Association between sleep difficulties as well as duration and hypertension: is BMI a mediator?
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ABSTRACT:
SUBMITTER: Carrillo-Larco RM
PROVIDER: S-EPMC5732577 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Housing environments can directly and indirectly affect sleep, and blacks are more likely than whites to live in suboptimal housing conditions, which may independently contribute to sleep disparities. However, few large-scale epidemiological studies consider the potential influence of housing type on sleep health. Using data from the 2004-2015 National Health Interview Survey, we investigated overall and Black-White differences in the association between housing type (house/apartment versus mobile home/trailer) and sleep duration as well as sleep difficulties among 226,208 adults in the U.S. Poisson regression with robust variance was used to estimate sex-specific prevalence ratios (PR) for sleep categories, first comparing houses/apartments to mobile homes/trailers and then blacks to whites within housing types. All models were adjusted for age, educational attainment, income, occupational class, self-reported general health status, and region of residence. Compared to participants living in houses/apartments, the prevalence of short sleep was higher for men (PR = 1.05 (95% confidence interval (CI): 1.02-1.08)) and women (PR = 1.07 (95% CI: 1.04-1.09)) in mobile homes/trailers. Black men (PR = 1.26 (95% CI: 1.21-1.30)) and women (PR = 1.24 (95% CI: 1.20-1.27)) in a house/apartment were more likely to be short sleepers than their white counterparts. There was generally no significant difference in sleep characteristics (except long sleep) between black and white men in mobile homes/trailers after adjustments, and black men in houses/apartments as well as black women in both housing types were less likely to report sleep difficulties although being more likely to report short sleep. Overall, individuals in mobile homes/trailers, which may represent suboptimal housing, had worse sleep than those in houses/apartments; and racial differences in the quality of houses and apartments are likely to greatly vary in ways that still contribute to sleep disparities. Race-sex group differences in sleep duration among residents in a house/apartment and even a lack of racial difference among individuals living in mobile homes/trailers support the need for more research on residential environments and eventually multi-level interventions designed to reduce sleep disparities.
| S-EPMC5923606 | biostudies-other
Project description:ObjectiveHypertension is a major risk factor and cause of many non-communicable diseases in China. While there have been studies on various diet and lifestyle risk factors, we do not know whether sleep duration has an association to blood pressure in southwest China. This predictor is useful in low-resource rural settings. We examined the association between sleep duration and hypertension in southwest China.DesignPopulation-based cross-sectional study.SettingThis study was part of the baseline survey of a large ongoing prospective cohort study, the China Kadoorie Biobank. Participants were enrolled in 15 townships of Pengzhou city in Sichuan province during 2004-2008.Participants55 687 participants aged 30-79 years were included. Sleep duration was assessed by a self-reported questionnaire.Main outcome measuresHypertension was defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg, or prior physician-diagnosed hypertension in hospitals at the township (community) level or above.ResultsThe prevalence of hypertension was 25.17%. The percentages of subjects with sleep durations of <6, 6, 7, 8 and ≥9 hours were 17.20%, 16.14%, 20.04%, 31.95% and 14.67%, respectively. In multivariable-adjusted analyses, the increased ORs of having hypertension were across those who reported ≥9 hours of sleep (men: 1.16, 95% CI 1.04 to 1.30; women: 1.19, 95% CI 1.08 to 1.32; general population: 1.17, 95% CI 1.08 to 1.26). The odds of hypertension was relatively flat until around 6.81 hours of sleep duration and then started to increase rapidly afterwards in subjects and a J-shaped pattern was observed. There was a U-shaped relationship between sleep duration and hypertension in females.ConclusionLong sleep duration was significantly associated with hypertension and a J-shaped pattern was observed among rural adults in southwest China, independent of potential confounders. However, this association was not obvious between short sleep duration and hypertension.
| S-EPMC9237882 | biostudies-literature
Project description:ImportanceAn association between sleep duration and the trajectory of cognitive decline has not been conclusively demonstrated.ObjectiveTo investigate the association between sleep duration and cognitive decline by a pooled analysis of 2 nationally representative aging cohorts.Design, setting, and participantsA pooled cohort study using data from waves 4 to 8 (2008-2009 to 2016-2017) in the English Longitudinal Study of Ageing and waves 1 to 3 (2011 to 2015) in the China Health and Retirement Longitudinal Study in a population-based setting. Participants were 2 randomly enrolled cohorts comprising 28 756 individuals living in England who were 50 years or older and those living in China who were 45 years or older.ExposureSelf-reported sleep duration per night according to face-to-face interviews.Main outcomes and measuresGlobal cognitive z scores were calculated according to immediate and delayed recall test, an animal fluency test, the serial sevens test, an intersecting pentagon copying test, and a date orientation test.ResultsData were analyzed from 20 065 participants, including 9254 from the English Longitudinal Study of Ageing (mean [SD] age, 64.6 [9.8] years; 55.9% [5174 of 9254] women; median follow-up duration, 8 [interquartile range, 6-8] years) and 10 811 from the China Health and Retirement Longitudinal Study (mean [SD] age, 57.8 [9.0] years; 50.2% [5425 of 10 811] men; median follow-up duration, 4 [interquartile range, 4-4] years). During 100 000 person-years of follow-up, global cognitive z scores in individuals with 4 hours or less (pooled β = -0.022; 95% CI, -0.035 to -0.009 SD per year; P = .001) and 10 hours or more (pooled β = -0.033; 95% CI, -0.054 to -0.011 SD per year; P = .003) of sleep per night declined faster than in the reference group (7 hours per night) after adjusting for a number of covariates. An inverted U-shaped association between sleep duration and global cognitive decline was also observed.Conclusions and relevanceIn this pooled cohort study, an inverted U-shaped association between sleep duration and global cognitive decline was found, indicating that cognitive function should be monitored in individuals with insufficient (≤4 hours per night) or excessive (≥10 hours per night) sleep duration. Future studies are needed to examine the mechanisms of the association between sleep duration and cognitive decline.
| S-EPMC7506513 | biostudies-literature
Project description:ObjectiveThe aim of this study is to explore sleep status and hypertension among oil workers in Xinjiang, China. It may provide new ideas and basis for the precise prevention and treatment of hypertension in occupational population.MethodsSleep status and hypertension were investigated in 3,040 workers by a multi-stage cluster sampling method in six oil field bases in Karamay City, Xinjiang. The Pittsburgh Sleep Quality Index was used to evaluate the sleep status of workers. Logistic regression was used to analyze the relationship between sleep duration and sleep quality, and hypertension. Stratified analysis was also performed.ResultsOur results show: 1. Insufficient sleep duration (OR = 1.51, 95% CI [1.19-1.90]) and poor sleep quality (OR = 1.78, 95% CI [1.33-2.38] were positively associated with hypertension. 2. Stratified analysis indicated insufficient sleep duration was associated with increased risk of hypertension in females (OR = 1.54, 95% CI [1.16-2.04]) than males (OR = 1.49, 95% CI [1.00-2.23]), and the risk of hypertension in the group <30 years old (OR = 9.03, 95% CI [2.32-35.15]) was higher than that in the group of 30-45 years old (OR = 1.59, 95% CI [1.14-2.20]). However, in the group > 45 years old, sleeping > 8 h was associated with increased risk of hypertension (OR = 3.36, 95% CI [1.42-7.91]). Oil workers doing shift work had a higher risk of hypertension (OR = 1.55, 95% CI [1.16-2.07]) to no shift work (OR = 1.48, 95% CI [1.02-2.15]). The risk of hypertension in the group with < 10 years of service (OR = 4.08, 95% CI [1.92-8.83]) was higher than that in the group with length of service of 10-20 years (OR = 2.79, 95% CI [1.59-4.86]). Poor sleep quality was associated with risk for hypertension in females (OR = 1.78, 95% CI [1.26-2.49]), those doing shift work (OR = 1.70, 95% CI [1.17-2.47]), those with length of service of > 20 years (OR = 1.64, 95% CI [1.18-2.27]). The risk of hypertension in the group 30-45 years old is higher than that in the group > 45 years old (OR 30-45 years old = 1.71, 95% CI [1.10-2.66]; OR > 45 years old = 1.60, 95% CI [1.09-2.34]).ConclusionInsufficient sleep duration and poor sleep quality are the potential factors affecting hypertension in Xinjiang oil workers.
| S-EPMC8101473 | biostudies-literature
Project description:OBJECTIVES:To examine the relationship between sleep duration and hypertension of migrant workers aged 18-59 years in China. DESIGN:Population-based cross-sectional study using a complex survey sampling design. PARTICIPANTS:There were 43?655 subjects in our analysis, after excluding people with missing information for key exposure and outcome variables and abnormal values for sleep duration (?2?or ?17?hours). PRIMARY OUTCOME MEASURE:Hypertension was defined as systolic blood pressure (BP) ?140?mm Hg and/or diastolic BP ?90?mm Hg, or self-reported history of hypertension diagnosis in hospitals at the township (community) level or above and use of hypertensive medicine in the last 2 weeks. RESULTS:Of 43?655 subjects, 15.6% (95% CI 15.1% to 16.1%) of migrant workers had hypertension. The prevalence of hypertension decreased with the increased sleep duration, both in males and females. Logistic regression models, using 7-8?hours sleep/day as the reference, showed a greater odds for hypertension among men and women who reported <6?hours of sleep after adjusting for sociodemographic characteristics, behavioural risk factors, body mass index, diabetes, stroke and myocardial infarction (men: OR 1.26; 95%?CI 1.03 to 1.54, women: OR 1.55; 95%?CI 1.13 to 2.06, pinteraction =0.096). Further stratified by age and migration time, it revealed that among adults less than 45 years old, those sleeping 9 or more hours had adjusted odds for hypertension of 0.82 (95% CI 0.72 to 0.93, pinteraction=0.020),while there was no evidence of an association between sleep duration and hypertension among adults aged 45-59 years. Among adults whose migration time was less than 4.5 years, those sleeping 9 or more hours had adjusted odds for hypertension of 0.80 (95% CI 0.68 to 0.94, pinteraction=0.097). CONCLUSION:The association between sleep duration and hypertension varies by age. Short sleep duration (<6?hours) is associated with an increased prevalence of hypertension in both genders.
| S-EPMC6924713 | biostudies-literature
Project description:We aimed to examine whether hypertension status modified the association between sleep duration and stroke among middle-aged and elderly population. This cross-sectional study included 10 516 participants aged ≥45 years from the China Hypertension Survey study. Sleep duration and history of stroke were assessed by questionnaires. Multivariate logistic regression analyses, a generalized additive model (GAM) and smooth curve fitting (penalized spline method) and a two-piecewise logistic regression models were performed to evaluate the association between sleep duration and stroke in different status of hypertension. 95% confidence interval (CI) for turning point was obtained by bootstrapping. Multiple logistic analyses showed that per 1 hour increase in sleep duration was associated with a 37% increased prevalence of stroke among participants without hypertension and associated with a 8% increased prevalence of stroke among hypertensive participants (without hypertension: odds ratio [OR] = 1.37, 95% CI 1.09-1.71; with hypertension: OR = 1.08, 95% CI 0.95-1.21; PInteraction = .029). The fully adjusted smooth curves presented a linear association between sleep duration and stroke among participants without hypertension, but a threshold, nonlinear association among hypertensive participants. The turning point for the curve was found at a sleep duration of 8 (95% CI 5-9) h among hypertensive patients. The ORs (95% CIs) for stroke were 0.92 (0.79, 1.06) and 1.60 (1.23, 2.08) to the left and right of the turning point, respectively. In conclusion, we found a linear association between sleep duration and stroke among middle-aged and elderly participants without hypertension, but a threshold, nonlinear association among hypertensive participants.
| S-EPMC8029756 | biostudies-literature
Project description:ObjectivesEpidemiologic studies have shown that chronic short sleep may be associated with the development of hypertension; however, the results are controversial. This meta-analysis was conducted to determine whether the duration of sleep is associated with hypertension.MethodsReference databases (PubMed, EmBase, the Cochrane Library, Chinese Biological Medicine database) were searched for studies related to sleep duration and hypertension. Sleep duration categories (≤ 5 h, 6 h, 7 h, 8 h, ≥ 9 h) and prevalence or incidence of hypertension in each sleep category were extracted. A general analysis and subgroup analyses stratified by gender, age, study design, and different definitions of sleep duration were conducted to evaluate the relationship between sleep duration and hypertension.ResultsThirteen articles out of a total of 1,628 articles involving 347,759 participants met the inclusion criteria. A U-shaped change in pooled odds ratios (ORs) for hypertension due to the change of sleep duration was observed. The unadjusted OR for hypertension of individuals who slept ≤ 5 h vs. 7 h was 1.61, 95% CI = 1.28-2.02; those who slept ≥ 9 h vs. 7 h was 1.29, 95% CI = 0.97-1.71. The pooled ORs were still significant after adjusted by age and gender. Women deprived of sleep (sleep time ≤ 5 h vs. 7 h, OR = 1.68, 95% CI = 1.39-2.03) had a higher risk of hypertension than men (OR = 1.30, 95% CI = 0.93-1.83).ConclusionExcessively longer and shorter periods of sleep may both be risk factors for high blood pressure; these associations are stronger in women than men.
| S-EPMC4543249 | biostudies-literature
Project description:ObjectivesTo advance understanding of the relationship between discrimination and sleep duration and difficulties, with consideration of multiple dimensions of discrimination, and attention to concurrent stressors; and to examine the contribution of discrimination and other stressors to racial/ ethnic differences in these outcomes.DesignCross-sectional probability sample.SettingChicago, IL.ParticipantsThere were 2,983 black, Hispanic, and white adults.Measurements and resultsOutcomes included self-reported sleep duration and difficulties. Discrimination, including racial and nonracial everyday and major experiences of discrimination, workplace harassment and incivilities, and other stressors were assessed via questionnaire. In models adjusted for sociodemographic characteristics, greater exposure to racial (? = -0.14)) and nonracial (? = -0.08) everyday discrimination, major experiences of discrimination attributed to race/ethnicity (? = -0.17), and workplace harassment and incivilities (? = -0.14) were associated with shorter sleep (P < 0.05). The association between major experiences of discrimination attributed to race/ethnicity and sleep duration (? = -0.09, P < 0.05) was independent of concurrent stressors (i.e., acute events, childhood adversity, and financial, community, employment, and relationship stressors). Racial (? = 0.04) and non-racial (? = 0.05) everyday discrimination and racial (? = 0.04) and nonracial (? = 0.04) major experiences of discrimination, and workplace harassment and incivilities (? = 0.04) were also associated with more (log) sleep difficulties, and associations between racial and nonracial everyday discrimination and sleep difficulties remained after adjustment for other stressors (P < 0.05). Racial/ethnic differences in sleep duration and difficulties were not significant after adjustment for discrimination (P > 0.05).ConclusionsDiscrimination was associated with shorter sleep and more sleep difficulties, independent of socioeconomic status and other stressors, and may account for some of the racial/ethnic differences in sleep.
| S-EPMC3865350 | biostudies-literature
Project description:ObjectivesPrevious studies have reported that sleep duration might increase the risk of hypertension. However, the results have been conflicting. We investigated whether sleep duration is independently associated with hypertension. We aimed to assess the relationship between sleep duration and hypertension in a population-based cross-sectional study.MethodsIn this study we used multistage stratified cluster sampling. A total of 19 407 adults aged 18-79 years were enrolled in the study. The participants were divided into three groups (<7 hours/day, 7-8 hours/day and >8 hours/day) according to self-reported sleep duration. Hypertension was defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or the use of anti-hypertensive medications. Univariate and multivariate logistic regressions were performed to determine the association between hypertension and sleep duration adjusted for sociodemographic, body mass index, and lifestyle covariates.ResultsThe overall prevalence of hypertension was 32.6%. Among participants aged 18-44 years, individuals sleeping less than 7 hours per day had a higher risk of hypertension (OR=1.24, 95% CI: 1.05 to 1.46), compared with those who slept 7-8 hours per day. There were no significant associations between sleep duration and hypertension in the total sample, among middle-aged adults (45-59 years) or older adults (60-79 years).ConclusionsOur study demonstrates that short sleep duration was significantly associated with hypertension among people aged 18-44 years in northeast China.
| S-EPMC6347883 | biostudies-literature
Project description:ObjectiveTo examine racial differences in sleep duration and its relationship with diabetes.Research design and methodsWe used data from a nationally representative sample of U.S. adults (n = 130,943) participating in the National Health Interview Survey from 2004 to 2011. Usual sleep duration was self-reported and categorized as <7 h (short), 7 h (optimal), and >7 h (long). Diabetes status was based on self-reported diagnosis from a health professional.ResultsParticipants' mean age was 50.6 years, 49% were men, and 13% were black. Compared with whites, blacks were more likely to report short sleep (37 vs. 28%) and less likely to get 7 h of sleep (24 vs. 33%). Diabetes (9,643 cases [9%] in whites and 3,612 cases [15%] in blacks) had a U-shaped distribution with sleep in whites (10, 7, and 9%, for short, optimal, and long sleep, respectively) and blacks (16, 13, and 15%). Suboptimal sleep duration was more strongly associated with diabetes in whites than in blacks among short (prevalence ratio 1.49 [95% CI 1.40-1.58] vs. 1.21 [1.09-1.34]) and long (1.32 [1.25-1.40] vs. 1.11 [1.00-1.23]) sleepers on the relative scale. Adjustment for socioeconomic status (SES) attenuated the short sleep-diabetes association in blacks (1.15 [1.02-1.29]), and the racial/ethnic difference in the short sleep-diabetes association became nonsignificant after SES adjustments.ConclusionsSuboptimal sleep duration was positively associated with diabetes in blacks and whites, although diabetes prevalence was higher at any level of sleep in blacks. Socioeconomic factors appear to partly explain the association for short sleep in blacks as well as disparity between racial groups.
| S-EPMC3816913 | biostudies-literature