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  1. Article ; Online: Associations between circadian disruption and cardiometabolic disease risk: A review.

    Ansu Baidoo, Velarie / Knutson, Kristen L

    Obesity (Silver Spring, Md.)

    2023  Volume 31, Issue 3, Page(s) 615–624

    Abstract: The human circadian system plays a vital role in many physiological processes, and circadian rhythms are found in virtually all tissues and organs. The disruption of circadian rhythms may lead to adverse health outcomes. Evidence from recent population- ... ...

    Abstract The human circadian system plays a vital role in many physiological processes, and circadian rhythms are found in virtually all tissues and organs. The disruption of circadian rhythms may lead to adverse health outcomes. Evidence from recent population-based studies was reviewed because they represent real-world behavior and can be useful in developing future studies to reduce the risk of adverse health conditions, including cardiovascular diseases, obesity, and diabetes mellitus, which may occur because of circadian disruption. An electronic search in PubMed and Web of Science (2012-2022) was performed. Selected articles were based on specific inclusion and exclusion criteria. Five factors that may disrupt circadian rhythm alignment are discussed: shift work, late chronotype, late sleep timing, sleep irregularity, and late meal timing. Evidence from observational studies of these circadian disruptors suggests potential detrimental effects on cardiometabolic health, including higher BMI/obesity, higher blood pressure, greater dyslipidemia, greater inflammation, and diabetes. Future research should identify the specific underlying pathways in order to mitigate the health consequences of shift work. Furthermore, optimal sleep and mealtimes for metabolic health can be explored in intervention studies. Lastly, it is important that the timing of external environmental cues (such as light) and behaviors that influence circadian rhythms are managed.
    MeSH term(s) Humans ; Sleep/physiology ; Circadian Rhythm/physiology ; Cardiovascular Diseases/etiology ; Hypertension/complications ; Obesity/complications
    Language English
    Publishing date 2023-02-07
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, N.I.H., Extramural
    ZDB-ID 2230457-5
    ISSN 1930-739X ; 1071-7323 ; 1930-7381
    ISSN (online) 1930-739X
    ISSN 1071-7323 ; 1930-7381
    DOI 10.1002/oby.23666
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  2. Article ; Online: Association between severity of obstructive sleep apnea and its common symptoms varies by race, ethnicity, and sex.

    Stepney, David / Attarian, Hrayr P / Knutson, Kristen L

    Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

    2023  Volume 19, Issue 10, Page(s) 1727–1733

    Abstract: ... who would benefit from treatment.: Citation: Stepney D, Attarian HP, Knutson KL. Association between ...

    Abstract Study objectives: The US Preventive Services Task Force recently released guidelines suggesting little evidence of benefit to screening asymptomatic adults for obstructive sleep apnea (OSA). Our goal was to provide important context to this statement. Specifically, we examined associations between common OSA symptoms, excessive daytime sleepiness and snoring, and OSA severity for different racial/ethnic and sex groups.
    Methods: Analyses were performed on 2 samples. One combined 2 observational studies that included full polysomnography, the Epworth Sleepiness Scale (ESS), and questions about snoring (mean [standard deviation] age 39 [15.2] years). The second sample was the Multi-Ethnic Study of Atherosclerosis study of older adults (mean [standard deviation] age 69 [9.1] years), which also included polysomnography, ESS and a question about snoring. Apnea-hypopnea index represented OSA severity. For each racial/ethnic-sex group we estimated correlations between apnea-hypopnea index and ESS and the sensitivity and specificity of excessive daytime sleepiness (ESS >10) or frequent snoring to predict moderate-to-severe OSA (apnea-hypopnea index >15 events/h).
    Results: A weak significant correlation between OSA severity and ESS was found only in White men in the first sample and Black men in the second sample. Screening tool characteristics for ESS and snoring were poor except for moderate specificity in some racial/ethnic-sex groups.
    Conclusions: Excessive daytime sleepiness and snoring are commonly used to identify symptomatic patients. Our results suggest that the accuracy of these symptoms to identify OSA varies by race/ethnicity and sex. Therefore, focus on common symptoms as an OSA screen could systematically leave out certain patient populations who would benefit from treatment.
    Citation: Stepney D, Attarian HP, Knutson KL. Association between severity of obstructive sleep apnea and its common symptoms varies by race, ethnicity, and sex.
    MeSH term(s) Male ; Humans ; Aged ; Adult ; Snoring ; Ethnicity ; Sleep Apnea, Obstructive/complications ; Sleep Apnea, Obstructive/diagnosis ; Disorders of Excessive Somnolence/diagnosis ; Polysomnography ; Surveys and Questionnaires
    Language English
    Publishing date 2023-10-03
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2397213-0
    ISSN 1550-9397 ; 1550-9389
    ISSN (online) 1550-9397
    ISSN 1550-9389
    DOI 10.5664/jcsm.10660
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  3. Article ; Online: The association between timing of dietary macronutrient and sodium consumption and sleep duration and quality.

    Baidoo, Velarie Yaa Ansu / Alexandria, Shaina J / Zee, Phyllis C / Knutson, Kristen L

    Sleep advances : a journal of the Sleep Research Society

    2024  Volume 5, Issue 1, Page(s) zpae007

    Abstract: Study objective: The objective of this study was to examine the association between the timing of dietary macronutrients and sodium intake and sleep quantity and quality.: Methods: This was a cross-sectional study that included 34 adults between 21 ... ...

    Abstract Study objective: The objective of this study was to examine the association between the timing of dietary macronutrients and sodium intake and sleep quantity and quality.
    Methods: This was a cross-sectional study that included 34 adults between 21 and 50 years of age. The main outcome measures were objective sleep measures assessed from three nights of wrist actigraphy including sleep duration, fragmentation, and wake after sleep onset (WASO), and one night of polysomnography (PSG), including rapid eye movement (REM) sleep, non-REM stage 2 (N2), stage 3 (N3), and WASO. Multiple linear regression models and linear mixed models were used to estimate the associations between sleep measures and dietary measures (carbohydrates, fats, saturated fats, proteins, and sodium). Dietary timing was examined in two ways: (1) the average amount of each nutrient consumed within 3 hours of sleep start, and (2) the interval between the final intake of each nutrient and sleep.
    Results: Average fat intake within 3 hours of sleep was associated with greater WASO from PSG (
    Conclusions: The study suggests that greater fat but not carbohydrate, protein, saturated fat, or sodium intake close to sleep may be associated with greater sleep disruption; however, no other associations were observed.
    Language English
    Publishing date 2024-01-23
    Publishing country United States
    Document type Journal Article
    ISSN 2632-5012
    ISSN (online) 2632-5012
    DOI 10.1093/sleepadvances/zpae007
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  4. Article ; Online: Associations between Timing and Duration of Eating and Glucose Metabolism: A Nationally Representative Study in the U.S.

    Ali, Marriam / Reutrakul, Sirimon / Petersen, Gregory / Knutson, Kristen L

    Nutrients

    2023  Volume 15, Issue 3

    Abstract: Diabetes is highly prevalent and is associated with dietary behaviors. Time-restricted eating, which consolidates caloric intake to a shortened eating duration, has demonstrated improvement in metabolic health. Timing of eating could also impact ... ...

    Abstract Diabetes is highly prevalent and is associated with dietary behaviors. Time-restricted eating, which consolidates caloric intake to a shortened eating duration, has demonstrated improvement in metabolic health. Timing of eating could also impact metabolism. Our objective was to examine whether the timing of eating was associated with metabolic health independently of eating duration. Data (n = 7619) are from four cycles (2005-2012) of the National Health and Nutrition Examination Survey (NHANES), a nationally representative U.S. survey that included surveys, physical examinations, and dietary recalls. The primary exposures are eating duration and eating start time estimated from two non-consecutive dietary recalls. Primary outcomes were fasting glucose and estimated insulin resistance using the homeostatic model assessment method (HOMA-IR). The mean (95% CI) eating duration was 12.0 h (11.9-12.0) and the mean (95% CI) start time was 8:21 (8:15-8:26). Earlier eating start time was significantly associated with lower fasting glucose and estimated insulin resistance but eating interval duration was not. Every hour later that eating commenced was associated with approximately 0.6% higher glucose level and 3% higher HOMA-IR (both
    MeSH term(s) Humans ; Insulin Resistance ; Nutrition Surveys ; Cross-Sectional Studies ; Blood Glucose/metabolism ; Diet
    Chemical Substances Blood Glucose
    Language English
    Publishing date 2023-02-01
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2518386-2
    ISSN 2072-6643 ; 2072-6643
    ISSN (online) 2072-6643
    ISSN 2072-6643
    DOI 10.3390/nu15030729
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  5. Article ; Online: Night-to-night associations between light exposure and sleep health.

    Mead, Michael P / Reid, Kathryn J / Knutson, Kristen L

    Journal of sleep research

    2022  Volume 32, Issue 2, Page(s) e13620

    Abstract: Previous research has demonstrated that exposure to light preceding and during sleep is associated with poor sleep, but most research to date has utilized either experimental or cross-sectional designs. The current study expands upon prior studies by ... ...

    Abstract Previous research has demonstrated that exposure to light preceding and during sleep is associated with poor sleep, but most research to date has utilized either experimental or cross-sectional designs. The current study expands upon prior studies by using a microlongitudinal design that examines the night-to-night associations between light and sleep health in a diverse sample of adults (pre-registered at osf.io/k5zgv). US adults aged 18-87 years from two parent studies (N = 124) wore an actiwatch for up to 10 nights. Light variables estimated from actigraphy include both average exposure and time above light threshold of 10 (TALT
    MeSH term(s) Adult ; Humans ; Cross-Sectional Studies ; Sleep ; Actigraphy ; Sleep Initiation and Maintenance Disorders/etiology ; Sleep Duration ; Light
    Language English
    Publishing date 2022-05-22
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1122722-9
    ISSN 1365-2869 ; 0962-1105
    ISSN (online) 1365-2869
    ISSN 0962-1105
    DOI 10.1111/jsr.13620
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  6. Article ; Online: Racial Disparities in Sleep: Potential Mediation by Discrimination and Psychological Distress.

    Mead, Michael P / Vargas, Emily A / Knutson, Kristen L

    Journal of racial and ethnic health disparities

    2022  Volume 10, Issue 2, Page(s) 573–580

    Abstract: Previous research has demonstrated that experiences of discrimination contribute to racial disparities in sleep, and that psychological distress mediates these relationships. However, previous research has not included race as part of the mediation ... ...

    Abstract Previous research has demonstrated that experiences of discrimination contribute to racial disparities in sleep, and that psychological distress mediates these relationships. However, previous research has not included race as part of the mediation pathway and has had limited dimensions of sleep health and psychological mediators. In the current study, we examine serial mediation pathways by which race and sleep health are mediated through discrimination and subsequently through psychological distress (i.e., depressive symptoms, chronic stress, and loneliness). Data were from the 2010 wave of the Health Retirement Study (HRS). The analytic sample (n = 7,749) included Black and White participants who were included in the enhanced face-to-face interview in 2010 and who completed the psychosocial questionnaire. Race was reported as either Black or White. Sleep health was assessed with a 4-item questionnaire. Depressive symptoms were assessed with the shortened CES-D, chronic stress via the ongoing chronic stressor scale, and loneliness via the UCLA loneliness scale. Covariates were included in all serial mediation models. Relative to White participants, Black participants reported increased experiences of discrimination, which was associated with increased psychological distress, and poorer sleep health. Findings demonstrate the significant adverse impact that discrimination has on both psychological well-being and sleep health.
    MeSH term(s) Humans ; Sleep ; Surveys and Questionnaires ; Loneliness ; Psychological Distress ; Longitudinal Studies
    Language English
    Publishing date 2022-02-01
    Publishing country Switzerland
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2760524-3
    ISSN 2196-8837 ; 2197-3792
    ISSN (online) 2196-8837
    ISSN 2197-3792
    DOI 10.1007/s40615-022-01247-0
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  7. Article ; Online: Taking to "heart" the proposed legislation for permanent daylight saving time.

    Carter, Jason R / Knutson, Kristen L / Mokhlesi, Babak

    American journal of physiology. Heart and circulatory physiology

    2022  Volume 323, Issue 1, Page(s) H100–H102

    Abstract: In March 2022, the US Senate passed the Sunshine Protection Act that would abolish the biannual change in clocks each fall and spring and permanently adopt daylight saving time that aligns with the "spring forward" time change each March. A number of ... ...

    Abstract In March 2022, the US Senate passed the Sunshine Protection Act that would abolish the biannual change in clocks each fall and spring and permanently adopt daylight saving time that aligns with the "spring forward" time change each March. A number of scientific and medical societies have endorsed the abolishment of the biannual clock change, but oppose the permanent adoption of daylight saving time. Instead, leading organizations such as the American Academy of Sleep Medicine (AASM) and the Society for Research on Biological Rhythms (SRBR) position statements highlight peer-reviewed evidence in favor of a permanent shift to standard time. The present perspectives will summarize some of the key AASM and SRBR recommendations, with a particular focus on the potential cardiovascular implications of a legislative change that would result in a permanent switch to either standard time or daylight saving time. Collectively, although there is building scientific consensus that abolishing the biannual time change has several sleep and circadian health benefits, the preponderance of evidence is opposite to the current legislation and instead suggests a permanent switch to standard time may offer the maximum health and safety benefits. This scientific evidence should be considered as the United States House of Representatives considers the Sunshine Protection Act.
    MeSH term(s) Cardiovascular System ; Circadian Rhythm ; Heart ; Seasons ; Sleep ; Time Factors ; United States
    Language English
    Publishing date 2022-05-27
    Publishing country United States
    Document type Editorial ; Research Support, N.I.H., Extramural
    ZDB-ID 603838-4
    ISSN 1522-1539 ; 0363-6135
    ISSN (online) 1522-1539
    ISSN 0363-6135
    DOI 10.1152/ajpheart.00218.2022
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  8. Article ; Online: The Association of Self-Reported Sleep and Circadian Measures with Glycemic Control and Diabetes Complications among Young Adults with Type 2 Diabetes.

    Koren, Dorit / Knutson, Kristen L / Burke, Brian K / Drews, Kimberly L / Bacha, Fida / Katz, Lorraine / Marcus, Marsha D / McKay, Siripoom / Nadeau, Kristen / Mokhlesi, Babak

    American journal of physiology. Heart and circulatory physiology

    2024  

    Abstract: We aim to examine the association of sleep duration, sleep quality, late chronotype and circadian misalignment with glycemic control and risk of complications in young adults with youth-onset type 2 diabetes followed in the Treatment Options for Type 2 ... ...

    Abstract We aim to examine the association of sleep duration, sleep quality, late chronotype and circadian misalignment with glycemic control and risk of complications in young adults with youth-onset type 2 diabetes followed in the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study. Self-reported sleep duration, quality, timing, and circadian misalignment were assessed via a modified Pittsburgh Sleep Quality Index (PSQI) questionnaire, and chronotype was assessed via the Morningness-Eveningness Questionnaire (MEQ). We examined diabetes complications including loss of glycemic control (defined as hemoglobin A1c ≥8%), hypertension, dyslipidemia, albuminuria, and diabetic peripheral neuropathy. Multivariable logistic regression models were constructed to assess associations between sleep and circadian measures with outcomes of interest, such as loss of glycemic control and diabetes complications. A total of 421 participants (34.2% male), mean age 23.6±2.5 years, mean BMI of 36.10±8.26 kg/m
    Language English
    Publishing date 2024-04-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603838-4
    ISSN 1522-1539 ; 0363-6135
    ISSN (online) 1522-1539
    ISSN 0363-6135
    DOI 10.1152/ajpheart.00550.2023
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  9. Article ; Online: Gender differences in the relationship between sleep and age in a Brazilian cohort: the Baependi Heart Study.

    Taporoski, Tâmara P / Beijamini, Felipe / Alexandria, Shaina / Aaby, David / von Schantz, Malcolm / Pereira, Alexandre C / Knutson, Kristen L

    Journal of sleep research

    2024  , Page(s) e14154

    Abstract: Gender and age are well-established determinants of health and sleep health that influence overall health, which also often varies by gender and age. Sleep architecture is an important component of sleep health. The goal of this analysis was to examine ... ...

    Abstract Gender and age are well-established determinants of health and sleep health that influence overall health, which also often varies by gender and age. Sleep architecture is an important component of sleep health. The goal of this analysis was to examine whether associations between age and sleep stages differ by gender in the absence of moderate-severe obstructive sleep apnea (OSA) in a rural setting in Brazil. This study conducted polysomnography recordings in the Baependi Heart Study, a cohort of Brazilian adults. Our sample included 584 women and 309 men whose apnea-hypopnea index was ≤15 events/h. We used splines to distinguish non-linear associations between age, total sleep time, wake after sleep onset (WASO), N2, N3, and rapid-eye-movement sleep. The mean (standard deviation; range) age was 47 (14; 18-89) years. All sleep outcomes were associated with age. Compared to men, women had more N3 sleep and less WASO after adjusting for age. Model-based comparisons between genders at specific ages showed statistically higher mean WASO for men at ages 60 (+13.6 min) and 70 years (+19.5 min) and less N3 for men at ages 50 (-13.2 min), 60 (-19.0 min), and 70 years (-19.5 min) but no differences at 20, 30, 40 or 80 years. The other sleep measures did not differ by gender at any age. Thus, even in the absence of moderate-severe OSA, sleep architecture was associated with age across adulthood, and there were gender differences in WASO and N3 at older ages in this rural community.
    Language English
    Publishing date 2024-01-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 1122722-9
    ISSN 1365-2869 ; 0962-1105
    ISSN (online) 1365-2869
    ISSN 0962-1105
    DOI 10.1111/jsr.14154
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  10. Article ; Online: Racial and Ethnic Differences in Eating Duration and Meal Timing: Findings from NHANES 2011-2018.

    Ansu Baidoo, Velarie Y / Zee, Phyllis C / Knutson, Kristen L

    Nutrients

    2022  Volume 14, Issue 12

    Abstract: Background: In addition to quantity and quality, meal timing and eating duration are additional dietary characteristics that impact cardiometabolic health. Given that cardiometabolic health disparities exist among racial and ethnic groups, we examined ... ...

    Abstract Background: In addition to quantity and quality, meal timing and eating duration are additional dietary characteristics that impact cardiometabolic health. Given that cardiometabolic health disparities exist among racial and ethnic groups, we examined whether meal timing and eating duration are additional diet-related differences among racial and ethnic groups. Methods: Participants (n = 13,084) were adults (≥20 years) from the National Health and Nutrition Examination (NHANES, 2011−2018) Survey. Times of first and last meal and the interval between them (eating duration) were derived from two 24-h dietary recalls. Multiple linear regression analyses compared these variables among race and ethnicity after adjusting for potential confounders. Results: Compared to non-Hispanic White adults, the first mealtime was significantly later for Mexican American (23 min), Non-Hispanic Asian (15 min), Non-Hispanic Black (46 min), and Other Hispanic (20 min) and Other Racial (14 min) adults (all p < 0.05). Mexican American and Non-Hispanic Asian adults had a significantly different last mealtime by 13 min earlier and 25 min later, respectively, compared to Non-Hispanic White adults. Compared to Non-Hispanic White adults, the mean eating duration was shorter for other Hispanic (20 min), Mexican American (36 min), and Non-Hispanic Black (49 min) adults. Conclusions: Meal timing and eating duration are additional dietary characteristics that vary significantly among racial and ethnic groups.
    MeSH term(s) Adult ; Cardiovascular Diseases ; Ethnicity ; Hispanic or Latino ; Humans ; Meals ; Nutrition Surveys ; United States
    Language English
    Publishing date 2022-06-11
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2518386-2
    ISSN 2072-6643 ; 2072-6643
    ISSN (online) 2072-6643
    ISSN 2072-6643
    DOI 10.3390/nu14122428
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