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1.
Non-linear relationship between sleep duration and metabolic syndrome: A population-based study.
Fan, L, Hao, Z, Gao, L, Qi, M, Feng, S, Zhou, G
Medicine. 2020;(2):e18753
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Abstract
The aims of this study were to evaluate the prevalence of metabolic syndrome (MetS) and explore the association between sleep duration and MetS. This study enrolled 8 272 adults aged 18 years and older from 6 urban and 8 rural areas during 2013 to 2014in Henan China. Participants were interviewed about demographic characteristics, lifestyle factors and medical history, and physical measurements were performed. The relationships between sleep duration and MetS were evaluated and plotted by Restricted Cubic Spline Regression. The mean age was 51.5 years (SD 14.2) and 4 916 (59.4%) were female. The crude prevalence of MetS was 30.3% and the age-standardized rate was 23.6%. Men were more likely to have MetS than women (P = .01). MetS was positively associated with age, education, smoking, drinking, BMI and sleep duration, and seemed irrelevant to occupation and sedentary behavior. In terms of individual component of MetS, high blood pressure was the most prevalent component for both men and women, while the lowest prevalent was high triglycerides in men and for women was low high-density lipoprotein cholesterol (HDL-C). There was a U-shaped relationship between sleep duration and MetS and its components. Sleep duration <6 hours or >9 hours were associated with higher risk of MetS (OR from 1.10 to 2.15). The MetS was prevalent, and more than half of total adult population was suffering from high blood pressure. Sleep duration may be a determinant of metabolic health. Both short (<6 hours) and long sleep duration (>9 hours) was linked to an increased risk of MetS.
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The Role of Vitamin C in Two Distinct Physiological States: Physical Activity and Sleep.
Otocka-Kmiecik, A, Król, A
Nutrients. 2020;(12)
Abstract
This paper is a literature overview of the complex relationship between vitamin C and two opposing physiological states, physical activity and sleep. The evidence suggests a clinically important bidirectional association between these two phenomena mediated by different physiological mechanisms. With this in mind, and knowing that both states share a connection with oxidative stress, we discuss the existing body of evidence to answer the question of whether vitamin C supplementation can be beneficial in the context of sleep health and key aspects of physical activity, such as performance, metabolic changes, and antioxidant function. We analyze the effect of ascorbic acid on the main sleep components, sleep duration and quality, focusing on the most common disorders: insomnia, obstructive sleep apnea, and restless legs syndrome. Deeper understanding of those interactions has implications for both public health and clinical practice.
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Adherence to the 2018 WCRF/AICR recommendations and sleep behaviour in people with metabolic syndrome.
Bruno, E, Roveda, E, Gargano, G, Baldassari, I, Oliverio, A, Galasso, L, Montaruli, A, Cortellini, M, Di Mauro, MG, Venturelli, E, et al
Epidemiologia e prevenzione. 2020;(4):288-294
Abstract
OBJECTIVES to investigate the association between the adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations and the prevalence of parameters of sleep quality and quantity in people with metabolic syndrome (MS). DESIGN cross-sectional study. SETTING AND PARTICIPANTS 126 people with MS included in a randomized controlled trial of Mediterranean diet and metformin for the primary prevention of age-related chronic diseases (Me.Me.Me. study) wore for one week an actigraph called Actiwatch to assess restful sleep parameters (sleep efficiency - SE, actual sleep time - AST, immobile time - IT) and fragmented sleep parameters (moving time - MT, movement and fragmentation index - MFI, sleep latency - SL). At the baseline visit, each participants completed a 24-hour food frequency diary listing what he/she ate the previous day, and the International Physical Activity Questionnaire. These questionnaires were used to build up a score for adherence to seven relevant 2018 WCRF/AICR recommendations. MAIN OUTCOME MEASURES the prevalence ratios (PRs) and 95% confidence intervals (CIs) of sleep parameters associated with each recommendation and with the number of met recommendations were calculated using a binomial regression model. RESULTS the PRs for SE>=85% and IT>=84% increased with the number of met recommendations. Meeting 5-7 recommendations compared to 0-2 was associated with a better SE (PR 3.24 for SE>=85%; p=0.03) and IT (PR 1.68 for IT>=84%; p=0.04). The PRs for MFI>=34.5 and SL>=18 minutes decreased with the number of met recommendations. Meeting 5-7 recommendations compared to 0-2 was associated with a 46% lower prevalence of MFI (p=0.02) and 40% lower prevalence of SL (p=0.04). CONCLUSIONS the findings of this paper suggest that the prevalence of better sleep quality in people with MS might be associated with closer adherence to 2018 WCRF/AICR recommendations.
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Sleep duration and cardiovascular risk factors in children and adolescents: A systematic review.
Sun, J, Wang, M, Yang, L, Zhao, M, Bovet, P, Xi, B
Sleep medicine reviews. 2020;:101338
Abstract
An association between short sleep duration and cardiovascular risk factors and outcomes is well demonstrated in adults. However, findings on the association in children and adolescents have been inconsistent. In this review, we searched PubMed, Embase and ISI Web of Science for eligible publications until March 16, 2020. We identified 37 reviews/meta-analyses on the association between sleep duration and cardiovascular risk factors and 15 studies on the association between sleep duration and metabolic syndrome (MetS) in children and adolescents. We found strong evidence on the association between short sleep duration and increased adiposity markers and high blood pressure, some evidence on the association between short sleep duration and insulin resistance, but inconsistent findings on the association between sleep duration and blood lipids, inflammation and MetS. Although more studies are needed to further assess the association between sleep duration and selected cardiovascular risk factors, our findings support interventions to improve sleep duration and quality as a potential means to promote cardiovascular health in children and adolescents.
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Prospective associations among objectively and subjectively assessed sleep and the metabolic syndrome.
Bowman, MA, Duggan, KA, Brindle, RC, Kline, CE, Krafty, RT, Thayer, JF, Hall, MH
Sleep medicine. 2019;:1-6
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Abstract
OBJECTIVE Subjective sleep disturbances have been associated with greater risk for concurrent and incident metabolic syndrome (MetS). Previous studies have not examined prospective associations among polysomnography-assessed sleep and the MetS, despite knowledge that self-reported sleep is subject to reporting bias, and that subjectively and objectively assessed sleep are weakly correlated. METHOD In the current study, objectively-assessed (polysomnography) and subjectively-assessed (Pittsburgh Sleep Quality Index, PSQI) sleep was measured in 145 adults at two timepoints, separated by 12-30 years. A continuous measure of the MetS was assessed at the second time point. Statistical analyses were adjusted for age, sex, lifetime history of major depressive disorder, follow-up time, and apnea-hypopnea index. RESULTS Polysomnography-assessed sleep duration, latency, efficiency, and slow wave sleep were not significantly prospectively associated with the MetS (ps ≥ 0.16). Self-reported longer sleep latency was prospectively associated with higher MetS scores in unadjusted (β = 0.29, p = 0.002) and adjusted models (β = 0.25, p = 0.009). Longer sleep latency was associated with higher fasting glucose levels (β = 0.47, p < 0.001). CONCLUSION Our study provides evidence that subjective and objective measures of sleep may differ in their ability to prospectively predict MetS.
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Children's sleep and health: A meta-review.
Matricciani, L, Paquet, C, Galland, B, Short, M, Olds, T
Sleep medicine reviews. 2019;:136-150
Abstract
Sleep is essential for children's health and well-being. Characteristics of children's sleep such as sleep duration, timing, quality and variability are increasingly being associated with a wide range of health outcomes. The purpose of this study is to conduct a meta-review (systematic review of systematic reviews) to examine the relationship between sleep and health in children. A systematic search of four electronic databases (Medline, PsychInfo, Scopus, and Embase) was conducted to identify systematic reviews that examine the association between characteristics of children's sleep and health. Key findings, as well as areas in need of further research were synthesised descriptively. A total of 39 systematic reviews were identified for inclusion, covering areas of cognition, psychosocial health, cardiometabolic health, adiposity and other outcomes such as musculoskeletal pain. There is substantial and consistent evidence relating sleep duration to adiposity and emotional outcomes. The relationships between sleep quality and timing and blood lipids and glycaemic control merit further research. Links between sleep and metabolic syndrome in children appear to be weak and inconsistent. Key areas identified in need for further research included studies that objectively assess children's sleep and move beyond cross-sectional study designs and consider characteristics of sleep other than duration. It was also noted that covariates applied across studies varied considerably and the issue of residual confounding was raised in a number of reviews. Lastly, all reviews reported studies adopted a traditional approach of examining only one aspect of children's sleep. Systematic reviews support the notion that sleep is important for children's health. However, further studies that objectively assess sleep and consider characteristics of sleep other than duration and outcomes other than adiposity are needed. An understanding of sleep as a multidimensional construct and as a component of the 24-h d, is also needed to better understand the relationship between sleep and health in children.
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Fatigue, Sleep, and Autoimmune and Related Disorders.
Zielinski, MR, Systrom, DM, Rose, NR
Frontiers in immunology. 2019;:1827
Abstract
Profound and debilitating fatigue is the most common complaint reported among individuals with autoimmune disease, such as systemic lupus erythematosus, multiple sclerosis, type 1 diabetes, celiac disease, chronic fatigue syndrome, and rheumatoid arthritis. Fatigue is multi-faceted and broadly defined, which makes understanding the cause of its manifestations especially difficult in conditions with diverse pathology including autoimmune diseases. In general, fatigue is defined by debilitating periods of exhaustion that interfere with normal activities. The severity and duration of fatigue episodes vary, but fatigue can cause difficulty for even simple tasks like climbing stairs or crossing the room. The exact mechanisms of fatigue are not well-understood, perhaps due to its broad definition. Nevertheless, physiological processes known to play a role in fatigue include oxygen/nutrient supply, metabolism, mood, motivation, and sleepiness-all which are affected by inflammation. Additionally, an important contributing element to fatigue is the central nervous system-a region impacted either directly or indirectly in numerous autoimmune and related disorders. This review describes how inflammation and the central nervous system contribute to fatigue and suggests potential mechanisms involved in fatigue that are likely exhibited in autoimmune and related diseases.
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Isotemporal substitution of inactive time with physical activity and time in bed: cross-sectional associations with cardiometabolic health in the PREDIMED-Plus study.
Galmes-Panades, AM, Varela-Mato, V, Konieczna, J, Wärnberg, J, Martínez-González, MÁ, Salas-Salvadó, J, Corella, D, Schröder, H, Vioque, J, Alonso-Gómez, ÁM, et al
The international journal of behavioral nutrition and physical activity. 2019;(1):137
Abstract
BACKGROUND This study explored the association between inactive time and measures of adiposity, clinical parameters, obesity, type 2 diabetes and metabolic syndrome components. It further examined the impact of reallocating inactive time to time in bed, light physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) on cardio-metabolic risk factors, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. METHODS This is a cross-sectional analysis of baseline data from 2189 Caucasian men and women (age 55-75 years, BMI 27-40 Kg/m2) from the PREDIMED-Plus study (http://www.predimedplus.com/). All participants had ≥3 components of the metabolic syndrome. Inactive time, physical activity and time in bed were objectively determined using triaxial accelerometers GENEActiv during 7 days (ActivInsights Ltd., Kimbolton, United Kingdom). Multiple adjusted linear and logistic regression models were used. Isotemporal substitution regression modelling was performed to assess the relationship of replacing the amount of time spent in one activity for another, on each outcome, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. RESULTS Inactive time was associated with indicators of obesity and the metabolic syndrome. Reallocating 30 min per day of inactive time to 30 min per day of time in bed was associated with lower BMI, waist circumference and glycated hemoglobin (HbA1c) (all p-values < 0.05). Reallocating 30 min per day of inactive time with 30 min per day of LPA or MVPA was associated with lower BMI, waist circumference, total fat, visceral adipose tissue, HbA1c, glucose, triglycerides, and higher body muscle mass and HDL cholesterol (all p-values < 0.05). CONCLUSIONS Inactive time was associated with a poor cardio-metabolic profile. Isotemporal substitution of inactive time with MVPA and LPA or time in bed could have beneficial impact on cardio-metabolic health. TRIAL REGISTRATION The trial was registered at the International Standard Randomized Controlled Trial (ISRCTN http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.
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The Association between Sleep Duration and Metabolic Syndrome: The NHANES 2013/2014.
Smiley, A, King, D, Bidulescu, A
Nutrients. 2019;(11)
Abstract
BACKGROUND We aimed to assess the association of sleep with metabolic syndrome in the 2013/2014 National Health and Nutrition Examination Survey (NHANES). METHODS Sample size included 2737 out of 2013 and 2014 NHANES surveys. Cross-sectional study of metabolic syndrome and sleep duration was conducted. Metabolic syndrome was defined according to NCEP ATPIII (National Cholesterol Education Program Adult Treatment Panel III) criteria. Metabolic syndrome severity score was calculated based on actual measurement of each component, adjusted for sex and race. The generalized additive model (GAM) was built to assess the smooth relationship between metabolic syndrome/metabolic syndrome severity score and sleep duration. Adjustment of models were done for age, sex, race, and sitting time. The value of effective degree of freedom (EDF) formed by the GAM model shows the degree of curvature of the relationship. A value of 1 for EDF is translated as the linear shape of relationship. Values larger than one denote a more complex relationship between the response variable and the predicting one. RESULTS There was a U-shaped association between sleep duration and metabolic syndrome in univariable GAM (EDF = 2.43, p = 0.06) and multivariable GAM (EDF = 2.03, p = 0.20). The lowest risk of metabolic syndrome was observed in people sleeping 7 hours/night. There was a significant U-shaped association between sleep duration and metabolic syndrome severity score in multivariable GAM (EDF = 2.94, p = 0.0004). Similarly, the lowest mean metabolic syndrome severity score was observed in people sleeping 7 hours/night. There was an effect modification of sex and sleep duration indicating strong U-shaped relationship of metabolic syndrome severity score and sleep duration in women (EDF = 3.43, p = 0.00002) and semi-linear association in men (EDF = 1.76, p = 0.04). CONCLUSION Short and long sleep duration was associated with higher risk of metabolic syndrome and higher scores of metabolic syndrome severity score in women. Short sleep duration was associated with higher risk of metabolic syndrome and higher scores of metabolic syndrome severity score in men.