History of Weight Cycling Is Prospectively Associated With Shorter and Poorer-Quality Sleep and Higher Sleep Apnea Risk in Diverse US Women : Journal of Cardiovascular Nursing

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ARTICLES: Nutrition and Cardiovascular Disease

History of Weight Cycling Is Prospectively Associated With Shorter and Poorer-Quality Sleep and Higher Sleep Apnea Risk in Diverse US Women

Cao, Vivian MS; Makarem, Nour PhD; Maguire, Moorea MS; Samayoa, Ivan MS; Xi, Huaqing MS; Liang, Citina MA; Aggarwal, Brooke EdD, MS, FAHA

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The Journal of Cardiovascular Nursing 36(6):p 573-581, 11/12 2021. | DOI: 10.1097/JCN.0000000000000818

Abstract

Background 

Poor sleep and history of weight cycling (HWC) are associated with worse cardiovascular health, yet limited research has evaluated the association between HWC and poor sleep patterns.

Methods 

The American Heart Association Go Red for Women Strategically Focused Research Network cohort at Columbia University (n = 506; mean age, 37 ± 15.7 years; 61% racial/ethnic minority) was used to evaluate the cross-sectional associations of HWC and sleep at baseline and the prospective associations of HWC from baseline with sleep at the 1-year visit. History of weight cycling, defined as losing and gaining 10 lb or more at least once (excluding pregnancy), was self-reported. Sleep duration, sleep quality, insomnia severity, and obstructive sleep apnea risk were assessed using the validated Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Berlin questionnaires. Linear and logistic regression models, adjusted for age, race/ethnicity, education, health insurance status, pregnancy history, and menopausal status, were used to evaluate the relation of HWC with sleep.

Results 

Most women reported 1 or more episodes of weight cycling (72%). In linear models of cross-sectional and prospective data, each additional weight cycling episode was related to shorter sleep duration, poorer sleep quality, longer sleep onset latency, greater insomnia severity, more sleep disturbances, lower sleep efficiency, and higher sleep medication use frequency. In the logistic models, HWC (≥1 vs 0 episodes) was associated with greater odds for short sleep, poor sleep quality, long sleep onset latency (≥26 minutes), high obstructive sleep apnea risk, and sleep efficiency lower than 85%.

Conclusion 

History of weight cycling predicted poor sleep among women, suggesting that weight maintenance may represent an important strategy to promote sleep health. The potential bidirectional relationship between HWC and sleep requires further investigation.

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