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Fluoride exposure and sleep patterns among older adolescents in the United States: a cross-sectional study of NHANES 2015-2016.

ABSTRACT: BACKGROUND:Fluoride from environmental sources accumulates preferentially in the pineal gland which produces melatonin, the hormone that regulates the sleep-wake cycle. However, the effects of fluoride on sleep regulation remain unknown. This population-based study examined whether chronic low-level fluoride exposure is associated with sleep patterns and daytime sleepiness among older adolescents in the United States (US). METHOD:This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (2015-2016). We analyzed data from adolescents who had plasma fluoride (n?=?473) and water fluoride (n?=?419) measures and were not prescribed medication for sleep disorders. Relationships between fluoride exposure and self-reported sleep patterns or daytime sleepiness were examined using survey-weighted linear, binomial logistic or multinomial logistic regression after covariate adjustment. A Holm-Bonferroni correction accounted for multiple comparisons. RESULTS:The average age of adolescents was 17?years (range?=?16-19). Median (IQR) water and plasma fluoride concentrations were 0.27 (0.52) mg/L and 0.29 (0.19) ?mol/L respectively. An IQR increase in water fluoride was associated with 1.97 times higher odds of reporting symptoms suggestive of sleep apnea (95% CI: 1.27, 3.05; p?=?0.02), a 24?min later bedtime (B?=?0.40, 95% CI: 0.10, 0.70; p?=?0.05), a 26?min later morning wake time (B?=?0.43, 95% CI: 0.13, 0.73; p?=?0.04), and among males, a 38% reduction in the odds of reporting snoring (95% CI: 0.45, 0.87, p?=?0.03). CONCLUSIONS:Fluoride exposure may contribute to changes in sleep cycle regulation and sleep behaviors among older adolescents in the US. Additional prospective studies are warranted to examine the effects of fluoride on sleep patterns and determine critical windows of vulnerability for potential effects.

SUBMITTER: Malin AJ

PROVIDER: S-EPMC6902325 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Fluoride exposure and sleep patterns among older adolescents in the United States: a cross-sectional study of NHANES 2015-2016.

Malin Ashley J AJ Bose Sonali S Busgang Stefanie A SA Gennings Chris C Thorpy Michael M Wright Robert O RO Wright Rosalind J RJ Arora Manish M

Environmental health : a global access science source 20191209 1

<h4>Background</h4>Fluoride from environmental sources accumulates preferentially in the pineal gland which produces melatonin, the hormone that regulates the sleep-wake cycle. However, the effects of fluoride on sleep regulation remain unknown. This population-based study examined whether chronic low-level fluoride exposure is associated with sleep patterns and daytime sleepiness among older adolescents in the United States (US).<h4>Method</h4>This cross-sectional study utilized data from the N ...[more]

PMID: 31818308

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Project description:BACKGROUND:Hepato- and nephrotoxicity of fluoride have been demonstrated in animals, but few studies have examined potential effects in humans. This population-based study examines the relationship between chronic low-level fluoride exposure and kidney and liver function among United States (U.S.) adolescents. This study aimed to evaluate whether greater fluoride exposure is associated with altered kidney and liver parameters among U.S. youth. METHODS:This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (2013-2016). We analyzed data from 1983 and 1742 adolescents who had plasma and water fluoride measures respectively and did not have kidney disease. Fluoride was measured in plasma and household tap water. Kidney parameters included estimated glomerular filtration rate (calculated by the original Schwartz formula), serum uric acid, and the urinary albumin to creatinine ratio. Liver parameters were assessed in serum and included alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, blood urea nitrogen, gamma-glutamyl transferase, and albumin. Survey-weighted linear regression examined relationships between fluoride exposure and kidney and liver parameters after covariate adjustment. A Holm-Bonferroni correction accounted for multiple comparisons. RESULTS:The average age of adolescents was 15.4?years. Median water and plasma fluoride concentrations were 0.48?mg/L and 0.33??mol/L respectively. A 1??mol/L increase in plasma fluoride was associated with a 10.36?mL/min/1.73?m2 lower estimated glomerular filtration rate (95% CI: -17.50, -3.22; p?=?0.05), a 0.29?mg/dL higher serum uric acid concentration (95% CI: 0.09, 0.50; p?=?0.05), and a 1.29?mg/dL lower blood urea nitrogen concentration (95%CI: -1.87, -0.70; p?<?0.001). A 1?mg/L increase in water fluoride was associated with a 0.93?mg/dL lower blood urea nitrogen concentration (95% CI: -1.44, -0.42; p?=?0.007). CONCLUSIONS:Fluoride exposure may contribute to complex changes in kidney and liver related parameters among U.S. adolescents. As the study is cross-sectional, reverse causality cannot be ruled out; therefore, altered kidney and/or liver function may impact bodily fluoride absorption and metabolic processes.

Project description:BackgroundThe A(H1N1)pdm09 virus strain used in the live attenuated influenza vaccine was changed for the 2015-2016 influenza season because of its lack of effectiveness in young children in 2013-2014. The Influenza Vaccine Effectiveness Network evaluated the effect of this change as part of its estimates of influenza vaccine effectiveness in 2015-2016.MethodsWe enrolled patients 6 months of age or older who presented with acute respiratory illness at ambulatory care clinics in geographically diverse U.S. sites. Using a test-negative design, we estimated vaccine effectiveness as (1-OR)×100, in which OR is the odds ratio for testing positive for influenza virus among vaccinated versus unvaccinated participants. Separate estimates were calculated for the inactivated vaccines and the live attenuated vaccine.ResultsAmong 6879 eligible participants, 1309 (19%) tested positive for influenza virus, predominantly for A(H1N1)pdm09 (11%) and influenza B (7%). The effectiveness of the influenza vaccine against any influenza illness was 48% (95% confidence interval [CI], 41 to 55; P<0.001). Among children 2 to 17 years of age, the inactivated influenza vaccine was 60% effective (95% CI, 47 to 70; P<0.001), and the live attenuated vaccine was not observed to be effective (vaccine effectiveness, 5%; 95% CI, -47 to 39; P=0.80). Vaccine effectiveness against A(H1N1)pdm09 among children was 63% (95% CI, 45 to 75; P<0.001) for the inactivated vaccine, as compared with -19% (95% CI, -113 to 33; P=0.55) for the live attenuated vaccine.ConclusionsInfluenza vaccines reduced the risk of influenza illness in 2015-2016. However, the live attenuated vaccine was found to be ineffective among children in a year with substantial inactivated vaccine effectiveness. Because the 2016-2017 A(H1N1)pdm09 strain used in the live attenuated vaccine was unchanged from 2015-2016, the Advisory Committee on Immunization Practices made an interim recommendation not to use the live attenuated influenza vaccine for the 2016-2017 influenza season. (Funded by the Centers for Disease Control and Prevention and the National Institutes of Health.).

Project description:BackgroundObstructive sleep apnea (OSA) is linked to hearing loss (HL). Another sleep characteristics, sleep duration might also be associated with HL, but prior evidence is limited. This study is aimed to investigate the association between sleep duration and hearing level in the adult US population.MethodsIn total, a sample of 2777 individuals aged 20-69 years from the 2015-2016 National Health and Nutrition Examination Survey cycle (NHANES, 2015-2016) were investigated in this study. Self-reported sleep duration data was classified into the short-sleep (< 7 h), normal-sleep (7-9 h), and long-sleep (> 9 h) group. Multivariable linear regression models between sleep duration and hearing threshold shifts were estimated. Interactions between sleep duration and age, gender, race, OSA were also considered, and the study population was stratified by age, gender, race, and OSA to analyze the potential disparities among adults in different subgroups.ResultsLong-sleep duration was positively associated with speech- and high-frequency pure-tone average (PTA) thresholds with statistical significance (β = 1.31, 95%CI: 0.10, 2.53, P = 0.0347, and β = 2.71, 95%CI: 0.69, 4.74, P = 0.0087, respectively). When stratified by age, short sleep duration was positively associated with low-, and speech-frequency PTAs (P = 0.0140 and 0.0225, respectively) for adults aged 40-59 years, and long-sleep duration was positively associated with low-, and speech-frequency PTAs (P = 0.0495 and 0.0142, respectively) for adults aged 60-69 years with statistical significance. There was statistically significant interaction between OSA and sleep duration on speech-frequency PTA, but no significant interaction between either gender or race with sleep duration on hearing thresholds among US adults.ConclusionShort/long sleep durations are associated with worse hearing level comparing to sleep 7-9 h in the American adults. Nonoptimal sleep duration may be a potential risk factor for HL.

Dataset Information

Fluoride exposure and sleep patterns among older adolescents in the United States: a cross-sectional study of NHANES 2015-2016.

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Fluoride exposure and sleep patterns among older adolescents in the United States: a cross-sectional study of NHANES 2015-2016.

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