Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Feb 10, 2023
Open Peer Review Period: Feb 9, 2023 - Feb 23, 2023
Date Accepted: Sep 26, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Damocles Sword Effect of Sleep on Metabolism, Musculoskeletal Disease, and Mortality in the General US Population: Evidence from the NHANES Program
ABSTRACT
Background:
Sleep is an important physiological process in humans, associated with the occurrence and development of various diseases.
Objective:
However, the associations of sleep duration with obesity-related factors, musculoskeletal diseases, and different mortality have not been systematically reported. This study investigated sleep duration with the factors mentioned above.
Methods:
This study included 54664 subjects with sleep information from 8 survey cycles of the National Health and Nutrition Examination Survey (NHANES 2005-2020). Death outcomes were obtained from National Death Index (NDI) records. Quantile regression models, the Cox regression model, and two-fold piecewise Cox analysis were utilized to elucidate the non-linear relationship between sleep duration and obesity, metabolism, musculoskeletal diseases, and mortality. In addition, threshold effects for different mortality risks were evaluated in musculoskeletal disorders.
Results:
During 54664 subjects, 4504 all-cause deaths occurred, including 1595 cardiovascular disease (CVD)-related deaths, 1025 cancer-cause deaths, and 495 diabetes-cause mortality. A significant threshold effect of abdominal (AB)-obesity, hyperuricemia (HUA), bone mineral density (BMD), osteoarthritis (OA), rheumatoid arthritis (RA), all-cause, CVD-cause, cancer-cause, and diabetes-cause mortality was found through proportional hazard model. The inflection point was between 6.5h and 9h. The closer the sleep time is to the inflection point, the lower the incidence of disease, and the higher the vice versa.
Conclusions:
Inflection points of sleep duration in obesity-relation factors, musculoskeletal diseases, mortality, and specific-musculoskeletal arthritis were found. This study found that sleep duration provides new evidence for the prevention of multi-system diseases.
Citation
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.