Veena Aggarwal

English

Indian Journal Of Clinical Practice

Indian Journal of Clinical Practice, Vol. 33, No. 10, March 2023 5EDITORIALSleep Quality and Premature MortalityDr Veena AggarwalConsultant, Womens’ HealthCMD and Group Editor-in-Chief, IJCP Group & MedtalksTrustee, Dr KK’s Heart Care Foundation of IndiaYoung people who have good sleep quality are at lower risk of premature mortality, all-cause or due to cardiovascular disease (CVD), cancer or other causes, compared to individuals who have poor sleep quality. These findings from a new study were presented at the American College of Cardiology’s Annual Scientific Session held in New Orleans earlier this month.1,2A total of 1,72,321 people, aged 50 years (average), from the United States were enrolled for the present study. All of them had been a part of the National Health Interview Survey conducted by the Centers for Disease Control and Prevention (CDC) and the National Center for Health Statistics between 2013 and 2018. Half (54%) of the participants were women. Through this study, the researchers aimed to examine the impact of sleep behavior on life expectancy. The National Death Index records were used to ascertain the association between sleep and mortality, both all-cause and cause-specific.Five parameters were used to determine the pattern score: Sleep duration of 7 to 8 hours (ideal), difficulty falling asleep no more than 2 times in a week, trouble staying asleep no more than 2 times a week, not using any sleep medication and feeling rested after waking up at least 5 days a week. Each variable was given a score of 0 or 1 with a maximum score of 5 indicating the highest quality sleep.Over 4.3 years (median) of follow-up, 8,681 deaths were recorded; CVDs accounted for 2,610 deaths (30%), while 2,052 (24%) were from cancer and the remaining (46%) were due to other causes. The all-cause mortality was reduced by 30% among those who had all five favorable sleep factors with a hazard ratio (HR) of 0.7 when compared to participants who either had none or had one favorable sleep factor. Death due to CVD decreased by 21% (HR 0.79), while deaths due to cancer declined by 19% (HR 0.81). They also had 40% less probability of dying due to other causes such as infections, accidents or neurodegenerative diseases like dementia and Parkinson’s disease (HR 0.6).When the role of gender was examined among the participants who had a score of 5, men had 4.7 years longer life expectancy at age 30 years versus those who had none or only one favorable sleep measure, whereas in women with all five favorable sleep factors, the life expectancy was greater by only 2.4 years. This variation, despite similar quality of sleep, needs further study, note the authors.Maintaining good sleep hygiene is important for health and well-being. By demonstrating an association between sleep pattern and life expectancy, this study highlights that while it is important to get adequate hours of sleep daily, a good sleep quality holds equal significance. There are four components of sleep quality: sleep efficiency (the percentage of time actually spent asleep while in bed), sleep duration, sleep latency (time it takes a person to fall asleep) and wake after sleep onset (difficulty in staying asleep).Good sleep quality heals and is restful, i.e., you feel rested after getting up in the morning. But if you wake up EDITORIALIndian Journal of Clinical Practice, Vol. 33, No. 10, March 20236feeling tired or feel sleepy during the day, this denotes poor quality sleep. Hence, patients should be enquired about their sleep habits as a routine “as part of their overall health assessment and disease management planning”.Here are few tips to improve sleep hygiene: Â Get up at the same time every day. Â Go to bed when you are ready to sleep. Â Avoid drinking tea/coffee or caffeinated drinks nearer to your bedtime. Â Remove cell phones, computers, TV, tablets, etc. from the bedroom. Â If you are anxious and unable to sleep, try meditation, deep breathing or progressive muscle relaxation to calm the mind and relax the muscles.RefeRences1. ACC Press Release. Getting good sleep could add years to your life. Feb. 23, 2023. Available at: https://www.acc. org/About-ACC/Press-Releases/2023/02/22/21/35/Getting-Good-Sleep-Could-Add-Years-to-Your-Life. Accessed Feb. 27, 2023.2. Higher-quality sleep may reduce risk for mortality. Feb. 23, 2023. Available at: https://www.healio.com/news/cardiology/20230223/higherquality-sleep-may-reduce-risk-for-mortality. Accessed Feb. 27, 2023.■ ■ ■ ■ART and surrogacy Bill are Designed to Provide Better Medical care says MandaviyaRecently, Mr Mansukh Mandaviya, the Union Minister of Health, stated that the goal of the Assisted Reproductive Technology (ART) and Surrogacy Bill is to improve patient security and medical care. He added that the incorporation of new methods and tools into ART has greatly benefited patients and raised knowledge of the causes and solutions to infertility. According to the Union Minister, the government’s health program for promoting quality motherhood has paid off and decreased the Maternal Mortality Rate (MMR). With the ongoing, unwavering efforts to adopt breakthroughs in ART, he reaffirmed his belief that India will make significant progress toward providing couples in India with the best facilities and care for fertility.In addition, Mr Mandaviya identified poor menstrual hygiene as a significant beginning cause of childlessness in relationships. He also praised ISAR’s efforts in providing a platform for thousands of in vitro fertilization, ART, gynecologists, embryologists and ART technologists to get together, exchange knowledge and discuss technical advancements and ideas that would ultimately benefit patients. (Source: https://health.economictimes.indiatimes.com/news/policy/art-surrogacy-bill-strive-to-provide-better-medical-care-mandaviya/97617766)experts concerned Over new Diabetes Drugs not Dealing with Root causes of ObesityRecent statistics show that between 1993 and 2019, the percentage of obese adults in England increased from 14.9% to 28%. Data from NHS England show that in 2019-20, 10,780 hospital admissions were directly related to obesity. Many people find it challenging to maintain their weight loss through diet and exercise, so interest in medications that work by stimulating the hormones that make people feel full after eating is growing. In one study, individuals dropped up to 20% of their body weight throughout a 72-week trial while taking tirzepatide and making lifestyle adjustments. However, doctors believe that while the dramatic effects of such treatments are welcome, there are worries they can make people less motivated to take steps to prevent obesity in the first place. Experts stated that there has been an increase in the prescription of blood pressure (BP) medications and statins due to the increased number of people who have high BP from overeating salt and high low-density lipoprotein (LDL) cholesterol from overeating saturated fat. There are obstacles to their use, although the UK’s National Institute for Health and Care Excellence (NICE) has already approved the use of two diabetes medications, liraglutide and the more potent semaglutide for certain groups of obese people. The medications have downsides, including the fact that they are pricey and can only be taken by injection. Experts say further research is needed on safety and adverse effects. According to a body image and mental health advocate, introducing the medications won’t lessen the pressure of the already obese people.Doctors’ suggested that it is better to avoid unhealthy foods rather than trying to reverse the effects of obesity. Hence warned and said that aim should also focus on helping people lose weight and prevent developing obesity. (Source: https://www.theguardian.com/society/2023/feb/05/new-diabetes-drugs-do-not-tackle-root-causes-of-obesity-experts-warn)

Sleep Quality and Premature Mortality

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Sleep Quality and Premature Mortality

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