Association between combined lifestyle factors and non-restorative sleep in japan: A cross-sectional study based on a japanese health database

Minako Wakasugi, Junichiro James Kazama, Ichiei Narita, Kunitoshi Iseki, Toshiki Moriyama, Kunihiro Yamagata, Shouichi Fujimoto, Kazuhiko Tsuruya, Koichi Asahi, Tsuneo Konta, Kenjiro Kimura, Masahide Kondo, Issei Kurahashi, Yasuo Ohashi, Tsuyoshi Watanabe

Research output: Contribution to journalArticle

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Abstract

Background: Although lifestyle factors such as cigarette smoking, excessive drinking, obesity, low or no exercise, and unhealthy dietary habits have each been associated with inadequate sleep, little is known about their combined effect. The aim of this study was to quantify the overall impact of lifestyle-related factors on non-restorative sleep in the general Japanese population.

Methods and Findings: A cross-sectional study of 243,767 participants (men, 39.8%) was performed using the Specific Health Check and Guidance System in Japan. A healthy lifestyle score was calculated by adding up the number of low-risk lifestyle factors for each participant. Low risk was defined as (1) not smoking, (2) body mass index<25 kg/m2, (3) moderate or less alcohol consumption, (4) regular exercise, and (5) better eating patterns. Logistic regression analysis was used to examine the relationship between the score and the prevalence of non-restorative sleep, which was determined from questionnaire responses. Among 97,062 men (mean age, 63.9 years) and 146,705 women (mean age, 63.7 years), 18,678 (19.2%) and 38,539 (26.3%) reported non-restorative sleep, respectively. The prevalence of non-restorative sleep decreased with age for both sexes. Compared to participants with a healthy lifestyle score of 5 (most healthy), those with a score of 0 (least healthy) had a higher prevalence of non-restorative sleep (odds ratio, 1.59 [95% confidence interval, 1.29-1.97] for men and 2.88 [1.74-4.76] for women), independently of hypertension, hypercholesterolemia, diabetes, and chronic kidney disease. The main limitation of the study was the cross-sectional design, which limited causal inferences for the identified associations.

Conclusions: A combination of several unhealthy lifestyle factors was associated with non-restorative sleep among the general Japanese population. Further studies are needed to establish whether general lifestyle modification improves restorative sleep.

Original languageEnglish
Article numbere108718
JournalPloS one
Volume9
Issue number9
DOIs
Publication statusPublished - Jan 1 2014

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sleep
cross-sectional studies
lifestyle
Life Style
Japan
Sleep
Cross-Sectional Studies
Health
Databases
exercise
Smoking
Exercise
steering systems
smoking (habit)
hypercholesterolemia
Feeding Behavior
Medical problems
kidney diseases
Hypercholesterolemia
drinking

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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Association between combined lifestyle factors and non-restorative sleep in japan : A cross-sectional study based on a japanese health database. / Wakasugi, Minako; Kazama, Junichiro James; Narita, Ichiei; Iseki, Kunitoshi; Moriyama, Toshiki; Yamagata, Kunihiro; Fujimoto, Shouichi; Tsuruya, Kazuhiko; Asahi, Koichi; Konta, Tsuneo; Kimura, Kenjiro; Kondo, Masahide; Kurahashi, Issei; Ohashi, Yasuo; Watanabe, Tsuyoshi.

In: PloS one, Vol. 9, No. 9, e108718, 01.01.2014.

Research output: Contribution to journalArticle

Wakasugi, M, Kazama, JJ, Narita, I, Iseki, K, Moriyama, T, Yamagata, K, Fujimoto, S, Tsuruya, K, Asahi, K, Konta, T, Kimura, K, Kondo, M, Kurahashi, I, Ohashi, Y & Watanabe, T 2014, 'Association between combined lifestyle factors and non-restorative sleep in japan: A cross-sectional study based on a japanese health database', PloS one, vol. 9, no. 9, e108718. https://doi.org/10.1371/journal.pone.0108718
Wakasugi, Minako ; Kazama, Junichiro James ; Narita, Ichiei ; Iseki, Kunitoshi ; Moriyama, Toshiki ; Yamagata, Kunihiro ; Fujimoto, Shouichi ; Tsuruya, Kazuhiko ; Asahi, Koichi ; Konta, Tsuneo ; Kimura, Kenjiro ; Kondo, Masahide ; Kurahashi, Issei ; Ohashi, Yasuo ; Watanabe, Tsuyoshi. / Association between combined lifestyle factors and non-restorative sleep in japan : A cross-sectional study based on a japanese health database. In: PloS one. 2014 ; Vol. 9, No. 9.
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AU - Narita, Ichiei

AU - Iseki, Kunitoshi

AU - Moriyama, Toshiki

AU - Yamagata, Kunihiro

AU - Fujimoto, Shouichi

AU - Tsuruya, Kazuhiko

AU - Asahi, Koichi

AU - Konta, Tsuneo

AU - Kimura, Kenjiro

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N2 - Background: Although lifestyle factors such as cigarette smoking, excessive drinking, obesity, low or no exercise, and unhealthy dietary habits have each been associated with inadequate sleep, little is known about their combined effect. The aim of this study was to quantify the overall impact of lifestyle-related factors on non-restorative sleep in the general Japanese population.Methods and Findings: A cross-sectional study of 243,767 participants (men, 39.8%) was performed using the Specific Health Check and Guidance System in Japan. A healthy lifestyle score was calculated by adding up the number of low-risk lifestyle factors for each participant. Low risk was defined as (1) not smoking, (2) body mass index<25 kg/m2, (3) moderate or less alcohol consumption, (4) regular exercise, and (5) better eating patterns. Logistic regression analysis was used to examine the relationship between the score and the prevalence of non-restorative sleep, which was determined from questionnaire responses. Among 97,062 men (mean age, 63.9 years) and 146,705 women (mean age, 63.7 years), 18,678 (19.2%) and 38,539 (26.3%) reported non-restorative sleep, respectively. The prevalence of non-restorative sleep decreased with age for both sexes. Compared to participants with a healthy lifestyle score of 5 (most healthy), those with a score of 0 (least healthy) had a higher prevalence of non-restorative sleep (odds ratio, 1.59 [95% confidence interval, 1.29-1.97] for men and 2.88 [1.74-4.76] for women), independently of hypertension, hypercholesterolemia, diabetes, and chronic kidney disease. The main limitation of the study was the cross-sectional design, which limited causal inferences for the identified associations.Conclusions: A combination of several unhealthy lifestyle factors was associated with non-restorative sleep among the general Japanese population. Further studies are needed to establish whether general lifestyle modification improves restorative sleep.

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