Difficulty in initiating sleep: DIS Difficulty in maintaining. chi-square test DMS

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1 Vol. 30, pp , 2002 MRFS Multiple Risk Factor Syndrome MRFS Multiple Risk Factor Syndrome ± ,509 Difficulty in initiating sleep: DISDifficulty in maintaining sleep: DMSMRFS chi-square test Cochran-Armitage chi-square test DMS DMS 1.26, , DMS DIS MRFS DMS % 14.1% MRFS Multiple Risk Factor Syndrome 10~12 Sleep apnea syndrome: SAS 13~15 SAS MRFS SAS MRFS 17

2 Table 1 Sleep Disorder and MRFS Components 16 MRFS 3 SAS MRFS ± ,509 Difficulty in initiating sleep: DIS Difficulty in maintaining sleep: DMS 3 4 MRFS MRFS body mass index 25 kg/m mg/dl 140 mmhg 90 mmhg 220 mg/dl 150 mg/dl chi-square test Cochran-Armitage SAS system Ver.8.02, SAS Institute Japan 17 5% 14, % DIS % DMS % chi-square test Table 1 p=0.010 DMS p=0.006p=0.004 DIS DIS p=0.044 Table 2 stepwise %CI DMS DIS DIS 18

3 MRFS Table 2 Age Adjusted Odds Ratio of MRFS Components in Sleep Disorder by Stepwise Multivariate Logistic Model Table 3 Trend between Sleep Disorders and Number of MRFS Components Table 3 Cochran- Armitage DMS p<0.001 p=0.015 DIS p=0.133 MRFS DMS DMS DIS 8 β-blocker 18 Peppard % SAS 20 SAS DMS 21 DMS 8 DMS Young 15 SAS healthy worker's effect 23 SAS 19

4 14 24 A1c 8 SAS BMI = 25 kg/m 2 BMI = 29 DIS DMS DIS 28 Kim 3 DMS DIS DIS Cochran-Armitage DMS MRFS DMS MRFS 29~31 DMS 8 DIS DMS 1 Friedman L, Brooks JO 3rd, Bliwise DL, Yesavage JA and Wicks DS. Perceptions of life stress and chronic insomnia in older adults. Psychol Aging 1995; 10: Kim K, Utiyama M, Okawa M, Doi Y, Oida T, Minowa M and Ogiwara R. Lifestyles and sleep disorders among the Japanese adult population. Psychiatry and Clinical Neurosciences 1999; 53: Branscomb BV. The difficult asthmatic. Clin Chest Med 1984; 5: Cohen L. A cotrolled study of trancopal in sleep disturbances due to rheumatic disease. J Int Med Res 1978; 6: Betts TA and Alford C. Beta-blocking drugs and sleep. Drugs 1983; 25 (Suppl 2): O'Connor PJ and Youngstedt SD. Influence of exercise on human sleep. Exert Sport Sci Rev 1995; 23: Gislason T and Almqvist M. Somatic diseases and sleep complaints. An epidemiological study of 3201 Swedish men. Acta Med Scand 1987; 221: ,..,,,,, Annual Review,,, 1994: Kaplan NM. The deadly quartet. Upper-body obesity, glucose intolerance, hypertriglyceridemia, and hypertension. Arch Intern Med 1989; 149: Fujioka S, Matsuzawa Y, Tokunaga K and Tarui S. Contribution of intra-abdominal fat accumulation to the impairment of glucose and lipid metabolism in human obesity. Metabolism 1987; 36: De Fronzo RA and Ferrannini E. Insulin resistance. A multifaceted syndorome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes Care 1991; 14: , ; 85: ,. Multiple Risk Factor Syndrome. 2001; 49:

5 MRFS 15 Young T, Peppard PE and Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 2002; 165: , ; 30: SAS Institute Inc. SAS/STAT User's Guide, Version 6, Fourth Edition Volume 1 2. Cary, NC, USA, Betts TA, et al. Beta-blocking drugs and sleep. Drugs 1983; 25: Peppard PE, Young T, Palta M and Skatrud J. Prospective study of the association between sleepdisordered breathing and hypertension. N Engl J Med 2000; 342: ,, ; 46: MEDICO 1999; 30: : 46; ,, ; 42: ,,,,, ; 37: Mebio 2000; 17: Janson C, Lindberg E, Gislason T, Elmasry A and Boman G. Insomnia in men a 10-year prospective population based study. Sleep 2001; 24: , Ye Tun ; 58: ,,, ; 29: Stamler J, Vaccaro O, Neaton JD and Wentworth D. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care 1993; 16: Trevisan M, Liu J, Bahsas FB and Menotti A. Syndrome X and mortality: a population-based study. Risk Factor and Life Expectancy Research Group. Am J Epidemiol 1998; 148: Yusuf HR, Giles WH, Croft JB, Anda RF and Casper ML. Impact of multiple risk factor profiles on determining cardiovascular disease risk. Prev Med 1998; 27:

6 Abstract Sleep Disorder and MRFS (Multiple Risk Factor Syndrome) in Japanese Male Workers Hirohito Kawaguchi 1, Hiroki Sugimori 2, Machi Suka 2, Ayano Kiyota 1, Toshiaki Suzuki 1, and Toshio Nakamura 1 PURPOSE: We conducted a cross-sectional study to elucidate the relationship between MRFS and sleep disorder. SUBJECT AND METHOD: The present study included Japanese male workers, aged years, who did not have history of cardiovascular disease in the regular health check-ups in We collected information about the sleep disorder (difficulty in initiating sleep: DIS or difficulty in maintaining sleep: DMS) from the questionnaire. We analyzed the relationship between sleep disorder and components of MRFS: obesity (body mass index 25 kg/m 2 ), impaired glucose tolerance (first plasma glucose 110 mg/dl or the initiation of antidiabetic therapy), hypertension (systolic blood pressure 140 mmhg and/or diastolic blood pressure 90 mmhg, or the initiation of antihypertensive therapy), hyperlipemia (total cholesterol 220 mg/dl or triglyceride 150 mg/dl or the initiation of antilipemic therapy). Moreover, we adjusted the age influence using stepwise multivariate logistic model analysis. Trend between sleep disorder and number of MRFS components was evaluated with the Cochran- Armitage test. RESULTS: A significant relationship was recognized with DMS in hypertension (p=0.006) and hyperlipemia (p=0.004). In DMS, hyperlipemia (Odds ratio 1.26: 95%CI ) and hypertension (1.26: ) were significantly incorporated into the multivariate logistic model. The number of workers who had DMS increased with the number of MRFS components (p<0.001). Adjusting age, the number of component did not show any significant relationship with DIS. CONCLUSION: DMS showed close relationships with MRFS. Our results indicate the possibility that a specific higher activity of metabolic status might cause sleep disorders. (St. Marianna Med. J., 30: , 2002) 1 Division of General Internal Medicine, Department of Internal Medicine 2 Department of Preventive Medicine St. Marianna University School of Medicine, Sugao, Miyamae-ku, Kawasaki , Japan 22

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