Hazard ratios (HR) and 95% Confidence Intervals for Type 2 Diabetes, Myocardial Infarction, Stroke, and Cancer by Sleep Duration in the EPIC-Potsdam Cohort.

a<p>Type 2 diabetes, myocardial infarction, stroke, or cancer, whichever occurs first.</p>b<p>Stratified by age and adjusted for sex.</p>c<p>Additionally adjusted for sleeping disorders (yes/no), alcohol intake from beverages (non-consumers, men: >0–12 g/d, >12–24 g/d, >24 g/d; women: >0–6 g/d, >6–12 g/d, >12 g/d), smoking status (never, former, current), walking, cycling, sports (hours/week), employment status (employed vs. unemployed), and education (technical school or lower degree vs. university of applied sciences or university degree).</p>d<p>Adjusted for the variables in model 2 plus potential mediators: BMI (kg/m²), waist-to-hip ratio, prevalent hypertension at baseline (yes/no), and history of high blood lipid levels at baseline (yes/no).</p>e<p>Adjusted for the variables in model 3 plus consumption of caffeinated beverages (coffee and tea in g/day), satisfaction with life (4 levels: very satisfied, rather satisfied, rather dissatisfied, very dissatisfied), satisfaction with health (4 levels: very satisfied, rather satisfied, rather dissatisfied, very dissatisfied), and intake of antidepressants (yes/no).</p>f<p>Model 3–4 for cancer includes the same covariable-set as models for type 2 diabetes, myocardial infarction, and stroke, except prevalent hypertension at baseline (yes/no), and history of high blood lipid levels at baseline (yes/no).</p

Hazard ratios (HR) and 95% confidence intervals for daytime sleep and chronic diseases stratified by prevalent hypertension.

a<p>Type 2 diabetes, myocardial infarction, stroke or cancer, whichever occurs first.</p>b<p>Stratified by age and adjusted for sex.</p>c<p>Additionally adjusted for sleeping disorders (yes/no), sleep duration at night (<6, 6-<7, 7-<8, 8-<9, ≥9 h), alcohol intake from beverages (non-consumers, men: >0–12 g/d, >12–24 g/d, >24 g/d; women: >0–6 g/d, >6–12 g/d, >12 g/d), smoking status (never, former, current), walking, cycling, sports (hours/week), employment status (employed vs. unemployed), and education (technical school or lower degree vs. university of applied sciences or university degree).</p>d<p>Adjusted for the variables in model 2 plus BMI (kg/m2), waist-to-hip ratio, and history of high blood lipid levels at baseline (yes/no).</p>e<p>Model 3 for cancer includes the same covariates as models for type 2 diabetes, myocardial infarction and stroke, except history of high blood lipid levels at baseline (yes/no).</p

Association of sleep duration with overall chronic disease risk.

<p>Stratified by age and adjusted for sex, sleeping disorders, alcohol intake from beverages, smoking status, walking/cycling/sports, employment status, education, BMI, waist-to-hip ratio, prevalent hypertension at baseline, history of high blood lipid levels at baseline, consumption of caffeinated beverages, satisfaction with life, satisfaction with health, and intake of antidepressants.</p

Baseline Characteristics and Risk Factors for Chronic Disease by Self-reported Sleep Duration.

<p>Categorical variables are presented as percentages within the respective subgroup and continuous variables are expressed as means with standard deviation in parentheses.</p>a<p>Low-energy beverages: water, coffee (including de-caffeinated coffee), tea (including herbal tea), low-energy soft drinks (energy-reduced cola, lemonades).</p>b<p>High-energy beverages: juice, high-energy soft drinks (cola, lemonades, non-alcoholic beer, malt beer).</p>c<p>Caffeinated beverages: coffee, black tea.</p>d<p>Vegetables are also including legumes.</p>e<p>Side dishes: pasta, rice, potatoes.</p>f<p>Dairy products: milk, yoghurt, curd, soured milk/kefir, cream, cheese.</p>g<p>Meat: red meat, poultry, processed meat.</p>h<p>Snacks: french fries, pizza, chips.</p>i<p>Sweets: cakes, cookies, confectionary, sweet bread spread, desserts.</p

REM Sleep Imposes a Vascular Load in COPD Patients Independent of Sleep Apnea

<p>Arterial stiffness, a marker for cardiovascular risk, is increased in patients with Chronic Obstructive Pulmonary Disease (COPD) and Obstructive Sleep Apnea (OSA). The specific influence of both on arterial stiffness during sleep is unknown. Nocturnal arterial stiffness (Pulse Propagation Time (PPT) of the finger pulse wave) was calculated in 142 individuals evaluated for sleep apnea: 27 COPD patients (64.7 ± 11y, 31.2 ± 8 kg/m²), 72 patients with cardiovascular disease (CVD group, 58.7 ± 13y, 33.6 ± 6 kg/m²) and 43 healthy controls (HC group 49.3 ± 12y, 27.6 ± 3 kg/m²). Sleep stage related PPT changes were assessed in a subsample of COPD patients and matched controls (n = 12/12). Arterial stiffness during sleep was increased in COPD patients (i.e. shortened PPT) compared to healthy controls (158.2 ± 31 vs. 173.2 ± 38 ms, p = 0.075) and to patients with CVD (161.4 ± 41 ms). Arterial stiffening was particular strong during REM sleep (145.9 ± 28 vs. 172.4 ± 43 ms, COPD vs. HC, p = 0.003). In COPD, time SaO₂ < 90% was associated with reduced arterial stiffness (Beta +1.7 ms (1.1–2.3)/10 min, p < 0.001). Sleep apnea did not affect PPT. In COPD, but not in matched controls, arterial stiffness increased from wakefulness to REM-sleep (ΔPPT-8.9 ± 10% in COPD and 3.7 ± 12% in matched controls, p = 0.021). Moreover, REM-sleep related arterial stiffening was correlated with elevated daytime blood pressure (r = −0.92, p < 0.001) and increased myocardial oxygen consumption (r = −0.88, p < 0.01). Hypoxia and REM sleep modulate arterial stiffness. In contrast to healthy controls, REM sleep imposes a vascular load in COPD patients independent of sleep apnea indices, intermittent and sustained hypoxia. The link between REM-sleep, vascular stiffness and daytime cardiovascular function suggests that REM-sleep plays a role for increased cardiovascular morbidity of COPD patients.</p

Study Design.

<p>Study Design.</p

RLS-associated SNPs representing <i>cis</i>-eQTLs in peripheral blood.

<p>A total of 23 <i>cis</i>-eQTLs were found in both KORA F4 and SHIP-TREND at p_nominal<1×10⁻³. SNPs which were carried into the replication phase are printed in bold. NS = not significant.</p