Sleep duration and the associated cardiometabolic risk scores in adults

Kanagasabai, Thirumagal; Chaput, Jean‐Philippe

doi:10.1016/j.sleh.2017.03.006

Cited by 31 publications

(24 citation statements)

References 45 publications

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“…Derangements in domains of allostatic load, such as immune dysregulation, 32 neuroendocrine dysfunction, 33 and metabolic dysfunction, 34 have been previously linked with suboptimal sleep patterns in the general population. However, these relations have not been consistently found in black populations 35, 36. Our findings also suggest that allostatic load may not be an important mediator of associations between sleep and poor kidney outcomes in black individuals.…”

Section: Discussioncontrasting

confidence: 66%

Evaluation of Allostatic Load as a Mediator of Sleep and Kidney Outcomes in Black Americans

Lunyera

Davenport

Jackson

et al. 2019

Kidney International Reports

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Introduction Poor sleep associates with adverse chronic kidney disease (CKD) outcomes yet the biological mechanisms underlying this relation remain unclear. One proposed mechanism is via allostatic load, a cumulative biologic measure of stress. Methods Using data from 5177 Jackson Heart Study participants with sleep measures available, we examined the association of self-reported sleep duration: very short, short, recommended, and long (≤5, 6, 7–8, or ≥9 hours per 24 hours, respectively) and sleep quality (high, moderate, low) with prevalent baseline CKD, and estimated glomerular filtration rate (eGFR) decline and incident CKD at follow-up. CKD was defined as eGFR <60 ml/min per 1.73 m 2 or urine albumin-to-creatinine ratio ≥30 mg/g. Models were adjusted for demographics, comorbidities, and kidney function. We further evaluated allostatic load (quantified at baseline using 11 biomarkers from neuroendocrine, metabolic, autonomic, and immune domains) as a mediator of these relations using a process analysis approach. Results Participants with very short sleep duration (vs. 7–8 hours) had greater odds of prevalent CKD (odds ratio [OR] 1.31, 95% confidence interval [CI] 1.03–1.66). Very short, short, or long sleep duration (vs. 7–8 hours) was not associated with kidney outcomes over a median follow-up of 8 years. Low sleep quality (vs. high) associated with greater odds of prevalent CKD (OR 1.26, 95% CI 1.00–1.60) and 0.18 ml/min per 1.73 m 2 (95% CI 0.00–0.36) faster eGFR decline per year. Allostatic load did not mediate the associations of sleep duration or sleep quality with kidney outcomes. Conclusions Very short sleep duration and low sleep quality were associated with adverse kidney outcomes in this all-black cohort, but allostatic load did not appear to mediate these associations.

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Section: Discussioncontrasting

confidence: 66%

Evaluation of Allostatic Load as a Mediator of Sleep and Kidney Outcomes in Black Americans

Lunyera

Davenport

Jackson

et al. 2019

Kidney International Reports

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“…Prospective cohort studies indicate that both long- and short-total sleep times are associated with higher mortality rates and risk for cardiometabolic diseases 10 – 13 , 39 . In a recent large-scale study in the USA, 7 h of sleep was associated with the lowest risk for cardiometabolic disease in all ethnic groups except non-Hispanic blacks, in whom 8 h of sleep was associated with the lowest risk score for cardiometabolic disease 32 . As in previous studies 40 , 41 , the long sleepers (>10 h) in the present study had a lower incidence of hypertension than the shorter sleepers (<7 h).…”

Section: Discussionmentioning

confidence: 90%

“…Since a previous study 20 reported longer sleep durations in black Africans than in the other ethnic groups living in South Africa, it is tempting to surmise that a longer self-reported sleep duration is particular to ethnicity or culture in this setting. Interestingly, data from the 2005–2012 National Health and Nutrition Examination Survey (NHANES) in the USA indicated that non-Hispanic black Americans reported shorter sleep durations than other ethnic groups 32 . Furthermore, a meta-analysis comparing the sleep of African-Americans to European-Americans using polysomnography, actigraphy, diaries and questionnaires found that African-Americans had shorter total sleep time (objectively and subjectively measured) and poorer quality sleep, as measured by worse sleep efficiency, longer sleep onset latency and less slow wave sleep 33 .…”

Section: Discussionmentioning

confidence: 99%

Associations between sleep parameters, non-communicable diseases, HIV status and medications in older, rural South Africans

Gómez‐Olivé

Rohr

Roden

et al. 2018

Sci Rep

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As part of the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), we investigated sleep habits and their interactions with HIV or non-communicable diseases (NCDs) in 5059 participants (median age: 61, interquartile range: 52—71, 54% females). Self-reported sleep duration was 8.2 ± 1.6h, and bed and rise times were 20:48 ± 1:15 and 05:31 ± 1:05 respectively. Ratings of insufficient sleep were associated with older age, lack of formal education, unemployment, and obesity (p < 0.05). Ratings of restless sleep were associated with being older, female, having more education, being unemployed, and single. Hypertension was associated with shorter self-reported sleep duration, poor sleep quality, restless sleep, and periods of stopping breathing during the night (p < 0.05). HIV positive individuals not on antiretroviral treatment (ART) reported more nocturnal awakenings than those on ART (p = 0.029) and HIV negative individuals (p = 0.024), suggesting a negative net effect of untreated infection, but not of ART, on sleep quality. In this cohort, shorter, poor-quality sleep was associated with hypertension, but average self-reported sleep duration was longer than reported in other regions globally. It remains to be determined whether this is particular to this cohort, South Africa in general, or low- to middle-income countries undergoing transition.

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“…Among the limited reports on ethnic differences, the Multi-Ethnic Study of Atherosclerosis (MESA) described that short but not long sleep duration as assessed by an objective method was associated with a higher rate of abnormal fasting glucose (24), but this relation disappeared after adjustment for sleep apnea and showed no evidence interaction by ethnicity. In a cross-sectional analysis of the National Health and Nutrition Examination Survey (25), 7 hours of sleep were associated with the lowest cardiometabolic risk score in whites, whereas African Americans had an optimal score at 8 hours of sleep. At this time, we cannot offer a definite explanation for the strong U-shaped association in Japanese Americans; under-reporting of sleep, the possibility of good sleep quality and health status despite short hours, and residual confounding may be responsible.…”

Section: Discussionmentioning

confidence: 99%