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. 2014 Aug;24(8):612-9.
doi: 10.1016/j.annepidem.2014.05.014. Epub 2014 Jun 6.

Associations of allostatic load with sleep apnea, insomnia, short sleep duration, and other sleep disturbances: findings from the National Health and Nutrition Examination Survey 2005 to 2008

Xiaoli Chen  1 , Susan Redline  2 , Alexandra E Shields  3 , David R Williams  4 , Michelle A Williams  5
Affiliations

Associations of allostatic load with sleep apnea, insomnia, short sleep duration, and other sleep disturbances: findings from the National Health and Nutrition Examination Survey 2005 to 2008

Xiaoli Chen et al. Ann Epidemiol. 2014 Aug.

Abstract

Purpose: To examine whether allostatic load (AL), a measure of cumulative physiologic dysregulation across biological systems, was associated with sleep apnea, insomnia, and other sleep disturbances.

Methods: Data from the National Health and Nutrition Examination Survey 2005-2008 were used. AL was measured using nine biomarkers representing cardiovascular, inflammatory, and metabolic system functioning. A total of 3330 US adults aged 18 years and older were included in this study.

Results: The prevalence of high AL (AL score ≥3) was the highest among African Americans (26.3%), followed by Hispanic Americans (20.3%), whites (17.7%), and other racial/ethnic group (13.8%). After adjustment for sociodemographic and lifestyle factors, high AL was significantly associated with sleep apnea (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.40-2.63), snoring (OR, 2.20; 95% CI, 1.79-2.69), snorting/stop breathing (OR, 2.16; 95% CI, 1.46-3.21), prolonged sleep latency (OR, 1.42; 95% CI, 1.08-1.88), short sleep duration (<6 hours) (OR, 1.35; 95% CI, 1.00-1.82), and diagnosed sleep disorder (OR, 2.26; 95% CI, 1.66-3.08). There was no clear evidence that observed associations varied by sociodemographic characteristics.

Conclusions: This study suggests significant associations of high AL with sleep apnea, sleep apnea symptoms, insomnia component, short sleep duration, and diagnosed sleep disorder among US adults.

Keywords: Adult; Allostatic load; Insomnia; National survey; Short sleep duration; Sleep apnea; Sleep disorder; Sleep disturbance.

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Figures

Figure 1
Figure 1
Race/ethnicity distributions and mean allostatic load scores among 3,330 US adults in the National Health and Nutrition Examination Survey 2005-2008: means and 95% confidence limits of means
Figure 1
Figure 1
Race/ethnicity distributions and mean allostatic load scores among 3,330 US adults in the National Health and Nutrition Examination Survey 2005-2008: means and 95% confidence limits of means
Figure 2
Figure 2
Sleep disturbances and mean allostatic load scores among 3,330 US adults in the National Health and Nutrition Examination Survey 2005-2008: Means and 95% confidence limits of means There were significant differences in the allostatic load scores between those with and without sleep problems (all P values <0.001). Tests were conducted using the ‘surveyreg’ commands.
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