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• Studies using strict definitions to investigate the association between metabolic phenotypes (MP) and diabetes are scarce. • Participants with obesity/healthy MP were not at increased diabetes risk compared to the ones with normal weight/healthy MP. • Reduced grip strength was associated with a higher risk of diabetes incidence in the long-term. • High grip strength attenuated the risk associated with metabolically unhealthy phenotypes. The association of diabetes risk in the long-term, metabolic phenotypes (MP) and muscle strength is unclear. We aimed to investigate the association between strictly defined MP, grip strength (GS) and diabetes. MP were defined according to BMI and presence of any individual metabolic abnormality for ≥18 years, in participants of the North West Adelaide Health Study (Australia) free of diabetes at baseline. The association of MP and dominant hand GS with incident diabetes over 15-years follow-up and the moderation effect of GS on the association between diabetes and MP were investigated by logistic regression models. Of 3039 participants followed over 13.3 years (SD 2.6), 236 (7.8%) developed diabetes. Compared to the metabolically healthy (MH) normal weight phenotype, the metabolically unhealthy (MU) overweight (OR 6.15, 95%CI 2.43–15.59) and obese (OR 12.32, 95%CI 4.97–30.52) phenotypes were associated with a high risk of diabetes, but not the MU normal weight (OR 1.73, 95%CI 0.57–5.25), MH overweight (OR 1.15, 95%CI 0.31–4.31) or MH obese phenotypes (OR 0.77, 0.07–8.89). GS was inversely associated with diabetes (OR 0.97, 95% CI 0.95–0.99) and attenuated the risk associated with MU overweight (beta = −0.296, p = 0.039) and MU normal weight (beta = −0.773; p for interaction = 0.009). Strictly defined MP (rather than based on metabolic syndrome criteria) and GS, a proxy of muscle strength, might be useful for stratifying the risk of diabetes in the long-term. Improving muscle strength might be an important strategy to reduce diabetes risk. [ABSTRACT FROM AUTHOR]

Summary: Background: The duel problems of obesity and the aging of society are likely to produce substantially increased demand on health services in the future. We examine the projected burden which four obesity-related conditions potentially can place on the hospital system in Australia: diabetes, obstructive sleep apnoea (OSA), knee replacements, and bariatric surgery. Methods: Separations for each condition were obtained from the Australian Institute of Health and Welfare (AIHW) data from 1990 to 2005. Projections of age specific rates for each condition/procedure to 2020 by sex and 5-year age groups developed using double exponential smoothing were applied to population projections to estimate numbers of separations or procedures. Results: Large, significant increases in rates per 100,000 population for each condition/procedure occurred from 1990 to 2005 for each gender and across all adult age groups. Numbers of separations for diabetes are estimated to increase from 50,258 in 2005 to 180,057 in 2020 and for OSA from 32,262 to 83,535. Procedures for total knee replacements are projected to increase from 28,490 in 2005 to 67,619 in 2020 and for bariatric surgery from 32,262 to 83,535. Conclusion: The combined effects of demographic change with a rapidly aging population along with a high and increasing prevalence of obesity will continue to drive the four conditions/procedures studied and this will have a considerable effect on health resources. The consequences of not acting, or acting ineffectively, are high and constitute a serious threat to future public health. [Copyright &y& Elsevier]

Objectives: To examine the influence of obstructive sleep apnea (OSA) on nocturia, controlling for their shared co-morbidities, in a population of community-based middle aged to elderly men.Methods: Participants were drawn from a randomly selected, community-dwelling cohort of men in Adelaide, Australia. Seven hundred and eight men (mean: 60.7 [41.6-88.2] years) who had polysomnography recordings, complete lower urinary tract symptoms (LUTS) measures (International Prostate Symptom Score), without prostate or bladder cancer and/or surgery, and no prior OSA diagnosis were selected. Nocturia was defined as ≥2 voids per main sleep. Unadjusted and multi-adjusted regression models of nocturia were combined with OSA, wake after sleep onset, total sleep period, excessive daytime sleepiness (EDS), and sleep quality (SQ) data, together with socio-demographic, and health-related factors.Results: Men with nocturia were found to have higher levels of OSA (32.2% [n = 65]), wake after sleep onset time (97.2 ± 52.9 minutes), sleep period (467.3 ± 58.4 minutes), EDS (18.2% [n = 37]), and poorer SQ (54.3% [n = 108]). Multiple-adjusted models showed nocturia was positively associated with OSA (odds ratio:1.64, 95% confidence interval [1.03,2.55]), EDS (1.72 [1.01,2.93]), and poorer SQ (1.65 [1.10,2.48]). Including other storage and voiding LUTS attenuated the effect of OSA and strengthened the association with EDS (2.44 [1.45,4.10] and 2.24 [1.19,4.22]), whereas voiding LUTS also strengthened the association with poorer SQ (2.61 [1.63,4.17]). Men with increasing nocturic frequency spent less time in N2 and rapid eye movement stage sleep.Conclusion: Nocturia is strongly associated with OSA in community-based men. Nocturia also reduces sleep efficiency/SQ, N2, and rapid eye movement sleep time, while increasing EDS. Other LUTS increase EDS through non-OSA means. [ABSTRACT FROM AUTHOR]

Introduction: Insomnia and obstructive sleep apnoea (OSA) are the two most prevalent sleep disorders, and frequently co-occur (COMISA) in sleep clinic samples. However, few studies have investigated the prevalence or associations of COMISA in the general population.Methods: We used population-based online survey data from 2044 Australian adults. The prevalence and associations of insomnia, OSA and COMISA were investigated according to symptom-level, and disorder-level definitions. Insomnia was defined according to chronic difficulties initiating and/or maintaining sleep (DIMS; symptom-level), and ICSD-3 chronic insomnia disorder (disorder-level). OSA was defined according to self-reported frequent obstructive events, snoring or doctor-diagnosed OSA (symptom-level), and doctor-diagnosed OSA (disorder-level). COMISA was defined if both conditions were met (for symptom-level, and disorder-level threshold). Associations with other conditions, and general health were investigated with Poisson regression analyses.Results: Chronic insomnia occurred more frequently among participants with doctor-diagnosed OSA (22.3%), compared to those without (14.3%, p = 0.010). Doctor-diagnosed OSA was more common among participants with chronic insomnia (10.2%) compared to those without (6.2%; p = 0.010). DIMS also occurred more frequently among participants with OSA symptoms (66.6%), compared to those without (47.2%; p < 0.001). Participants with symptom-level COMISA reported increased co-morbid conditions, and worse general health compared to participants with symptoms of insomnia-alone, OSA-alone, or neither insomnia/OSA.Conclusions: COMISA at symptom and disorder level were common and associated with increased medical and psychiatric co-morbidity, as well as poor general health. More investigation is required to understand bi-directional associations underpinning the high co-morbidity, and improve diagnostic and treatment approaches for COMISA to reduce associated morbidity. [ABSTRACT FROM AUTHOR]

Background: Frailty and sarcopenia are age-related conditions with shared features and are both associated with adverse health outcomes. Relatively little is known about outcomes of these conditions in combination. The aim of this study was to examine the predictive ability of combined frailty and sarcopenia classification on mortality.Methods: Frailty was measured in 716 community-dwelling adults aged ≥65 years from the North West Adelaide Health Study (mean age 74.1(6.1) years, 55.5 % female) using the frailty phenotype (FP) and sarcopenia using the revised consensus definition from the European Working Group on Sarcopenia. Participants were classified as: neither frail nor sarcopenic, frail-only, sarcopenic-only, or both frail and sarcopenic. All participants had a minimum of 10 years of mortality follow-up.Results: We identified 2.8 % of participants as both frail and sarcopenic, 15.5 % as frail-only, and 3.5 % as sarcopenic-only. Classification as both frail and sarcopenic, in a multivariable model, resulted in significantly elevated mortality risk (HR = 3.52, p < .001), which was over three times that of those neither frail nor sarcopenic. Frail-only was also a significant mortality predictor (HR = 2.03, p = .001), while classification as sarcopenic-only was not a significant predictor of mortality (HR = 1.65, p = .141). There was no significant difference in severity of frailty (mean number of characteristics) or grip strength between frail-only and those with both conditions when stratified by sex.Conclusions: Individuals identified as frail would benefit from screening and assessment for sarcopenia, and vice versa for those identified as sarcopenic, as the mortality risk for individuals with these conditions in combination is nearly double that of each separately. [ABSTRACT FROM AUTHOR]

Social jetlag is a term used to describe misalignment between biological and social time. Measured as the difference in sleep midpoints between work and free days, social jetlag has been associated with unhealthy lifestyle behaviours and adverse health outcomes. This study aimed to identify the prevalence of social jetlag, and its sociodemographic and behavioural correlates in 837 respondents who completed the Sleep Health Foundation Australia 2016 online survey. Binomial logistic regression models determined associations between social jetlag and self-reported lifestyle and work outcomes, excluding night, evening or rotating shift workers. One third (31.1%) of respondents experienced >1h of social jetlag. In analyses adjusted for sociodemographic variables associated with social jetlag (age, marital status, work status and metropolitan living plus the significant interaction term for age by metro living), social jetlag was associated with longer sleep duration on free days (OR = 2.8, CI = 1.9-4.1), evening preference (OR = 2.0, CI = 1.4-2.4), often staying up later than planned on work days (OR 1.9, CI = 1.3-2.9), and having a computer (OR = 1.7, CI = 1.2-2.4) or phone (OR = 1.6, CI = 1.1-2.4) in the bedroom and internet use in the hour before bed (OR = 1.7, CI 1.2-2.5). Almost twice as many working respondents with social jetlag reported going to work when they should have taken sick leave due to their state of health (OR = 1.9, CI = 1.3-3.0). In conclusion, social jetlag is prevalent in the Australian community and associated with bedtime technology use. Work attendance when in poor health is cause for concern in Australian day workers and requires further investigation. [ABSTRACT FROM AUTHOR]