Observational and genetic evidence highlight the association of human sleep behaviors with the incidence of fracture

We combined conventional evidence from longitudinal data in UK Biobank and genetic evidence from Mendelian randomization (MR) approach to infer the causality between sleep behaviors and fracture risk. We found that participants with insomnia showed 6.4% higher risk of fracture (hazard ratio [HR] = 1.064, 95% CI = 1.038–1.090, P = 7.84 × 10−7), falls and bone mineral density (BMD) mediated 24.6% and 10.6% of the intermediary effect; the MR analyses provided the consistent evidence. A U-shape relationship was observed between sleep duration and fracture risk (P < 0.001) with the lowest risk at sleeping 7–8 h per day. The excessive daytime sleepiness and “evening” chronotype were associated with fracture risk in observational study, but the association between chronotype and fracture did not show in MR analyses. We further generated a sleep risk score (SRS) with potential risk factors (i.e., insomnia, sleep duration, chronotype, and daytime sleepiness). We found that the risk of fracture increased with an increasing SRS (HR = 1.087, 95% CI = 1.065–1.111, P = 1.27 × 10−14). Moreover, 17.4% of the fracture cases would be removed if all participants exhibited a healthy sleep pattern. In conclusion, insomnia had a causal effect on fracture, falls had a larger intermediary effect than BMD in this association. Individuals with fracture risk could benefit from the intervention on unhealthy sleep pattern.

Examining 24-Hour Activity and Sleep Behaviors and Related Determinants in Latino Adolescents and Young Adults With Obesity

Background. Few studies have examined 24-hour activity and sleep behaviors and their contribution to type 2 diabetes (T2D) in Latino adolescents and young adults with obesity. Aim. This study included quantitative data on T2D risk and 24-hour activity and sleep behaviors and qualitative data on individual, social, and environmental behavioral determinants. Method. A 7 day, 24-hour, wrist-worn accelerometer protocol assessed moderate-to-vigorous physical activity (PA), sedentary behaviors (SB), sleep, and sleep regularity, in adolescents ( N = 38; 12–16 years) and young adults ( N = 22; 18–22 years). T2D-related outcomes included adiposity (BMI, BF%, waist circumference), fasting, and 2-hour glucose. A subsample of participants ( N = 16 adolescents, N = 15 young adults) completed interviews to identify behavioral determinants. Results. High levels of PA were observed among adolescents ( M = 103.8 ± 67.5 minutes/day) and young adults ( M = 96.8 ± 78.8 minutes/day) as well as high levels of SB across both age groups (≥10 hours/day). Sleep regularity was negatively associated with adiposity (all ps < .05) in both age groups as well as fasting and 2-hour glucose in young adults (all ps < .05). Social support was associated with PA in both age groups as well as SB in younger youth. Auditory noises, lights, and safety inhibited sleep in both age groups. Conclusion. PA is critical for disease reduction, yet reducing SB and improving sleep are also important targets for reducing T2D risk in Hispanic adolescents and young adults. Future health promotion and disease prevention strategies should leverage qualitative findings regarding behavioral determinants.

Individual Differences in Concurrent Developmental Trajectories of Pain and Insomnia in Adolescents Are Predicted by Chronotype and Arousal-causing Pre-sleep Behaviors.

The onset of both chronic pain and insomnia is high during adolescence. Although a bidirectional relationship between pain and insomnia has support, how pain and sleep co-develop throughout adolescence remains unknown. Both sleep-wake patterns and pre-sleep behaviors that cause arousal may influence the co-development of pain and insomnia. Four waves of longitudinal self-report data were used (Nbaseline = 2767, Agebaseline M = 13.65 years, SD = 0.65). Multidimensional growth mixture modeling was used to identify four subgroups of adolescents with different concurrent trajectories of pain and insomnia. The trajectories followed each other across time in all classes: one class of consistently low pain and insomnia (68.7 %), one class with persistent high symptoms (4.9 %), as well as one class of increasing (13.9 %), and one of decreasing (12.5 %), trajectories. Later sleep-wake patterns and more pre-sleep behaviors causing cognitive-emotional arousal predicted both increasing and decreasing trajectories of concurrent pain and insomnia. The current study showed that developmental trajectories of pain and insomnia follow each other within adolescents and across adolescence. Both sleep-phase focused interventions as well as psychological interventions that focus on pre-sleep behaviors causing cognitive-emotional arousal may prove beneficial for adolescents with comorbid pain and insomnia.

Measurement of Sleep Behaviors in Chromosome 15q11.2-13.1 Duplication (Dup15q Syndrome)

Duplication of chromosome 15q11.2-q13.1 (dup15q syndrome) results in hypotonia, intellectual disability (ID), and autism symptomatology. Clinical electroencephalography has shown abnormal sleep physiology, but no studies have characterized sleep behaviors. The present study used the Children's Sleep Habits Questionnaire (CSHQ) in 42 people with dup15q syndrome to examine the clinical utility of this questionnaire and quantify behavioral sleep patterns in dup15q syndrome. Individuals with fully completed forms (56%) had higher cognitive abilities than those with partially completed forms. Overall, caregivers indicated a high rate of sleep disturbance, though ratings differed by epilepsy status. Results suggest that clinicians should use caution when using standardized questionnaires and consider epilepsy status when screening for sleep problems in dup15q syndrome.

Association Between Primary School Students’ Unhealthful Behaviors and Overweight/Obesity: A Cross-Sectional Analysis in Urban Kenya

Introduction : Although obesity prevalence is known to be rising in East Africa, research on childhood obesity is still minimal. We conducted a cross-sectional study to examine the prevalence of unhealthful dietary patterns, physical activity and sleep behaviors among primary school children in two urban settings in Kenya and explored the association between the behaviors and overweight/obesity among the children. Methods Six public schools, with children from low-, medium- and high-income households in Nairobi and Kisumu cities were purposively selected to participate in the study. Data was collected on randomly-selected students aged 10–12 years at each school. Students’ weights, heights, waist circumferences, and tricep, bicep, subscapular and suprailiac skinfolds were measured. Body-mass-index-for-age z-scores were used to classify students into underweight, healthy weight, overweight and obese categories. Waist-circumference-to-height ratio above 0.5 was used to define abdominal obesity and the total amount of body fat was estimated from the sum of skinfold measures. Parents, with the help of their children, completed questionnaires on student’s dietary, physical activity, and sleep behaviors. Anthropometric measurements and questionnaires were available for 390 students. We utilized prevalence ratio analysis to examine the association between socio-economic/demographic characteristics, unhealthful behaviors and overweight/obesity. Results Overall, 21% of the students were overweight or obese and 9% of them had abdominal obesity. Median total skinfold measurements was 32.5 mm. Prevalence of unhealthful behaviors varied significantly by student’s age, gender, school income levels, city, and frequency of consumption of restaurant foods. Students who consumed less than recommended amount of fruit servings had 1.68 times the risk of being overweight/obese, 2.49 times the risk of having abdominal obesity and 1.47 times the risk of having high total skinfold values compared to students with adequate fruit intake. Students with high frequency of consumption of red/processed meats had 1.50 times the risk of being overweight/obesity compared to students with less-frequent consumption. Conclusion We found a rather high prevalence of unhealthful dietary behaviors among primary school students in Kenya, identified their determinants, and the association between specific behaviors and overweight/obesity. These results can guide childhood obesity prevention measures in Kenya and other nations in East Africa.

Role of sleep quality in the acceleration of biological aging and its potential for preventive interaction on air pollution insults: findings from the UK Biobank cohort

Background: Sleep has been associated with aging and relevant health outcomes, but their causal relationship remains inconclusive. Methods: In this study, we investigated the associations of sleep behaviors with biological ages (BAs) among 363,886 middle and elderly-aged adults from UK Biobank. Sleep index (0 [worst]-6 [best]) of each participant was retrieved from six sleep behaviors: snoring, chronotype, daytime sleepiness, sleep duration, insomnia, and difficulties in getting up. Two BAs, the KDM-biological age and PhenoAge, were estimated by corresponding algorithms based on clinical traits, and their discrepancies with chronological age were defined as the age accelerations (AAs). Results: We first observed negative associations between the sleep index and the two AAs, and demonstrated that the change of AAs could be the consequence of sleep quality using Mendelian randomization with genetic risk scores of sleep index and BAs. Particularly, one unit increase in sleep index was associated with 0.105- and 0.125-year decreases in KDM-biological age acceleration and PhenoAge acceleration, respectively. Furthermore, we observed significant independent and joint effects of sleep and air pollution (i.e. PM2.5 and NO2), another key driver of aging, on BAs. Sleep quality also showed modifying effect on the associations of elevated PM2.5 and NO2 levels with accelerated aging. For instance, an interquartile range increase in PM2.5 level was associated with 0.011-, 0.047-, and 0.078-year increase in PhenoAge acceleration among people with high (5-6), medium (3-4), and low (0-2) sleep index, respectively. Conclusions: Our findings elucidate that better sleep quality could lessen accelerated biological aging resulting from exogenous exposures including air pollution.