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1.
Psychol Med ; : 1-8, 2020 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-32026794

RESUMO

BACKGROUND: Sleep apnea is one of the most common sleep disorders and it is related to multiple negative health consequences. Previous studies have shown that sleep apnea is influenced by genetic factors. However, studies have not investigated the genetic and environmental influences of symptoms of sleep apnea in young adults. Furthermore, the underpinnings of the relationship between apnea symptoms and internalizing/externalizing problems are unknown. The objectives of this study were to estimate the magnitude of: (1) genetic and environmental influences on self-reported apnea symptoms; (2) the relationship between self-reported apnea symptoms and internalizing/externalizing traits; (3) genetic and environmental influences on the associations between self-reported apnea symptoms, internalizing behaviors and externalizing behaviors. METHODS: In a twin/sibling study, univariate and multivariate models were fitted to estimate both individual variance and sources of covariance between symptoms of sleep apnea and internalizing/externalizing behaviors. RESULTS: Our results show that genetic influences account for 40% of the variance in sleep apnea symptoms. Moreover, there are modest associations between depression, anxiety and externalizing behaviors with apnea symptoms (ranging from r = 0.22-0.29). However, the origins of these associations differ. For example, whereas most of the covariation between symptoms of depression and sleep apnea can be explained by genes (95%), there was a larger role for the environment (53%) in the association between symptoms of anxiety and sleep apnea. CONCLUSIONS: Genetic factors explain a significant proportion of variance in symptoms of apnea and most of the covariance with depression.

2.
J Urban Health ; 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31993870

RESUMO

African Americans and socioeconomically disadvantaged individuals have higher rates of a variety of sleep disturbances, including short sleep duration, poor sleep quality, and fragmented sleep. Such sleep disturbances may contribute to pervasive and widening racial and socioeconomic (SES) disparities in health. A growing body of literature demonstrates that over and above individual-level SES, indicators of neighborhood disadvantage are associated with poor sleep. However, there has been scant investigation of the association between sleep and the most proximal environments, the home and residential block. This is the first study to examine the association between objective and self-reported measures of housing and block conditions and sleep. The sample included 634 adults (mean age = 58.7 years; 95% African American) from two low-income urban neighborhoods. Study participants reported whether they experienced problems with any of seven different housing problems (e.g., broken windows) and rated the overall condition of their home. Trained data collectors rated residential block quality. Seven days of wrist actigraphy were used to measure average sleep duration, efficiency, and wakefulness after sleep onset (WASO), and a sleep diary assessed sleep quality. Multivariate regression analyses were conducted for each sleep outcome with housing or block conditions as predictors in separate models. Participants reporting "fair" or "poor" housing conditions had an adjusted average sleep duration that was 15.4 min shorter than that of participants reporting "good" or "excellent" conditions. Those reporting any home distress had 15.9 min shorter sleep and .19 units lower mean sleep quality as compared with participants who did not report home distress. Poor objectively measured block quality was associated with 14.0 min shorter sleep duration, 1.95% lower sleep efficiency, and 10.7 additional minutes of WASO. Adverse housing and proximal neighborhood conditions are independently associated with poor sleep health. Findings highlight the importance of considering strategies that target upstream determinants of sleep health disparities.

3.
Compr Psychiatry ; 97: 152151, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31954287

RESUMO

BACKGROUND: Individual dimensions of sleep health, including satisfaction, sleepiness/alertness, timing, efficiency, and duration, are associated with depression. We investigated whether a composite sleep health score is associated with symptoms of depression among Japanese female hospital nurses. METHODS: Participants were nurses (n = 2482, all women, age 31.2 ± 8.9 years) working at three general hospitals in Tokyo, Japan. A cross-sectional survey, conducted in 2015, assessed self-reported sleep and symptoms of depression. Sleep health was categorized as "good" or "poor" across five dimensions: satisfaction, daytime sleepiness, mid-sleep time, efficiency, and duration. A composite sleep health score was calculated by summing the number of "poor" dimensions. Depression was defined by depressed mood, loss of interest, or at least one of those symptoms ("depression symptoms"). Associations between sleep health and symptoms of depression were evaluated with multivariate logistic regression analyses, adjusting for sociodemographic factors and hypnotic medication use. RESULTS: In multivariate logistic regression analyses, sleep health symptoms of poor satisfaction, efficiency, and duration were significantly associated with depressed mood; daytime sleepiness and poor efficiency were significantly associated with loss of interest; and poor satisfaction, daytime sleepiness, mid-sleep time, and efficiency were significantly associated with having at least one depressive symptom. The composite sleep health score was associated in a graded fashion with greater odds of depression symptoms. CONCLUSION: Individual and composite sleep health scores were associated with symptoms of depression. Assessing composite measures of multidimensional sleep health may help to better understand the well-known associations between poor sleep and depression and lead to improved intervention strategies.

4.
Ann Am Thorac Soc ; 2020 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-31899656

RESUMO

RATIONALE: Sleep constitutes a fundamental pillar of health in individuals and is an indicator of the health of a population. OBJECTIVES: Aiming to develop an easy-to-use tool to measure sleep health, we translated into Spanish, adapted and validated the Satisfaction Alertness Timing Efficiency Duration (SATED) questionnaire. METHODS: The reliability of the questionnaire was evaluated using a sample of 4385 participants from the 2015 Catalan Health Survey. Criterion validity, construct validity and feasibility were assessed in an independent sample of 200 subjects who completed the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, anxiety scale of the State-Trait Anxiety Inventory, mood scale of the Profile of Mood States and a one-week sleep diary. RESULTS: The SATED questionnaire obtained adequate internal consistency (Cronbach's α = 0.77); statistically significant correlations of its five items with the total score (rho = 0.55-0.69); and a suitable goodness of fit in the confirmatory factor analysis (χ2 = 30.93, df = 5, p <0.001, RMSEA = 0.049, CFI = 0.99, SRMR = 0.043). The criterion and construct validity were adequate, with correlations in the expected directions. The feasibility of the questionnaire was satisfactory, being easy and intelligible, and requiring approximately one minute to be completed. CONCLUSIONS: This questionnaire is reliable and valid for measuring sleep health in the general population. Encouraging the use of SATED is expected to raise awareness that sleep, like diet and physical activity, is a key modifiable factor for promoting health.

5.
Artigo em Inglês | MEDLINE | ID: mdl-31900098

RESUMO

The concept of sleep health provides a positive holistic framing of multiple sleep characteristics, including sleep duration, continuity, timing, alertness, and satisfaction. Sleep health promotion is an underrecognized public health opportunity with implications for a wide range of critical health outcomes, including cardiovascular disease, obesity, mental health, and neurodegenerative disease. Using a socioecological framework, we describe interacting domains of individual, social, and contextual influences on sleep health. To the extent that these determinants of sleep health are modifiable, sleep and public health researchers may benefit from taking a multilevel approach for addressing disparities in sleep health. For example, in addition to providing individual-level sleep behavioral recommendations, health promotion interventions need to occur at multiple contextual levels (e.g., family, schools, workplaces, media, and policy). Because sleep health, a key indicator of overall health, is unevenly distributed across the population, we consider improving sleep health a necessary step toward achieving health equity. Expected final online publication date for the Annual Review of Public Health, Volume 41 is April 1, 2020. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

6.
Sleep Breath ; 2020 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-31900885

RESUMO

PURPOSE: Physical activity has been associated with several individual dimensions of sleep. However, the association between physical activity and sleep health, a construct that emphasizes the multidimensional nature of sleep, has not been explored. This analysis examined the relationship between physical activity and a composite measure of sleep health. METHODS: A total of 114 adults (66% female, 60.3 ± 9.2 years) were included in the analyses. Participants reported daily light-intensity physical activity (LPA) and moderate- and vigorous-intensity physical activity (MVPA) via diary, while wearing a pedometer (Omron HJ-720ITC) to measure daily steps. Sleep health was measured using the RU_SATED questionnaire, which addresses regularity of sleep patterns, satisfaction with sleep, daytime alertness, and sleep timing, efficiency, and duration. Multiple linear regression, binary logistic regression, and analysis of covariance (ANCOVA) were utilized for analyses. RESULTS: Mean sleep health score was 9.6 ± 2.4 (0 [poor]-12 [good]). Participants reported 62.9 ± 66.0 and 51.2 ± 51.2 min/day of LPA and MVPA, respectively, and took 5585.5 ± 2806.7 steps/day. Greater MVPA was associated with better sleep health (ß = 0.27, P = 0.005) and sleep health scores differed between those reporting < 30 min/day and ≥ 60 min/day of MVPA (P = 0.004). Greater MVPA was associated with higher odds of having good sleep satisfaction (OR = 1.58 [1.14-2.20], P < 0.01), timing (OR = 2.07 [1.24-3.46], P < 0.01), and duration (OR = 1.48 [1.02-2.18], P = 0.04). Pedometer-based physical activity and LPA were not related to sleep health or its individual dimensions. CONCLUSIONS: In middle- to older-aged adults, higher-intensity activity, but not lower-intensity or volume of activity, was associated with greater sleep health. These data suggest that physical activity intensity may be important for sleep health.

7.
Mol Psychiatry ; 25(2): 283-296, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31745239

RESUMO

Adverse posttraumatic neuropsychiatric sequelae (APNS) are common among civilian trauma survivors and military veterans. These APNS, as traditionally classified, include posttraumatic stress, postconcussion syndrome, depression, and regional or widespread pain. Traditional classifications have come to hamper scientific progress because they artificially fragment APNS into siloed, syndromic diagnoses unmoored to discrete components of brain functioning and studied in isolation. These limitations in classification and ontology slow the discovery of pathophysiologic mechanisms, biobehavioral markers, risk prediction tools, and preventive/treatment interventions. Progress in overcoming these limitations has been challenging because such progress would require studies that both evaluate a broad spectrum of posttraumatic sequelae (to overcome fragmentation) and also perform in-depth biobehavioral evaluation (to index sequelae to domains of brain function). This article summarizes the methods of the Advancing Understanding of RecOvery afteR traumA (AURORA) Study. AURORA conducts a large-scale (n = 5000 target sample) in-depth assessment of APNS development using a state-of-the-art battery of self-report, neurocognitive, physiologic, digital phenotyping, psychophysical, neuroimaging, and genomic assessments, beginning in the early aftermath of trauma and continuing for 1 year. The goals of AURORA are to achieve improved phenotypes, prediction tools, and understanding of molecular mechanisms to inform the future development and testing of preventive and treatment interventions.

8.
Behav Sleep Med ; 18(1): 10-22, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30252506

RESUMO

Background/Objective: Insomnia is common among adults with asthma and is associated with worse asthma control. Cognitive-behavioral therapy for insomnia (CBT-I) is an effective treatment for insomnia with medical comorbidities, but it has not been tested in asthma. The purpose of this study was to assess the feasibility and acceptability of an Internet-based CBT-I intervention, called Sleep Healthy Using the Internet (SHUTi), among adults with asthma and comorbid insomnia, and to gather preliminary efficacy data on changes in insomnia severity, sleep quality, asthma control, and asthma-related quality of life. Methods: A single-group, pretest-posttest design was employed, where all participants completed the SHUTi program. Online questionnaires were completed pre- and postintervention. Individual telephone interviews were conducted after posttreatment data collection to obtain participants' experiences with SHUTi and suggestions for improvement. Results: The sample (N = 23) comprised men and women aged 18-75 years with moderate to severe, not well-controlled asthma, and comorbid insomnia. Nineteen (83%) completed postintervention assessments. Improvements on the Insomnia Severity Index, Pittsburgh Sleep Quality Index, Asthma Control Test, and Asthma Quality of Life Questionnair-Marks were observed at postintervention. Data from the telephone interviews suggest that most participants had a positive experience with SHUTi. Participants suggested incorporating asthma-specific content into future versions of the intervention. Conclusions: Internet-based CBT-I is a potential treatment option for adults with asthma and comorbid insomnia.

9.
Chest ; 2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31785255

RESUMO

BACKGROUND: The Patient-Reported Outcomes Measurement Information System (PROMIS) includes two instruments to quantify sleep symptoms (sleep disturbance [SDA] and sleep-related impairment [SRI]) in diverse populations across a wide symptom spectrum. However, the responsiveness of PROMIS measures to treatment of sleep disorders is unknown. We examined the responsiveness of the PROMIS sleep scales to the treatment of OSA. METHODS: We collected SDA, SRI, and Epworth Sleepiness Scale (ESS) before and after initiation of positive airway pressure (PAP) in patients with type 2 diabetes newly diagnosed with OSA. To compare responsiveness, we compared effect sizes and classifications of symptom improvement using both the reliable change method and thresholds of minimum important difference (MID). RESULTS: A total of 103 patients completed assessments pre- and post-PAP. SDA, SRI, and ESS scores all declined significantly with PAP therapy. We observed the largest effect size for SDA (-0.64; 95% CI, -0.86 to -0.42), followed by SRI (-0.43; 95% CI, -0.63 to -0.23), and ESS (-0.28; 95% CI, -0.42 to -0.15). More patients experienced the reliable change category of symptom remission categorized by the PROMIS measures (SDA: 23.3%; SRI: 31.1%) relative to the ESS (5.8%) (P < .001 for both). Using the MID, SDA and SRI also classified more patients as improved (SDA: 54.4%; SRI: 49.5%) relative to the ESS (35.0%) (P < .001 for both pairwise comparisons). CONCLUSIONS: PROMIS sleep measures were more likely than the ESS to detect an improvement with PAP therapy. Incorporating PROMIS measures into research and clinical care may provide a more sensitive assessment of symptomatic response to OSA treatment.

10.
Sleep ; 2019 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-31755954

RESUMO

STUDY OBJECTIVES: Determine the association of poor multidimensional sleep health with health-care costs and utilization. METHODS: We linked 1,459 community-dwelling women (mean age 83.6 years) participating in the Study of Osteoporotic Fractures Year 16 visit (2002-2004) with their Medicare claims. Five dimensions of sleep health (satisfaction, daytime sleepiness, timing, latency, and duration) were assessed by self-report. The number of impaired dimensions was expressed as a score (range 0-5). Total direct health-care costs and utilization were ascertained during the subsequent 36 months. RESULTS: Mean (SD) total health-care costs/year (2017 dollars) increased in a graded manner across the sleep health score ranging from $10,745 ($15,795) among women with no impairment to up to $15,332 ($22,810) in women with impairment in three to five dimensions (p = 0.01). After adjustment for age, race, and enrollment site, women with impairment in three to five dimensions vs. no impairment had greater mean total costs (cost ratio [CR] 1.34 [95% CI = 1.13 to 1.60]) and appeared to be at higher risk of hospitalization (odds ratio (OR) 1.31 [95% CI = 0.96 to 1.81]). After further accounting for number of medical conditions, functional limitations, and depressive symptoms, impairment in three to five sleep health dimensions was not associated with total costs (CR 1.02 [95% CI = 0.86 to 1.22]) or hospitalization (OR 0.91 [95% CI = 0.65 to 1.28]). Poor multidimensional sleep health was not related to outpatient costs or risk of skilled nursing facility stay. CONCLUSIONS: Older women with poor sleep health have higher subsequent total health-care costs largely attributable to their greater burden of medical conditions, functional limitations, and depressive symptoms.

12.
Int Psychogeriatr ; : 1-8, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31658928

RESUMO

OBJECTIVES: Self-reported activity restriction is an established correlate of depression in dementia caregivers (dCGs). It is plausible that the daily distribution of objectively measured activity is also altered in dCGs with depression symptoms; if so, such activity characteristics could provide a passively measurable marker of depression or specific times to target preventive interventions. We therefore investigated how levels of activity throughout the day differed in dCGs with and without depression symptoms, then tested whether any such differences predicted changes in symptoms 6 months later. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: We examined 56 dCGs (mean age = 71, standard deviation (SD) = 6.7; 68% female) and used clustering to identify subgroups which had distinct depression symptom levels, leveraging baseline Center for Epidemiologic Studies of Depression Scale-Revised Edition and Patient Health Questionnaire-9 (PHQ-9) measures, as well as a PHQ-9 score from 6 months later. Using wrist activity (mean recording length = 12.9 days, minimum = 6 days), we calculated average hourly activity levels and then assessed when activity levels relate to depression symptoms and changes in symptoms 6 months later. RESULTS: Clustering identified subgroups characterized by: (1) no/minimal symptoms (36%) and (2) depression symptoms (64%). After multiple comparison correction, the group of dCGs with depression symptoms was less active from 8 to 10 AM (Cohen's d ≤ -0.9). These morning activity levels predicted the degree of symptom change on the PHQ-9 6 months later (per SD unit ß = -0.8, 95% confidence interval: -1.6, -0.1, p = 0.03) independent of self-reported activity restriction and other key factors. CONCLUSIONS: These novel findings suggest that morning activity may protect dCGs from depression symptoms. Future studies should test whether helping dCGs get active in the morning influences the other features of depression in this population (i.e. insomnia, intrusive thoughts, and perceived activity restriction).

13.
Behav Sleep Med ; : 1-11, 2019 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-31545653

RESUMO

Objective/Background: Food Insecurity (FI) can be a profound source of stress, which may increase the risk for sleep disturbance. This is the first study to examine the association between FI and objectively and subjectively measured sleep. Participants: The sample included 785 adults living in two low-income neighborhoods (mean age = 56; 95% African American). Methods: FI was measured using a validated 10-item survey that assesses conditions and behaviors that characterize households when they lack financial resources to meet basic food needs. Sleep duration, efficiency, wakefulness after sleep onset (WASO), and variability in sleep duration were measured via actigraphy. Sleep quality was assessed via sleep diary. Sleep outcomes were analyzed as a function of FI, adjusting for covariates. Psychological distress was tested as a potential mediator. Results: Greater FI was associated with shorter actigraphy-assessed sleep duration (B = -2.44; SE = 1.24; i.e., 24 minutes shorter for the most as compared to least insecure group), poorer sleep efficiency (B = -.27; SE = .13); p's < .05), and poorer subjective sleep quality (B = -.03; SE = .01; p < .01). Greater FI was also associated with greater likelihood of short (<7 hours; OR = 1.11; CI: 1.02-1.21) and long sleep (>9 hours; OR = 1.19; CI: 1.01-1.39), compared to the recommended sleep duration of 7-9 hours. Psychological distress partially mediated the association between FI and subjective sleep quality. Conclusions: Addressing or mitigating food insecurity may present a novel opportunity for improving sleep health among low-income populations.

14.
Behav Sleep Med ; : 1-16, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31455144

RESUMO

Objective: To examine agreement between multiple commercial activity monitors (CAMs) and a validated actigraph to measure sleep. Methods: Thirty adults without sleep disorders wore an Actiwatch Spectrum (AW) and alternated wearing 6 CAMs for one 24-h period each (Fitbit Alta, Jawbone Up3, Misfit Shine 2, Polar A360, Samsung Gear Fit2, Xiaomi Mi Band 2). Total sleep time (TST) and wake after sleep onset (WASO) were compared between edited AW and unedited CAM outputs. Comparisons between AW and CAM data were made via paired t-tests, mean absolute percent error (MAPE) calculations, and intra-class correlations (ICC). Intra-model reliability was performed in 10 participants who wore a pair of each AW and CAM model. Results: Fitbit, Jawbone, Misfit, and Xiaomi overestimated TST relative to AW (53.7-80.4 min, P ≤ .001). WASO was underestimated by Fitbit, Misfit, Samsung and Xiaomi devices (15.0-27.9 min; P ≤ .004) and overestimated by Polar (27.7 min, P ≤ .001). MAPEs ranged from 5.1% (Samsung) to 25.4% (Misfit) for TST and from 36.6% (Fitbit) to 165.1% (Polar) for WASO. TST ICCs ranged from .00 (Polar) to .92 (Samsung), while WASO ICCs ranged from .38 (Misfit) to .69 (Samsung). Differences were similar between poor sleepers (Pittsburgh Sleep Quality Index global score >5; n = 10) and good sleepers. Intra-model reliability analyses revealed minimal between-pair differences and high ICCs. Conclusions: Agreement between CAMs and AW varied by device, with greater agreement observed for TST than WASO. While reliable, variability in agreement across CAMs with traditional actigraphy may complicate the interpretation of CAM data obtained for clinical or research purposes.

15.
J Behav Med ; 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31435891

RESUMO

Background The aims of the study were to understand sleep problems and their effects in advanced cancer patients and spousal and intimate partner caregivers and to examine the directionality of the link between patients' and caregivers' sleep problems. Methods Fifty-four advanced cancer patients and their spousal and intimate partners were administered a battery of questionnaires that included the Pittsburgh Sleep Quality Index and the Center for Epidemiological Studies at the patients' cancer diagnosis and at 2, 4, and 6 months after diagnosis. Results Patients' and caregivers' sleep duration was significantly related. Using cross-lagged panel analyses, caregivers' sleep quality significantly predicted patients' sleep quality and patients' sleep quality subsequently predicted caregivers' sleep quality. Patients' sleep latency significantly was found to significantly predict caregivers' sleep latency. Conclusion Patients diagnosed with cancer and their intimate partners have poor sleep quality and sleep patterns are related.

16.
Psychiatry Res ; 280: 112502, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31382180

RESUMO

Persistent infection with Herpes Simplex viruses (HSV) and other brain infections is consistently associated with cognitive impairment. These infections can also affect sleep. Thus, sleep abnormalities could explain the cognitive dysfunction. We investigated the association between sleep variables and persistent HSV-1, HSV-2, cytomegalovirus (CMV) and Toxoplasma gondii (Tox) infections. Sleep data were collected from older adults with or without insomnia (N = 311, total); a subset completed polysomnographic and actigraphy studies (N = 145). No significant associations were found between the infections and insomnia or the remaining sleep variables following corrections for multiple comparisons. Sleep dysfunction is unlikely to explain the infection-related cognitive dysfunction.

17.
Sleep ; 2019 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-31152182

RESUMO

STUDY OBJECTIVES: For most women, the menopause is accompanied by hot flashes and sleep problems. Although hot flashes reportedly wake women from sleep, in the few studies that have used objective measures of both sleep and hot flashes, links between hot flashes and nocturnal wakening have been inconsistent. In a well-characterized cohort of midlife women, we examined the association between objectively-assessed hot flashes and actigraphically-defined wake from sleep. We hypothesized that wake episodes would be more likely during an objective hot flash relative to minutes without a hot flash. METHODS: Peri- and postmenopausal midlife women underwent simultaneous objective measurement of hot flashes (sternal skin conductance) and sleep (actigraphy) over 24 hours in the home. The likelihood of waking in the minutes during the hot flash relative to the minutes preceding the hot flash were compared using generalized estimating equations. RESULTS: We studied 168 women with at least one objective nocturnal hot flash and actigraphy data. Actigraphy-assessed wake episodes were concurrent with seventy-eight percent of the objective hot flashes. We found an increased likelihood of wake in the minutes during the objective hot flash [0 to +5 minutes: OR(95%CI)=5.31(4.46-6.33), p<.0001] relative to the minutes preceding it [-10 to -1 minutes]. The increased likelihood of wake occurred irrespective of whether the women reported the objective hot flash. CONCLUSION: Among these women who underwent objective measurement of sleep and hot flashes, nocturnal wakefulness was observed with the majority of hot flashes.

18.
Sleep Health ; 5(5): 514-520, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31208939

RESUMO

OBJECTIVES: Although multiple individual sleep measures (eg, sleep duration, satisfaction) have been linked to a wide range of physical and mental health conditions, scant research has examined how individual sleep dimensions may act independently or additively to influence health. The current study investigates associations of 5 sleep dimensions (duration, satisfaction, efficiency, timing, and regularity), analyzed separately and simultaneously, with psychological distress, body mass index, and physical functioning among a low-income, predominantly African American population. DESIGN: We constructed a composite sleep health (SH) score from the sum of scores, representing "good' and "poor" ranges of 5 sleep measures (range 0-5). SETTING: Two low-income, predominantly African American neighborhoods in Pittsburgh. PARTICIPANTS: Participants included 738 community-dwelling adults (78% female and 98% black). MEASUREMENTS: Actigraphy-based measures of sleep duration, regularity, timing, and efficiency, and self-reported sleep satisfaction. Outcomes included self-reported psychological distress, physical functioning, and measured body mass index (BMI). RESULTS: Each 1-unit higher SH score was associated with 0.55-unit lower psychological distress score (range 0-24) and 2.23-unit higher physical functioning score. Participants with at least 2, 3, or 4 sleep dimensions in the "healthy" range, vs fewer, had lower psychological distress scores. Greater sleep satisfaction was associated with higher physical functioning, and longer sleep duration was associated with lower physical functioning. Neither the composite SH score nor any of the individual sleep dimensions were associated with BMI. CONCLUSIONS: Assessing multiple sleep dimensions may provide a more comprehensive understanding of associations of sleep with psychological distress than assessing any single sleep dimension. Although no sleep measures were related to BMI in the current sample, analyses should be replicated in other samples to determine generalizability.


Assuntos
Afro-Americanos/psicologia , Sono/fisiologia , Actigrafia , Adulto , Afro-Americanos/estatística & dados numéricos , Idoso , Índice de Massa Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pennsylvania , Desempenho Físico Funcional , Áreas de Pobreza , Características de Residência/estatística & dados numéricos
19.
Sleep ; 2019 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-31083710

RESUMO

STUDY OBJECTIVES: Emerging evidence supports a multidimensional perspective of sleep in the context of health. The sleep health model, and composite sleep health score, are increasingly used in research. However, specific cut-off values that differentiate "good" from "poor" sleep, have not been empirically-derived and its relationship to cardiometabolic health is less-well understood. We empirically-derived cut-off values for sleep health dimensions and examined the relationship between sleep health and cardiometabolic morbidity. METHODS: Participants from two independent Biomarker Studies in the MIDUS II (N = 432, 39.8% male, age = 56.92±11.45) and MIDUS Refresher (N = 268, 43.7% male, age = 51.68±12.70) cohorts completed a 1-week study where sleep was assessed with daily diaries and wrist actigraphy. Self-reported physician diagnoses, medication use, and blood values were used to calculate total cardiometabolic morbidity. Receiver operating characteristic (ROC) curves were generated in the MIDUS II cohort for each sleep health dimension to determine cut-off values. Using derived cut-off values, logistic regression was used to examine the relationship between sleep health scores and cardiometabolic morbidity in the MIDUS Refresher cohort, controlling for traditional risk factors. RESULTS: Empirically-derived sleep health cut-off values aligned reasonably well to cut-off values previously published in the sleep health literature and remained robust across physical and mental health outcomes. Better sleep health was significantly associated with a lower odds of cardiometabolic morbidity [OR(95%CI) =0.901(0.814-0.997), p = .044]. CONCLUSIONS: These results contribute to the ongoing development of the sleep health model and add to the emerging research supporting a multidimensional perspective of sleep and health.

20.
Sci Rep ; 9(1): 7284, 2019 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-31086269

RESUMO

Although sleep habits have long been recognized as a promoter of health, the World Health Organization 2014 report on non-communicable diseases (NCDs) only listed smoking, alcohol intake, diet and physical activity (PA) as key modifiable risk factors that could enhance health and prevent NCDs. Cross-sectional data on 4385 surveys from the 2015 Catalan Health Survey, representative of the 2015 non-institutionalized Catalan population over age 14, were used to assess and compare the independent associations of low PA (International Physical Activity Questionnaire (IPAQ): low activity); poor diet (PREvención con DIeta MEDiterránea questionnaire (PREDIMED): low-adherent); poor sleep health (Satisfaction, Alertness, Timing, Efficiency and Duration scale (SATED): <8); smoking status; and, alcohol intake (high-risk drinker based on standard drink units) with having a poor self-perceived health status. Logistic regression models adjusted by age, gender, education level and number of comorbidities showed that poor sleep health had the strongest independent association with poor self-perceived health status (OR = 1.70; 95%CI: 1.37-2.12), followed by poor diet (OR = 1.37; 95%CI: 1.10-1.72) and low PA (OR = 1.31; 95%CI: 1.01-1.69). This suggests that sleep habits should be included among the important modifiable health risk factors and be considered a key component of a healthy lifestyle.

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