title: Sleep, type 2 diabetes, dyslipidemia, and hypertension in elderly Alzheimer's caregivers.
abstract: Research indicates that very short or long durations of sleep and inefficient sleep are associated with higher total cholesterol and risk of type 2 diabetes and hypertension. This study tested the hypothesis that inefficient sleep or short/long sleep durations are associated with an elevated prevalence of type 2 diabetes, dyslipidemia, and hypertension in a community-dwelling sample of elderly Alzheimer's caregivers. Participants were 126 caregivers for spouses with Alzheimer's disease who underwent in-home sleep assessment by wrist actigraphy for 72 consecutive hours. Sleep data were averaged across the 3 days/nights; nighttime sleep and daytime napping were computed. Morning fasting blood samples were collected to determine measures of blood lipids and glucose. The average of three resting blood pressure measurements was used to estimate mean resting blood pressure. Logistic regression models including covariates related to sleep and metabolic regulation indicated that nighttime sleep duration, percent sleep at night, and daytime naps were not significantly associated with odds of having diabetes (OR, 0.92; 95% CI, 0.56-1.53; OR, 0.93; 95% CI, 0.83-1.03; OR, 1.75; 95% CI, 0.74-4.11, respectively), dyslipidemia (OR, 0.83; 95% CI, 0.57-1.20; OR, 0.99; 95% CI, 0.92-1.07; OR, 0.64; 95% CI, 0.33-1.24, respectively), or hypertension (OR, 0.97; 95%CI, 0.62-1.52; OR, 1.02; 95% CI, 0.93-1.11; OR, 1.10; 95% CI, 0.44-2.74, respectively). When categorical and combined sleep parameters were examined, there were no significant associations with any of the metabolic conditions (all p>0.05). The current study suggests that in an elderly sample of Alzheimer's caregivers, nighttime sleep duration, nighttime sleep efficiency and daytime naps are not significantly associated with prevalent type 2 diabetes, dyslipidemia, or hypertension. As several of the associations demonstrated clinically relevant magnitudes of the associations, larger studies to more fully test these hypotheses are warranted.
authors.affiliation: San Diego State University/University of California, San Diego, Joint Doctoral Program in Public Health, San Diego, CA, United States. Jeschwartz@ucsd.edu
authors.forename: Jennifer
authors.initials: J
authors.lastname: Schwartz
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Allison
authors.forename: Sonia
authors.initials: S
authors.lastname: Ancoli-Israel
authors.forename: Melbourne F
authors.initials: MF
authors.lastname: Hovell
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Patterson
authors.forename: Loki
authors.initials: L
authors.lastname: Natarajan
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Marshall
authors.forename: Igor
authors.initials: I
authors.lastname: Grant
mesh_terms: D000368:Aged; D000544:Alzheimer Disease; D017028:Caregivers; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D050171:Dyslipidemias / Q000150:complications*; D005192:Family Health; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012892:Sleep Deprivation / Q000150:complications*; D013315:Stress, Psychological