Abstract
Objectives
To determine sleep clusters among young adults and describe the prevalence of modifiable
risk behaviors for noncommunicable diseases (NCDs) according to these clusters.
Methods
A cross-sectional analysis was carried out with the 1993 Pelotas Birth Cohort participants
at the 22-year follow-up. Sleep onset, sleep offset, total sleep time (TST), TST variability,
and sleep efficiency were evaluated by a triaxial accelerometer. We asked participants
to wear the devices for 7 days on a nondominant wrist. Excessive daytime sleepiness
was assessed by the Epworth sleep scale and sleep quality by the Pittsburgh Sleep
Quality Index. Sleep clusters of 2738 individuals were determined using k-means cluster
analysis. Crude and adjusted prevalence of modifiable risk behaviors for NCDs (smoking,
harmful alcohol intake, leisure physical inactivity, overweight, screen time, and
ultra-processed food consumption) were presented according to the sleep clusters.
Adjustments included wealth index, skin color, years of schooling, current occupation,
shift work, and having children under 2 years. All analyses were stratified according
to sex.
Results
We identified 3 sleep clusters for men (Healthy sleepers, Late and variant sleepers, and Shorter and poorer sleepers) and 3 for women (Healthy sleepers, Late and poor-quality sleepers, and Shorter, variant, and inefficient
sleepers). Both males and females classified as Healthy sleepers presented a lower prevalence of modifiable risk behaviors for NCDs compared to individuals
from other sleep clusters.
Conclusions
Poor sleep health is associated with higher prevalence of modifiable risk behaviors
for NCDs. Prevention strategies for NCDs should also focus on sleep health.
Keywords
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References
World Health Organization (WHO). Noncommunicable diseases [Internet]. 2021. Available at: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases. Accessed june 27, 2022.
- Clustering of multiple risk behaviors among a sample of 18-year-old australians and associations with mental health outcomes: a latent class analysis.Front Public Health. 2018; 6: 1-11
- Sleep health of Australian adults in 2016: results of the 2016 Sleep Health Foundation National Survey.Sleep Health. 2017; 3 ([Internet]): 35-42https://doi.org/10.1016/j.sleh.2016.11.005
- Smoking, screen-based sedentary behavior, and diet associated with habitual sleep duration and chronotype: data from the UK biobank.Ann Behav Med. 2016; 50 ([Internet]): 715-726https://doi.org/10.1007/s12160-016-9797-5
- Delayed sleep timing is associated with low levels of free-living physical activity in normal sleeping adults.Sleep Med. 2014; 15: 1586-1589
- Dietary nutrients associated with short and long sleep duration. Data from a nationally representative sample.Appetite. 2013; 64: 71-80
- Is late bedtime an overlooked sleep behaviour? Investigating associations between sleep timing, sleep duration and eating behaviours in adolescence and adulthood.Public Health Nutr. 2021; 24: 1671-1677
- Interactive effects of sleep duration and morning/evening preference on cardiovascular risk factors.Eur J Public Health. 2017; 28: 155-161
- Sleep health: can we define It? Does it matter?.Sleep. 2014; 37: 9-17
- The multidimensionality of sleep in population-based samples: a narrative review.J Sleep Res. 2022; 31: 1-11
- Sleep and cardiometabolic risk: a cluster analysis of actigraphy-derived sleep profiles in adults and children.Sleep. 2021; 44: 1-11
- Impact of sleep health on self-perceived health status.Sci Rep. 2019; 9: 1-7
- Sleep health composites are associated with the risk of heart disease across sex and race.Sci Rep. 2022; 12 ([Internet]): 1-11https://doi.org/10.1038/s41598-022-05203-0
- A preliminary study of a composite sleep health score: associations with psychological distress, body mass index, and physical functioning in a low-income African American community.Sleep Health. 2019; 5: 514-520
- Cohort profile update: the 1993 Pelotas (Brazil) birth cohort follow-up at 22 years.Int J Epidemiol. 2017; 47: 1389-1390E
- Portuguese-language version of the Epworth sleepiness scale: validation for use in Brazil.J Bras Pneumol. 2009; 35: 877-883
- Validation of the Brazilian Portuguese version of the Pittsburgh Sleep Quality Index.Sleep Med. 2011; 12 ([Internet]): 70-75https://doi.org/10.1016/j.sleep.2010.04.020
- A novel, open access method to assess sleep duration using a wrist-worn accelerometer.PLoS One. 2015; 10: 1-13
- Concurrent and construct validity of the audit in an urban Brazillian sample.Alcohol Alcohol. 2005; 40: 584-589
- Prevalence of insufficient physical activity and associated factors in Brazilian adolescents.J Phys Act Health. 2008; 5: 777-794
- Overall and leisure-time physical activity among Brazilian adults: national survey based on the global physical activity questionnaire.J Phys Act Health. 2018; 15: 212-218
- Desenho de um questionário de frequência alimentar digital autoaplicado para avaliar o consumo alimentar de adolescentes e adultos jovens: Coortes de nascimentos de Pelotas, Rio Grande do Sul.Rev Bras Epidemiol. 2016; 19: 419-432
- The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing.Public Health Nutr. 2017; 21: 5-17
- Consumption of ultra-processed foods at 11, 22 and 30 years at the 2004, 1993 and 1982 Pelotas birth cohorts.Public Health Nutr. 2021; 24: 299-308
Mooi E, Sarstedt M, Mooi-Reci I. Market research: The process, data, and methods using Stata. 1st ed. Singapore: Springer; 2018.
- Exploring sex and gender differences in sleep health: a society for women's health research report.J Womens Health. 2014; 23: 553-562
- A comparison of the dietary patterns derived by principal component analysis and cluster analysis in older Australians.Int J Behav Nutr Phys Act. 2016; 13 ([Internet]): 1-14https://doi.org/10.1186/s12966-016-0353-2
- The measurement of observer agreement for categorical data.Biometrics. 1977; 33: 159-174
- Sleep patterns and predictors of disturbed sleep in a large population of college students.J Adolesc Health. 2010; 46 ([Internet]): 124-132https://doi.org/10.1016/j.jadohealth.2009.06.016
- Sleep duration irregularity is associated with elevated blood pressure in young adults.Chronobiol Int. 2022; 00 ([Internet]): 1-9https://doi.org/10.1080/07420528.2022.2101373
- Differential effects of physical activity and sleep duration on cognitive function in young adults.J Sport Health Sci. 2018; 7 ([Internet]): 227-236https://doi.org/10.1016/j.jshs.2017.01.005
- Sleep behaviors in traditional-age college students: a state of the science review with implications for practice.J Am Assoc Nurse Pract. 2017; 29: 695-703
- Calculating the contribution of sleep problems to undergraduates’ academic success.Sleep Health. 2018; 4 ([Internet]): 463-471https://doi.org/10.1016/j.sleh.2018.07.002
- Psychosocial stress and impaired sleep.Work Environ Health. 2006; 32: 493-501
- Influence of socioeconomic status on objective sleep measurement: a systematic review and meta-analysis of actigraphy studies.Sleep Health. 2021; 7 ([Internet]): 417-428https://doi.org/10.1016/j.sleh.2021.05.005
- Long-term effects of pregnancy and childbirth on sleep satisfaction and duration of first-time and experienced mothers and fathers.Sleep. 2019; 42: zsz015
- A composite measure of sleep health predicts concurrent mental and physical health outcomes in adolescents prone to eveningness.Sleep Health. 2019; 5 ([Internet]): 166-174https://doi.org/10.1016/j.sleh.2018.11.009
- Sleep, impulse control, and sensation-seeking predict delinquent behavior in adolescents, emerging adults, and adults.J Adolesc Health. 2013; 53 ([Internet]): 293-299https://doi.org/10.1016/j.jadohealth.2013.03.012
- Protecting the melatonin rhythm through circadian healthy light exposure.Int J Mol Sci. 2014; 15: 23448-23500
- Association between the degree of processing of consumed foods and sleep quality in adolescents.Nutrients. 2020; 12: 1-12
- Sleep restriction increases the neuronal response to unhealthy food in normal-weight individuals.Int J Obes. 2013; 38: 411-416
- Sleep disturbance, sleep duration, and inflammation: a systematic review and meta-analysis of cohort studies and experimental sleep deprivation.Biol Psychiatry. 2016; 80 ([Internet]Available from: file:///C:/Users/Carla Carolina/Desktop/Artigos para acrescentar na qualificação/The impact of birth weight on cardiovascular disease risk in the.pdf): 40-52
- Sleep, sleepiness, and alcohol use.Alcohol Res Health. 2001; 25: 101-109
- The association between alcohol-related problems and sleep quality and duration among college students: a multicountry pooled analysis.Int J Ment Health Addict. 2022; 27: 1-18https://doi.org/10.1007/s11469-022-00763-8
- Current alcohol use is associated with sleep patterns in first-year college students.Sleep. 2016; 39: 1321-1326
Article info
Publication history
Published online: January 23, 2023
Accepted:
January 3,
2023
Received in revised form:
December 17,
2022
Received:
July 8,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
