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Retirement is a major life event characterized by removal of work-related stressors and changes in health behaviours. The association between retirement and changes in blood pressure (BP), and particularly in ambulatory BP, has been scarcely studied. We aimed to examine changes in ambulatory BP during retirement transition.Two hundred and fifty ageing workers (mean age 63.2 years, 84% women) from the Finnish Retirement and Aging study participated in annual office BP measurements and 114 (mean age 63.1, 90% women) of them underwent annual ambulatory BP measurements before and after retirement. On average, the participants provided data on ambulatory BP at 2.7 (range 2-4) measurements. We used generalized linear models to examine BP changes at retirement.Most marked changes in BP during the follow-up were observed for asleep SBP, which decreased before retirement, increased during retirement transition and plateaued after retirement (before retirement vs. retirement transition P = 0.07 and after retirement vs. retirement transition P = 0.02). Awake SBP and 24-h SBP declined with most apparent decrease before retirement (before retirement vs. retirement transition P = 0.07 and P = 0.07). Awake DBP and 24-h DBP showed relatively consistent decline throughout the follow-up with no differences between the time periods. SBP and DBP dipping reduced before and during retirement transition, but not after retirement. Among shift workers, asleep BP increased and BP dipping decreased more than in regular day workers.Retirement was found to associate with beneficial changes in awake BP but unfavourable changes in asleep BP, especially in shift workers.

Upper respiratory tract infections (“common cold”) are the most common acute illnesses in elite athletes. Numerous studies on exercise immunology have proposed that intense exercise may increase susceptibility to respiratory infections. Virological data to support that view are sparse, and several fundamental questions remain. Immunity to respiratory viral infections is highly complex, and there is a lack of evidence that minor short- or long-term alterations in immunity in elite athletes have clinical implications. The degree to which athletes are infected by respiratory viruses is unclear. During major sport events, athletes are at an increased risk of symptomatic infections caused by the same viruses as those in the general population. The symptoms are usually mild and self-limiting. It is anecdotally known that athletes commonly exercise and compete while having a respiratory viral infection; there are no virological studies to suggest that such activity would affect either the illness or the performance. The risk of myocarditis exists. Which simple mitigation procedures are crucial for effective control of seasonal respiratory viral infections is not known.

Introduction: This is one of the first intervention studies to examine how low- (LIT) and high-intensity endurance training (HIT) affect durability, defined as ‘time of onset and magnitude of deterioration in physiological-profiling characteristics over time during prolonged exercise’.Methods: Sedentary and recreationally active men (n = 16) and women (n = 19) completed either LIT (average weekly training time 6.8 ± 0.7 h) or HIT (1.6 ± 0.2 h) cycling for 10 weeks. Durability was analyzed before and after the training period from three factors during 3-h cycling at 48% of pretraining maximal oxygen uptake (VO2max): 1) by the magnitude and 2) onset of drifts (i.e. gradual change in energy expenditure, heart rate, rate of perceived exertion, ventilation, left ventricular ejection time, and stroke volume), 3) by the ‘physiological strain’, defined to be the absolute responses of heart rate and its variability, lactate, and rate of perceived exertion.Results: When all three factors were averaged the durability was improved similarly (time x group p = 0.42) in both groups (LIT: p = 0.03, g = 0.49; HIT: p = 0.01, g = 0.62). In the LIT group, magnitude of average of drifts and their onset did not reach statistically significance level of p < 0.05 (magnitude: 7.7 ± 6.8% vs. 6.3 ± 6.0%, p = 0.09, g = 0.27; onset: 106 ± 57 min vs. 131 ± 59 min, p = 0.08, g = 0.58), while averaged physiological strain improved (p = 0.01, g = 0.60). In HIT, both magnitude and onset decreased (magnitude: 8.8 ± 7.9% vs. 5.4 ± 6.7%, p = 0.03, g = 0.49; onset: 108 ± 54 min vs. 137 ± 57 min, p = 0.03, g = 0.61), and physiological strain improved (p = 0.005, g = 0.78). VO2max increased only after HIT (time x group p < 0.001, g = 1.51).Conclusion: Durability improved similarly by both LIT and HIT based on reduced physiological drifts, their postponed onsets, and changes in physiological strain. Despite durability enhanced among untrained people, a 10-week intervention did not alter drifts and their onsets in a large amount, even though it attenuated physiological strain.

Background With advancing age, physical capacity gradually decreases which may lead to decreased work ability, if the physical work requirements remain the same. Examination of the importance of physical fitness for work ability among aging workers will help to find potential strategies to promote work ability in old age. The aim of this study was to investigate the association between physical fitness and work ability among aging workers. Methods Aging workers (n = 288, mean age 62.5, 83% women) from the Finnish Retirement and Aging study underwent cardiorespiratory, muscular fitness and functional testing. Work ability was inquired on a scale 0–10 from poor to excellent. Association between physical fitness indicators and work ability was examined using ordinary least squares regression, taking into account age, gender, occupational status, heavy physical work, body mass index and accelerometer-measured daily total physical activity. Results VO2peak, modified push-up test and maximal walking speed were positively associated with work ability (β = 0.51, 95% confidence interval (CI) 0.29–0.74, β = 0.46, 95% CI 0.26–0.66 and β = 0.23, 95% CI 0.07–0.39, respectively), while chair rise test time was inversely associated with work ability (β = −0.23, 95% CI −0.39–−0.06). No associations were found between hand grip strength or sit-up test and work ability. Conclusions Cardiorespiratory fitness, upper body strength, and lower extremity function were positively associated with work ability. Good physical fitness may help to maintain work ability among aging workers.

Influenza A outbreaks occurred in two professional hockey teams just after two games they played against each other. Thirteen players and two staff members fell ill during 17–20 April 2022, while COVID-19 was prevalent. Altogether, seven players missed an important game due to influenza. The rapid diagnosis permitted effective pharmaceutical and nonpharmaceutical control of the outbreaks.

Background Regardless of competitive athletes’ body image pressures, only few studies have focused on adolescent sport participants’ body image and the findings are inconclusive. Furthermore, the role of competitive goals in sports on adolescents’ body size perception has not been studied. We examined the factors associated with adolescents’ competitive goals in sports and body size perception, and the associations between adolescents’ competitive goals in sports and body size perception. Methods The cross-sectional study consisted of 475 goal-oriented sports club participants and 936 reference youths (aged 14–16 years). The study questionnaire included multiple choice items on health behaviours, motives to exercise, competitive goals in sports and body size perception. The multinomial logistic regression analysis was used to investigate the associations. Results Adolescents with competitive goals in sports perceived their body size as about the right size more frequently than reference youths (68% vs 47%, p p Conclusions Adolescents’ BMI, appearance/weight motives to exercise, and perceived physical fitness were more strongly associated with body size perception than their competitive goals in sports. However, perceived fatness among girls with competitive goals in sports should be considered in organized sports.

We performed prospective studies on respiratory viral infections among Team Finland participants during the 2021 Oberstdorf World Ski Championships and the 2022 Beijing Olympic Games. We enrolled 73 athletes and 110 staff members. Compared with similar studies we conducted before the COVID-19 pandemic, illnesses and virus detections dropped by 10-fold.

The operation of naval vessels involves watchkeeping 24 h per day, which is globally carried out by a variety of different watch systems. In this study, the rotating 4:4 and fixed 4:4/6:6 two-section watch systems were compared in terms of sleepiness, fatigue, and stress responses. The data collection took place on a Finnish Defence Forces' (FDF) Navy missile patrol boat with 15 crew members serving as study participants. The data collection periods lasted two separate weeks (7 days, 6 nights) with the different watch systems. The subjective sleepiness of the participants was assessed before and after every watch using the Karolinska Sleepiness Scale (KSS). Stress responses were assessed daily by the recorded levels of salivary alpha-amylase (sAA), cortisol (sCor), immunoglobulin A (sIgA), and dehydroepiandrosterone (sDHEA). The participants' sustained attention, inhibitory control, and working memory were assessed daily by cognitive tests (SART, N-Back). The heart rate variability (HRV) during an orthostatic test was used as an additional daily marker to assess the amount of psychological stress of the participants. In this study, the difference regarding sleepiness and fatigue between the study weeks was most visible in the subjective KSS, which clearly favored the 4:4/6:6 system. The results of sAA and sIgA also suggested that the subjects were psychologically less stressed during the study week with the 4:4/6:6 watch system. Cognitive test results (SART, N-Back) indicated that there were overall no significant differences in the subjects' sustained attention, inhibitory control, or working memory during the study weeks or between the study weeks. The results of the HRV data during the daily orthostatic tests were inconclusive but there was some indication that the subjects were less stressed during the study week with the 4:4/6:6 watch system. In conclusion, the present study indicates that in navy surface operations: working with the fixed 4:4/6:6 watch system causes less sleepiness, fatigue, and psychological stress than working with the rotating 4:4 watch system. The study result is well in line with previous research regarding watch systems. publishedVersion

Exercise has been shown to affect gut the microbiome and metabolic health, with athletes typically displaying a higher microbial diversity. However, research on the gut microbiota and systemic metabolism in elite athletes remains scarce. In this study, we compared the gut microbiota profiles and serum metabolome of national team cross-country skiers at the end of an exhausting training and competitive season to those of normally physically-active controls. The gut microbiota were analyzed using 16S rRNA amplicon sequencing. Serum metabolites were analyzed using nuclear magnetic resonance. Phylogenetic diversity and the abundance of several mucin-degrading gut microbial taxa, including Akkermansia, were lower in the athletes. The athletes had a healthier serum lipid profile than the controls, which was only partly explained by body mass index. Butyricicoccus associated positively with HDL cholesterol, HDL2 cholesterol and HDL particle size. The Ruminococcustorques group was less abundant in the athlete group and positively associated with total cholesterol and VLDL and LDL particles. We found the healthier lipid profile of elite athletes to co-occur with known health-beneficial gut microbes. Further studies should elucidate these links and whether athletes are prone to mucin depletion related microbial changes during the competitive season.

Exercise has been shown to affect gut the microbiome and metabolic health, with athletes typically displaying a higher microbial diversity. However, research on the gut microbiota and systemic metabolism in elite athletes remains scarce. In this study, we compared the gut microbiota profiles and serum metabolome of national team cross-country skiers at the end of an exhausting training and competitive season to those of normally physically-active controls. The gut microbiota were analyzed using 16S rRNA amplicon sequencing. Serum metabolites were analyzed using nuclear magnetic resonance. Phylogenetic diversity and the abundance of several mucin-degrading gut microbial taxa, including

This study aimed to identify organized sports participation patterns and their prevalence from adolescence to emerging adulthood, and the educational and family-related determinants of the patterns. Adolescents in the Finnish Health Promoting Sports Club (FHPSC) study answered a health behaviour questionnaire and reported on sports club participation at ages 15 and 19 (N = 609). In emerging adulthood, dropouts (total 41.05%; females 43.72%; males 36.56%), maintainers (30.87; 26.44; 38.33), nonparticipants (27.59; 29.32; 24.67), and joiners (0.49; 0.52; 0.44) (p =.024) were identified. A mixed multinomial logistic regression analysis showed, that male gender, as compared to female gender, increased the odds of being a maintainer rather than a nonparticipant or dropout. Among females, high achievement at school and aspiration towards upper secondary school at age 15 increased the odds of being a maintainer at age 19 rather than a nonparticipant. High achievement at school and experiencing a (strong) decrease in parental support for physical activity/sport increased the odds of being a dropout rather than a nonparticipant. Having no experience of a strong decrease in parental support increased the odds of being a maintainer rather than a dropout. Among males, aspiration towards upper secondary school increased the odds of being a maintainer or dropout rather than a nonparticipant. The most common reason for dropping out was study, which was also the most prevalent life status at age 19. The findings highlight a need for more flexible possibilities to combine organized sports participation and school studies, and the importance of parental support for physical activity/sport. publishedVersion

Purpose Whether elite athletes, who have been exposed to vigorous-intensity exercise combined with other stressors, have elevated systemic low-grade inflammation, remains largely unclear. To address this question, we studied the levels of six inflammatory cytokines as potential biomarkers of a low-grade inflammatory state in elite athletes after an 11-month training and competition season. Methods We collected sera from 27 Finnish elite cross-country skiers and 27 gender- and age-matched, moderately-exercising controls. The serum concentrations of C-reactive protein (CRP), interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α), glycoprotein acetyls (GlycA), interleukin 10 (IL-10), and interferon gamma (IFN-γ) cytokines were quantified as surrogate markers of low-grade inflammation. Results The athletes were found to have significantly lower concentrations of CRP (P = 0.0232) and higher concentrations of IL-10, TNF-α, and IFN-γ (P = 0.0097, P = 0.0256, and P = 0.0185, respectively) than the controls. No significant differences between athletes and controls were detected in the concentrations of IL-6 and GlycA. The inflammatory score (IS) did not differ significantly between athletes and controls. Conclusion The results of this study argued against the hypothesis of a significant chronic low-grade inflammation in response to prolonged high-performance exercise among elite endurance athletes.

Objective: The aerobic part of the recently updated physical activity (PA) guidelines for adults no longer requires the minimum 10-minute bouts for the accumulated time. In this study, the adherence of Finnish adult population to the new PA guidelines was evaluated using both absolute and relative cut-points describing the individual cardiorespiratory fitness (CRF) in relation to the intensity of PA.Methods: Totally, 1645 adults aged 20-64 years, participated in this study. The participants were instructed to wear a triaxial hip-worn accelerometer for one week. The participants with estimated maximal oxygen uptake less than 7.9 MET were categorized as low CRF group and the others as adequate CRF group. Results: The adequate CRF group had higher adherence to PA guidelines with the absolute thresholds, but the use of relative thresholds inverted the results. The adherence varied from 16 % to 100 % depending on the fitness group and the analysis parameters of accelerometer data.Conclusion: The absolute thresholds provide a more appropriate basis to assess the adherence to PA recommendations in population-based samples and interventions. The use of individually determined relative thresholds may be more useful for individual exercise prescriptions in PA counseling.

Background: Naval service can have a significant impact on the wellbeing of seafarers, and the operation of warships is highly dependent on the personnel on board. Nevertheless, there is a lack of knowledge concerning the impact of seafarers’ individual characteristics on their wellbeing in a naval environment. Therefore, the aim of this study was to investigate individual characteristics of the naval personnel that may be associated with the amount of sleepiness, fatigue and stress responses experienced during shift work and irregular working hours in a naval environment. Methods: The study took place on a Finnish Defence Forces’ Navy missile patrol boat on which 18 crewmembers served as study participants. The measurement periods lasted two separate weeks (seven days and six nights) during shift work with two different watchkeeping systems (4:4, 4:4/6:6). The onboard measurements consisted of the Karolinska Sleepiness Scale, salivary stress hormones, cognitive tests (Sustained Attention to Response Task and N-back Task) and heart rate variability. Results: Participants of older ages or with a longer history in naval service were associated with a greater amount of sleepiness, fatigue and stress responses on board. On the contrary, increased physical activity and a higher level of physical fitness, especially standing long jump, were associated with a lower amount of sleepiness, fatigue and fewer stress responses. In addition, an athletic body composition together with a healthy lifestyle may be beneficial, considering the stress responses on board. Conclusion: The present results are well in line with the previous literature regarding shift work and irregular working hours. The results highlight the importance of regular physical activity and good physical fitness during service in the naval environment. publishedVersion

A 10-year observational follow-up study to evaluate the changes in sleep architecture during the menopausal transition.Fifty-seven premenopausal women (mean age 46 years, SD 0.9) were studied at baseline and after a 10-year follow-up. At both time points, polysomnography (PSG) was performed, and the serum follicle-stimulating hormone (S-FSH) concentration was measured. Linear regression models were used to study the effects of aging and menopause (assessed as change in S-FSH) on sleep.After controlling for body mass index, vasomotor, and depressive symptoms, higher S-FSH level was associated with longer sleep latency (B 0.45, 95% confidence interval [CI]: 0.07 to 0.83). Aging of 10 years was associated with shorter sleep latency (B -46.8, 95% CI: -77.2 to -16.4), shorter latency to stage 2 sleep (B -50.6, 95% CI: -85.3 to -15.9), decreased stage 2 sleep (B -12.4, 95% CI: -21.4 to -3.4), and increased slow-wave sleep (B 12.8, 95% CI: 2.32 to 23.3) after controlling for confounding factors.This study suggests that PSG measured sleep of middle-aged women does not worsen over a 10-year time span due to the menopausal transition. The observed changes seem to be rather age- than menopause-dependent.

Background This study aimed to identify accelerometer-measured daily physical activity patterns, and to examine how they associate with health-related physical fitness among aging workers. Methods The study population consisted of 263 participants (mean age 62.4 years, SD 1.0) from the Finnish Retirement and Aging study, who used wrist-worn ActiGraph accelerometer for at least 1 week including both workdays and days off. Health-related physical fitness measures included body composition (waist circumference, bioimpedance), cardiorespiratory fitness (bicycle ergometer test), and muscular fitness (push-up and chair rise tests). Results Based on the latent class trajectory analysis, 6 trajectories were identified for workdays showing variation in activity level on working hours and on evening hours. Moderate activity during working hours and increase of activity level in the evening was associated with the most favorable health-related fitness in comparison to low activity throughout the workday: waist circumference 90.0 cm (95% confidence interval [CI] 85.5–94.5) versus 99.5 cm (95% CI 96.8–102.3), fat mass 13.9 kg (9.3–18.5) versus 23.8 kg (20.2–27.4), cardiorespiratory fitness 33.4 mL/kg/min (95% CI 31.4–35.3) versus 29.1 mL/kg/min (95% CI 27.8–30.3) (adjusted for age, sex, days off activity, smoking, and alcohol). For the days off, 2 different trajectories were identified, but they differed only in terms of level and not by timing of physical activity. Conclusions A large variation in the workday physical activity patterns was observed among aging workers. Independent of worktime activity, people who were more active in the evenings had more favorable health-related physical fitness than those who were less active throughout the day.

Objectives Individuals with reduced nocturnal blood pressure (BP) dipping are at increased risk of cardiovascular disease compared to persons with normal BP dipping. Although the relation of work-related factors and BP has been studied extensively, very little is known of the association between work-related factors and 24-h BP patterns in aging workers. We examined the cross-sectional relation of work-related risk factors, including occupational status, work-time mode, job demands and job control, with ambulatory BP in aging workers, focusing on nocturnal BP dipping. Methods 208 workers (mean age 62 ± 3 years; 75% women) from two Finnish population-based cohort studies underwent 24-h ambulatory BP monitoring. Work-related factors were inquired using a questionnaire. Nocturnal BP dipping was calculated as [1 − (asleep BP/awake BP)] × 100. Results Shift workers demonstrated a higher nocturnal diastolic BP dipping than regular day workers (19% vs. 17%, p = 0.03) and had a significantly higher systolic awake BP than regular day workers (136.5 mmHg vs. 132.5 mmHg, p = 0.03). Participants with high job demands demonstrated a smaller nocturnal systolic BP dipping than participants with low job demands (14% vs. 16%, p = 0.04). We did not observe significant differences in nocturnal systolic or diastolic BP dipping between groups categorized by occupational status or job control. Conclusions Although shift workers have a higher daytime BP than regular daytime workers, they exhibit greater nighttime BP dipping. Participants with high job demand had smaller nighttime BP dipping than participants with low job demand. Job control or occupation did not affect the 24-h ambulatory BP profile of aging workers.

Irisin is a myokine that is thought to be secreted in response to exercise that may help to prevent obesity and maintain normal glucose metabolism. In this study we investigated the associations between irisin and glucose homeostasis in middle-aged, overweight and obese men (n = 144) with impaired glucose regulation, and the impact of exercise training on these relationships. The participants underwent 12 weeks of resistance or aerobic (Nordic walking) exercise training three times per week, 60 minutes per session. Venous blood (n = 105) and skeletal muscle samples (n = 45) were obtained at baseline and post-intervention. Compared to controls, Nordic walking, but not resistance training, increased irisin levels in plasma (9.6 ± 4.2%, P = 0.014; 8.7 ± 4.9%, P = 0.087; respectively) compared to controls. When considering all subjects, baseline irisin correlated positively with atherogenic index of plasma (r = 0.244, P = 0.013) and 2-hour insulin levels (r = 0.214, P = 0.028), and negatively with age (r = -0.262, P = 0.007), adiponectin (r = -0.240, P = 0.014) and McAuley index (r = -0.259, P = 0.008). Training-induced FNDC5 mRNA changes were negatively correlated with HbA1c (r = -0.527, P = 0.030) in the resistance training group and with chemerin in the Nordic walking group (r = -0.615, P = 0.033). In conclusion, 12-weeks of Nordic walking was more effective than resistance training in elevating plasma irisin, in middle-aged men with impaired glucose tolerance. Thus, the change in irisin in response to exercise training varied by the type of exercise but showed limited association with improvements in glucose homeostasis.

Both training volume and overall physical activity (PA) play a role in young athletes’ sports performance and athletic development. The purpose of this study was to describe the training volume and PA of young athletes in endurance, aesthetics, ball games, and power sports. Questionnaire data (n = 671) were obtained from 15-year-old Finnish athletes on sports participation, along with accelerometer data (n = 350) assessing the amount and intensity of their PA. The athletes’ mean weekly training volume was 11 h 41 min. Objectively assessed PA amounted to 4 h 31 min daily, out of which 1 h 31 min was at a level of moderate-to-vigorous intensity (MVPA). Among 24% of the athletes, the weekly training volume (in hours) exceeded the recommended level of age-in-years, which might increase their risk of sports injuries. At the same time, one in six athletes (16%) did not—on average—reach the internationally recommended threshold level of at least 60 minutes of MVPA per day. Compared to girls, boys averaged 2.5 more hours of training per week, and had 21 more minutes of MVPA per day. Moreover, boys had a higher goal orientation than girls, with 52% of the boys and only 29% of the girls focused on success at adult level. Although total training volume and PA did not differ among sports types, there were differences in training forms, and in the proportions of MVPA. The young athletes were found to vary greatly in training forms, training volumes, MVPA, and goal orientation; hence, training should be planned individually, both for team sports and individual sports. peerReviewed

Ojective: To investigate the injury characteristics in Finnish male football players. Design: One-season prospective epidemiological study. Data were collected via injury reports from the medical staff and directly from the players using the Olso Sports Trauma Research Center Health Questionnaire. Participants: The first team squads of Finnish football league (n = 12 teams, 236 players). Main outcome measurement: Injury incidence. Results: A total of 541 injuries occurred during the exposure of 62 878 hours. Injury incidence per 1000 exposure hours was 8.6 (30.6 in matches and 3.4 in training). A player sustained on average 2.3 (median 2, range 0–13) injuries during the study. Thigh and ankle were the most commonly injured body parts for acute injuries and hip/groin were the most commonly injured body part for overuse injuries. The median absence time for all injuries was 12 (range 0–107) days, 12 (range 0–107) for acute, and 8 (range 0–61) for overuse injuries. Thigh injuries caused the greatest consequences in terms of absence from full participation (median 5 days, range 0–88). Conclusion: Lower limb muscle injuries were the most prevalent injuries in the study. Collecting data directly from the players enabled to report more injuries compared to what was reported only by the medical staff. publishedVersion

Objective: Besides traditional risk factors, other factors such as life stressors are linked with incident cardiovascular disease. However, the underlying mechanisms for this association remain mostly unknown. We studied the relation of life stressors (job strain, sleep loss due to worry, illness or death in family, financial difficulties and caregiving) and their accumulation with arterial stiffness, an independent predictor of cardiovascular disease. Methods: 258 participants (mean age 62.4 years, 82% women) from the Finnish Retirement and Aging Study underwent measurements for carotid-femoral Pulse Wave Velocity (PWV), a standard criterion for assessing arterial stiffness and responded to a survey inquiring life stressors. Using analysis of covariance, we estimated group means adjusted for age, gender, occupation, lifestyle factors and hypertension. Results: Participants with recent illness or death in family (8.04 m/s; 95% CI, 7.40–8.73 vs. 7.52 m/s; 95% CI, 7.03–8.05) and financial difficulties (8.65 m/s; 95% CI, 7.62–9.81 vs. 7.71 m/s; 95% CI, 7.21–8.24) had increased PWV compared to those who did not have exposed to these stressors independent of lifestyle factors, diabetes and systolic blood pressure. In addition, increasing number of life stressors demonstrated an association towards increased PWV (≥2 stressors: 8.04 m/s; 95% CI, 7.42–8.72 vs. 0 stressors 7.74 m/s; 95% CI, 7.23–8.28; p for trend 0.27) but the association attenuated after adjusting for lifestyle factors, diabetes and systolic blood pressure. Conclusion: Life stress was found to associate with higher arterial stiffness. Increased arterial stiffness could explain some of the increased cardiovascular disease risk related to life stressors. •Arterial stiffness was assesed as carotid-femoral pulse wave velocity. •Illness or death in the family were associated with an increased arterial stiffness. •Financial difficulties were associated with an increased arterial stiffness. •A trend toward increasing number of stressors and higher arterial stiffness exists.

Adults with a low physical activity (PA) level are at increased risk for cardiometabolic diseases, but little is known on the association between physical inactivity since youth and cardiometabolic health in adulthood. We investigated the association of persistent physical inactivity from youth to adulthood with adult cardiometabolic risk factors. Data were drawn from the ongoing Cardiovascular Risk in Young Finns Study with seven follow-ups between 1980 and 2011 (baseline age 3–18 years, n = 1961). Physical activity data from a standardized questionnaire was expressed as a PA-index. Using the PA-index, four groups were formed: 1)persistently physically inactive (n = 246), 2)decreasingly active (n = 305), 3)increasingly active (n = 328), and 4)persistently active individuals (n = 1082). Adulthood cardiometabolic risk indicators included waist circumference, body mass index (BMI), blood pressure, and fasting lipids, insulin, and glucose. Clustered cardiometabolic risk was defined using established criteria for metabolic syndrome. Persistently physically inactive group was used as a reference. Compared to the persistently physically inactive group, those who were persistently active had lower risk for adult clustered cardiometabolic risk (RR = 0.67;CI95% = 0.53–0.84; Harmonized criteria), obesity (BMI > 30 kg/m2, RR = 0.76;CI95% = 0.59–0.98), high waist circumference (RR = 0.82;CI95% = 0.69–0.98), and high triglyceride (RR = 0.60;CI95% = 0.47–0.75), insulin (RR = 0.58;CI95% = 0.46–0.74) and glucose (RR = 0.77;CI95% = 0.62–0.96) concentrations as well as low high-density lipoprotein cholesterol (HDLsingle bondC) concentration (RR = 0.78;CI95% = 0.66–0.93). Comparable results were found when persistently physically inactive individuals were compared with those who increased PA. The results remained essentially similar after adjustment for education, diet, smoking, and BMI. Persistently physically inactive lifestyle since youth is associated with an unfavorable cardiometabolic risk profile in adulthood. Importantly, even minor increase in PA lowers the cardiometabolic risk. peerReviewed

For adolescent athletes, data on nutrition behaviours are limited. The present study aimed to evaluate the dietary habits of adolescent sports club participants (SPs) compared with those of non‐participants (NPs). The cross‐sectional study of 1917 adolescents aged 14–16 was based on data from the Finnish Health Promoting Sports Club (FHPSC) study. The health behaviour surveys were conducted among SPs (n=1093) and NPs (n=824). Logistic regression was used to test statistical significance of the differences in dietary habits between SPs and NPs. SPs were more likely than NPs to eat breakfast on weekends [89% vs. 79%, odds ratio (OR) 1.46, 95% confidence interval (CI) 1.07–2.01] and to report daily consumption of vegetables (46% vs. 32%, OR 1.33, 95% CI 1.04–1.69) and fat‐free or semi‐skimmed milk (72% vs. 55%, OR 1.33, 95% CI 1.04–1.68). Dietary habits regarded as unhealthy, such as sugared soft drink consumption, were similar between the groups. The aforementioned healthy dietary habits are more frequent in SPs than NPs and unhealthy dietary habits are equally frequent in the groups. Both adolescent SPs’ and NPs’ dietary habits have deficiencies, like inadequate vegetable and fruit consumption. Sports clubs’ opportunities for adolescents’ healthy eating promotion should be examined. peerReviewed

Study Objectives A 10-year observational follow-up study to evaluate the changes in sleep architecture during the menopausal transition. Methods Fifty-seven premenopausal women (mean age 46 years, SD 0.9) were studied at baseline and after a 10-year follow-up. At both time points, polysomnography (PSG) was performed, and the serum follicle-stimulating hormone (S-FSH) concentration was measured. Linear regression models were used to study the effects of aging and menopause (assessed as change in S-FSH) on sleep. Results After controlling for body mass index, vasomotor, and depressive symptoms, higher S-FSH level was associated with longer sleep latency (B 0.45, 95% confidence interval [CI]: 0.07 to 0.83). Aging of 10 years was associated with shorter sleep latency (B −46.8, 95% CI: −77.2 to −16.4), shorter latency to stage 2 sleep (B −50.6, 95% CI: −85.3 to −15.9), decreased stage 2 sleep (B −12.4, 95% CI: −21.4 to −3.4), and increased slow-wave sleep (B 12.8, 95% CI: 2.32 to 23.3) after controlling for confounding factors. Conclusions This study suggests that PSG measured sleep of middle-aged women does not worsen over a 10-year time span due to the menopausal transition. The observed changes seem to be rather age- than menopause-dependent.

Context Much information is available on electrocardiogram (ECG) and blood pressure (BP) changes in senior athletes. However, corresponding data on adolescent athletes are scarce. Objective To study the differences in resting ECG and BP values among adolescent endurance athletes, nonendurance athletes, and nonathletes. Design Cross-sectional study. Setting A total of 154 youth sports clubs in Finland and 100 secondary schools for comparison data. Patients or Other Participants We recruited young athletes (n = 410) aged 14 to 16 years in 10 popular sport disciplines, including winter and summer as well as team and individual sports, and categorized them as endurance or nonendurance sports. Comparison data for age-matched, non–sports club participants (n = 164) were collected via secondary schools. Main Outcome Measure(s) Resting ECG, including heart rate, PR interval, QRS duration, QRS axis, QRS amplitude, T axis, and QT interval as well as systolic and diastolic BPs. Results No differences in any ECG variable of interest were found between the endurance and nonendurance athletes. The PR interval was longer in endurance athletes than in nonathletes (P = .05). The QRS amplitude (P = .03) was higher among nonendurance athletes than among nonathletes. Diastolic BP was lower among endurance (P = .002) and nonendurance (P = .02) athletes than among nonathletes. Endurance athletes (odds ratio [OR] = 2.85; 95% CI = 1.81, 4.50) and nonendurance athletes (OR = 2.19; 95% CI = 1.43, 3.35) were more likely to have sinus bradycardia than were nonathletes. Nonendurance athletes were more likely to have elevated systolic BP than were endurance athletes (OR = 1.70; 95% CI = 1.07, 2.72) and nonathletes (OR = 1.73; 95% CI = 1.04, 2.87). Conclusions Young athletes had similar ECG and BP findings independent of their sports. Physiological adaptations including sinus bradycardia, higher QRS amplitude, and lower diastolic BP, which are commonly seen in adult athletes, were also present in adolescent athletes.

Introduction: Physical activity (PA) is important in the prevention and treatment of impaired glucose metabolism. However, association of physical inactivity during the transition between childhood and adulthood with glucose metabolism is unknown. Therefore, we studied the association of persistent physical inactivity since childhood with glucose metabolism in adulthood. Methods: Data were drawn from the ongoing, Cardiovascular Risk in Young Finns Study with repeated follow-ups between 1980 and 2011 (baseline age, 3-18 yr; n = 3596). Impaired glucose metabolism was defined as having impaired fasting glucose (6.1-6.9 mmol·L-1) or type 2 diabetes in adulthood. Leisure-time PA habits were repeatedly collected with a standardized questionnaire and expressed as a PA Index. Using PA Index, four groups were formed (n = 2000): 1) persistently low PA, 2) decreasingly active, 3) increasingly active, and 4) persistently active subjects. Poisson regression model was used to examine the association between PA groups and impaired glucose metabolism. Results: The proportion of the sample with impaired glucose metabolism was 16.1% in individuals with persistently low PA, 14.5% in decreasingly active, 6.8% in increasingly active, and 11.1% in persistently active. Compared with individuals with persistently low PA, age and sex-adjusted risk for impaired glucose metabolism were lower in those who increased PA (relative risk [RR], 0.47; 95% confidence interval [CI], 0.29-0.76) and in those who were persistently active (RR, 0.70; 95% CI, 0.51-0.97), but similar in those who decreased PA (RR, 0.93; 95% CI, 0.66-1.36). Conclusions: Persistently physically inactive lifestyle from youth to adulthood is associated with increased risk of impaired glucose metabolism in adulthood. Importantly, a moderate increase in PA lowered the risk. The results highlight the importance of avoiding physically inactive lifestyle at all stages of life.

Background Cardiac troponins (cTn) are highly sensitive and specific markers for cardiac injury and a key element in the diagnosis of acute coronary syndrome. Strenuous exercise is known to induce increases in cTn, but the causative factors remain ambiguous. It is also equivocal whether exercise induced skeletal muscle injury is associated with cTn elevation. Purpose The aim of this study was to identify independent predictors for the rise in cardiac troponin T (cTnT) and I (cTnI) concentration and to focus on the relationship between skeletal muscle injury measured by skeletal troponin I (skTnI) and cTn elevations after a marathon race in a large group of male recreational runners. Methods A total of 40 recreational runners participating in the marathon in our city were recruited. The study included baseline visit (prerace) and immediate post-race sampling. Results The post-marathon cTnT concentration rose above the reference limit in 38 (95%) participants and the detection limit for cTnI was exceeded in 34 (85%) participants. Similarly, a 10-fold increase in skTnI concentration was observed and elevated post-race values were seen in all participants. There was no significant correlation between the post-race cTnT or cTnT change and post-race skTnI (Spearman's rho = 0.249, p=0.122, rho = 0.285, p=0.074). However, post-race cTnI and change in cTnI were associated with post-race skTnI (rho = 0.404, p=0.01, rho = 0.460, p=0.003) and creatine kinase (r=0.368, p=0.019) concentration. Subjective exertion or self-reported muscle symptoms did not correlate with post-race cTnT, cTnI or skTnI levels. Post-Race cTnT Figure 1 Conclusions Cardiac troponin became abnormal in almost all runners after marathon race. The exercise-induced rise in cardiac troponin I is related to simultaneous release of skeletal troponin I. The mechanism of this association remains uncertain, but clinicians should be cautious when interpreting post-exercise troponin levels without clinical symptoms and signs of myocardial ischemia.

To determine the prevalence of menstrual dysfunction (MD; i.e. oligomenorrhea or amenorrhea) and attitudes towards body weight among athletes and non‐athletes, we studied a cohort of athletes and non‐athletes, in adolescence (14–16 years) and subsequently in young adulthood (18–20 years). We further studied the differences between athletes reporting MD and eumenorrheic athletes at both time periods and identified physical and behavioural characteristicsthat might predict MD in young adulthood. Data were collected using questionnaires, accelerometers, and a pre‐participation screening. In adolescence, the athletes reported current primary amenorrhea more often than the non‐athletes (4.7% vs. 0%, p=0.03). In young adulthood, athletes reported MD more frequently than non‐athletes (38.7% vs. 5.6%, p

Background Marathon running is associated with transient risk of sudden cardiac death and high cardiac troponin levels are common after race. There is limited data whether coronary atherosclerosis or skeletal muscle injury are related to troponin release caused by strenuous exercise. We aimed to assess whether coronary artery calcification (CAC), plaque vulnerability or skeletal muscle injury relate to cardiac troponin T (cTnT) elevations after marathon race. Methods In this observational study, 40 male runners participating in Paavo Nurmi 2018 Marathon were recruited with an open email invitation to evaluate the prevalence of post-race cTnT elevations and their predictors. In addition to baseline and post-race laboratory investigations, 28 runners aged >44 years underwent CAC measurement with computed tomography. Coronary plaque vulnerability was evaluated by free pregnancy-associated plasma protein A (fPAPP-A) concentration and skeletal muscle injury by skeletal troponin I (skTnI) measurement. Results The post-marathon cTnT concentrations rose above the normal reference limit in 38 (95%) participants. A 10-fold increase in skTnI concentrations was observed and elevated post-race values were seen in all participants. The correlation between the post-race cTnT and post-race skTnI (rs = −0.26, p = 0.11) was non-significant. CAC was detected (Agatston score > 0) in 15 (53.6%) participants, with a median score of 2.0 (interquartile range [IQR] 80). There was no correlation between cTnT with CAC score or post-race fPAPP-A levels. Conclusions Asymptomatic cardiac troponin elevations are common after prolonged strenuous exercise, but are not related to markers of coronary atherosclerosis, plaque vulnerability or skeletal muscle injury.

Background Physical activity in adolescence is promoted for its multi-dimensional health benefits. However, too intensive sports participation is associated with an increased injury risk. Our aim was to compare the occurrence of acute and overuse injuries in Finnish sports club members and non-members and to report training and competing habits associated with a higher injury risk in sports club members. Methods In this cross-sectional survey targeted at 14–16-year-old adolescents, a structured questionnaire was completed by 1077 sports club members and 812 non-members. The main outcome measures were self-reported acute and overuse injuries, their location and type. Results At least one acute injury in the past year was reported by 44.0% of sports club members and 19.8% of non-members (P

Introduction: Physical activity (PA) has been suggested to protect against old-age cognitive deficits. However, the independent role of childhood/youth PA for adulthood cognitive performance is unknown. This study investigated the association between PA from childhood to adulthood and midlife cognitive performance. Methods: This study is a part of the Cardiovascular Risk in Young Finns Study. Since 1980, a population-based cohort of 3596 children (age, 3–18 yr) have been followed up in 3- to 9-yr intervals. PA has been queried in all study phases. Cumulative PA was determined in childhood (age, 6–12 yr), adolescence (age, 12–18 yr), young adulthood (age, 18–24 yr), and adulthood (age, 24–37 yr). Cognitive performance was assessed using computerized neuropsychological test, CANTAB (N = 2026; age, 34–49 yr) in 2011. Results: High PA in childhood (A = 0.119; 95% confidence interval [CI], 0.055–0.182) and adolescence (A = 0.125; 95% CI, 0.063–0.188) were associated with better reaction time in midlife independent of PA in other age frames. Additionally, an independent association of high PA in young adulthood with better visual processing and sustained attention in midlife was observed among men (A = 0.101; 95% CI, 0.001–0.200). There were no associations for other cognitive domains. Conclusions: Cumulative exposure to PA from childhood to adulthood was found to be associated with better midlife reaction time. Furthermore, cumulative PA exposure in young adulthood and adulthood was associated with better visual processing and sustained attention in men. All associations were independent of participants PA level in other measured age frames. Therefore, a physically active lifestyle should be adopted already in childhood, adolescence, and young adulthood and continued into midlife to ensure the plausible benefits of PA on midlife cognitive performance. peerReviewed

The aim of this cross-sectional study was to compare mobility and muscle strength in male former elite endurance and power athletes aged 66-91 years (n = 150; 50 men in both former elite athlete groups and in their control group). Agility, dynamic balance, walking speed, chair stand, self-rated balance confidence (ABC-scale), jumping height, and handgrip strength were assessed. Former elite power athletes had better agility performance time than the controls (age- and body mass index, BMI-adjusted mean difference -3.6 s; 95% CI -6.3, -0.8). Adjustment for current leisure time physical activity (LTPA) and prevalence of diseases made this difference non-significant (P = 0.214). The subjects in the power sports group jumped higher than the men in the control group (age- and BMI-adjusted mean differences for vertical squat jump, VSJ 4.4 cm; 95% CI 2.0, 6.8; for countermovement jump, CMJ 4.0 cm; 95% CI 1.7, 6.4). Taking current LTPA and chronic diseases for adjusting process did not improve explorative power of the model. No significant differences between the groups were found in the performances evaluating dynamic balance, walking speed, chair stand, ABC-scale, or handgrip strength. In conclusion, power athletes among the aged former elite sportsmen had greater explosive force production in their lower extremities than the men in the control group.

Background Advanced echocardiographic methods may reveal signs of late anthracycline cardiac toxicity (ACT) even in asymptomatic patients. We studied echocardiographic tissue Doppler imaging (TDI) and velocity vector imaging (VVI) in long-term survivors of childhood acute lymphoblastic leukemia (ALL) before and after an exercise intervention. Methods Twenty-one asymptomatic, anthracycline-treated, long-term childhood ALL survivors with matched controls were studied at baseline. Seventeen of the survivors participated in a 3-month home-based exercise program. Echocardiography with TDI and VVI was performed. Results At baseline, ejection fraction (60.7 ± 4.7% vs. 62.3 ± 3.7%, P = 0.22) and fractional shortening (32.6 ± 3.1% vs. 34.0 ± 2.8%, P = 0.13) were similar in survivors and controls. Lateral early diastolic mitral annulus velocity E′ (32.81 ± 5.71 cm/sec vs. 38.03 ± 6.21 cm/sec, P = 0.01), E′/A′ (1.60 ± 0.48 vs. 2.07 ± 0.63, P = 0.01), and E/E′ (2.78 ± 0.35 vs. 2.42 ± 0.62, P = 0.04) were impaired compared to controls. Peak circumferential strain and strain rate were attenuated at apex (–24.50 ± 3.46% vs. –28.06 ± 4.39%, P = 0.01 and –1.47 ± 0.22 sec–1 vs. –1.68 ± 0.33 sec–1, P = 0.02) compared to controls. After the intervention, early diastolic mitral inflow velocity E (87.76 ± 12.54 cm/s vs. 95.28 ± 10.48 cm/s, P = 0.04) and E′ increased (31.78 ± 5.50 cm/s vs. 34.96 ± 5.41 cm/s, P

This study aimed to identify accelerometer measured daily physical activity patterns and to examine how they associate with health-related physical fitness among 258 participants (mean age 62.4 years, SD 1.0) from the Finnish Retirement and Aging Study. Wrist-worn ActiGraph accelerometer was used and health-related physical fitness measures included body composition, cardiorespiratory fitness and muscular fitness. Based on latent class trajectory analysis, six different patterns of daily physical activity was identified on workdays and two on days off. Having low activity throughout the workday was associated with poorest health-related physical fitness, whereas a combination of low or moderate activity during working hours and increase of activity level in the evening was associated with most favorable body composition and better physical fitness compared to the other trajectories. In conclusion, a large variation in the workday physical activity patterns and health-related physical fitness was observed among aging workers.

BackgroundRetirement is associated with an increase in self-reported daily sedentary time, but no longitudinal evidence exists on how objectively measured sedentary time changes during retirement transition. The aim of this study was to compare objectively measured daily and hourly sedentary time before and after retirement and examine whether these changes differ by gender and occupational status.MethodsThe study population consisted of 478 participants (mean age 63.2 years, standard deviation 1.7, 85% women) from the Finnish Retirement and Aging Study. Sedentary time was measured using a wrist-worn triaxial ActiGraph accelerometer before and after transition to retirement with 1 year interval. Preretirement occupational status was categorized as manual and non-manual.ResultsDaily sedentary time was 8 hours 10 minutes in women and 9 hours 49 minutes in men before retirement. Considering all measurement days before and after retirement, daily sedentary time increased in women by 29 minutes (95% confidence interval [CI]: 20 to 38). Especially women retiring from manual occupations showed marked increase in sedentary time (63 minutes, 95% CI: 50 to 77). When only non-working days before retirement were considered, increase in daily sedentary time among women was less marked (16 minutes, 95% CI: 7 to 25). Among men, daily sedentary time did not change in retirement transition (−7 minutes, 95% CI: −26 to 12).ConclusionsObjectively measured sedentary time increases among women and remains at high level among men during the retirement transition. Attention should be paid to reduce daily sedentary time in retiring women and men.

BackgroundRetirement is a major life transition which may influence health behaviours and time use. Little is known about how sedentary behaviour changes as a result of increased time availability after retirement. The aim of this study was to examine changes in non-occupational sedentary behaviours across the retirement transition. In addition, we examined which preretirement characteristics were associated with these changes.MethodsThe study population consisted of 2011 participants from the Finnish Retirement and Aging Study. Repeated postal survey including questions on sedentary behaviour domains (television viewing, computer use at home, sitting in a vehicle and other sitting) were conducted once a year across the retirement transition, covering on average 3.4 study waves. Linear regression with generalised estimating equations was used for the analyses.ResultsTotal sedentary time increased by 73 (95% CI 66 to 80) min/day during the retirement transition. Of the domain-specific sedentary behaviours, television viewing time increased by 28 (95% CI 25 to 32) min/day, computer use at home by 19 (95% CI 17 to 22) min/day and other sitting time by 37 (95% CI 33 to 41) min/day, while time sitting in a vehicle decreased by 6 (95% CI 4 to 9) min/day. Highest increase in total sedentary time was among women and persons who had high occupational sitting time, low physical activity level, sleep difficulties, mental disorders or poor health before retirement (all p values for interaction ConclusionTotal and domain-specific sedentary time, except sitting in a vehicle, increased during the retirement transition.

ObjectivesTo determine the inter-rater repeatability of a musculoskeletal examination and to compare findings between adolescent athletes and non-athletes in Finland.MethodsIn this cross-sectional study, a musculoskeletal examination assessing posture, mobility and movement control was carried out by a sports and exercise medicine physician on 399 athletes aged 14–17 years and 177 non-athletes. Within 2 weeks another sports and exercise medicine physician repeated the examination for 41 adolescents to test the inter-rater repeatability.ResultsIn total, 10 of the 11 tests performed had at least moderate inter-rater reliability (κ ≥0.4 or percentage agreement >80%). Athletes more often than non-athletes had one shoulder protruded (8.0% vs 4.0%, OR 2.81, 95% CI 1.16 to 6.81). Forty-six per cent of athletes had good knee control in the two-legged vertical drop jump test compared with 32% of non-athletes (OR 1.99, 95% CI 1.29 to 3.06). Athletes had better core muscle control with 86.3% being able to remain in the correct plank position for 30 s compared with 68.6% of non-athletes (OR 2.70, 95% CI 1.67 to 4.36). In the deep squat test, good lumbar spine control was maintained only by 35.8% of athletes and 38.4% of non-athletes.ConclusionA basic musculoskeletal examination is sufficiently reliable to be performed by trained physicians as a part of a periodic health evaluation. Shortfalls in mobility, posture and movement control are common in both athletes and non-athletes. These deficits could have been caused by sedentary behaviour, monotonous training, or both.

The American Heart Association recently defined 7 ideal health behaviors and factors that can be used to monitor ideal cardiovascular health (ICH) over time. These relate to smoking, physical activity, diet, body mass index (BMI), blood pressure, blood glucose and total cholesterol. Associations between repeated measures of ICH across the life-course with outcomes of subclinical atherosclerosis in adult life have not been reported.The sample comprised 1465 children and young adults aged 12 to 24 years (mean age 17.5 years) from the Cardiovascular Risk in Young Finns Study cohort. Participants were followed-up for 21 years since baseline (1986) and had complete ICH data available at baseline and follow-up. Average lifetime ICH index was associated with reduced risk of coronary artery calcification (CAC) (P=0.0004), high-risk carotid intima-media thickness (IMT) (P=0.0005) and high-risk carotid distensibility (0.0001) in middle age. Participants with persistently low ICH status (lower than the median), as compared with persons with persistently high ICH status (higher than the median), had an increased risk of CAC (P=0.02), high-risk IMT (P=0.02), and high-risk distensibility (P0.0001). Participants who improved their ICH status from low to high did not have a different risk of CAC (P=0.90), high-risk IMT (P=0.25), or high-risk distensibility (P=0.80) than participants who always had high ICH status.The results show that ICH can be lost and regained, and importantly that regaining of ICH has a beneficial effect on cardiometabolic health. Health care providers should work to improve health behaviors especially in those who have lost ICH.

This study aims to examine the association between change in physical activity over time and accumulation of cardiometabolic risk factors. Four consecutive surveys (Time 1 to 4) were conducted with 4-year intervals in 1997-2013 (the Finnish Public Sector study). Physical activity of 15,634 cardio-metabolically healthy participants (mean age 43.3 (SD 8.7) years, 85% women) was assessed using four-item survey measure and was expressed as weekly metabolic equivalent (MET) hours in Time 1, 2, and 3. At each time point, participants were categorised into low (= 14 to= 30MET-h/week) activity level and change in physical activity levels between Time 1 and 3 (over 8 years) was determined. The outcome was the number of incident cardiometabolic risk factors (hypertension, dyslipidemia, diabetes, and obesity) at Time 4. Cumulative logistic regression was used for data analysis. Compared to maintenance of low physical activity, increase in physical activity from low baseline activity level was associated with decreased accumulation of cardiometabolic risk factors in a dose-response manner (cumulative odds ratio [cOR]= 0.73, 95% CI 0.59-0.90 for low-to-moderate and cOR= 0.67, 95% CI 0.49-0.89 for low-to-high, P for trend 0.0007). Decrease in physical activity level from high to low was associated with increased accumulation of cardiometabolic risk factors (cOR= 1.60, 95% CI 1.27-2.01) compared to those who remained at high activity level. Thus even a modest long-term increase in physical activity was associated with reduction in cardiometabolic risk whereas decrease in physical activity was related to increased risk.

Correction: Volume44, Issue12 Article Numberzsab211 DOI10.1093/sleep/zsab211 PublishedDEC 2021 Study Objectives: Menopausal transition is associated with increased dissatisfaction with sleep, but the effects on sleep architecture are conflicting. This prospective 6-year follow-up study was designed to evaluate the changes in sleep stages and sleep continuity that occur in women during menopausal transition. Methods: Sixty women (mean age 46.0 years, SD 0.9) participated. All women were premenopausal at baseline, and at the 6-year follow-up, women were in different stages of menopausal transition. Polysomnography was used to study sleep architecture at baseline and follow-up. The effects of aging and menopause (assessed as change in serum follicle-stimulating hormone [S-FSH]) on sleep architecture were evaluated using linear regression models. Results: After controlling for body mass index, vasomotor, and depressive symptoms, aging of 6 years resulted in shorter total sleep time (B -37.4, 95% confidence interval [CI] -71.5 to (-3.3)), lower sleep efficiency (B -6.5, 95% CI -12.7 to (-0.2)), as well as in increased transitions from slow-wave sleep (SWS) to wakefulness (B 1.0, 95% CI 0.1 to 1.9), wake after sleep onset (B 37.7, 95% CI 12.5 to 63.0), awakenings per hour (B 1.8, 95% CI 0.8 to 2.8), and arousal index (B 2.3, 95% CI 0.1 to 4.4). Higher S-FSH concentration in menopausal transition was associated with increased SWS (B 0.09, 95% CI 0.01 to 0.16) after controlling for confounding factors. Conclusions: A significant deterioration in sleep continuity occurs when women age from 46 to 52 years, but change from premenopausal to menopausal state restores some SWS.