Objective: The recent obesity epidemic has been accompanied by a parallel growth in chronic sleep deprivation. Physiologic studies suggest sleep deprivation may influence weight through effects on appetite, physical activity, and/or thermoregulation. This work reviews the literature regarding short sleep duration as an independent risk factor for obesity and weight gain.

Short sleep duration and weight gain : a systematic review

https://link.springer.com/content/pdf/10.1007%2Fs13311-012-0145-6.pdf

Classification of Sleep Disorders

To evaluate the quality of available evidence on the effects of environmental noise exposure on sleep a systematic review was conducted. The databases PSYCINFO, PubMed, Science Direct, Scopus, Web of Science and the TNO Repository were searched for non-laboratory studies on the effects of environmental noise on sleep with measured or predicted noise levels and published in or after the year 2000. The quality of the evidence was assessed using GRADE criteria. Seventy four studies predominately conducted between 2000 and 2015 were included in the review. A meta-analysis of surveys linking road, rail, and aircraft noise exposure to self-reports of sleep disturbance was conducted. The odds ratio for the percent highly sleep disturbed for a 10 dB increase in Lnight was significant for aircraft (1.94; 95% CI 1.61–2.3), road (2.13; 95% CI 1.82–2.48), and rail (3.06; 95% CI 2.38–3.93) noise when the question referred to noise, but non-significant for aircraft (1.17; 95% CI 0.54–2.53), road (1.09; 95% CI 0.94–1.27), and rail (1.27; 95% CI 0.89–1.81) noise when the question did not refer to noise. A pooled analysis of polysomnographic studies on the acute effects of transportation noise on sleep was also conducted and the unadjusted odds ratio for the probability of awakening for a 10 dBA increase in the indoor Lmax was significant for aircraft (1.35; 95% CI 1.22–1.50), road (1.36; 95% CI 1.19–1.55), and rail (1.35; 95% CI 1.21–1.52) noise. Due to a limited number of studies and the use of different outcome measures, a narrative review only was conducted for motility, cardiac and blood pressure outcomes, and for children’s sleep. The effect of wind turbine and hospital noise on sleep was also assessed. Based on the available evidence, transportation noise affects objectively measured sleep physiology and subjectively assessed sleep disturbance in adults. For other outcome measures and noise sources the examined evidence was conflicting or only emerging. According to GRADE criteria, the quality of the evidence was moderate for cortical awakenings and self-reported sleep disturbance (for questions that referred to noise) induced by traffic noise, low for motility measures of traffic noise induced sleep disturbance, and very low for all other noise sources and investigated sleep outcomes.

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Effects on Sleep.

In the past few decades, several devastating heat wave events have significantly challenged public health. As these events are projected to increase in both severity and frequency in the future, it is important to assess the relationship between heat waves and the health indicators that can be used in the early warning systems to guide the public health response. Yet there is a knowledge gap in the impact of heat waves on morbidity. In this study, a comprehensive review was conducted to assess the relationship between heat waves and different morbidity indicators, and to identify the vulnerable populations. The PubMed and ScienceDirect database were used to retrieve published literature in English from 1985 to 2014 on the relationship between heat waves and morbidity, and the following MeSH terms and keywords were used: heat wave, heat wave, morbidity, hospital admission, hospitalization, emergency call, emergency medical services, and outpatient visit. Thirty-three studies were included in the final analysis. Most studies found a short-term negative health impact of heat waves on morbidity. The elderly, children, and males were more vulnerable during heat waves, and the medical care demand increased for those with existing chronic diseases. Some social factors, such as lower socioeconomic status, can contribute to heat-susceptibility. In terms of study methods and heat wave definitions, there remain inconsistencies and uncertainties. Relevant policies and guidelines need to be developed to protect vulnerable populations. Morbidity indicators should be adopted in heat wave early warning systems in order to guide the effective implementation of public health actions.

/pdf/heat-waves-and-morbidity-current-knowledge-and-further-1q7vz3xtcj.pdf

Heat Waves and Morbidity: Current Knowledge and Further Direction-A Comprehensive Literature Review

Objectives
This review assessed the confounding effect of one traffic-related exposure (noise or air pollutants) on the association between the other exposure and cardiovascular outcomes.

/pdf/cardiovascular-health-traffic-related-air-pollution-and-17eep5rx0a.pdf

Cardiovascular health, traffic-related air pollution and noise: are associations mutually confounded? A systematic review

Noise exposure generated by air traffic has been linked with sleep disturbances. The purpose of this systematic review is to clarify whether there is a causal link between aircraft noise exposure and sleep disturbances. Only complete, peer-reviewed articles published in scientific journals were examined. Papers published until December 2010 were considered. To be included, articles had to focus on subjects aged 18 or over and include an objective evaluation of noise levels. Studies were classified according to quality. Given the paucity of studies with comparable outcome measures, we performed a narrative synthesis using a best-evidence synthesis approach. The primary study findings were tabulated. Similarities and differences between studies were investigated. Of the 12 studies surveyed that dealt with sleep disturbances, four were considered to be of high quality, five were considered to be of moderate quality and three were considered to be of low quality. All moderate- to high-quality studies showed a link between aircraft noise events and sleep disturbances such as awakenings, decreased slow wave sleep time or the use of sleep medication. This review suggests that there is a causal relation between exposure to aircraft noise and sleep disturbances. However, the evidence comes mostly from experimental studies focusing on healthy adults. Further studies are necessary to determine the impact of aircraft noise on sleep disturbance for individuals more than 65 years old and for those with chronic diseases.

Review of the effect of aircraft noise on sleep disturbance in adults

OBJECTIVES: The objective of this paper is to describe Montreal’s heat response plan and its application during the July 2010 heat wave. PARTICIPANTS AND SETTING: The Montreal heat response plan is designed to ensure the surveillance of weather and health indicators during the summer season and to coordinate actions to be undertaken during this period to reduce morbidity and mortality due to heat, particularly when weather thresholds are reached or an increase in health indicators is observed. It was developed to coordinate and apply intervention measures on the Island of Montreal and has been in effect since 2004. INTERVENTION: In the beginning of July 2010, Montreal experienced a heat wave that lasted 5 days. During this period, health indicators such as total mortality, prehospital emergency transports, calls to the health information line and hospital admissions were monitored by the Montreal public health surveillance system. The decision to implement emergency interventions and actions performed by regional and local public health and municipal partners (intervention level) was made following attainment of a predetermined weather threshold and increases in health indicators. The significant increase in daily observed mortality from all causes and in particular people dying at home or in the community prompted the Director of public health to conduct a chart review of all people deceased from July 5 to July 11, 2010 to determine cause of death and underlying health conditions. OUTCOME: During the heat wave, there were 304 reported deaths from all causes in Montreal residents, of which 106 were probably or possibly heatrelated. Major underlying health conditions in heat-related deaths included cardiovascular problems and mental health illness. Furthermore, in the case of people with mental illness who died during the heat wave, the chart review revealed that many were contacted 24 hours prior to their death by health care professionals, family members, neighbours or friends. CONCLUSION: Following the 2010 heat wave, the Montreal heat response plan and heat surveillance system were updated to include initiatives to better communicate preventive measures to the vulnerable populations and to intervene earlier during a heat wave.

/pdf/implementation-of-the-montreal-heat-response-plan-during-the-1j2q1h0df5.pdf

Implementation of the Montreal heat response plan during the 2010 heat wave.

OBJECTIVE: Estimate the number of awakenings additional to spontaneous awakenings, induced by the nighttime aircraft movements at an international airport in Montreal, in the population residing nearby in 2009. METHODS: Maximum sound levels (L AS,max ) were derived from aircraft movements using the Integrated Noise Model 7.0b, on a 28 x 28 km grid centred on the airport and with a 0.1 x 0.1 km resolution. Outdoor L AS,max were converted to indoor L AS,max by reducing noise levels by 15 dB(A) or 21 dB(A). For all grid points, L AS,max were transformed into probabilities of additional awakening using a function developed by Basner et al. (2006). The probabilities of additional awakening were linked to estimated numbers of exposed residents for each grid location to assess the number of aircraft-noise-induced awakenings in Montreal. RESULTS: Using a 15 dB(A) sound attenuation, 590 persons would, on average, have one or more additional awakenings per night for the year 2009. In the scenario using a 21 dB(A) sound attenuation, on average, no one would be subjected to one or more additional awakenings per night due to aircraft noise. CONCLUSION: Using the 2009 flight patterns, our data suggest that a small number of Montreal residents are exposed to noise levels that could induce one or more awakenings additional to spontaneous awakenings per night.

Risk assessment of aircraft noise on sleep in Montreal.

Commentary on the Tétreault et Al. 2012 Article "Risk Assessment of Aircraft Noise on Sleep in Montreal"/Authors' Response to Boivin and Savard Commentary

Risk estimates are frequently used in public health practice to guide authorities responsible for adopting policies that protect public health. There are uncertainties in all risk estimates, most of which do not invalidate their conclusions. Boivin and Savard point out that the flight trajectories used to estimate night-time noise levels are imprecise. As stated in the methods section of our article, we used five potential aerial trajec-tories to account for variations associated with winds, pilot habits, air traffic control, etc. This methodology is used worldwide and supported by institutions like the European Civil Aviation Conference. 1 Furthermore, to obtain an idea of the imprecision associated with the flight trajectories, we estimated how the sleep disturbance probabilities varied for the five trajectories. The mean difference between the trajectories was less than 10% additional or fewer awakenings per night. This suggests that while the use of precise trajectories would definitely be preferable to modeled trajecto-ries, the imprecision associated with modeled trajectories is low. Boivin and Savard also question the methodology used to assess the number of individuals exposed to aircraft noise that could generate one or more awakenings per night. As mentioned in the discussion and in the conclusion of our paper, we agree that our analysis only roughly estimates the number of individuals exposed. Yet, in order to quantify the magnitude of the imprecision, we revised our analysis to remove the number of residences built in 2009 and afterwards and used the 2011 census data. This new analysis modified our original results by 0.1%. In our discussion, we stated the limits to the external and internal validity of the function developed by Basner et al. 2 Thus, we agree with the limitations mentioned by the authors of the commentary. However, we disagree with their interpretation of these limitations. As presented in the article, the risk function could overestimate or underestimate the number of awakenings generated by aircraft noise. It is true that the subjects from whom the function was generated were more annoyed by aircraft noise than the general population, but not all individuals of the general population are exposed to aircraft noise. The subjects studied by Basner et al. are more likely to be representative of the population regularly exposed to aircraft noise. Furthermore, it is worth noting that Bas-ner's function curve was used in other locations in Europe. 3 The authors also claim that the noise attenuations used are …

/pdf/authors-response-to-boivin-and-savard-commentary-55jm8gn1zh.pdf

Norman King

Papers

Review of the effect of aircraft noise on sleep disturbance in adults

Implementation of the Montreal heat response plan during the 2010 heat wave.

Risk assessment of aircraft noise on sleep in Montreal.

Commentary on the Tétreault et Al. 2012 Article "Risk Assessment of Aircraft Noise on Sleep in Montreal"/Authors' Response to Boivin and Savard Commentary

Authors' response to Boivin and Savard commentary.