Actigraphic sleep fragmentation, efficiency and duration associate with dietary intake in the Rotterdam study

Authors: DASHTI, HASSAN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; ZUURBIER, LISETTE - Erasmus Medical Center; DE JONGE, ESTER - Erasmus Medical Center; VOORTMAN, TRUDY - Erasmus Medical Center; JACQUES, PAUL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; LAMON-FAVA, STEFANIA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; SCHEER, FRANK - Harvard University; KIEFTE-DE JONG, JESSICA - Erasmus Medical Center; HOFMAN, ALBERT - Erasmus Medical Center; ORDOVAS, JOSE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; FRANCO, OSCAR - Erasmus Medical Center; TIEMEIER, HENNING - Erasmus Medical Center

Submitted to: Journal of Sleep Research
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/9/2016
Publication Date: 2/9/2016
Citation: Dashti, H.S., Zuurbier, L.A., De Jonge, E., Voortman, T., Jacques, P.F., Lamon-Fava, S., Scheer, F.A., Kiefte-De Jong, J.C., Hofman, A., Ordovas, J.M., Franco, O.H., Tiemeier, H. 2016. Actigraphic sleep fragmentation, efficiency and duration associate with dietary intake in the Rotterdam study. Journal of Sleep Research. doi: 10.1111/jsr.12397.

Interpretive Summary: Short self-reported sleep duration is associated with dietary intake, and this association may partly mediate the previously-observed relationship between short sleep duration and abnormal metabolism. While previous studies have used data obtained through questionnaires, these subjective self-reported data may be inaccurate and biased. The objective of this present investigation is to evaluate the relationship between objectively measured sleep fragmentation, efficiency, and duration and energy and macronutrient intakes by using a unique dataset from a subgroup of 439 participants of the population-based cohort, the Rotterdam Study. Sleep was assessed using 7-d actigraphy, or non-invasive monitoring of human rest and activity cycles, and sleep diaries, and dietary data was measured with a validated food frequency questionnaire. We assessed the associations of actigraphic sleep parameters with dietary intake using multivariable linear regression models. We observed higher sleep fragmentation was associated with lower carbohydrate intake and that each additional percent increase in sleep efficiency was associated with lower energy. Furthermore, we observed that very short sleep duration (<5.5h) was associated with 210.8 kcal higher energy intake, relative to the reference group (>/=6.5 to <7.5h.) In conclusion, we observed associations between higher sleep fragmentation with lower carbohydrate intake and both lower sleep efficiency and very short sleep duration (<5h) with higher energy intake. The present influence of sleep on higher energy intake could, in part, explain the link between short sleep or sleep fragmentation and metabolic abnormalities that have been observed in previous investigations.

Technical Abstract: Short self-reported sleep duration is associated with dietary intake and this association may partly mediate the link between short sleep and metabolic abnormalities. Subjective sleep measures, however, may be inaccurate and biased. The objective of this study was to evaluate the associations between actigraphic measures of sleep fragmentation, efficiency and duration and energy and macronutrient intakes. We used data from a subgroup of 439 participants of the population-based cohort, Rotterdam Study. Sleep was assessed using 7-day actigraphy and sleep diaries, and dietary data with a validated food frequency questionnaire. We assessed the associations of actigraphic sleep parameters with dietary intake using multivariable linear regression models. Higher sleep fragmentation was associated with 4.19 g lower carbohydrate intake per standard deviation of fragmentation {beta [95% confidence interval (CI) = -4.19 (-8.0, -0.3)]; P=0.03}. Each additional percentage increase in sleep efficiency was associated with 11.1 kcal lower energy intake [beta (95% CI = 218.06 (33.3, 402.8), P=0.02], relative to the reference group (>/=6.5 to <7.5 h). We observed associations between higher sleep fragmentation with lower carbohydrate intake, and both lower sleep efficiency and very short sleep duration (<5 h) with higher energy intake. The association between sleep and higher energy intake could mediate, in part, the link between short sleep or sleep fragmentation index and metabolic abnormalities.