Journal of Preventive Medicine and Public Health

Systematic Review

Effects of Physical and Mind-body Exercise on Sleep Quality in Individuals With Diabetes Mellitus: A Systematic Review and Meta‐analysis: Yohanes Andy Rias, Renny Wulan Apriliyasari, Made Satya Nugraha Gautama, Faizul Hasan, Margareta Teli, Hsiao-Yean Chiu, Ratsiri Thato; J Prev Med Public Health. 2025;58(1):1-10. Published online October 7, 2024; DOI: https://doi.org/10.3961/jpmph.24.354

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Objectives
Physical and mind-body exercises represent distinct intervention strategies that may improve sleep quality by influencing physiological and psychological factors. Nevertheless, their effectiveness in individuals with diabetes is not well-established. This systematic review and meta-analysis aimed to examine the impacts of physical and mind-body exercise interventions on sleep quality in patients with diabetes mellitus.
Methods
Six randomized controlled trials (RCTs) that met the inclusion criteria were identified from PubMed, CINAHL, Embase, Scopus, Web of Science, Cochrane, and Ovid-Medline Library. The effect size for sleep quality was calculated using the standardized mean difference (SMD) with a 95% confidence interval (CI), employing a random-effects model. Heterogeneity and publication bias were also examined, and subgroup, meta-regression, and sensitivity analyses were performed.
Results
Physical and mind-body exercise interventions significantly improved sleep quality, with an SMD of -1.040 (95% CI, -1.686 to -0.394). Subgroup analysis revealed significant differences with respect to the type of intervention (p=0.047), or its duration (p=0.282). Meta-regression analysis indicated that mean hemoglobin A1c level was the only factor to be significantly related to the effect size for sleep quality, demonstrating a negative association (p=0.033). The assessment of publication bias and the sensitivity analysis suggested that the findings were reliable and robust.
Conclusions
Physical and mind-body exercises may serve as effective interventions for patients with diabetes mellitus who experience poor sleep quality. However, to substantiate these findings, additional rigorous RCTs with larger sample sizes, longer follow-up periods, and standardized interventions are required.

Summary

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Acute and chronic effects of inspiratory muscle training in patients with type 2 diabetes mellitus: a systematic review of randomized controlled trials
Zoé Breuil-Marsal, Clémence Godek, Amandine Lotti, Patrick Feiereisen, Isabela Roque Marçal, Patricia Rehder-Santos, Juliana Cristina Milan-Mattos, Raphael Martins de Abreu
Frontiers in Sports and Active Living.2024;[Epub] CrossRef

Original Articles

Sleep Quality and Associated Factors Among Firefighters in Bangkok, Thailand: A Cross-sectional Study: Nunnapat Piyachaiseth, Pornchai Sithisarankul, Jate Ratanachina; J Prev Med Public Health. 2024;57(1):83-90. Published online December 9, 2023; DOI: https://doi.org/10.3961/jpmph.23.305

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Abstract Summary PDF Supplementary Material: Objectives
Professional firefighters face various health hazards and are required to maintain both physical and mental fitness to effectively mitigate crises and respond to emergencies. Moreover, the long working hours and shift work of this profession impact sleep quality. This study investigated the quality of sleep and its associated factors among firefighters in Bangkok, Thailand.
Methods
This was a cross-sectional study of firefighters affiliated with the Bangkok Fire and Rescue Department, Bangkok Metropolitan Administration, Thailand between January 2023 and March 2023. A cluster random sampling technique was utilized to distribute 600 questionnaires to firefighters in 15 fire stations. The questionnaire addressed demographic, work-related, and environmental factors. Sleep quality was assessed using the Thai version of the Pittsburgh Sleep Quality Index (PSQI). Data analysis involved both descriptive and inferential statistics. Bivariate and multiple logistic regressions were performed.
Results
The response rate was 78.7% (n=472), and 44.1% of the firefighters reported poor sleep quality (PSQI score >5). Sleep quality was statistically associated with conflicting family relationships (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1 to 2.9), additional part-time jobs (daytime, OR, 2.4; 95% CI, 1.3 to 4.4; or nighttime, OR, 4.3; 95% CI, 1.1 to 16.7), noisy sleeping areas (OR, 1.7; 95% CI, 1.1 to 2.8), and the availability of adequate bedding (OR, 3.0; 95% CI, 1.8 to 4.9).
Conclusions
Poor sleep quality among firefighters was associated with various personal, work-related, and environmental factors. Organizations should promote policies that improve sleep quality through good sleep hygiene practices and facilities.; Summary

Key Message
This cross-sectional study aimed to investigate sleep quality among firefighters in Bangkok, Thailand its associated factors. 44.1% of the firefighters reported poor sleep quality (the Pittsburgh Sleep Quality Index: PSQI score >5). Sleep quality was statistically associated with conflicting family relationships, additional part-time jobs (daytime or nighttime), noisy sleeping areas, and the availability of adequate bedding.

Sleep Duration, Comorbidities, and Mortality in Korean Health Examinees: A Prospective Cohort Study: Sukhong Min, Woo-Kyoung Shin, Katherine De la Torre, Dan Huang, Hyung-Suk Yoon, Aesun Shin, Ji-Yeob Choi, Daehee Kang; J Prev Med Public Health. 2023;56(5):458-466. Published online September 26, 2023; DOI: https://doi.org/10.3961/jpmph.23.311

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Abstract Summary PDF Supplementary Material

Objectives
The association between long sleep duration and mortality is frequently attributed to the confounding influence of comorbidities. Nevertheless, past efforts to account for comorbidities have yielded inconsistent outcomes. The objective of this study was to evaluate this relationship using a large prospective cohort in Korea.
Methods
The study included 114 205 participants from the Health Examinees Study, who were followed for a median of 9.1 years. A composite comorbidity score was developed to summarize the effects of 21 diseases. Using Cox proportional hazards regression, hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, cancer, and cardiovascular mortality associated with sleep duration were estimated. These estimates were adjusted for socio-demographic factors, lifestyle factors, body mass index, and comorbidity score. Additionally, a stratified analysis by subgroups with and without comorbidities was conducted.
Results
Throughout the follow-up period, 2675 deaths were recorded. After all adjustments, an association was observed between a sleep duration of 8 hours or more and all-cause mortality (HR, 1.10; 95% CI, 1.01 to 1.20). However, no such association was detected in the stratified analysis for the subgroups based on comorbidity status.
Conclusions
Long sleep duration was found to be associated with all-cause mortality among Koreans, even after adjusting for comorbidities. Additional studies are required to explore the mechanism underlying the association between sleep duration and major causes of mortality.

Summary

Korean summary
- 한국의 대규모 코호트 자료를 이용, 긴 수면 시간과 사망률 간의 연관성이 동반 상병으로 인한 교란 효과로 인한 것인지를 검토하였다. - 수면 시간과 총 사망률, 암 사망률, 심혈관질환 사망률 간의 연관성을 확인하였고, 이 중 총 사망률과 긴 수면 시간이 동반 상병 지수로 보정 한 뒤에도 유의한 연관성을 보였다.

Key Message
Using a large prospective cohort in Korea, the association between long sleep duration and mortality was evaluated, after adjusting for the confounding influence of comorbidities. When 114,205 participants from the Health Examinees Study were followed for a median of 9.1 years, sleep duration of 8 hours or more were found to be associated with all-cause mortality (HR, 1.10; 95% CI, 1.01 to 1.20). Additional studies are required to explore the mechanism underlying the association between sleep duration and major causes of mortality.

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Non-linear association of sleep duration with osteoarthritis among U.S. middle-aged and older adults
Guoliang Ma, Bo Xu, Zhizhuang Wang, Weili Duan, Xin Chen, Liguo Zhu, Bowen Yang, Dian Zhang, Xiaokuan Qin, He Yin, Xu Wei
BMC Public Health.2024;[Epub] CrossRef

Sleep Quality and Poor Sleep-related Factors Among Healthcare Workers During the COVID-19 Pandemic in Vietnam: Thang Phan, Ha Phan Ai Nguyen, Cao Khoa Dang, Minh Tri Phan, Vu Thanh Nguyen, Van Tuan Le, Binh Thang Tran, Chinh Van Dang, Tinh Huu Ho, Minh Tu Nguyen, Thang Van Dinh, Van Trong Phan, Binh Thai Dang, Huynh Ho Ngoc Quynh, Minh Tran Le, Nhan Phuc Thanh Nguyen; J Prev Med Public Health. 2023;56(4):319-326. Published online May 31, 2023; DOI: https://doi.org/10.3961/jpmph.22.528

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Abstract PDF

Objectives
The coronavirus disease 2019 (COVID-19) pandemic has increased the workload of healthcare workers (HCWs), impacting their health. This study aimed to assess sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and identify factors associated with poor sleep among HCWs in Vietnam during the COVID-19 pandemic.
Methods
In this cross-sectional study, 1000 frontline HCWs were recruited from various healthcare facilities in Vietnam between October 2021 and November 2021. Data were collected using a 3-part self-administered questionnaire, which covered demographics, sleep quality, and factors related to poor sleep. Poor sleep quality was defined as a total PSQI score of 5 or higher.
Results
Participants’ mean age was 33.20±6.81 years (range, 20.0-61.0), and 63.0% were women. The median work experience was 8.54±6.30 years. Approximately 6.3% had chronic comorbidities, such as hypertension and diabetes mellitus. About 59.5% were directly responsible for patient care and treatment, while 7.1% worked in tracing and sampling. A total of 73.8% reported poor sleep quality. Multivariate logistic regression revealed significant associations between poor sleep quality and the presence of chronic comorbidities (odds ratio [OR], 2.34; 95% confidence interval [CI], 1.17 to 5.24), being a frontline HCW directly involved in patient care and treatment (OR, 1.59; 95% CI, 1.16 to 2.16), increased working hours (OR, 1.84; 95% CI,1.37 to 2.48), and a higher frequency of encountering critically ill and dying patients (OR, 1.42; 95% CI, 1.03 to 1.95).
Conclusions
The high prevalence of poor sleep among HCWs in Vietnam during the COVID-19 pandemic was similar to that in other countries. Working conditions should be adjusted to improve sleep quality among this population.

Summary

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A cross‐sectional study of sleep disturbance among middle‐aged cancer patients at Vietnam National Cancer Hospital
Anh Tuan Pham, Mai Tuyet Do, Huong Thi Thanh Tran
Cancer Reports.2024;[Epub] CrossRef
Poor sleep quality and associated factors among healthcare professionals at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia
Winta Tesfaye, Ayechew Adera Getu, Baye Dagnew, Alemu Lemma, Yigizie Yeshaw
Frontiers in Psychiatry.2024;[Epub] CrossRef

Discrete-time Survival Analysis of Risk Factors for Early Menarche in Korean Schoolgirls: Yong Jin Gil, Jong Hyun Park, Joohon Sung; J Prev Med Public Health. 2023;56(1):59-66. Published online December 29, 2022; DOI: https://doi.org/10.3961/jpmph.22.428

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Abstract Summary PDF

Objectives
The aim of this study was to evaluate the effect of body weight status and sleep duration on the discrete-time hazard of menarche in Korean schoolgirls using multiple-point prospective panel data.
Methods
The study included 914 girls in the 2010 Korean Children and Youth Panel Study who were in the elementary first-grader panel from 2010 until 2016. We used a Gompertz regression model to estimate the effects of weight status based on age-specific and sex-specific body mass index (BMI) percentile and sleep duration on an early schoolchild’s conditional probability of menarche during a given time interval using general health condition and annual household income as covariates.
Results
Gompertz regression of time to menarche data collected from the Korean Children and Youth Panel Study 2010 suggested that being overweight or sleeping less than the recommended duration was related to an increased hazard of menarche compared to being average weight and sleeping 9 hours to 11 hours, by 1.63 times and 1.38 times, respectively, while other covariates were fixed. In contrast, being underweight was associated with a 66% lower discrete-time hazard of menarche.
Conclusions
Weight status based on BMI percentiles and sleep duration in the early school years affect the hazard of menarche.

Summary

Korean summary
초경연령의 조기화는 세계적인 현상이나 유독 우리나라에서는 그 단축속도가 매우 빠르나. 그 위험요인은 비만 이외에 확립되어 있지 못하다. 본 연구는 한국아동청소년패널의 2010-16년도까지 추적관찰된 914 명의 여아 자료를 Gompetz 회귀모형 (다중 분절형 생존분석모형)을 통해 분석하였며, 그 결과 과체중은 1년의 초경연령 단축을 유발할 위험도가 정상체중 여아에 비해 1.63배, 수면시간이 충분하지 못한 여아는 충분한 수면을 취하는 여아에 비해 1년의 초경연령 단축이 발생할 위험도가 1.38배 높은 것으로 나타났다.

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Neighbourhood environment and early menarche among adolescent girls of five countries
Erdenetuya Bolormaa, Taemi Kim, Eunson Gwak, Seung-Ah Choe, Adriane Martin Hilber
The European Journal of Contraception & Reproductive Health Care.2024; 29(6): 263. CrossRef

The Relationship Between Thiamine Intake and Long Sleep Duration: Results From the Korea National Health and Nutrition Examination Survey: Dongkyu Lee, Kwanghyun Kim, Youngrong Lee, Kyungwon Oh, Sun Jae Jung; J Prev Med Public Health. 2022;55(6):520-528. Published online October 14, 2022; DOI: https://doi.org/10.3961/jpmph.22.313

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Abstract Summary PDF Supplementary Material

Objectives
Thiamine is thought to modify sleeping patterns, while alcohol use diminishes internal thiamine levels. We investigated the association between thiamine intake and sleep duration and explored possible heterogeneity in the effect according to alcohol use.
Methods
In total, 15 384 participants aged 19-64 were obtained from the Korea National Health and Nutrition Examination Survey 2012-2016. Nutrient intake, including thiamine, was measured using a food frequency questionnaire. Sleep duration was measured by a self-reported questionnaire. The highest thiamine intake quartile was set as the reference group. Participants were divided into 3 groups, with 7-8 hours of daily sleep as a reference group and those who slept more or less than that as “oversleeping” and “insufficient sleeping,” respectively. Multivariate logistic regression was used, adjusting for socioeconomic, medical, and nutritional factors. Additionally, participants were stratified according to high-risk alcohol use defined by the World Health Organization standards on alcohol use.
Results
Low thiamine intake was associated with oversleeping (Q3: odds ratio [OR], 1.06; 95% confidence interval [CI], 0.86 to 1.32; Q2: OR, 1.24; 95% CI, 0.99 to 1.55; Q1: OR, 1.49; 95% CI, 1.16 to 1.91) and showed a significant trend for higher ORs at lower intake levels (p-trend<0.001). The effect was stronger in the high-risk alcohol use group (Q1: OR, 1.78; 95% CI, 1.28 to 2.49).
Conclusions
Low thiamine intake was associated with oversleeping, and alcohol use intensified that association. These results were found in a context where overt clinical symptoms due to thiamine deficiency are considered rare. More awareness of the potential relationship of thiamine intake with oversleeping and its related risks should be considered.

Summary

Korean summary
국민건강영양조사 자료에서 낮은 비타민 B1 섭취가 과도한 수면시간과 연관성이 있으며, 고위험 알코올 섭취군에서 더 큰 상관성을 보였다. 현저한 임상 증상이 나타나지 않는 선에서의 섭취부족도 잠재적으로 과도한 수면시간 및 이와 관련된 건강에 대한 부정적 효과들과 관련이 있을 수 있어 주의가 필요하다.

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The Therapeutic Potential of Vitamins B1, B3 and B6 in Charcot–Marie–Tooth Disease with the Compromised Status of Vitamin-Dependent Processes
Victoria Bunik
Biology.2023; 12(7): 897. CrossRef
Enhancing Sleep Quality: Assessing the Efficacy of a Fixed Combination of Linden, Hawthorn, Vitamin B1, and Melatonin
Matteo De Simone, Rosario De Feo, Anis Choucha, Elena Ciaglia, Francis Fezeu
Medical Sciences.2023; 12(1): 2. CrossRef

Association Between Sleep Quality and Anxiety in Korean Adolescents: Hyunkyu Kim, Seung Hoon Kim, Sung-In Jang, Eun-Cheol Park; J Prev Med Public Health. 2022;55(2):173-181. Published online February 10, 2022; DOI: https://doi.org/10.3961/jpmph.21.498

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Abstract Summary PDF

Objectives
Anxiety disorder is among the most prevalent mental illnesses among adolescents. Early detection and proper treatment are important for preventing sequelae such as suicide and substance use disorder. Studies have suggested that sleep duration is associated with anxiety disorder in adolescents. In the present study, we investigated the association between sleep quality and anxiety in a nationally representative sample of Korean adolescents.
Methods
This cross-sectional study was conducted using data from the 2020 Korea Youth Risk Behavior Web-based Survey. The Generalized Anxiety Disorder-7 questionnaire was used to evaluate anxiety. The chi-square test was used to investigate and compare the general characteristics of the study population, and multiple logistic regression analysis was used to analyze the relationship between sleep quality and anxiety.
Results
In both sexes, anxiety was highly prevalent in participants with poor sleep quality (adjusted odds ratio [aOR], 1.56; 95% confidence interval [CI], 1.43 to 1.71 in boys; aOR, 1.30; 95% CI, 1.19 to 1.42 in girls). Regardless of sleep duration, participants with poor sleep quality showed a high aOR for anxiety.
Conclusions
This study identified a consistent relationship between sleep quality and anxiety in Korean adolescents regardless of sleep duration.

Summary

Korean summary
청소년건강행태조사를 이용하여 청소년들의 수면의 질과 불안과의 연관성을 분석하였다. 좋지 않은 수면의 질은 불안감과 연관성이 있었으며 이 연관성은 대상자들의 수면시간과 상관없이 나타났다.

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Association Between Cohabitation Status and Sleep Quality in Families of Persons With Dementia in Korea: A Cross-sectional Study: Seung Hoon Kim, Minah Park, Sung Hoon Jeong, Sung-In Jang, Eun-Cheol Park; J Prev Med Public Health. 2021;54(5):317-329. Published online August 14, 2021; DOI: https://doi.org/10.3961/jpmph.21.077

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Abstract Summary PDF Supplementary Material

Objectives
The aim of this study was to identify the association between cohabitation status and sleep quality in family members of people with dementia (PwDs).
Methods
Data of 190 365 participants aged ≥19 years from the 2018 Korea Community Health Survey were analyzed. Participants were categorized according to their cohabitation status with PwDs. Multiple logistic regression and ordinal logistic regression analyses were performed to evaluate the relationship between the cohabitation status of PwDs’ relatives and sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI) and PSQI subscales.
Results
Compared to participants without PwDs in their families, both cohabitation and non-cohabitation with PwDs were associated with poor sleep quality (cohabitation, male: odds ratio [OR],1.28; 95% confidence interval [CI], 1.08 to 1.52; female: OR, 1.40; 95% CI, 1.20 to 1.64; non-cohabitation, male: OR, 1.14; 95% CI, 1.05 to 1.24; female: OR, 1.23; 95% CI, 1.14 to 1.33). In a subgroup analysis, non-cohabiting family members showed the highest odds of experiencing poor sleep quality when the PwD lived alone (male: OR, 1.48; 95% CI, 1.14 to 1.91; female: OR, 1.58; 95% CI, 1.24 to 2.01). Cohabiting male and female participants had higher odds of poor subjective sleep quality and use of sleeping medications than non-cohabiting male and female participants, respectively.
Conclusions
The residence of PwDs and cohabitation status may contribute to poor sleep quality among PwDs’ family members. The circumstances faced by cohabiting and non-cohabiting family members should be considered when evaluating sleep quality in family members of PwDs, and appropriate interventions may be needed to improve sleep quality in both cohabiting and non-cohabiting family members.

Summary

Korean summary
2018년 지역사회건강조사를 이용하여 190 365명을 대상으로 가족 중 치매환자 유무 및 치매환자와의 동거여부와 수면의 질 사이의 연관성을 분석하였다. 치매환자와의 동거여부와 상관없이 가족 중 치매환자가 존재하는 것은 낮은 수면의 질과 유의한 연관성이 있었다. 가족 중 치매환자가 있지만 동거하지 않는 가족 구성원의 경우 치매환자가 혼자 살 때 낮은 수면의 질과의 연관성이 가장 높게 나타났다.

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Factors related to cognitive performance among black caregivers of persons living with a chronic illness: An exploratory study
Glenna Brewster, Irene Yang, Jordan Pelkmans, Melinda Higgins, Drenna Waldrop, Sandra B. Dunbar, Katherine A. Yeager
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Association Between Sleep Quality and Anxiety in Korean Adolescents
Hyunkyu Kim, Seung Hoon Kim, Sung-In Jang, Eun-Cheol Park
Journal of Preventive Medicine and Public Health.2022; 55(2): 173. CrossRef
Association of compliance with COVID-19 public health measures with depression
Ju An Byun, Tae Jun Sim, Tae Yoon Lim, Sung-In Jang, Seung Hoon Kim
Scientific Reports.2022;[Epub] CrossRef

Daytime Napping and Nighttime Sleep During Pregnancy and Preterm Birth in Iran: Farnaz Shaliha, Maryam Mozaffari, Faeze Ramezani, Hamideh Hajnasiri, Farnoosh Moafi; J Prev Med Public Health. 2021;54(3):182-189. Published online March 31, 2021; DOI: https://doi.org/10.3961/jpmph.20.372

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Abstract PDF

Objectives
This study investigated the relationship between sleep quality during pregnancy and preterm birth.
Methods
This longitudinal study was conducted between August 2018 and May 2019. The participants were 150 pregnant women who had been referred to 7 healthcare centers in the city of Qazvin, Iran and met the inclusion criteria. The Petersburg Sleep Quality Index, the Epworth Sleepiness Scale, and 2 questions about daytime sleep status and a demographic questionnaire were administered at 14-18 weeks and 28-32 weeks of gestation. Data were analyzed using the Mann-Whitney test, the Fisher exact test, and univariate and multivariable logistic regression.
Results
In the present study, poor sleep quality affected 84.7% of the participants at 14-18 weeks and 93.3% at 28-32 weeks of gestation. The final model for preterm birth prediction incorporated age and the Petersburg Sleep Quality Index score in the second and third trimesters. Preterm birth increased by 14% with each unit increase in age. With each unit increase in the Petersburg Sleep Quality Index score in the second and third trimesters, preterm birth increased by 42% and 28%, respectively, but the p-values of these factors were not significant.
Conclusions
Although a significant percentage of pregnant women had poor sleep quality, no significant relationship was found between sleep quality during pregnancy and preterm birth.

Summary

Citations

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Ee Yin Kok, Satvinder Kaur, Nurul Husna Mohd Shukri, Nurliyana Abdul Razak, Masaki Takahashi
BMC Pregnancy and Childbirth.2024;[Epub] CrossRef
Association between sleep quality with maternal and neonatal outcomes during the covid-19 pandemic
Maryam Akbari, Sara EsmaeilzadehSaeieh, Malihe Farid, Arman Shafiee, Mahmood Bakhtiyari, Touran Bahrami Babaheidari, Mansoureh Yazdkhasti
BMC Pregnancy and Childbirth.2024;[Epub] CrossRef
Sleep duration, napping behaviors and restless legs syndrome during pregnancy and the trajectories of ultrasonographic measures of fetal growth: Findings from the NICHD Fetal Growth Studies–Singletons
Muzi Na, Samidha Sudhakar Shetty, Xiaoyue Niu, Stefanie N. Hinkle, Cuilin Zhang, Xiang Gao
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Journal of Integrative Nursing and Palliative Care.2022; 1(1): 18. CrossRef

Effects of Comorbid Sleep Disorders on Cardiovascular Complications of Hypertension Among Patients With Newly-diagnosed Hypertension: An Analysis of the Korean National Health Insurance Service-National Sample Cohort: Jeongmook Kang, Yoon-Hyung Park, Kwang Ik Yang, Jose Rene Bagani Cruz, Young Hwangbo; J Prev Med Public Health. 2020;53(1):37-44. Published online November 6, 2019; DOI: https://doi.org/10.3961/jpmph.19.248

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Abstract Summary PDF

Objectives
This study investigated the effects of comorbid sleep disorders (SD) on the incidence of cardiovascular complications among newly-diagnosed hypertension (HTN) patients.
Methods
As study population, 124 057 newly-diagnosed essential HTN patients aged 30 or older, without cardiovascular complications at diagnosis with HTN, were selected from the National Health Insurance Service-National Sample Cohort. The incidence of cardiovascular complications was calculated, Cox proportional-hazards regression model was used to analyze the risk of complications, and the population attributable fraction (PAF) for cardiovascular complications of having comorbid SD at HTN diagnosis was calculated.
Results
Over 10 years, 32 275 patients (26.0%) developed cardiovascular complications. In HTN patients with comorbid SD at diagnosis of HTN, the incidence of cardiovascular complications (78.3/1000 person-years; 95% confidence interval [CI], 75.8 to 80.9) was higher than in those without comorbid SD (58.6/1000 person-years; 95% CI, 57.9 to 59.3) and the risk of cardiovascular complications was 1.21 times higher (95% CI, 1.17 to 1.25), adjusting for age, gender, income, area of residence, and comorbid diabetes mellitus. The PAF of having comorbid SD at diagnosis of HTN for the incidence of cardiovascular complications was 2.07% (95% CI, 1.69 to 2.44).
Conclusions
Newly-diagnosed essential HTN patients aged 30 or older who had comorbid SD at the time of their HTN diagnosis had a higher incidence of cardiovascular complications than those without comorbid SD. Age, gender, income, area of residence, and comorbid diabetes mellitus had a significant effect on the incidence of cardiovascular complications. Approximately 2% of cardiovascular complications were found to occur due to the presence of SD.

Summary

Korean summary
본 연구 결과 심뇌혈관 합병증이 없었던 30세 이상 신규 일차성 고혈압 환자에서 고혈압 진단시 수면장애을 동반한 경우 심뇌혈관합병증 발생율은 78.3/1000인년(95% CI 75.8-80.9)으로 나타났으며, 수면장애을 동반하지 않은 경우 심뇌혈관합병증 발생율은 58.6/1000인년(95%CI 57.9-59.3)인 것으로 관찰되었다. 고혈압 진단시의 연령, 성별, 수입, 거주지역, 동반된 당뇨병력을 보정한 다중회귀분석에서 수면장애병력이 있는 고혈압 환자군의 심뇌혈관합병증 발생 위험도는 수면장애병력이 없는 환자에 비하여 1.21배(95% CI 1.17-1.25) 높은 것으로 나타났으며, 연구대상자에게 발생한 심뇌혈관합병증의 약 2%는 고혈압 진단시 동반된 수면장애가 기여한 것으로 분석되었다.

Citations

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Hyunkyu Kim, Seung Hoon Kim, Sung-In Jang, Eun-Cheol Park
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The Effect of Sleep Duration on the Risk of Unintentional Injury in Korean Adults: Yeon-Yong Kim, Un-Na Kim, Jin-Seok Lee, Jong-Heon Park; J Prev Med Public Health. 2014;47(3):150-157. Published online May 30, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.3.150

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Abstract PDF

Objectives

The decrease or increase in sleep duration has recently been recognized as a risk factor for several diseases, including hypertension and obesity. Many studies have explored the relationship of decreased sleep durations and injuries, but few have examined the relationship between increased sleep duration and injury. The objective of this research is to identify the risk for injury associated with both decreased and increased sleep durations.

Methods

Data from the 2010 Community Health Survey were used in this study. We conducted logistic regression with average sleep duration as the independent variable, injury as a dependent variable, and controlling for age, sex, occupation, education, region (cities and provinces), smoking, alcohol use, body mass index, hypertension, diabetes, arthritis, and depression. Seven categories of sleep duration were established: ≤4, 5, 6, 7, 8, 9, and ≥10 hours.

Results

Using 7 hours of sleep as the reference, the adjusted injury risk (odds ratio) for those sleeping a total of ≤4 h/d was 1.53; 1.28 for 5 hours, for 1.11 for 6 hours, 0.98 for 8 hours, 1.12 for 9 hours, and 1.48 for ≥10 hours. The difference in risk was statistically significant for each category except for the 8 and 9 hours. In this study, risk increased as the sleep duration decreased or increased, except for the 8 and 9 hours.

Conclusions

This research found that either a decrease or increase in sleep duration was associated with an increased risk for injury. The concept of proper sleep duration can be evaluated by its associated injury risk.

Summary

Citations

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Musculoskeletal injuries in UK Service Personnel and the impact of in-theatre rehabilitation during Cold Weather Warfare training: Exercise CETUS 2020
David H Ferraby, D Hayhurst, R Strachan, H Knapman, S Wood, J L Fallowfield
BMJ Military Health.2023; 169(6): 517. CrossRef
Prevalence and behavioural associations of unintentional injuries among Chinese college students: a 50-University population-based study
Dan Wu, Tingzhong Yang, Randall R Cottrell, Huan Zhou, Xueying Feng
Injury Prevention.2019; 25(1): 52. CrossRef
Association of physical activity, sedentary time, and sleep duration on the health-related quality of life of college students in Northeast China
Yinjian Ge, Shimeng Xin, Dechun Luan, Zhili Zou, Mengting Liu, Xue Bai, Qian Gao
Health and Quality of Life Outcomes.2019;[Epub] CrossRef
Risk factors for unintentional injuries among the rural elderly: a county-based cross-sectional survey
Hongping Zhang, Feng Wei, Mo Han, Jianquan Chen, Songxu Peng, Yukai Du
Scientific Reports.2017;[Epub] CrossRef
Unintentional Injuries among Psychiatric Outpatients with Major Depressive Disorder
Ching-I Hung, Chia-Yih Liu, Ching-Hui Yang, Yinglin Xia
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Relationship Between Current Sleep Duration and Past Suicidal Ideation or Attempt Among Korean Adolescents: Sung-In Jang, Kwang-Sig Lee, Eun-Cheol Park; J Prev Med Public Health. 2013;46(6):329-335. Published online November 28, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.6.329

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Abstract PDF

Objectives

To comprehensively examine the relationship between current sleep duration and past suicidal idea or attempt among Korean adolescents.

Methods

Data came from the 2009 Korea Youth Risk Behavior Web-based Survey with 75 066 participants (with the participation rate of 97.6%) in 800 middle and high schools. Binary logistic regression was conducted by gender and depressed mood to identify significant factors for suicidal ideation/attempt. The dependent variable was the log odds of suicidal ideation/attempt, while the independent/control variables were sleep duration and other demographic, socio-economic and health-related factors.

Results

A negative association between sleep duration and suicidal ideation or attempt was weaker for those with depressed mood than for those without such experience in Korea for Year 2009. The odds ratio of suicidal ideation/attempt regarding less than 4 hours of sleep compared to 6 to 7 hours of sleep, was smaller in a group with depressed mood than in a group without such experience, for example, 1.64 (95% confidence interval [CI], 1.29 to 2.08) vs. 2.06 (95% CI, 1.34 to 3.17) for men's suicidal ideation, 2.50 (95% CI, 1.69 to 3.69) vs. 3.89 (95% CI, 1.74 to 8.66) for men's suicidal attempt. A negative association between age (or self-rated health) and suicidal ideation/attempt was also weaker for those with depressed mood than for those without such experience in the nation for the year.

Conclusions

There was a negative association between sleep duration and suicidal ideation/attempt in Korea for Year 2009 and this association was weaker for those with depressed mood than for those without such experience. Based on the findings of this study, adolescents' better mental health and longer, more comfortable sleep might help to prevent their suicidal ideation and attempt in Korea.

Summary

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Association between stress types and adolescent suicides: findings from the Korea Youth Risk Behavior Survey
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Association between sleep disturbances and suicidal behavior in adolescents: a systematic review and meta-analysis
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Association between the number of hours of sleep during weekdays and suicidality among Korean adolescents: Mediating role of depressive and anxiety symptoms
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Wonjeong Jeong, Yun Kyung Kim, Hyeon Ji Lee, Jieun Jang, Selin Kim, Eun-Cheol Park, Sung-In Jang
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A Prospective Cohort Study on the Relationship of Sleep Duration With All-cause and Disease-specific Mortality in the Korean Multi-center Cancer Cohort Study: Yohwan Yeo, Seung Hyun Ma, Sue Kyung Park, Soung-Hoon Chang, Hai-Rim Shin, Daehee Kang, Keun-Young Yoo; J Prev Med Public Health. 2013;46(5):271-281. Published online September 30, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.5.271

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Abstract PDF

Objectives

Emerging evidence indicates that sleep duration is associated with health outcomes. However, the relationship of sleep duration with long-term health is unclear. This study was designed to determine the relationship of sleep duration with mortality as a parameter for long-term health in a large prospective cohort study in Korea.

Methods

The study population included 13 164 participants aged over 20 years from the Korean Multi-center Cancer Cohort study. Information on sleep duration was obtained through a structured questionnaire interview. The hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality were estimated using a Cox regression model. The non-linear relationship between sleep duration and mortality was examined non-parametrically using restricted cubic splines.

Results

The HRs for all-cause mortality showed a U-shape, with the lowest point at sleep duration of 7 to 8 hours. There was an increased risk of death among persons with sleep duration of ≤5 hours (HR, 1.21; 95% CI, 1.03 to 1.41) and of ≥10 hours (HR, 1.36; 95% CI, 1.07 to 1.72). In stratified analysis, this relationship of HR was seen in women and in participants aged ≥60 years. Risk of cardiovascular disease-specific mortality was associated with a sleep duration of ≤5 hours (HR, 1.40; 95% CI, 1.02 to 1.93). Risk of death from respiratory disease was associated with sleep duration at both extremes (≤5 and ≥10 hours).

Conclusions

Sleep durations of 7 to 8 hours may be recommended to the public for a general healthy lifestyle in Korea.

Summary

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Zolpidem Use and Risk of Fracture in Elderly Insomnia Patients: Dong-Yoon Kang, Soyoung Park, Chul-Woo Rhee, Ye-Jee Kim, Nam-Kyong Choi, Joongyub Lee, Byung-Joo Park; J Prev Med Public Health. 2012;45(4):219-226. Published online July 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.4.219

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Abstract PDF

Objectives

To evaluate the risk of fractures related with zolpidem in elderly insomnia patients.

Methods

Health claims data on the entire South Korean elderly population from January 2005 to June 2006 were extracted from the Health Insurance Review and Assessment Service database. We applied a case-crossover design. Cases were defined as insomnia patients who had a fracture diagnosis. We set the hazard period of 1 day length prior to the fracture date and four control periods of the same length at 5, 10, 15, and 20 weeks prior to the fracture date. Time independent confounding factors such as age, gender, lifestyle, cognitive function level, mobility, socioeconomic status, residential environment, and comorbidity could be controlled using the casecrossover design. Time dependent confounding factors, especially co-medication of patients during the study period, were adjusted by conditional logistic regression analysis. The odds ratios and their 95% confidence intervals (CIs) were estimated for the risk of fracture related to zolpidem.

Results

One thousand five hundred and eight cases of fracture were detected in insomnia patients during the study period. In our data, the use of zolpidem increased the risk of fracture significantly (adjusted odds ratio [aOR], 1.72; 95% CI, 1.37 to 2.16). However, the association between benzodiazepine hypnotics and the risk of fracture was not statistically significant (aOR, 1.00; 95% CI, 0.83 to 1.21). Likewise, the results were not statistically significant in stratified analysis with each benzodiazepine generic subgroup.

Conclusions

Zolpidem could increase the risk of fracture in elderly insomnia patients. Therefore zolpidem should be prescribed carefully and the elderly should be provided with sufficient patient education.

Summary

Citations

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English Abstract

The Association between Sleep and Obesity in Korean Adults.: Young Jun Park, Won Chul Lee, Hyeon Woo Yim, Young Moon Park; J Prev Med Public Health. 2007;40(6):454-460.; DOI: https://doi.org/10.3961/jpmph.2007.40.6.454

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Abstract PDF

OBJECTIVES
Obesity is currently an epidemic in Korea, and sleep duration is thought to be one of the risk factors for obesity. The objective of this study was to test the hypothesis that short sleep duration is associated with obesity in Korean adults. METHODS: The data from the 2001 Korean National Health and Nutrition Survey were used, and 6,174 subjects aged 18~80 years were included in the analysis. Sleep duration was measured using information obtained from self-reported questionnaires. Obesity, the main outcome variable, was measured according to body mass index. Multiple regression modeling was used to adjust for potential confounding variables. RESULTS: The study results revealed a negative association between sleep duration and body mass index among Korean adults. These associations persisted after controlling for the potential confounding variables. CONCLUSIONS: These findings support the hypothesis that sleep duration is associated with obesity in Korean adults. In addition, these observations support earlier experimental sleep studies and provide a basis for future studies on weight control intervention by increasing the amount of sleep.

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