Sleep and long COVID: Preexisting sleep issues and the risk of PASC in a large general population using 3 different model definitions.

Study Objectives: Insomnia, poor sleep quality and extremes of sleep duration are associated with COVID-19 infection. This study assessed whether these factors are related to Post-Acute Sequelae of SARS-CoV-2 infection (PASC). Methods: Cross-sectional survey of a general population of 24,803 U.S. adults to determine the association of insomnia, poor sleep quality and sleep duration with PASC. Results: Prevalence rates of PASC among previously COVID-19 infected participants for three definitions of PASC were COPE (21.9%), NICE (38.9%) and RECOVER PASC Score (15.3%). PASC was associated with insomnia in all 3 models in fully adjusted models with adjusted odds ratios (aORs) and 95% confidence intervals (CI) ranging from 1.30 (95% CI: 1.11-1.52, p≤0.05, PASC Score) to 1.52 (95% CI: 1.34-1.71, p≤0.001, (NICE). Poor sleep quality was related to PASC in all models with aORs ranging from 1.77 (95% CI: 1.60-1.97, p≤0.001, NICE) to 2.00 (95% CI: 1.77-2.26, p≤0.001, COPE). Sleep <6 hours was associated with PASC with aORs between 1.59 (95% CI: 1.40-1.80, p≤0.001, PASC Score) to 1.70 (95% CI: 1.53-1.89, p≤0.001, COPE). Sleep ≥ 9 hours was not associated with PASC in any model. Although vaccination with COVID-19 booster decreased the likelihood of developing PASC, it did not attenuate associations between insomnia, poor sleep quality and short sleep duration with PASC in any of the models. Conclusions: Insomnia, poor sleep quality and short sleep duration are potential risk factors for PASC. Interventions to improve sleep may decrease the development of PASC.

Association between sleep duration and possible sarcopenia in middle-aged and elderly Chinese individuals: evidence from the China health and retirement longitudinal study.

BACKGROUND: Sarcopenia is a common cause of disability in the aging population, and managing sarcopenia is an important step in building intrinsic capacity and promoting healthy aging. A growing body of evidence suggests that sleep deprivation may be a mediator of the development of sarcopenia. The purpose of this study was to explore the longitudinal association between sleep duration and possible sarcopenia using data from a national sample. METHODS: Two waves of data from the CHARLS database for 2011 and 2015 were used in this study. All possible sarcopenia participants met the Asia Working Group for Sarcopenia 2019 (AWGS 2019) diagnostic criteria. Sleep duration was assessed using a self-report questionnaire, and sleep duration was categorized as short (≤ 6 h), medium (6-8 h), or long (> 8 h) based on previous studies. Longitudinal associations between sleep duration and possible sarcopenia will be calculated by univariate and multifactorial logistic regression analyses and expressed as odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: A total of 5654 individuals participated in the follow-up study, with a prevalence of possible sarcopenia of 53.72% (578) in the short sleep duration group, 38.29% (412) in the medium sleep duration group, and 7.99% (86) in the long sleep duration group. According to the crude model of the second-wave follow-up study, short sleep durations were significantly more strongly associated with possible sarcopenia than were medium and long sleep durations (OR: 1.35, 95% CI: 1.17-1.55, P = 0.000). The association between short sleep duration and possible sarcopenia was maintained even after adjustment for covariates such as age, gender, residence, education level, BMI, smoking status, alcohol consumption and comorbidities (OR: 1.18, 95% CI: 1.02-1.36, P = 0.029). In the subgroup analysis, short sleep duration was associated with low grip strength (OR: 1.20, 95% CI: 1.02-1.41, P = 0.031). CONCLUSIONS: Sleep deprivation may be closely associated with the development of possible sarcopenia in middle-aged and elderly people, which provides new insights and ideas for sarcopenia intervention, and further studies are needed to reveal the underlying mechanisms involved.

Associations of 24-hour movement behaviors with emotional and behavioral problems among Chinese adolescents.

PURPOSE: The role of adherence to the recommendations for 24-hour movement behaviors (24-HMB), including physical activity (PA), screen time (ST), and sleep duration (SLP), in relation to emotional and behavioral problems in Chinese adolescents remains uncertain. This study aimed to investigate these associations and explore potential sex differences. METHODS: This school-based cross-sectional study included 15,071 Chinese adolescents with a mean age of 14.53 (SD: 1.65) years. Data on emotional and behavioral problems and 24-HMB (including PA, ST, and SLP) were collected. Analysis was performed using general linear mixed models, with additional sex-stratified analyses conducted. RESULTS: The number of 24-HMB recommendations met was negatively associated with total difficulties (ß estimate=-0.96, 95% CI: -1.07 to -0.85) and positively related to prosocial behavior (ß estimate = 0.41, 95% CI: 0.37 to 0.46) among adolescents. Compared with none of the recommendations met, meeting all recommendations (total difficulties: ß estimate=-2.98, 95% CI: -3.41 to -2.55; prosocial behaviors: ß estimate = 1.05, 95%CI: 0.87 to 1.24) demonstrated the strongest association with both difficulties and prosocial behaviors, followed by meeting recommendations for PA + ST (total difficulties: ß estimate=-2.15, 95% CI: -2.41 to -1.90; prosocial behaviors: ß estimate = 0.98, 95% CI: 0.87 to 1.09). These associations were consistently significant in both boys and girls. CONCLUSION: Adherence to more 24-HMB recommendations, particularly meeting all recommendations or combined PA + ST recommendations, could improve emotional and behavioral well-being among adolescent girls and boys. The significance of balanced movement behaviors for promoting adolescent mental health merits increased attention.

Associations of Accelerometer-measured Sleep Duration with Incident Cardiovascular Disease and Cardiovascular Mortality.

STUDY OBJECTIVES: This study aimed to determine the associations between accelerometer-measured sleep durations and the risks of incident cardiovascular disease (CVD) and CVD-related mortality. METHODS: A total of 92,261 participants (mean age: 62.4±7.8 years, 56.4% female) were included in UK Biobank between 2013 and 2015. Average daily sleep durations were measured using wrist-worn accelerometers over a seven-day period. Sleep durations were categorized as <7 hours/day, 7-9 hours/day (reference), and >9 hours/day. The incidence of CVD and CVD-related mortality were ascertained by hospital records and death registries. RESULTS: During a median follow-up period of 7.0 years, a total of 13,167 participants developed CVD, and 1,079 participants died of CVD. Compared with a sleep duration 7-9 hours/day, an accelerometer-measured sleep duration <7 hours/day but not >9 hours/day was associated with higher risks of incident CVD (HR 1.06, 95% CI: 1.02-1.10), CVD-related mortality (HR 1.29, 95% CI: 1.14-1.47), coronary heart disease (HR 1.11, 95% CI: 1.03-1.19), myocardial infarction (HR 1.14, 95% CI: 1.03-1.27), heart failure (HR 1.20, 95% CI: 1.08-1.34), and atrial fibrillation (HR 1.15, 95% CI: 1.07-1.24). A curvilinear dose‒response pattern was observed between accelerometer-measured sleep durations and incident CVD (Poverall<0.001), with L-shaped associations found for incident CVD and CVD-related mortality. CONCLUSIONS: An accelerometer-measured sleep duration <7 hours/day but not >9 hours/day was associated with elevated risks of incident CVD and CVD-related mortality. Maintaining adequate sleep may help promote cardiovascular health.

Association between sleep duration and subjective memory complaints: A large-scale cross-sectional study based on NHANES.

Objective: When chatting, people often forget what they want to say, that is, they suffer from subjective memory complaints (SMCs). This research examines the Association between sleep duration and self-reported SMC in a sample representing the entire United States. Methods: We examined data from 5567 individuals (aged 20-80) who participated in the National Health and Nutrition Examination Survey (2015-2018) to evaluate the association between sleep duration and SMC. Odds ratios (ORs) and a restricted cubic spline (RCS) curve were calculated with multiple logistic regression, and subgroup analysis was performed. Results: Approximately 5.8 % (3 2 3) reported SMC, and most are older people (1 6 3). RCS analysis treating sleep duration as a continuous variable revealed a J-shaped curve association between sleep duration and SMC. Self-reported sleep duration was significantly linked to a 33 % elevated risk of SMC (OR, 1.33; 95 % confidence interval [CI], 1.23-1.43; P < 0.001). In the group analysis, individuals who slept more than 8 h per day had a greater association of experiencing SMC than those who slept for 6-8 h/day (OR, 1.75; 95 % CI, 1.36-2.23; P < 0.001). In the analysis of age groups, the stable association between sleep duration and SMC was observed only in the 60-80 age bracket (OR, 1.59; 95 % CI, 1.09-2.33; P < 0.001). Conclusions: We found that people with self-report sleep duration exceeding 8 h are more likely to experience SMC, especially older adults. Improving sleep health may be an effective strategy for preventing SMC and cognitive impairment.

Association between Circadian Rhythm-Disturbing Factors and Metabolic Syndrome in Korean Adults: Korea National Health and Nutrition Examination Survey (2016-2020).

Background: Circadian misalignment is associated with metabolic syndrome. This study aimed to examine the association between circadian rhythm-disturbing factors and metabolic syndrome. Methods: We used data from the 7th and 8th Korea National Health and Nutrition Examination Survey conducted between 2016 and 2020, which surveyed 16,253 individuals. Circadian rhythm-disturbing factors were defined as follows: sleep duration outside the reference group (6-8 hours), irregular breakfast, shift work, and physical inactivity. The adjusted odds ratio (aOR) for metabolic syndrome was calculated based on the number of circadian rhythm-disturbing factors present in adults over the age of 19 years. Results: Among a total of 16,253 participants (mean age 48.2±15 years), metabolic syndrome was found in 5,237 participants (29.3 %). The participants were classified into three categories based on the number of circadian rhythm-disturbing factors as follows: 2,627 (15.6%) did not have any factors, 6,406 (38.13%) had one factor, and 7,220 (46.3%) had two or more factors. Participants with a single circadian rhythm-disturbing factor were 21% more likely to have metabolic syndrome (aOR, 1.21; 95% confidence interval [CI], 1.08-1.36), and participants with two or more factors were 27% more likely to have metabolic syndrome (aOR, 1.27; 95% CI, 1.12-1.43). Conclusion: Circadian rhythm-disturbing factors were significantly associated with the prevalence of metabolic syndrome in Korean adults. This finding has potential clinical implications for maintaining circadian rhythms by avoiding certain factors to prevent metabolic syndrome. Further studies are required to confirm these findings.

The Effect of Sleep Duration on Hypertension Risk in an Adult Asian Population: A Systematic Review and Meta-Analysis.

Sleep duration has been proposed as a potential and important modifiable risk factor, yet its precise relationship with hypertension among Asian adults remains unclear. This meta-analysis aims to elucidate the impact of short sleep duration on hypertension risk within the adult Asian population. A systematic search of databases, including PubMed, Scopus, and ScienceDirect, was conducted to identify relevant studies published up to January 4, 2024. Eligible studies comprised observational cohort studies and cross-sectional studies that compared short sleep duration to normal sleep duration in relation to hypertension risk among Asian adults. The definitions for short and normal sleep durations were derived from the respective studies. The random effects model was utilized to pool effect estimates, and all statistical analyses were conducted using Review Manager 5.4 software (RevMan) (Cochrane Collaboration, Oxford, UK). Results from a systematic search obtained seven studies assessing sleep duration and hypertension risk in Asian populations. Based on a meta-analysis of six studies, short sleep duration is associated with a higher hypertension risk when compared to normal sleep duration (OR: 1.36; 95% CI: 1.13-1.64; p: 0.0010; I2: 75%). Subgroup analysis based on sex showed that the association is evident across males (OR: 1.12; 95% CI: 1.01-1.25; p: 0.03; I2: 64%) and females (OR: 1.22; 95% CI: 1.10-1.35; p: 0.0003; I2: 82%). In conclusion, based on the analyzed studies, short sleep duration is associated with a higher mild risk of hypertension, irrespective of sex. Thus, short sleep duration can be a modifiable risk factor that can be prevented to reduce the risk of hypertension. By incorporating sleep hygiene practices and promoting healthy sleep habits, significant improvement in cardiovascular health can be made, especially in hypertension risk at a population level. Further studies on the effect of sleep duration in different age populations should be conducted to confirm the impact of short sleep duration.

Adolescent sleep patterns, genetic predisposition, and risk of multiple sclerosis.

STUDY OBJECTIVES: Shift work, insufficient sleep, and poor sleep quality at young age have been associated with increased risk of multiple sclerosis (MS). This study aimed to investigate the potential interaction between aspects of inadequate sleep (short sleep, phase shift, and poor sleep quality) during adolescence and HLA-DRB1*15:01 in relation to MS risk. METHODS: We used a Swedish population-based case-control study (1253 cases and 1766 controls). Subjects with different sleep patterns during adolescence and HLA-DRB1*15:01 status were compared regarding MS risk by calculating odds ratios (OR) with 95% confidence intervals (CI) using logistic regression models. Additive interaction between aspects of inadequate sleep and HLA-DRB1*15:01 status was assessed by calculating the attributable proportion due to interaction (AP) with 95% CI. RESULTS: Short sleep duration (<7 hours/night) during adolescence acted synergistically with HLA-DRB1*15:01, increasing the risk of MS (AP 0.38, 95% CI 0.01-0.75, p=0.04). Similarly, subjective low sleep quality during adolescence interacted with HLA-DRB1*15:01 regarding risk of MS (AP 0.30, 95% CI 0.06-0.56, p=0.03), whereas phase shift did not significantly influence the risk of the disease, irrespective of HLA-DRB1*15:01 status. CONCLUSIONS: Our findings underscore the importance of addressing inadequate sleep during adolescence, particularly in the context of the HLA-DRB1*15:01 allele, as it appears to amplify the risk of subsequently developing MS.

Restricted linear association between night sleep duration and diabetes risk in middle-aged and older adults: a 7-year follow-up analysis from the China health and retirement longitudinal study.

Background: A rapid increase in the prevalence of diabetes is an urgent public health concern among older adults, especially in developing countries such as China. Despite several studies on lifestyle factors causing diabetes, sleep, a key contributor, is understudied. Our study investigates the association between night sleep duration and diabetes onset over a 7-year follow-up to fill information gaps. Method: A population-based cohort study with 5437 respondents used 2011-2018 China Health and Retirement Longitudinal Study data. Using self-reported night sleep duration from the 2011 baseline survey, information on new-onset diabetes was collected in follow-up surveys. Baseline characteristics of participants with vs. without new-onset diabetes were compared using Chi-square and Mann-Whitney U tests. Multivariable Cox regression models estimated the independent relationship between night sleep and new-onset diabetes. The addictive Cox regression model approach and piece-wise regression described the nonlinear relationship between night sleep and new-onset diabetes. Subgroup analysis was also performed by age, gender, body measurement index, dyslipidemia, drinking status, smoking, hypertension, and afternoon napping duration. Result: 549 respondents acquired diabetes during a median follow-up of 84 months. After controlling for confounders, night sleep duration was substantially linked with new-onset diabetes in the multivariable Cox regression model. The risk of diabetes is lower for respondents who sleep longer than 5 hours, except for those who sleep over 8 hours [5.1-6h Hazard ratios (HR) [95% confidence intervals (CI)] = 0.71 (0.55, 0.91); 6.1-7h HR = 0.69 (0.53, 0.89); 7.1-8h HR = 0.58 (0.45, 0.76)]. Nonlinear connections were delineated by significant inflection points at 3.5 and 7.5 hours, with a negative correlation observed only between these thresholds. With one hour more night sleep, the risk of diabetes drops 15%. BMI and dyslipidemia were identified as modifiers when only consider the stand linear effect of sleep duration on diabetes. Conclusion: This study establishes a robust association between night sleep and new-onset diabetes in middle-aged and older Chinese individuals within the 3.5-7.5-hour range, offering a foundation for early glycemic management interventions in this demographic. The findings also underscore the pivotal role of moderate night sleep in preventing diabetes, marking a crucial juncture in community medical research.

Exploring the association between sleep duration and cancer risk in middle-aged and older Chinese adults: observations from a representative cohort study (2011-2020).

BACKGROUND: This prospective cohort study aimed to investigate the relationship between sleep duration and cancer incidence among 9996 participants over a median follow-up period of 9 years. METHODS: Participants without cancer at baseline were followed for over 88,790 person-years. The incidence of cancer and sleep duration was self-reported. The relationship between sleep duration and cancer incidence was analyzed using Cox proportional hazards models adjusted for various confounding factors, including age, gender, lifestyle factors, and comorbidities. RESULTS: During the follow-up, 325 participants were diagnosed with incident cancer, resulting in an incidence rate of 20.49 per 1000 person-years. After adjusting for confounders, a total sleep duration of less than 6 h was significantly associated with an increased risk of cancer (HR: 1.27; 95% CI: 1.01-1.61). This association was particularly strong for cancers in the digestive and respiratory systems (HR: 1.41; 95% CI: 1.03-1.93). Longer sleep durations (> 9 h) showed a potential increase in cancer risk, but results were not consistently significant. Age-stratified analyses revealed a similar significant increase in cancer incidence among individuals aged 60 years or younger with less than 6 h of sleep per day, showing a 35% increase in overall cancer risk and an 83% increase in digestive and respiratory system cancer. No significant association was found between nocturnal sleep durations or daytime naps and cancer incidence. However, a significant interaction was observed between daytime naps longer than 30 min and cancer incidence in women (p = 0.041). CONCLUSIONS: We observed that short sleep duration may increase the risk of cancer, particularly cancers in the digestive and respiratory systems. Additionally, while longer sleep durations might also increase cancer risk, this finding requires validation with larger sample sizes.

Poor sleep quality and overweight/obesity in healthcare professionals: a cross-sectional study.

Objective: This study aimed to analyze the relationship between the sleep quality of healthcare professionals and the incidence of overweight and obesity, exploring the potential impact of sleep quality on the onset of overweight and obesity in order to provide a scientific basis for formulating effective health intervention measures. Methods: A convenience sampling method was used to conduct a survey on the sleep characteristics and obesity status among healthcare professionals at Peking Union Medical College Hospital and Tianjin Dongli District Traditional Chinese Medicine Hospital. The survey was conducted via online questionnaires, which included demographic data, the Pittsburgh Sleep Quality Index (PSQI), height, weight, and related sleep, exercise, and dietary habits. Univariate and multivariate logistic regression analyses were applied to study the relationship between sleep quality and overweight/obesity among healthcare professionals. Results: A total of 402 questionnaires were distributed, with a 100% retrieval rate, yielding 402 valid questionnaires. The average body mass index of the 402 participants was 23.22 ± 3.87 kg/m^2. Among them, 144 cases were overweight or obese, accounting for 35.8% (144/402) of the total. The prevalence of poor sleep quality among healthcare professionals was 27.4% (110/402), with an average PSQI score of 8.37 ± 3.624. The rate of poor sleep quality was significantly higher in the overweight and obese group compared to the normal weight group (36.1% vs. 22.5%, p = 0.003). The multivariate analysis indicated that gender, marital status, lower education level, sleep duration (odds ratio [OR] =1.411, 95% confidence interval [CI] 1.043-1.910, p = 0.026), and sleep disturbances (OR = 1.574, 95%CI 1.123-2.206, p = 0.008) were significant risk factors for overweight and obesity among healthcare professionals. Conclusion: Overweight or obese healthcare professionals had poorer sleep quality compared to those with a normal weight. Sleep duration and sleep disorders were identified as independent risk factors for overweight or obesity in healthcare professionals. Increasing sleep duration and improving sleep disorders may play a positive role in controlling overweight and obesity among healthcare professionals.

Sleep duration and the risk of new-onset arthritis in middle-aged and older adult population: results from prospective cohort study in China.

Background: The pain and sleep disorders caused by arthritis are health issues that have been re-emphasized with the aging population. However, the majority of research on arthritis and sleep disorders has focused on cases that have already been diagnosed with arthritis. This research aims to explore the correlation between sleep duration and new-onset arthritis in middle-aged and older adult individuals. Methods: Utilizing data from the China Health and Retirement Longitudinal Study from baseline (2011) to the Wave 3 follow-up (2018), we conducted a 7-year longitudinal investigation targeting populations with valid sleep questionnaire records and without arthritis. Sleep duration was assessed from nighttime sleep and daytime nap records. The new-onset of arthritis was determined based on self-reported diagnosis. We employed different logistic regression models to consider the potential impact of sleep duration on arthritis and conducted mediation analyses to assess the involvement of BMI in the association between sleep duration and the new-onset risk of arthritis. Results: Out of the 6,597 individuals analyzed in the cohort, 586 (8.9%) were diagnosed with new-onset arthritis. Median sleep duration was notably shorter in the new-onset arthritis group (6.63 vs. 6.41 h, p < 0.05). There was a notable negative correlation found between new-onset risk of arthritis and sleep duration, with each Interquartile Range (IQR) increment in sleep leading to a 16% risk reduction (OR: 0.864; 95% CI: 0.784-0.954). Stratified analyses revealed BMI as a potential modifier in the sleep-arthritis relationship (P for interaction = 0.05). Mediation analyses further showed that about 3.5% of the association was mediated by BMI. Additionally, the inclusion of sleep duration improved the arthritis predictive power of our model, with an IDI of 0.105 (0.0203, 0.1898) and an NRI of 0.0013 (0.0004, 0.0022) after adding sleep duration to the basic model. Conclusion: In the middle-aged and older adult demographic of China, increased sleep duration is associated with a decreased new-onset risk of arthritis, with BMI potentially playing a role in mediating this connection.

Association of lifestyle and flourishing during the COVID-19 pandemic in Japan.

Introduction: COVID-19 have changed our lifestyle and little is known how our lifestyle associated with flourishing during COVID-19. This study examined the association between lifestyle, including sleep time, drinking, and smoking, and flourishing during the COVID-19 pandemic in Japan. Methods: We used the population-based study, Utsunomiya COVID-19 seROprevalence Neighborhood Association (U-CORONA) survey conducted in November 2021 to examine the association between lifestyle such as sleeping time, drinking and smoking, and flourishing (n = 473). Flourishing was assessed with the flourishing index, a 10-item multidimensional scale with five domains. Multivariate linear regression analysis was performed adjusted for sex, age, income, and education. Results: We found that the flourishing index was significantly lower in the group that slept less than 6 h than in the group that slept 6-8 h (coef = -0.49, SE = 0.17, p < 0.01). We also found that drinking once to several times/week showed higher flourishing than those who almost never drink (coef = 0.57, SE = 0.19, p < 0.01). Smoking was not associated with flourishing. Discussion: Sleep duration and drinking habit, but not smoking, may be important for flourishing during the COVID-19 pandemic.

Sleep regulation and host genetics.

Due to the multifactorial and complex nature of rest, we focus on phenotypes related to sleep. Sleep regulation is a multifactorial process. In this chapter, we focus on those phenotypes inherent to sleep that are highly prevalent in the population, and that can be modulated by lifestyle, such as sleep quality and duration, insomnia, restless leg syndrome and daytime sleepiness. We, therefore, leave in the background those phenotypes that constitute infrequent pathologies or for which the current level of scientific evidence does not favour the implementation of practical approaches of this type. Similarly, the regulation of sleep quality is intimately linked to the regulation of the circadian rhythm. Although this relationship is discussed in the sections that require it, the in-depth study of circadian rhythm regulation at the molecular level deserves a separate chapter, and this is how it is dealt with in this volume.

Sleep patterns, genetic susceptibility, and risk of cirrhosis among individuals with nonalcoholic fatty liver disease.

BACKGROUND: The associations between sleep patterns or behaviors and the risk of cirrhosis and the influence of genetic susceptibility on these associations among NAFLD participants remain inadequately elucidated. METHODS: This study conducted a prospective follow-up of 112,196 NAFLD participants diagnosed at baseline from the UK Biobank cohort study. Five sleep behaviors were collected to measure a healthy sleep score. Five genetic variants were used to construct a polygenic risk score. We used Cox proportional hazard model to assess hazard ratios (HR) and 95% confidence intervals (CIs) for incidence of cirrhosis. RESULTS: During the follow-up, 592 incident cirrhosis cases were documented. Healthy sleep pattern was associated with reduced risk of cirrhosis in a dose-response manner (ptrend < 0.001). Participants with favourable sleep score (versus unfavourable sleep score) had an HR of 0.55 for cirrhosis risk (95% CI 0.39-0.78). Multivariable-adjusted HRs (95% CIs) of cirrhosis incidence for NAFLDs with no frequent insomnia, sleeping for 7-8 h per day, and no excessive daytime dozing behaviors were 0.73 (0.61-0.87), 0.79 (0.66-0.93), and 0.69 (0.50-0.95), respectively. Compared with participants with favourable sleep pattern and low genetic risk, those with unfavourable sleep pattern and high genetic risk had higher risks of cirrhosis incidence (HR 3.16, 95% CI 1.88-5.33). In addition, a significant interaction between chronotype and genetic risk was detected for the incidence of cirrhosis (p for multiplicative interaction = 0.004). CONCLUSION: An association was observed between healthy sleep pattern and decreased risk of cirrhosis among NAFLD participants, regardless of low or high genetic risk.

Association of night-time sleep and daytime napping with painful temporomandibular disorder.

BACKGROUND: Painful temporomandibular disorder (TMD) is the common cause of chronic oro-facial pain, which may interfere with sleep. Previous studies have documented an association between sleep and TMD. OBJECTIVES: This study aimed to further explore the association of night-time sleep and daytime napping with painful TMD. METHODS: A total of 419 patients (aged 31.88 ± 11.54 years with women forming 85.4%) from a TMD/Orofacial Pain center were enrolled. Patients' sleep conditions were evaluated with the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and information on night-time sleep duration, napping duration and napping frequency was interviewed. TMD was diagnosed according to the Diagnostic Criteria for TMD protocol and stratified into myalgia (muscle pain), arthralgia (joint pain) and combined (muscle and joint pain) subgroups. The severity of TMD was measured with the Fonseca Anamnestic Index (FAI) questionnaire. Restricted cubic spline (RCS) regression models were established to explore relationships between sleep and painful TMD subgroups. RESULTS: Patients with poor sleep quality (PSQI≥6) had higher FAI scores (median 60, p < .001) and higher proportions of painful TMDs. The myalgia subgroup had higher PSQI scores (median 8, p < .001) than the arthralgia subgroup. The RCS models indicated a non-linear relationship between night-time sleep duration and myalgia (p < .001), which was not observed in arthralgia. However, there were no significant findings concerning napping and painful TMD subgroups. CONCLUSION: This study found that the association between sleep and TMD is mainly related to painful TMD conditions, which are associated with night-time sleep duration.

Joint Association of Sleep Onset Time and Sleep Duration With Cardiometabolic Health Outcome.

BACKGROUND: The association of sleep onset time and duration with cardiometabolic health is not well characterized. METHODS AND RESULTS: This study included 6696 adults aged 20 to 80 years from the NHANES (National Health and Nutrition Examination Study) 2015 to 2018. Participants were categorized into 9 groups according to the cross-tabulation of sleep onset time (<22:00 [early], 22:00-23:59 [optimal], and ≥24:00 [late]) and duration (<7 hours [insufficient], 7-8 hours [sufficient], and ≥9 hours [excessive]), with optimal sleep onset time and sufficient duration as the reference. The primary outcomes included hypertension, hypertriglyceridemia, low high-density lipoprotein cholesterol, hyperglycemia, central obesity, and metabolic syndrome. Inappropriate sleep onset time and sleep duration were associated with increased odds of hypertension, hypertriglyceridemia, and metabolic syndrome, especially among participants aged 40 to 59 years. Compared with men reporting optimal onset and sufficient duration, men reporting optimal onset with excessive duration (odds ratio [OR]: 2.01 [95% CI, 1.12-3.58]) and late onset with insufficient duration (OR, 1.74 [95% CI, 1.13-2.68]) had higher odds of metabolic syndrome. Compared with women reporting optimal onset and sufficient duration, women reporting optimal onset and insufficient duration (OR, 1.61 [95% CI, 1.11-2.32]) and early onset and excessive duration (OR, 2.16 [95% CI, 1.30-3.57]) had higher odds of hypertension, and women reporting late onset and excessive duration (OR, 5.64 [95% CI, 1.28-6.77]) were at the highest odds of hypertriglyceridemia. CONCLUSIONS: Late sleep onset as well as insufficient or excessive sleep duration are associated with adverse cardiometabolic outcomes, particularly in participants aged 40 to 59 years.

Association between Sleep Duration, Social Jetlag, and the Metabolic Syndrome by Shift Works.

Lifestyle factors, including sleep characteristics, have been implicated in the development of metabolic syndrome, particularly among shift workers. This study aimed to explore the relationship between shift work, sleep duration, social jetlag, and the risk of metabolic syndrome among U.S. workers and the moderating effect of sleep duration and social jetlag on this relationship. Data from the National Health and Nutrition Examination Survey (NHANES) in 2017-2020 March were analyzed. Poisson regression models were employed to examine associations. Among 4136 U.S. workers, 53.3% had metabolic syndrome, with a higher proportion of shift workers (63.8% vs. 56.7%, p = 0.001) and those sleeping less than 6 h or more than 9 h per week (22.3% vs. 19.1%, p = 0.044) in the affected group. Shift workers were initially found to have an increased risk of metabolic syndrome (Coef. = 0.03, 95% CI: 0.02, 0.16); however, this association was mitigated when accounting for the interaction with social jetlag. Specifically, 1 to <2 h of social jetlag interacted significantly, increasing metabolic risk (Coef. = 0.15, 95% CI: 0.09, 0.22), whereas 1 to <2 h alone showed a protective effect (Coef. = -0.11, 95% CI: -0.17, -0.06). These findings suggest that optimizing sleep schedules and addressing social jetlag may be crucial in mitigating metabolic syndrome risks among shift workers.

Maternal Reports of Preterm and Sick Term Infants' Settling, Sleeping and Feeding in the 9 Months after Discharge from Neonatal Nursery: An Observational Study.

The effects of preterm birth, neonatal morbidities and environmental influences on infant sleep development is an important yet under-researched topic, with little known about normative sleep for infants born sick or preterm. The aim of this prospective, observational longitudinal study was to evaluate maternal perceptions and degree of bother with infant sleep behaviours and feeding outcomes across the first 9 months after discharge for sick/preterm infants cared for in the neonatal intensive care unit (NICU) and for healthy term-born infants. This paper reports outcomes for the sick/preterm cohort (I = 94) that were recruited from two NICUs in Perth, Western Australia. Total bother scores were on average 20.2% higher at 9 months than at two weeks post-discharge (p < 0.001). Increased night waking frequency, evening settling duration and crying duration were all positively associated with total bother scores. Maternal confidence scores were negatively associated with maternal bother scores; with each unit increase in confidence, maternal bother decreased by 8.5% (p < 0.001). Covariates such as birth gestation, breastfeeding status and multiple births were not associated with maternal bother. Families may benefit from additional support when experiencing increased night waking frequency and crying and settling durations in the first 9 months after discharge from NICU.

Nonlinear relationships between sleep duration, mental health, and quality of life: The dangers of less sleep versus more sleep.

BACKGROUND: Recent research has found a non-linear relationship between sleep duration and mental health/quality of life. However, it is currently unclear which age group is more affected by sleep duration and what the optimal sleep duration is for each age group. Additionally, the underlying mechanisms of the non-linear relationship between sleep duration and quality of life are not well understood. METHODS: Therefore, this study utilized questionnaire data from 20,962 participants in the Chinese PBICR-2022 database(Cross-sectional study) and constructed models to analyze the relationship between sleep duration and quality of life. RESULTS: The results showed that the optimal sleep duration varied among different age groups: approximately 9 h for adolescents, 8 h for early/middle-aged adults, and 7 h for older adults. Compared to other age groups, less or more sleep duration had a greater impact on mental health and quality of life in adolescents. Furthermore, mental health was found to play a significant mediating role between sleep duration and quality of life in both the less sleep group and the more sleep group, but this mediating effect was not significant among the older adults in the less sleep group, whereas the mediating effect of mental health was not significant among the middle-aged adults in the more sleep group. CONCLUSIONS: This suggests that different age groups have different optimal sleep duration, and age may be an important factor influencing the relationship between sleep duration and mental health/quality of life, with mental health playing a mediating role in the relationship between sleep duration and quality of life.