Association of Accelerometer-Derived Rest-Activity Rhythms and Sleep Health With Overactive Bladder: Depression as a Potential Explanatory Factor in a Nationally Representative Study.
Jul 2026· Neurourology and Urodynamics· 0 citations· 27 references
Medicine
TL;DR
Weaker rest-activity rhythms and poorer sleep health are cross-sectionally associated with higher OAB prevalence, and depression may partially explain this relationship.
Abstract
Purpose
We examined whether accelerometer-derived rest-activity rhythms (RAR) and multidimensional sleep metrics are associated with overactive bladder (OAB) and whether depression may partially account for this relationship.
Materials And Methods
This cross-sectional study included 6,603 adults from the National Health and Nutrition Examination Survey (2011-2014). OAB was defined by an Overactive Bladder Symptom Score ≥ 3. Nonparametric RAR metrics-interdaily stability (IS), intradaily variability (IV), and relative amplitude (RA)-and sleep parameters were extracted from 7-day wrist-worn accelerometry. Depression was evaluated with the Patient Health Questionnaire-9. Survey-weighted logistic regression examined associations between RAR and sleep exposures and OAB. Mediation analysis quantified the potential indirect pathway through depression severity.
Results
Weighted OAB prevalence was 21.4%. After full adjustment, each 0.1-unit increase in RA was associated with 17% lower odds of OAB (OR 0.83, 95% CI 0.79-0.88), while each 0.1-unit increase in IV was associated with 5% higher odds (OR 1.05, 95% CI 1.02-1.08). Higher sleep efficiency (OR 0.81 per 10% increase, 95% CI 0.73-0.90) and longer sleep duration (OR 0.95 per hour, 95% CI 0.91-0.99) were also inversely associated with OAB. IS, social jetlag and catch-up sleep showed no independent associations. Depression partially accounted for the RA-OAB relationship.
Conclusions
Weaker rest-activity rhythms and poorer sleep health are cross-sectionally associated with higher OAB prevalence, and depression may partially explain this relationship. These observational findings require prospective validation.
Background Osteoporosis (OP) is a common metabolic bone disease whose onset and progression are influenced by sleep patterns. However, previous related studies have mostly relied on self-reported sleep data and have often been confined to a single dimension such as sleep duration. Therefore, this study aimed to evaluate the associations between multidimensional, objective sleep characteristics and OP. Methods This study was based on the UK Biobank and included 72,211 participants. Five objective sleep metrics were derived from 7 consecutive days of wrist accelerometer data: sleep duration, sleep efficiency, sleep regularity index, sleep midpoint, and relative amplitude. Incident OP events were identified through linkage with electronic medical records. Multivariable Cox proportional hazards models were used to examine the associations between objective sleep metrics and OP. Restricted cubic splines (RCS) were applied to test potential nonlinear relationships. Interaction analyses and sex-stratified subgroup analyses were also conducted based on the above results. Results Average sleep duration (HR = 0.91, 95% CI: 0.87–0.95; P < 0.001), sleep efficiency (HR = 0.92, 95% CI: 0.88–0.97; P = 0.001), and relative amplitude (HR = 0.80, 95% CI: 0.76–0.85; P < 0.001) were all associated with a reduced risk of OP. RCS analyses showed no significant nonlinear effects (all Pnonlinear > 0.05). Interaction analysis suggested a significant negative interaction between relative amplitude and sleep duration (HR 0.96, 95% CI 0.93–0.99; P = 0.012). In sex-stratified subgroup analyses, the pattern of associations in women was consistent with the main analysis, whereas in men only sleep duration and relative amplitude were significantly associated with lower OP risk (all P < 0.05). Conclusions Longer objective sleep duration, higher sleep efficiency, and stronger relative amplitude were independently associated with a lower risk of OP. The association between sleep duration and OP also varied by relative amplitude. These findings suggest that objective sleep characteristics and behavioral rest-activity rhythmicity may be relevant to OP risk, although further mechanistic and interventional studies are needed to clarify causality.
Zhenyu Hu, Guosheng Wang, Xiaoyi Kong et al.· Frontiers in Endocrinology· 0 citations
Introduction Physical activity, strength training, and sleep are important determinants of mental health. The authors of this study examined the associations of these lifestyle behaviors with emotional health outcomes among U.S. adults. Methods Authors conducted a cross-sectional analysis of data from the 2024 Health Information National Trends Survey® 7, a nationally representative survey of U.S. adults aged ≥18 years (N = 7278). Outcomes included depression (PHQ-2), anxiety (GAD-2), overall loneliness (PROMIS Social Isolation Short Form), social loneliness, and emotional loneliness. Predictors included moderate-intensity physical activity (≥150 min/week), strength training (≥2 days/week), and weekday and weekend sleep duration. Survey-weighted logistic and multinomial logistic regression analyses were performed, adjusting for sociodemographic and health-related covariates. Results Most respondents screened negative for depression (79.4%) and anxiety (78.4%), and 61.6% reported low loneliness. Most respondents did not meet the recommended levels of moderate-intensity physical activity (56.6%) or strength training (55.4%). In adjusted analyses, meeting strength-training guidelines was associated with lower odds of depression (adjusted odds ratio [aOR], 0.71; 95% confidence interval [CI], 0.53–0.95) and loneliness (aOR, 0.65; 95% CI, 0.43–0.98). Moderate-intensity physical activity was not independently associated with emotional health outcomes. Obtaining the recommended 7–9 hours of weekend sleep was associated with lower odds of depression, anxiety, and loneliness, whereas obtaining the recommended weekday sleep duration was associated with lower social and emotional loneliness. Conclusions Strength training and adequate sleep were independently associated with better emotional health among U.S. adults. These findings support muscle-strengthening activities and healthy sleep habits as potential targets for mental health promotion.
Samuel Ofei-Dodoo, Y. Khan, Ibrahim Touffaha et al.· Kansas journal of medicine· 0 citations
OBJECTIVES
We examined the association between sleep duration and quality with cardiometabolic risk factors, assessed whether these associations varied by socioeconomic status, and identified prevalent risk factor combinations in those with poor sleep health.
METHODS
We conducted a cross-sectional analysis of 25,433 adults using the 2022 National Health Interview Survey data. Sleep health exposures included self-reported sleep duration (<7, 7-9, >9 h), sleep quality measures (frequency of feeling well rested, difficulty falling asleep, difficulty staying asleep), and a composite sleep health indicator. Cardiometabolic risk factors included overweight/obesity, diabetes, hypertension, and hyperlipidemia. We examined the mean count of cardiometabolic risk factors (individual range: 0-4) and patterns of cardiometabolic risk factor combinations across sleep measures using Poisson regression with marginal standardization for covariates, accounting for the complex survey design.
RESULTS
Population-average cardiometabolic risk factor count was 9% higher among short sleepers, 15% to 20% higher across poor sleep quality measures, and 18% higher among those without healthy composite sleep compared with healthy reference groups. Associations between difficulty staying asleep and mean cardiometabolic risk factor count were stronger among those with lower SES (p-interaction ≤0.001) on the ratio scale. Poor sleep quality was associated with more severe CMRF combinations and patterns, while sleep duration showed heterogeneous associations across cardiometabolic outcomes.
CONCLUSION
Poor sleep quality and short sleep duration were associated with higher population-level cardiometabolic risk factor burden. Associations for difficulty staying asleep were stronger among individuals with lower socioeconomic status. Poor sleep quality was also associated with more severe cardiometabolic risk factor combinations, suggesting sleep quality may be a potential target for multimorbidity prevention.
K. Vashist, Laura Ward, Amit J. Shah et al.· Sleep Health· 0 citations
Higher SIRI levels were associated with increased odds of depressive symptoms among emerging adults, and sleep duration played a modest suppressor role in this relationship, suggesting complex interactions between inflammation, sleep, and mental health warranting further investigation through prospective studies.
Yingying Zhang, Yunyun Zheng, Yuting Zhang et al.· International Journal of Psy...· 0 citations
Background/Objectives: To examine the association between caffeine intake and mental health- and sleep-related outcomes, including anxiety, sleep duration, and perceived stress, in a nationally representative sample of Korean adults. Methods: We analyzed 20,504 participants from the Korea National Health and Nutrition Examination Survey (KNHANES) 2021–2024. Caffeine intake was categorized into six groups, and mental health- and sleep-related outcomes included clinically significant anxiety symptoms (GAD-7 ≥ 10), sleep duration, and perceived stress. Survey-weighted multivariable logistic regression models and restricted cubic spline analyses were used to evaluate associations between caffeine intake and mental health- and sleep-related outcomes, adjusting for demographic, socioeconomic, behavioral, dietary, and clinical factors. Results: The prevalence of clinically significant anxiety symptoms was 4.7%. Restricted cubic spline analyses demonstrated a non-linear association between caffeine intake and anxiety (p-overall = 0.010; p-nonlinear = 0.016). Higher caffeine intake was associated with progressively increasing odds of short sleep duration (<6 h/day), indicating a clear dose–response relationship (p-overall < 0.001; p-nonlinear < 0.001). Higher caffeine intake was also associated with increased perceived stress (p-overall = 0.025), although evidence for a nonlinear relationship was weaker (p-nonlinear = 0.062). These findings were generally consistent across multivariable-adjusted models. Conclusions: Caffeine intake is differentially associated with mental health- and sleep-related outcomes, with excessive intake related to adverse effects on sleep and stress.
In this online convenience sample of adults aged ≥50 years, sleep quality, anxiety symptoms, and total physical activity showed consistent cross-sectional associations and require confirmation in representative longitudinal studies.
Hammad S. Alhasan, M. Alshehri· Journal of Clinical Medicine· 0 citations