UvA-DARE (Digital Academic Repository) The role of sleep in ethnic inequalities in health: Cardiovascular disease and risk factors Anujuo, K.O. Publication date 2018 Document Version Final published version License Other Link to publication Citation for published version (APA): Anujuo, K. O. (2018). The role of sleep in ethnic inequalities in health: Cardiovascular disease and risk factors. General rights It is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulations If you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. 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UvA-DARE is a service provided by the library of the University of Amsterdam (https://dare.uva.nl) Download date:07 Oct 2021 THETHE ROLEROLE OFOF SLEEPSLEEP ININ ETHNICETHNIC INVITATIONINVITATION The role of sleep in ethnic inequalities health The role of sleep in ethnic inequalities health INEQUALITIESINEQUALITIES ININ HEALTH:HEALTH: YouYou are are cordially cordially invited invited to to cardiovascularcardiovascular diseasedisease andand riskrisk factorsfactors attendattend the the public public defense defense ofof the the doctoral doctoral thesis thesis of of KENNETHKENNETH OKWUDILI OKWUDILI ANUJUO ANUJUO titledtitled THETHE ROLE ROLE OF OF SLEEP SLEEP IN IN ETHNIC ETHNIC INEQULITIESINEQULITIES IN IN HEALTH: HEALTH: CARDIOVASCULARCARDIOVASCULAR DISEASE DISEASE ANDAND RISK RISK FACTORS FACTORS OnOn Friday, Friday, September September 21, 21, 2018 2018 AtAt 12:00 12:00 InIn the the Agnietenkapel Agnietenkapel OudezijdsOudezijds Voorburgwal Voorburgwal 229-231 229-231 AmsterdamAmsterdam ReceptionReception follows follows immediately immediately afterafter the the defense defense in in the the reception reception areaarea of of the the Agnietenkapel Agnietenkapel PARANYMPHS:PARANYMPHS: K K IkennaIkenna Ebuenyi Ebuenyi ENNETH ENNETH [email protected]@vu.nl BenBen Nieuwenhuizen Nieuwenhuizen O O b.p.vannieuwenhuizenb.p.vannieuwenhuizen@@amc.uva.nlamc.uva.nl KWUDILI KWUDILI A A NUJUO NUJUO KennethKenneth OkwudiliOkwudili AnujuoAnujuo Anujuo_omslag_FINAL.inddAnujuo_omslag_FINAL.indd All All Pages Pages 30/07/201830/07/2018 21:13 21:13 THE ROLE OF SLEEP IN ETHNIC INEQUALITIES IN HEALTH: CARDIOVASCULAR DISEASE AND RISK FACTORS Kenneth Okwudili Anujuo Anujuo_binnenwerk_FINAL.indd 1 30/07/2018 21:19 COLOFON The role of sleep in ethnic inequalities in health: Cardiovascular disease and risk factors. PhD thesis Academic Medical Center – University of Amsterdam. ISBN: 978-94-6375-046-2 © Kenneth O Anujuo All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the author or the copyright-owning journalists for published chapters. Layout by Lize Jansen Printing: Ridderprint BV, www.ridderprint.nl The studies presented in this thesis were conducted at the Department of Public Health, Academic Medical Center, University of Amsterdam, the Netherlands. The research was mainly from the HELIUS study and partly from the ABCD study. The HELIUS study was funded by Academic Medical Center, Amsterdam, the Public Health Service of Amsterdam, the Dutch Heart Foundation (grant number: 2010T084), the Netherlands Organization for Health Research and Development (ZonMw) (grant number: 200500003), and the European Fund for the Integration of non- EU immigrants (EIF) (grant number: 2013EIF013). The ABCD study was funded by the Netherlands Organization for Health Research and Development (ZonMw) (TOP grant: 40-00812-98-11010). Anujuo_binnenwerk_FINAL.indd 2 30/07/2018 21:19 THE ROLE OF SLEEP IN ETHNIC INEQUALITIES IN HEALTH: CARDIOVASCULAR DISEASE AND RISK FACTORS ACADEMISCH PROEFSCHRIFT ter verkrijging van de graad van doctor aan de Universiteit van Amsterdam op gezag van de Rector Magnificus prof. dr. ir. K.I.J. Maex ten overstaan van een door het College voor Promoties ingestelde commissie, in het openbaar te verdedigen in de Agnietenkapel op vrijdag 21 september 2018, te 12:00 uur door Kenneth Okwudili Anujuo geboren te Okohia, Nigeria Anujuo_binnenwerk_FINAL.indd 3 30/07/2018 21:19 PROMOTIECOMMISSIE: Promotor(es): Prof.dr. K. Stronks AMC – UvA Copromotor(es): Dr. C.O. Agyemang AMC – UvA Overige leden: Prof.dr. A.K. Groen AMC – UvA Prof.dr. B.J.C. Middelkoop Universiteit Leiden Prof.dr. S.A. Reijneveld Rijksuniversiteit Groningen Dr. E.J. de Bruin Universiteit van Amsterdam Dr. I.G.M. van Valkengoed AMC – UvA Faculteit der Geneeskunde Anujuo_binnenwerk_FINAL.indd 4 30/07/2018 21:19 In loving memory of my late parents: Simeon and Louisa Anujuo Anujuo_binnenwerk_FINAL.indd 5 30/07/2018 21:19 Anujuo_binnenwerk_FINAL.indd 6 30/07/2018 21:19 CONTENTS Chapter 1 General introduction 9 Chapter 2 Ethnic differences in self-reported sleep duration 27 in the Netherlands – the HELIUS study Chapter 3 Ethnic differences in sleep duration at 5 years, 53 and its Relationship with overweight and blood pressure Chapter 4 Relationship between short sleep duration and 73 Cardiovascular risk factors in a multi-ethnic cohort – the HELIUS study Chapter 5 Relationship between sleep duration and arterial 99 stiffness in a multi-ethnic population: the HELIUS study Chapter 6 Contribution of short sleep duration to ethnic 123 Differences in cardiovascular disease: results from a Cohort study in the Netherlands Chapter 7 Association between depressed mood and sleep 147 duration Among various ethnic groups – the HELIUS study Chapter 8 General discussion 165 Summary 185 Samenvatting 191 Acknowledgements 197 About the author 201 Lists of publications 205 Portfolio 209 Anujuo_binnenwerk_FINAL.indd 7 30/07/2018 21:19 Anujuo_binnenwerk_FINAL.indd 8 30/07/2018 21:19 CHAPTER 1 GENERAL INTRODUCTION Anujuo_binnenwerk_FINAL.indd 9 30/07/2018 21:19 Chapter 1 Ethnic inequalities in health has been widely acknowledged across the globe. Different studies both in Europe and the United States of America (USA) indicate variations in inequalities in health between ethnic minority groups and the European populations [1]. In the Netherlands, various studies have been conducted and reasonable extensive information on inequalities in health status among ethnic minorities both at regional and national level have been well investigated [2,3,4]. A lot of studies show remarkable variations in health outcomes such as CVD and risk factors (e.g. diabetes, hypertension) and mental health among ethnic minority groups and host European populations [5,6,7,8]. Explanations for the ethnic inequalities in health are unclear and with the increasing minority populations, it is relevant to understand the underlying factors to help guide prevention and treatment initiatives. This thesis focuses on the role of sleep in ethnic inequalities in CVD and risk factors. Sleep and its impact on health is increasingly becoming important but very little is known about its influence on ethnic inequalities in health. THE ROLE OF SLEEP IN HEALTH By definition, sleep is “a natural periodic state of the body and mind characterized by closing of the eyes, partial or total loss of consciousness and reduced response to external stimuli” [9]. Sleep has a restorative function for the body and mind, and thus helps to maintain health. Poor sleep quality may result in deleterious health outcomes. The National Sleep Foundation (NSF), American Academy of Sleep Medicine (AASM), and Sleep Research Society, in a joint consensus, recommend 7-9 hours and 10-11 hours of sleep at night as healthy for adults and preschool children, respectively [10]. Inadequate sleep has become a common problem in our modern society. On average, many people fall short of reaching the recommended hours of sleep per night. This can be attributed to the busy schedules that is inherent in our modern society, resulting from long working hours, doing multiple jobs, shift-work, late night use of technology at bed time such as, mobile phones, television, computers and computer games, sedentary lifestyle, lack of physical activity, sleeping with pets; stress, and adoption of some cultural practices which tend to negatively influence sleep duration such as co-sleeping, disregard for napping, and believe that hardworking and successful people require short sleep duration [2,11,12,13,14]. 10 Anujuo_binnenwerk_FINAL.indd 10 30/07/2018 21:19 General introduction Sleep disruption has been linked to several adverse health outcomes due to its effect on the body`s homoeostasis which regulate human cellular, tissue, organ and system activities. Although sleep disruption affects other vital organs of the body such as the brain [15], sleep affects metabolic and 1 cardiovascular health, as have been reflected in previous studies [16]. The studies have shown that sleep deprivation has serious or major metabolic and cardiovascular consequences, and therefore a risk factor for poor health in the future [16]. Studies