Abstract
Sleep is integral to human health. Accumulating evidence has revealed that sleep characteristics could be influenced by altitudes. However, few studies explored what the trajectories of sleep status are along with the altitudes. Therefore, this study aims to find the relationship between altitudes and sleep status using data from CHARLS, a nationwide survey data from China. The generalized additive model and generalized additive mixed-effects model were used to explore the association between sleep status and altitudes. Age, gender, education level, and other common confounding factors were included in the models as covariates. The sleep duration showed a rapid increase trend after the altitude of 1600 m. The probabilities of long sleep duration were increased with the evaluation of altitudes (edf = 1.945, P = 0.004), while the similar statistically significant change was not observed for short sleep duration (edf = 2.204, P = 0.193). Gender, residence, and ethnicity were the main influencing factors for the increase in sleep duration as altitude increased. The high-altitude environment could have effects on the sleep status of individuals, especially on the sleep duration. Long sleep duration was found more prevalent among highlanders. This study shed light on the underlying relationship between altitudes and sleep status which could provide clues for further mechanism studies.
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Data availability
The data that support the findings of this study are available from the corresponding author, [Zeng], upon reasonable request.
References
Cappuccio FP, D’Elia L, Strazzullo P, et al. Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care. 2010;33:414–20.
Itani O, Jike M, Watanabe N, et al. Short sleep duration and health outcomes: a systematic review, meta-analysis, and meta-regression. Sleep Med. 2017;32:246–56.
Laksono S, Yanni M, Iqbal M, et al. Abnormal sleep duration as predictor for cardiovascular diseases: a systematic review of prospective studies. Sleep Disord. 2022;2022:9969107.
Valverde G, Zhou H, Lippold S, et al. A novel candidate region for genetic adaptation to high altitude in Andean populations. PLoS ONE. 2015;10:e0125444.
Pasha MA, Newman JH. High-altitude disorders: pulmonary hypertension: pulmonary vascular disease: the global perspective. Chest. 2010;137:13s–9s.
Singh LC. High altitude dermatology. Indian J Dermatol. 2017;62:59–65.
San T, Polat S, Cingi C, et al. Effects of high altitude on sleep and respiratory system and theirs adaptations. Sci World J. 2013;2013:241569.
Szymczak RK, Sitek EJ, Sławek JW, et al. Subjective sleep quality alterations at high altitude. Wilderness Environ Med. 2009;20:305–10.
Weil JV. Sleep at high altitude. High Alt Med Biol. 2004;5:180–9.
Wickramasinghe H, Anholm JD. Sleep and breathing at high altitude. Sleep Breath. 1999;3:89–102.
Gupta R, Ulfberg J, Allen RP, et al. Comparison of subjective sleep quality of long-term residents at low and high altitudes: SARAHA study. J Clin Sleep Med. 2018;14:15–21.
Ruiz AJ, Sepúlveda MA, Martínez PH, et al. Prevalence of sleep complaints in Colombia at different altitudes. Sleep Sci. 2016;9:100–5.
Luo H, Li J, Zhang Q, et al. Obesity and the onset of depressive symptoms among middle-aged and older adults in China: evidence from the CHARLS. BMC Public Health. 2018;18:909.
Zhao Y, Hu Y, Smith JP, et al. Cohort profile: the China health and retirement longitudinal study (CHARLS). Int J Epidemiol. 2014;43:61–8.
National Meteorological Information Centre (2015) CHINA METEOROLOGICAL DATA SERVICE CENTRE. National Meteorological information Centre. https://data.cma.cn/
Watson NF, Badr MS, Belenky G, et al. Recommended amount of sleep for a healthy adult: a joint consensus statement of the American academy of sleep medicine and sleep research society. Sleep. 2015;38:843–4.
Li H, Li C, Wang A, et al. Associations between social and intellectual activities with cognitive trajectories in Chinese middle-aged and older adults: a nationally representative cohort study. Alzheimers Res Ther. 2020;12:115.
Cheng HG, Chen S, McBride O, et al. Prospective relationship of depressive symptoms, drinking, and tobacco smoking among middle-aged and elderly community-dwelling adults: results from the China health and retirement longitudinal study (CHARLS). J Affect Disord. 2016;195:136–43.
Li LW, Liu J, Zhang Z, et al. Late-life depression in rural China: do village infrastructure and availability of community resources matter? Int J Geriatr Psychiatry. 2015;30:729–36.
Cheng ST, Chan AC. The center for epidemiologic studies depression scale in older Chinese: thresholds for long and short forms. Int J Geriatr Psychiatry. 2005;20:465–70.
**ong Z, Ling CX, Gu B. Kernel error path algorithm. IEEE Trans Neural Netw Learn Syst. 2022. https://doi.org/10.1109/TNNLS.2022.3153953.
Wood SN. Generalized additive models: an introduction with R. Biometrics. 2007;63(4):1298–9.
Clarke A, Ladha C, Wright A, et al. Losartan may attenuate altitude-related sleep disturbance. BMJ Mil Health. 2021;167:424–8.
Heinzer R, Saugy JJ, Rupp T, et al. Comparison of sleep disorders between real and simulated 3450-m altitude. Sleep. 2016;39:1517–23.
Roy K, Chauhan G, Kumari P, et al. Phosphorylated delta sleep inducing peptide restores spatial memory and p-CREB expression by improving sleep architecture at high altitude. Life Sci. 2018;209:282–90.
Ainslie PN, Lucas SJ, Burgess KR. Breathing and sleep at high altitude. Respir Physiol Neurobiol. 2013;188:233–56.
Smith CA, Forster HV, Blain GM, et al. An interdependent model of central/peripheral chemoreception: evidence and implications for ventilatory control. Respir Physiol Neurobiol. 2010;173:288–97.
Bloch KE, Buenzli JC, Latshang TD, et al. Sleep at high altitude: guesses and facts. J Appl Physiol. 1985;2015(119):1466–80.
Tellez HF, Morrison SA, Neyt X, et al. Exercise during short-term and long-term continuous exposure to hypoxia exacerbates sleep-related periodic breathing. Sleep. 2016;39:773–83.
Gott J, Rak M, Bovy L, et al. Sleep fragmentation and lucid dreaming. Conscious Cogn. 2020;84:102988.
Levenson JC, Thoma BC, Hamilton JL, et al. Sleep among gender minority adolescents. Sleep. 2021. https://doi.org/10.1093/sleep/zsaa185.
Anderson PJ, Wood Wentz CM, Bailey KR, et al. Objective versus self-reported sleep quality at high altitude. High Alt Med Biol. 2017;24:144–8.
Acknowledgements
We gratefully acknowledge all research assistants for their contribution to this study.
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This work was supported by the [Sichuan Applied Psychology Research Center] under Grant [number CSXL-22229].
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JHL and SW contributed equally and were responsible for data extraction, data analyses, and the manuscript writing. CWZ and ZZQ were involved in conducting data analyses and manuscript revision. WXM, YQL and XHD contributed to the data interpretation. ZZQ and CWZ contributed equally.
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The studies involving human participants were reviewed and approved by CHARLS was ethically approved by the Ethics Review Board of the Peking University (approval number: IRB00001052-11015), and each respondent signed an informed consent form.
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Jiang, H., Su, W., Wu, X. et al. Increased altitudes change sleep status among Chinese population. Sleep Biol. Rhythms (2024). https://doi.org/10.1007/s41105-024-00527-y
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DOI: https://doi.org/10.1007/s41105-024-00527-y