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BMC Pregnancy and Childbirth May 2024The potential effect modification of sleep on the relationship between anxiety and elevated blood pressure (BP) in pregnancy is understudied. We evaluated the...
BACKGROUND
The potential effect modification of sleep on the relationship between anxiety and elevated blood pressure (BP) in pregnancy is understudied. We evaluated the relationship between anxiety, insomnia, and short sleep duration, as well as any interaction effects between these variables, on BP during pregnancy.
METHODS
This was a prospective pilot cohort of pregnant people between 23 to 36 weeks' gestation at a single institution between 2021 and 2022. Standardized questionnaires were used to measure clinical insomnia and anxiety. Objective sleep duration was measured using a wrist-worn actigraphy device. Primary outcomes were systolic (SBP), diastolic (DBP), and mean (MAP) non-invasive BP measurements. Separate sequential multivariable linear regression models fit with generalized estimating equations (GEE) were used to separately assess associations between anxiety (independent variable) and each BP parameter (dependent variables), after adjusting for potential confounders (Model 1). Additional analyses were conducted adding insomnia and the interaction between anxiety and insomnia as independent variables (Model 2), and adding short sleep duration and the interaction between anxiety and short sleep duration as independent variables (Model 3), to evaluate any moderating effects on BP parameters.
RESULTS
Among the 60 participants who completed the study, 15 (25%) screened positive for anxiety, 11 (18%) had subjective insomnia, and 34 (59%) had objective short sleep duration. In Model 1, increased anxiety was not associated with increases in any BP parameters. When subjective insomnia was included in Model 2, increased DBP and MAP was significantly associated with anxiety (DBP: β 6.1, p = 0.01, MAP: β 6.2 p < 0.01). When short sleep was included in Model 3, all BP parameters were significantly associated with anxiety (SBP: β 9.6, p = 0.01, DBP: β 8.1, p < 0.001, and MAP: β 8.8, p < 0.001). No moderating effects were detected between insomnia and anxiety (p interactions: SBP 0.80, DBP 0.60, MAP 0.32) or between short sleep duration and anxiety (p interactions: SBP 0.12, DBP 0.24, MAP 0.13) on BP.
CONCLUSIONS
When including either subjective insomnia or objective short sleep duration, pregnant people with anxiety had 5.1-9.6 mmHg higher SBP, 6.1-8.1 mmHg higher DBP, and 6.2-8.8 mmHg higher MAP than people without anxiety.
Topics: Humans; Female; Pregnancy; Pilot Projects; Prospective Studies; Adult; Anxiety; Blood Pressure; Sleep Initiation and Maintenance Disorders; Sleep; Pregnancy Complications; Surveys and Questionnaires; Actigraphy
PubMed: 38750438
DOI: 10.1186/s12884-024-06540-w -
MedRxiv : the Preprint Server For... Apr 2024Light is a salient environmental exposure, serving as the primary entraining cue for the circadian system and having other, non-circadian, effects on health. Gender...
Light is a salient environmental exposure, serving as the primary entraining cue for the circadian system and having other, non-circadian, effects on health. Gender differences in light exposure patterns could contribute to gender differences in health outcomes and would have important implications for sleep and circadian research. Gender differences in real-world light exposure (measured over a week with wrist-worn ActiGraph GT3X+ devices) were investigated in cross- sectional data from the 2011-2014 National Health and Nutrition Examination Survey (NHANES). Measures of time above light threshold (TALT), individual photoperiod (IP), first and last timing of light (FTL and LTL, respectively), and mean light timing revised (MLiTR) at different light intensity thresholds were derived. Gender differences in light exposure were tested using two-sample t-tests, Watson's two-sample test of homogeneity, and linear regression models. Exploratory analyses to investigate work and physical activity-related factors in relation to bright light exposure were also conducted. A total of 11,318 NHANES participants (age range: 3-80+, 52.2% women) with 6 days of valid actigraphy and light data were included in the analysis. The findings suggest that for every 60 minutes of bright light (≥1,000 lux) that men receive, women receive 39.6 minutes. Men spend approximately 52% more time in bright light than women and this gender difference begins in childhood. The IP of bright light exposure is also longer for men, with earlier first and later last timing of bright light exposure compared to women. These gender differences were robust across ages and between race and ethnicity groups. While further research is needed, these gender differences in light exposure may be due to gender differences in indoor vs. outdoor activities. Future studies of gender differences in response to light exposure should consider light exposure history in study design and analysis. The results of this study may inform future health disparities research and support the importance of the study of light as an important environmental exposure and component of the human exposome.
PubMed: 38746463
DOI: 10.1101/2024.04.28.24306495 -
Sleep Advances : a Journal of the Sleep... 2024Evidence suggests that adolescents and adults with a later chronotype have poorer sleep habits and are more susceptible to unhealthy behaviors, but little is known about...
STUDY OBJECTIVES
Evidence suggests that adolescents and adults with a later chronotype have poorer sleep habits and are more susceptible to unhealthy behaviors, but little is known about these associations in younger children. The objective of the study was to (1) identify and compare individual chronotype tendencies among preschool-aged children and (2) investigate associations of sleep dimensions and chronotype with diet.
METHODS
Participants were 636 3-6 years old (mean ± SD age: 4.74 ± 0.89 years, 49% girls) preschoolers from the cross-sectional Increased Health and Well-Being in Preschoolers (DAGIS) study in Finland. Sleep duration, sleep variability (in duration and midpoint), social jetlag, and midsleep on weekends adjusted for sleep debt (MSWEadj) were measured with 7-day actigraphy. Morning, intermediate, and evening chronotype tendencies were defined based on the lowest and highest 10th percentile cutoffs of MSWEadj. Food, energy, and macronutrient intake were assessed from 3-day records. Associations between sleep dimensions and diet were assessed with regression models.
RESULTS
MSWEadj was 1:13 ± 14 minutes for morning ( = 64), 2:25 ± 28 minutes for intermediate ( = 560), and 3:38 ± 15 minutes for evening ( = 64) chronotype tendency. Children with an evening chronotype tendency had greater social jetlag and sleep variability. Having an evening chronotype tendency was associated with higher added sugar, higher sugary food consumption, and lower vegetable consumption compared to intermediate tendency types. A later chronotype (MSWEadj) was associated with higher sugary food consumption, as well as lower vegetable and fiber intake. Sleep duration, social jetlag, and sleep variability were not associated with diet.
CONCLUSIONS
Several less healthy sleep and diet behaviors were observed among children with later chronotypes. Future public health interventions aimed towards children would benefit from taking into account chronotype.
PubMed: 38737796
DOI: 10.1093/sleepadvances/zpae026 -
PloS One 2024This study aimed to determine whether filtering out walking-related actigraphy data improves the reliability and accuracy of real-world upper extremity activity... (Randomized Controlled Trial)
Randomized Controlled Trial
This study aimed to determine whether filtering out walking-related actigraphy data improves the reliability and accuracy of real-world upper extremity activity assessment in children with unilateral cerebral palsy. Twenty-two children aged 4-12 years diagnosed with unilateral cerebral palsy were included in this study, which was drawn from a two-phase randomized controlled trial conducted from July 2021 to December 2022. Data were collected from a tertiary hospital in Seoul, Republic of Korea. Participants were monitored using tri-axial accelerometers on both wrists across three time points (namely, T0, T1, and T2) over 3 days; interventions were used between each time point. Concurrently, an in-laboratory study focusing on walking and bimanual tasks was conducted with four participants. Data filtration resulted in a reduction of 8.20% in total data entry. With respect to reliability assessment, the intra-class correlation coefficients indicated enhanced consistency after filtration, with increased values for both the affected and less-affected sides. Before filtration, the magnitude counts for both sides showed varying tendencies, depending on the time points; however, they presented a consistent and stable trend after filtration. The findings of this research underscore the importance of accurately interpreting actigraphy measurements in children with unilateral cerebral palsy for targeted upper limb intervention by filtering walking-induced data.
Topics: Humans; Cerebral Palsy; Actigraphy; Child; Walking; Male; Female; Child, Preschool; Reproducibility of Results; Republic of Korea
PubMed: 38722902
DOI: 10.1371/journal.pone.0303090 -
Sports Medicine - Open May 2024Maintaining a consistent sleep and wake time is often reported as a key component of circadian rhythmicity and quality sleep. However, the impact of sleep onset and...
BACKGROUND
Maintaining a consistent sleep and wake time is often reported as a key component of circadian rhythmicity and quality sleep. However, the impact of sleep onset and offset time variability on overall sleep outcomes are underreported in elite athlete populations. This study investigated the relationship between sleep onset and offset time variability using the sleep regularity index (SRI) and measures of sleep and well-being in professional rugby union athletes. Twenty-three professional male rugby union athletes (mean ± SD, age: 23 ± 3 y) underwent sleep monitoring via wrist actigraphy for three weeks during a pre-season phase of training and completed a daily wellness questionnaire. Median SRI was calculated and used to stratify the trainees into two quantile groups: >76.4 SRI (Regular, n = 11) and < 76.4 SRI (Irregular, n = 12).
RESULTS
The regular sleep group showed significantly longer total sleep duration (p = 0.02, d = 0.97) compared to the irregular group (7:42 ± 0:29 vs. 7:18 ± 0:20 h: min per night, respectively). Furthermore, while not statistically significant, the regular sleep group showed greater sleep efficiency and less wake episodes compared to irregular sleepers, as demonstrated by moderate effect sizes (d = 0.71 and 0.69, respectively).
CONCLUSIONS
The results from this study indicate that minimizing variability in sleep onset and offset time is beneficial for increasing sleep duration and may improve sleep efficiency during pre-season training in elite male rugby union athletes. This study provides evidence for the importance of including sleep-wake routines as a key component of sleep education interventions.
PubMed: 38722443
DOI: 10.1186/s40798-024-00709-5 -
Nature and Science of Sleep 2024Irregularity in nightly sleep duration is reported to associate with elevated blood pressure (BP), but it is unclear whether this association can be observed with BP...
PURPOSE
Irregularity in nightly sleep duration is reported to associate with elevated blood pressure (BP), but it is unclear whether this association can be observed with BP measured during exercise after controlling for factors known to influence the exercise pressor reflex.
METHODS
Twenty-nine young adults (22±4y; 19 men, 10 women) performed cycling exercise until volitional fatigue to assess peak oxygen uptake (VO). Actigraphy was used to monitor sleep duration and daily physical activity for seven consecutive days after which participants completed two bouts of moderate-intensity cycling while BP and VO were measured using a Tango+ device and indirect calorimetry, respectively. Systolic BP was averaged from the two bouts of exercise and expressed as a change from seated rest (∆SBP). Sleep duration regularity was calculated as standard deviation (SD) and coefficient of variation (CV).
RESULTS
Systolic BP at seated rest, during exercise, and ∆SBP was 113±13, 152±21, and 38±13 mmHg, respectively. Sleep duration SD (range 10-146 min) and sleep duration CV (range 2-54%) when excluding weekend nights were significantly correlated with ∆SBP (r = 0.58 and r = 0.62, respectively; both <0.01) after adjusting for age, sex, body mass index, peak VO, physical activity, resting systolic BP, chronotype, and the VO response to exercise. Sleep duration regularity analyzed with weekend nights included (across all seven days) was also significantly correlated with ∆SBP (≤0.01), but had weaker correlation coefficients.
CONCLUSION
These results indicate that sleep regularity, especially when excluding weekend nights, is associated with the rise in systolic BP during moderate-intensity exercise in young adults. Sleep duration regularity may be a useful tool to capture the impact of intermittent nights of insufficient sleep on BP dysregulation.
PubMed: 38721523
DOI: 10.2147/NSS.S460212 -
BMC Geriatrics May 2024Abnormal amyloid β (Aβ) deposits in the brain are a hallmark of Alzheimer's disease (AD). Insufficient sleep duration and poor sleep quality are risk factors for... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Abnormal amyloid β (Aβ) deposits in the brain are a hallmark of Alzheimer's disease (AD). Insufficient sleep duration and poor sleep quality are risk factors for developing AD. Sleep may play a role in Aβ regulation, but the magnitude of the relationship between sleep and Aβ deposition remains unclear. This systematic review examines the relationship between sleep (i.e., duration and efficiency) with Aβ deposition in later-life adults.
METHODS
A search of PubMed, CINAHL, Embase, and PsycINFO generated 5,005 published articles. Fifteen studies met the inclusion criteria for qualitative syntheses; thirteen studies for quantitative syntheses related to sleep duration and Aβ; and nine studies for quantitative syntheses related to sleep efficiency and Aβ.
RESULTS
Mean ages of the samples ranged from 63 to 76 years. Studies measured Aβ using cerebrospinal fluid, serum, and positron emission tomography scans with two tracers: Carbone 11-labeled Pittsburgh compound B or fluorine 18-labeled. Sleep duration was measured subjectively using interviews or questionnaires, or objectively using polysomnography or actigraphy. Study analyses accounted for demographic and lifestyle factors. Based on 13 eligible articles, our synthesis demonstrated that the average association between sleep duration and Aβ was not statistically significant (Fisher's Z = -0.055, 95% CI = -0.117 ~ 0.008). We found that longer self-report sleep duration is associated with lower Aβ (Fisher's Z = -0.062, 95% CI = -0.119 ~ -0.005), whereas the objectively measured sleep duration was not associated with Aβ (Fisher's Z = 0.002, 95% CI = -0.108 ~ 0.113). Based on 9 eligible articles for sleep efficiency, our synthesis also demonstrated that the average association between sleep efficiency and Aβ was not statistically significant (Fisher's Z = 0.048, 95% CI = -0.066 ~ 0.161).
CONCLUSION
The findings from this review suggest that shorter self-reported sleep duration is associated with higher Aβ levels. Given the heterogeneous nature of the sleep measures and outcomes, it is still difficult to determine the exact relationship between sleep and Aβ. Future studies with larger sample sizes should focus on comprehensive sleep characteristics and use longitudinal designs to better understand the relationship between sleep and AD.
Topics: Humans; Amyloid beta-Peptides; Sleep; Aged; Sleep Quality; Time Factors; Cognition; Alzheimer Disease; Middle Aged; Sleep Duration
PubMed: 38714912
DOI: 10.1186/s12877-024-05010-4 -
JMIR Public Health and Surveillance May 2024The relationship between 24-hour rest-activity rhythms (RARs) and risk for dementia or mild cognitive impairment (MCI) remains an area of growing interest. Previous...
BACKGROUND
The relationship between 24-hour rest-activity rhythms (RARs) and risk for dementia or mild cognitive impairment (MCI) remains an area of growing interest. Previous studies were often limited by small sample sizes, short follow-ups, and older participants. More studies are required to fully explore the link between disrupted RARs and dementia or MCI in middle-aged and older adults.
OBJECTIVE
We leveraged the UK Biobank data to examine how RAR disturbances correlate with the risk of developing dementia and MCI in middle-aged and older adults.
METHODS
We analyzed the data of 91,517 UK Biobank participants aged between 43 and 79 years. Wrist actigraphy recordings were used to derive nonparametric RAR metrics, including the activity level of the most active 10-hour period (M10) and its midpoint, the activity level of the least active 5-hour period (L5) and its midpoint, relative amplitude (RA) of the 24-hour cycle [RA=(M10-L5)/(M10+L5)], interdaily stability, and intradaily variability, as well as the amplitude and acrophase of 24-hour rhythms (cosinor analysis). We used Cox proportional hazards models to examine the associations between baseline RAR and subsequent incidence of dementia or MCI, adjusting for demographic characteristics, comorbidities, lifestyle factors, shiftwork status, and genetic risk for Alzheimer's disease.
RESULTS
During the follow-up of up to 7.5 years, 555 participants developed MCI or dementia. The dementia or MCI risk increased for those with lower M10 activity (hazard ratio [HR] 1.28, 95% CI 1.14-1.44, per 1-SD decrease), higher L5 activity (HR 1.15, 95% CI 1.10-1.21, per 1-SD increase), lower RA (HR 1.23, 95% CI 1.16-1.29, per 1-SD decrease), lower amplitude (HR 1.32, 95% CI 1.17-1.49, per 1-SD decrease), and higher intradaily variability (HR 1.14, 95% CI 1.05-1.24, per 1-SD increase) as well as advanced L5 midpoint (HR 0.92, 95% CI 0.85-0.99, per 1-SD advance). These associations were similar in people aged <70 and >70 years, and in non-shift workers, and they were independent of genetic and cardiovascular risk factors. No significant associations were observed for M10 midpoint, interdaily stability, or acrophase.
CONCLUSIONS
Based on findings from a large sample of middle-to-older adults with objective RAR assessment and almost 8-years of follow-up, we suggest that suppressed and fragmented daily activity rhythms precede the onset of dementia or MCI and may serve as risk biomarkers for preclinical dementia in middle-aged and older adults.
Topics: Humans; Female; Male; Cognitive Dysfunction; Middle Aged; Aged; Dementia; Prospective Studies; Rest; Adult; United Kingdom; Actigraphy; Risk Factors; Circadian Rhythm
PubMed: 38713911
DOI: 10.2196/55211 -
Sleep Advances : a Journal of the Sleep... 2024Disrupted sleep is common in individuals with Alzheimer's disease (AD) and may be a marker for AD risk. The timing of sleep affects sleep-wake activity and is also...
INTRODUCTION
Disrupted sleep is common in individuals with Alzheimer's disease (AD) and may be a marker for AD risk. The timing of sleep affects sleep-wake activity and is also associated with AD, but little is known about links between sleep architecture and the midpoint of sleep in older adults. In this study, we tested if the midpoint of sleep is associated with different measures of sleep architecture, AD biomarkers, and cognitive status among older adults with and without symptomatic AD.
METHODS
Participants ( = 243) with a mean age of 74 underwent standardized cognitive assessments, measurement of CSF AD biomarkers, and sleep monitoring via single-channel EEG, actigraphy, a home sleep apnea test, and self-reported sleep logs. The midpoint of sleep was defined by actigraphy.
RESULTS
A later midpoint of sleep was associated with African-American race and greater night-to-night variability in the sleep midpoint. After adjusting for multiple potential confounding factors, a later sleep midpoint was associated with longer rapid-eye movement (REM) onset latency, decreased REM sleep time, more actigraphic awakenings at night, and higher < 2 Hz non-REM slow-wave activity.
CONCLUSIONS
Noninvasive in vivo markers of brain function, such as sleep, are needed to track both future risk of cognitive impairment and response to interventions in older adults at risk for AD. Sleep timing is associated with multiple other sleep measures and may affect their utility as markers of AD. The midpoint of sleep may be changed through behavioral intervention and should be taken into account when using sleep as a marker for AD risk.
PubMed: 38711547
DOI: 10.1093/sleepadvances/zpae023 -
Journal of the Academy of Nutrition and... Apr 2024Limited data exist examining whether timing and/or duration of eating behaviors throughout the day affect sleep health.
BACKGROUND
Limited data exist examining whether timing and/or duration of eating behaviors throughout the day affect sleep health.
OBJECTIVE
The aim of this study was to identify the relationship between eating behaviors and sleep in young adults without chronic diseases or conditions.
DESIGN
This was a cross-sectional study using 7 days of baseline data from a randomized crossover trial.
PARTICIPANTS/SETTING
Participants included 52 young adults. The study took place in West Lafayette, Indiana, between April 2017 and May 2018.
MAIN OUTCOME MEASURES
Timing and duration of eating were assessed via 3 nonconsecutive, 24-hour dietary recalls. Bedtime, wake time, total sleep time, sleep latency, sleep efficiency, and wake after sleep onset were measured over 7 days via wrist actigraphy and sleep diaries.
STATISTICAL ANALYSES PERFORMED
Two-way analyses of variance were applied to assess group differences based on timing of consumption (early vs late eating) and duration of eating (long: >13 hours, short: <11 hours, or standard: 11-13 hours) with post-hoc pairwise comparisons.
RESULTS
Main effects of timing of consumption, but not duration of eating, were detected for wake time, bedtime, and sleep efficiency (all, P < .05). Specifically, participants with later eating patterns that included breakfast skipping had later wake times and later bedtimes than those with earlier eating patterns. In addition, those who had later eating patterns that included breakfast skipping and nighttime eating experienced lower sleep efficiency (mean [SE], 77.0% [2.3%]) vs those who consumed breakfast and no nighttime eating (mean [SE], 84.6% [1.4%]; P < .001) and those who skipped breakfast but had no nighttime eating (mean [SE], 84.2% [2.5]; P < .05). Those who consumed breakfast but also had nighttime eating had a mean (SE) sleep efficiency of 82.4% (1.4%) (P = .09).
CONCLUSIONS
The timing of eating was associated with sleep-wake onset and sleep efficiency. This study provides the preliminary characterization of eating behaviors relative to sleep-wake cycles and highlights the need for experimental studies to understand whether manipulating the timing of eating occasions to better align with sleep-wake cycles could improve sleep health.
PubMed: 38697355
DOI: 10.1016/j.jand.2024.04.016