3 Paula Sleep Symposium · Working long hours Business travel Stress Anxiety Depression Fatigue...
Transcript of 3 Paula Sleep Symposium · Working long hours Business travel Stress Anxiety Depression Fatigue...
2018/09/22
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Associations between self-reported sleep duration and cardiometabolic disease risk factors in
executive employees
Paula R. Pienaar, BSc. (Hons) Biokinetics, MSc.(med)
PhD candidate | Health through Physical Activity, Lifestyle and Sport Research Centre | Department of Human Biology | Faculty of Health
Sciences | University of Cape Town
Sleep Scientist | Sleep Science | Sports Science Institute of South Africa
Scientific Advisor | Life Healthcare| Employee Health Solutions
BACKGROUND
57.4%
43.1% employment rate
58% overweight or obese
31% elevated serum cholesterol
19% high blood pressure
9% elevated blood glucose
Non-communicable diseases
Strategic decision-making
Working long hours
Business travel
Stress
Anxiety
Depression
FatigueLifestyle factors
CMD risk factors
Sleep health Employees sleeping <7h
45% 35%26% 30% 56%
PP2
Slide 4
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�CDC analyzed data from currently employed adults surveyed for the 2013 and 2014 Behavioral Risk Factor Surveillance System
(BRFSS) in 29 states.�Paula Pienaar, 2018/09/08
2018/09/22
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AIM
To undertake a preliminary assessment of the self reported sleep duration of corporate employees and its associations with risk
factors for cardiometabolic diseases.
Ongoing data collection Preliminary data
METHODS
2014 - present
Blood glucose
HDL cholesterol
Triglycerides (TG)
Body mass index (BMI)
Waist circumference (WC)
Blood pressure (BP)
International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute joint consensus
3 of 5 risk factors for Metabolic
Syndrome classification
Cardiometabolic risk factors - objective�WC
� M ≥102cm
� F ≥ 88cm
�TG ≥ 1.7 mmol/l
�HDL-C� M <1mmol/l
� F <1.3 mmol/l
�BP ≥130/85 mmHg
� Diagnosed HT
�Blood glucose ≥ 5.6mmol/l
� Diagnosed diabetes
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Sleep duration (h)
Fatigue risk score
Depression, Anxiety and Stress
screening (DASS) tool
• Snoring, urinary problems, high blood
pressure, diabetes, sleep disorders,
sleep medication
• ≤6h sleep/night; ≥60h work/wk; raised
alcohol intake
• Selected DASS responses
• Score: low, moderate high
• Validated tool
• 3 subdomains mental health:
depression, anxiety, stress
• 4-point Likert scale
• Higher score = poorer mental health
measure
Lifestyle risk factors – self-report
RESULTS
Age (y) 45 (39-51) 42 (37-47) <0.001
Sleep duration (h) 7 (7-7) 7 (7-7) 0.19
BMI (kg����m-2) 27.4 (25.1-30.4) 25.5 (22.5-29.6) <0.001
WC (cm) 94.0 (87.0-102.0) 88.0 (73.0-89.0) <0.001
TG (mmol����L-1) 1.2 (0.9-1.8) 0.9 (0.6-1.2) <0.001
HDL (mmol����L-1) 1.2 (1.0-1.4) 1.6 (1.3-1.9) <0.001
SBP (mmHg) 124 (120-130) 120 (110-120) <0.001
DBP (mmHg) 80 (71-84) 70 (70-80) <0.001
Glucose (mmol����L-1) 5.1 (4.8-5.5) 4.8(4.5-5.1) <0.001
P valueN=2768 N=1130
N=3898 baseline assessments
No. Obese (%) 781 (28.3) 262 (23.2) <0.05
No. high WC (%) 723 (26.4) 320 (28.7) 0.14
No. high TG (%) 810 (30.4) 131 (12.0) <0.001
No. low HDL (%) 462 (16.9) 30 (2.7) <0.001
No. high BP (%) 543 (20.3) 94 (8.5) <0.001
No. high glucose (%) 99 (3.6) 14 (1.3) <0.001
No. MetS (%) 460 (16.6) 58 (5.1) <0.001
Age group: 25-64y
7.7-19.0%Vs 28.3%
SADHS 2016
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Meeting the recommended sleep duration guideline
Sleeping <7h
16.4% 19.9%
Men (n=2768)
Women (n=1130)
2
4
6
8
10
7
9
Sle
ep
du
ratio
n (h
ou
rs)
≤6h 7h 8h ≥9h
0
25
50
75
100
Fre
qu
en
cy (
%)
WC<102cm
WC ≥102cm
68.6
31.4
68.5
31.5
74.6
25.4
73.9
26.1
Sleep duration (h)
≤6h 7h 8h ≥9h
0
25
50
75
100
Sleep duration (h)
Fre
qu
en
cy (
%)
Normal weight
Overweight
Obese
19.2
47.2
33.6
27.4
43.8
28.8
25.1
47.6
27.4
22.7
50.0
27.3
≤6h 7h 8h ≥9h
10
20
30
40
50
60
Sleep duration (h)
BM
I (k
g/m
2)
≤6h 7h 8h ≥9h
50
75
100
125
150
175
200
Sleep duration (h)
Wa
ist
cir
cu
mfe
ren
ce
(c
m)
P <0.05
Association between sleep duration obesity and waist circumference
OR: 0.86, 95%CI: 0.75-0.98
WC: OR: 0.84, 95%CI: 0.73-0.97
Change in sleep: visit 3 vs visit 1
No significant relationship between changes in BMI or WC and sleep duration between visit 1 and visit 3
Sleep duration
52 (12.2%)68 (15.9%) 308 (72.0%)
n=428
Stress
Anxiety
Depression
Fatigue
Sleep health
Self-reported short sleep duration
Strategic decision-making
Working long hours
Business travel
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�CDC analyzed data from currently employed adults surveyed for the 2013 and 2014 Behavioral Risk Factor Surveillance System
(BRFSS) in 29 states.�Paula Pienaar, 2018/09/08
2018/09/22
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Short sleep duration
P <0.001
Raised stress scores
Working > 60h per week vs 40-60h
OR:1.03, [95%CI 1.01-1.05]
OR:2.12, [95%CI 1.37-3.48]
OR:1.05, [95%CI 1.04-1.06]
OR:3.29, [95%CI 2.51-4.30]
Predictors at visit 1
SUMMARY
Working long hoursBusiness travel
Strategic decision-making
StressAnxiety
Depression
Fatigue
Sleep healthShort sleep duration
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Thank you!
Slide 19
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�CDC analyzed data from currently employed adults surveyed for the 2013 and 2014 Behavioral Risk Factor Surveillance System
(BRFSS) in 29 states.�Paula Pienaar, 2018/09/08
2018/09/22
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References
1. https://tradingeconomics.com/south-africa/employment-rate
2. http://www.statssa.gov.za/publications/P03093/P030932016.pdf Mortality and causes of death in South Africa, 2016
3. Kolbe-Alexander, T. L., and E. V. Lambert. "Non-communicable disease prevention and worksite health promotion programs: a brief review." Occupational Medicine and Health Affairs 1.7 (2013): 1-8.
4. Conway, Sadie H., et al. "Dose-response relation between work hours and cardiovascular disease risk: findings from the panel study of income dynamics." Journal of occupational and environmental medicine/American College of Occupational and Environmental Medicine 58.3 (2016): 221.
5. Afonso, P., M. Fonseca, and J. F. Pires. "Impact of working hours on sleep and mental health." Occupational Medicine67.5 (2017): 377-382.
6. Hafner, Marco, et al. "Why sleep matters–the economic costs of insufficient sleep." Europe: RAND Corporation (2016).
7. Alberti, K. G. M. M., et al. "Harmonizing the metabolic syndrome: a joint interim statement of the international diabetes federation task force on epidemiology and prevention; national heart, lung, and blood institute; American heart association; world heart federation; international atherosclerosis society; and international association for the study of obesity." Circulation 120.16 (2009): 1640-1645.
8. Hoek, Rianne JA, et al. "Stress Prevention@ Work: A study protocol for the evaluation of a multifaceted integral stress prevention strategy to prevent employee stress in a healthcare organization: a cluster controlled trial." BMC Public Health18.1 (2018): 26.
9. https://www.statssa.gov.za/publications/Report%2003-00-09/Report%2003-00-092016.pdf South Africa Health Survey Demographic and Health Survey, 2016