检索问题
睡眠障碍的流行病学 病因诱因 近10年
历年来，睡眠障碍已成为一个日益关注的公共卫生问题。根据研究，约10%的成人群体受睡眠障碍影响，20%的人则经历偶发性睡眠症状。睡眠障碍的种类繁多，其中失眠是最常见的一种，通常分为急性、间歇性和慢性形式。近年来，流行病学研究的增加帮助学术界更深入地理解了睡眠障碍的流行病学特征、病因和诱因。
一、流行病学
睡眠障碍的流行病学特征表明，某些人群更容易受到影响。研究显示，女性、老年人及经济状况较差的人群更为脆弱。根据最新的统计数据，慢性失眠具有40%的长期持续率，意味着许多患者不仅面临短期的问题，还需长期管理其健康状况。
1.1 睡眠障碍的类型与流行率
睡眠障碍包括失眠、睡眠呼吸暂停、夜间肢体不宁等。不同类型的失眠可以在流行病学研究中得以识别，并显示出个体差异。例如，青少年群体面临的睡眠缺失和睡眠卫生不良的情况显著高于其他年龄段。在大学生中，26%的受访者报告有失眠症状，反映出缺乏有效睡眠管理的趋势。
1.2 地域与社会经济因素
流行病学数据显示，社会经济状态对睡眠质量有显著影响。有研究指出，经济困难的人群更容易受到失眠等睡眠障碍的侵扰，这又可能与心理健康问题相互影响。此外，城市与农村之间的睡眠障碍流行率差异也值得关注，例如，在城市中，由于工作压力和生活节奏的加快，睡眠问题更为普遍。
二、病因与诱因
睡眠障碍的成因是多方面的，其中包括生理、心理和环境因素。
2.1 生理因素
许多研究探讨了生理条件与睡眠障碍之间的关系。长期的慢性疾病、内分泌失调等都会影响睡眠质量。例如，心血管疾病、高血压和糖尿病等都与睡眠质量有直接关联。此外，肾脏疾病患者中，失眠的发生率也显著提高，这可能与药物、情绪问题及身体不适共同作用有关。
2.2 心理因素
心理健康问题，如焦虑和抑郁，往往与睡眠障碍并存。例如，有研究显示，失眠与抑郁的风险显著相关，增加了患抑郁症的几率。自我报告的失眠症状与抑郁症状之间存在强关联性，这表明心理因素对睡眠障碍的影响不可忽视。
2.3 环境因素
环境因素，尤其是生活方式与社会环境，对睡眠质量有非常重要的影响。现代社会的高压力环境和不规律的作息习惯使人们的睡眠更加脆弱。此外，噪音、光污染以及不适宜的温度都可以破坏正常睡眠。
三、近10年的研究进展
过去十年里，关于睡眠障碍的研究进展显著。在流行病学领域，研究者们不断探索不同人群中睡眠障碍的流行率及其与健康风险之间的关系。例如，某些研究强调了睡眠障碍与心血管病、代谢综合症和认知功能障碍之间的相关性。
3.1 疫情与睡眠
COVID-19疫情的爆发对全球的睡眠模式产生了深远影响。疫情导致的隔离和不安情绪使得许多人报告了新的或加重的睡眠障碍。例如，在疫情期间，许多人员的失眠症状明显加重，这增加了公共卫生干预的必要性。
3.2 预防与干预措施
在干预措施方面，认知行为疗法已被业内广泛认可为治疗失眠的首选方法，其有效性与安全性得到了一系列研究支持。此外，促进良好的睡眠卫生教育也是越来越多研究提倡的方法，例如，建立规律的作息时间、减少咖啡因摄入和增加身体活动等都是改善睡眠质量的有效策略。
3.3 饮食与睡眠的关系
饮食模式也被认为是改进睡眠质量的重要因素之一，尤其是地中海饮食与睡眠质量之间的关系日益受到重视。有研究表明，遵循地中海饮食的人群，其睡眠障碍比例相对较低，这吸引了对饮食干预的进一步研究。
四、总结
综上所述，睡眠障碍已成为一个复杂的公共健康问题，涉及生理、心理和环境多方面的因素。流行病学数据表明，女性、老年人、低收入群体等更易受到此问题的影响，而病因诱因则涵盖多种疾病、心理状态及生活方式。
展开对睡眠障碍的进一步研究，尤其是针对特定人群的干预策略，将有助于改善整体公众健康，且相关的研究成果将为未来的公共卫生政策提供重要参考。
References
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Charles M Morin, Denise C Jarrin
Sleep Med Clin. 2022 Jun;17(2):173-191. doi: 10.1016/j.jsmc.2022.03.003. Epub 2022 Apr 23.
This article summarizes epidemiologic evidence on insomnia, including the prevalence, incidence, and risk factors, as well as its course and consequences. Approximately 10% of the adult population suffers from an insomnia disorder and another 20% experiences occasional insomnia symptoms. Women, older adults, and people with socioeconomic hardship are more vulnerable to insomnia. Insomnia is often a chronic condition, with a 40% persistence rate over a 5-year period. Insomnia is a significant public health problem that should be addressed at the individual level with appropriate clinical care and at the population level with large-scale sleep health interventions.
2Insomnia.PubMed
Eliza L Sutton
Ann Intern Med. 2021 Mar;174(3):ITC33-ITC48. doi: 10.7326/AITC202103160. Epub 2021 Mar 9.
Insomnia-the unwelcome experience of difficulty sleeping-is common and can be acute, intermittent, or chronic. Insomnia can be the presenting symptom for several common sleep disorders, but it also often occurs comorbidly with mental and physical health conditions. Evaluating the symptom of insomnia requires assessing-largely by history-whether an underlying condition explains it. is the diagnostic term for the symptom of insomnia that merits specific attention. Cognitive behavioral therapy for insomnia is the preferred treatment approach because of its efficacy, safety, and durability of benefit, but pharmaceutical treatments are widely used for insomnia symptoms.
3Sleep Disorders in Adolescents.PubMed
Sujay Kansagra
Pediatrics. 2020 May;145(Suppl 2):S204-S209. doi: 10.1542/peds.2019-2056I.
Chronic sleep deprivation is a common, treatable condition among adolescents. Growing literature supports a myriad consequences that impact overall health, behavior, mood, and academic performance in this vulnerable age group during a time when there are rapid changes in physical development and emotional regulation. This article reviews the epidemiology and health effects of sleep deprivation in adolescents as well as common disorders leading to sleep loss and evidence to support treatment. Although a variety of important sleep disorders may disrupt quality of sleep in adolescents, such as obstructive sleep apnea, restless leg syndrome, and narcolepsy, this article will focus on common disorders that affect the quantity of sleep, such as poor sleep hygiene, circadian rhythm disorders, and insomnia.
4Sleep disorders and cancer: State of the art and future perspectives.PubMed
Maria Paola Mogavero, Lourdes M DelRosso, Francesco Fanfulla, et al.
Sleep Med Rev. 2021 Apr;56:101409. doi: 10.1016/j.smrv.2020.101409. Epub 2020 Nov 28.
A bidirectional connection between sleep and cancer exists; however, the specific associations between individual sleep disorders and particular tumors are not very clear. An accurate assessment of sleep disorders in cancer patients is necessary to improve patient health, survival, response to therapy, quality of life, reduction of comorbidities/complications. Indeed, recent scientific evidence shows that knowledge and management of sleep disorders offer interesting therapeutic perspectives for the treatment of cancer. In light of this need, the objective of this review is to assess the evidence highlighted in the research of the last ten years on the correlation between each specific category of sleep disorder according to the International Classification of Sleep Disorders 3rd Ed. and several types of tumor based on their anatomical location (head-neck, including the brain and thyroid; lung; breast; ovary; endometrium; testes; prostate; bladder; kidney; gastrointestinal tract, subdivided into: stomach, liver, colon, pancreas; skin; bone tumors; hematological malignancies: leukemia, lymphoma, multiple myeloma, polycythemia), in order to evaluate what is currently known about: 1) sleep disorders as cancer risk factor; 2) tumors associated with the onset of sleep disorders; 3) targeted therapies of sleep disorders in cancer patients and new oncological perspectives following the evaluation of sleep.
5Sleep and Cardiovascular Risk.PubMed
Lyudmila Korostovtseva, Mikhail Bochkarev, Yurii Sviryaev
Sleep Med Clin. 2021 Sep;16(3):485-497. doi: 10.1016/j.jsmc.2021.05.001. Epub 2021 Jun 25.
Sleep is essential for healthy being and healthy functioning of human body as a whole, as well as each organ and system. Sleep disorders, such as sleep-disordered breathing, insomnia, sleep fragmentation, and sleep deprivation are associated with the deterioration in human body functioning and increased cardiovascular risks. However, owing to the complex regulation and heterogeneous state sleep per se can be associated with cardiovascular dysfunction in susceptible subjects. The understanding of sleep as a multidimensional concept is important for better prevention and treatment of cardiovascular diseases.
6An overview of cardiovascular-kidney-metabolic syndrome.PubMed
Keith C Ferdinand
Am J Manag Care. 2024 Dec;30(10 Suppl):S181-S188. doi: 10.37765/ajmc.2024.89670.
Cardio-kidney-metabolic (CKM) syndrome is a term to describe the interconnection between cardiovascular disease, type 2 diabetes, and chronic kidney disease. The National Health and Nutrition Examination Survey from 1999 to 2020 estimated that 25% of participants had at least 1 CKM condition. It is proposed that CKM syndrome originates in excess and/or dysfunctional adipose tissue, which secretes proinflammatory and prooxidative products leading to damaged tissues in arteries, the heart, and the kidney, and reduction in insulin sensitivity. CKM syndrome is classified into 4 stages based on the presence of risk factors and clinical signs. Risk factors associated with progression of CKM syndrome include chronic inflammatory conditions, family history of diabetes or kidney disease, mental health and sleep disorders, increased levels of elevated high-sensitivity C-reactive protein, and sex-specific risk enhancers. There are substantial racial and ethnic differences, although they are likely due to social determinants of health (SDOH). The American Heart Association suggests that CKM syndrome screening should include both biological factors and SDOH. Interventions in patients with stages 0 to 3 CKM syndrome focus on preventing future cardiovascular events by management of excess adiposity, mainly through diet and exercise in the early stages, then through pharmacological treatment of metabolic syndrome components in later stages. There is a general acceptance that treatment of CKM syndrome should involve a holistic approach to prevention, screening, and management to improve outcomes and reduce long-term morbidity and mortality.
7Sleep disorders in chronic kidney disease.PubMed
Owen D Lyons
Nat Rev Nephrol. 2024 Oct;20(10):690-700. doi: 10.1038/s41581-024-00848-8. Epub 2024 May 24.
Sleep disorders are highly prevalent in chronic kidney disease (CKD) but are often under-recognized. Restless legs syndrome, which is common in CKD owing to issues with dopamine metabolism and is exacerbated by iron deficiency and uraemia, can lead to poor sleep quality and increased daytime fatigue. Insomnia is also prevalent in CKD, particularly in patients requiring dialysis, with increased sleep latency and sleep fragmentation being reported. The cause of insomnia in CKD is multifactorial - poor sleep habits and frequent napping during dialysis, uraemia, medications and mood disorders have all been suggested as potential contributing factors. Sleep apnoea and CKD are also now recognized as having a bi-directional relationship. Sleep apnoea is a risk factor for accelerated progression of CKD, and fluid overload, which is associated with kidney failure, can lead to both obstructive and central sleep apnoea. The presence of obstructive sleep apnoea in CKD can exacerbate the already heightened cardiovascular morbidity and mortality in these patients, as well as leading to daytime fatigue and reduced quality of life. Increased awareness, timely diagnosis and appropriate therapeutic interventions are essential to reduce the negative impact of sleep disorders in patients with kidney disease.
8Sleep disturbances increase the risk of dementia: A systematic review and meta-analysis.PubMed
Le Shi, Si-Jing Chen, Meng-Ying Ma, et al.
Sleep Med Rev. 2018 Aug;40:4-16. doi: 10.1016/j.smrv.2017.06.010. Epub 2017 Jul 6.
Sleep disturbances and dementia are two common and significant health problems in older adults. Investigations suggest that sleep disturbances might increase the risk of dementia. The aim of the present study was to systematically review and meta-analyze the predictive roles of overall sleep disturbances, their subtypes (e.g., insomnia, sleep disordered breathing [SDB]), and other sleep problems (e.g., excessive daytime sleepiness, sleep-related movement disorder, circadian rhythm sleep disorder, and nonspecific sleep problems) in incident all-cause dementia and Alzheimer's disease (AD) and vascular dementia subtypes. We performed a systematic search of the PubMed, EMBase, ISI Web of Science, and PsycINFO databases for longitudinal studies that were published up to October 28, 2016. A total of 12,926 papers were retrieved. Eighteen longitudinal studies that included 246,786 subjects at baseline and 25,847 dementia cases after an average 9.49 y of follow-up were eligible for inclusion. Compared with individuals without sleep disturbances, subjects who reported sleep disturbances had a higher risk of incident all-cause dementia, AD, and vascular dementia. The subgroup analysis showed that insomnia increased the risk of AD but not vascular or all-cause dementia. In contrast, SDB was associated with a higher incidence of all-cause dementia, AD, and vascular dementia. This meta-analysis suggests that sleep disturbances may predict the risk of incident dementia. Moreover, insomnia was associated only with incident AD, and SDB was a risk factor of all-cause dementia, AD, and vascular dementia. However, sleep disturbances were evaluated mainly based on self-reports, and some confounders may mediate the relationship between sleep disturbances and dementia. Therefore, the results should be further validated. In summary, these findings may help identify individuals who are at risk for dementia and optimize early prevention strategies.
9Sleep, sleep deprivation, autonomic nervous system and cardiovascular diseases.PubMed
Eleonora Tobaldini, Giorgio Costantino, Monica Solbiati, et al.
Neurosci Biobehav Rev. 2017 Mar;74(Pt B):321-329. doi: 10.1016/j.neubiorev.2016.07.004. Epub 2016 Jul 7.
Sleep deprivation (SD) has become a relevant health problem in modern societies. We can be sleep deprived due to lifestyle habits or due to sleep disorders, such as insomnia, obstructive sleep apnea (OSA) and neurological disorders. One of the common element of sleep disorders is the condition of chronic SD, which has complex biological consequences. SD is capable of inducing different biological effects, such as neural autonomic control changes, increased oxidative stress, altered inflammatory and coagulatory responses and accelerated atherosclerosis. All these mechanisms links SD and cardiovascular and metabolic disorders. Epidemiological studies have shown that short sleep duration is associated with increased incidence of cardiovascular diseases, such as coronary artery disease, hypertension, arrhythmias, diabetes and obesity, after adjustment for socioeconomic and demographic risk factors and comorbidities. Thus, an early assessment of a condition of SD and its treatment is clinically relevant to prevent the harmful consequences of a very common condition in adult population.
10Association between triglyceride glucose index and sleep disorders: results from the NHANES 2005-2008.PubMed
Heng Pei, Shuyu Li, Xin Su, et al.
BMC Psychiatry. 2023 Mar 10;23(1):156. doi: 10.1186/s12888-022-04434-9.
BACKGROUND: To determine the association between sleep disorders and Triglyceride glucose index. METHODS: A cross-sectional analysis of the 2005 to 2008 National Health and Nutrition Examination Survey (NHANES) was performed. The 2005 to 2008 NHANES national household survey for adults ≥ 20 years was examined for the sleep disorders.TyG index: ln [triglyceride (mg/ dL) × fasting blood glucose (mg/dL)/2].Multivariable logistic and linear regression models were used to explore the association between the TyG index and sleep disorders. RESULTS: A total of 4,029 patients were included. Higher TyG index is significantly associated with elevated sleep disorders in U.S. adults. TyG was moderately correlated with HOMA-IR (Spearman r = 0.51). TyG was associated with higher odds of sleep disorders(adjusted OR [aOR],1.896; 95% CI, 1.260 2.854), Sleep apnea (aOR, 1.559; 95% CI, 0.660 3.683), Insomnia(aOR, 1.914;95% CI, 0.531 6.896), and Restless legs (aOR, 7.759; 95% CI,1.446 41.634). CONCLUSIONS: In this study, our result shown that population with higher TyG index are significantly more likely to have sleep disorders in U.S. adults.
11Understanding and approaching excessive daytime sleepiness.PubMed
Laura Pérez-Carbonell, Emmanuel Mignot, Guy Leschziner, et al.
Lancet. 2022 Sep 24;400(10357):1033-1046. doi: 10.1016/S0140-6736(22)01018-2. Epub 2022 Sep 14.
Excessive daytime sleepiness (EDS) is a public health issue. However, it remains largely undervalued, scarcely diagnosed, and poorly supported. Variations in the definition of EDS and limitations in clinical assessment lead to difficulties in its epidemiological study, but the relevance of this symptom from a socioeconomic perspective is inarguable. EDS might be a consequence of several behavioural issues leading to insufficient or disrupted sleep, as well as a consequence of sleep disorders including sleep apnoea syndrome, circadian disorders, central hypersomnolence disorders (narcolepsy and idiopathic hypersomnia), other medical or psychiatric conditions, or medications. Furthermore, EDS can have implications for health as it is thought to act as a risk factor for other conditions, such as cardiovascular and neurodegenerative disorders. Because of the heterogeneous causes of EDS and the complexity of its pathophysiology, management will largely depend on the cause, with the final aim of making treatment specific to the individual using precision medicine and personalised medicine.
12Sleep, Cognitive impairment, and Alzheimer's disease: A Systematic Review and Meta-Analysis.PubMed
Omonigho M Bubu, Michael Brannick, James Mortimer, et al.
Sleep. 2017 Jan 1;40(1). doi: 10.1093/sleep/zsw032.
STUDY OBJECTIVES: Mounting evidence implicates disturbed sleep or lack of sleep as one of the risk factors for Alzheimer's disease (AD), but the extent of the risk is uncertain. We conducted a broad systematic review and meta-analysis to quantify the effect of sleep problems/disorders on cognitive impairment and AD. METHODS: Original published literature assessing any association of sleep problems or disorders with cognitive impairment or AD was identified by searching PubMed, Embase, Web of Science, and the Cochrane library. Effect estimates of individual studies were pooled and relative risks (RR) and 95% confidence intervals (CI) were calculated using random effects models. We also estimated the population attributable risk. RESULTS: Twenty-seven observational studies (n = 69216 participants) that provided 52 RR estimates were included in the meta-analysis. Individuals with sleep problems had a 1.55 (95% CI: 1.25-1.93), 1.65 (95% CI: 1.45-1.86), and 3.78 (95% CI: 2.27-6.30) times higher risk of AD, cognitive impairment, and preclinical AD than individuals without sleep problems, respectively. The overall meta-analysis revealed that individuals with sleep problems had a 1.68 (95% CI: 1.51-1.87) times higher risk for the combined outcome of cognitive impairment and/or AD. Approximately 15% of AD in the population may be attributed to sleep problems. CONCLUSION: This meta-analysis confirmed the association between sleep and cognitive impairment or AD and, for the first time, consolidated the evidence to provide an "average" magnitude of effect. As sleep problems are of a growing concern in the population, these findings are of interest for potential prevention of AD.
13Lifestyle effects on aging and CVD: A spotlight on the nutrient-sensing network.PubMed
Kaiying Yang, Rongyao Hou, Jie Zhao, et al.
Ageing Res Rev. 2023 Dec;92:102121. doi: 10.1016/j.arr.2023.102121. Epub 2023 Nov 8.
Aging is widespread worldwide and a significant risk factor for cardiovascular disease (CVD). Mechanisms underlying aging have attracted considerable attention in recent years. Remarkably, aging and CVD overlap in numerous ways, with deregulated nutrient sensing as a common mechanism and lifestyle as a communal modifier. Interestingly, lifestyle triggers or suppresses multiple nutrient-related signaling pathways. In this review, we first present the composition of the nutrient-sensing network (NSN) and its metabolic impact on aging and CVD. Secondly, we review how risk factors closely associated with CVD, including adverse life states such as sedentary behavior, sleep disorders, high-fat diet, and psychosocial stress, contribute to aging and CVD, with a focus on the bridging role of the NSN. Finally, we focus on the positive effects of beneficial dietary interventions, specifically dietary restriction and the Mediterranean diet, on the regulation of nutrient metabolism and the delayed effects of aging and CVD that depend on the balance of the NSN. In summary, we expound on the interaction between lifestyle, NSN, aging, and CVD.
14Risk Factors for Obstructive Sleep Apnea Syndrome in Children: State of the Art.PubMed
Giampiero Gulotta, Giannicola Iannella, Claudio Vicini, et al.
Int J Environ Res Public Health. 2019 Sep 4;16(18):3235. doi: 10.3390/ijerph16183235.
The obstructive sleep apnea syndrome (OSAS) represents only part of a large group of pathologies of variable entity called respiratory sleep disorders (RSD) which include simple snoring and increased upper airway resistance syndrome (UARS). Although the etiopathogenesis of adult OSAS is well known, many aspects of this syndrome in children are still debated. Its prevalence is about 2% in children from 2 to 8 years of age, mostly related to the size of the upper airways adenoid tissue. Several risk factors linked to the development of OSAS are typical of the pediatric age. The object of this paper is to analyze the state of the art on this specific topic, discussing its implications in terms of diagnosis and management.
15Poor sleep quality and its related risk factors among university students.PubMed
Xiaohong Liu, Lin Lang, Rui Wang, et al.
Ann Palliat Med. 2021 Apr;10(4):4479-4485. doi: 10.21037/apm-21-472.
BACKGROUND: Poor sleep quality is a major health problem worldwide. In universities, poor sleep quality can effect student's ability to study and have a serious impact on their psychological and physical well-being. The aim of this study was to explore the quality of sleep among university students and identify risk factors associated with poor sleep quality. METHODS: A cross-sectional study was conducted and the Pittsburgh sleep quality index scale was used to measure sleep quality. The overall score of the PSQI ranges from 0 to 21, with a score of 4 or less indicating good sleep quality, a score of 5-10 indicating fairly good sleep quality, 11-15 indicating fairly bad sleep quality, and a score of 16-21 indicating poor sleep quality. RESULTS: A total of 1,317 subjects were enrolled in the study. Most subjects were female (64.6%) and rural based (69.2%). Low intensity sports activity more than once per week was reported by 81.9% of subjects and 59.8% reported they participated in high-intensity sports more than once a week. In addition, 72.8% of subjects took a nap more than three times per week. CONCLUSIONS: We found that physical activity and taking a nap may be important factors in improving sleep quality and preventing sleep disorders among university students.
16Sleep disturbances and sleep disorders as risk factors for chronic postsurgical pain: A systematic review and meta-analysis.PubMed
Giorgia Varallo, Emanuele M Giusti, Chiara Manna, et al.
Sleep Med Rev. 2022 Jun;63:101630. doi: 10.1016/j.smrv.2022.101630. Epub 2022 Apr 7.
This systematic review and meta-analysis aimed at evaluating the role of sleep disturbances and sleep disorders in influencing presence and intensity of chronic postsurgical pain (CPSP). We included cohort studies which enrolled adults, assessed sleep disturbances or disorders before surgery, measured pain intensity, presence of pain, or opioid use at least three months after surgery. Eighteen studies were included in a narrative synthesis and 12 in a meta-analysis. Sleep disturbances and disorders were significantly related to CPSP, with a small effect size, r = 0.13 (95% CI 0.06-0.20). The certainty of evidence was rated low due to risk of bias and heterogeneity. In subgroup analyses the above association was significant in studies that used pain intensity as the outcome, but not in those that used presence of pain; in studies on patients who underwent total knee arthroplasty or other surgeries, but not in those on patients who had breast cancer surgery or total hip arthroplasty; in the single study that assessed insomnia and in studies that assessed sleep disturbances as predictors. A meta-regression showed that the follow-up length was positively associated with the overall estimate. Our findings suggest that presurgical sleep disturbances and disorders should be evaluated to detect patients at risk for CPSP. Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=272654.
17Relationship between Sleep and Hypertension: Findings from the NHANES (2007-2014).PubMed
Chunnan Li, Shaomei Shang
Int J Environ Res Public Health. 2021 Jul 25;18(15):7867. doi: 10.3390/ijerph18157867.
BACKGROUND: To evaluate the association of sleep factors (sleep duration, self-reported trouble sleeping, diagnosed sleep disorder) and combined sleep behaviors with the risk of hypertension. METHODS: We analyzed 12,166 adults aged 30-79 years who participated in the 2007-2014 National Health and Nutrition Examination Survey. Sleep duration, self-reported trouble sleeping and sleep disorders were collected using a standardized questionnaire. We included three sleep factors (sleep duration, self-reported trouble sleeping and sleep disorder) to generate an overall sleep score, ranging from 0 to 3. We then defined the sleep pattern as "healthy sleep pattern" (overall sleep score = 3), "intermediate sleep pattern" (overall sleep score = 2), and "poor sleep pattern" (0 ≤ overall sleep score ≤ 1) based on the overall sleep score. The definition of hypertension was based on self-reported antihypertensive medication use or biological measurement (systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg). We used weighted logistic regression models to investigate the associations between sleep and hypertension. RESULTS: The overall prevalence of hypertension was 37.8%. A short sleep duration (OR = 1.20, 95% CI: 1.08 to 1.33, = 0.001), self-reported trouble sleeping (OR = 1.45, 95% CI: 1.28 to 1.65, < 0.001) and sleep disorder (OR = 1.33, 95% CI: 1.07 to 1.66, = 0.012) were related to the risk of hypertension. Poor sleep patterns were closely correlated with the risk of hypertension (OR = 1.90, 95% CI: 1.62 to 2.24). CONCLUSIONS: Participants with poor sleep patterns were associated with an increased risk for hypertension.
18Mediterranean Diet and Sleep Features: A Systematic Review of Current Evidence.PubMed
Justyna Godos, Raffaele Ferri, Giuseppe Lanza, et al.
Nutrients. 2024 Jan 17;16(2):282. doi: 10.3390/nu16020282.
The prevalence of sleep disorders, characterized by issues with quality, timing, and sleep duration is increasing globally. Among modifiable risk factors, diet quality has been suggested to influence sleep features. The Mediterranean diet is considered a landmark dietary pattern in terms of quality and effects on human health. However, dietary habits characterized by this cultural heritage should also be considered in the context of overall lifestyle behaviors, including sleep habits. This study aimed to systematically revise the literature relating to adherence to the Mediterranean diet and sleep features in observational studies. The systematic review comprised 23 reports describing the relation between adherence to the Mediterranean diet and different sleep features, including sleep quality, sleep duration, daytime sleepiness, and insomnia symptoms. The majority of the included studies were conducted in the Mediterranean basin and reported a significant association between a higher adherence to the Mediterranean diet and a lower likelihood of having poor sleep quality, inadequate sleep duration, excessive daytime sleepiness or symptoms of insomnia. Interestingly, additional studies conducted outside the Mediterranean basin showed a relationship between the adoption of a Mediterranean-type diet and sleep quality, suggesting that biological mechanisms sustaining such an association may exist. In conclusion, current evidence suggests a relationship between adhering to the Mediterranean diet and overall sleep quality and different sleep parameters. The plausible bidirectional association should be further investigated to understand whether the promotion of a healthy diet could be used as a tool to improve sleep quality.
19Sleep and diabetes.PubMed
Silke Ryan
Curr Opin Pulm Med. 2018 Nov;24(6):555-560. doi: 10.1097/MCP.0000000000000524.
PURPOSE OF REVIEW: Abnormal sleep duration, including short and long sleep, and sleep disorders, in particular obstructive sleep apnea (OSA), have evolved as major public health concerns attributed to their high prevalence and significant links with mortality and comorbid conditions. There is compelling evidence of an independent association of such sleep disturbances with the development, control, and progression of disorders affecting glucose metabolism such as type 2 diabetes (T2D). However, little is known of the underlying pathophysiological mechanisms and the potential interactions of these sleep disturbances in this process. The present review explores emerging evidence in this field. RECENT FINDINGS: Cross-sectional and longitudinal analyses of large cohorts support the association of abnormal sleep duration and T2D. However, significant methodological limitations hinder the conclusive interpretation of the data. OSA is a fast-emerging risk factor for the development and control of T2D. Experimental studies support a key role of intermittent hypoxia as the hallmark feature of OSA in the pathophysiology. SUMMARY: The present review highlights the need for large-scale, multicenter, prospective studies in order to determine the causative role of sleep disturbances in diabetes. There is also a clear demand of a greater understanding of the detailed pathophysiological mechanisms.
20Insomnia and the risk of depression: a meta-analysis of prospective cohort studies.PubMed
Liqing Li, Chunmei Wu, Yong Gan, et al.
BMC Psychiatry. 2016 Nov 5;16(1):375. doi: 10.1186/s12888-016-1075-3.
BACKGROUND: Observational studies suggest that insomnia might be associated with an increased risk of depression with inconsistent results. This study aimed at conducting a meta-analysis of prospective cohort studies to evaluate the association between insomnia and the risk of depression. METHODS: Relevant cohort studies were comprehensively searched from the PubMed, Embase, Web of Science, and China National Knowledge Infrastructure databases (up to October 2014) and from the reference lists of retrieved articles. A random-effects model was used to calculate the pooled risk estimates and 95 % confidence intervals (CIs). The I statistic was used to assess the heterogeneity and potential sources of heterogeneity were assessed with meta-regression. The potential publication bias was explored by using funnel plots, Egger's test, and Duval and Tweedie trim-and-fill methods. RESULTS: Thirty-four cohort studies involving 172,077 participants were included in this meta-analysis with an average follow-up period of 60.4 months (ranging from 3.5 to 408). Statistical analysis suggested a positive relationship between insomnia and depression, the pooled RR was 2.27 (95 % CI: 1.89-2.71), and a high heterogeneity was observed (I = 92.6 %, P < 0.001). Visual inspection of the funnel plot revealed some asymmetry. The Egger's test identified evidence of substantial publication bias (P <0.05), but correction for this bias using trim-and-fill method did not alter the combined risk estimates. CONCLUSIONS: This meta-analysis indicates that insomnia is significantly associated with an increased risk of depression, which has implications for the prevention of depression in non-depressed individuals with insomnia symptoms.