| 1. |
- Asplund, Ragnar, et al.
(author)
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Sleep complaints in women of ages 40-64 years in relation to sleep in their parents
- 2001
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In: Sleep Medicine. - 1389-9457 .- 1878-5506. ; 2:3, s. 233-237
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Journal article (peer-reviewed)abstract
- Objective: To study the occurrence of sleep complaints in women in relation to such complaints in their parents. Background: Sleep complaints are common and may be affected by many somatic, mental, and life-style and environmental factors. Methods: A cross-sectional questionnaire survey was undertaken among 3669 randomly selected women of ages 40-64 years. The women were asked about their own health and sleep and their recollection of the sleep of their parents. Results: The frequency of poor sleep was low among women reporting that neither parent had sleep disturbances. Sleep disturbances in the father, mother and both parents implied a 2.5 (95% confidence interval, 2.0-3.2), 2.5 (2.1-3.0) and 4.8-fold (3.4-6.8) increase in sleep complaints in the investigated women, respectively. The frequencies of numerous awakenings, difficulty in falling asleep again and too little sleep increased similarly. A series of logistic regression analyses revealed that all sleep characteristics were evaluated more negatively in women who reported sleep disturbances in their parents and also reported themselves to be in poor health. All sleep variables deteriorated with age. Because data regarding parent sleep was based on subjects' recall of that sleep, the results should be interpreted with some caution. Conclusions: The frequency of sleep complaints in womem aged from 40 to 64 years was increased if sleep disturbances were reported in their parents.
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| 2. |
- Westerlund, Anna, 1980-, et al.
(author)
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Sleep duration does not predict major adverse cardiac events in the Swedish National March cohort study
- 2011
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In: Sleep Medicine. - Amsterdam : Elsevier. - 1389-9457 .- 1878-5506. ; 12:Supplement 1, s. S22-S22
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Journal article (peer-reviewed)abstract
- Introduction and Objectives: Experimental research suggests that sleep deprivation may alter physiological factors associated with an increased risk for cardiovascular diseases (CVDs). Prior observational studies examining the effects of sleep duration have focused on narrowly defined CVD outcomes, such as myocardial infarction or stroke only. A more comprehensive measure of CVDs is lacking. Therefore, we examined the relationship between sleep duration and Major Adverse Cardiac Events (MACE).Materials and Methods: In 1997, 39,047 Swedish residents (women: 64%, age: 18-94 years) were enrolled in the National March cohort study and asked to self-report their habitual sleep duration in a questionnaire. They were followed-up over approximately 7 years to study incidents of MACE. Events were defined as death from all CVDs, nonfatal myocardial infarction, stroke, or heart failure. The relationship between sleep duration and MACE was analyzed using Cox proportional hazards models.Results: A total of 1,730 events were observed during a median follow-up period of 7.25 years. We found 665 nonfatal myocardial infarctions, 641 nonfatal strokes, 212 nonfatal heart failures, and 198 deaths from all CVDs. Age- and sex-adjusted hazard ratios (95% confidence intervals) of MACE (with 7 hours of sleep/day as the reference group) for individuals reporting ≤5, 6, and ≥ 8 hours of sleep were 1.24 (1.05-1.47), 1.03 (0.91-1.16), and 1.09 (0.97-1.23), respectively. Adjusting for BMI and physical activity did not change the hazard ratios. When adjusting for additional confounders, e.g., depressive symptoms, sleep apnea, and smoking, the association between ≤5h of sleep and MACE was attenuated (HR: 1.22, 95% CI: 0.98-1.52).Conclusion: Sleep duration was not associated with the risk of Major Adverse Cardiac Events. Sleep duration, however, may not in itself explain the effects of inadequate sleep on cardiovascular diseases. Yet, it may serve as an essential component in the understanding of cardiovascular diseases. Copyright © 2011 Elsevier B.V. All rights reserved.
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| 3. |
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| 4. |
- Alonderis, A, et al.
(author)
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Medico-legal implications of sleep apnoea syndrome: Driving license regulations in Europe.
- 2008
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In: Sleep medicine. - : Elsevier BV. - 1389-9457 .- 1878-5506. ; 9:4, s. 362-75
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Journal article (peer-reviewed)abstract
- BACKGROUND: Sleep apnoea syndrome (SAS), one of the main medical causes of excessive daytime sleepiness, has been shown to be a risk factor for traffic accidents. Treating SAS results in a normalized rate of traffic accidents. As part of the COST Action B-26, we looked at driving license regulations, and especially at its medical aspects in the European region. METHODS: We obtained data from Transport Authorities in 25 countries (Austria, AT; Belgium, BE; Czech Republic, CZ; Denmark, DK; Estonia, EE; Finland, FI; France, FR; Germany, DE; Greece, GR; Hungary, HU; Ireland, IE; Italy, IT; Lithuania, LT; Luxembourg, LU; Malta, MT; Netherlands, NL; Norway, EC; Poland, PL; Portugal, PT; Slovakia, SK; Slovenia, SI; Spain, ES; Sweden, SE; Switzerland, CH; United Kingdom, UK). RESULTS: Driving license regulations date from 1997 onwards. Excessive daytime sleepiness is mentioned in nine, whereas sleep apnoea syndrome is mentioned in 10 countries. A patient with untreated sleep apnoea is always considered unfit to drive. To recover the driving capacity, seven countries rely on a physician's medical certificate based on symptom control and compliance with therapy, whereas in two countries it is up to the patient to decide (on his doctor's advice) to drive again. Only FR requires a normalized electroencephalography (EEG)-based Maintenance of Wakefulness Test for professional drivers. Rare conditions (e.g., narcolepsy) are considered a driving safety risk more frequently than sleep apnoea syndrome. CONCLUSION: Despite the available scientific evidence, most countries in Europe do not include sleep apnoea syndrome or excessive daytime sleepiness among the specific medical conditions to be considered when judging whether or not a person is fit to drive. A unified European Directive seems desirable.
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| 5. |
- Amid Hägg, Shadi, et al.
(author)
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Nocturnal gastroesophageal reflux increases the risk of daytime sleepiness in women
- 2019
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In: Sleep Medicine. - : Elsevier BV. - 1389-9457 .- 1878-5506. ; 53, s. 94-100
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Daytime sleepiness is common in women and has negative health effects. Nocturnal gastroesophageal reflux (nGER) and snoring are risk factors for daytime sleepiness, but the effect of their interaction remains unknown. The aim of this study was to examine how nGER and snoring combined affected daytime sleepiness and involuntary falling asleep in women.METHODS: A questionnaire was sent to randomly selected women in 2000 and 2010. Participants who answered questions regarding both nGER and snoring in both questionnaires were included (N = 4882). Daytime sleepiness was defined as severe or very severe problems with daytime sleepiness. Involuntary falling asleep was defined as sometimes, often or very often falling asleep involuntarily during the day. Respondents snoring loudly and disturbingly sometimes, often or very often were defined as snorers. Having nocturnal heartburn or acid reflux sometimes, often or very often was defined as having nGER.RESULTS: Daytime sleepiness was reported by 14% of the participants, involuntary falling asleep by 11%. After adjustment for age, smoking, physical activity, caffeine intake and alcohol dependency, increased odd ratios (ORs) for both daytime sleepiness (adjusted OR 4.2, 95% confidence interval (CI): 1.9-9.2) and involuntary falling asleep (adjusted OR 3.1, 95% CI: 1.5-6.4) were seen in women with the combination of nGER and snoring at both baseline and follow-up. The association with daytime sleepiness was also strong for those with only persistent nGER but not for those with only persistent snoring.CONCLUSION: Women with nGER were at increased risk of developing daytime sleepiness and snoring augmented this association. In addition, women with both nGER and snoring were also at increased risk of developing involuntary falling asleep.
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| 6. |
- Andreasson, Anna, et al.
(author)
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Poor sleep quality is associated with worse self-rated health in long sleep duration but not short sleep duration
- 2021
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In: Sleep Medicine. - : Elsevier BV. - 1389-9457 .- 1878-5506. ; 88, s. 262-266
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Journal article (peer-reviewed)abstract
- Unhealthy sleep duration, either short or long, is associated with worse health and central subjective dimensions of sleep and health such as fatigue. It has been argued that the link between sleep duration and health may depend on the quality of the slept hours, and on its functional impact (ie, fatigue). The present study therefore assessed whether the relationship between last night's sleep duration and general self-rated health (SRH) differs as a function of sleep quality, and secondly, whether current fatigue and sleep quality are factors linking sleep duration and SRH. The present cross-sectional dataset involved 1304 individuals (57% female, M age = 28.8, range 18-79). Participants completed surveys for general SRH, previous night's sleep duration and sleep quality, and current fatigue. Results showed the expected inverted U-shaped (ie, quadratic) relation between last night's sleep duration and SRH and a linear relation between last night's sleep quality and SRH. However, long sleep duration was only associated with poorer SRH in individuals who also reported poor sleep quality. Further, the quadratic relationship between sleep duration and SRH was partially mediated by fatigue and sleep quality. The results of this multi-study analysis suggest that SRH is particularly poor in those who slept both long and with poor quality the night before, while good sleep quality may protect those with a long sleep duration from poor SRH. Thus, last night's long sleep does not seem to be associated with poor subjective health unless it is coupled with poor sleep quality. Furthermore, fatigue and sleep quality are potential pathways linking short and long sleep duration with SRH. Different dimensions of sleep interact in their association with health, and future research will benefit from an integrative approach.
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| 7. |
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| 8. |
- Balcan, B., et al.
(author)
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Impact of CPAP treatment on leptin and adiponectin in adults with coronary artery disease and nonsleepy obstructive sleep apnoea in the RICCADSA trial
- 2020
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In: Sleep Medicine. - : Elsevier BV. - 1389-9457 .- 1878-5506. ; 67, s. 7-14
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Journal article (peer-reviewed)abstract
- Background: Increased leptin and decreased adiponectin levels are reported in coronary artery disease (CAD) as well as in obstructive sleep apnoea (OSA). Less is known regarding the impact of continuous positive airway pressure (CPAP) on these biomarkers. We aimed to determine variables associated with leptin and adiponectin in adults with CAD and nonsleepy OSA, and evaluate the effect of CPAP adjusted for confounding factors. Methods: This was one of the secondary outcomes of the RICCADSA trial, conducted in Sweden between 2005 and 2013. From 244 revascularized CAD and OSA patients (apnoeaehypopnoea index > 15/h) without excessive daytime sleepiness (Epworth Sleepiness Scale score <10), 196 with blood samples at baseline, after 3, and 12 months were included in the randomized controlled trial arm; of those, 98 were allocated to auto-titrating CPAP, and 98 to no-CPAP. Results: No significant changes in leptin and adiponectin levels were observed during follow-up, whereas Body-Mass-Index and waist circumference increased in both CPAP and no-CPAP groups with no significant between-group differences. Alterations in plasma leptin were determined by changes in waist circumference (beta coefficient 2.47; 95% confidence interval 0.77-4.40), whereas none of the analyzed parameters was predictive for changes in adiponectin levels. No association was found with CPAP adherence. Conclusions: CPAP had no significant effect on leptin and adiponectin in this cohort of nonsleepy OSA patients. An increase in waist circumference predicted an increase in plasma levels of leptin after 12 months, suggesting that lifestyle modifications should be given priority in adults with CAD and OSA regardless of CPAP treatment. (C) 2019 Elsevier B.V. All rights reserved.
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| 9. |
- Bauducco, Serena, 1988-, et al.
(author)
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Adolescents' sleep trajectories over time : school stress as a potential risk factor for the development of chronic sleep problems
- 2019
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In: Sleep Medicine. - : Elsevier. - 1389-9457 .- 1878-5506. ; 64:Suppl. 1, s. S27-S27
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Journal article (other academic/artistic)abstract
- Introduction: Sleep is a complex behavior affected by biological, psychosocial and contextual factors typically present during adolescent development (Becker, Langberg, & Byars, 2015), including increasing autonomy from parents, increasing school demands, and socializing more with peers. However, these normative changes do not explain temporary vs chronic sleep disturbances. Who are the adolescents at risk for developing chronic sleep problems? Some risk factors have been identified as crucial, such as poor sleep hygiene and family stressors, others are not as clear, such as technology use (Bartel et al., 2015). The impact of another important stressor for youths other than family, the school context, has received less attention (Meldrum, 2018). The aim of this study was twofold; first, we explored sleep trajectories from early to mid-adolescence to be able to identify a risk group showing persistent sleep problems (including insomnia and short sleep duration); then, we investigated the role of school stressors (i.e., conflicts with teachers, performance, school-leisure conflict, attendance), controlling for well-established risk factors, in the development of chronic sleep problems in a large cohort of adolescents.Materials and methods: We used three longitudinal waves of questionnaire data collected annually from a sample of Swedish adolescents (n = 1457; Mage = 13.2 [range: 12- 15 years], SD = .43; 52.7% boys). We collected the data from all schools in three communities in central Sweden, during school hours. Using established measures, the students reported on their sleep duration (calculated from reported bedtime, wake-time, and sleep onset latency; SSHS [Wolfson & Carskadon, 1998]), insomnia symptoms (ISI; Morin, 1993), sleep hygiene (ASHS; LeBourgeois, Giannotti, Cortesi, Wolfson, & Harsh, 2005), technology use, and perceived stress (including school, home and peer related stress) (ASQ; Byrne, Davenport, & Mazanov, 2007).First we used latent class analysis (LCA) to identify adolescents' sleep trajectories, then we used regression analyses to predict the risk-group trajectory of chronic insomnia and short sleep duration, controlling for gender.Results: We found four trajectories for adolescents' insomnia; 1) low-stable (69%), 2) low-increasing (18%), 3) high-decreasing (8%), 4) high-increasing (5%; 'risk-group'). For sleep duration, we found two trajectories; 1) ∼8 h slightly decreasing (79%), 2) ∼7 h decreasing (21%; 'risk-group').School stressors including stress of fitting in with peers, stress of schoolwork leaving too little leisure time, a stressful home environment, poor sleep hygiene, and being female were risk factors for chronic insomnia symptoms. Conflicts with teachers, poor sleep hygiene, and being female were risk-factors for chronic insufficient sleep.Conclusions: Over and above well-known risk-factors for poor sleep, such as poor sleep hygiene, (Bartel et al., 2015), school-related stress was a significant predictor of persistent sleep problems in adolescents. Therefore, helping adolescents to handle school stress might be a promising strategy to improve sleep health in this population.
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| 10. |
- Bauducco, Serena, 1988-, et al.
(author)
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Bidirectional associations between adolescents’ sleep problems and impulsive behavior over time
- 2019
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In: Sleep Medicine. - : Elsevier. - 1389-9457 .- 1878-5506 .- 2590-1427. ; 1
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Journal article (peer-reviewed)abstract
- Objective/Background: Adolescents who experience sleep problems are less able to resist impulses. Furthermore, youths who show more impulsive behaviors are, in turn, assumed to have more sleep problems, which sets the stage for a negative cycle over time. Empirical research has shown some evidence that sleep problems affect impulse control, but the bidirectional link has previously not been tested. Therefore, the aim of this study was to test this assumption.Methods: In this study, we used cross-lagged models to investigate the bidirectional association between sleep problems (ie, insomnia and sleep duration) and impulsive behaviors over two years in a cohort of young adolescents (n = 2767, mean age ∼13.7, 47.6% girls). We also investigated the moderating role of age and gender.Results: The results showed that the links between sleep duration/insomnia and impulsive behavior are bidirectional. Youths who experienced sleep problems also experienced increased difficulties with impulse control, and problems regulating impulses were also linked with increases in sleep problems, and these effects were systematic over two years. Moreover, age did not moderate these associations but impulsive behaviors had a larger impact on girls’ insomnia as compared to boys.Conclusions: By confirming the bi-directionality of this association, this study supports the importance of developing interventions to promote sleep health in adolescents but also the need to tailor such programs to adolescents’ development because adolescents might not be able to prioritize sleep if they cannot control their impulses.
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