주관적 수면만족도에 따른 수면시간과 대사증후군과의 관계
Relationship between Sleep Duration, Sleep Satisfaction and Metabolic Syndrome
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연구배경: 지금까지 수면부족과 대사증후군 및 대사위험인자와의 관련성에 대한 연구는 있었지만, 단순한 수면의 양뿐 아니라 그 질적인 측면까지 고려하여 그 관련성을 살펴본 연구는 드물다. 방법: 2005년 국민건강영양조사 자료를 이용하여 20세 이상의 남녀 4,970명을 주관적 수면만족도에 따라 두 군으로 분류하고, propensity score matching법을 이용하여 양 군의 일반적 특성을 균일하게 한 후, 최종적으로 남녀 3,572명(남자 1,443명, 여자 2,129명)의 자료를 분석하였다. 대사증후군의 진단은 National Heart, Lung, and Blood Institute/ American Heart Association 지침을 이용하였고, 복부비만은 아시아 태평양 기준을 따랐다. 수면시간은 5시간 이하를 수면부족군, 6~8시간을 적정 수면군, 그리고 9시간 이상을 수면과다군으로 분류하였고, 적정 수면군을 기준군으로 하여 분석하였다. 결과: 일반적으로 수면시간이 길수록 주관적 수면만족도는 높았다. 수면만족군과는 달리 수면불만족군에서는, 수면부족군이 적정 수면군에 비해 대사증후군 및 모든 대사위험인자에 대해 높은 유병률을 보였으며, 이러한 양상은 기존의 연구에서 보이지 않았던 지질관련 요소에서도 나타났다. 대사증후군 유병률에 대한 로지스틱 회귀 분석에서는 자신의 수면시간에 만족하지 못하면서 수면이 부족한 군에서만이 유의한 결과를 보였는데, 그 교차비는 보정 전 2.08 (95% CI, 1.64~2.64), 보정 후 1.64 (95% CI, 1.27~2.12)였다. 결론: 자신의 수면시간에 만족하는 군과는 다르게, 만족하지 않는 군에서는 수면시간이 부족한 사람이 적정 수면을 취하는 사람에 비해 대사 증후군의 위험이 더 높다.
Abstract
Background: Previous studies have indicated that a short sleep duration is associated with several metabolic risk factors and metabolic syndrome (MS). However, studies that consider not only sleep duration but also subjective sleep satisfaction are rare. Methods: This study was based on data obtained from the third Korean National Health and Nutrition Examination Survey (2005). A total of 4,970 individuals aged 20 years and older were selected and then divided into two groups based on subjective sleep satisfaction, satisfied with their sleep or dissatisfied. Hereafter, we matched each group using propensity score matching methods resulting in a final analytical sample of 3,572 subjects (1,443 men and 2,129 women). These subjects were categorized into 3 groups based on the average number of hours slept per night- short sleepers (≤5h), optimal sleepers (6~8h), and long sleepers (≥9h). Optimal sleepers served as the reference group. Results: In terms of satisfaction, the longer our subjects slept, the more satisfied they felt. In the dissatisfied group, by contrast with the satisfied group, short sleepers demonstrated a significantly higher prevalence of metabolic risk factors and MS than optimal sleepers. Similar findings were also observed with lipid profiles, which had not been shown in previous studies. In logistic regression analysis for prediction of MS, unadjusted odds ratio (OR) was 2.08 (95% CI: 1.64~2.64) and adjusted OR was 1.64 (95% CI: 1.27~2.12) in short sleepers of the dissatisfied group. Conclusions: Contrary to the sleep satisfied group, the sleep dissatisfied group exhibited a higher prevalence of MS in short sleepers.
참고문헌 (32)
- Malik SW, "Sleep deprivation", Prim Care, 32, pp.475~490 (2005)
- Lee-Chiong TL, "Sleep: a comprehensive handbook" (2006), Wiley-Liss
- Gangwisch JE, "Short sleep duration as a risk factor for hypertension: analyses of the first National Health and Nutrition Examination Survey", Hypertension, 47, pp.833~839 (2006)
- Taheri S, "The link between short sleep duration and obesity: we should recommend more sleep to prevent obesity", Arch Dis Child, 91, pp.881~884 (2006)
- Hasler G, "The association between short sleep duration and obesity in young adults: a 13-year prospective study", Sleep, 27, pp.661~666 (2004)
- Ayas NT, "A prospective study of self-reported sleep duration and incident diabetes in women", Diabetes Care, 26, pp.380~384 (2003)
- Chaput JP, "Sleep duration as a risk factor for the development of type 2 diabetes or impaired glucose tolerance: analyses of the Quebec Family Study", Sleep Med, 10, pp.919~924 (2009)
- Choi KM, "Relationship between sleep duration and the metabolic syndrome: Korean National Health and Nutrition Survey 2001", Int J Obes, 32, pp.1091~1097 (2008)
- Bjorkelund C, "Sleep disturbances in midlife unrelated to 32-year diabetes incidence: the prospective population study of women in Gothenburg", Diabetes Care, 28, pp.2739~2744 (2005)
- Stranges S, "Cross-sectional versus prospective associations of sleep duration with changes in relative weight and body fat distribution: the Whitehall II Study", Am J Epidemiol, 167, pp.321~329 (2008)
- Ford ES, "Defining the metabolic syndrome in children and adolescents: will the real definition please stand up?", J Pediatr, 152, pp.160~164 (2008)
- D’Agostino RB, Jr, "Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group", Stat Med, 17, pp.2265~2281 (1998)
- Coates RA, "Risk of fatty infiltration or cirrhosis of the liver in relation to ethanol consumption: a case-control study", Clin Invest Med, 9, pp.26~32 (1986)
- Gallicchio L, "Sleep duration and mortality: a systematic review and meta-analysis", J Sleep Res, 18, pp.148~158 (2009)
- Burazeri G, "Over 8 hours of sleep-marker of increased mortality in Mediterranean population: follow-up population study", Croat Med J, 44, pp.193~198 (2003)
- Oh JJ, "A study on development of Korean sleep scale", Korean Acad Nurs, 28, pp.563~572 (1998)
- Friedewald WT, "Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge", Clin Chem, 18, pp.499~502 (1972)
- Grundy SM, "Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute", American Heart Association conference on scientific issues related to definition, 2004, pp.109, 433~438
- Lee SY, "Appropriate waist circumference cutoff points for central obesity in Korean adults", Diabetes Res Clin Pract, 75, pp.72~80 (2007)
- Jennings JR, "Self-reported sleep quality is associated with the metabolic syndrome", Sleep, 30, pp.219~223 (2007)
- Carpenter JS, "Psychometric evaluation of the Pittsburgh Sleep Quality Index", J Psychosom Res, 45, pp.5~13 (1998)
- Spiegel K, "Impact of sleep debt on metabolic and endocrine function", Lancet, 354, pp.1435~1439 (1999)
- Taheri S, "Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index", PLoS Med, 1, pp.e62~ (2004)
- Vgontzas AN, "Sleep apnea and daytime sleepiness and fatigue: relation to visceral obesity, insulin resistance, and hypercytokinemia", J Clin Endocrinol Metab, 85, pp.1151~1158 (2000)
- Resnick HE, "Diabetes and sleep disturbances: findings from the Sleep Heart Health Study", Diabetes Care, 26, pp.702~709 (2003)
- Spiegel K, "Adaptation of the 24-h growth hormone profile to a state of sleep debt", Am J Physiol Regul Integr Comp Physiol, 279, pp.R874~883 (2000)
- Spiegel K, "Brief communication: Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite", Ann Intern Med, 141, pp.846~850 (2004)
- Vorona RD, "Overweight and obese patients in a primary care population report less sleep than patients with a normal body mass index", Arch Intern Med, 165, pp.25~30 (2005)
- Yaggi HK, "Sleep duration as a risk factor for the development of type 2 diabetes", Diabetes Care, 29, pp.657~661 (2006)
- Newman AB, "Relation of sleep-disordered breathing to cardiovascular disease risk factors: the Sleep Heart Health Study", Am J Epidemiol, 154, pp.50~59 (2001)
- Chin K, "Changes in intra-abdominal visceral fat and serum leptin levels in patients with obstructive sleep apnea syndrome following nasal continuous positive airway pressure therapy", Circulation, 100, pp.706~712 (1999)