Associations between Aircraft Noise, Sleep, and Sleep–Wake Cycle: Actimetric Data from the UK Biobank Cohort near Four Major Airports

BACKGROUND: Nighttime aircraft noise may affect people's sleep, yet large-scale evidence using objective and subjective measures remains limited. OBJECTIVE: Our aim was to investigate associations between nighttime aircraft noise exposure and objectively measured sleep disturbance using a large UK cohort. METHODS: We used data from 105,770 UK Biobank cohort participants exposed and unexposed to aircraft noise who lived in 44 local authority districts near 4 international airports in England. We used a generalized linear regression model to examine cross-sectional associations between aircraft noise formula presented (23:00 hours-07:00 hours) and 7-d actimetric measures collected 2013-2015 (formula presented ). We also used Logit and generalized estimating equations models to examine associations between formula presented and self-reported sleep measures at enrollment (2006-2010) and follow-up (2012-2013). This approach allowed us to compare and contrast the results and support potential future meta-analyses on noise-related sleep disturbance. RESULTS: Cross-sectional analyses of actimetric data suggested sleep disturbance associated with formula presented , showing higher level of movements during the least active continuous 8-h time period [formula presented : 0.12 milligravitational units; 95% confidence interval (CI): 0.013, 0.23]. We also saw disrupted sleep-wake cycles as indicated by index scores of lower relative amplitude (formula presented : formula presented ; 95% CI: formula presented ), poorer interdaily stability (formula presented : formula presented ; 95% CI: formula presented ), and greater intradaily variability (formula presented : 0.021; 95% CI: 0.019, 0.023), comparing formula presented dB with formula presented dB. Repeated cross-sectional analyses found a 52% higher odds of more frequent daytime dozing [odds ratio (OR) formula presented ; 95% CI: 1.32, 1.75] for formula presented dB in comparison with formula presented dB, whereas the likelihood for more frequent sleeplessness was more uncertain (formula presented ; 95% CI: 0.92, 1.39). Higher effect sizes were seen in preidentified vulnerable groups, including individuals formula presented of age and those with diabetes or dementia. CONCLUSION: Individuals exposed to higher levels of aircraft noise experienced objectively higher levels of sleep disturbance and changes in sleep-wake cycle. https://doi.org/10.1289/EHP14156

Myocardial scar and remodelling predict long-term mortality in severe aortic stenosis beyond 10 years

Aortic stenosis (AS) is characterized by the narrowing of the aortic valve and compensatory myocardial remodelling.1 However, ultimately the left ventricle decompensates, leading to heart failure and death, and intervention is advised for severe AS accompanied by either symptoms or left ventricular (LV) dysfunction.2 Yet, over half of patients receiving aortic valve replacement (AVR) have irreversible myocardial scarring.3 Our multi-centre UK consortium linked pre-operative myocardial scarring, detected by late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) with increased all-cause and cardiovascular (CV) mortality, regardless of intervention type, after a median of 3.5 years.4 With the integration of machine learning for CMR analysis, we achieve 40% greater precision than human assessment, potentially uncovering patterns obscured by human variability.5 We now examine whether the association of myocardial scar with mortality persists over longer-term follow-up.</p

Study protocol: MyoFit46—the cardiac sub-study of the MRC National Survey of Health and Development

Background: The life course accumulation of overt and subclinical myocardial dysfunction contributes to older age mortality, frailty, disability and loss of independence. The Medical Research Council National Survey of Health and Development (NSHD) is the world’s longest running continued surveillance birth cohort providing a unique opportunity to understand life course determinants of myocardial dysfunction as part of MyoFit46–the cardiac sub-study of the NSHD.  Methods: We aim to recruit 550 NSHD participants of approximately 75 years+ to undertake high-density surface electrocardiographic imaging (ECGI) and stress perfusion cardiovascular magnetic resonance (CMR). Through comprehensive myocardial tissue characterization and 4-dimensional flow we hope to better understand the burden of clinical and subclinical cardiovascular disease. Supercomputers will be used to combine the multi-scale ECGI and CMR datasets per participant. Rarely available, prospectively collected whole-of-life data on exposures, traditional risk factors and multimorbidity will be studied to identify risk trajectories, critical change periods, mediators and cumulative impacts on the myocardium.  Discussion: By combining well curated, prospectively acquired longitudinal data of the NSHD with novel CMR–ECGI data and sharing these results and associated pipelines with the CMR community, MyoFit46 seeks to transform our understanding of how early, mid and later-life risk factor trajectories interact to determine the state of cardiovascular health in older age.  Trial registration: Prospectively registered on ClinicalTrials.gov with trial ID: 19/LO/1774 Multimorbidity Life-Course Approach to Myocardial Health- A Cardiac Sub-Study of the MCRC National Survey of Health and Development (NSHD).</p