[Sleep conditions of adult residents in Shandong Province from 2010 to 2012].

OBJECTIVE: To understand the sleep conditions of adults in Shandong Province. METHODS: From 2010 to 2012, 10 201 residents aged ≥6 years old were selected from 7 counties and cities in Shandong Province by multi-stage stratified cluster sampling method in proportion to the population. A face-to-face interview was conducted with a questionnaire uniformly formulated by "China National Nutrition and Health Surveillance"to investigate and analyze the sleep status of residents aged 18 years and above. RESULTS: A total of 6626 people over the age of 18 were investigated. The average daily sleep was(7. 84±1. 29) h. There was no significant difference between male((7. 80 ± 1. 07) h) and female((7. 86 ± 1. 18) h). However, there was significant difference between males((7. 87±1. 17) h) and females((8. 01±1. 27) h) in rural areas(t = 3. 08, P < 0. 01). There was significant difference in different regions(big cities(7. 62± 1. 17) h, small and medium-sized cities(7. 85 ± 0. 89) h, rural areas(7. 95 ±1. 23) h, F = 39. 733, P<0. 001) and in different age groups(18-44 years old(7. 97±0. 98) h, 45-49 years old(7. 80±1. 07) h, 60 years old and above(7. 74±1. 33) h, F =21. 642, P<0. 001), the average daily sleep time was decreased with increasing age. The insufficient sleep rate was 9. 8%, there was no significant different between male(9. 5%)and female(10. 1%). There was significant difference in different regions(big cities15. 3%, small and medium-sized cities 5. 2%, rural areas 9. 7%, χ~2= 105. 870, P <0. 001) and in different age groups(18-44 years old 5. 1%, 45-59 years old 9. 7%, 60 years old and above 15. 3%, χ~2= 114. 308, P < 0. 001). Big cities had the higher insufficient sleep rate than medium-sized cities and rural areas, The insufficient sleep rate showed an upward trend with the increase of age. The proportion of excessive sleep was9. 3%. The difference between male(8. 4%) and female(10. 0%) was statistically significant(t = 2. 11, P < 0. 05). There were statistically significant differences in different regions(7. 0% in large cities, 6. 0% in medium and small cities, 12. 8% in rural areas, χ~2= 77. 156, P< 0. 01) and different, age groups(6. 7% in 18-44 years old, 6. 1% in 45-59 years old, 16. 8% in 60 years old and above, χ~2= 175. 556, P <0. 01). The rate of excessive sleep in rural areas was higher than that in cities, and the rate of excessive sleep in the 45-59 age group was the highest. CONCLUSION: Insufficient sleep is common in adult residents in Shandong Province. The insufficient sleep is more significant among elderly population and residents of big cities. The problem of excessive sleep also exists.

Sleep duration and falls: a systemic review and meta-analysis of observational studies.

Several epidemiological studies have linked sleep duration with falls; however, the findings yielded inconsistent results. No quantitative analysis has specifically assessed the influence of sleep duration on falls. PubMed and Embase were screened for observational studies from inception to 13 September 2016. A generic inverse-variance method was used to pool the outcome data for sleep duration categories of the lowest category versus reference, and the highest category versus reference with a random-effects model. Dose-response analysis was performed to evaluate the potential relationship of sleep duration with falls. Finally, seven eligible observational studies involving a total of 212 829 participants were included in the present meta-analysis. Compared with the reference category, both short and long sleep duration were significantly associated with falls, and the pooled odds ratios (95% confidence intervals) were 1.32 (1.21, 1.46) and 1.35 (1.17, 1.56), respectively, both with evidence of significant heterogeneity. An approximately 'U-shaped' curve was observed, and the lowest risk of falls was shown at 7-8 h day-1 of sleep duration. Further subgroup analysis found that the association of long sleep duration and falls was more pronounced among Caucasians. The present study is limited to its small number of included studies, considerable heterogeneity, observational study design and the large contribution of a single article. Further researches are still needed to confirm the causal association between sleep duration and falls in populations with different gender, age and ethnicity.

Higher intakes of nutrients and regular drinking are associated with habitual sleep duration in pre- and postmenopausal women with comorbidities.

OBJECTIVES: We aimed to assess the association between nutrient intake, health-related behaviors, and habitual sleep duration in pre- and postmenopausal women. DESIGN: A cross-sectional study. PARTICIPANTS: 2084 pre- and postmenopausal women aged 18-80 years old. MEASUREMENTS: Nutrient intake and sleep duration were measured by a 24-hour recall approach and self-reports, respectively. We examined the association and interaction between comorbidities, nutrient intake, and sleep duration groups among 2084 women using data from KNHASES (2016-2018) and multinomial logistic regression. RESULTS: In premenopausal women, we observed negative associations between very short (<5 hours)/short (5-6 hours)/long (≥9 hours) sleep duration and 12 nutrients (vitamin B1, B3, vitamin C, PUFA, n-6 fatty acid, iron, potassium, phosphorus, calcium, fiber, carbohydrate) and a positive association between retinol and short sleep duration (prevalence ratio (PR), 1.08; 95% CI, 1.01-1.15). In premenopausal women, interactions were found between comorbidities and PUFA (PR, 3.83; 95% CI, 1.56-9.41), n-3 fatty acid (PR, 2.43; 95% CI, 1.17-5.05), n-6 fatty acid (PR, 3.45; 95% CI, 1.46-8.13), fat (PR, 2.77; 95% CI, 1.15-6.64), and retinol (PR, 1.28; 95% CI, 1.06-1.53) for very short and short sleep duration, respectively. Interactions between comorbidities, vitamin C (PR, 0.41; 95% CI, 0.24-0.72), and carbohydrates (PR, 1.67; 95% CI, 1.05-2.70) for very short and short sleep duration in postmenopausal women, respectively. Regular drinking was positively associated with a risk of short sleep duration in postmenopausal women (PR, 2.74, 95% CI: 1.11-6.74). CONCLUSIONS: Dietary intake and alcohol use were found to be involved in sleep duration, so healthcare staff should encourage women to maintain a healthy diet and reduce alcohol use to improve sleep duration.

Sleep Duration and Chronic Disease Among Older Native Hawaiians or Other Pacific Islanders and Asians: Analysis of the Behavioral Risk Factor Surveillance System.

OBJECTIVES: Older adults are particularly vulnerable to unhealthy sleep. This study examines the relationship between sleep duration and chronic diseases among older Native Hawaiians or Other Pacific Islanders (NHOPIs) and identifies variations with older Asians. METHODS: In this cross-sectional study, data were analyzed using the 2016 Behavioral Risk Factor Surveillance System. The total sample of adults 50 years and older included 1277 NHOPIs and 4655 Asians. Weighted, survey logistic regressions were employed to analyze the relationship between sleep duration (i.e., short, healthy, and long) and seven chronic diseases: coronary heart disease, stroke, heart attack/myocardial infarction, pre-diabetes, diabetes, chronic obstructive pulmonary disease, and depressive disorder. Sleep duration was categorized into short sleep (SS; ≤ 6 h), healthy sleep (7-8 h), and long sleep (LS; ≥ 9 h), with healthy sleep as the reference group. RESULTS: Among NHOPIs, SS and LS were significantly related to stroke (OR 3.19, 95% CI: 1.35-7.53 for SS and OR 9.52, 95% CI: 2.99-30.34 for LS) and SS was associated with pre-diabetes (OR 2.22 CI: 1.07-4.59), after adjusting for all covariates. In contrast, Asians with SS and LS reported higher odds of depression (OR 2.40, 95% CI: 1.20-4.79 and OR 5.03, 95% CI: 1.57-16.13, respectively). CONCLUSIONS: Findings suggest older NHOPIs with SS or LS experience worse health. NHOPIs and Asians varied on the relationship between sleep and chronic disease, underscoring the need to disaggregate Asian/NHOPI data to understand health disparities.

Sleep Duration and Waking Activities in Relation to the National Sleep Foundation's Recommendations: An Analysis of US Population Sleep Patterns from 2015 to 2017.

The objective was to investigate the association between time spent on waking activities and nonaligned sleep duration in a representative sample of the US population. We analysed time use data from the American Time Use Survey (ATUS), 2015-2017 (N = 31,621). National Sleep Foundation (NSF) age-specific sleep recommendations were used to define recommended (aligned) sleep duration. The balanced, repeated, replicate variance estimation method was applied to the ATUS data to calculate weighted estimates. Less than half of the US population had a sleep duration that mapped onto the NSF recommendations, and alignment was higher on weekdays (45%) than at weekends (33%). The proportion sleeping longer than the recommended duration was higher than those sleeping shorter on both weekdays and weekends (p < 0.001). Time spent on work, personal care, socialising, travel, TV watching, education, and total screen time was associated with nonalignment to the sleep recommendations. In comparison to the appropriate recommended sleep group, those with a too-short sleep duration spent more time on work, travel, socialising, relaxing, and leisure. By contrast, those who slept too long spent relatively less time on each of these activities. The findings indicate that sleep duration among the US population does not map onto the NSF sleep recommendations, mostly because of a higher proportion of long sleepers compared to short sleepers. More time spent on work, travel, and socialising and relaxing activities is strongly associated with an increased risk of nonalignment to NSF sleep duration recommendations.

Waking Activities and Sleep: Analysis of United Kingdom Adolescents' Daily Time-Use Diaries.

PURPOSE: To investigate waking activities associated with risks of short and long sleep in a representative cohort of UK adolescents. METHODS: Data from 14-year-olds participating in the UK Millennium Cohort Study were used. Daily time-use diaries were completed by adolescents on two randomly selected days (one weekday and one weekend) to capture their activities within a 24-hour period from 4 a.m. of each selected day. Short and long sleep duration categories were defined as beyond the extreme lower and upper thresholds of acceptable age-specific sleep durations recommended by the National Sleep Foundation, respectively. RESULTS: Approximately 8% and 6% were short sleepers on weekdays and weekends, respectively. On average, adolescents spent 33% of their time awake per weekend day on recreational digital media activities. Compared with those who had optimal sleep on weekdays, short sleepers spent more time on personal care (mean difference = +56 minutes; 95% confidence interval [CI]: 21; 92) and less time on exercise activities (mean difference = -15 minutes; 95% CI: -27; -3). Ten-minute increase in daily digital media activity was associated with 2% (95% CI: 1.01; 1.03) higher relative risk of adolescents being short sleepers on weekdays. Relative risk of short sleeping was 1.03 (95% CI: 1.01; 1.04) times higher for every10-minute daily increase in travel time on weekdays. CONCLUSIONS: Adolescents spend up to one-third of their time awake per day on digital media. However, more time spent on personal care and travel on weekdays and weekends is associated with increased risk of short sleep. These findings permit a reflection on appropriate interventions needed to improve sleep duration in sleep-deprived teens.

Association of Insufficient or Excess Sleep with Type 2 Diabetes Mellitus in the Presence of Periodontitis.

We aimed to investigate the effects of sleep duration on impaired fasting glucose and diabetes in Korean adults with periodontal disease. This cross-sectional study was performed using data for 10,465 subjects aged >19 years who completed the periodontal examination and questionnaires in the Sixth Korea National Health and Nutrition Examination Survey (2013-2015). The effect of sleep was confirmed by a complex-sample multinomial logistic regression analysis. Confounding variables were age, sex, household income, education level, smoking status, and sleep duration. Of all participants, 25.7% had periodontitis, of which 28.6% had fasting serum glucose disorder and 14.2% had diabetes. Among participants with periodontitis, the prevalence of diabetes was 1.49 times higher in participants with an average sleep duration of ≥8 h than those with an average sleep duration of 6-7 h. The prevalence of diabetes among participants without periodontitis was 1.49 times and 1.57 times higher in participants with an average sleep duration of ≤5 and ≥8 h, respectively, than those with an average sleep duration of 6-7 h. We found that altered sleep duration may be a risk factor for diabetes and that proper sleep duration is important to control diabetes incidence.