@article {12462, title = {Age at menopause and insomnia in a racially diverse cohort}, journal = {Sleep}, volume = {45}, year = {2022}, pages = {A26{\textendash}A27}, abstract = {Introduction Menopause is related to major hormonal, physical, and psychological changes for women, each of which could influence their sleep. However, sleep in women post-menopause may differ by race and ethnicity. We aimed to examine associations between age at menopause and insomnia symptoms among US women by race and ethnicity. Methods We utilized 2008-2012 data from the Health and Retirement Study, a nationally representative cohort of US adults age 50+, restricted to women with natural transition to menopause. Age at menopause was retrieved from baseline information (2008) and was used to categorized women into premature menopause (age<=40y), early menopause (age 41-45y), and normal menopause (age>45y). An insomnia composite score was constructed from 2010 and 2012 survey items that assessed insomnia symptoms (i.e., trouble falling asleep, nighttime awakenings, early morning awakenings, and feelings of nonrestorative sleep). Insomnia items that were reported as {\textquotedblleft}most of the time{\textquotedblright} were considered positive and contributed to the composite score (range: 0-4). We estimated associations between age at menopause and insomnia symptoms using linear regression models and logistic regression models for continuous and binary outcomes, respectively. Models were stratified by White/non-White race and were adjusted for age, education, physical activity, parity, marital status, and survey year. Results Among 4,435 women, 338, 701, and 3,396 reported premature, early, and normal menopause, respectively. In White women, premature menopause was associated with a higher mean composite insomnia score than those who had normal menopause (b=0.20, p=0.03). However, this association was not seen in non-Whites. For individual insomnia survey items, premature menopause in White women was associated with greater odds of nonrestorative sleep (OR=1.98, 1.30-3.03) compared with normal menopause. In contrast, a premature menopause was not associated with nonrestorative sleep in non-Whites. Premature menopause was not associated with other individual insomnia symptoms for both groups. Conclusion Premature transition to menopause is associated with increased insomnia symptoms in White women. Among individual insomnia features, premature menopause had the greatest impact on nonrestorative sleep. Given the importance of sleep quality for various health outcomes, our findings highlight a need for more dedicated sleep assessments in women who experience premature menopause.}, keywords = {ethnic group, insomnia, Linear regression, Marital Status, Menopause, Physical activity, Sleep}, doi = {https://doi.org/10.1093/sleep/zsac079.055}, author = {Shieu, Monica and Braley, Tiffany and Zaheed, Afsara and Perry, Julie and Becker, Jill and Galit L Dunietz} } @article {12046, title = {The association between obstructive sleep apnea risk and cognitive disorders: A population-based study.}, journal = {Journal of Clinical Sleep Medicine}, volume = {18}, year = {2022}, pages = {1177-1185}, abstract = {

STUDY OBJECTIVES: To examine the association between OSA risk and cognitive disorders among US adults.

METHODS: Data from the 2016 wave of the Health and Retirement Study (HRS) were utilized. Probable OSA cases were identified with survey items that resembled critical elements of a clinically validated OSA screen (STOP-Bang questionnaire). Weighted prevalence of cognitive impairment not dementia (CIND) and dementia among individuals with and without probable OSA were assessed. Cross-sectional analyses of associations between OSA risk and cognitive outcomes, along with effect modification by race and ethnicity, were estimated using imputed data.

RESULTS: Of the 20,910 HRS participants, 60\% had probable OSA. CIND and dementia were more common among adults with probable OSA as compared to those without (12.7\% vs. 8.0\% for CIND; 3.2\% vs 2.0\% for dementia). Probable OSA was associated with CIND (OR=1.22, 1.08-1.37) and dementia (OR=1.27, 1.04-1.54). Race/ethnicity significantly modified the association between probable OSA and CIND, with a higher risk for CIND in Whites (OR=1.35, 1.17-1.57) as compared to non-Whites (OR=0.98, 0.81-1.19).

CONCLUSIONS: CIND and dementia are more common among older adults who are at high risk for OSA, as compared to low-risk individuals. These data highlight the importance of consideration of OSA risk in large-scale studies of OSA and cognitive disorders.

}, keywords = {cognitive disorders, Dementia, effect modification, obstructive sleep apnea}, issn = {1550-9397}, doi = {10.5664/jcsm.9832}, author = {Shieu, Monica M and Galit L Dunietz and Paulson, Henry L and Ronald D Chervin and Braley, Tiffany J} } @article {Whibleye036219, title = {Sleep disturbance as a moderator of the association between physical activity and later pain onset among American adults aged 50 and over: evidence from the Health and Retirement Study}, journal = {BMJ Open}, volume = {10}, year = {2020}, pages = {e036219}, abstract = {Objective To examine whether sleep disturbance modifies the association between physical activity and incident pain.Design Prospective population-based study.Setting Health and Retirement Study.Participants American adults aged >=50 years who reported no troublesome pain in 2014 were re-assessed for pain in 2016. Of 9828 eligible baseline respondents, 8036 (82\%) had complete follow-up data for adjusted analyses (weighted analysis population N=42 407 222).Exposures Physical activity was assessed via interview with questions about time spent in moderate and vigorous physical activity. Sleep disturbance, assessed using a modified form of the Jenkins Sleep Scale, was examined as a potential moderator.Main outcome measure Troublesome pain.Results In weighted analyses, 37.9\% of the 2014 baseline pain-free sample participated in moderate or vigorous physical activity once a week or less, with an overall mean Physical Activity Index Score of 9.0 (SE=0.12). 18.6\% went on to report troublesome pain in 2016. Each one-point higher on the Physical Activity Index Score was associated with a reduced odds ratio (OR) of incident pain for those who endorsed sleep disturbance never/rarely (OR=0.97, 95\% CI 0.94 to 0.99), but not for those who endorsed sleep disturbance sometimes (OR=0.99, 95\% CI 0.97 to 1.01) or most of the time (OR=1.01, 95\% CI 0.99 to 1.03). The analysis of possible interaction demonstrated that frequency of sleep disturbance moderated the physical activity and incident pain association (Wald test: p=0.02).Conclusions The beneficial association of physical activity on reduced likelihood of later pain was only observed in persons who endorsed low levels of sleep disturbance.}, keywords = {pain, Physical activity, sleep disorders}, issn = {2044-6055}, doi = {10.1136/bmjopen-2019-036219}, author = {Whibley, Daniel and Heidi M Guyer and Swanson, Leslie M and Braley, Tiffany J and Kratz, Anna L and Galit L Dunietz} }