The roles of serum vitamin D and tobacco smoke exposure in insomnia: a cross-sectional study of adults in the United States.
Tianci Gao,
Mengxing Hou,
Qianfei Wang,
Dong Liu,
Fenqiao Chen
et al.
Other
Frontiers in nutrition
2023
3 citas
PubMed
DOI
CC-BY
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Study Design
- Tipo de estudio
- Cross-sectional
- Intervención
- The roles of serum vitamin D and tobacco smoke exposure in insomnia: a cross-sectional study of adults in the United States. None
- Comparador
- Placebo
- Dirección del efecto
- Mixed
- Riesgo de sesgo
- Moderate
Abstract
AIM: Tobacco smoke exposure and vitamin D (VD) status were both associated with insomnia. However, the combined effect of smoking and VD on insomnia has not been discussed. This study aimed to explore the role of VD in the association between tobacco smoke exposure and insomnia. METHODS: Data on adults were extracted from the National Health and Nutrition Examination Surveys (NHANES) database in 2005-2008 for this cross-sectional study. Weighted univariate and multivariate logistic regression analyses were used to explore the associations between serum cotinine, serum VD, and insomnia. A surface diagram was drawn to reflect the effect of VD on the association between serum cotinine and insomnia. In addition, the potential regulating effect of VD in subgroups of smoking status was also performed. The evaluation index was odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: Among the eligible participants, 1,766 had insomnia. After adjusting for covariates, we found that elevated serum cotinine levels were associated with higher odds of insomnia [OR = 1.55, 95% CI: (1.22, 1.97)]. However, the relationship between serum VD level and insomnia was not significant (P = 0.553). Higher serum cotinine levels were also associated with higher odds of insomnia [OR = 1.52, 95% CI: (1.17, 1.98)] when serum VD level was <75 nmol/L; however, this relationship became non-significant when serum VD concentration was elevated (P = 0.088). Additionally, the potential regulating effect of VD was also found in adults who were not smoking. CONCLUSION: VD may play a potential regulative role in the association between tobacco smoke exposure and insomnia. Further studies are needed to clarify the causal relationships between VD, tobacco smoke exposure, and insomnia.
Full Text
Figures
Figure 1
Prevalence of insomnia stratified by serum vitamin D status and tobacco smoke exposure categories in a cross-sectional analysis of US adults.
chart
Figure 2
Interaction analysis showing the combined effect of vitamin D deficiency and smoking on insomnia risk, suggesting a synergistic association between the two exposures.
chartTables
Table 1
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| Age, years, mean ± SE | 45.04 (0.45) | 44.61 (0.45) | 46.08 (0.61) | 1.01 (1.00–1.01) | 0.005 |
| Male | 3,278 (50.80) | 2,479 (53.81) | 799 (43.37) | Ref | |
| Female | 3,034 (49.20) | 2,067 (46.19) | 967 (56.63) | 1.52 (1.35–1.72) | < 0.001 |
| Mexican American | 1,234 (8.42) | 966 (9.58) | 268 (5.56) | Ref | |
| Other hispanic | 454 (4.10) | 323 (4.05) | 131 (4.22) | 1.80 (1.33–2.43) | < 0.001 |
| Non-hispanic white | 3,033 (71.65) | 2,072 (69.70) | 961 (76.46) | 1.89 (1.57–2.28) | < 0.001 |
| Non-hispanic black | 1,363 (10.90) | 1,015 (11.32) | 348 (9.84) | 1.50 (1.22–1.84) | < 0.001 |
| Other races | 228 (4.93) | 170 (5.35) | 58 (3.92) | 1.27 (0.88–1.82) | 0.210 |
| Less than 9th grade | 728 (5.64) | 518 (5.72) | 210 (5.46) | Ref | |
| 9–11th grade | 1,043 (12.26) | 730 (11.72) | 313 (13.60) | 1.22 (0.87–1.71) | 0.268 |
| High school grad/GED or equivalent | 1,515 (24.40) | 1,049 (23.11) | 466 (27.59) | 1.25 (0.93–1.69) | 0.154 |
| Some college or AA degree | 1,745 (30.85) | 1,271 (30.97) | 474 (30.55) | 1.03 (0.76–1.41) | 0.835 |
| College graduate or above | 1,281 (26.85) | 978 (28.48) | 303 (22.80) | 0.84 (0.61–1.16) | 0.292 |
| ≤ 1 | 1,159 (11.85) | 768 (10.84) | 391 (14.35) | Ref | |
| >1 | 5,153 (88.15) | 3,778 (89.16) | 1,375 (85.65) | 0.73 (0.60–0.87) | 0.002 |
| Working at a job or business | 3,958 (71.26) | 2,990 (74.23) | 968 (63.90) | Ref | |
| Not working at a job or business | 2,354 (28.74) | 1,556 (25.77) | 798 (36.10) | 1.63 (1.41–1.88) | < 0.001 |
| A regular daytime schedule | 2,958 (53.77) | 2,253 (56.60) | 705 (46.78) | Ref | |
| A regular evening/night shift | 357 (5.86) | 257 (5.70) | 100 (6.23) | 1.32 (1.05–1.67) | 0.026 |
| A rotating shift | 297 (4.96) | 221 (5.17) | 76 (4.45) | 1.04 (0.72–1.51) | 0.835 |
| Another schedule | 345 (6.65) | 258 (6.73) | 87 (6.44) | 1.16 (0.84–1.60) | 0.386 |
| Unknown | 2,355 (28.76) | 1,557 (25.80) | 798 (36.10) | 1.69 (1.46–1.96) | < 0.001 |
| ≤ 25 | 1,827 (31.69) | 1,339 (32.25) | 488 (30.30) | Ref | |
| >25 | 4,485 (68.31) | 3,207 (67.75) | 1,278 (69.70) | 1.10 (0.98–1.23) | 0.125 |
| ≤ 450 | 899 (15.34) | 669 (15.93) | 230 (13.89) | Ref | |
| >450 | 3,425 (58.19) | 2,476 (58.20) | 949 (58.18) | 1.15 (0.94–1.40) | 0.191 |
| Unknown | 1,988 (26.47) | 1,401 (25.87) | 587 (27.93) | 1.24 (0.99–1.54) | 0.066 |
| No | 1,829 (24.28) | 1,336 (24.55) | 493 (23.63) | Ref | |
| Yes | 4,483 (75.72) | 3,210 (75.45) | 1,273 (76.37) | 1.05 (0.93–1.19) | 0.450 |
| No | 4,877 (76.28) | 3,612 (78.30) | 1,265 (71.29) | Ref | |
| Yes | 1,435 (23.72) | 934 (21.70) | 501 (28.71) | 1.45 (1.24–1.71) | < 0.001 |
| No | 2,949 (51.08) | 2,228 (53.36) | 721 (45.43) | Ref | |
| Yes | 3,363 (48.92) | 2,318 (46.64) | 1,045 (54.57) | 1.37 (1.14–1.66) | 0.002 |
| No | 4,877 (76.28) | 3,612 (78.30) | 1,265 (71.29) | Ref | |
| Yes | 1,435 (23.72) | 934 (21.70) | 501 (28.71) | 1.25 (1.07–1.45) | 0.008 |
| No | 1,660 (27.48) | 1,236 (28.91) | 424 (23.95) | Ref | |
| Yes | 4,652 (72.52) | 3,310 (71.09) | 1,342 (76.05) | 1.29 (1.10–1.51) | 0.004 |
| No | 5,504 (86.50) | 4,120 (89.59) | 1,384 (78.87) | Ref | |
| Yes | 808 (13.50) | 426 (10.41) | 382 (21.13) | 2.31 (1.93–2.76) | < 0.001 |
| No | 3,117 (49.21) | 2,319 (50.42) | 798 (46.20) | Ref | |
| Yes | 3,195 (50.79) | 2,227 (49.58) | 968 (53.80) | 1.18 (1.06–1.33) | 0.007 |
| CRP, mg/dL, Mean ± SE | 0.40 (0.01) | 0.37 (0.01) | 0.46 (0.03) | 1.14 (1.06–1.22) | 0.002 |
| Total energy intake, Kcal, mean ± SE | 2,251.75 (21.49) | 2,273.64 (19.37) | 2,197.62 (41.65) | 1.00 (1.00–1.00) | 0.069 |
| Caffeine intake, mg, mean ± SE | 197.25 (6.75) | 193.67 (6.77) | 206.10 (10.79) | 1.00 (1.00–1.00) | 0.211 |
| HEI−2015, mean ± SE | 49.52 (0.38) | 49.72 (0.40) | 49.02 (0.53) | 1.00 (0.99–1.00) | 0.159 |
| November 1 to April 30 | 2,879 (39.48) | 2,138 (40.62) | 741 (36.68) | Ref | |
| May 1 to October 31 | 3,433 (60.52) | 2,408 (59.38) | 1,025 (63.32) | 1.18 (1.02–1.36) | 0.031 |
| Morning | 3,051 (48.52) | 2,201 (48.64) | 850 (48.22) | Ref | |
| Afternoon | 2,297 (34.01) | 1,633 (33.26) | 664 (35.85) | 1.09 (0.96–1.23) | 0.205 |
| Evening | 964 (17.47) | 712 (18.10) | 252 (15.93) | 0.89 (0.71–1.11) | 0.302 |
| < 0.05 | 2,754 (43.39) | 2,068 (45.03) | 686 (39.32) | Ref | |
| 0.05–2.99 | 1,743 (27.03) | 1,288 (27.81) | 455 (25.08) | 1.03 (0.85–1.25) | 0.745 |
| ≥3.00 | 1,815 (29.58) | 1,190 (27.16) | 625 (35.60) | 1.50 (1.24–1.81) | < 0.001 |
| < 75 | 5,079 (73.81) | 3,671 (73.99) | 1,408 (73.37) | Ref | |
| ≥75 | 1,233 (26.19) | 875 (26.01) | 358 (26.63) | 1.03 (0.90–1.19) | 0.657 |
Table 2
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|---|---|---|---|---|---|
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| Cotinine, ng/mL | < 0.05 | Ref | Ref | ||
| 0.05–2.99 | 1.03 (0.85–1.25) | 0.745 | 1.06 (0.87–1.29) | 0.599 | |
| ≥3.00 | 1.50 (1.24–1.81) | < 0.001 | 1.55 (1.22–1.97) | 0.006 | |
| VD, nmol/L | < 75 | Ref | Ref | ||
| ≥75 | 1.03 (0.90–1.19) | 0.657 | 0.95 (0.80–1.12) | 0.553 | |
Table 3
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|---|---|---|---|---|---|
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| < 75 | < 0.05 | Ref | |||
| 0.05–2.99 | 1.01 (0.83–1.23) | 0.942 | 1.03 (0.83–1.27) | 0.821 | |
| ≥3.00 | 1.55 (1.22–1.98) | 0.001 | 1.52 (1.17–1.98) | 0.011 | |
| ≥75 | < 0.05 | Ref | |||
| 0.05–2.99 | 1.13 (0.72–1.75) | 0.604 | 1.15 (0.74–1.80) | 0.545 | |
| ≥3.00 | 1.38 (1.00–1.91) | 0.063 | 1.75 (1.00–3.07) | 0.088 | |
Table 4
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|---|---|---|---|---|---|
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| < 75 | < 0.05 | Ref | Ref | ||
| 0.05–2.99 | 1.06 (0.86–1.31) | 0.588 | 0.36 (0.08–1.69) | 0.221 | |
| ≥3.00 | 1.62 (1.23–2.12) | 0.005 | 0.77 (0.20–2.94) | 0.715 | |
| ≥75 | < 0.05 | Ref | |||
| 0.05–2.99 | 1.16 (0.74–1.82) | 0.528 | |||
| ≥3.00 | 1.53 (0.86–2.70) | 0.180 | |||
References
- Insomnia Lancet., 2022
- Insomnia J Am Med Assoc., 2013
- Brain mechanisms of insomnia: new perspectives on causes and consequences Physiol Rev., 2021
- Physical and social environment relationship with sleep health and disorders Chest., 2020
- Tobacco and nicotine use Nat Rev Dis Primers., 2022
- Nicotine inhibits the VTA-to-amygdala dopamine pathway to promote anxiety Neuron., 2021
- The association between exposure to second-hand smoke and sleep disturbances: a systematic review and meta-analysis Sleep Health., 2020
- How smoking affects sleep: a polysomnographical analysis Sleep Med., 2012
- Vitamin D and brain health: an observational and mendelian randomization study Am J Clin Nutr., 2022
- Vitamin D and the central nervous system: causative and preventative mechanisms in brain disorders Nutrients., 2022
- Sleep neurobiology from a clinical perspective Sleep., 2011
- Distribution of the vitamin D receptor and 1 alpha-hydroxylase in human brain J Chem Neuroanat., 2005
- Low serum 25-hydroxyvitamin D concentrations in chronic insomnia patients and the association with poor treatment outcome at 2 months Clin Chim Acta., 2017
- Vitamin D and sleep regulation: is there a role for vitamin D? Curr Pharm Des., 2020
- The role of vitamin D in sleep disorders of children and adolescents: a systematic review Int J Mol Sci., 2022
- The association between vitamin D deficiency and sleep disorders: a systematic review and meta-analysis Nutrients., 2018
- Maternal vitamin D status modifies the effects of early life tobacco exposure on child lung function J Allergy Clin Immunol., 2023
- Maternal passive smoking, vitamin D deficiency and risk of spontaneous abortion Nutrients., 2022
- Joint effect of 25-hydroxyvitamin D and secondhand smoke exposure on hypertension in non-smoking women of childbearing age: Nhanes 2007–2014 Environ Health., 2021
- Depression and lifestyle: focusing on nutrition, exercise, and their possible relevance to molecular mechanisms Psychiatry Clin Neurosci., 2023
- Prevalence, trend, and predictor analyses of vitamin D deficiency in the US population, 2001–2018 Front Nutr., 2022
- Tobacco smoke exposure, respiratory health, and health-care utilization among US adolescents Chest., 2020
- Biochemical verification of tobacco use and abstinence: 2019 update Nicotine Tob Res., 2020
- Associations among vitamin D, tobacco smoke, and hypertension: a cross-sectional study of the Nhanes 2001–2016 Hypertens Res., 2022
- Insomnia symptoms are not associated with dyslipidemia: a population-based study Sleep., 2016
- Smoking and incidence of insomnia: a systematic review and meta-analysis of cohort studies Public Health., 2021
- Smoke at night and sleep worse? The associations between cigarette smoking with insomnia severity and sleep duration Sleep Health., 2021
- Electronic cigarette use and sleep health in young adults J Sleep Res., 2020
- Physical activity, smoking, and the incidence of clinically diagnosed insomnia Sleep Med., 2017
- Insomnia among town residents in Ethiopia: a community-based cross-sectional survey Sleep Disord., 2019
- What keeps us awake: the neuropharmacology of stimulants and wakefulness-promoting medications Sleep., 2004
- Power spectral analysis of EEG activity during sleep in cigarette smokers Chest., 2008
- Smoking as a risk factor for sleep-disordered breathing Arch Intern Med., 1994
- Clinical guideline for the evaluation and management of chronic insomnia in adults J Clin Sleep Med., 2008
- Anxiety sensitivity and daily cigarette smoking in relation to sleep disturbances in treatment-seeking smokers Cogn Behav Ther., 2020
- Caffeine intake among undergraduate students: sex differences, sources, motivations, and associations with smoking status and self-reported sleep quality Nutrients., 2022
- Use of machine learning to identify risk factors for insomnia PLoS ONE., 2023
- Association between triglyceride glucose index and sleep disorders: results from the NHANES 2005-2008 BMC Psychiatry., 2023
- Relationship between nutritional status and insomnia severity in older adults J Am Med Dir Assoc., 2019
- Vitamin D and actigraphic sleep outcomes in older community-dwelling men: the MROS sleep study Sleep., 2015
- Insomnia in the elderly: a review J Clin Sleep Med., 2018
- Shift work and depressive symptoms: the mediating effect of vitamin D and sleep quality Chronobiol Int., 2019
- Vitamin D nuclear binding to neurons of the septal, substriatal and amygdaloid area in the siberian hamster (Phodopus sungorus) brain Neuroscience., 1992
- Brain target sites for 1,25-dihydroxyvitamin D3 Science., 1982
- Immunologic effects of vitamin D on human health and disease Nutrients., 2020
- Shift work and serum vitamin D levels: a systematic review and meta-analysis Int J Environ Res Public Health., 2022
- Vitamin D, smoking, EBV, and long-term cognitive performance in MS: 11-year follow-up of benefit Neurology., 2020
- Smoking behavior and circulating vitamin D levels in adults: a meta-analysis Food Sci Nutr., 2021
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