title: 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.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA. Electronic address: xchen@hsph.harvard.edu.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Susan
authors.initials: S
authors.lastname: Redline
authors.affiliation: Department of Medicine, Harvard Medical School and Harvard/MGH Center for Genomics, Vulnerable Populations and Health Disparities, Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA.
authors.forename: Alexandra E
authors.initials: AE
authors.lastname: Shields
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA.
authors.forename: David R
authors.initials: DR
authors.lastname: Williams
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D017677:Age Distribution; D052636:Allostasis / Q000502:physiology*; D015415:Biomarkers / Q000032:analysis; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D010808:Physical Examination; D012891:Sleep Apnea Syndromes / Q000208:ethnology / Q000209:etiology / Q000503:physiopathology; D007319:Sleep Initiation and Maintenance Disorders / Q000208:ethnology / Q000209:etiology / Q000503:physiopathology; D012893:Sleep Wake Disorders / Q000208:ethnology / Q000209:etiology / Q000503:physiopathology*; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications* / Q000208:ethnology; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: Adult; Allostatic load; Insomnia; National survey; Short sleep duration; Sleep apnea; Sleep disorder; Sleep disturbance