Healthy sleep habits help lower risk of heart failure

 

Adults with the healthiest sleep patterns had a 42% lower risk of heart failure regardless of other risk factors compared to adults with unhealthy sleep patterns, according to new research published today in the American Heart Association's flagship journal Circulation. Healthy sleep patterns are rising in the morning, sleeping 7-8 hours a day and having no frequent insomnia, snoring or excessive daytime sleepiness.

Heart failure affects more than 26 million people, and emerging evidence indicates sleep problems may play a role in the development of heart failure.

This observational study examined the relationship between healthy sleep patterns and heart failure and included data on 408,802 UK Biobank participants, ages 37 to 73 at the time of recruitment (2006-2010). Incidence of heart failure was collected until April 1, 2019. Researchers recorded 5,221 cases of heart failure during a median follow-up of 10 years.

Researchers analyzed sleep quality as well as overall sleep patterns. The measures of sleep quality included sleep duration, insomnia and snoring and other sleep-related features, such as whether the participant was an early bird or night owl and if they had any daytime sleepiness (likely to unintentionally doze off or fall asleep during the daytime).

"The healthy sleep score we created was based on the scoring of these five sleep behaviors," said Lu Qi, M.D., Ph.D., corresponding author and professor of epidemiology and director of the Obesity Research Center at Tulane University in New Orleans. "Our findings highlight the importance of improving overall sleep patterns to help prevent heart failure."

Sleep behaviors were collected through touchscreen questionnaires. Sleep duration was defined into three groups: short, or less than 7 hours a day; recommended, or 7 to 8 hours a day; and prolonged, or 9 hours or more a day.

After adjusting for diabetes, hypertension, medication use, genetic variations and other covariates, participants with the healthiest sleep pattern had a 42% reduction in the risk of heart failure compared to people with an unhealthy sleep pattern.

They also found the risk of heart failure was independently associated and:

• 8% lower in early risers;
• 12% lower in those who slept 7 to 8 hours daily;
• 17% lower in those who did not have frequent insomnia; and
• 34% lower in those reporting no daytime sleepiness.

Participant sleep behaviors were self-reported, and the information on changes in sleep behaviors during follow-up were not available. The researchers noted other unmeasured or unknown adjustments may have also influenced the findings.

Qi also noted that the study's strengths include its novelty, prospective study design and large sample size.

First-author is Xiang Li, Ph.D.; other co-authors are Qiaochu Xue, M.P.H.; Mengying Wang, M.P.H.; Tao Zhou, Ph.D.; Hao Ma, Ph.D.; and Yoriko Heianza, Ph.D. Author disclosures are detailed in the manuscript.

 

Journal Reference:

1. Xiang Li, Qiaochu Xue, Mengying Wang, Tao Zhou, Hao Ma, Yoriko Heianza, Lu Qi. Adherence to a Healthy Sleep Pattern and Incident Heart Failure: A Prospective Study of 408802 UK Biobank Participants. Circulation, 2020; DOI: 10.1161/CIRCULATIONAHA.120.050792

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Courtesy:

American Heart Association. "Healthy sleep habits help lower risk of heart failure." ScienceDaily. ScienceDaily, 16 November 2020. <www.sciencedaily.com/releases/2020/11/201116075728.htm>.

 

Researchers examine which approaches are most effective at reducing COVID-19 spread

 

Simon Fraser University professors Paul Tupper and Caroline Colijn have found that physical distancing is universally effective at reducing the spread of COVID-19, while social bubbles and masks are more situation-dependent.

The researchers developed a model to test the effectiveness of measures such as physical distancing, masks or social bubbles when used in various settings.

Their paper was published Nov. 19 in the journal Proceedings of the National Academy of Sciences of the United States of America (PNAS).

They introduce the concept of "event R," which is the expected number of people who become infected with COVID-19 from one individual at an event.

Tupper and Colijn look at factors such as transmission intensity, duration of exposure, the proximity of individuals and degree of mixing -- then examine what methods are most effective at preventing transmission in each circumstance.

The researchers incorporated data from reports of outbreaks at a range of events, such as parties, meals, nightclubs, public transit and restaurants. The researchers say that an individual's chances of becoming infected with COVID-19 depend heavily on the transmission rate and the duration -- the amount of time spent in a particular setting.

Events were categorized as saturating (high transmission probability) or linear (low transmission probability). Examples of high transmission settings include bars, nightclubs and overcrowded workplaces while low transmission settings include public transit with masks, distancing in restaurants and outdoor activities.

The model suggests that physical distancing was effective at reducing COVID-19 transmission in all settings but the effectiveness of social bubbles depends on whether chances of transmission are high or low.

In settings where there is mixing and the probability of transmission is high, such as crowded indoor workplaces, bars and nightclubs and high schools, having strict social bubbles can help reduce the spread of COVID-19.

The researchers found that social bubbles are less effective in low transmission settings or activities where there is mixing, such as engaging in outdoor activities, working in spaced offices or travelling on public transportation wearing masks.

They note that masks and other physical barriers may be less effective in saturating, high transmission settings (parties, choirs, restaurant kitchens, crowded offices, nightclubs and bars) because even if masks halve the transmission rates that may not have much impact on the transmission probability (and so on the number of infections).

The novel coronavirus is relatively new but the science continues to evolve and increase our knowledge of how to effectively treat and prevent this highly contagious virus. There is still much that we do not know and many areas requiring further study.

"It would be great to start collecting information from exposures and outbreaks: the number of attendees, the amount of mixing, the levels of crowding, the noise level and the duration of the event," says Colijn, who holds a Canada Research Chair in Mathematics for Evolution, Infection and Public Health.

 

Journal Reference:

1. Paul Tupper, Himani Boury, Madi Yerlanov, Caroline Colijn. Event-specific interventions to minimize COVID-19 transmission. Proceedings of the National Academy of Sciences, 2020; 202019324 DOI: 10.1073/pnas.2019324117 

Courtesy:

Simon Fraser University. "Researchers examine which approaches are most effective at reducing COVID-19 spread: Social bubbles and masks more situation-dependent in terms of effectiveness." ScienceDaily. ScienceDaily, 20 November 2020. <www.sciencedaily.com/releases/2020/11/201120150726.htm>.

 

Researchers examine the decline in average body temperature among healthy adults over the past two decades

In the nearly two centuries since German physician Carl Wunderlich established 98.6°F as the standard "normal" body temperature, it has been used by parents and doctors alike as the measure by which fevers -- and often the severity of illness -- have been assessed.

Over time, however, and in more recent years, lower body temperatures have been widely reported in healthy adults. A 2017 study among 35,000 adults in the United Kingdom found average body temperature to be lower (97.9°F), and a 2019 study showed that the normal body temperature in Americans (those in Palo Alto, California, anyway) is about 97.5°F.

A multinational team of physicians, anthropologists and local researchers led by Michael Gurven, UC Santa Barbara professor of anthropology and chair of the campus's Integrative Anthropological Sciences Unit, and Thomas Kraft, a postdoctoral researcher in the same department, have found a similar decrease among the Tsimane, an indigenous population of forager-horticulturists in the Bolivian Amazon. In the 16 years since Gurven, co-director of the Tsimane Health and Life History Project, and fellow researchers have been studying the population, they have observed a rapid decline in average body temperature -- 0.09°F per year, such that today Tsimane body temperatures are roughly 97.7°F.

"In less than two decades we're seeing about the same level of decline as that observed in the U.S. over approximately two centuries," said Gurven. Their analysis is based on a large sample of 18,000 observations of almost 5,500 adults, and adjust for multiple other factors that might affect body temperature, such as ambient temperature and body mass.

The anthropologists' research appears in the journal Sciences Advances.

"The provocative study showing declines in normal body temperature in the U.S. since the time of the Civil War was conducted in a single population and couldn't explain why the decline happened," said Gurven. "But it was clear that something about human physiology could have changed. One leading hypothesis is that we've experienced fewer infections over time due to improved hygiene, clean water, vaccinations and medical treatment. In our study, we were able to test that idea directly. We have information on clinical diagnoses and biomarkers of infection and inflammation at the time each patient was seen.

While some infections were associated with higher body temperature, adjusting for these did not account for the steep decline in body temperature over time, Gurven noted. "And we used the same type of thermometer for most of the study, so it's not due to changes in instrumentation," he said.

Added Kraft, "No matter how we did the analysis, the decline was still there. Even when we restricted analysis to the <10% of adults who were diagnosed by physicians as completely healthy, we still observed the same decline in body temperature over time."

A key question, then, is why body temperatures have declined over time both for Americans and Tsimane. Extensive data available from the team's long-term research in Bolivia addresses some possibilities. "Declines might be due to the rise of modern health care and lower rates of lingering mild infections now as compared to the past," Gurven explained. "But while health has generally improved over the past two decades, infections are still widespread in rural Bolivia. Our results suggest that reduced infection alone can't explain the observed body temperature declines."

It could be that people are in better condition, so their bodies might be working less to fight infection, he continued. Or greater access to antibiotics and other treatments means the duration of infection is shorter now than in the past. Consistent with that argument, Gurven said, "We found that having a respiratory infection in the early period of the study led to having a higher body temperature than having the same respiratory infection more recently."

It's also possible that greater use of anti-inflammatory drugs like ibuprofen may reduce inflammation, though the researchers found that the temporal decline in body temperature remained even after their analyses accounted for biomarkers of inflammation.

"Another possibility is that our bodies don't have to work as hard to regulate internal temperature because of air conditioning in the summer and heating in the winter," Kraft said. "While Tsimane body temperatures do change with time of year and weather patterns, the Tsimane still do not use any advanced technology for helping to regulate their body temperature. They do, however, have more access to clothes and blankets."

The researchers were initially surprised to find no single "magic bullet" that could explain the decline in body temperature. "It's likely a combination of factors -- all pointing to improved conditions," Gurven said.

According to Gurven, the finding of lower-than-expected body temperatures in the U.S., and the decline over time, had a lot of people scratching their heads. Was it a fluke? In this study, Gurven and his team confirm that body temperatures below 98.6°F are found in places outside the U.S. and the U.K. "The area of Bolivia where the Tsimane live is rural and tropical with minimal public health infrastructure," he noted. "Our study also gives the first indication that body temperatures have declined even in this tropical environment, where infections still account for much morbidity and mortality."

As a vital sign, temperature is an indicator of what's occurring physiologically in the body, much like a metabolic thermostat. "One thing we've known for a while is that there is no universal 'normal' body temperature for everyone at all times, so I doubt our findings will affect how clinicians use body temperature readings in practice" said Gurven. Despite the fixation on 98.6°F, most clinicians recognize that 'normal' temperatures have a range. Throughout the day, body temperature can vary by as much as 1°F, from its lowest in the early morning, to its highest in the late afternoon. It also varies across the menstrual cycle and following physical activity and tends to decrease as we age.

But by linking improvements in the broader epidemiological and socioeconomic landscape to changes in body temperature, the study suggests that information on body temperature might provide clues to a population's overall health, as do other common indicators such as life expectancy. "Body temperature is simple to measure, and so could easily be added to routine large-scale surveys that monitor population health," Gurven said.

 

Journal Reference:

1. Michael Gurven, Thomas S. Kraft, Sarah Alami, Juan Copajira Adrian, Edhitt Cortez Linares, Daniel Cummings, Daniel Eid Rodriguez, Paul L. Hooper, Adrian V. Jaeggi, Raul Quispe Gutierrez, Ivan Maldonado Suarez, Edmond Seabright, Hillard Kaplan, Jonathan Stieglitz, Benjamin Trumble. Rapidly declining body temperature in a tropical human population. Science Advances, 2020; 6 (44): eabc6599 DOI: 10.1126/sciadv.abc6599 

Courtesy: University of California - Santa Barbara. "A drop in temperature: Researchers examine the decline in average body temperature among healthy adults over the past two decades." ScienceDaily. ScienceDaily, 28 October 2020. <www.sciencedaily.com/releases/2020/10/201028171432.htm>.