Showing papers by "Eva S. Schernhammer published in 2014"
TL;DR: To evaluate associations between sleep duration at midlife and later life and change in sleep duration over time and cognition in older women, a large sample of women in their 40s and 50s were surveyed.
Abstract: Objectives: To evaluate associations between sleep duration at midlife and later life and change in sleep duration over time and cognition in older women.
Design: Participants reported sleep duration in 1986 and 2000, and a subgroup of older participants began cognitive testing in 1995 to 2001; follow-up testing was conducted three times, at 2-year intervals.
Setting: Prospective Nurses' Health Study cohort.
Participants: Female nurses aged 70 and older free of stroke and depression at the initial cognitive assessment (N = 15,385).
Measurements: Validated, telephone-based cognitive battery to measure cognitive function; four repeated assessments over 6 years were averaged to estimate overall cognition at older ages, and trajectories of cognitive change were evaluated over follow up.
Results: Extreme sleep durations in later life were associated with worse average cognition (P < .001 for the quadratic term for a global score averaging all six cognitive tests). For example, women sleeping 5 h/d or less had worse global cognition than those sleeping 7 h/d, as did women sleeping 9 h/d or more; differences were equivalent to nearly 2 additional years of age. Associations were similar, although slightly attenuated, for sleep duration in midlife. Women whose sleep duration changed by 2 h/d or more over time had worse cognition than women with no change in sleep duration (e.g., for the global score, P < .001 for the quadratic term). Sleep duration was not associated with trajectories of cognitive function over 6 years, which might be attributable to short follow-up for detecting cognitive decline.
Conclusion: Extreme sleep durations at midlife and later life and extreme changes in sleep duration over time appear to be associated with poor cognition in older women.
115 citations
TL;DR: This is the first randomized placebo-controlled study among breast cancer survivors to demonstrate that melatonin was associated with an improvement in subjective sleep quality, without any significant adverse effects.
Abstract: The purpose is to examine the effects of melatonin supplementation on sleep, mood, and hot flashes in postmenopausal breast cancer survivors. In a randomized, double-blind, placebo-controlled study, 95 postmenopausal women with a prior history of stage 0–III breast cancer, who had completed active cancer treatment (including hormonal therapy) were randomly assigned 1:1 to either 3 mg oral melatonin (n = 48) or placebo daily (n = 47) for 4 months. Sleep, mood, and hot flashes were assessed at baseline and 4 months via self-administered questionnaire using the Pittsburgh Sleep Quality Index (PSQI), Center for Epidemiologic Studies—Depression (CES-D), and the North Central Cancer Treatment Group (NCCTG) hot flash diary, respectively. Eighty-six women (91 %) completed the study and provided pre- and post-questionnaires. At baseline, 52 % of participants reported poor sleep in the month prior to enrollment. Compared to subjects on placebo, subjects randomized to melatonin experienced significantly greater improvements in subjective sleep quality as measured by the PSQI, including domains on sleep quality, daytime dysfunction and total score. For example, the mean change in PSQI score was −0.1 in the placebo group compared to −1.9 in the melatonin group (p < 0.001). There were no significant differences in measures of depression or hot flashes. Sleep disturbances are common among breast cancer survivors, even after completion of active cancer treatment. This is the first randomized placebo-controlled study among breast cancer survivors to demonstrate that melatonin was associated with an improvement in subjective sleep quality, without any significant adverse effects.
84 citations
TL;DR: Less than 6 hours sleep/day and more than 9 hoursSleep/day are each associated with an increased risk of UC and further studies are needed to evaluate sleep as a modifiable risk factor in the pathogenesis and progression of IBD.
74 citations
TL;DR: Higher alcohol consumption was associated with risk of colorectal cancer with IGF2 DMR0 hypomethylation but not risk of cancer with high-level IGF2DMR0 methylation, and the association of vitamin B-6, Vitamin B-12, methionine, and folate intakes with cancer risk did not significantly differ according to IGF 2 DMR 0 methylation level.
28 citations
TL;DR: Caring for a spouse with a serious chronic illness is associated with a slight but consistent elevation in mortality risk, and living with a person with Parkinson disease 5 years after first Parkinson hospitalization was associated with higher risk of all-cause mortality.
Abstract: Background Caring for a chronically ill spouse is stressful, but the health effects of caregiving are not fully understood. We studied the effect on mortality of being married to a person with Parkinson disease. Methods All patients in Denmark with a first-time hospitalization for Parkinson disease between 1986 and 2009 were identified, and each case was matched to five population controls. We further identified all spouses of those with Parkinson disease (n = 8,515) and also the spouses of controls (n = 43,432). All spouses were followed in nationwide registries until 2011. Results Among men, being married to a Parkinson disease patient was associated with a slightly higher risk of all-cause mortality (hazard ratio = 1.06 [95% confidence interval = 1.00-1.11]). Mortality was particularly high for death due to external causes (1.42 [1.09-1.84]) including suicide (1.89 [1.05-3.42]) and death from undefined symptoms/abnormal findings (1.25 [1.07-1.47]). Censoring at the time of death of the patient attenuated the findings for all-cause mortality in husbands (1.02 [0.95-1.09]), indicating that part of the association is with bereavement. Still, living with a person with Parkinson disease 5 years after first Parkinson hospitalization was associated with higher risk of all-cause mortality for both husbands (1.15 [1.07-1.23]) and wives (1.11 [1.04-1.17]). Conclusions Caring for a spouse with a serious chronic illness is associated with a slight but consistent elevation in mortality risk.
20 citations
TL;DR: 25(OH) vitamin D was not associated with risk of CVD and CHD events, however, vitamin D deficiency may be associated with an increased risk of cerebrovascular events.
Abstract: Context: Evidence suggests an inverse association between circulating 25(OH) vitamin D and cardiovascular disease (CVD). Objective: To determine the association between serum 25(OH) vitamin D and risk for CVD events. Setting and Design: From March 2000 to April 2002, participants were recruited for the Osteoporotic Fractures in Men (MrOS) study. Between December 2003 and March 2005, members of the MrOS cohort were invited to participate in the MrOS Sleep Study. Participants were recruited from 6 clinical centers across the United States and followed for a mean of 5.9 years. Three-thousand-one-hundred-thirty-five men ages 65 and older were included from the MrOS cohort, of whom 116 were excluded for missing vitamin D or CVD data. Participants were divided into two groups based on serum 25(OH) vitamin D levels, <20 ng/mL and ≥20 ng/mL. Participants were followed for CVD endpoints including coronary heart disease (CHD) and cerebrovascular events. Age- and multivariable-adjusted hazard ratios were calculated ...
20 citations
TL;DR: It is suggested that long-term rotating night shift work particularly early in career may be associated with an increased risk of breast cancer, which appears to diminish after nightshift work ceases.
Abstract: Objectives Using two large prospective data sets, we explored associations between rotating nightshift work and breast cancer risk. Method Among 193 396 women from the Nurses’ Health Study (NHS and NHS2) cohorts, we documented 5575 (NHS) and 2869 (NHS2) incident invasive breast cancer cases as well as 696 (NHS) breast cancer deaths over 22 years of follow-up. Compared to our initial analysis within NHS, which was based only on 10 years of follow-up and showed that 30+ years of rotating nightshift work was associated with a 36% significant increase in breast cancer risk, we added 12 years of follow-up, which were accrued for the most part after nurses’ retirement. Results In these extended analyses, 30+ years of rotating night shift work was no longer associated with breast cancer risk (multivariable RR 30+yrs =0.95, 95% CI 0.77–1.17; p trend =0.95), and only insignificantly associated with breast cancer mortality (multivariable HR 30+yrs =1.50, 95% CI, 0.95–2.36). By contrast, in the younger NHS2 cohort, baseline 20+ years of rotating nightshift work was associated with a significantly increased risk of breast cancer (RR 20+yrs =2.11, 95% CI 1.21–3.66; p trend =0.22). Updated rotating night shift work exposure was also associated, albeit non-significantly, with a modest increase in risk of breast cancer (RR 20+yrs =1.33, 95% CI0.93–1.89; p trend =0.68). Conclusions Taken together, these results suggest that long-term rotating night shift work particularly early in career may be associated with an increased risk of breast cancer, which appears to diminish after nightshift work ceases. Future studies are needed to confirm these findings and should explore the potential for tailored risk factor counselling in nightshift workers.
12 citations
TL;DR: Sugar sweetened beverages are the single largest source of calories and added sugars in the US diet and regular consumption has been associated with weight gain and risk of chronic diseases.
Abstract: Background: Sugar sweetened beverages (SSBs) are the single largest source of calories and added sugars in the US diet and regular consumption has been associated with weight gain and risk of chronic diseases. Artificially sweetened beverages (ASBs) are often suggested as alternatives to SSB but little is known about their long-term health effects. Whether consumption of SSBs or ASBs is associated with risk of mortality is unknown. Methods: We prospectively followed 38,602 men from the Health Professional’s Follow-up study (1986-2010) and 82,592 women from the Nurses’ Health study (1980-2010) who were free from cardiovascular disease (CVD) and cancer at baseline. Diet was assessed using validated food frequency questionnaires every 4 years and Cox Proportional Hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI). Results: We documented 27,691 deaths (6,631 CVD and 10,447 cancer deaths) during 3.14 million person-years. After adjusting for major dietary and lifes...
1 citations
TL;DR: Women working rotating night-shifts for more than 15 years had modestly increased colorectal and lungcancer mortality but the increase in lung cancer mortality was largely limited to current smokers and it is possible that these observations remain residually confounded by smoking.
Abstract: Proceedings: AACR Annual Meeting 2014; April 5-9, 2014; San Diego, CA
Rotating night-shift work is common in western societies, but epidemiological studies on shift work and cancer mortality are limited.
In a prospective closed cohort of 74,914 registered US nurses, the Nurses' Health Study, we examined the impact of rotating night-shift work on total-cancer and cancer-specific mortality. Rotating night-shift work was defined as having worked at least 3 nights per month. Cox proportional hazards models adjusting for age, smoking, BMI, and other important confounders, were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
During 22 years of follow-up, we documented 5,123 cancer deaths. Overall, we observed no association between rotating night-shift work and total-cancer mortality (HR15+years=1.07; 95% CI, 0.97-1.19; Ptrend=0.17). However, women with 15 or more years of night-shift work had a significant increase in lung cancer mortality (multivariable HR=1.25; 95% CI, 1.04-1.50) and a borderline significant increase in colorectal cancer mortality (MV HR=1.32; 95% CI, 0.97-1.81). The increase in lung cancer mortality was limited to current smokers. We observed no increase in breast cancer mortality (HR15+years=1.03; 95%CI, 0.76-1.38; Ptrend=0.97). For cancers with fewer than 200 deaths, we observed a non-significant increase in mortality from kidney cancer, myeloma and leukemia among women with 6-14 and 15+ years of rotating night-shift work: the HRs were 1.58 (95% CI, 0.92-2.71) and 1.36 (95% CI, 0.72-2.56) for kidney cancer, 1.66 (95% CI, 0.98-2.81) and 1.47 (95% CI, 0.79-2.77) for myeloma, 1.25 (95% CI, 0.70-2.23) and 1.53 (95% CI, 0.83-2.83) for leukemia, respectively.
We conclude that after adjusting for important confounders, the impact of rotating night-shift work on cancer mortality appears modest. Women working rotating night-shifts for more than 15 years had modestly increased colorectal and lung cancer mortality but the increase in lung cancer mortality was largely limited to current smokers and it is possible that these observations remain residually confounded by smoking. Additional studies are warranted to confirm our findings.
Citation Format: Fangyi Gu, Jiali Han, Sue Hankinson, Eva Schernhammer, Nurses' Health Study Group. Rotating night shift work and cancer mortality in the nurses' health study. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2178. doi:10.1158/1538-7445.AM2014-2178
1 citations
01 Jan 2014
TL;DR: A comprehensive review of epidemiologic studies, both retrospective and prospective, on a worldwide basis, examining the association of shift work with cancer, particularly breast and prostate cancer are provided.
Abstract: Experimental data has consistently demonstrated that disruption of circadian rhythm can promote carcinogenesis in animal models, and epidemiologic data continues to accumulate indicating that disrupting circadian rhythm by shift work increases the risk of cancer in humans. In this chapter, we provide a comprehensive review of epidemiologic studies, both retrospective and prospective, on a worldwide basis, examining the association of shift work with cancer, particularly breast and prostate cancer. We also provide information on the relation of shift work to colorectal, endometrial, lung, skin, and bladder cancer. Also discussed are issues surrounding the relation of shift work to weight gain and obesity and the possibility that obesity may mediate the effect of shift work on cancer.