a negative correlation between both values in all of the patients after cardiac surgery (r = −0.41, p = 0.003). Conclusions; Although there were no age-related differences in the ESS and SF-6D utility values between the two groups, there was a negative correlation between these values in all patients at 5 months after cardiac surgery. This suggested that sleepiness is associated with decreased utility scores in patients at 5 months after cardiac surgery. Full article

(This article belongs to the Special Issue Sleep Health)

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12 pages, 854 KiB

Open AccessArticle

The Association between Migraine and Types of Sleep Disorder

by Seung Ju Kim, Kyu-Tae Han, Suk-Yong Jang, Ki-Bong Yoo and Sun Jung Kim

Int. J. Environ. Res. Public Health 2018, 15(12), 2648; https://doi.org/10.3390/ijerph15122648 - 26 Nov 2018

Cited by 18 | Viewed by 6151

Abstract

Background: Migraines gradually increase year by year, as does its burden. Management and prevention are needed to reduce such burdens. Previous studies have suggested that daily health behaviors can cause migraines. Sleep is a substantial part of daily life, and in South [...] Read more.

Background: Migraines gradually increase year by year, as does its burden. Management and prevention are needed to reduce such burdens. Previous studies have suggested that daily health behaviors can cause migraines. Sleep is a substantial part of daily life, and in South Korea, the average sleep duration is shorter than in other countries. Thus, this study focused on the increase of both diseases, and analyzed sleep disorders as a risk factor for migraines. Methods: The data used in this study was that of the national health insurance service (NHIS) national sample cohort. We used a matched cohort study design that matched non-patients based on patients with sleep disorders, and included 133,262 patients during 2012–2015. We carried out a survival analysis using a Cox proportional hazard model with time-dependent covariates to identify the association between migraines and sleep disorders. Results: Approximately 11.72% of patients were diagnosed with migraines. Sleep disorders were positively correlated with the diagnosis of migraine (Hazard Ratio, 1.591; p < 0.0001). By the types of sleep disorder, patients who were diagnosed as having insomnia, rather than other types of sleep disorder, had the greatest associations with migraine. The associations were greater for males, people with lower income, the elderly population, and patients with mild comorbid conditions. Conclusion: This study provides evidence that migraine is associated with sleep disorders, especially insomnia. Based on these findings, healthcare professionals and policy makers have to reconsider the present level of insurance coverage for sleep medicine, recognize the risk of sleep-related diseases and educate patients about the need for appropriate care. Full article

(This article belongs to the Special Issue Sleep Health)

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16 pages, 1358 KiB

Open AccessArticle

The Associations between Dietary Patterns and Short Sleep Duration in Polish Adults (LifeStyle Study)

by Jerzy Gębski, Marzena Jezewska-Zychowicz, Dominika Guzek, Monika Świątkowska, Dagmara Stangierska and Marta Plichta

Int. J. Environ. Res. Public Health 2018, 15(11), 2497; https://doi.org/10.3390/ijerph15112497 - 8 Nov 2018

Cited by 14 | Viewed by 4249

Abstract

Short sleep duration appears to put adults at risk of excessive energy intake and obesity; less is known specifically about how sleep quantity relates to dietary patterns. Therefore, the aim of this study was to assess the associations of dietary patterns (DPs) with [...] Read more.

Short sleep duration appears to put adults at risk of excessive energy intake and obesity; less is known specifically about how sleep quantity relates to dietary patterns. Therefore, the aim of this study was to assess the associations of dietary patterns (DPs) with short sleep duration. The data were collected in November 2016 through a cross-sectional quantitative survey among 972 Polish adults with both normal weight and excessive weight. Principal components analysis (PCA) was conducted to derive DPs. Logistic regression analysis was used to verify associations between short sleep duration (independent variable) and DPs (dependent variables). Five DPs (‘Fast foods & sweets’—FF&S; ‘Meat & meat products’—M&MP; ‘Fruit & vegetable’—F&V; ‘Wholemeal food’—WF; and ‘Fruit & vegetable juices’—F&VJ) were identified. Adults whose diet was based both on fruit and vegetables (OR 0.62, 95% CI: 0.44–0.88; p < 0.01) and on fast food and sweets (OR 0.63, 95% CI: 0.44–0.99; p < 0.01) were less likely to be short sleepers on weekdays. On weekdays short sleep duration was associated with smaller odds of FF&S both for men (OR 0.58, 95% CI: 0.33–0.97; p < 0.05) and for women (OR 0.61, 95% CI: 0.38–0.98; p < 0.05), and with smaller odds of F&V (OR 0.34, 95% CI: 0.20–0.58; p < 0.001) for men. Short sleep duration on weekend days was associated with a smaller odds of F&VJ (OR 0.56, 95% CI: 0.30–0.96; p < 0.05- only in crude model) and higher odds of F&V (OR 1.70, 95% CI: 1.02–3.11; p < 0.05) for women, and with a smaller odds of FF&S (OR 0.37, 95% CI: 0.17–0.79; p < 0.05) for men. The number of significant associations between dietary patterns and sleep duration was higher among people with normal weight and overweight compared to those with BMI ≥ 30. We found that both short sleep duration on weekdays and weekend days was associated with some dietary patterns including both healthy and unhealthy DPs. Gender significantly differed these relationships in groups with normal and excessive weight. Findings of the study confirmed the potential effectiveness of combined use of sleep duration and dietary patterns in the development of recommendations for prevention of obesity. Future studies are called for to evaluate these links using dietary patterns identified according to food intake. Full article

(This article belongs to the Special Issue Sleep Health)

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18 pages, 763 KiB

Open AccessArticle

Sleep Quality and Its Associated Factors among Low-Income Adults in a Rural Area of China: A Population-Based Study

by Wenwen Wu, Wenru Wang, Zhuangzhuang Dong, Yaofei Xie, Yaohua Gu, Yuting Zhang, Mengying Li and Xiaodong Tan

Int. J. Environ. Res. Public Health 2018, 15(9), 2055; https://doi.org/10.3390/ijerph15092055 - 19 Sep 2018

Cited by 48 | Viewed by 5786

Abstract

Background: There is limited population-based research focusing on sleep quality among low-income Chinese adults in rural areas. This study aimed to assess sleep quality among low-income adults in a rural area in China and identify the association between sleep quality and sociodemographic, lifestyle [...] Read more.

Background: There is limited population-based research focusing on sleep quality among low-income Chinese adults in rural areas. This study aimed to assess sleep quality among low-income adults in a rural area in China and identify the association between sleep quality and sociodemographic, lifestyle and health-related factors. Methods: The study was conducted from September to November in 2017 using a cross-sectional survey questionnaire. A total of 6905 participants were recruited via multistage, stratified cluster sampling. Data were collected using the Chinese versions of Pittsburgh Sleep Quality Index and Food Frequency Questionnaire, while we also determined the sociodemographic profiles of the participants. Results: The mean age of the sample was 58.71 ± 14.50 years, with 59.7% being male, while the mean duration of daily sleep was 5.95 ± 1.31 h, with 56.7% reportedly experiencing poor sleep quality. Multiple regression analysis revealed that older age, unemployment, lower income, disability and chronic disease comorbidities were significant factors associated with an increased risk of poor sleep quality for both genders. Moreover, married and higher education level were associated with decreased risk of poor sleep quality for females, while a meat-heavy diet and illness during the past two weeks increased the risk of poor sleep quality for males. Conclusions: Sociodemographic, lifestyle and health-related factors had an impact on the frequently poor sleep quality of low-income Chinese adults in rural areas. Thus, comprehensive measures must be developed to address the modifiable predictive factors that can possibly enhance sleep quality. Full article

(This article belongs to the Special Issue Sleep Health)

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12 pages, 924 KiB

Open AccessArticle

Is Sleep Duration Associated with Biological Age (BA)?: Analysis of (2010–2015) South Korean NHANES Dataset South Korea

by Kyu-Tae Han, Dong Wook Kim and Sun Jung Kim

Int. J. Environ. Res. Public Health 2018, 15(9), 2009; https://doi.org/10.3390/ijerph15092009 - 14 Sep 2018

Cited by 10 | Viewed by 3585

Abstract

(1) Background: South Korea ranked worst in sleep duration compared to other countries, but there are no clear healthcare programs to guarantee sufficient sleep. Studies are needed to suggest evidence and arouse public awareness of the negative effects of abnormal sleep duration. In [...] Read more.

(1) Background: South Korea ranked worst in sleep duration compared to other countries, but there are no clear healthcare programs to guarantee sufficient sleep. Studies are needed to suggest evidence and arouse public awareness of the negative effects of abnormal sleep duration. In this study, we investigated the relationship between biological age (BA) and sleep duration. (2) Methods: We used data from the Korea National Health and Nutrition Examination Surveys (KNHANES V-VI; 2010–2015, which is an annually cross-sectional study including 29,309 participants). We performed multiple linear regression to investigate the associations between sleep duration and differences in BA and chronological age (CA). (3) Results: A total of 14.22% of respondents had short sleep duration (less than 6 h per day) and 7.10% of respondents had long sleep duration (more than 8 h per day). People with long sleep duration had a positive correlation with difference between BA and CA (>8 h per day, β = 1.308, p-value = 0.0001; ref = 6~8 h per day, normal). Short sleep duration had an inverse trend with the difference, although the result was not statically significant. Associations were greater in vulnerable populations, such as low income, obese, or people with chronic diseases. (4) Conclusions: Excess sleep duration that is greater than the normal range was associated with increased BA. In particular, such relationships that are related to worsening BA were greater in patients with low income, obesity, and chronic diseases. Based on our findings, healthcare professionals should also consider the negative effects of excess sleep, not only insufficient sleep. Alternatives for controlling optimal sleep duration should be reviewed, especially with vulnerable populations. Full article

(This article belongs to the Special Issue Sleep Health)

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15 pages, 537 KiB

Open AccessArticle

Relationship between Sleep Disorders and Health Related Quality of Life—Results from the Georgia SOMNUS Study

by Nato Darchia, Nikoloz Oniani, Irine Sakhelashvili, Mariam Supatashvili, Tamar Basishvili, Marine Eliozishvili, Lia Maisuradze and Katerina Cervena

Int. J. Environ. Res. Public Health 2018, 15(8), 1588; https://doi.org/10.3390/ijerph15081588 - 26 Jul 2018

Cited by 54 | Viewed by 6608

Abstract

The extent to which sleep disorders are associated with impairment of health-related quality of life (HRQoL) is poorly described in the developing world. We investigated the prevalence and severity of various sleep disorders and their associations with HRQoL in an urban Georgian population. [...] Read more.

The extent to which sleep disorders are associated with impairment of health-related quality of life (HRQoL) is poorly described in the developing world. We investigated the prevalence and severity of various sleep disorders and their associations with HRQoL in an urban Georgian population. 395 volunteers (20–60 years) completed Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, STOP-Bang questionnaire, Insomnia Severity Index, Beck Depression Inventory-Short Form, and Short Form Health Survey (SF-12). Socio-demographic data and body mass index (BMI) were obtained. The prevalence of sleep disorders and their association with HRQoL was considerable. All SF-12 components and physical and mental component summaries (PCS, MCS) were significantly lower in poor sleepers, subjects with daytime sleepiness, apnea risk, or insomnia. Insomnia and apnea severity were also associated with lower scores on most SF-12 dimensions. The effect of insomnia severity was more pronounced on MCS, while apnea severity—on PCS. Hierarchical analyses showed that after controlling for potential confounding factors (demographics, depression, BMI), sleep quality significantly increased model’s predictive power with an R² change (ΔR²) by 3.5% for PCS (adjusted R² = 0.27) and by 2.9% for MCS (adjusted R² = 0.48); for the other SF-12 components ΔR² ranged between 1.4% and 4.6%. ESS, STOP-Bang, ISI scores, all exerted clear effects on PCS and MCS in an individual regression models. Our results confirm and extend the findings of studies from Western societies and strongly support the importance of sleep for HRQoL. Elaboration of intervention programs designed to strengthen sleep-related health care and thereof HRQoL is especially important in the developing world. Full article

(This article belongs to the Special Issue Sleep Health)

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9 pages, 315 KiB

Open AccessArticle

Self-Reported Sleep Duration and Its Correlates with Sociodemographics, Health Behaviours, Poor Mental Health, and Chronic Conditions in Rural Persons 40 Years and Older in South Africa

by Karl Peltzer and Supa Pengpid

Int. J. Environ. Res. Public Health 2018, 15(7), 1357; https://doi.org/10.3390/ijerph15071357 - 28 Jun 2018

Cited by 16 | Viewed by 4111

Abstract

This study aims to investigate sleep duration and its association with sociodemographic, health behaviour, mental health, and chronic disease factors among rural individuals 40 years and older in South Africa. Cross-sectional data from the “Health and Aging in Africa: A Longitudinal Study of [...] Read more.

This study aims to investigate sleep duration and its association with sociodemographic, health behaviour, mental health, and chronic disease factors among rural individuals 40 years and older in South Africa. Cross-sectional data from the “Health and Aging in Africa: A Longitudinal Study of an INDEPTH community in South Africa” (HAALSI) baseline survey were analysed. Socio-demographic, clinical, health, and sleep duration data were collected. The total sample included 4725 persons 40 years and older (mean age 61.5 years, SD = 13.0, age range of 40–111 years) in one sub-district in rural South Africa. The mean sleep duration was 8.28 ± 1.93 h. Short (<7 h) and long (≥9 h) sleepers accounted for 13.1% and 40.0% of the sample, respectively. In adjusted multinomial logistic regression, greater wealth status (p < 0.05), inadequate fruit and vegetable consumption (p < 0.001), and depressive symptoms (p < 0.05) were associated with a higher odds and physical inactivity (p < 0.05) with a lower odds of short sleep duration. Being male (p < 0.001) and depressive symptoms (p < 0.001) were associated with a higher odds and being 50 to 69 years old (p < 0.01), having Grade 1 to 11 education (p < 0.05), and greater wealth status (p < 0.001) were associated with a lower odds of long sleep duration. In adjusted multinomial logistic regression, compared to normal sleepers, long sleepers were more likely to have myocardial infarction (p < 0.05). In unadjusted analysis, compared to normal sleepers, short sleepers were more likely to have cataracts (p < 0.05). This study found that a significant proportion of rural dwellers 40 years and older in South Africa had a short sleep duration and a high proportion had a long sleep duration. Some associations, such as depression and myocardial infarction, with short and/or long sleep duration were confirmed, while no associations were found for many chronic conditions. Full article

(This article belongs to the Special Issue Sleep Health)

13 pages, 1412 KiB

Open AccessArticle

Comparison of Wearable Trackers’ Ability to Estimate Sleep

by Jung-Min Lee, Wonwoo Byun, Alyssa Keill, Danae Dinkel and Yaewon Seo

Int. J. Environ. Res. Public Health 2018, 15(6), 1265; https://doi.org/10.3390/ijerph15061265 - 15 Jun 2018

Cited by 79 | Viewed by 9984

Abstract

Tracking physical activity and sleep patterns using wearable trackers has become a current trend. However, little information exists about the comparability of wearable trackers measuring sleep. This study examined the comparability of wearable trackers for estimating sleep measurement with a sleep diary (SD) [...] Read more.

Tracking physical activity and sleep patterns using wearable trackers has become a current trend. However, little information exists about the comparability of wearable trackers measuring sleep. This study examined the comparability of wearable trackers for estimating sleep measurement with a sleep diary (SD) for three full nights. A convenience sample of 78 adults were recruited in this research with a mean age of 27.6 ± 11.0 years. Comparisons between wearable trackers and sleep outcomes were analyzed using the mean absolute percentage errors, Pearson correlations, Bland–Altman Plots, and equivalent testing. Trackers that showed the greatest equivalence with the SD for total sleep time were the Jawbone UP3 and Fitbit Charge Heart Rate (effect size = 0.09 and 0.23, respectively). The greatest equivalence with the SD for time in bed was seen with the SenseWear Armband, Garmin Vivosmart, and Jawbone UP3 (effect size = 0.09, 0.16, and 0.07, respectively). Some of the wearable trackers resulted in closer approximations to self-reported sleep outcomes than a previously sleep research-grade device, these trackers offer a lower-cost alternative to tracking sleep in healthy populations. Full article

(This article belongs to the Special Issue Sleep Health)

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15 pages, 3188 KiB

Open AccessArticle

Relationship between Job Stress and 5-HT2A Receptor Polymorphisms on Self-Reported Sleep Quality in Physicians in Urumqi (Xinjiang, China): A Cross-Sectional Study

by Xiaoyan Gao, Hua Ge, Yu Jiang, Yulong Lian, Chen Zhang and Jiwen Liu

Int. J. Environ. Res. Public Health 2018, 15(5), 1034; https://doi.org/10.3390/ijerph15051034 - 21 May 2018

Cited by 14 | Viewed by 4888

Abstract

The serotonin receptor (5-HTR) plays a key role in sleep quality regulation. Job-related stress is an important factor that influences sleep quality. However, few reports on the interaction between 5-HTR2A polymorphisms and job stress, and how they may impact upon sleep quality are [...] Read more.

The serotonin receptor (5-HTR) plays a key role in sleep quality regulation. Job-related stress is an important factor that influences sleep quality. However, few reports on the interaction between 5-HTR2A polymorphisms and job stress, and how they may impact upon sleep quality are available. Therefore this study investigated the effects of job stress, 5-HTR2A polymorphisms, and their interaction on sleep quality, in physicians. Using a two-stage stratified sampling method, 918 participants were initially invited to participate in the study. After screening for study inclusion and exclusion criteria, 504 subjects were eventually included in the study. Job stress and sleep quality were assessed using the Job Stress Survey (JSS) and Pittsburgh Sleep Quality Index (PSQI), respectively. The 5-HTR2A receptor gene polymorphisms T102C and -1438G/A of were determined using polymerase chain reaction-restriction fragment length polymorphism. Job stress was significantly associated with sleep quality. High levels of job stress were linked to a higher risk of poor sleep quality compared to low or moderate levels [odds ratio (OR) = 2.909, 95% confidence interval (CI): 1.697–4.986]. High levels of stress may reduce subjects’ sleep quality, leading to an increase the likelihood of sleep disturbances and subsequent daytime dysfunction. The 5-HTR2A receptor gene polymorphism T102C was not significantly associated with sleep quality in this study, however, the -1438G/A polymorphism was significantly associated with sleep quality. The GG genotype of the -1438G/A polymorphism was linked to poorer sleep quality. When compared with subjects with low job-related stress levels×AG/AA genotype (OR = 2.106, 95% CI: 1.278–3.471), physicians with high job-related stress levels×GG genotype had a higher risk of experiencing poor sleep quality (OR = 13.400, 95% CI: 3.143–57.137). The findings of our study indicate that job stress and 5-HTR2A receptor gene polymorphisms are associated with sleep quality in physicians. Subjects with high job stress level or/and the -1438G/A GG genotype were more likely to report poor sleep quality, and furthermore, their combination effect on sleep quality was higher than their independent effects, so it may be suggested that job-related stress and genes have a cumulative effect on sleep quality; that is, stress can increase the risk of poor sleep quality, but this effect is worse in a group of people with specific gene polymorphisms. Full article

(This article belongs to the Special Issue Sleep Health)

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10 pages, 331 KiB

Open AccessArticle

The Associations between Sleep Duration and Sleep Quality with Body-Mass Index in a Large Sample of Young Adults

by Tomislav Krističević, Lovro Štefan and Goran Sporiš

Int. J. Environ. Res. Public Health 2018, 15(4), 758; https://doi.org/10.3390/ijerph15040758 - 15 Apr 2018

Cited by 53 | Viewed by 8984

Abstract

Background: The main aims of this study were to explore the associations between time spent in bed (as a proxy of sleep duration) and sleep quality with overweight/obesity status in a large sample of young adults. Methods: In this cross-sectional study, participants were [...] Read more.

Background: The main aims of this study were to explore the associations between time spent in bed (as a proxy of sleep duration) and sleep quality with overweight/obesity status in a large sample of young adults. Methods: In this cross-sectional study, participants were 2100 university students (49.6% of women). We used Pittsburgh Sleep Quality Index (PSQI) questionnaire to assess time spent in bed and sleep quality. Body-mass index (BMI) was self-reported and dichotomized as normal (<25 kg/m²) vs. overweight/obesity (≥25 kg/m²) status. Results: In model 1, both short (<6 h/day, OR = 2.72; 95% CI 1.27 to 5.84) and long (>10 h/day, OR = 3.38; 95% CI 2.12 to 5.40) time spent in bed were associated with a greater likelihood of being overweight/obese. In model 2, poor sleep quality (>5 points, OR = 1.45; 95% CI 1.14 to 1.83) was associated with a greater likelihood of being overweight/obese. After entering time spent in bed and sleep quality simultaneously into the model 3, both short (OR = 2.64; 95% CI 1.23 to 5.66) and long (OR = 3.27; 95% CI 2.04 to 5.23) time spent in bed and poor sleep quality (OR = 1.40; 95% CI 1.10 to 1.78) were associated with overweight/obesity status. Conclusions: Our results show that both short and long time spent in bed and poor sleep quality are associated with overweight/obesity status in young adults. Special interventions and policies that use both sleep duration and sleep quality as protective factors against overweight/obesity are warranted. Full article

(This article belongs to the Special Issue Sleep Health)

14 pages, 354 KiB

Open AccessArticle

Black–White Differences in Housing Type and Sleep Duration as Well as Sleep Difficulties in the United States

by Dayna A. Johnson, Roland J. Thorpe, John A. McGrath, W. Braxton Jackson and Chandra L. Jackson

Int. J. Environ. Res. Public Health 2018, 15(4), 564; https://doi.org/10.3390/ijerph15040564 - 21 Mar 2018

Cited by 33 | Viewed by 5552

Abstract

Housing environments can directly and indirectly affect sleep, and blacks are more likely than whites to live in suboptimal housing conditions, which may independently contribute to sleep disparities. However, few large-scale epidemiological studies consider the potential influence of housing type on sleep health. [...] Read more.

Housing environments can directly and indirectly affect sleep, and blacks are more likely than whites to live in suboptimal housing conditions, which may independently contribute to sleep disparities. However, few large-scale epidemiological studies consider the potential influence of housing type on sleep health. Using data from the 2004–2015 National Health Interview Survey, we investigated overall and Black-White differences in the association between housing type (house/apartment versus mobile home/trailer) and sleep duration as well as sleep difficulties among 226,208 adults in the U.S. Poisson regression with robust variance was used to estimate sex-specific prevalence ratios (PR) for sleep categories, first comparing houses/apartments to mobile homes/trailers and then blacks to whites within housing types. All models were adjusted for age, educational attainment, income, occupational class, self-reported general health status, and region of residence. Compared to participants living in houses/apartments, the prevalence of short sleep was higher for men (PR = 1.05 (95% confidence interval (CI): 1.02–1.08)) and women (PR = 1.07 (95% CI: 1.04–1.09)) in mobile homes/trailers. Black men (PR = 1.26 (95% CI: 1.21–1.30)) and women (PR = 1.24 (95% CI: 1.20–1.27)) in a house/apartment were more likely to be short sleepers than their white counterparts. There was generally no significant difference in sleep characteristics (except long sleep) between black and white men in mobile homes/trailers after adjustments, and black men in houses/apartments as well as black women in both housing types were less likely to report sleep difficulties although being more likely to report short sleep. Overall, individuals in mobile homes/trailers, which may represent suboptimal housing, had worse sleep than those in houses/apartments; and racial differences in the quality of houses and apartments are likely to greatly vary in ways that still contribute to sleep disparities. Race–sex group differences in sleep duration among residents in a house/apartment and even a lack of racial difference among individuals living in mobile homes/trailers support the need for more research on residential environments and eventually multi-level interventions designed to reduce sleep disparities. Full article

(This article belongs to the Special Issue Sleep Health)

16 pages, 1619 KiB

Open AccessArticle

The Relationship between Alcohol Drinking Patterns and Sleep Duration among Black and White Men and Women in the United States

by Chandra L. Jackson, Symielle A. Gaston, Rui Liu, Kenneth Mukamal and Eric B. Rimm

Int. J. Environ. Res. Public Health 2018, 15(3), 557; https://doi.org/10.3390/ijerph15030557 - 20 Mar 2018

Cited by 14 | Viewed by 7573

Abstract

In the United States, racial minorities generally experience poorer cardiovascular health compared to whites, and differences in alcohol consumption and sleep could contribute to these disparities. With a nationally representative sample of 187,950 adults in the National Health Interview Survey from 2004 to [...] Read more.

In the United States, racial minorities generally experience poorer cardiovascular health compared to whites, and differences in alcohol consumption and sleep could contribute to these disparities. With a nationally representative sample of 187,950 adults in the National Health Interview Survey from 2004 to 2015, we examined the relationship between alcohol-drinking patterns and sleep duration/quality by race and sex. Using Poisson regression models with robust variance, we estimated sex-specific prevalence ratios for each sleep duration/quality category among blacks compared to whites within categories of alcohol-drinking pattern, adjusting for socioeconomic status and other potential confounders. Across alcohol drinking patterns, blacks were less likely than whites to report recommended sleep of 7–<9 h/day. Short (PR = 1.30 [95% CI: 1.22–1.39]) and long (PR = 1.30 [95% CI: 1.07–1.58]) sleep were 30% more prevalent among black-male infrequent heavy drinkers compared to white-male infrequent heavy drinkers. Short (PR = 1.27 [95% CI: 1.21–1.34]) sleep was more prevalent among black-female infrequent heavy drinkers compared to white-female infrequent heavy drinkers, but there was no difference for long sleep (PR = 1.09 [95% CI: 0.97–1.23]). Black female infrequent moderate drinkers, however, had a 16% higher (PR = 1.16 [95% CI: 1.01–1.33]) prevalence of long sleep compared to their white counterparts. Environmental, social, and biological factors contributing to these findings, along with their impact on disparate health outcomes, should be studied in greater detail. Full article

(This article belongs to the Special Issue Sleep Health)

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15 pages, 1492 KiB

Open AccessArticle

The Acute Effects of Intermittent Light Exposure in the Evening on Alertness and Subsequent Sleep Architecture

by Minqi Yang, Ning Ma, Yingying Zhu, Ying-Chu Su, Qingwei Chen, Fan-Chi Hsiao, Yanran Ji, Chien-Ming Yang and Guofu Zhou

Int. J. Environ. Res. Public Health 2018, 15(3), 524; https://doi.org/10.3390/ijerph15030524 - 15 Mar 2018

Cited by 25 | Viewed by 6710

Abstract

Exposure to bright light is typically intermittent in our daily life. However, the acute effects of intermittent light on alertness and sleep have seldom been explored. To investigate this issue, we employed within-subject design and compared the effects of three light conditions: intermittent [...] Read more.

Exposure to bright light is typically intermittent in our daily life. However, the acute effects of intermittent light on alertness and sleep have seldom been explored. To investigate this issue, we employed within-subject design and compared the effects of three light conditions: intermittent bright light (30-min pulse of blue-enriched bright light (~1000 lux, ~6000 K) alternating with 30-min dim normal light (~5 lux, ~3600 K) three times); continuous bright light; and continuous dim light on subjective and objective alertness and subsequent sleep structure. Each light exposure was conducted during the three hours before bedtime. Fifteen healthy volunteers (20 ± 3.4 years; seven males) were scheduled to stay in the sleep laboratory for four separated nights (one for adaptation and the others for the light exposures) with a period of at least one week between nights. The results showed that when compared with dim light, both intermittent light and continuous bright light significantly increased subjective alertness and decreased sleep efficiency (SE) and total sleep time (TST). Intermittent light significantly increased objective alertness than dim light did during the second half of the light-exposure period. Our results suggested that intermittent light was as effective as continuous bright light in their acute effects in enhancing subjective and objective alertness and in negatively impacting subsequent sleep. Full article

(This article belongs to the Special Issue Sleep Health)

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12 pages, 455 KiB

Open AccessArticle

The Cost of Inadequate Sleep among On-Call Workers in Australia: A Workplace Perspective

by Grace E. Vincent, Irina Kinchin, Sally A. Ferguson and Sarah M. Jay

Int. J. Environ. Res. Public Health 2018, 15(3), 398; https://doi.org/10.3390/ijerph15030398 - 26 Feb 2018

Cited by 28 | Viewed by 6423

Abstract

On-call or stand-by is becoming an increasingly prevalent form of work scheduling. However, on-call arrangements are typically utilised when workloads are low, for example at night, which can result in inadequate sleep. It is a matter of concern that on-call work is associated [...] Read more.

On-call or stand-by is becoming an increasingly prevalent form of work scheduling. However, on-call arrangements are typically utilised when workloads are low, for example at night, which can result in inadequate sleep. It is a matter of concern that on-call work is associated with an increased risk of workplace injury. This study sought to determine the economic cost of injury due to inadequate sleep in Australian on-call workers. The prevalence of inadequate sleep among on-call workers was determined using an online survey, and economic costs were estimated using a previously validated costing methodology. Two-thirds of the sample (66%) reported obtaining inadequate sleep on weekdays (work days) and over 80% reported inadequate sleep while on-call. The resulting cost of injury is estimated at $2.25 billion per year ($1.71–2.73 billion). This equates to $1222 per person per incident involving a short-term absence from work; $2.53 million per incident classified as full incapacity, and $1.78 million for each fatality. To the best of our knowledge this is the first study to quantify the economic cost of workplace injury due to inadequate sleep in on-call workers. Well-rested employees are critical to safe and productive workplace operations. Therefore, it is in the interest of both employers and governments to prioritise and invest far more into the management of inadequate sleep in industries which utilise on-call work arrangements. Full article

(This article belongs to the Special Issue Sleep Health)

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331 KiB

Open AccessArticle

Sleep Duration and Quality in Pregnant Women: A Cross-Sectional Survey in China

by Xianglong Xu, Dengyuan Liu, Zhangyi Zhang, Manoj Sharma and Yong Zhao

Int. J. Environ. Res. Public Health 2017, 14(7), 817; https://doi.org/10.3390/ijerph14070817 - 20 Jul 2017

Cited by 46 | Viewed by 7059

Abstract

Objectives: Good maternal health and fetal development require sufficient and good quality of sleep during pregnancy. This study investigated sleep duration and quality in pregnant women, assessing factors with possibly influence on sleep. Method: A cross-sectional survey was conducted on pregnant women between [...] Read more.

Objectives: Good maternal health and fetal development require sufficient and good quality of sleep during pregnancy. This study investigated sleep duration and quality in pregnant women, assessing factors with possibly influence on sleep. Method: A cross-sectional survey was conducted on pregnant women between June and August in 2015 in 16 hospitals in five provinces in China. A total of 2345 pregnant women aged 18 years and older were surveyed. Insufficient sleeping duration was defined as sleeping of less than 7 h per day. Excessive sleep duration was defined as sleeping of more than 9 h per day. Results: A total of 561 (23.9%) participants reported insufficient sleeping duration, whereas 485 (20.9%) claimed excessive sleep duration. A total of 358 (15.2%) of pregnant women reported problems regarding sleep quality. Compared to pregnant women with sufficient sleeping duration, those with insufficient sleeping duration were prone to have poor sleep quality, whereas those with excessive sleeping duration featured low possibility of poor sleep quality. High-risk groups of insufficient sleep duration include women of Han nationality, with siblings, in their first trimester of pregnancy, receiving care in low-capacity/quality hospital settings, and with daily or 1–3 days of secondhand smoke exposure. High-risk groups of excessive sleep duration include women living in rural areas, unemployed, in their third trimester of pregnancy, and receiving care in medium-capacity/quality hospital settings. High-risk groups of poor sleep quality include women of non-Han nationality, low income level, in their third trimester of pregnancy, and with insufficient sleep duration. Conclusions: Insufficient/excessive sleep duration and poor sleep quality commonly occur during pregnancy in China. Findings provide a better understanding of the influencing factors of insufficient/excessive sleep duration and poor quality of sleep. These findings have some implications for future interventions on sleep among pregnant women. Full article

(This article belongs to the Special Issue Sleep Health)

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Open AccessArticle

Association between Visual Impairment and Low Vision and Sleep Duration and Quality among Older Adults in South Africa

by Karl Peltzer and Nancy Phaswana-Mafuya

Int. J. Environ. Res. Public Health 2017, 14(7), 811; https://doi.org/10.3390/ijerph14070811 - 19 Jul 2017

Cited by 20 | Viewed by 4706

Abstract

This study aims to estimate the association between visual impairment and low vision and sleep duration and poor sleep quality in a national sample of older adults in South Africa. A national population-based cross-sectional Study of Global Ageing and Adults Health (SAGE) wave [...] Read more.

This study aims to estimate the association between visual impairment and low vision and sleep duration and poor sleep quality in a national sample of older adults in South Africa. A national population-based cross-sectional Study of Global Ageing and Adults Health (SAGE) wave 1 was conducted in 2008 with a sample of 3840 individuals aged 50 years or older in South Africa. The interviewer-administered questionnaire assessed socio-demographic characteristics, health variables, sleep duration, quality, visual impairment, and vision. Results indicate that 10.0% of the sample reported short sleep duration (≤5 h), 46.6% long sleep (≥9 h), 9.3% poor sleep quality, 8.4% self-reported and visual impairment (near and/or far vision); and 43.2% measured low vision (near and/or far vision) (0.01–0.25 decimal) and 7.5% low vision (0.01–0.125 decimal). In fully adjusted logistic regression models, self-reported visual impairment was associated with short sleep duration and poor sleep quality, separately and together. Low vision was only associated with long sleep duration and poor sleep quality in unadjusted models. Self-reported visual impairment was related to both short sleep duration and poor sleep quality. Population data on sleep patterns may want to include visual impairment measures. Full article

(This article belongs to the Special Issue Sleep Health)

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Open AccessArticle

Place of Birth and Sleep Duration: Analysis of the National Health Interview Survey (NHIS)

by Valerie Newsome, Azizi Seixas, Juliet Iwelunmor, Ferdinand Zizi, Sanjeev Kothare and Girardin Jean-Louis

Int. J. Environ. Res. Public Health 2017, 14(7), 738; https://doi.org/10.3390/ijerph14070738 - 7 Jul 2017

Cited by 7 | Viewed by 3995

Abstract

While sleep disturbance has been related to a number of negative health outcomes, few studies have examined the relationship between place of birth and sleep duration among individuals living in the US. Data for 416,152 adult participants in the 2000–2013 National Health Interview [...] Read more.

While sleep disturbance has been related to a number of negative health outcomes, few studies have examined the relationship between place of birth and sleep duration among individuals living in the US. Data for 416,152 adult participants in the 2000–2013 National Health Interview Survey (NHIS), who provided self-reported hours of sleep and place of birth were examined. Associations were explored between healthy sleep (7–8 h), referenced to unhealthy sleep (<7 or >8 h), and place of birth using multivariate logistic regression analysis. The mean age of the sample was 47.4 ± 0.03 years; 56% were female. Of the respondents, 61.5% reported experiencing healthy sleep, 81.5% reported being born in the US and 18.5% were foreign-born adults. Descriptive statistics revealed that Indian Subcontinent-born respondents (71.7%) were more likely to report healthy sleep compared to US-born respondents (OR = 1.53, 95% CI = 1.37–1.71, p < 0.001), whereas African-born respondents (43.5%) were least likely to report healthy sleep (OR = 0.78, 95% CI = 0.70–0.87, p < 0.001). These findings suggest that place of birth should be considered in the assessment of risk factors for unhealthy sleep. Full article

(This article belongs to the Special Issue Sleep Health)

284 KiB

Open AccessArticle

Differences in Sleep Duration among Four Different Population Groups of Older Adults in South Africa

by Karl Peltzer

Int. J. Environ. Res. Public Health 2017, 14(5), 502; https://doi.org/10.3390/ijerph14050502 - 9 May 2017

Cited by 17 | Viewed by 4250

Abstract

The study aims to investigate sleep duration in four different population groups in a national probability sample of older South Africans who participated in the Study of Global Ageing and Adult Health (SAGE) Wave 1. A national population-based cross-sectional study with a sample [...] Read more.

The study aims to investigate sleep duration in four different population groups in a national probability sample of older South Africans who participated in the Study of Global Ageing and Adult Health (SAGE) Wave 1. A national population-based cross-sectional study with a sample of 3284 aged 50 years or older in South Africa was conducted in 2008. The questionnaire included socio-demographic characteristics, health variables, and self-reported sleep duration. Results indicate that White Africans compared to other population groups had the lowest mean sleep duration (7.88 h among men and 7.46 h among women). The prevalence of short sleep was the highest among both men and women among the White African (18.8% in men and 16.9% in women) and Indian or Asian African population groups (14.5% in men and 17.1% in women), and lowest among both men and women in the Black African (7.0% in men and 6.5% in women) and multi-ancestry population groups (15.6% in men and 12.7% in women). The prevalence of long sleep was among both men and women the highest in the Black African population group (56.2% in men and 58.5% in women), and the lowest in the White African population group (36.4% in men and 24.3% in women). In a Poisson regression model, adjusted for sociodemographics and chronic disease status, coming from the male and female White African population group was associated with short sleep. In addition, coming from the Indian or Asian African population group was associated with short sleep. No population group differences were found regarding long sleep prevalence. White Africans reported more short sleep duration than the other population groups, while there were no racial or ethnic differences in long sleep. White Africans are more likely to have sleep durations that are associated with negative health outcomes. An explanation of the high short sleep prevalence among White Africans may be related to their racial or ethnic minority status in South Africa. Full article

(This article belongs to the Special Issue Sleep Health)

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