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Associations of objectively measured sleep characteristics and incident hypertension among police officers: The role of obesity.

ABSTRACT: This study investigated the associations of baseline sleep onset latency, wake after sleep onset, longest wake episode, number of awakenings, sleep efficiency and sleep duration with incident hypertension during a 7-year follow-up (n = 161, 68% men) and the joint effect of insufficient sleep and obesity on incident hypertension. Sleep parameters were derived from 15-day actigraphy data. Relative risks and 95% confidence intervals were estimated using a robust Poisson regression model. Each 10-min increase in sleep onset latency was associated with an 89% higher risk of hypertension (95% confidence interval [CI] = 1.12-3.20). Each 10-min increase in longest wake episode was associated with a 23% higher risk of hypertension (95% CI = 1.01-1.50) and each 10% decrease in sleep efficiency was associated with a 50% higher risk of hypertension (95% CI = 1.02-2.22). These associations were independent of demographic and lifestyle characteristics, depressive symptoms, shift work, sleep duration and body mass index. Having <6 hr of sleep and a body mass index ≥30 kg/m² increased the risk of hypertension (relative risk = 2.81; 95% CI = 1.26-6.25) compared with having ≥6 hr of sleep and a body mass index <30 after controlling for confounders. Relative excess risk due to interaction was 3.49 (95% CI = -1.69-8.68) and ratio of relative risk was 3.21 (95% CI = 0.72-14.26). These results suggest that poor sleep quality is a risk factor for hypertension. Longitudinal studies with larger sample sizes are warranted to examine the joint effect of insufficient sleep and obesity on development of hypertension.

SUBMITTER: Ma CC

PROVIDER: S-EPMC7417279 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Risk factors for obstructive sleep apnea-related hypertension in police officers in Southern China.

Project description:Background:Obstructive sleep apnea (OSA) is an independent risk factor for hypertension. OSA-related hypertension is common and treatment of OSA can reduce blood pressure (BP). However, few studies have been conducted on this type of hypertension in the Chinese occupational population. Methods:We conducted a field investigation of a team of police officers who underwent an annual health check-up in 2017 in the city of Guangzhou, in southern China. Participants were screened with the Berlin Questionnaire and those at high risk for OSA performed a home sleep apnea test (HSAT). BP over 140/90 mmHg or taking antihypertensive drugs is considered hypertension. Results:Of the 1,036 individuals (799 males and 237 females) included in our study, the mean age was 40.7±9.1 years (range, 22-63 years), 228 (22.0%) were at high risk for OSA, and 103 (9.9%) were diagnosed with OSA. Of the 103 diagnosed with OSA, none had ever been diagnosed with and treated for OSA, and 49 (47.6%) were also diagnosed with hypertension; of these 49, 15 (30.6%) had not been diagnosed with hypertension before, and 27 (55.1%) had never been treated for hypertension. Age [odds ratio (OR) =5.81, 95% confidence interval (CI): 1.78-18.98, P<0.01] and severity of OSA (OR =5.07, 95% CI: 1.72-14.89, P<0.01) were associated with increased risk of OSA-related hypertension. After mood (depression and anxiety) status adjustment, age (adjusted OR =5.81, 95% CI: 1.80-18.80, P<0.01) and severity of OSA (adjusted OR =4.56, 95% CI: 1.49-13.93, P<0.01) were still risk factors for OSA-related hypertension. Conclusions:Among the policemen of southern China, a higher prevalence was detected not only of OSA but also of OSA-related hypertension which was associated with higher OSA severity and age.

| S-EPMC6837957 | biostudies-literature

Associations between shift work characteristics, shift work schedules, sleep and burnout in North American police officers: a cross-sectional study.

Project description:ObjectivesTo examine associations between shift work characteristics and schedules on burnout in police and whether sleep duration and sleepiness were associated with burnout.MethodsPolice officers (n=3140) completed the Maslach Burnout Inventory (emotional exhaustion, depersonalisation, personal accomplishment) and self-reported shift schedules (irregular, rotating, fixed), shift characteristics (night, duration, frequency, work hours), sleep duration and sleepiness.ResultsIrregular schedules, long shifts (?11?hours), mandatory overtime, short sleep and sleepiness were associated with increased risk of overall burnout in police. Police working a greater frequency of long shifts were more likely to have emotional exhaustion (adjusted OR 1.91, 95%?CI 1.35 to 2.72) than those not working long shifts. Night shifts were associated with depersonalisation (1.32, 1.05 to 1.66) compared with not working nights. Police working mandatory overtime had increased risk of emotional exhaustion (1.37, 1.14 to 1.65) than those who did not. Compared with fixed schedules, irregular schedules were associated with emotional exhaustion and depersonalisation (1.91, 1.44 to 2.54 and 1.39, 1.02 to 1.89, respectively). Police sleeping <6?hours were more likely to have emotional exhaustion (1.60, 1.33 to 1.93) than those sleeping longer, and excessive sleepiness was associated with emotional exhaustion (1.81, 1.50 to 2.18).ConclusionsIrregular schedules and increased night shifts, sleep disturbances and work hours were related to higher burnout risk in police. Future research should evaluate work schedules in law enforcement that optimise shift duration and frequency, and increase consistency in scheduling and control over work hours to limit burnout in police.

| S-EPMC6924705 | biostudies-literature

Objectively Measured Sleep Characteristics and Incidence of Ischemic Stroke: The Sleep Heart Health Study.

Project description:ObjectiveSleep disorders are associated with the prevalence of stroke. However, there is limited evidence regarding the association between objectively measured sleep characteristics and ischemic stroke.MethodsIschemic stroke was assessed during the mean follow-up period of 11 years in the Sleep Heart Health Study. Sleep parameters such as wake after sleep onset (WASO) and sleep efficiency (SE) were objectively measured based on in-home polysomnography records. Multivariable Cox regression analysis was utilized to examine the relationship between objective sleep characteristics and ischemic stroke incidence.ResultsThis study involved 4204 participants (1978 males and 2226 females, 63.8±11.1 years). The incidence of ischemic stroke increased in individuals with long WASO, poor SE, and short sleep duration. Multivariable Cox regression analysis showed that WASO within the fourth quartile (hazard ratio [HR] 3.771, 95% confidence interval [CI] 1.805-7.877, P<0.001), third quartile (HR 3.009, 95% CI 1.433-6.317, P=0.004), and second quartile (HR 3.108, 95% CI 1.470-6.568, P=0.003) had a higher incidence of ischemic stroke than WASO within the first quartile. Poor SE (<80.0%) was also found to be a predictor for ischemic stroke (HR 2.220, 95% CI 1.244-3.960, P=0.007). Additionally, a short sleep duration (<6 h) was associated with an increased risk of ischemic stroke (HR 1.725, 95% CI 1.026-2.899, P=0.040).ConclusionOur results revealed a relationship between WASO, SE, and sleep duration and ischemic stroke. Therefore, these sleep characteristics may be adequate predictors for the incidence of ischemic stroke.

| S-EPMC8403018 | biostudies-literature

Associations of burnout with awakening and diurnal cortisol among police officers.

Project description:The aim of this cross-sectional study was to assess the associations of burnout with cortisol parameters in 197 police officers from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) study (2010-2014). The Maslach Burnout Inventory-General Survey assessed depersonalization, exhaustion, and professional efficacy. Officers provided salivary cortisol samples collected upon awakening, and 15, 30, and 45 min thereafter as well as three additional samples at lunchtime, dinnertime, and bedtime. Total area under the curve with respect to increase (AUCWI for waking and AUCDI for diurnal), total area under the curve with respect to ground (AUCWG for waking and AUCDG for diurnal), and diurnal slope were determined and used in this study. Unadjusted and adjusted (age, sex, and race/ethnicity) associations were examined using linear regression. The mean age of the officers was 48 years and 72% were males. The depersonalization component of burnout was negatively associated with AUCDG (β = -108.4; p = 0.036). Similarly, as exhaustion increased, AUCWI (β = -9.58, p = 0.038), AUCDG (β = -114.7, p = 0.029) and the diurnal slope (β = -0.000038; p = 0.017) decreased. The Professional efficacy was not associated with any of the cortisol parameters. These results suggest that certain characteristics of burnout may be associated with diminished cortisol secretion in this group of urban police officers. Our findings add to previous studies examining associations of burnout with the cortisol awakening response. Future longitudinal studies are needed to evaluate the temporal relationship between burnout and these cortisol parameters.

| S-EPMC8455162 | biostudies-literature

Objectively measured sleep characteristics and prevalence of coronary artery calcification: the Multi-Ethnic Study of Atherosclerosis Sleep study.

Project description:BackgroundWe tested whether objectively measured indices of obstructive sleep apnoea (OSA) and sleep quality are associated with coronary artery calcification (CAC) prevalence independent of obesity, a classic confounder.Methods1465 Multi-Ethnic Study of Atherosclerosis participants (mean age 68 years), who were free of clinical cardiovascular disease, had both coronary CT and in-home polysomnography and actigraphy performed. OSA categories were defined by the Apnea-Hypopnea Index (AHI). Prevalence ratios (PRs) for CAC >0 and >400 (high burden) were calculated.ResultsParticipants with severe OSA (AHI ≥30; 14.6%) were more likely to have prevalent CAC, relative to those with no evidence of OSA, after adjustment for demographics and smoking status (PR 1.16; 95% CI 1.06 to 1.26), body mass index (1.11; 1.02 to 1.21) and traditional cardiovascular risk factors (1.10; 1.01 to 1.19). Other markers of hypoxaemia tended to be associated with a higher prevalence of CAC >0. For CAC >400, a higher prevalence was observed with both a higher arousal index and less slow-wave sleep. Overall, associations were somewhat stronger among younger participants, but did not vary by sex or race/ethnicity.ConclusionsIn this population-based multi-ethnic sample, severe OSA was associated with subclinical coronary artery disease (CAC >0), independent of obesity and traditional cardiovascular risk factors. Furthermore, the associations of the arousal index and slow-wave sleep with high CAC burden suggest that higher nightly sympathetic nervous system activation is also a risk factor. These findings highlight the potential importance of measuring disturbances in OSA as well as sleep fragmentation as possible risk factors for coronary artery disease.

| S-EPMC4858321 | biostudies-literature

Sleep Quality and Dietary Patterns in an Occupational Cohort of Police Officers.

Project description:We examined the association between self-reported sleep quality, sleep duration, and dietary patterns among police officers in the Buffalo Cardio-Metabolic Occupational Stress (BCOPS) study.422 police officers aged 21-74 (2004-2009).We used a cross-sectional study design and obtained sleep quality and duration from responses to the 19-item Pittsburgh Sleep Quality Index. Using 46 energy-adjusted food groups derived from a 125-item food frequency questionnaire, we identified dietary patterns using exploratory factor analysis. Multiple linear regression analysis was used to examine the associations of sleep quality and duration with the derived dietary patterns.We identified major dietary patterns: fruits and vegetables (FV), dairy products, starches and fried foods, and meat and eggs. Individuals with poor sleep quality had a lower average FV score than those with optimal sleep (β [SE] = -0.32 [0.13]; p = .01). Significant interactions were observed between sex and the FV and dairy products dietary patterns, where women with poor sleep quality had a lower mean FV score compared to women with optimal sleep quality (β [SE] = -0.81 [0.29]; p = .01). Women with < 6 hours sleep duration had a lower mean dairy score compared to women with ≥ 7 hours sleep duration (β [SE] = -0.69 [0.29]; p = .02). We did not observe these associations among men.Among women, good sleep quality and long sleep duration were associated with a dietary pattern high in consumption of both fruits and vegetables and dairy products.Abbreviations: BCOPS: Buffalo Cardio-Metabolic Occupational Stress study; BMI: body mass index; FFQ: food frequency questionnaire; FV: fruits and vegetables; KMO: Kaiser-Meyer-Olkin test; MET: metabolic equivalent of task score; PSQI: Pittsburgh Sleep Quality Index questionnaire.

| S-EPMC8786972 | biostudies-literature

Objectively measured sleep duration and hyperglycemia in pregnancy.

Project description:Our primary purpose was to assess the impact of objectively measured nighttime sleep duration on gestational glucose tolerance. We additionally examined associations of objectively measured daytime sleep duration and nap frequency on maternal glycemic control.Sixty-three urban, low-income, pregnant women wore wrist actigraphs for an average of 6 full days in mid-pregnancy prior to screening for hyperglycemia using the 1-h oral glucose tolerance test (OGTT). Correlations of nighttime and daytime sleep durations with 1-h OGTT values were analyzed. Multivariable logistic regression was used to evaluate independent associations between sleep parameters and hyperglycemia, defined as 1-h OGTT values ?130 mg/dL.Mean nighttime sleep duration was 6.9±0.9 h which was inversely correlated with 1-h OGTT values (r=-0.28, P=.03). Shorter nighttime sleep was associated with hyperglycemia, even after controlling for age and body mass index (adjusted odds ratio [OR], 0.2 [95% confidence interval {CI}, 0.1-0.8]). There were no associations of daytime sleep duration and nap frequency with 1-h OGTT values or hyperglycemia.Using objective measures of maternal sleep time, we found that women with shorter nighttime sleep durations had an increased risk for gestational hyperglycemia. Larger prospective studies are needed to confirm our negative daytime sleep findings.

| S-EPMC3947268 | biostudies-other

Associations between parent-reported and objectively measured sleep duration and timing in infants at age 6 months.

Project description:To compare the estimates of sleep duration and timing from survey, diary, and actigraphy in infants at age 6 months, overall and by select demographics and other factors. In total, 314 infants participating in the Rise & SHINE (Sleep Health in Infancy & Early Childhood study) cohort in Boston, MA, USA, wore an actigraph on their left ankle for 7 days. Parents concurrently completed a sleep diary and the expanded version of the Brief Infant Sleep Questionnaire. Concordance between parent-reported and objective sleep estimates was assessed using Bland-Altman plots, Spearman's rank correlations, intraclass correlations, and linear regression models. Mean infant age was 6.4 (0.6 SD) months; 51% were female and 42% were Non-Hispanic white. Mean total sleep duration using actigraphy was 526 (67 SD) minutes per night, 143 (42 SD) minutes per day, and 460 (100 SD) minutes during the longest nighttime sleep period. Relative to actigraphy, parent-completed survey and diary overestimated total day (by 29 and 31 minutes, respectively) and night sleep duration (67 and 43 minutes, respectively) and underestimated the longest sleep (58 minutes), with the highest agreement for sleep onset and offset timing (differences < 30 minutes). There was a tendency toward greater bias among short- and long-sleeping infants. Self-reporting bias for diary-measured longest nighttime sleep and total night sleep duration was higher in infants of parents reporting a problem with their baby's night awakenings and in low-income families, respectively. Our findings underscore the need to be cautious when comparing findings across studies using different sleep assessment methods.

| S-EPMC8033447 | biostudies-literature

PTSD or resilient - Genetic and Epigenetic association studies in police officers

Project description:Epigenetic and genetic profiles (N=67) were based on the Illumina Infinium HumanMethylation450 BeadChip. We searched for differentially methylated probes (DMPs) and regions (DMRs). For genetic associations we analyzed the CpG-SNPs present on the array

2018-01-24 | GSE99755 | GEO

Associations of Objectively Measured Physical Activity and Sleep with Weight Loss Maintenance: A Preliminary Study of Japanese Adults.

Project description:Maintaining weight loss is considerably more challenging than losing weight. Most previous studies on weight loss maintenance have been conducted in Western countries and have assessed physical activity and sleep with the use of questionnaires. This preliminary study investigated the associations of objectively measured physical activity and sleep with weight loss maintenance among 25 Japanese adults who had intentionally lost ? 10% of their original weight. Participants wore tri-axial accelerometers on their waists and sleep monitors on their wrists for two weeks to measure their physical activity and sleep, respectively. A linear regression adjusted for sex, age, maximum weight, and time since losing weight was performed to investigate these associations. Participants had a mean body mass index of 23.4 kg/m2 and a median weight loss of 12.5%. Compared to those who maintained < 12.5% weight loss, those who maintained ? 12.5% weight loss slept longer (adjusted mean difference: 66.1 min/night, 95% confidence interval (CI): -14.0, 146.3 min/night, p = 0.10) and performed less moderate-to-vigorous physical activity (adjusted mean difference: -21.7 min/day, 95% CI: -58.0, 14.5 min/day, p = 0.22). Though statistical power was limited, sleep behavior may be an important modifiable factor that facilitates weight loss maintenance. Our findings can be used to establish a well-designed study to confirm this association.

| S-EPMC7016799 | biostudies-literature

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