title: Relationship of sleep quantity and quality with 24-hour urinary catecholamines and salivary awakening cortisol in healthy middle-aged adults.
abstract: OBJECTIVE
  a. Explore the stability in sleep/wake patterns of middle-aged adults over a 3-year follow-up period. b. Explore the relationship between objectively measured sleep indices, urinary catecholamines, and salivary cortisol.
  
  
  METHODS
  Naturalistic follow-up for sleep/wake patterns (n = 114) by 2-week sleep log and cross-sectional design for objective sleep assessments and hormonal measures (n = 96) at follow-up period nearly 3 years after baseline measurements.
  
  
  METHODS
  Community
  
  
  METHODS
  Healthy middle-aged adults
  
  
  METHODS
  N/A.
  
  
  RESULTS
  There were high correlations between baseline and follow-up period (2.6 ± 0.5 years) on sleep/wake patterns (r = 0.6-0.79) as measured by 2-week sleep log. For wave 2 cross-sectional study, objective poor sleepers (3-day actigraphy sleep efficiency < 85%) had a higher 24-h urinary norepinephrine (NE) level (205.7 ± 105 nmol/d vs 162.1 ± 55.6 nmol/d, P = 0.03) and a nearly significantly higher 24-h urinary epinephrine (E) level (P = 0.12) than good sleepers. There were no differences in 3-day mean salivary awakening cortisol and 24-h urinary catecholamines (NE and E) between short and normal/long sleepers. Linear regression results, however, showed that shorter time in bed and actual sleep time, longer sleep onset latency, and lower sleep efficiency were correlated with higher 24-h urinary E and NE (all P < 0.05) but not salivary cortisol. The effect of poor sleep quality on 24-h urinary catecholamines was stronger in males than females.
  
  
  CONCLUSIONS
  Increased sympathetic activity as measured by 24-h urinary catecholamines might play a critical role in the pathogenesis mediating the relationship of insufficient sleep (quantity and quality) with subsequent cardiovascular and metabolic complications. Salivary awakening cortisol was not associated with sleep quantity and quality in healthy middle-aged adults.
authors.affiliation: Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Jihui
authors.initials: J
authors.lastname: Zhang
authors.forename: Ronald C W
authors.initials: RC
authors.lastname: Ma
authors.forename: Alice P S
authors.initials: AP
authors.lastname: Kong
authors.forename: Wing Yee
authors.initials: WY
authors.lastname: So
authors.forename: Albert M
authors.initials: AM
authors.lastname: Li
authors.forename: Sui Ping
authors.initials: SP
authors.lastname: Lam
authors.forename: Shirley Xin
authors.initials: SX
authors.lastname: Li
authors.forename: Mandy W M
authors.initials: MW
authors.lastname: Yu
authors.forename: Chung Shun
authors.initials: CS
authors.lastname: Ho
authors.forename: Michael H M
authors.initials: MH
authors.lastname: Chan
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.forename: Yun Kwok
authors.initials: YK
authors.lastname: Wing
mesh_terms: D000328:Adult; D002395:Catecholamines / Q000652:urine*; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000652:urine*; D008297:Male; D011446:Prospective Studies; D012016:Reference Values; D012463:Saliva / Q000378:metabolism*; D012890:Sleep / Q000502:physiology*; D013995:Time; D014851:Wakefulness
chemical_list: D002395:Catecholamines; D006854:Hydrocortisone