Kim Sun-Young, Lee Mi Hyun, Lim Weon-Jeong, Kim Soo In, Lee Yu Jin
Department of Psychiatry, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul University College of Medicine, Seoul, Republic of Korea.
Nat Sci Sleep. 2020 Nov 3;12:883-894. doi: 10.2147/NSS.S275464. eCollection 2020.
The mean sleep duration of Koreans is 7 hours 49 minutes, which is the lowest among Organization for Economic Cooperation and Development countries. Although vitamin D deficiency and arthritis are considered modifiable factors influencing restorative sleep, mean vitamin D levels are low (17.33 ng/mL) and arthritis is prevalent among Koreans. This study investigated whether vitamin D deficiency and arthritis increase the risk of short sleep duration.
The current study used data from the Korean National Health and Nutrition Examination Survey (KNHANES) for 46,405 Korean adults. Vitamin D levels were measured using a radioimmunoassay kit. Sleep duration and arthritis history were assessed using a self-reported questionnaire. Sleep duration was categorized as optimal (7 to <9 hours/day), short (<7 hours/day), and long (≥9 hours/day). Vitamin D levels were grouped as vitamin D sufficiency (≥20 ng/mL), insufficiency (10-19.99 ng/mL), and deficiency (<10 ng/mL). Multiple imputation was used to compensate for missing data. Multinomial logistic regression was used to examine the associations of vitamin D and arthritis status with sleep duration. The regressions were adjusted for covariates, and each model was adjusted for vitamin D and arthritis.
Among these participants, 23,078 (49.73%) and 3518 (7.58%) had short and long sleep duration, respectively; 26,724 (57.59%) and 4349 (9.37%) exhibited vitamin D insufficiency and deficiency, respectively; and 4709 (10.15%) were arthritis patients. Compared with vitamin D sufficiency, vitamin D insufficiency and deficiency were associated with short sleep duration (vitamin D insufficiency group: OR = 1.07, 95% CI = 1.01-1.13; vitamin D deficiency group: OR = 1.13, 95% CI = 1.03-1.24). The presence of arthritis was associated with short sleep duration (OR = 1.14, 95% CI = 1.06-1.22) compared with its absence. The interaction between vitamin D deficiency and the presence of arthritis was significantly associated with short sleep duration. However, long sleep duration was not significantly associated with vitamin D levels or arthritis status.
Low vitamin D levels and the presence of arthritis were associated with an increased risk of short sleep duration. Additionally, there was a positive interaction effect between vitamin D deficiency and arthritis on short sleep duration.
韩国人的平均睡眠时间为7小时49分钟，在经济合作与发展组织国家中是最短的。尽管维生素D缺乏和关节炎被认为是影响恢复性睡眠的可改变因素，但韩国人的平均维生素D水平较低（17.33纳克/毫升），且关节炎患病率较高。本研究调查了维生素D缺乏和关节炎是否会增加短睡眠时间的风险。
本研究使用了韩国国家健康与营养检查调查（KNHANES）中46405名韩国成年人的数据。使用放射免疫分析试剂盒测量维生素D水平。通过自我报告问卷评估睡眠时间和关节炎病史。睡眠时间分为最佳（7至<9小时/天）、短（<7小时/天）和长（≥9小时/天）。维生素D水平分为维生素D充足（≥20纳克/毫升）、不足（10 - 19.99纳克/毫升）和缺乏（<10纳克/毫升）。采用多重填补法来弥补缺失数据。使用多项逻辑回归来检验维生素D和关节炎状态与睡眠时间的关联。回归分析对协变量进行了调整，每个模型都对维生素D和关节炎进行了调整。
在这些参与者中，分别有23078名（49.73%）和3518名（7.58%）睡眠时间短和长；分别有26724名（57.59%）和4349名（9.37%）维生素D不足和缺乏；4709名（10.15%）是关节炎患者。与维生素D充足相比，维生素D不足和缺乏与短睡眠时间相关（维生素D不足组：比值比 = 1.07，95%置信区间 = 1.01 - 1.13；维生素D缺乏组：比值比 = 1.13，95%置信区间 = 1.03 - 1.24）。与无关节炎相比，患有关节炎与短睡眠时间相关（比值比 = 1.14，95%置信区间 = 1.06 - 1.22）。维生素D缺乏与患有关节炎之间的相互作用与短睡眠时间显著相关。然而，长睡眠时间与维生素D水平或关节炎状态无显著关联。
低维生素D水平和患有关节炎与短睡眠时间风险增加相关。此外，维生素D缺乏和关节炎在短睡眠时间方面存在正向交互作用。
