Introduction
Materials and methods
Study population
Definition of the sleep-related disorder
Definition of the systemic immune-inflammation index
Covariates
Statistical analysis
Results
Participant characteristics
Characters | Overall (n = 8,505) | Q1 (n = 2,127) (13.750, 364.219) | Q2 (n = 2,124) (364.219, 506.647) | Q3 (n = 2,127) (506.647, 708.923) | Q4 (n = 2,127) (708.923, 5137.500) | P-value |
---|---|---|---|---|---|---|
Age, year | 45.74 ± 0.39 | 44.69 ± 0.57 | 45.72 ± 0.41 | 45.88 ± 0.44 | 46.48 ± 0.66 | 0.031 |
Sex | < 0.0001 | |||||
Male | 49.50(45.43–53.58) | 58.03(55.96–60.10) | 49.63(46.76–52.50) | 50.40(48.30–52.50) | 41.39(39.35–43.42) | |
Female | 50.50(46.08–54.91) | 41.97(39.90–44.04) | 50.37(47.50–53.24) | 49.60(47.50–51.70) | 58.61(56.58–60.65) | |
Race | < 0.0001 | |||||
Mexican American | 8.62( 6.96–10.29) | 8.76(6.88–10.64) | 8.40(6.52–10.28) | 8.94(6.78–11.11) | 8.40(6.17–10.63) | |
Non-Hispanic Black | 11.15( 8.98–13.32) | 19.82(15.28–24.36) | 10.05( 7.35–12.74) | 8.63( 6.40–10.85) | 7.51( 5.49–9.52) | |
Non-Hispanic White | 70.13(60.31–79.96) | 60.42(54.42–66.41) | 71.16(66.59–75.72) | 72.44(68.17–76.71) | 74.96(70.39–79.52) | |
Other Hispanic | 4.33( 2.90–5.76) | 4.27(2.83–5.70) | 4.60(2.76–6.43) | 4.49(2.84–6.14) | 3.96(2.50–5.41) | |
Other race | 5.76( 4.69–6.84) | 6.74(4.78–8.69) | 5.80(4.15–7.44) | 5.50(3.84–7.16) | 5.18(3.64–6.72) | |
Education | 0.352 | |||||
Less than hight school | 18.86(16.39–21.32) | 19.85(17.13–22.56) | 18.74(16.22–21.26) | 18.66(15.79–21.54) | 18.34(15.44–21.24) | |
Hight school | 24.98(22.20–27.76) | 22.77(19.49–26.04) | 24.30(22.15–26.45) | 25.39(22.90–27.87) | 27.07(25.12–29.02) | |
Above hight school | 56.17(50.81–61.52) | 57.39(53.74–61.03) | 56.96(53.71–60.21) | 55.95(51.74–60.16) | 54.59(50.75–58.44) | |
Poverty-income ratio | 0.016 | |||||
< 1.3 | 17.97(16.06–19.89) | 19.12(16.58–21.65) | 15.96(14.28–17.65) | 17.15(14.73–19.57) | 19.78(17.24–22.31) | |
1.3–3.5 | 38.34(35.03–41.65) | 40.24(36.59–43.89) | 37.37(34.35–40.38) | 37.01(33.65–40.37) | 41.21(37.21–45.21) | |
> 3.5 | 43.69(38.03–49.35) | 40.64(36.11–45.17) | 46.67(43.14–50.20) | 45.84(41.06–50.62) | 41.21(37.21–45.21) | |
BMI (kg/m2) | < 0.0001 | |||||
< 30 | 65.95(60.79–71.11) | 72.39(69.81–74.97) | 66.89(64.16–69.61) | 63.74(61.22–66.27) | 61.87(58.57–65.18) | |
≥ 30 | 34.05(30.22–37.87) | 27.61(25.03–30.19) | 33.11(30.39–35.84) | 36.26(33.73–38.78) | 38.13(34.82–41.43) | |
Smoking status | 0.045 | |||||
Now | 24.03(21.22–26.83) | 21.64(19.03–24.26) | 21.70(18.85–24.56) | 25.24(22.74–27.75) | 27.06(23.90–30.21) | |
Former | 23.57(21.23–25.91) | 24.50(22.13–26.86) | 23.78(21.65–25.91) | 23.15(20.86–25.44) | 23.01(20.77–25.26) | |
Never | 52.40(47.82–56.98) | 53.86(51.31–56.41) | 54.52(51.75–57.29) | 51.61(48.34–54.88) | 49.93(45.69–54.17) | |
Alcohol consumption status | 0.472 | |||||
Never | 11.90(10.39–13.40) | 12.85(11.05–14.65) | 11.54( 9.12–13.96) | 11.87( 9.76–13.98) | 11.48( 9.74–13.21) | |
Former | 16.55(14.08–19.02) | 16.25(14.30–18.21) | 16.95(14.34–19.56) | 16.72(14.26–19.18) | 16.24(14.16–18.33) | |
Mild-Moderate | 33.18(29.79–36.56) | 33.50(30.71–36.30) | 34.28(31.48–37.07) | 33.78(30.94–36.61) | 31.25(28.46–34.05) | |
Heavy | 38.38(34.64–42.11) | 37.39(34.19–40.60) | 37.24(34.02–40.46) | 37.63(34.64–40.63) | 41.03(38.32–43.73) | |
Recreational activitie | < 0.0001 | |||||
Vigorous | 31.45(28.19–34.70) | 36.95(33.10–40.80) | 33.15(30.07–36.23) | 30.27(27.78–32.76) | 26.37(23.10–29.65) | |
Moderate | 28.03(25.11–30.95) | 26.16(23.62–28.69) | 28.93(26.47–31.39) | 28.72(25.65–31.79) | 28.05(25.51–30.59) | |
Inactive | 40.52(35.49–45.55) | 36.89(32.90–40.88) | 37.92(34.09–41.74) | 41.01(37.74–44.28) | 45.58(40.99–50.16) | |
CVD | 7.70( 6.55–8.85) | 8.19(7.06–9.32) | 6.25(5.15–7.35) | 7.26(5.75–8.76) | 9.14(7.60–10.69) | 0.011 |
Hypertension | 46.70(42.31–51.10) | 44.11(40.71–47.52) | 44.78(41.99–47.56) | 48.31(45.69–50.93) | 49.12(46.74–51.51) | 0.028 |
Diabetes | 9.95( 8.79–11.11) | 10.95(9.23–12.66) | 8.55(7.26–9.84) | 9.89(8.63–11.16) | 10.53(8.74–12.33) | 0.098 |
Taking immunosuppressants | 0.71( 0.47–0.95) | 0.86(0.29–1.43) | 0.44(0.08–0.80) | 0.39(0.07–0.72) | 1.17(0.55–1.78) | 0.079 |
Sleep duration | 0.301 | |||||
< 7 h/night | 37.48(34.51–40.45) | 39.85(36.30–43.40) | 36.92(33.85–39.98) | 36.07(33.47–38.67) | 37.45(34.76–40.14) | |
7–9 h/night | 60.35(54.37–66.33) | 58.35(54.95–61.75) | 61.15(58.02–64.29) | 61.54(58.75–64.32) | 60.08(57.48–62.67) | |
> 9 h/night | 2.17( 1.70–2.63) | 1.80(1.10–2.51) | 1.93(1.34–2.52) | 2.39(1.62–3.16) | 2.48(1.88–3.07) | |
Sleep problems | 41.40(37.20–45.60) | 37.77(35.06–40.47) | 40.47(37.92–43.01) | 40.23(38.12–42.33) | 46.51(43.94–49.09) | < 0.001 |
OSA symptoms | 43.16(38.97–47.34) | 38.83(36.70–40.97) | 40.62(37.77–43.47) | 45.32(43.01–47.63) | 47.05(44.28–49.82) | < 0.0001 |
Daytime sleepiness | 29.13(26.27–32.00) | 26.48(24.29–28.68) | 27.44(25.21–29.67) | 28.09(26.02–30.16) | 34.01(31.42–36.60) | < 0.0001 |
Association between sleep duration and SII
Exposure | Outcome | Categories | Model 1a β (95% CI), P- value | Model 2b β (95% CI), P- value | Model 3c β (95% CI), P- value |
---|---|---|---|---|---|
Sleep duration | SII | 7–9 h/night | Reference | Reference | Reference |
< 7 h/night | 0.038(-16.479, 16.555) P = 0.996 | 12.165(-4.594, 28.925) P = 0.147 | 1.229(-17.940, 20.399) P = 0.884 | ||
> 9 h/night | 54.748(-0.861,110.357) P = 0.053 | 52.542(-0.858,105.941) P = 0.053 | 35.656(-29.280,100.592) P = 0.235 | ||
PLR | 7–9 h/night | Reference | Reference | Reference | |
< 7 h/night | -5.311(-8.397,-2.224) P = 0.001 | -4.848(-8.074,-1.622) P = 0.005 | -3.227(-6.918, 0.465) P = 0.078 | ||
> 9 h/night | 5.694(-3.956,15.344) P = 0.237 | 3.817(-6.155,13.788) P = 0.437 | 5.426(-6.092, 16.944) P = 0.302 | ||
NLR | 7–9 h/night | Reference | Reference | Reference | |
< 7 h/night | -0.038(-0.085,0.010) P = 0.115 | 0.003(-0.045,0.050) P = 0.913 | -0.024(-0.077, 0.029) P = 0.321 | ||
> 9 h/night | 0.145(0.003,0.288) P = 0.046 | 0.161(0.028,0.295) P = 0.020 | 0.089(-0.072, 0.251) P = 0.232 |
Association between sleep-related disorder and SII
Exposure | Outcome | Categories | Model 1a β (95% CI), P- value | Model 2b β (95% CI), P- value | Model 3c β (95% CI), P- value |
---|---|---|---|---|---|
Sleep problems | SII | No | Reference | Reference | Reference |
Yes | 42.557(24.671,60.444) P < 0.0001 | 30.607(12.271, 48.942) P = 0.002 | 21.421(1.484, 41.358) P = 0.038 | ||
PLR | No | Reference | Reference | Reference | |
Yes | 2.967(0.801,5.134) P = 0.009 | 0.545(-1.620, 2.709) P = 0.608 | 1.776(-0.485, 4.038) P = 0.108 | ||
NLR | No | Reference | Reference | Reference | |
Yes | 0.083(0.015,0.151) P = 0.019 | 0.050(-0.018,0.118) P = 0.143 | 0.027(-0.047, 0.102) P = 0.421 | ||
OSA symptoms | SII | No | Reference | Reference | Reference |
Yes | 36.329(20.009,52.650) P < 0.0001 | 38.260(20.259, 56.261) P < 0.001 | 23.088(0.441, 45.735) P = 0.046 | ||
PLR | No | Reference | Reference | Reference | |
Yes | 1.115(-1.208,3.439) P = 0.335 | 0.168(-2.129, 2.464) P = 0.881 | 0.427(-1.894, 2.747) P = 0.707 | ||
NLR | No | Reference | Reference | Reference | |
Yes | 0.105(0.047,0.163) P < 0.001 | 0.054(-0.002,0.111) P = 0.058 | 0.033(-0.050, 0.116) P = 0.382 | ||
Daytime sleepiness | SII | No | Reference | Reference | Reference |
Yes | 45.143(21.344,68.943) P < 0.001 | 39.479(17.142, 61.816) P = 0.001 | 30.320(5.851, 54.789) P = 0.021 | ||
PLR | No | Reference | Reference | Reference | |
Yes | 0.643(-2.772,4.058) P = 0.703 | 0.016(-3.183, 3.216) P = 0.992 | 1.258(-2.300, 4.816) P = 0.439 | ||
NLR | No | Reference | Reference | Reference | |
Yes | 0.086(0.014,0.157) P = 0.021 | 0.107(0.035,0.178) P = 0.005 | 0.081(0.002, 0.159) P = 0.046 |