ORCID Profile
0000-0003-2819-2799
Current Organisations
Uppsala University Hospital
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Uppsala University
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Publisher: Wiley
Date: 08-04-2020
DOI: 10.1111/JSR.13041
Publisher: Wiley
Date: 09-03-2021
DOI: 10.1111/JSR.13284
Abstract: Sleep problems and short sleep duration have been linked to adverse health effects, such as cardiovascular disease and diabetes, but the mechanisms are not fully understood. Finding biomarkers could explain mechanistic pathways and help in understanding relationships between sleep and cardiometabolic health. The aim was to assess if sleep duration and sleep quality affect the cardiometabolic‐related protein profile. In total, 242 proteins related to cardiometabolic health were measured in 2,430 plasma s les (male:female ratio 1:1, aged 45–75 years) from the population‐based EpiHealth cohort, using a proximity extension assay. The association of self‐reported sleep duration and sleep quality with each of the 242 proteins (primary outcome) was assessed with linear regression modelling, adjusting for confounders, and corrected for multiple testing using the false discovery rate (5%). Potential effect modification of age and sex was also tested using an interaction term. We identified U‐shaped associations between sleep duration and the plasma levels of the proteins follistatin (more prominent in younger in iduals), matrix metallopeptidase 9 (men only), urokinase receptor, adrenomedullin and kidney injury molecule, all previously known to be related to cardiovascular risk. There was no relationship between sleep quality and any of the proteins, after adjustment for confounders. These results give new leads to investigate the potential mechanistic pathways between sleep and cardiometabolic health.
Publisher: Oxford University Press (OUP)
Date: 11-2012
DOI: 10.5665/SLEEP.2202
Publisher: Oxford University Press (OUP)
Date: 04-2020
DOI: 10.1093/SLEEP/ZSAA056.457
Abstract: Insomnia disorder has a very weak link to polysomnography (PSG) and so does sleep problems in the general population. The reason for this is not clear. One possibility is that the perception of disturbed sleep may be related to immune activation or anxiety/depression, without impairment of objective sleep. 400 women participated, constituting a representative s le of the city of Uppsala with overs ling of snorers. Insomniacs (N=41) were compared with normal sleepers in terms of polysomnography (PSG), immune parameters, anxiety and depression The results (after adjustment for age and BMI) show that C-reactive protein (CRP) reached a higher level (4.4±.5) in insomniacs (vs 2.3±.2 for normal sleepers) (p=.003) and lower subjective health (p=.000), while anxiety (p=.000) and depression (p=.000) (Hospital Anxiety and Depression Scale (HAD)) showed higher levels. PSG sleep continuity variables lacked association with insomnia, as did all sleep stage variables except for REM%, with a lower level in the insomnia group (p=.021). Interleukin 6 and Tumor Necrosis Factor alpha were not related to insomnia. CRP levels did not correlate significantly with anxiety or depression, but with subjective health (r=-.21, p=.000). A logistic regression analysis (excluding the variable subjective health) with insomnia as outcome (0/1) yielded as predictors CRP (OR=1.14, Ci= 1.05 1.24, p=.000), depression (OR=1.21, Ci=1.06 .38, p=.000) and anxiety (OR=1.15, Ci=1.02 .30, p=.021). It was concluded that increased CRP levels may be part of the subjective experience of insomnia. No external funding
Publisher: European Respiratory Society (ERS)
Date: 10-2020
DOI: 10.1183/23120541.00214-2020
Abstract: Obesity is often associated with lower lung function however, the interaction of lung function with central obesity and physical inactivity is less clear. As such, we investigated the effect on lung function of body size (body mass index (BMI)), central obesity (waist circumference (WC)) and self-reported physical activity. Lung function, height, weight and WC were measured in 22 743 participants (12 791 women), aged 45–75 years, from the EpiHealth cohort study. Physical activity, gender and educational level were assessed using a questionnaire. Obesity, central obesity and physical inactivity were all associated with lower forced expiratory volume in 1 s (FEV 1 ) and forced vital capacity (FVC). However, in participants without central obesity there was an increase in both FEV 1 and FVC by BMI (% predicted FVC increasing from median 98%, interquartile range (IQR) 89–110% in underweight participants (BMI ) to 103%, IQR 94–113% in obese participants (BMI ≥30)). In contrast, there was a decrease in % predicted FVC in participants with central obesity (from 98%, IQR 89–109% in the normal weight group to 95%, IQR 85–105% in the obese weight group). We further found a negative association between physical activity and lung function among those with low and high levels of physical activity (% predicted FEV 1 97%, IQR 86–107% versus 103%, IQR 94–113%, respectively and % predicted FVC 96%, IQR 85–106% versus 103%, IQR 94–113%, respectively). All results remained when calculated by z-scores. The association between BMI and lung function is dependent on the presence of central obesity. Independent of obesity, there is an association between physical activity and lung function.
Publisher: Informa UK Limited
Date: 2016
DOI: 10.2147/COPD.S94268
Publisher: Wiley
Date: 17-01-2017
DOI: 10.1111/JSR.12478
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 s les. 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 f
Publisher: BMJ
Date: 11-2020
DOI: 10.1136/BMJOPEN-2020-040396
Abstract: Chronic hypoxic and hypercapnic respiratory failure and obstructive sleep apnoea (OSA) are chronic diseases associated with decreased quality of life and increased mortality. The rationale behind the set up the retrospective nationwide DISCOVERY cohort was to study several questions including disease course and risk factors for incident disease, impaired quality of life, hospitalisation risk and mortality in patients with chronic respiratory failure with long-term oxygen therapy (LTOT), long-term mechanical ventilation (LTMV) and obstructive sleep apnoea (OSA) on treatment with continuous positive airway pressure (CPAP). Data from the national quality registry for respiratory insufficiency and sleep apnoea (Swedevox) and a population-based control group from Statistics Sweden were merged with governmental registries, the Swedish Cancer Registry, the Swedish Cause of Death Registry, the Swedish Drug registry, the Swedish National Patient Registry and the Swedish Dental Health Registry and with national quality registries for diabetes, rheumatic diseases (Swedish Rheumatology Quality Registry), stroke (RiksStroke), heart failure (RiksSvikt), acute heart infarction care (SwedeHeart) and intensive care (SIR) and with socioeconomic data from Statistics Sweden (SCB). The cohort comprises 25 804 unique patients with LTOT since 1987 (54.1% females, age 73.3±9.8 years, body mass index (BMI) 26.6±6.5 kg/m 2 ), 8111 with LTMV since 1996 (48.6% women, age 60.6±16.9 years, BMI 32.9±10.8 kg/m 2 ), 65 809 with OSA on CPAP since 2010 (29.5% women, age 57.2±12.5 years, BMI 31.9±6.2 kg/m 2 ) and 145 224 persons in a population-based control group from same time span up to March 2018 (51.7% women, age 49.9±20.4 year, BMI 24.9±4.0 years). In patients with chronic respiratory failure and sleep apnoea important questions regarding comorbidity burden, hospitalisation rate, mortality and treatment outcomes are still unexplored to a large extent. The DISCOVERY cohort will provide unique opportunities by its size and comprehensiveness to fill this clinically relevant gap of knowledge.
Publisher: Oxford University Press (OUP)
Date: 2022
DOI: 10.1093/SLEEPADVANCES/ZPAC028
Abstract: The relationship between sleep duration and sleepiness has seen much research, but no data are available on the association between polysomnographically (PSG) determined total sleep time (TST) (or other PSG variables) and subjective sleepiness during the subsequent day in in iduals in their habitual life situation. The purpose of the present study was to study the association between TST and sleep efficiency (SE) (and other PSG variables) and next-day sleepiness at 7 times of the day. A large population-based group of women (N = 400) participated. Daytime sleepiness was measured with the Karolinska Sleepiness Scale (KSS). The association was studied through analysis of variance (ANOVA), as well as regression analyses. For SE there was a significant difference in sleepiness across groups with & %, 80%–89.99%, and & % SE (F = 7.2, p & .001, eta2 = 0.04), with lowest sleepiness in the first group. In contrast, TST groups of & h, 6–6.99 h, and ≥7 h did not differ significantly. In addition, a pronounced U-shape (eta2 & 0.45) was seen for both analyses, with maximum sleepiness at bedtime (≈ 7.5 KSS units). A multiple regression analysis, including all PSG variables (adjusted for age and BMI), showed that SE was a significant predictor (β = 0.16, p & .05) of mean sleepiness, even after depression, anxiety, and subjective sleep duration were entered, but this was eliminated by subjective sleep quality. It was concluded that high SE is modestly associated with lower next-day sleepiness in women in a real-life context, but that TST is not.
Publisher: Elsevier BV
Date: 11-2018
DOI: 10.1016/J.SLEEP.2018.07.004
Abstract: Combined insomnia and obstructive sleep apnea has been the focus of considerable research with respect to its health effects. A related issue is whether sleep disturbances in combination with snoring might exert effects on objective sleep variables in the non-clinical general population. The purpose of the present study was to investigate the polysomnographical characteristics of in iduals who had sought medical help for both disturbed sleep and for snoring. No previous work of this type has been carried out. For this study we used a representative set of data of 384 women with one night of in-home PSG. We identified those in iduals who had sought medical help for sleep problems (SL), in iduals that had sought help for snoring (SN), as well as those that had sought help for either both (Combined), or for neither (Control). Our results yielded an N of 46, 16, 21, and 301 in iduals, respectively. A one-factor analysis of variance showed significant main effects on N1% (F = 10.2, p < 0.001), N3% (F = 2.7, p < 0.05), AHI/h (F = 5.5, p < 0.001), and a delta power measure (F = 3.8, p < 0.05). The combined group showed significantly higher levels than the other groups for N1% (29% vs < 21%), AHI/h (19/h vs < 10/h) and lower levels for N3%, and a measure of delta power. Reported sleep quality measures did not show the same pattern, since the highest/lowest value were found for either the group presenting snoring alone or sleep problems alone. We concluded that in iduals who had sought help for both insomnia and snoring showed impaired sleep in terms of PSG and that this was not reflected in ratings of sleep or health. This suggests that simultaneous sleep disturbances and snoring may potentiate each other to cause impaired sleep, yet the mechanism still needs to be elucidated.
Publisher: Wiley
Date: 20-06-2023
DOI: 10.1111/JSR.13968
Abstract: Telemonitoring of obstructive sleep apnea patients is increasingly being adopted though its cost‐effectiveness evidence base is scanty. This study investigated whether telemonitoring is a cost‐effective strategy compared with the standard follow‐up in patients with obstructive sleep apnea who are starting continuous positive airway pressure treatment. In total, 167 obstructive sleep apnea patients were randomised into telemonitoring ( n = 79) or standard follow‐up ( n = 88), initiated continuous positive airway pressure treatment, and were followed up for 6 months. The frequencies of healthcare contacts, related costs (in USD 2021 prices), treatment effect and compliance were compared between the follow‐up approaches using generalised linear models. The cost effectiveness analysis was conducted from a healthcare perspective and the results presented as cost per avoided extra clinic visit. Additionally, patient satisfaction between the two approaches was explored. The analysis showed no baseline differences. At follow‐up, there was no significant difference in treatment compliance, and the mean residual apnea–hypoapnea index. There was no difference in total visits, adjusted incidence rate ratio 0.87 (0.72–1.06). Participants in the telemonitoring arm made eight times more telephone visits, 8.10 (5.04–13.84), and about 73% fewer physical healthcare visits 0.27 (0.20–0.36). This translated into significantly lower total costs for the telemonitoring approach compared with standard follow‐up, −192 USD (−346 to −41). The form of follow‐up seemed to have no impact on the extent of patient satisfaction. These results demonstrate the telemonitoring of patients with obstructive sleep apnea initiating continuous positive airway pressure treatment as a cost saving strategy and can be argued as a potential worthy investment.
Publisher: Wiley
Date: 27-09-2022
DOI: 10.1111/JSR.13725
Abstract: Accelerometers placed on the thigh provide accurate measures of daily physical activity types, postures and sedentary behaviours, over 24 h and across consecutive days. However, the ability to estimate sleep duration or quality from thigh-worn accelerometers is uncertain and has not been evaluated in comparison with the 'gold-standard' measurement of sleep polysomnography. This study aimed to develop an algorithm for sleep estimation using the raw data from a thigh-worn accelerometer and to evaluate it in comparison with polysomnography. The algorithm was developed and optimised on a dataset consisting of 23 single-night polysomnography recordings, collected in a laboratory, from 15 asymptomatic adults. This optimised algorithm was then applied to a separate evaluation dataset, in which, 71 adult males (mean [SD] age 57 [11] years, height 181 [6] cm, weight 82 [13] kg) wore ambulatory polysomnography equipment and a thigh-worn accelerometer, simultaneously, whilst sleeping at home. Compared with polysomnography, the algorithm had a sensitivity of 0.84 and a specificity of 0.55 when estimating sleep periods. Sleep intervals were underestimated by 21 min (130 min, Limits of Agreement Range [LoAR]). Total sleep time was underestimated by 32 min (233 min LoAR). Our results evaluate the performance of a new algorithm for estimating sleep and outline the limitations. Based on these results, we conclude that a single device can provide estimates of the sleep interval and total sleep time with sufficient accuracy for the measurement of daily physical activity, sedentary behaviour, and sleep, on a group level in free-living settings.
Publisher: European Respiratory Society
Date: 28-09-2019
Publisher: Springer Science and Business Media LLC
Date: 05-05-2014
DOI: 10.1007/S00405-014-3067-6
Abstract: The aim of the study was to analyse the impact of self-reported nasal obstruction on sleep quality in women. A community-based s le 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 sub ided 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.
Publisher: Elsevier BV
Date: 09-2006
Publisher: American Academy of Sleep Medicine (AASM)
Date: 15-02-2019
DOI: 10.5664/JCSM.7616
Publisher: European Respiratory Society (ERS)
Date: 26-01-2023
DOI: 10.1183/23120541.00321-2022
Abstract: Epidemiological studies have shown that impaired lung function is common and associated with increased risk of cardiovascular disease. Increased levels of several inflammatory and cardiovascular disease-related plasma proteins have been associated with impaired lung function. The aim was to study the association between plasma proteomics and forced expiratory volume in 1 s (FEV 1 ), forced vital capacity (FVC) and FEV 1 /FVC ratio. We used a discovery and replication approach in two community-based cohorts, EpiHealth and the Malmö Offspring Study (total n=2874), to cross-sectionally study 242 cardiovascular disease- and metabolism-linked proteins in relation to FEV 1 , FVC (both % predicted) and FEV 1 /FVC ratio. A false discovery rate of 5% was used as the significance threshold in the discovery cohort. Plasma fatty acid-binding protein 4, interleukin-1 receptor antagonist, interleukin-6 and leptin were negatively associated with FEV 1 and paraoxonase 3 was positively associated therewith. Fatty acid-binding protein 4, fibroblast growth factor 21, interleukin-1 receptor antagonist, interleukin-6 and leptin were negatively associated with FVC and agouti-related protein, insulin-like growth factor-binding protein 2, paraoxonase 3 and receptor for advanced glycation end products were positively associated therewith. No proteins were associated with FEV 1 /FVC ratio. A sensitivity analysis in EpiHealth revealed only minor changes after excluding in iduals with known cardiovascular disease, diabetes or obesity. Five proteins were associated with both FEV 1 and FVC. Four proteins associated with only FVC and none with FEV 1 /FVC ratio, suggesting associations mainly through lung volume, not airway obstruction. However, additional studies are needed to investigate underlying mechanisms for these findings.
Publisher: Elsevier BV
Date: 09-2021
Publisher: European Respiratory Society
Date: 04-09-2022
Publisher: European Respiratory Society (ERS)
Date: 19-11-2020
DOI: 10.1183/23120541.00340-2020
Abstract: The Swedish Registry of Respiratory Failure (Swedevox) collects nationwide data on patients starting continuous positive airway pressure (CPAP) treatment, long-term mechanical ventilator (LTMV) and long-term oxygen therapy (LTOT). We validated key information in Swedevox against source data from medical records. This was a retrospective validation study of patients starting CPAP (n=175), LTMV (n=177) or LTOT (n=175) across seven centres 2013–2017. Agreement with medical record data was analysed using differences in means ( sd ) and proportion (%) of a selection of clinically relevant variables. Variables of interest included for CPAP: apnoea–hypopnoea index (AHI), height, weight, body mass index (BMI) and Epworth Sleepiness Scale (ESS) score for LTMV: date of blood gas, arterial carbon dioxide tension ( P aCO 2 ) (breathing air), weight and diagnosis group and for LTOT: blood gases breathing air and oxygen, spirometry and main diagnosis. Data on CPAP and LTOT had very high validity across all evaluated variables (all % discrepancy). For LTMV, variability was higher against source information for P aCO 2 ( .5 kPa in 25.9%), weight ( kg in 47.5%) and diagnosis group. Inconsistency was higher for patients starting LTMV acutely versus electively ( P aCO 2 difference .5 kPa in 36% versus 21%, p .05, respectively). However, there were no signs of systematic bias (mean differences close to zero) across the evaluated variables. Validity of Swedevox data, compared with medical records, was very high for CPAP, LTMV and LTOT. The large s le size and lack of systematic differences support that Swedevox data are valid for healthcare quality assessment and research.
Publisher: Elsevier BV
Date: 12-2021
Publisher: Elsevier BV
Date: 02-2012
Publisher: Wiley
Date: 12-04-2022
DOI: 10.1111/JSR.13599
Abstract: Rapid eye movement (REM) obstructive sleep apnea might be particularly harmful to the cardiovascular system. We aimed to investigate the association between sleep apnea during REM sleep and signs of atherosclerotic disease in the form of carotid intima thickness in a community-based s le of men and women and possible sex differences in this association. The association between sleep apnea during REM sleep and intima thickness was analysed cross-sectionally in women from the community-based "Sleep and Health in Women" (SHE) study (n = 253) and age- and body mass index (BMI)-matched men from the "Men in Uppsala a Study of sleep, Apnea and Cardiometabolic Health" (MUSTACHE) study (n = 338). Confounders adjusted for were age, BMI, gender, alcohol, and smoking. All participants underwent a full-night polysomnography, high-resolution ultrasonography of the common carotid artery, anthropometric measurements, blood pressure measurements, and answered questionnaires. There was an association between sleep apnea during REM sleep and thicker carotid intima that remained after adjustment for confounding (adjusted β = 0.008, p = 0.032). The intima was increased by 9.9% in the group with severe sleep apnea during REM sleep, and this association between severe sleep apnea during REM sleep and increased intima thickness remained after adjustment for confounders (adjusted β = 0.043, p = 0.021). More women than men had severe sleep apnea during REM sleep moreover, in sex-stratified analyses, the association between sleep apnea during REM sleep and intima thickness was found in women but not in men. We conclude that severe REM sleep apnea is independently associated with signs of atherosclerosis. When stratified by sex, the association is seen in women but not in men.
Publisher: European Respiratory Society
Date: 11-04-2019
Publisher: Oxford University Press (OUP)
Date: 05-2010
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.SLEEP.2018.03.009
Abstract: 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. 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. A total of 18,823 participants (mean age = 60 ys) were included in this study. The reported prevalence of short ( 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 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.
Publisher: Elsevier BV
Date: 12-2017
Publisher: Elsevier BV
Date: 12-2017
Publisher: Stichting Nase
Date: 05-2020
DOI: 10.4193/RHIN19.189
Publisher: BMJ
Date: 03-2023
DOI: 10.1136/BMJOPEN-2022-064501
Abstract: Nocturnal hypoxia in obstructive sleep apnoea (OSA) is a potential risk factor for cancer. We aimed to investigate the association between OSA measures and cancer prevalence in a large national patient cohort. Cross-sectional study. 44 sleep centres in Sweden. 62 811 patients from the Swedish registry for positive airway pressure (PAP) treatment in OSA, linked to the national cancer registry and national socioeconomic data (the course of DIsease in patients reported to Swedish CPAP, Oxygen and VEntilator RegistrY cohort). After propensity score matching for relevant confounders (anthropometric data, comorbidities, socioeconomic status, smoking prevalence), sleep apnoea severity, measured as Apnoea-Hypopnoea Index (AHI) or Oxygen Desaturation Index (ODI), were compared between those with and without cancer diagnosis up to 5 years prior to PAP initiation. Subgroup analysis for cancer subtype was performed. OSA patients with cancer (n=2093) (29.8% females, age 65.3 (SD 10.1) years, body mass index 30 (IQR 27–34) kg/m 2 ) had higher median AHI (n/hour) (32 (IQR 20–50) vs 30 (IQR 19–45), n/hour, p=0.002) and median ODI (n/hour) (28 (IQR 17–46) vs 26 (IQR 16–41), p .001) when compared with matched OSA patients without cancer. In subgroup analysis, ODI was significantly higher in OSA patients with lung cancer (N=57 38 (21–61) vs 27 (16-43), p=0.012)), prostate cancer (N=617 28 (17–46) vs 24, (16–39)p=0.005) and malignant melanoma (N=170 32 (17–46) vs 25 (14–41),p=0.015). OSA mediated intermittent hypoxia was independently associated with cancer prevalence in this large, national cohort. Future longitudinal studies are warranted to study the potential protective influence of OSA treatment on cancer incidence.
Publisher: Oxford University Press (OUP)
Date: 28-04-2017
Publisher: BMJ
Date: 06-2021
DOI: 10.1136/BMJOPEN-2020-044911
Abstract: Habitual snoring is associated with fatigue, headaches and low work performance. This cross-sectional study aimed to investigate if snoring is affected by environmental factors such as home d ness and exposure to air pollution. General population s le from four Swedish cities. 25 848 participants from the Swedish part of the epidemiological Global Asthma and Allergy and European network of excellence study carried out in 2008. The participants completed a postal questionnaire on snoring and, indoor and outdoor environmental exposure as well as potential confounders including smoking, weight, height and educational level. Of the participants, 4211 (16.3%) were habitual snorers. Habitual snorers reported water damage (8.3% vs 7.0% p .0001), floor d ness (4.6% vs 3.8% % p .0001) and visible mould (5.2% vs 3.8% p .0001) in their homes more often than non-snorers. Habitual snorers stated being annoyed by air pollution more often than non-snorers with habitual snorers reporting being irritated with the air in their residential area to a higher extent (sometimes 16.2% vs 13.9%, and daily 4.6% vs 3.1%) as well as annoyance from traffic fumes (somewhat 19% vs 18.5% and very 5% vs 3.6%) (p .0001). These results remained significant after adjustment for age, body mass index, smoking history and educational level. Snoring is more prevalent in subjects reporting home d ness and air pollution. These association should be confirmed in further research using objective measurements and a longitudinal approach.
Publisher: Elsevier BV
Date: 09-2023
Publisher: Elsevier BV
Date: 08-2023
Publisher: Elsevier BV
Date: 11-2008
Abstract: The aim was to investigate the significance of snoring and sleep apnea on daytime symptoms in a population-based s le of women. From the general population, 400 women aged 20 to 70 years were randomly selected, with overs ling of habitually snoring women. The women were investigated using full-night polysomnography and a questionnaire. The apnea-hypopnea index (AHI) was calculated, and women who acknowledged snoring loudly and disturbingly often or very often were considered habitual snorers. Habitual snoring was independently related to excessive daytime sleepiness (odds ratio [OR], 2.28 95% confidence interval [CI], 1.31 to 3.99), to falling asleep involuntarily during the day (OR, 2.11 95% CI, 1.06 to 4.21), to waking up unrefreshed (OR, 2.14 95% CI, 1.30 to 3.52), to daytime fatigue (OR, 2.77 95% CI, 1.54 to 4.99), and to a dry mouth on awakening (OR, 2.00 95% CI, 1.22 to 3.27) after adjustment for AHI, age, body mass index (BMI), smoking, total sleep time, percentage of slow-wave sleep, and percentage of rapid eye movement (REM) sleep. An AHI > or = 15/h was only related to a dry mouth on awakening after adjustment for snoring, age, BMI, smoking, total sleep time, percentage of slow-wave sleep, and percentage of REM sleep (OR, 2.24 95% CI, 1.14 to 4.40). An AHI of 5 to 15/h was not related to any daytime symptom. Excessive daytime sleepiness and daytime fatigue are related to habitual snoring independent of the apnea-hypopnea frequency, age, obesity, smoking, and sleep parameters in a population-based s le of women, but not to the AHI. This indicates that snoring is an independent cause of excess daytime sleepiness and not merely a proxy for sleep apnea.
Publisher: Elsevier BV
Date: 12-2017
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.SMRV.2017.03.003
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.
Publisher: Elsevier BV
Date: 10-2014
DOI: 10.1016/J.SLEEP.2014.02.014
Abstract: To assess how change in sleep duration is related to subsequent obesity. In this 10-year follow-up, 4903 non-pregnant participants answered a questionnaire on sleeping habits, obesity, and lifestyle factors (questions identical to baseline questionnaire). Habitual normal sleepers were defined as sleeping 6-9 h/night at both baseline and follow-up, whereas women sleeping <6 h/night or ≥9 h/night at both occasions were defined as habitual short sleepers and habitual long sleepers, respectively. Logistic regression was used to analyze associations between changes in sleep duration, general obesity (body mass index ≥30 kg/m(2)), weight gain (≥10 kg) and also, central obesity (waist circumference ≥88 cm), and increase in waist circumference (≥10 cm) at follow-up. Among younger women (aged <40 years) both habitual short sleepers and habitual long sleepers had a higher prevalence of general (short: 31.3%, P 40 years at baseline. In younger women, both habitual short and long sleep duration was a risk factor for obesity, whereas no such relationship was seen in older women.
Publisher: Elsevier BV
Date: 04-2014
Publisher: Elsevier BV
Date: 12-2017
Publisher: European Respiratory Society
Date: 04-09-2022
Publisher: European Respiratory Society (ERS)
Date: 09-01-2008
DOI: 10.1183/09031936.00074907
Abstract: The aim of the present study was to assess associations between obstructive sleep apnoea and insulin sensitivity in a population-based s le of females. In total, 400 females aged 20-70 yrs underwent a full-night polysomnography, fasting blood s ling, measurement of anthropometric variables and oral glucose tolerance test with measurement of the insulin response (n = 358). The apnoea/hypopnoea index (AHI) was calculated from the results of the polysomnography. From the results of the oral glucose tolerance test, an insulin sensitivity index (ISI) was calculated. Females with an AHI or = 30 (n = 34) had an ISI of 6.2+/-4.0. Nocturnal minimal saturation was independently associated with decreased insulin sensitivity when controlling for age, waist/hip ratio, level of physical activity, smoking and alcohol consumption (95% confidence interval (CI) 0.004-0.14). When adjusting for confounders, the AHI was associated with increased fasting and 2-h insulin levels (95% CI 0.14-0.99 and 95% CI 0.28-6.47, respectively). Obstructive sleep apnoea was found to be independently associated with decreased insulin sensitivity in the present population-based s le of females.
Publisher: American Academy of Sleep Medicine (AASM)
Date: 07-2022
DOI: 10.5664/JCSM.9928
Publisher: Springer Science and Business Media LLC
Date: 02-07-2016
DOI: 10.1007/S13679-016-0225-8
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.
Publisher: Oxford University Press (OUP)
Date: 12-2015
DOI: 10.5665/SLEEP.5258
Publisher: Oxford University Press (OUP)
Date: 06-2006
Abstract: To analyze the relation between different risk factors and excessive daytime sleepiness (EDS) and fatigue in women from a general-population s le. Cross-sectional population study. The municipality of Uppsala, Sweden. Five thousand five hundred eight women (response rate 73.3%) aged 20 to 60 years. EDS, fatigue, and potential risk factors were assessed in a self-administered questionnaire. Risk factors for EDS and fatigue were analyzed using a multiple logistic regression model. In the whole population, 16.1% of the women reported EDS and 14.3% fatigue. The risk of having EDS and fatigue decreased with increasing age: adjusted odds ratios (95% confidence interval) for EDS and fatigue were 0.73 (0.66-0.88) and 0.86 (0.77-0.96) per 10 years, respectively. The combination of anxiety and depression was highly related to both EDS and fatigue (4.51 [3.51-5.79] and 7.00 [5.39-9.10], respectively). Insomnia, somatic disease, snoring, being overweight, and being on sick leave were also independently related to both conditions, whereas lifestyle factors, such as physical inactivity and smoking, were related to fatigue but not to EDS. Having children did not influence the risk of either EDS or fatigue. Psychological distress, insomnia, and somatic disease are the most important conditions in women reporting daytime sleepiness and fatigue. Because 1 in 5 (21%) of the women in this study reported sleepiness, fatigue, or both, interventions that improve psychiatric health and reduce insomnia are important in improving the quality of life in women with these sleep symptoms.
Publisher: Elsevier BV
Date: 12-2017
Publisher: Oxford University Press (OUP)
Date: 04-09-2021
Abstract: In iduals with evening chronotype have a higher risk of cardiovascular and metabolic disorders, although the underlying mechanisms are not well understood. In a population-based cohort, we aimed to investigate the association between chronotype and 242 circulating proteins from three panels of established or candidate biomarkers of cardiometabolic processes. In 2,471 participants (49.7% men, mean age 61.2 ± 8.4 SD years) from the EpiHealth cohort, circulating proteins were analyzed with a multiplex proximity extension technique. Participants self-reported their chronotype on a five-level scale from extreme morning to extreme evening chronotype. With the intermediate chronotype set as the reference, each protein was added as the dependent variable in a series of linear regression models adjusted for confounders. Next, the chronotype coefficients were jointly tested and the resulting p-values adjusted for multiple testing using a false discovery rate (5%). For the associations identified, we then analyzed the marginal effect of each chronotype category. We identified 17 proteins associated with chronotype. Evening chronotype was positively associated with proteins previously linked to insulin resistance and cardiovascular risk, namely retinoic acid receptor protein 2, fatty acid-binding protein adipocyte, tissue-type plasminogen activator, and plasminogen activator inhibitor 1 (PAI-1). Additionally, PAI-1 was inversely associated with the extreme morning chronotype. In this population-based study, proteins previously related to cardiometabolic risk were elevated in the evening chronotypes. These results may guide future research in the relation between chronotype and cardiometabolic disorders.
Publisher: Cold Spring Harbor Laboratory
Date: 14-06-2022
DOI: 10.1101/2022.06.10.22276241
Abstract: Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder. In animal models, OSA has been shown to alter the gut microbiota however, little is known about such effects in humans. Here, we used respiratory polygraphy data from 3,570 in iduals aged 50–64 from the Swedish CardioPulmonary bioImage Study (SCAPIS) and deep shotgun metagenomics to identify OSA-associated gut microbiota features. We found that OSA-related hypoxia parameters were associated with 128 bacterial species, including positive associations with Blautia obeum and Collinsela aerofacines . The latter was also associated with increased systolic blood pressure. Further, the cumulative time in hypoxia was associated with nine gut microbiota metabolic pathways, including propionate production from lactate, a biomarker of hypoxia. In conclusion, in this first large-scale study on gut microbiota alterations in OSA, we found that OSA-related hypoxia is associated with specific microbiota features. Our findings can direct future research on microbiota-mediated health effects of OSA.
Publisher: MDPI AG
Date: 20-03-2023
DOI: 10.3390/DIAGNOSTICS13061179
Abstract: Introduction: This paper describes the development of “Swedish Guidelines for OSA treatment” and the underlying managed care process. The Apnea Hypopnea Index (AHI) is traditionally used as a single parameter for obstructive sleep apnea (OSA) severity classification, although poorly associated with symptomatology and outcome. We instead implement a novel matrix for shared treatment decisions based on available evidence. Methods: A national expert group including medical and dental specialists, nurses, and patient representatives developed the knowledge-driven management model. A Delphi round was performed amongst experts from all Swedish regions (N = 24). Evidence reflecting treatment effects was extracted from systematic reviews, meta-analyses, and randomized clinical trials. Results: The treatment decision in the process includes a matrix with five categories from a “very weak”” to “very strong” indication to treat, and it includes factors with potential influence on outcome, including (A) OSA-related symptoms, (B) cardiometabolic comorbidities, (C) frequency of respiratory events, and (D) age. OSA-related symptoms indicate a strong incitement to treat, whereas the absence of symptoms, age above 65 years, and no or well-controlled comorbidities indicate a weak treatment indication, irrespective of AHI. Conclusions: The novel treatment matrix is based on the effects of treatments rather than the actual frequency of respiratory events during sleep. A nationwide implementation of this matrix is ongoing, and the outcome is monitored in a prospective evaluation by means of the Swedish Sleep Apnea Registry (SESAR).
Publisher: American Thoracic Society
Date: 05-2010
DOI: 10.1164/AJRCCM-CONFERENCE.2010.181.1_MEETINGABSTRACTS.A3688
Publisher: Wiley
Date: 04-01-2019
DOI: 10.1111/JSR.12812
Publisher: American Thoracic Society
Date: 05-2010
DOI: 10.1164/AJRCCM-CONFERENCE.2010.181.1_MEETINGABSTRACTS.A6515
Publisher: Springer Science and Business Media LLC
Date: 31-05-2022
DOI: 10.1038/S41598-022-13009-3
Abstract: Although development of microbiota in childhood has been linked to chronic immune-related conditions, early childhood determinants of microbiota development have not been fully elucidated. We used 16S rRNA sequencing to analyse faecal and saliva s les from 83 children at four time-points during their first 2 years of life and from their mothers. Our findings confirm that gut microbiota in infants have low ersity and highlight that some properties are shared with the oral microbiota, although inter-in idual differences are present. A considerable convergence in gut microbiota composition was noted across the first 2 years of life, towards a more erse adult-like microbiota. Mode of delivery accounted for some of the inter-in idual variation in early childhood, but with a pronounced attenuation over time. Our study extends previous research with further characterization of the major shift in gut microbiota composition during the first 2 years of life.
Publisher: Elsevier BV
Date: 2016
DOI: 10.1016/J.SLEEP.2015.09.018
Abstract: 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 s le of women. 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. 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). 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.
Publisher: Wiley
Date: 22-05-2020
DOI: 10.1111/JSR.13093
Publisher: European Respiratory Society
Date: 04-09-2022
Publisher: Elsevier BV
Date: 10-2012
Abstract: It has been suggested that sleep-disordered breathing (SDB) is a risk factor for diabetes, but long-term follow-up studies are lacking. The aim of this community-based study was to analyze the influence of SDB on glucose metabolism after > 10 years. Men without diabetes (N = 141 mean age, 57.5 years) were investigated at baseline, including whole-night respiratory monitoring. After a mean period of 11 years and 4 months, they were followed up with an interview, anthropometric measurements, and blood s ling. Insulin resistance was quantified using the homeostasis model assessment of insulin resistance (HOMA-IR). ΔHOMA-IR was calculated as (HOMA-IR at follow-up − HOMA-IR at baseline). An oral glucose tolerance test was performed on 113 men to calculate the insulin sensitivity index. The mean apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) at baseline were 4.7 and 3.3, respectively. At follow-up, 23 men had diabetes. An ODI > 5 was a predictor of developing diabetes (OR, 4.4 95% CI, 1.1-18.1, after adjusting for age, BMI, and hypertension at baseline and ΔBMI and years with CPAP during follow-up). The ODI was inversely related to the insulin sensitivity index at follow-up (r = −0.27, P = .003). A deterioration in HOMA-IR was significantly related to all variables of SDB (AHI, AHI > 5 ODI, ODI > 5 minimum arterial oxygen saturation), even when adjusting for confounders. When excluding the variable years with CPAP from the multivariate model, all associations weakened. SDB is independently related to the development of insulin resistance and, thereby, the risk of manifest diabetes mellitus.
Publisher: Oxford University Press (OUP)
Date: 28-04-2017
Publisher: Oxford University Press (OUP)
Date: 14-05-2018
DOI: 10.1093/SLEEP/ZSY099
Abstract: 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 s le of women. In the community-based "Sleep and Health in Women" (SHE) cohort study, 400 women underwent polysomnography, anthropometric measurements, blood s ling, 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 in idual thickness of the layers of the artery wall. 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 (β-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. In this study of a community-based s le of women, severe OSA during REM sleep was independently associated with early signs of atherosclerosis.
Publisher: Elsevier BV
Date: 2012
Publisher: European Respiratory Society
Date: 04-09-2022
Publisher: Elsevier BV
Date: 10-2021
Publisher: Elsevier BV
Date: 11-2018
DOI: 10.1016/J.SLEEP.2018.07.007
Abstract: 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. 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. 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). 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.
Publisher: Elsevier BV
Date: 04-2011
DOI: 10.1016/J.SLEEP.2010.06.014
Abstract: The aim of this study was to assess associations between obstructive sleep apnea (OSA) and metabolic syndrome in a population-based s le of women. Four hundred women aged 20-70 years underwent a full-night polysomnography, fasting blood s ling and measurement of anthropometric variables. Metabolic syndrome was defined according to the National Cholesterol Education Program (NCEP) criteria. The NCEP criteria of metabolic syndrome were fulfilled by 104 (26.0%) of the women. The frequency of metabolic syndrome increased from 10.5% in women with apnea-hypopnea-index (AHI) <5 to 57.1% in women with AHI ≥30 (p for trend <0.0001). In the multivariate analysis, the severity of OSA measured as AHI, ODI (oxygen desaturation index), minimal saturation or T(90) (percentage of time during night with saturation <90%) were associated with metabolic syndrome after adjustment for age, level of physical activity, smoking and alcohol consumption. AHI (adj. OR 1.45 95% CI 1.11-1.91), ODI (1.37 1.09-1.73) and minimal saturation level (0.93 0.87-0.99) remained significantly associated with metabolic syndrome also when adjusting for the waist-to-hip-ratio. The three markers of OSA were independently associated with central obesity, hypertriglyceridemia and reduced HDL cholesterol concentration. Measures of OSA were closely associated with metabolic syndrome and its components in this population-based s le of women also after adjustments. Therefore, when the health consequences of sleep-disordered breathing are investigated it is important to consider metabolic syndrome. Sleep-disordered breathing should also be considered when treating patients with metabolic syndrome.
Publisher: Wiley
Date: 25-09-2017
DOI: 10.1111/JSR.12606
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-naïve male patients with obstructive sleep apnea (age = 49 ± 12 years, apnea-hypopnea index = 39.9 ± 17.7 events h
Publisher: American Academy of Sleep Medicine (AASM)
Date: 15-01-2020
DOI: 10.5664/JCSM.8112
Publisher: Wiley
Date: 27-04-2016
DOI: 10.1111/JSR.12407
Abstract: Women complain more about sleep than men, but polysomnography (PSG) seems to suggest worse sleep in men. This raises the question of how women (or men) perceive objective (PSG) sleep. The present study sought to investigate the relation between morning subjective sleep quality and PSG variables in older and younger women. A representative s le of 251 women was analysed in age groups above and below 51.5 years (median). PSG was recorded at home during one night. Perceived poor sleep was related to short total sleep time (TST), long wake within total sleep time (WTSP), low sleep efficiency and a high number of awakenings. The older women showed lower TST and sleep efficiency and higher WTSP for a rating of good sleep than did the younger women. For these PSG variables the values for good sleep in the older group were similar to the values for poor sleep in the young group. It was concluded that women perceive different levels of sleep duration, sleep efficiency and wake after sleep onset relatively well, but that older women adjust their objective criteria for good sleep downwards. It was also concluded that age is an important factor in the relation between subjective and objective sleep.
Publisher: Springer Science and Business Media LLC
Date: 19-06-2020
DOI: 10.1007/S12020-020-02369-3
Abstract: Obstructive sleep apnea (OSA) is associated with obesity and risk for type 2 diabetes. In this community-based study, we thoroughly investigated fatty acid metabolism, incretin response, glucose tolerance, insulin secretion and insulin sensitivity, and autonomic nerve activity in men with or without OSA. Fifteen men without diabetes but with signs of severe OSA, defined as apnea–hypopnea index (AHI) , and 15 age- and BMI-matched men without OSA (AHI 5) were recruited from a community-based cohort. Assessments included clinical and anthropometric measurements, a 2-h oral glucose tolerance test (OGTT), and autonomic nerve activity using heart rate variability (HRV). Men with OSA had higher body fat % than BMI-matched men without OSA ( p = 0.046) and it was associated with markers of insulin resistance. The area under the curve for nonesterified fatty acids (NEFA) during OGTT was higher in men with OSA ( p = 0.021) and fasting NEFA levels were numerically higher ( p = 0.097). The plasma glucose at fasting and during OGTT was higher in men with OSA ( p 0.001). Incretin response was similar between groups. Fasting and OGTT-derived indices indicated impaired insulin sensitivity in men with OSA. Compared with men without OSA, Matsuda index ( p = 0.068) and Gutt index ( p 0.01) were lower in men with OSA. The HRV measures did not differ between groups. Our study suggests that fatty acid handling, glucose tolerance, and insulin sensitivity are impaired in men with severe OSA. This might partly be explained by the increased body fat percentage.
Publisher: Elsevier BV
Date: 09-2012
DOI: 10.1016/J.SLEEP.2012.06.013
Abstract: To assess characteristics of short sleepers and long sleepers and to assess association between sleep duration and central obesity in a population-based s le of women. Non-pregnant women ≥20 years that were randomly selected from the population-registry of Uppsala, Sweden, answered a questionnaire (n=6461) including questions on sleeping habits and somatic disorders. There was a U-shaped association between sleep duration and waist circumference. Short sleeping women (<5 h) had a waist circumference of 89.2±14.9 cm (mean±SD) decreasing to 82.9±11.9 cm for women sleeping 7-<8 h and increasing to 89.0±16.7 cm for women sleeping ≥10 h. Both short sleepers and long sleepers were more often physically inactive, smokers, ill or taking medication, and psychologically distressed than normal sleepers (6-<9 h). In women <50 years both short and long sleep duration were risk factors for central obesity. Short sleep duration remained a risk factor for central obesity, whereas the association with long sleep duration did not reach statistical significance after adjustments. Short sleepers and long sleepers showed differences in characteristics compared to normal sleepers. Furthermore, we showed an independent association between short sleep duration and central obesity, which was strongest in younger women. It is important to identify short sleepers, especially in younger women.
No related grants have been discovered for Jenny Theorell-Haglöw.