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The impact of obesity and weight gain on development of sleep problems in a population-based sample
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
2015 (English)In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 16, no 5, p. 593-597Article in journal (Refereed) Published
Abstract [en]

Objectives: The objective of this study was to investigate the role of obesity and weight gain in the development of sleep problems in a population-based cohort. Material and methods: A population-based sample of men (n = 1896, aged 40-79 years) and women (n = 5116, age = 20 years) responded to questionnaires at baseline and follow-up after 10-13 years. Sleep problems were assessed through questions about difficulties initiating sleep (DIS), difficulties maintaining sleep (DMS), excessive daytime sleepiness (EDS), and insomnia. Body mass index (BMI) was calculated from self-reported weight and height at both baseline and follow-up, while confounding factors (physical activity, tobacco and alcohol use, somatic disease, and snoring) were based on responses at baseline. Results: Although overweight and obese subjects reported more sleep problems at baseline, there was no independent association between BMI level at baseline and development of new sleep problems. Subjects in the quartile with the highest rise in BMI with a weight gain exceeding 2.06 kg/m(2) had a higher risk of developing DMS [adjusted odds ratio (OR) 1.58; 95% confidence interval (CI) 1.25-2.01), EDS (2.25; 1.65-3.06], and insomnia (2.78; 1.60-4.82). Weight gain was not associated with the development of DIS. Conclusions: Weight gain is an independent risk factor for developing several sleep problems and daytime sleepiness. The presence of overweight and weight gain should be considered when treating patients with sleep problems. (C) 2015 Elsevier B.V. All rights reserved.

Place, publisher, year, edition, pages
2015. Vol. 16, no 5, p. 593-597
Keywords [en]
Weight gain, Overweight, Obesity, Sleep problems, Insomnia, Sleepiness
National Category
Neurology
Identifiers
URN: urn:nbn:se:uu:diva-255278DOI: 10.1016/j.sleep.2015.01.016ISI: 000353892800010PubMedID: 25819416OAI: oai:DiVA.org:uu-255278DiVA, id: diva2:824779
Funder
Swedish Heart Lung Foundation, 20080526Available from: 2015-06-22 Created: 2015-06-15 Last updated: 2018-09-25Bibliographically approved
In thesis
1. Obesity, Sleep and Sleep-disordered Breathing
Open this publication in new window or tab >>Obesity, Sleep and Sleep-disordered Breathing
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Sleep problems are associated with impaired quality of life and daytime sleepiness. Obstructive sleep apnoea (OSA) and obesity hypoventilation syndrome (OHS), are associated with metabolic changes and an increased cardiovascular morbidity and mortality. The most preferred treatment of OSA and OHS is positive airway pressure (PAP) therapy. Diagnostic delay and non-adherence to PAP therapy are major clinical problems.

Aims and methods: Paper I: A longitudinal population-based cohort study aimed to investigate the role of obesity and weight gain in the development of sleep problems in 1,896 men and 5,116 women who responded to questionnaires at baseline and followed up after 10–13 years.

Paper II: A national registry-based cohort study aimed to analyse gender differences in patients with OHS starting long term mechanical ventilation (LTMV) and to study how the prescription of LTMV due to OHS has changed over time with data on 1,527 patients derived from the Swedish quality registry Swedevox between 1996 and 2014.

Paper III: A longitudinal observational cohort study aimed to investigate the impact of adherence to continuous positive airway pressure (CPAP) treatment on IGF-1 concentration in 69 patients with OSA followed up after 4.8 ± 2.5 months.

Paper IV: A national registry-based cohort study aimed to identify protective and risk factors against the discontinuation of CPAP treatment in patients with OSA and to estimate the mortality risk in those who were non-adherent to CPAP therapy on 16,425 patients derived from the Swedish quality registry Swedevox between July 2010 and March 2017.

Results and conclusions: Weight gain is a risk factor for developing several sleep problems and daytime sleepiness. Women with OHS are older with a more advanced clinical picture at initiation of LTMV and start LTMV more frequently in a non-elective situation than men. CPAP usage ≥ 4 h/night is associated with increased IGF-1 concentration in patients with OSA. Use of humidifier, increasing age, more severe OSA and BMI up to 35 are associated with greater adherence to CPAP treatment. Female gender and coexisting hypertension are risk factors for the discontinuation of CPAP. Failure to adhere to CPAP is associated with increased mortality.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2018. p. 94
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1496
Keywords
Sleep, Obesity, Obstructive Sleep Apnea, Obesity Hypoventilation syndrome
National Category
Respiratory Medicine and Allergy
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-361345 (URN)978-91-513-0453-3 (ISBN)
Public defence
2018-11-09, Brömssalen, Gävle sjukhus, Lasarettsvägen 1, Gävle, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2018-10-17 Created: 2018-09-23 Last updated: 2018-11-19

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Palm, AndreasJanson, ChristerLindberg, Eva

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