No description available.

Background Preterm birth is a leading cause of perinatal morbidity and mortality worldwide, resulting in a pressing need to identify risk factors leading to effective interventions. Limited evidence suggests potential relationships between maternal sleep or vital exhaustion and preterm birth, yet the literature is generally inconclusive. Methods We examined the relationship between maternal sleep duration and vital exhaustion in the first six months of pregnancy and spontaneous (non-medically indicated) preterm birth among 479 Peruvian women who delivered a preterm singleton infant (<37 weeks gestation) and 480 term controls who delivered a singleton infant at term (≥37 weeks gestation). Maternal nightly sleep and reports of vital exhaustion were ascertained through in-person interviews. Spontaneous preterm birth cases were further categorized as those following either spontaneous preterm labor or preterm premature rupture of membranes. In addition, cases were categorized as very (<32 weeks), moderate (32–33 weeks), and late (34- <37 weeks) preterm birth for additional analyses. Logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Results After adjusting for confounders, we found that short sleep duration (≤6 hours) was significantly associated with preterm birth (aOR = 1.56; 95% CI 1.11-2.19) compared to 7–8 hours of sleep. Vital exhaustion was also associated with increased odds of preterm birth (aOR = 2.41; 95% CI 1.79-3.23) compared to no exhaustion (Ptrend <0.001). These associations remained significant for spontaneous preterm labor and preterm premature rupture of membranes. We also found evidence of joint effects of sleep duration and vital exhaustion on the odds of spontaneous preterm birth. Conclusions The results of this case–control study suggest maternal sleep duration, particularly short sleep duration, and vital exhaustion may be risk factors for spontaneous preterm birth. These findings call for increased clinical attention to maternal sleep and the study of potential intervention strategies to improve sleep in early pregnancy with the aim of decreasing risk of preterm birth.

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京都大学 / 0048 / 新制・課程博士 / 博士(社会健康医学) / 甲第22008号 / 社医博第94号 / 新制||社医||10(附属図書館) / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 中山 健夫, 教授 木原 正博, 教授 別所 和久 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

No description available.

Youth violence is a public health threat in the United States. Inadequate sleep is identified as a risk factor, however, the majority of previous studies were cross-sectional and focused only on adolescents. This study aimed to investigate the association between average hours of sleep during adolescence and violent behavior among youths. Individuals who participated in both Waves II (1996) and III (2000-2001) of National Longitudinal Study of Adolescent and Adult Health (n=3,557) were included. A composite variable on violent behavior was created using three different questions on fighting or using a weapon. Age, gender, ethnicity, violent behavior during adolescence, depressive symptoms, impulsivity, and current sleep hours were considered as covariates. Negative binomial regressions were conducted using SAS 9.4. The mean age of the participants was 15.85 years (SD=1.62) and 21.29 years (SD=1.60) in waves II and III, respectively. The majority of the participants were female (54.15%) and non-Hispanics (88.93%). Average hours of sleep during adolescence was not significantly associated with violent behavior during young adulthood (p=0.75). In the final model, gender (beta=1.65, p<0.001), age (beta=-0.1267, p<0.001), history of violent behavior (wave II) (beta=0.3158, p<0.0001), current average hours of sleep (wave III) (beta=-0.073, p=0.044), depressive symptoms (beta=0.0834, p <0.0001), and impulsivity (beta=0.1379, p<0.0001) were significantly associated with violent behavior in early adulthood. Reduced number of sleep hours during early adulthood, unlike during adolescence, increased the likelihood of getting involved in violent activities during early adulthood. This information is useful to promote healthy behavior among individuals in all phases of their life.

Bakgrund: Normal sömn är viktigt för en rad olika faktorer, bland annat för cellförnyelse och hormonreglering. Förekomsten av övervikt hos barn (Iso-BMI ≥25) och fetma hos barn (Iso-BMI ≥30) ökar i samhället. Övervikt och fetma ger sämre sömnkvalitét. Då sömn är en del av sjuksköterskans omvårdnadsansvar är det eventuella problemet med sömnbrist vid övervikt/fetma viktigt att belysa. Syfte: Syftet med denna studie var att se om det finns samband mellan bukfetma och sömnduration hos barn mellan 7-13 år inom Uppsala län och jämföra detta mellan flickor och pojkar. Metod: En kvantitativ tvärsnittsstudie där materialet har samlats in genom enkäter som varje deltagare besvarat tillsammans med föräldrarna. Enkäterna besvarades i samband med nybesök till Överviktsenheten Barn och ungdom på Akademiska sjukhuset i Uppsala. Deltagarna bestod av 27 flickor och 22 pojkar. Resultat: Resultatet visade att det inte finns en statistisk signifikant skillnad mellan flickor och pojkars sömnduration under vardagar eller helgdagar. Ett statistisk signifikant samband påvisades mellan stort bukomfång och kort sömnduration under vardagar för samtliga deltagare. Liknande samband kunde inte ses för sömnduration under helgdagar och bukomfång eller mellan sömnduration och bukhöjd. Slutsats: Det finns ett samband mellan stort bukomfång och kort sömnduration för barn mellan 7-13 år. Mer omfattande studier kring detta krävs för att resultatet ska kunna generaliseras över en stor grupp människor och för att kunna förstå varför resultatet blev som det blev. Inga statistiskt signifikanta skillnader mellan flickor och pojkars sömnduration kunde ses i arbetet och inte heller några samband mellan sömnduration och bukhöjd. / Background: Normal sleep is important for several different reasons, among others for the regeneration of cells and hormone regulation. The prevalence of overweight children (Iso-BMI ≥25) and obese children (Iso-BMI ≥30) has increased in society. Being overweight or obese can lead to poor sleep quality. As sleep is part of the responsibility of nurses, it is important to highlight the possible problems that result with a lack of sleep due to being overweight or obese. Objective: The aim of this study was to determine whether there is a correlation between being overweight/obese and sleep duration in children aged 7-13 years in the Uppsala region and compare the results between genders. Method: A quantitative cross-section study in which the material has been collected with questionnaires that every participant and their parents have answered. The questionnaires were answered for a first time visit at the Overweight unit for children and youths at Uppsala University Hospital. The participants consisted of 27 girls and 22 boys. Results: The results showed that there is no statistical significant difference between girls and boys sleep duration at weekdays or weekends. There is a statistical significant correlation between a large abdominal size and short sleep duration in weekdays. The same correlation could not been seen between abdominal size and sleep duration during weekends nor between abdominal height and sleep duration. Conclusion: There is a correlation between a large abdominal size and short sleep duration in children aged 7-13 years. More embraced studies are needed to put the results over a large group of people and to find out why the result showed what it showed. No statistical significant differences were evident between girls and boys sleep duration or between sleep duration and abdominal height.

Bakgrund: Övervikt och fetma är ett ökat problem bland barn och ungdomar runt om i världen. Det finns många faktorer som kan påverka att ett barn blir överviktig, bland annat dåligt sömnmönster. Syftet med denna studie är att kartlägga hur barn och ungdomar med övervikt eller fetma i åldrarna 6-18 år sover.   Metod: En kvantitativ studie gjordes genom att sammanställa data från enkäter som lämnats genom ett vårdprogram för överviktiga barn och ungdomar vid ett sjukhus i Mellansverige. Totalt deltog 40 barn i åldrarna 6-12 år och 36 ungdomar i åldrarna 13-18 år.   Resultat: Barn 6-12 år sov i genomsnitt 9,1 timmar på vardagar och 9,4 timmar under helgdagar. Motsvarande siffror för ungdomar 13-18 år var 7,3 respektive 9,1 timmar. Det finns en signifikant skillnad i sömnduration mellan barn och ungdomar under vardagar. Barn och ungdomar skattar sin sömnkvalité som generellt bra, dock har ungdomar i högre grad problem som är kopplade till sömn än vad barn har och en signifikant skillnad mellan grupperna kan ses avseende snarkningar. Det finns inte något samband mellan antal sömntimmar per natt och upplevelsen av sömnkvalité.   Slutsats: Barn och ungdomar sover inte tillräckligt, eller på gränsen till för lite, enligt de rekommendationer som finns men de upplever själva att deras sömnkvalité är generellt bra. Mer forskning behövs kring barn och ungdomar med övervikt eller fetma och deras sömnvanor för säkrare resultat. / Background: Overweight and obesity are increased problems in the world. There are many factors that possibly can have an effect on overweight, for example bad sleep patterns. The purpose of this study is to investigate the sleep duration and quality amongst children and adolescents with overweight or obesity.   Method: A quantitative study has been made by compiling information from a questionnaire. The questionnaire was given out at a hospital in the middle of Sweden. 40 children, in ages 6-12 years, and 36 adolescents, in ages 13-18 years, participated in the study.   Results: Children (6-12 years old) slept in average 9,4 hours during weekdays and 9,1 hours during weekends. Adolescents (13-18 years old) slept in average 7,3 hours during weekdays and 7,1 hours during weekends. There´s a significant difference between the groups considering sleep duration during weekdays. The children and adolescents value their sleep quality as good, though adolescents report a higher level of sleep issues than children. There´s a significant difference between the groups considering loud snoring. There´s no significant correlation between sleep duration and reported sleep quality.   Conclusion: Children and adolescents don’t sleep enough, or barely sleep enough, according to the recommendations for children in 6-18 years. However, the participants consider themselves having an, in general, good sleep quality. More research about sleep patterns amongst obese and overweight children and adolescents is needed, to acquire a higher understanding.

This dissertation includes three studies that examined the impact of inadequate sleep duration in adolescents and young adults on asthma and systemic inflammation. We used data from the Florida Youth Risk Behavior Survey (YRBS), years 2009-2013, and from the National Longitudinal Study of Adolescent to Adult Health (Add health), which was conducted between 1994 and 2008. The first study used data from 16,738 high school students participating in the Florida YRBS. We examined the cross-sectional association between sleep duration and asthma, and the interactive effects of sleep duration and BMI. We found that short and long sleep durations were associated with increased odds of current asthma. Compared with 7-8 hours of sleep per night, sleeping for(95% CI) of 1.22 (1.07, 1.40), while sleeping for ≥ 9 hours had and OR of 1.31 (1.06, 1.63). We found a significant effect modification by BMI, with the associations between sleep duration and asthma mostly limited to overweight adolescents. Compared with normal weight students who sleep for 7-8 hours per night, those who are overweight and sleep for≥ 9 hours have approximately twice the odds of having current asthma [OR= 1.75 (1.45, 2.11), and OR=2.00 (1.32, 3.02) respectively]. No significant associations were found in normal-weight adolescents. The second study used data from 12,633 adolescents (age 13-19) participating in the National Longitudinal Study of Adolescent to Adult Health (Add health), and followed through 4 waves of interviews through their young adulthood (age 24-32). We constructed trajectories of sleep duration through 4 waves of data for participants without asthma at wave I (n=11,016), and examined the association between sleep duration and the risk of asthma by young adulthood. Similarly, we constructed trajectories of sleep duration for participants with asthma at wave I (n=1,395) through 3 waves of data, and examined the association between sleep duration and persistence of asthma into young adulthood. Sleep trajectories in non-asthmatic participants showed that 13.8% of them had persistent short sleep duration, while 80.7% had adequate sleep durations from adolescence though young adulthood. Those with consistently short sleep had 1.59 times the risk of new onset asthma by age 32 (95% CI 1.12, 2.26), compared with consistently adequate sleepers. Among adolescents with asthma, 10.2% had consistently short sleep through age 24, while 81.2% had adequate sleep. Short sleepers were 2.35 times more likely than adequate sleepers to have their asthma symptoms persist into young adulthood (95% CI 1.12, 4.96). The third study used data from waves III and IV of the Add health study, and examined the association between sleep trajectories over a 6-year follow-up in young adulthood, and the risk of elevated high sensitivity C-reactive protein (hs-CRP), a marker of systemic inflammation. Short sleep trajectories were associated with a significant increase in log-transformed hs-CRP (coefficient=0.11, p-value 0.03), and with a significant increase in the odds of having hs-CRP levels >3 mg/dl (OR=1.85, 95% CI 1.29, 2.67). The association was modified by sex, with the association between short sleep duration and hs-CRP limited to males. In males, both the continuous (coefficient 0.117, p-value=0.0362) and the categorized hs-CRP (OR= 2.21, 95% CI 1.48, 3.30) were significantly increased with short sleep durations, while no significant associations were seen in females with short sleep durations. By contrast, there was a significant increase in log hs-CRP in females with long sleep durations (coefficient=0.232, p-value=0.0296), and a non-significant increase in the odds of having hs-CRP levels greater than 3 mg/dl (OR=1.48, 95% CI 0.75, 2.93), while there were no associations with long sleep duration in males. The results of this dissertation research point to the detrimental effects of sleep loss on the bodies of adolescents and young adults. We found sleep loss to be associated with the incidence of asthma and its persistence, in addition to heightened systemic inflammation, which is a likely pathway that links sleep duration with the above outcomes. Our findings indicate that males are more susceptible to the effect of insufficient sleep on the risk of heightened inflammation, while females are more susceptible to the effects of long sleep durations. Interestingly, adolescents in the more recent YRBS study had shorter sleep durations than those who participated in the earlier Add health study. The prevalence of sleeping less than 7 hours was 16.5% in the add health study (years 1994-1995), compared with 47.2% in the YRBS study (years 2009-2013), indicating a progressive decrease in the average sleep duration of adolescents.

Results from prospective studies examining associations between sleep duration and weight gain have been mixed. Melatonin has been hypothesized to mediate the association between sleep duration and weight/body composition. In cross-sectional studies, aMT6s has been shown to be inversely associated with weight/body fat percentage. We examined associations between baseline sleep duration, insomnia status, aMT6s levels with weight/body fat percentage through 6 years, utilizing a subset 690 women who participated in a breast cancer case-control study nested within the WHI-OS. Multi-variable and mixed-effects regression was used to calculate beta-coefficients and 95% confidence intervals. Cross-sectional analyses showed urinary aMT6s levels were inversely associated with BMI and body fat percentage. No associations were observed between sleep patterns and measures of adiposity. The prospective relationship between urinary aMT6 levels and weight/body fat percentage was complex. Age-adjusted mixed models show an association in the interaction term between year and aMT6s with body fat percentage (βinteraction:0.09, pinteraction:0.16, p=0.07), demonstrating the influence of baseline aMT6s and time on changes in outcome. Women with higher baseline aMT6s had a trajectory of increased body fat percentage and weight gain steepest between baseline and year 3, whereas women with lower baseline aMT6 levels had a trajectory of decreased body fat percent and weight between year 3 and year 6. The prospective association between melatonin levels and adiposity measures was unexpected. Future studies with objective measures of sleep and repeated measures of melatonin may shed light of possible explanations for our findings.