Objectively Measured Sleep Characteristics among Early-Middle-Aged Adults

Lauderdale, Diane S.; Knutson, Kristen L.; Yan, Lijing L.; Rathouz, Paul J.; Hulley, Stephen B.; Sidney, Steve; Liu, Kiang

doi:10.1093/aje/kwj199

Cited by 513 publications

(457 citation statements)

References 33 publications

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“…Habitual sleep duration was assessed at home by actigraphy using the Actiwatch (Mini-Mitter, Bend, OR) in accordance with previously described methods (23)(24)(25). Participants were asked to wear the Actiwatch for 5 consecutive days-3 weekdays and 2 weekend days-and to maintain their habitual bedtimes and fill out daily sleep logs.…”

Section: Actigraphymentioning

confidence: 99%

Impact of Untreated Obstructive Sleep Apnea on Glucose Control in Type 2 Diabetes

Aronsohn

Whitmore

Cauter

et al. 2010

Am J Respir Crit Care Med

401

255

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Rationale: Obstructive sleep apnea (OSA), a treatable sleep disorder that is associated with alterations in glucose metabolism in individuals without diabetes, is a highly prevalent comorbidity of type 2 diabetes. However, it is not known whether the severity of OSA is a predictor of glycemic control in patients with diabetes. Objectives: To determine the impact of OSA on hemoglobin A1c (HbA1c), the major clinical indicator of glycemic control, in patients with type 2 diabetes. Methods: We performed polysomnography studies and measured HbA1c in 60 consecutive patients with diabetes recruited from outpatient clinics between February 2007 and August 2009. Measurements and Main Results: A total of 77% of patients with diabetes had OSA (apnea-hypopnea index [AHI] >5). Increasing OSA severity was associated with poorer glucose control, after controlling for age, sex, race, body mass index, number of diabetes medications, level of exercise, years of diabetes and total sleep time. Compared with patients without OSA, the adjusted mean HbA1c was increased by 1.49% (P 5 0.0028) in patients with mild OSA, 1.93% (P 5 0.0033) in patients with moderate OSA, and 3.69% (P , 0.0001) in patients with severe OSA (P , 0.0001 for linear trend). Measures of OSA severity, including total AHI (P 5 0.004), rapid eye movement AHI (P 5 0.005), and the oxygen desaturation index during total and rapid eye movement sleep (P 5 0.005 and P 5 0.008, respectively) were positively correlated with increasing HbA1c levels. Conclusions: In patients with type 2 diabetes, increasing severity of OSA is associated with poorer glucose control, independent of adiposity and other confounders, with effect sizes comparable to those of widely used hypoglycemic drugs.

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Section: Actigraphymentioning

confidence: 99%

Impact of Untreated Obstructive Sleep Apnea on Glucose Control in Type 2 Diabetes

Aronsohn

Whitmore

Cauter

et al. 2010

Am J Respir Crit Care Med

401

255

View full text Add to dashboard Cite

show abstract

“…A study conducted between 1990 and 1994 found that participants slept on average 6.2 h per night, as measured with wrist actigraphy (11). Recently, in the Coronary Artery Risk Development in Young Adults Sleep Study (2000)(2001)(2002)(2003)(2004)(2005)(2006), sleep duration derived from several days of wrist actigraphy averaged 6.1 h per night (12), whereas self-reported sleep averaged 6.7 h per weeknight and 7.3 h per weekend night (13). Declines in sleep time can be attributed, in part, to extended work schedules including shift work, long commuting times, stressful lifestyles, modern conveniences such as 24-h television and computer/Internet use, and social and leisure activities.…”

Section: Epidemiologic Evidence For a Link Between Sleep Disturbancesmentioning

confidence: 99%

Quantification of sleep behavior and of its impact on the cross-talk between the brain and peripheral metabolism

Hanlon

Cauter

2011

Proc. Natl. Acad. Sci. U.S.A.

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Rates of obesity have been steadily increasing, along with disorders commonly associated with obesity, such as cardiovascular disease and type II diabetes. Simultaneously, average sleep times have progressively decreased. Recently, evidence from both laboratory and epidemiologic studies has suggested that insufficient sleep may stimulate overeating and thus play a role in the current epidemic of obesity and diabetes. In the human sleep laboratory it is now possible to carefully control sleep behavior and study the link between sleep duration and alterations in circulating hormones involved in feeding behavior, glucose metabolism, hunger, and appetite. This article focuses on the methodologies used in experimental protocols that have examined modifications produced by sleep restriction (or extension) compared with normal sleep. The findings provide evidence that sleep restriction does indeed impair glucose metabolism and alters the cross-talk between the periphery and the brain, favoring excessive food intake. A better understanding of the adverse effects of sleep restriction on the CNS control of hunger and appetite may have important implications for public health.

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“…Several authors, including the American Academy of Sleep Medicine's Standards of Practice Committee, view actigraphy as a reliable method for assessing sleepwake patterns in adults. [11][12][13][14][15] Lauderdale et al 16 collected actigraphy data over two 3-day periods for 669 participants aged 38-50 years in the CARDIA Study. They demonstrated substantial discrepancies between self-reported and actigraphically measured sleep duration.…”

Section: Introductionmentioning

confidence: 99%

Actigraphic sleep duration and fragmentation are related to obesity in the elderly: the Rotterdam Study

et al. 2008

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Objective: The epidemiological evidence for the association between sleep duration and obesity in the elderly is inconsistent and has not been investigated with objective measures. Furthermore, the role of sleep fragmentation in this relationship is unknown. Our aim was to investigate the association of sleep measures with body mass index (BMI) and obesity in a normal elderly population. Design: Cross-sectional study. Subjects: A total of 983 community-dwelling elderly (mean age 68.4±6.9 years, range, 57-97). Measurements: Weight and height were measured, and sleep duration and fragmentation were assessed with on average six nights of actigraphy.Results: A quadratic model adequately described the association between continuous measures of sleep duration and BMI. Actigraphic sleep duration had a significant U-shaped relationship with BMI (b of quadratic term ¼ 0.30, 95% confidence interval (CI): 0.08, 0.52). Both short sleepers (o5 h: OR, 2.76 (95% CI: 1.38, 5.49), 5 to o6 h: OR, 1.97 (95% CI: 1.26, 3.08)) and long sleepers (X8 h: OR, 2.93 (95% CI: 1.39, 6.16)) were more likely to be obese, compared to participants who slept 7 to o8 h. BMI increased with 0.59 kg m À2 per standard deviation of sleep fragmentation (95% CI: 0.34, 0.84). After adjustment for sleep fragmentation, the association between short sleep and obesity was no longer significant. Exclusion of participants with probable sleep apnea only marginally changed these associations. Self-reported habitual sleep duration was not associated with BMI or obesity. Conclusions: Sleep duration, as measured with actigraphy, had a U-shaped relationship with BMI and obesity in an elderly population. A highly fragmented sleep is associated with a higher BMI and a higher risk of obesity, and may explain why short sleep is related to obesity. To preclude bias that can be introduced by self-report measures of sleep duration, using multiple measures of sleep parameters is recommended in future research.

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Objectively Measured Sleep Characteristics among Early-Middle-Aged Adults

Cited by 513 publications

References 33 publications

Impact of Untreated Obstructive Sleep Apnea on Glucose Control in Type 2 Diabetes

Impact of Untreated Obstructive Sleep Apnea on Glucose Control in Type 2 Diabetes

Quantification of sleep behavior and of its impact on the cross-talk between the brain and peripheral metabolism

Actigraphic sleep duration and fragmentation are related to obesity in the elderly: the Rotterdam Study

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