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| 5. |
- Bengtsson, Caroline, et al.
(author)
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Impact of nasal obstruction on sleep quality : a community-based study of women
- 2015
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In: European Archives of Oto-Rhino-Laryngology. - : Springer Science and Business Media LLC. - 0937-4477 .- 1434-4726. ; 272:1, s. 97-103
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Journal article (peer-reviewed)abstract
- The aim of the study was to analyse the impact of self-reported nasal obstruction on sleep quality in women. A community-based sample of 400 women underwent a full night of polysomnography. Airway diseases, allergies and sleep-related symptoms were assessed by questionnaires. Women with subjective nasal obstruction were subdivided into three groups: persistent nasal obstruction (PNO, n = 46), hay fever (n = 88) and nasal obstruction at night (NON, n = 30). Sleep problems and related daytime symptoms were most prevalent among women with NON. After adjusting for age, BMI, smoking and asthma, NON was an independent predictor of 'Difficulties inducing sleep due to nasal obstruction' [adjusted odds ratio (95 % CI): 89.5 (27.0-296.7)], 'Snoring' [4.2 (1.7-10.2)], 'Sweating at night' [2.6 (1.1-6.1)], 'Difficulties maintaining sleep' [2.7 (1.2-6.2)], and 'Waking up hastily gasping for breath' [32.2 (8.7-119.1)]. 'Dry mouth on awakening' [7.7 (3.2-18.4)], 'Waking up unrefreshed' [2.7 (1.2-6.0)], 'Excessive daytime sleepiness' [2.6 (1.1-6.0)], and 'Daytime nasal obstruction' [12.2 (4.8-31.2)] were also associated with NON. Persistent nasal obstruction and hay fever were both associated with some reported sleep problems due to an overlap with NON. When women with NON were excluded, only 'Daytime nasal obstruction' was still significantly associated with PNO, while hay fever was associated with 'Daytime nasal obstruction' and 'Waking up hastily gasping for breath'. There were no significant differences in objectively measured sleep variables between any of the three subgroups and the study cohort. Self-reported nasal obstruction at night in women has a significant effect on several subjective day- and nighttime symptoms, but it does not appear to affect objectively measured sleep quality.
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| 6. |
- Bengtsson, Caroline, 1975-
(author)
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Nasal obstruction – impact on insomnia symptoms and sleep-disordered breathing
- 2019
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Doctoral thesis (other academic/artistic)abstract
- Background: Nasal obstruction is very common in the general population, but the role of nasal obstruction in sleep quality is not clear. Nasal obstruction is also prevalent in patients with obstructive sleep apnoea (OSA) and may contribute to poor adherence to continuous positive airway pressure (CPAP) treatment.Aims: To investigate the impact of subjective nasal obstruction, as a single symptom or as part of chronic rhinosinusitis (CRS), in both objective and subjective sleep quality, in three different population based cohorts. Another aim was to investigate the usefulness of the Sinonasal Outcome Test-22 (SNOT-22) and peak nasal inspiratory flow (PNIF) in the treatment of OSA patients.Methods and results: In paper I (the SHE-study), a community-based sample of 400 women were investigated with polysomnography and questions on sleep quality, daytime- and nasal symptoms. Women with nasal obstruction at night (n=30) had significantly higher prevalence of several night time symptoms and excessive daytime sleepiness (EDS), but the polysomnography was normal.In paper II (the GA2LEN study, n= 26, 647) and paper III (RHINE II and RHINE III studies, n= 5, 145) questionnaires on sleep quality, daytime- and nasal symptoms were used, and CRS was defined according to the epidemiological diagnostic criteria of the European Position Paper of Rhinosinusitis and Nasal Polyps (EPOS). In paper II, sleep problems were highly prevalent in CRS, and there was a dose-response relationship between the disease severity of CRS and sleep problems. The addition of persistent allergic rhinitis to CRS further increased the risk of sleep problems.In paper III, 2.7% of individuals without nasal symptoms at baseline had developed CRS at follow-up 10 years later. Strong associations between incident CRS and impaired sleep quality and EDS were found. Three insomnia symptoms at baseline increased the risk for CRS at follow-up.In paper IV, 197 OSA patients initiating CPAP treatment were investigated before starting CPAP and at the follow-up 3-4 weeks later. SNOT-22 scores were generally high among all OSA patients indicating a large sinonasal disease burden, and improved among those with CPAP adherence ≥ 4 hours/night. A low PNIF value increased the risk for poor CPAP adherence.Conclusions: Subjective nasal obstruction at night impairs subjective sleep quality in women, but does not affect objective sleep quality. CRS impairs subjective sleep quality, and insomnia symptoms may be a risk factor for CRS. SNOT-22 and PNIF may be useful tools in the treatment of OSA patients.
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| 7. |
- Cai, Gui-Hong, et al.
(author)
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Both weight at age 20 and weight gain have an impact on sleep disturbances later in life : Results of the EpiHealth study
- 2018
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In: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 41:1
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Journal article (peer-reviewed)abstract
- Study Objectives: Obesity is often associated with impaired sleep, whereas the impact of body mass index (BMI) at younger age and previous weight gain on sleep problems remains unknown. Methods: The present study utilized data from the Swedish EpiHealth cohort study. A total of 15845 participants (45–75 years) filled out an internet-based questionnaire. BMI was calculated from both measured data at study time and self-reported data at age 20 from the questionnaire. Results: Sleep-related symptoms were most common among obese individuals (BMI > 30 kg/m2). An association between weight gain and sleep problems was found and those with a low BMI at age 20 were most vulnerable to weight gain when it came to risk of sleep problems. Among those who were underweight (BMI < 18.5 kg/m2) at age 20, weight gain (kg/year) was associated with difficulties initiating sleep with an adjusted OR of 2.64 (95% CI: 1.51–4.62) after adjusting for age, sex, smoking, alcohol consumption, physical activity, education, and civil status. The corresponding adjusted OR’s among those who had been normal weight (BMI 18.5–24.99) and overweight (BMI 25–29.99 kg/m2) at age 20 were 1.89 (1.47–2.45) and 1.02 (0.48–2.13), respectively. Also difficulties maintaining sleep and snoring were most strongly related to weight gain among those who were underweight at age 20 with decreasing odds with increasing BMI at that age. Conclusions: Sleep problems are related to weight gain and obesity. The impact of weight is most pronounced among those who had a low BMI when young.
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- Cai, Gui-Hong, et al.
(author)
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Insomnia symptoms and sleep duration and their combined effects in relation to associations with obesity and central obesity
- 2018
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In: Sleep Medicine. - : Elsevier BV. - 1389-9457 .- 1878-5506. ; 46, s. 81-87
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Journal article (peer-reviewed)abstract
- Objective: Previous studies have shown that both sleep duration and insomnia have an impact on obesity and central obesity. However, studies of the joint effects of these sleep disorders are still sparse. Methods: The present study utilized data from the Swedish EpiHealth cohort study. Participants (45 - 78 y) were asked to fill out an internet-based questionnaire. Body mass index (BMI) and central obesity (calculated from waist circumference) were based on measured data. Results: A total of 18,823 participants (mean age = 60 ys) were included in this study. The reported prevalence of short (<6 h/night) and long (>9 h/night) sleep duration was 8% and 4% respectively, and insomnia symptoms was 19%. Of the study population, 16% were obese (BMI >= 30 kg/m(2)) and 40% had central obesity. There was a U-shaped association between sleep duration and obesity and central obesity, and significant associations between insomnia symptoms and obesity. When stratifying sleep duration by concurrent insomnia symptoms, there were associations (odds ratios, (95% confidence intervals)) between the combination of both short (1.48, (1.22-1.80)) and long sleep duration (1.77 (1.00 - 3.16)) with insomnia symptoms and obesity and central obesity (1.36 (1.16-1.61) and 2.44 (1.41-3.24) respectively). However, there was no significant association between insomnia symptoms and obesity or central obesity in participants with normal sleep duration. For central obesity there was an association with long sleep duration regardless of insomnia symptoms, while the association with short sleep duration was significant only if insomnia symptoms were present. Conclusions: Both short and long sleep duration, as well as insomnia symptoms, are associated with obesity and central obesity. There is an important joint effect of sleep duration and insomnia symptoms and there is no association between insomnia symptoms and obesity, as long as a normal sleeping time can be attained. This indicates that sleep duration rather than insomnia symptoms per se is of importance for the relationship between sleep and obesity.
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| 10. |
- Ljunggren, Mirjam, et al.
(author)
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Increased risk of heart failure in women with symptoms of sleep-disordered breathing
- 2016
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In: Sleep Medicine. - : Elsevier BV. - 1389-9457 .- 1878-5506. ; 17, s. 32-37
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Journal article (peer-reviewed)abstract
- BACKGROUND: An association between obstructive sleep apnea and the incidence of heart failure has been reported in men but not in women. The aim of this study was to investigate whether a combination of snoring and excessive daytime sleepiness, the two main symptoms of obstructive sleep apnea syndrome, was able to predict incident heart failure in a population-based sample of women.METHODS: The population-based cohort study Sleep and Health in Women (SHE; n = 5990 women born between 1901 and 1980) was used, with baseline questionnaire data from April 2000 relating to snoring, excessive daytime sleepiness, and covariates. Using data retrieved from the Swedish National Patient Register and Cause of Death Register, the follow-up of incident heart failure continued until 31 December 2011.RESULTS: Among women with both snoring and excessive daytime sleepiness at baseline, 5.3% developed heart failure during follow-up compared with 0.9% in the reference group with neither snoring nor excessive daytime sleepiness. After adjustment for age, waist circumference, smoking, alcohol, hypertension, diabetes, previous myocardial infarction, physical inactivity, depressive symptoms, menopausal status, and hormone replacement therapy, women with the combination of snoring and excessive daytime sleepiness had a twofold increase in the risk of incident heart failure (hazard ratio [HR] 2.2 95% confidence interval [CI] 1.1-4.4).CONCLUSION: Symptoms of obstructive sleep apnea, that is, the combination of snoring and excessive daytime sleepiness, are associated with an increased risk of developing heart failure in women.
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| 11. |
- Ljunggren, Mirjam, et al.
(author)
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Obstructive sleep apnea during rapid eye movement sleep is associated with early signs of atherosclerosis in women
- 2018
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In: Sleep. - : Oxford University Press. - 0161-8105 .- 1550-9109. ; 41:7
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Journal article (peer-reviewed)abstract
- Study Objectives: Although obstructive sleep apnea (OSA) is associated with overall cardiovascular disease and mortality, the association with atherosclerotic cardiovascular disease is less clear, especially in women. Recently, it has been suggested that OSA during rapid eye movement (REM) sleep, associated with long apneas and deep desaturations, could have severe cardiometabolic consequences. The aim of this study was to investigate whether OSA during REM sleep is associated with early signs of atherosclerosis in a population-based sample of women. Methods: In the community-based "Sleep and Health in Women" (SHE) cohort study, 400 women underwent polysomnography, anthropometric measurements, blood sampling, blood pressure measurement, and answered questionnaires. Ten years later, 201 of the original participants, free of known atherosclerotic disease at baseline and without continuous positive airway pressure treatment for OSA, underwent a high-frequency ultrasound of the common carotid artery to assess the individual thickness of the layers of the artery wall. Results: Severe OSA during REM sleep (REM apnea-hypopnea index [AHI] >= 30) was associated with a thicker intima. This association was still significant after adjustment for age, body mass index, alcohol, and smoking, as well as for further adjustment for systolic blood pressure, low-density lipoprotein, C-reactive protein, and diabetes (ss-coefficient, 0.008; p-value, 0.022). The association between a REM AHI of >= 30 and intima thickness was also seen in women with no or mild OSA and normal non-REM AHI. Conclusions: In this study of a community-based sample of women, severe OSA during REM sleep was independently associated with early signs of atherosclerosis. Statement of Significance Individuals with obstructive sleep apnea run an increased risk of cardiovascular disease, but the relationship between obstructive sleep apnea and atherosclerotic diseases is still unclear, especially in women. Sleep apnea and respiration deteriorate during rapid eye movement (REM)-sleep and sleep apnea during REM sleep might have severe adverse effects. In this study of a community-based sample of women, severe sleep apnea during REM sleep was associated with early signs of atherosclerosis, defined as increased intima thickness, at 10 years of follow-up. The association was also seen in women with low overall apnea-hypopnea index, normally not considered for treatment of sleep apnea. This suggests that occurrence of frequent obstructive apneas during REM sleep has to be taken into consideration when diagnosing and treating sleep apnea.
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| 12. |
- Palm, Andreas, 1971-, et al.
(author)
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Factors influencing adherence to continuous positive airway pressure treatment in obstructive sleep apnea and mortality associated with treatment failure - a national registry-based cohort study
- 2018
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In: Sleep Medicine. - : Elsevier BV. - 1389-9457 .- 1878-5506. ; 51, s. 85-91
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Journal article (peer-reviewed)abstract
- Objectives: Adherence to continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA) is crucial. Our aim was to identify protective and risk factors against the discontinuation of CPAP treatment in patients with OSA and to estimate the mortality risk in those who were non-adherent to CPAP therapy.Methods: This was a registry-based cohort study from 37 centers across Sweden with OSA patients on CPAP in the Swedevox Swedish national registry between July 2010 and March 2017.Results: In 16,425 patients (70.8% men) with complete follow-up data after 1.2 ± 0.8 years the adjusted relative risk ratio (aRRR) for the discontinuation of CPAP was 0.57 (95% confidence interval (CI) 0.50–0.65) for use of humidifier, 0.87 (95% CI 0.82–0.92) for increasing age per 10 years, 0.80 (95% CI 0.77–0.83) for increasing apnea hypopnea index (AHI) per 5 units/hour, and 0.96 (95% CI 0.95–0.97) per increased unit on the Epworth Sleepiness Scale (ESS). Increasing BMI was associated with increased adherence up to BMI 35. Women and patients with hypertension ran an increased risk of discontinuing CPAP treatment, aRRR 1.28 (95% CI 1.12–1.46) and 1.24 (95% CI 1.12–1.42) respectively. The adjusted hazard ratio (HR) for mortality was 1.74 (95% CI 1.32–2.28) among those who did not adhere to CPAP (median follow-up period 2.4 years after the one year adherence evaluation).Conclusion: Use of humidifier is associated with greater adherence to CPAP treatment. Other factors predicting adherence are increasing age, more severe OSA and overweight up to BMI 35, whereas female gender and coexisting hypertension are risk factors for discontinuation of CPAP. Failure to adhere to CPAP is associated with increased mortality.
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- Phan, Hang Thi, et al.
(author)
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An educational intervention to improve hand hygiene compliance in Vietnam
- 2018
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In: BMC Infectious Diseases. - : BIOMED CENTRAL LTD. - 1471-2334. ; 18
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Journal article (peer-reviewed)abstract
- Background: Hand hygiene compliance is the basis of infection control programs. In developing countries models to improve hand hygiene compliance to reduce healthcare acquired infections are required. The aim of this study was to determine hand hygiene compliance following an educational program in an obstetric and gynecological hospital in Vietnam.Methods: Health care workers from neonatal intensive care, delivery suite and a surgical ward from Hung Vuong Hospital, Ho Chi Minh City, Vietnam undertook a 4-h educational program targeting hand hygiene. Compliance was monitored monthly for six months following the intervention. Hand hygiene knowledge was assessed at baseline and after six months of the study.Results: There were 7124 opportunities over 370 hand hygiene recording sessions with 1531 opportunities at baseline and 1620 at 6 months following the intervention. Hand hygiene compliance increased significantly from baseline across all sites (43.6% [95% Confidence interval CI:41.1-46.1] to 63% [95% CI:60.6-65.3]; p < 0.0001). Health care worker hand hygiene compliance increased significantly after intervention (p < 0.0001). There were significant improvements in knowledge scores from baseline to 2 months post educational intervention with mean difference standard deviations (SD):1.5 (2.5); p < 0.001).Conclusions: A simple educational model was implemented in a Vietnamese hospital that revealed good hand hygiene compliance for an extended period of time. Hand hygiene knowledge increased during the intervention. This hand hygiene model could be used in developing countries were resources are limited.
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| 15. |
- Schwarz, Johanna F. A., et al.
(author)
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Age affects sleep microstructure more than sleep macrostructure
- 2017
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In: Journal of Sleep Research. - : Wiley. - 0962-1105 .- 1365-2869. ; 26:3, s. 277-287
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Journal article (peer-reviewed)abstract
- It is well known that the quantity and quality of physiological sleep changes across age. However, so far the effect of age on sleep microstructure has been mostly addressed in small samples. The current study examines the effect of age on several measures of sleep macro- and microstructure in 211 women (22–71 years old) of the ‘Sleep and Health in Women’ study for whom ambulatory polysomnography was registered. Older age was associated with significantly lower fast spindle (effect size f2 = 0.32) and K-complex density (f2 = 0.19) during N2 sleep, as well as slow-wave activity (log) in N3 sleep (f2 = 0.21). Moreover, total sleep time (f2 = 0.10), N3 sleep (min) (f2 = 0.10), rapid eye movement sleep (min) (f2 = 0.11) and sigma (log) (f2 = 0.05) and slow-wave activity (log) during non-rapid eye movement sleep (f2 = 0.09) were reduced, and N1 sleep (f2 = 0.03) was increased in older age. No significant effects of age were observed on slow spindle density, rapid eye movement density and beta power (log) during non-rapid eye movement sleep. In conclusion, effect sizes indicate that traditional sleep stage scoring may underestimate age-related changes in sleep.
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| 16. |
- Sundström, Johan, Professor, 1971-, et al.
(author)
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Risk factors for subarachnoid haemorrhage : a nationwide cohort of 950 000 adults
- 2019
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In: International Journal of Epidemiology. - : Oxford University Press. - 0300-5771 .- 1464-3685. ; 48:6, s. 2018-2025
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Journal article (peer-reviewed)abstract
- BACKGROUND: Subarachnoid haemorrhage (SAH) is a devastating disease, with high mortality rate and substantial disability among survivors. Its causes are poorly understood. We aimed to investigate risk factors for SAH using a novel nationwide cohort consortium.METHODS: We obtained individual participant data of 949 683 persons (330 334 women) between 25 and 90 years old, with no history of SAH at baseline, from 21 population-based cohorts. Outcomes were obtained from the Swedish Patient and Causes of Death Registries.RESULTS: During 13 704 959 person-years of follow-up, 2659 cases of first-ever fatal or non-fatal SAH occurred, with an age-standardized incidence rate of 9.0 [95% confidence interval (CI) (7.4-10.6)/100 000 person-years] in men and 13.8 [(11.4-16.2)/100 000 person-years] in women. The incidence rate increased exponentially with higher age. In multivariable-adjusted Poisson models, marked sex interactions for current smoking and body mass index (BMI) were observed. Current smoking conferred a rate ratio (RR) of 2.24 (95% CI 1.95-2.57) in women and 1.62 (1.47-1.79) in men. One standard deviation higher BMI was associated with an RR of 0.86 (0.81-0.92) in women and 1.02 (0.96-1.08) in men. Higher blood pressure and lower education level were also associated with higher risk of SAH.CONCLUSIONS: The risk of SAH is 45% higher in women than in men, with substantial sex differences in risk factor strengths. In particular, a markedly stronger adverse effect of smoking in women may motivate targeted public health initiatives.
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| 18. |
- Theorell-Haglöw, Jenny, et al.
(author)
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Associations Between Obstructive Sleep Apnea and Measures of Arterial Stiffness
- 2019
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In: Journal of Clinical Sleep Medicine (JCSM). - : AMER ACAD SLEEP MEDICINE. - 1550-9389 .- 1550-9397. ; 15:2, s. 201-206
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Journal article (peer-reviewed)abstract
- Study Objectives: The aim of this study was to determine whether severity measures of obstructive sleep apnea (OSA) are associated with arterial stiffness and central blood pressure (two important cardiovascular risk factors) in a large group of patients with OSA. Methods: Baseline data from six studies on OSA in which arterial stiffness and central aortic blood pressure measures were determined using applanation tonometry were pooled. Associations between measures of arterial stiffness (heart rate corrected augmentation index [AI75]), central aortic blood pressure (central systolic pressure [CSP] and heart rate corrected central augmentation pressure [CAP75]) and measures of OSA severity were explored using stepwise regression modelling. Results: Data from 362 participants (M:F ratio 13:1) with mean (standard deviation) age 49.2 (11.0) years, body mass index 31.9 (5.3) kg/m(2), apnea-hypopnea index (AHI) 35.7 (20.7) events/h were included in the analyses. The AHI, oxygen desaturation index (ODI3%), and sleep time with SpO(2) < 90% (T90) were all associated with arterial stiffness (AI75), (AHI: adj. beta = .069; P = .01; ODI3%: adj. beta = .072; P = .01; T90: adj. beta = .18; P < .0001) and CAP75 (AHI: adj. beta = .030; P = .01; ODI3%: adj. beta = .027; P = .02; T90: adj. beta = .080; P < .0001). AHI was also associated with CSP (AHI: adj. beta = .11; P = .002). Conclusion: OSA severity was significantly associated with augmentation index and CAP75 although the relationships were not strong.
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| 19. |
- Theorell-Haglöw, Jenny, et al.
(author)
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Changes of vitamin D levels and bone turnover markers after CPAP therapy : a randomized sham-controlled trial
- 2018
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In: Journal of Sleep Research. - : WILEY. - 0962-1105 .- 1365-2869. ; 27:4
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Journal article (peer-reviewed)abstract
- The aim was to investigate whether continuous positive airway pressure treatment could modulate serum vitamin D (25-hydroxyvitamin D) and bone turnover markers (collagen-type 1 cross-linked C-telopeptide, osteocalcin and N-terminal propeptide of type 1 collagen) in secondary analysis from a randomized controlled trial. Sixty-five continuous positive airway pressure-naive male patients with obstructive sleep apnea (age=49 +/- 12years, apnea-hypopnea index=39.9 +/- 17.7events h(-1), body mass index=31.3 +/- 5.2kgm(-2)) were randomized to receive either real (n=34) or sham (n=31) continuous positive airway pressure for 12weeks. At 12weeks, all participants received real continuous positive airway pressure for an additional 12weeks. After 12weeks of continuous positive airway pressure (real versus sham), there were nobetween-group differences for any of the main outcomes [25-hydroxyvitamin D: -0.80 +/- 5.28ngmL(-1) (mean +/- SE) versus 3.08 +/- 3.66ngmL(-1), P=0.42; collagen-type 1 cross-linked C-telopeptide: 0.011 +/- 0.014ngmL(-1) versus -0.004 +/- 0.009ngmL(-1), P=0.48; osteocalcin: 1.13 +/- 1.12ngmL(-1) versus 0.46 +/- 0.75ng mL(-1), P=0.80; N-terminal propeptide of type 1 collagen: 2.07 +/- 3.05gL(-1) versus -1.05 +/- 2.13gL(-1), P=0.48]. There were no further differences in subgroup analyses (continuous positive airway pressure-compliant patients, patients with severe obstructive sleep apnea or sleepy patients). However, after 24weeks irrespective of initial randomization, vitamin D increased in patients with severe obstructive sleep apnea (9.56 +/- 5.51ngmL(-1), P=0.045) and in sleepy patients (14.0 +/- 4.69ngmL(-1), P=0.007). Also, there was a significant increase in osteocalcin at 24weeks (3.27 +/- 1.06ngmL(-1), P=0.01) in compliant patients. We conclude that 12weeks of continuous positive airway pressure did not modulate vitamin D or modulate any of the bone turnover markers compared with sham. However, it is plausible that continuous positive airway pressure may have late beneficial effects on vitamin D levels and bone turnover markers in selected groups of patients with obstructive sleep apnea.
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| 21. |
- Theorell-Haglöw, Jenny, et al.
(author)
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Gender differences in obstructive sleep apnoea, insomnia and restless legs syndrome in adults - What do we know? : A clinical update
- 2018
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In: Sleep Medicine Reviews. - : Saunders Elsevier. - 1087-0792 .- 1532-2955. ; 38, s. 28-38
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Research review (peer-reviewed)abstract
- Research in sleep medicine over the last decades has involved a broad variety of sleep disorders in both men and women. Gender differences have been identified in sleep physiology as well as in the three most common sleep disorders: obstructive sleep apnoea (OSA), insomnia and restless legs syndrome (RLS). However, research on gender differences in sleep medicine appears limited. This clinical review aims to give an updated overview of gender differences, in relation to prevalence, clinical presentation, treatment and quality of life in OSA, insomnia and RLS. Future research directions in the adult population will also be discussed. (C) 2017 Elsevier Ltd. All rights reserved.
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| 22. |
- Theorell-Haglöw, Jenny, et al.
(author)
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Predictors for Development of Excessive Daytime Sleepiness in Women : A Population-Based 10-Year Follow-Up
- 2015
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In: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 38:12, s. 1995-2002
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Journal article (peer-reviewed)abstract
- Study Objectives:To analyze predictors of excessive daytime sleepiness (EDS) and to analyze how changes within risk factors over time predict incident EDS in women.Design:Population-based prospective study.Setting:General population of the City of Uppsala, Sweden.Participants:From a random, general population sample of 7,051 women from the Sleep and HEalth in women (“SHE”) cohort, 4,322 women without EDS at baseline were followed up after 10 y.Interventions:N/A.Measurements and Results:At baseline and follow-up, women answered a questionnaire on sleeping habits, somatic disease, obesity, insomnia, anxiety and depression, lifestyle, and social factors. The risk of incident EDS was analyzed from changes over time in risk factors using logistic regression modeling. Of the women, EDS developed in 7.9%. Incident: insomnia (adjusted odds ratio = 5.01; 95% confidence interval 3.63–6.92), anxiety and/or depression (3.34; 2.22–5.02), somatic disease (1.73; 1.17–2.55), obesity (1.91; 1.14–2.57), snoring (1.91; 1.17–3.10) and smoking (4.31; 1.95–9.54) were all independent risk factors for the development of EDS. In addition, persistent: insomnia (4.44; 2.97–6.65) and anxiety and/or depression (4.91; 3.17–7.62) increased the risk of developing EDS. Apart from incident: snoring and obesity, similar results were obtained when only including women without somatic disease in the analyses.Conclusion:Insomnia, anxiety and/or depression, and smoking were the most important factors for predicting incident excessive daytime sleepiness (EDS) and, in addition, somatic disease, obesity, and snoring predicted EDS. It is important not only to treat these conditions but also to inform women of the importance of a healthy lifestyle in order to prevent and reduce EDS in women.
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| 23. |
- Theorell-Haglöw, Jenny, et al.
(author)
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Sex differences in reported and objectively measured sleep in COPD
- 2016
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In: The International Journal of Chronic Obstructive Pulmonary Disease. - 1176-9106 .- 1178-2005. ; 11, s. 151-160
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Journal article (peer-reviewed)abstract
- Background: The aim was to assess and compare reported sleep disturbances and objectively measured sleep in men and women with COPD compared with controls and also explore sex differences. Methods: A total of 96 patients with COPD and 90 age-and sex-matched controls answered a sleep questionnaire, underwent ambulatory polysomnography, a post-bronchodilatory spirometry, and blood sampling. Results: Of the patients with COPD, 51% reported sleep disturbances as compared with 31% in controls (P= 0.008). Sleep disturbances were significantly more prevalent in males with COPD compared with controls, whereas there was no significant difference in females. The use of hypnotics was more common among patients with COPD compared with controls, both in men (15% vs 0%, P= 0.009) and women (36% vs 16%, P= 0.03). The men with COPD had significantly longer recorded sleep latency than the male control group (23 vs 9.3 minutes, P<0.001), while no corresponding difference was found in women. In men with COPD, those with reported sleep disturbances had lower forced vital capacity, higher C-reactive protein, myeloperoxidase, and higher prevalence of chronic bronchitis. Conclusion: The COPD was associated with impaired sleep in men while the association was less clear in women. This was also confirmed by recorded longer sleep latency in male subjects with COPD compared with controls.
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| 24. |
- Theorell-Haglöw, Jenny, et al.
(author)
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Sleep Duration and Obesity in Adults : What Are the Connections?
- 2016
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In: Current Obesity Reports. - : Springer Science and Business Media LLC. - 2162-4968. ; 5:3, s. 333-343
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Journal article (peer-reviewed)abstract
- Collectively, cross-sectional and longitudinal studies on self-reported sleep duration and obesity do not show a clear pattern of association with some showing a negative linear relationship, some showing a U-shaped relationship, and some showing no relationship. Associations between sleep duration and obesity seem stronger in younger adults. Cross-sectional studies using objectively measured sleep duration (actigraphy or polysomnography (PSG)) also show this mixed pattern whereas all longitudinal studies to date using actigraphy or PSG have failed to show a relationship with obesity/weight gain. It is still too early and a too easy solution to suggest that changing the sleep duration will cure the obesity epidemic. Given novel results on emotional stress and poor sleep as mediating factors in the relationship between sleep duration and obesity, detection and management of these should become the target of future clinical efforts as well as future research.
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