Associations of sleep duration variability and depressive symptoms with gastrointestinal disease among middle-aged and older adults

Frailty mediates the association between sleep duration and physical, psychological, and cognitive multimorbidity in Chinese middle-aged and older adults.

The association between sleep duration and physical, psychological and cognitive multimorbidity (PPC-MM) remains unclear. This study explores whether frailty accounts for part of this association using both cross-sectional and longitudinal analyses. This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) collected between 2011 and 2018, involving 7,193 participants for cross-sectional and 5,380 for longitudinal analysis. Multivariate logistic regression and Cox proportional hazards models evaluated the association between sleep duration, frailty, and PPC-MM risk. Nonlinear dose-response relationships were assessed with restricted cubic spline (RCS) analysis, and subgroup analyses examined demographic differences. Bootstrap resampling with 1,000 iterations was used to estimate the indirect pathways. In the cross-sectional path analysis, logistic regression analysis showed that sleep duration was negatively associated with PPC-MM (OR = 0.84, 95% CI: 0.80-0.89, P < 0.001). Frailty showed a positive association with PPC-MM (OR = 4.80, 95%CI: 3.92-5.88, P < 0.001). Frailty accounted for 31.61% of the statistical association between sleep duration and PPC-MM. In the longitudinal exploratory mediation analysis, Cox models showed that longer sleep duration was associated with a lower risk of incident PPC-MM (HR = 0.85, 95% CI: 0.80-0.89, P < 0.001). Frailty was positively associated with PPC-MM risk (HR = 5.89, 95% CI: 4.81-7.21, P < 0.001). Exploratory mediation analysis further indicated that the indirect pathway via frailty accounted for 26.99% of the total prospective association between sleep duration and incident PPC-MM. Sleep duration was negatively associated with PPC-MM, while frailty was positively associated with PPC-MM. Exploratory analyses suggested that frailty may serve as a partial intermediary in this association.

Association between sleep duration and risk of new-onset gastric diseases in middle-aged and older adults: A prospective cohort study in China.

Insufficient sleep has been linked to an increased risk of gastric diseases among middle-aged and older adults. However, prospective evidence on the relationship between sleep duration and the incidence of gastric diseases remains limited. This study aimed to investigate the longitudinal associations of nighttime sleep and daytime nap duration with the risk of new-onset gastric diseases in an elderly Chinese population. Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS), conducted from 2011 to 2020. A total of 7,539 participants aged ≥ 45 y and free of gastric diseases at baseline were included and followed for up to 9 y. Nighttime sleep duration and daytime nap duration were collected through self-reported questionnaires at baseline. Cox proportional hazards models were used as the primary analysis to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Multiple logistic regression models were employed for predictive metrics (C-statistic, continuous Net Reclassification Improvement [NRI], and Integrated Discrimination Improvement [IDI]). Restricted cubic spline analyses were employed to explore the dose-response relationship between sleep duration and the risk of new-onset gastric diseases. Among the 7,539 individuals included in the cohort, 1,452 (19. 3%) were diagnosed with new-onset gastric diseases. Participants with shorter nighttime sleep duration had a significantly higher risk of developing gastric diseases. Specifically, each interquartile range increase in nighttime sleep duration was associated with a 14% reduction in risk (HR: 0. 86; 95% CI: 0. 79-0. 95). Compared to those in the shortest sleep quartile, participants in the longest quartile experienced an approximately 20% lower risk (HR: 0. 80; 95% CI: 0. 64-1. 01; p = 0. 06). No significant association was found between daytime nap duration and the incidence of gastric diseases. Stratified analyses yielded consistent results across demographic and clinical subgroups, with stronger associations observed among females, married individuals, and rural residents. Shorter nighttime sleep duration was independently associated with an increased risk of new-onset gastric diseases in middle-aged and older adults. In contrast, daytime napping showed no significant relationship with gastric disease risk. These findings underscore nighttime sleep duration as a potentially modifiable factor for gastric disease prevention among older populations.

The associations of trouble sleeping, biological age acceleration with depressive symptoms: Evidence from three cohorts.

OBJECTIVE This study investigates the relationship between trouble sleeping, biological age (BA) acceleration, and depressive symptoms, and their combined association with depressive symptoms. METHODS Data were utilized from three cohorts: NHANES, CHARLS, and HRS. Depressive symptoms were assessed using PHQ-9 or CES-D. BA acceleration was calculated as the residual difference between BA and chronological age. In the cross-sectional analysis, logistic regression models were used to examine the associations of BA acceleration and trouble sleeping with depressive symptoms. RESULTS Trouble sleeping exhibited an association with higher odds of depressive symptoms (NHANES: OR = 4.714; CHARLS: OR = 6.643; HRS: OR = 1.842, all P < 0.001). BA acceleration was positively associated with depressive symptoms in NHANES (OR = 1.036, P < 0.001) and HRS (OR = 1.011, P = 0.007), but negatively in CHARLS (OR = 0.960, P = 0.039). Individuals with "accelerated aging & trouble sleeping" had the highest odds of depressive symptoms among different groups compared to those with "non-accelerated aging & no trouble sleeping" in NHANES (OR = 5.762, P < 0.001) and HRS (OR = 2.089, P < 0.001). In CHARLS, the highest odds were observed in the "non-accelerated aging & trouble sleeping" group (OR = 6.405, P < 0.001), while the "accelerated aging & no trouble sleeping" group showed no significant association (OR = 0.889, P = 0.126). CONCLUSIONS In NHANES and HRS, the combined association of BA acceleration and trouble sleeping was associated with the highest odds of depressive symptoms. In CHARLS, however, there was an inverse association between BA acceleration and depressive symptoms, and a lack of higher odds of depressive symptoms in the combined association. These findings reveal cross-national differences between U.S. and Chinese populations.

Relationship between MSpO2 and depressive symptoms in older patients with obstructive sleep apnea: a cross-sectional study

Association of sleep duration and hypertension in Older Adults: a cross-sectional study.

OBJECTIVE Sleep duration, a modifiable lifestyle factor, has been variably associated with blood pressure regulation, yet evidence among the oldest-old populations remains limited and inconsistent. This study aims to investigate the association between self-reported sleep duration and hypertension in a large cohort of Chinese older adults. METHODS We analyzed cross-sectional data from the 2008 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). A total of 15,650 participants aged 65 years and older were included. Sleep duration was self-reported and categorized as <6 hours, 6-8 hours, and ≥9 hours. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, or a self-reported physician diagnosis. Multivariate logistic regression models were used to evaluate the associations. Restricted cubic splines were applied to model non-linearity. RESULTS Among 15,650 participants (mean age 87.16 years, SD 11.36; 57.0% female), 7,345 (46.9%) met criteria for hypertension. In the fully adjusted model, short sleep duration (<6 hours) was associated with a 1.30-fold higher odds of hypertension compared with sleeping 6-9 hours (adjusted odds ratio [OR] 1.30; 95% confidence interval [CI] 1.17, 1.44). Long sleep duration (≥9 hours) showed no statistically significant association after full adjustment (OR 1.04; 95% CI 0.97, 1.12). The relationship followed a non-linear J-shaped curve (p for non-linearity < 0.05). Interaction analyses revealed that the effect of short sleep duration on hypertension was more pronounced among adults with no limitations in activities of daily living (p for interaction = 0.009). CONCLUSION Short sleep duration (<6 hours) is independently associated with hypertension in Chinese older adults. These findings suggest sleep assessment may help identify older adults at hypertension risk, and support future trials on sleep hygiene for hypertension prevention.

Association between sleep disorders and diabetic kidney disease among U.S. adults aged 45 and older: findings from the 2007–2014 NHANES

Sleep disorders and abnormal sleep duration were associated with diabetic kidney disease among Americans aged 45 and older, and sleep-related factors may warrant consideration in the comprehensive clinical assessment of individuals with diabetes.