TY - JOUR
T1 - Mediating effects of body mass index, physical activity, and emotional distress on the relationship between short sleep and cardiovascular disease
AU - Seixas, Azizi A.
AU - Vallon, Julian
AU - Barnes-Grant, Andrea
AU - Butler, Mark
AU - Langford, Aisha T.
AU - Grandner, Michael A.
AU - Schneeberger, Andres R.
AU - Huthchinson, Jhenelle
AU - Zizi, Ferdinand
AU - Jean-Louis, Girardin
N1 - Funding Information:
Both A. Seixas and J. Vallon are first authors. Funding/support: This work was supported by funding from the NHLBI (K01HL13452), NIMHD (R01MD007716), and the NIA (K07AG052685). The authors have no conflict of interest to report. aNYU Langone Health, Department of Population Health, New York, bDepartment of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, cDepartments of Psychiatry, Psychology, and Medicine, Sleep & Health Research Program, University of Arizona College of Medicine, Tucson, AZ, dUniversitaere Psychiatrische Kliniken, Universitaet Basel, Basel, ePsychiatrische Dienste Graubuenden, St. Moritz, Switzerland, fDepartment of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, gNYU Langone Health, Department of Psychiatry, New York, NY. ∗Correspondence: Azizi A. Seixas, Center for Healthful Behavior Change (CHBC), Departments of Population Health and Psychiatry, NYU Langone Health, 227 East 30th Street (between 2nd and 3rd Ave), Floor # 6 - 629D, New York, NY 10016 (e-mail: Azizi.Seixas@nyumc.org).
Publisher Copyright:
Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
PY - 2018/9
Y1 - 2018/9
N2 - The current study investigated the mediating effects of body mass index (BMI), physical activity, and emotional distress on the association between short sleep duration (<7 hours per 24-hour period) and cardiovascular disease (CVD) and risk factors. We used data from the National Health Interview Survey, an ongoing nationally representative cross-sectional study of noninstitutionalized US adults (≥18 years) from 2004 to 2013 (N = 206,049). Participants provided information about anthropometric features (height and weight), sociodemographic factors, health behaviors (smoking and physical activity), emotional distress, and physician-diagnosed health conditions, including hypertension, coronary heart disease, diabetes, heart attack, stroke, kidney disease, and cancer. Structural equation modeling was used to assess the mediating effects of physical activity, BMI, and emotional distress on the relationship between short sleep and CVDs and risk factors (coronary heart disease, hypertension, diabetes, chronic kidney disease, heart attack, and stroke). Of the sample, 54.7% were female, 60.1% identified as white, 17.7% as Hispanic, and 15.4% as black. The mean age of the respondents was 46.75 years (SE = 0.12), with a mean BMI of 27.11 kg/m2 (SE = 0.02) and approximately 32.5% reported short sleep duration. The main relationship between short sleep and CVD and risk factors was significant (b = 0.08, P < .001), as was the mediated effect via BMI (indirect effect = 0.047, P < .001), emotional distress (indirect effect = 0.022, P < .001), and physical activity (indirect effect = -0.022, P = .035), as well as after adjustment for covariates, including age, race, sex, marital status, and income: short sleep and CVD (B = 0.15; SE = 0.01; P < .001), BMI (B = 0.05; SE = 0.00; P < .001), emotional distress (B = 0.02; SE = 0.00; P < .001), and physical activity (B = 0.01; SE = 0.00; P < .001). Our findings indicate that short sleep is a risk factor for CVD and that the relationship between short sleep and CVD and risk factors may be mediated by emotional distress and obesity, and negatively mediated by physical activity.
AB - The current study investigated the mediating effects of body mass index (BMI), physical activity, and emotional distress on the association between short sleep duration (<7 hours per 24-hour period) and cardiovascular disease (CVD) and risk factors. We used data from the National Health Interview Survey, an ongoing nationally representative cross-sectional study of noninstitutionalized US adults (≥18 years) from 2004 to 2013 (N = 206,049). Participants provided information about anthropometric features (height and weight), sociodemographic factors, health behaviors (smoking and physical activity), emotional distress, and physician-diagnosed health conditions, including hypertension, coronary heart disease, diabetes, heart attack, stroke, kidney disease, and cancer. Structural equation modeling was used to assess the mediating effects of physical activity, BMI, and emotional distress on the relationship between short sleep and CVDs and risk factors (coronary heart disease, hypertension, diabetes, chronic kidney disease, heart attack, and stroke). Of the sample, 54.7% were female, 60.1% identified as white, 17.7% as Hispanic, and 15.4% as black. The mean age of the respondents was 46.75 years (SE = 0.12), with a mean BMI of 27.11 kg/m2 (SE = 0.02) and approximately 32.5% reported short sleep duration. The main relationship between short sleep and CVD and risk factors was significant (b = 0.08, P < .001), as was the mediated effect via BMI (indirect effect = 0.047, P < .001), emotional distress (indirect effect = 0.022, P < .001), and physical activity (indirect effect = -0.022, P = .035), as well as after adjustment for covariates, including age, race, sex, marital status, and income: short sleep and CVD (B = 0.15; SE = 0.01; P < .001), BMI (B = 0.05; SE = 0.00; P < .001), emotional distress (B = 0.02; SE = 0.00; P < .001), and physical activity (B = 0.01; SE = 0.00; P < .001). Our findings indicate that short sleep is a risk factor for CVD and that the relationship between short sleep and CVD and risk factors may be mediated by emotional distress and obesity, and negatively mediated by physical activity.
KW - Cardiovascular disease
KW - Emotional distress
KW - Obesity
KW - Physical activity
KW - Sleep
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U2 - 10.1097/MD.0000000000011939
DO - 10.1097/MD.0000000000011939
M3 - Article
C2 - 30212927
AN - SCOPUS:85053810311
VL - 97
JO - Medicine (United States)
JF - Medicine (United States)
SN - 0025-7974
IS - 37
M1 - e11939
ER -