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The Impact of Sleep Health on Chronic Diseases

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 31039

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Special Issue Editors

Prof. Gerard A. Kennedy

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Guest Editor

Psychology, School of Health and Life Sciences, Federation University, Mt Helen, Australia
Interests: sleep; sleep disorders; circadian rhythms; insomnia; sleep apnoea; diabetes; obesity; wellbeing; clinical psychology; physical activity

Dr. Russell Conduit

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Assistant Guest Editor

Department of Psychology, RMIT University, Melbourne, VIC 3001, Australia
Interests: sleep; circadian rhythms; sleep disorders; sleep and cognition; sleep and health

Special Issue Information

Dear Colleagues,

We are very pleased to invite you to submit research articles to a Special Issue of the International Journal of Environmental Research and Public Health that will explore “The Impact of Sleep Health on Chronic Diseases”. An increasing number of research articles have shown that various indicators of disordered sleep, such as reduced sleep duration, insufficient sleep, sleep fragmentation and hypoxia are strongly related to diabetes, hypertension and stroke, cardiovascular disease, asthma, arthritis, obesity, cognitive impairment, depression and anxiety. Most studies have acknowledged the role of obesity and mental health issues as mediators between disordered sleep and chronic diseases. However, when obesity and mental health issues are controlled for, the effects of disordered sleep on chronic diseases remain significant. The negative effects of sleep disorders can be reduced by treatments designed to improve poor sleep habits, encourage weight loss and manage sleep apnoea (continuous positive airway pressure, oral splints, surgery), and via various pharmacological treatments. Improvement of sleep quantity and quality needs to be part of the standard treatment regimen for chronic diseases. More research should be encouraged to examine the role of disordered sleep in chronic diseases and to assess the impact of treating disordered sleep on chronic diseases.

Prof. Gerard A. Kennedy
Dr. Russell Conduit
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Sleep disorders
Chronic disease
Sleep quantity
Sleep quality
Insufficient sleep
Obstructive sleep apnoea
Obesity
Mental health issues
Diabetes
Cardiovascular disease
Hypertension and stroke
Asthma
Arthritis
Cognitive impairment
Depression and anxiety

Published Papers (9 papers)

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Research

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14 pages, 1244 KiB

Open AccessArticle

The Combination of Sleep Disorders and Depression Significantly Increases Cancer Risk: A Nationwide Large-Scale Population-Based Study

by Fang-Chin Hsu, Chih-Hsiung Hsu, Chi-Hsiang Chung, Ta-Wei Pu, Pi-Kai Chang, Tzu-Chiao Lin, Shu-Wen Jao, Chao-Yang Chen, Wu-Chien Chien and Je-Ming Hu

Int. J. Environ. Res. Public Health 2022, 19(15), 9266; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19159266 - 28 Jul 2022

Viewed by 1551

Abstract

Introduction: Sleep disorders, depression, and cancer have become increasingly prevalent worldwide. However, it is unknown whether coexistence of sleep disorders and depression influences the risk of cancer development. Therefore, we conducted a nationwide population-based study to examine this association among patients in Taiwan. Materials and Methods: A total of 105,071 individuals diagnosed with cancer and 420,284 age- and sex-matched patients without a diagnosis of cancer between 2000 and 2015 were identified from Taiwan’s National Health Insurance Research Database. The underlying chronic diseases of patients that may developed cancer were gathered and studied as the predictor. A multivariate Cox proportional odds model was used to estimate the crude and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) to estimate the interaction effect between sleep disorders and depression on the risk of cancer. Results: After adjusting for age, sex, comorbidities, and other covariates, the cancer group was associated with increased exposure to sleep disorders than the non-cancer group (aOR = 1.440, 95% CI = 1.392–1.489, p < 0.001). In addition, patients with both sleep disorders and depression were at an even higher risk for cancer than the general population (aOR = 6.857, p < 0.001). Conclusions: This retrospective cohort study shows that patients with both sleep disorders and depression are at a higher risk of cancer. Clinically, a meticulous cancer risk evaluation is recommended for patients with both sleep disorders and depression. Full article

(This article belongs to the Special Issue The Impact of Sleep Health on Chronic Diseases)

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14 pages, 414 KiB

Open AccessArticle

Sleep Disturbances, Degree of Disability and the Quality of Life in Multiple Sclerosis Patients

by Aleksandra Kołtuniuk, Magdalena Kazimierska-Zając, Dominika Pogłódek and Justyna Chojdak-Łukasiewicz

Int. J. Environ. Res. Public Health 2022, 19(6), 3271; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19063271 - 10 Mar 2022

Cited by 9 | Viewed by 2678

Abstract

Sleep disturbances are pervasive in patients with multiple sclerosis (MS), with incidence about four times higher compared to the general population. The most frequent primary sleep problems include insomnia, restless leg syndrome, sleep-related movement disorders, and sleep-disordered breathing. This study aims to assess the relationships between sleeping problems and the quality of life (QoL) in MS patients. This cross-sectional study was conducted among 152 MS patients (mean age: 36.27 ± 9.60) between November 2018 and February 2019 at a neurological health center in Wroclaw, Poland. The study was based on a questionnaire that included questions concerning sociodemographic and clinical data in addition to the following standardized questionnaires: Athens Insomnia Scale (AIS), Epworth Sleepiness Scale (ESS), and Multiple Sclerosis International Quality of Life (MusiQoL). The degree of physical disability was evaluated following the Expanded Disability Status Scale (EDSS). Analysis of the research material showed that 66.45% of MS patients had insomnia, and 41.45% presented with daytime sleepiness. The QoL of respondents was assessed as average (50.73). Univariate linear regression model analysis showed the effects of professional status, daytime sleepiness, insomnia, and degree of disability on the QoL of MS patients. Sleep disturbances are widespread in MS patients. The presence of sleep disturbances (insomnia and daytime sleepiness) significantly affects the QoL of MS patients. Full article

(This article belongs to the Special Issue The Impact of Sleep Health on Chronic Diseases)

11 pages, 1043 KiB

Open AccessArticle

The Effect of Sleep Quality on Pain in Chilean Individuals with Musculoskeletal Disorders

by Claudio Bascour-Sandoval, Hellen Belmar-Arriagada, Javier Albayay, Claudia Lacoste-Abarzua, Diego Bielefeldt-Astudillo, Rubén Gajardo-Burgos, Mirko Vidal-Torres and Germán Gálvez-García

Int. J. Environ. Res. Public Health 2021, 18(21), 11370; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111370 - 29 Oct 2021

Cited by 3 | Viewed by 2313

Abstract

Poor sleep quality (SQ) negatively affects pain associated with musculoskeletal disorders (MSD). As the level of economic development of a country determines its sanitary conditions, these can influence the sleep–pain relationship; therefore, it is relevant to generate evidence in the population with MSD in developing countries. This cross-sectional study sought to determine the effect of poor SQ on pain in Chilean individuals with MSD, controlling for sex and duration of pain (in months). Method: A total of 228 individuals were included. SQ was measured with the Pittsburg Sleep Quality Index (PSQI), pain (intensity, interference and distress relative to pain) was measured with visual analog scales. Structural equation modeling (SEM) was performed to analyze the effect of SQ on pain. Results: A high frequency of poor SQ was present in the studied group, and was more prevalent in women. The SEM model evidenced that poor SQ predicts greater pain. Sex influences sleep quality and pain, but not pain duration. Conclusions: These findings indicate that poor SQ predicts higher pain in MSD and that women exhibit worse SQ and more significant pain than men. Our findings support that SQ should be considered in the comprehensive approach to pain in individuals with MSD. Full article

(This article belongs to the Special Issue The Impact of Sleep Health on Chronic Diseases)

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9 pages, 316 KiB

Open AccessArticle

Sleep Quality in Patients Undergoing Transcatheter Aortic Valve Implantation (TAVI)

by Giulia Lorenzoni, Danila Azzolina, Chiara Fraccaro, Caterina Zoccarato, Clara Minto, Sabino Iliceto, Dario Gregori and Giuseppe Tarantini

Int. J. Environ. Res. Public Health 2021, 18(16), 8889; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168889 - 23 Aug 2021

Cited by 3 | Viewed by 1832

Abstract

The present study aimed to analyze sleep quality and quality of Life (QoL) in patients undergoing Transcatheter Aortic Valve Implantation (TAVI). It was conducted at the Interventional Cardiology Unit of the Department of Cardiac, Thoracic, Vascular Sciences and Public Health of the University of Padova on 27 adult patients who underwent TAVI via the transfemoral approach. Patients completed two validated instruments, i.e., the Pittsburgh Sleep Quality Index (PSQI) and the EuroQoL (EQ-5D-5L), on the day of discharge and one month after the hospital discharge. Twenty-seven patients were enrolled with a severe aortic stenosis diagnosis, treated with transfemoral TAVI procedure. The study population included seventeen poor sleepers and ten good sleepers with a median age of 81.92 years overall. The global PSQI evaluation revealed a small significant improvement at follow-up (p-value 0.007). Small positive changes were detected in the Self-care and Usual activity domains of the EQ-5D-5L and the EQ-VAS. No correlation was detected between EQ-5D-5L and sleep quality. The present study confirms the importance of sleep quality monitoring in patients who undergo TAVI procedure for aortic stenosis treatment. Full article

(This article belongs to the Special Issue The Impact of Sleep Health on Chronic Diseases)

11 pages, 641 KiB

Open AccessArticle

Relationship between Self-Reported Sleep Duration and Risk of Anemia: Data from the Korea National Health and Nutrition Examination Survey 2016–2017

by Min-Young Chun, Jeong-hoon Kim and Ju-Seop Kang

Int. J. Environ. Res. Public Health 2021, 18(9), 4721; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18094721 - 28 Apr 2021

Cited by 3 | Viewed by 2560

Abstract

The importance of sleep has been gaining more and more attention nowadays. It has been widely studied that some major health issues, such as cardiovascular diseases or mortality, are closely related to the extreme ends of sleep durations. Anemia is one of the health problems in modern society. In this study, we aimed to find a relationship between anemia occurrence and sleep duration. Data of 11,131 Korean adults aged 19 years or older were recruited from the 2016–2017 Korea National Health and Nutrition Examination Survey and analyzed in this cross-sectional study. ‘Anemia’ was defined in this study by hemoglobin level of <13 g/dL in men and <12 g/dL in women. Selected data were sorted into five groups by sleep duration: <5 h, 5 h ~ <6 h, 6 h ~ <8 h, 8 h ~ <9 h, and ≥9 h per day. We performed multivariate logistic regression analysis to assess the relationship between sleep duration and risk of anemia after adjusting for covariates including age, gender, family income level, education level, physical activity, cigarette smoking, and alcohol usage. Other factors were assessed in the analysis, such as depression, hypertension, diabetes, dyslipidemia, stroke, coronary artery disease, malignancy, stress level, and body mass index (BMI). We found that sleep duration of <5 h was related to high risk of anemia (odds ratio = 1.87; 95% confidence interval = 1.01–3.49, sleep duration of 6 h ~ <8 h as the reference group). Also, sleep duration of ≥9 h was related to lower risk of anemia in most premenopausal women after adjusting for covariates (odds ratio = 0.61; 95% confidence interval = 0.38–0.96, sleep duration of 6 h ~ < 8 h as the reference group). Male individuals with sleep durations of <5 h (odds ratio = 2.01; 95% confidence interval =1.05–3.84) and of ≥9 h (odds ratio = 2.48; 95% confidence interval =1.63–3.81) had a significantly higher risk of anemia without covariate adjustment. Postmenopausal women with sleep durations of ≥9 h had a significantly higher risk of anemia (odds ratio =2.02; 95% confidence interval =1.33–3.08) without adjusting for covariates. However, the associations became statistically insignificant after adjusting for age and covariates in both men and postmenopausal women. In conclusion, we found significant associations between extreme ends of sleep duration and risk of anemia in premenopausal Korean women. However, we did not observe strong associations between self-reported sleep duration and anemia risk in men or postmenopausal women. Full article

(This article belongs to the Special Issue The Impact of Sleep Health on Chronic Diseases)

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13 pages, 354 KiB

Open AccessArticle

Sleep Quality and Associated Factors in Adults with Type 2 Diabetes: A Retrospective Cohort Study

by Ching-Pyng Kuo, Shu-Hua Lu, Chien-Ning Huang, Wen-Chun Liao and Meng-Chih Lee

Int. J. Environ. Res. Public Health 2021, 18(6), 3025; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18063025 - 15 Mar 2021

Cited by 12 | Viewed by 2774

Abstract

Purpose: Sleep disturbance is one of the major complaints among patients with diabetes. The status of diabetes control and associated complications may contribute to sleep disturbance. This study explored night time sleep and excessive daytime sleepiness in adults with type 2 diabetes and examined the association of diabetes control and associated complications on their sleep quality. Methods: A retrospective cohort study design was used. Type 2 diabetic patients (87 females and 79 males, aged 63.1 ± 10.5 years) were recruited from the outpatient clinics of the endocrine department. Sleep quality was assessed by the Pittsburg Sleep Quality Index and the Epworth Sleepiness Scale. Diabetes control and complications were obtained by retrospectively reviewing patients’ medical records over 1 year prior to study enrollment. Results: 72.3% of recruited patients had poor glycemic control, and 71.1% had at least one diabetic complication. 56.0% of patients experienced poor sleep quality, and 24.1% had excessive daytime sleepiness. Those who were female (OR = 3.45) and who had ophthalmological problems (OR = 3.17) were associated with poor night time sleep quality, but if they did exercise to the point of sweating (OR = 0.48) reduced the risk of poor sleep quality. Furthermore, poor sleep quality (OR = 4.35) and having nephropathy (OR = 3.78) were associated with a higher risk of excessive daytime sleepiness. Conclusions: Sex, ophthalmological problems, nephropathy, and no exercise to the point of sweating are associated with sleep problems in patients with type 2 diabetes. Both lifestyle behaviors and diabetic complications affect sleep disturbances in patients with diabetes. Full article

(This article belongs to the Special Issue The Impact of Sleep Health on Chronic Diseases)

Review

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19 pages, 775 KiB

Open AccessReview

OSA and Chronic Respiratory Disease: Mechanisms and Epidemiology

by Brian W. Locke, Janet J. Lee and Krishna M. Sundar

Int. J. Environ. Res. Public Health 2022, 19(9), 5473; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19095473 - 30 Apr 2022

Cited by 24 | Viewed by 5007

Abstract

Obstructive sleep apnea (OSA) is a highly prevalent disorder that has profound implications on the outcomes of patients with chronic lung disease. The hallmark of OSA is a collapse of the oropharynx resulting in a transient reduction in airflow, large intrathoracic pressure swings, and intermittent hypoxia and hypercapnia. The subsequent cytokine-mediated inflammatory cascade, coupled with tractional lung injury, damages the lungs and may worsen several conditions, including chronic obstructive pulmonary disease, asthma, interstitial lung disease, and pulmonary hypertension. Further complicating this is the sleep fragmentation and deterioration of sleep quality that occurs because of OSA, which can compound the fatigue and physical exhaustion often experienced by patients due to their chronic lung disease. For patients with many pulmonary disorders, the available evidence suggests that the prompt recognition and treatment of sleep-disordered breathing improves their quality of life and may also alter the course of their illness. However, more robust studies are needed to truly understand this relationship and the impacts of confounding comorbidities such as obesity and gastroesophageal reflux disease. Clinicians taking care of patients with chronic pulmonary disease should screen and treat patients for OSA, given the complex bidirectional relationship OSA has with chronic lung disease. Full article

(This article belongs to the Special Issue The Impact of Sleep Health on Chronic Diseases)

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Other

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25 pages, 11711 KiB

Open AccessSystematic Review

Traditional East Asian Herbal Medicine for Post-Stroke Insomnia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

by Sang-Ho Kim and Jung-Hwa Lim

Int. J. Environ. Res. Public Health 2022, 19(3), 1754; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19031754 - 03 Feb 2022

Cited by 2 | Viewed by 3037

Abstract

Post-stroke insomnia (PSI) is a highly prevalent complication after stroke. Current evidence of psychotropic drug use for PSI management is scarce and indicates harmful adverse events (AEs). Traditional East Asian herbal medicine is a widely used traditional remedy for insomnia. However, so far, no study has systematically reviewed the efficacy and safety of traditional east asian herbal medicine (HM) for PSI. Therefore, we perform meta-analysis to evaluate the effectiveness and safety of HM for PSI. After a comprehensive electronic search of 15 databases, we review the randomized controlled trials (RCTs) of HM use as monotherapy for PSI. Our outcomes were the Pittsburgh sleep quality index and total effective rate. In total, 24 RCTs were conducted with 1942 participants. HM showed statistically significant benefits in sleep quality. It also appeared to be safer than psychotropic drugs in terms of AEs, except when the treatment period was two weeks. The methods used for RCTs were poor, and the quality of evidence assessed was graded “low” or “moderate.” The findings of this review indicate that the use of HM as a monotherapy may have potential benefits in PSI treatment when administered as an alternative to conventional medications. However, considering the methodological quality of the included RCTs, we were uncertain of the clinical evidence. Further, well-designed RCTs are required to confirm these findings. Full article

(This article belongs to the Special Issue The Impact of Sleep Health on Chronic Diseases)

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13 pages, 1343 KiB

Open AccessSystematic Review

A Systematic Review of the Impact of Wildfires on Sleep Disturbances

by Fadia Isaac, Samia R. Toukhsati, Mirella Di Benedetto and Gerard A. Kennedy

Int. J. Environ. Res. Public Health 2021, 18(19), 10152; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910152 - 27 Sep 2021

Cited by 7 | Viewed by 2952

Abstract

Wildfires present a serious risk to humans as well as to the environment. Wildfires cause loss of lives, economic losses, expose people to personal as well as collective trauma, and compromise the mental health of survivors. Sleep disturbances are highly prevalent following a traumatic event; however, their prevalence is not well established amongst those confronted by natural disasters such as wildfires. The aim of this systematic review is to synthesise the empirical findings pertaining to wildfires and the prevalence of sleep disturbances in the general community affected by this natural disaster. We searched EBSCO, PsychINFO, Medline, SpringerLink, CINAHL Complete, EMBASE, PubMed, Scopus and Cochrane Library between January 2012 and March 2021. Five studies met the inclusion criteria. Findings from this systematic review suggest that sleep disturbances, assessed one to ten months following the fires, are highly prevalent in wildfire survivors, with insomnia (ranging between 63–72.5%) and nightmares (ranging between 33.3–46.5%), being the most prevalent sleep disturbances reported in this cohort. Results also highlight the significant associations between sleep disturbances and post-traumatic symptoms following the trauma of wildfires. There is a possible link between sleep disturbance prevalence, severity of, and proximity to fires. Full article

(This article belongs to the Special Issue The Impact of Sleep Health on Chronic Diseases)

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