Predictors of slow-wave sleep in a clinic-based sample
Open accessAbstract
Slow-wave sleep has been associated with several physiological phenomena, including glucose metabolism, sympathetic nervous system activity, hormonal secretion and blood pressure regulation. The aim of these analyses was to determine which sociodemographic and medical factors were associated with slow-wave sleep duration in a large clinical sample. We conducted cross-sectional analysis of clinical data from 1019 consecutive adults over a 10-month period who had their first in-laboratory polysomnogram for suspicion of obstructive sleep apnea. Patients either underwent in-laboratory full-night polysomnogram followed by full-night continuous positive airway pressure titration or split-night polysomnogram. Patients also completed questionnaires to assess race, education, marital status and medical co-morbidities. A multiple linear regression model that predicted the natural log of slow-wave sleep in minutes indicated that African Americans had approximately 48% less slow-wave sleep than non-African Americans. Increasing age and male gender were also associated with less slow-wave sleep. Overweight and obese individuals had significantly less slow-wave sleep than those not overweight, even after adjustment for obstructive sleep apnea severity. Finally, those with severe obstructive sleep apnea had significantly less slow-wave sleep than those with less severe obstructive sleep apnea even after adjustment for obesity. Results remained unchanged when patients who had a split-night polysomnogram were excluded. We observed less slow-wave sleep in African Americans, a group at increased risk of diabetes and hypertension compared with Caucasians, and in those who are overweight and obese and those with severe obstructive sleep apnea. Future research needs to explore potential reasons for reduced slow-wave sleep in these individuals.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Blacks/African-Americans obtained less Slow Wave Sleep than Non-Hispanic Whites.
“Blacks/African-Americans also obtained less Slow Wave Sleep. Other studies have also found that Blacks/African-Americans obtained less Slow Wave Sleep(215-219)”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [216]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale
Johns, M. W. (1991) · Sleep · doi:10.1093/sleep/14.6.540 · Cited by 17,364 · see citing works
(2007) · Cited by 6,530 · see citing works
Impact of sleep debt on metabolic and endocrine function
Spiegel, K., Leproult, R., & Van Cauter, E. (1999) · The Lancet · doi:10.1016/s0140-6736(99)01376-8 · Cited by 3,668 · see citing works
Van Dongen, H. P. A., Maislin, G., Mullington, J. M., & Dinges, D. F. (2003) · Sleep · doi:10.1093/sleep/26.2.117 · Cited by 3,173 · see citing works
Reliability and factor analysis of the Epworth Sleepiness Scale.
Johns, M. (1992) · Sleep · doi:10.1093/sleep/15.4.376 · Cited by 2,193 · see citing works
Meta-Analysis of Short Sleep Duration and Obesity in Children and Adults
Cappuccio, F. P., Taggart, F. M., Kandala, N.-B., Currie, A., Peile, E., Stranges, S., & Miller, M. A. (2008) · Sleep · doi:10.1093/sleep/31.5.619 · Cited by 2,076 · see citing works
Sympathetic-Nerve Activity during Sleep in Normal Subjects
Somers, V. K., Dyken, M. E., Mark, A. L., & Abboud, F. M. (1993) · New England Journal of Medicine · doi:10.1056/nejm199302043280502 · Cited by 1,574 · see citing works
Self-Reported and Measured Sleep Duration: How Similar Are They?
Lauderdale, D. S., Knutson, K. L., Yan, L. L., Liu, K., & Rathouz, P. J. (2008) · Epidemiology · doi:10.1097/ede.0b013e318187a7b0 · Cited by 1,565 · see citing works
Self-citationSlow-wave sleep and the risk of type 2 diabetes in humans
Tasali, E., Leproult, R., Ehrmann, D. A., & Van Cauter, E. (2008) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0706446105 · Cited by 921 · see citing works
Van Cauter, E. (2000) · JAMA · doi:10.1001/jama.284.7.861 · Cited by 773 · see citing works
The effects of age, sex, ethnicity, and sleep-disordered breathing on sleep architecture
Redline, S., Kirchner, H. L., Quan, S. F., Gottlieb, D. J., Kapur, V., & Newman, A. (2004) · Archives of Internal Medicine · doi:10.1001/archinte.164.4.406 · Cited by 732 · see citing works
Sympathetic Nervous System Overactivity and Its Role in the Development of Cardiovascular Disease
Malpas, S. C. (2010) · Physiological Reviews · doi:10.1152/physrev.00007.2009 · Cited by 696 · see citing works
Effects of Sleep Fragmentation on Glucose Metabolism in Normal Subjects
Stamatakis, K. A., & Punjabi, N. M. (2010) · Chest · doi:10.1378/chest.09-0791 · Cited by 614 · see citing works
Predictive Role of the Nighttime Blood Pressure
Hansen, T. W., Li, Y., Boggia, J., Thijs, L., Richart, T., & Staessen, J. A. (2011) · Hypertension · doi:10.1161/hypertensionaha.109.133900 · Cited by 597 · see citing works
Beccuti, G., & Pannain, S. (2011) · Current Opinion in Clinical Nutrition and Metabolic Care · doi:10.1097/mco.0b013e3283479109 · Cited by 507 · see citing works
Fagard, R. H., Thijs, L., Staessen, J. A., Clement, D. L., De Buyzere, M. L., & De Bacquer, D. A. (2009) · Journal of Human Hypertension · doi:10.1038/jhh.2009.9 · Cited by 324 · see citing works
Influence of race and socioeconomic status on sleep: Pittsburgh SleepSCORE project
Mezick, E. J., Matthews, K. A., Hall, M., Strollo, P. J., Buysse, D. J., Kamarck, T. W., Owens, J. F., & Reis, S. E. (2008) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31816fdf21 · Cited by 321 · see citing works
Sleep and morningness‐eveningness in the ‘middle’ years of life (20–59y)
CARRIER, J., MONK, T. H., BUYSSE, D. J., & KUPFER, D. J. (1997) · Journal of Sleep Research · doi:10.1111/j.1365-2869.1997.00230.x · Cited by 303 · see citing works
Nighttime blood pressure dipping: the role of the sympathetic nervous system
Sherwood, A., Steffen, P. R., Blumenthal, J. A., Kuhn, C. M., & Hinderliter, A. L. (2002) · American Journal of Hypertension · doi:10.1016/s0895-7061(01)02251-8 · Cited by 289 · see citing works
SYMPATHETIC MUSCLE NERVE ACTIVITY DURING SLEEP IN MAN
Hornyak, M., Cejnar, M., Elam, M., Matousek, M., & Wallin, B. G. (1991) · Brain · doi:10.1093/brain/114.3.1281 · Cited by 283 · see citing works
Sex Differences in the Sleep EEG of Young Adults: Visual Scoring and Spectral Analysis
Dijk, D., Beersma, D. G. M., & Bloem, G. M. (1989) · SLEEP · doi:10.1093/sleep/12.6.500 · Cited by 206 · see citing works
Iber, C., Redline, S. S., Gilpin, A. M. K., Quan, S. F., Zhang, L., Gottlieb, D. J., Rapoport, D. M., Resnick, H. E., SANDERS, M. H., & Smith, P. L. (2004) · SLEEP · doi:10.1093/sleep/27.3.536 · Cited by 194 · see citing works
Sleep Quality and Blood Pressure Dipping in Normal Adults
Loredo, J. S., Nelesen, R. A., Ancoli‐Israel, S., & Dimsdale, J. E. (2004) · SLEEP · doi:10.1093/sleep/27.6.1097 · Cited by 167 · see citing works
Quan, S. F., Griswold, M. E., Iber, C., Nieto, F. J., Rapoport, D. M., Redline, S. S., SANDERS, M. H., & Young, T. B. (2002) · SLEEP · doi:10.1093/sleep/25.8.8 · Cited by 130 · see citing works
Association Between Sleep Architecture and Measures of Body Composition
Rao, M. N., Blackwell, T., Redline, S., Stefanick, M. L., Ancoli-Israel, S., Stone, K. L., & for the Osteoporotic Fractures in Men (MrOS) Study Group (2009) · Sleep · doi:10.1093/sleep/32.4.483 · Cited by 118 · see citing works
Routledge, F. S., & McFetridge-Durdle, J. (2007) · European Journal of Cardiovascular Nursing · doi:10.1016/j.ejcnurse.2006.05.001 · Cited by 105 · see citing works
Slow Wave Sleep Drives Inhibition of Pituitary‐AdrenalSecretion in Humans
Bierwolf, C., Struve, K., Marshall, L., Born, J., & Fehm, H. L. (1997) · Journal of Neuroendocrinology · doi:10.1046/j.1365-2826.1997.00605.x · Cited by 104 · see citing works
Associations between Short Sleep Duration and Central Obesity in Women
Theorell-Haglöw, J., Berne, C., Janson, C., Sahlin, C., & Lindberg, E. (2010) · Sleep · doi:10.1093/sleep/33.5.593 · Cited by 102 · see citing works
Blood Pressure Dipping and Sleep Disturbance in African-American and Caucasian Men and Women
Matthews, K. A., Kamarck, T. W., Hall, M. H., Strollo, P. J., Owens, J. F., Buysse, D. J., Lee, L., & Reís, S. E. (2008) · American Journal of Hypertension · doi:10.1038/ajh.2008.183 · Cited by 96 · see citing works
Associations between short sleep duration and central obesity in women.
Theorell‐Haglöw, J., Berne, C., Janson, C., Sahlin, C., & Lindberg, E. (2010) · Europe PMC (PubMed Central) · Cited by 95 · see citing works
Sleep Homeostasis During Repeated Sleep Restriction and Recovery: Support from EEG Dynamics
Åkerstedt, T., Kecklund, G., Ingre, M., Lekander, M., & Axelsson, J. (2009) · SLEEP · doi:10.1093/sleep/32.2.217 · Cited by 90 · see citing works
Are there ethnic differences in sleep architecture?
Profant, J., Ancoli‐Israel, S., & Dimsdale, J. E. (2002) · American Journal of Human Biology · doi:10.1002/ajhb.10032 · Cited by 87 · see citing works
The Metabolic Syndrome in African Americans: a review.
Hall, W. D., Clark, L. T., Wenger, N. K., Wright, J. T., Kumanyika, S., Watson, K. E., Horton, E. W., Flack, J. M., Ferdinand, K. C., Gavin, J. R., et al. (2003) · PubMed · Cited by 78 · see citing works
Tan, X., Campbell, I. G., & Feinberg, I. (2001) · Clinical Neurophysiology · doi:10.1016/s1388-2457(01)00570-3 · Cited by 72 · see citing works
Effect of Ethnicity on Sleep: Complexities for Epidemiologic Research
Stepnowsky, C. J., Moore, P., & Dimsdale, J. E. (2003) · SLEEP · doi:10.1093/sleep/26.3.329 · Cited by 70 · see citing works
Phasic electromyographic activity of the genioglossus increases in normals during slow-wave sleep
Basner, R. C., Ringler, J., Schwartzstein, R. M., Weinberger, S. E., & Weiss, J. W. (1991) · Respiration Physiology · doi:10.1016/0034-5687(91)90028-h · Cited by 67 · see citing works
The Effect of Race and Sleep-Disordered Breathing on Nocturnal BP “Dipping”
Ancoli‐Israel, S., Stepnowsky, C. J., Dimsdale, J. E., Marler, M., Cohen‐Zion, M., & Johnson, S. (2002) · CHEST Journal · doi:10.1378/chest.122.4.1148 · Cited by 66 · see citing works
Childhood Socioeconomic Status and Race Are Associated With Adult Sleep
Tomfohr‐Madsen, L. M., Ancoli‐Israel, S., & Dimsdale, J. E. (2010) · Behavioral Sleep Medicine · doi:10.1080/15402002.2010.509236 · Cited by 51 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Sleep disparity, race/ethnicity, and socioeconomic position
Grandner, M. A., Williams, N. J., Knutson, K. L., Roberts, D., & Jean-Louis, G. (2016) · Sleep Medicine · doi:10.1016/j.sleep.2015.01.020 · Cited by 481 · see citing works
Knutson, K. L. (2013) · Social Science & Medicine · doi:10.1016/j.socscimed.2012.05.002 · Cited by 228 · see citing works
Self-citationSleep: important considerations for the prevention of cardiovascular disease
Grandner, M. A., Alfonso-Miller, P., Fernandez-Mendoza, J., Shetty, S., Shenoy, S., & Combs, D. (2016) · Current Opinion in Cardiology · doi:10.1097/hco.0000000000000324 · Cited by 166 · see citing works
Self‐reported sleep disturbance is associated with Alzheimer's disease risk in men
Benedict, C., Byberg, L., Cedernaes, J., Hogenkamp, P. S., Giedratis, V., Kilander, L., Lind, L., Lannfelt, L., & Schiöth, H. B. (2014) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2014.08.104 · Cited by 160 · see citing works
Lempel-Ziv complexity of cortical activity during sleep and waking in rats
Abásolo, D., Simons, S., da Silva, R. M., Tononi, G., & Vyazovskiy, V. V. (2015) · Journal of Neurophysiology · doi:10.1152/jn.00575.2014 · Cited by 108 · see citing works
Determinants of racial/ethnic disparities in disordered sleep and obesity
Jackson, C. L. (2017) · Sleep Health · doi:10.1016/j.sleh.2017.08.001 · Cited by 62 · see citing works
Baker, F. C., Willoughby, A. R., Massimiliano, D. Z., Franzen, P. L., Prouty, D., Javitz, H., Hasler, B., Clark, D. B., & Colrain, I. M. (2016) · SLEEP · doi:10.5665/sleep.5978 · Cited by 61 · see citing works
Rutters, F., Gonnissen, H. K., Hursel, R., Lemmens, S. G., Martens, E. A., & Westerterp-Plantenga, M. S. (2012) · International Journal of Obesity · doi:10.1038/ijo.2011.250 · Cited by 54 · see citing works
African Genetic Ancestry is Associated with Sleep Depth in Older African Americans
Halder, I., Matthews, K. A., Buysse, D. J., Strollo, P. J., Causer, V., Reís, S. E., & Hall, M. H. (2015) · SLEEP · doi:10.5665/sleep.4888 · Cited by 40 · see citing works
Gender differences of clinical and polysomnographic findings with obstructive sleep apnea syndrome
Zhou, X., Zhou, B., Li, Z., Qiao, L., Li, S., Pu, Z., & Luo, F. (2021) · Scientific Reports · doi:10.1038/s41598-021-85558-y · Cited by 38 · see citing works
Chung, J., Goodman, M. O., Huang, T., Wallace, M. L., Johnson, D. A., Bertisch, S. M., & Redline, S. S. (2021) · American Journal of Epidemiology · doi:10.1093/aje/kwab232 · Cited by 27 · see citing works
George, K. M., Peterson, R. L., Gilsanz, P., Mungas, D., Glymour, M. M., Mayeda, E. R., & Whitmer, R. A. (2020) · Ethnicity & Disease · doi:10.18865/ed.30.3.469 · Cited by 28 · see citing works
Kianersi, S., Redline, S. S., Mongraw‐Chaffin, M., & Huang, T. (2023) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad229 · Cited by 21 · see citing works
Intermittent nocturnal hypoxia and metabolic risk in obese adolescents with obstructive sleep apnea
Narang, I., McCrindle, B. W., Manlhiot, C., Lu, Z., Al‐Saleh, S., Birken, C. S., & Hamilton, J. K. (2018) · Sleep And Breathing · doi:10.1007/s11325-018-1631-9 · Cited by 21 · see citing works
Disturbed Sleep as a Mechanism of Race Differences in Nocturnal Blood Pressure Non-Dipping
Bowman, M. A., Buysse, D. J., Foust, J. E., Oyefusi, V., & Hall, M. H. (2019) · Current Hypertension Reports · doi:10.1007/s11906-019-0954-7 · Cited by 17 · see citing works
Taporoski, T. P., Beijamini, F., Alexandria, S. J., Aaby, D., von Schantz, M., Pereira, A. C., & Knutson, K. L. (2024) · Journal of Sleep Research · doi:10.1111/jsr.14154 · Cited by 15 · see citing works
Brindle, R. C., Duggan, K. A., Cribbet, M. R., Kline, C. E., Krafty, R. T., Thayer, J. F., Mulukutla, S. R., & Hall, M. H. (2018) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000560 · Cited by 13 · see citing works
Differences in sleep architecture according to body mass index in children with type 1 diabetes
Elrokhsi, S. H., Bluez, G., Chin, C. N., Wheeler, M. D., Silva, G. E., & Perfect, M. M. (2019) · Pediatric Diabetes · doi:10.1111/pedi.12918 · Cited by 9 · see citing works
Neighborhood Stress Predicts Fear of Sleep Independently of Posttraumatic Stress Disorder
Poindexter, M., Stokes, A., & Mellman, T. A. (2022) · Behavioral Sleep Medicine · doi:10.1080/15402002.2022.2067162 · Cited by 6 · see citing works
Determinants and health consequences of modifiable sleep health disparities
Jackson, C. L. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-815501-1.00014-4 · Cited by 3 · see citing works
Sleep Disturbances in Type 1 Diabetes and Mitigating Cardiovascular Risk
Irsheed, G. A., Martyn-Nemeth, P. A., Baron, K. G., & Reutrakul, S. (2024) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgae539 · Cited by 4 · see citing works
Effects of Sleep Deprivation and Sleepiness on Society and Driving
Grandner, M. A., & Mian, R. (2017) · Springer eBooks · doi:10.1007/978-1-4939-6578-6_4 · Cited by 3 · see citing works
Multidimensional Sleep Health: Concepts, Advances, and Implications for Research and InterventionPreprint
Chung, J., Goodman, M. O., Huang, T., Bertisch, S. M., & Redline, S. S. (2021) · medRxiv · doi:10.1101/2021.04.20.21255799 · Cited by 2 · see citing works
Obstrüktif Uyku Apnesinde Apne ve Hipopne İçeriğindeki Cinsiyet Farkı
Yüceege, M., Fırat, H., Ardiç, S., & Demır, A. U. (2014) · Journal of Turkish Sleep Medicine · doi:10.4274/jtsm.03 · Cited by 1 · see citing works
From apnea and insomnia in Iceland to season and slow wave sleep
Dijk, D. (2012) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2012.01014.x · Cited by 1 · see citing works
Consequences of Chronic Sleep Restriction on Energy Balance in Healthy Adults
Spaeth, A. M. (2014) · ScholarlyCommons (University of Pennsylvania)
Xia, N., Wang, H., Zhang, L., Fan, X.-J., & Nie, X. (2023) · Blood Pressure · doi:10.1080/08037051.2023.2195009
Janevic, M. R., Quinn, M., Cheng, P., Whibley, D., Hopson, J., Nkemere, L., Lindsay, R., & Wisdom, K. (2026) · Journal of Applied Gerontology · doi:10.1177/07334648261466707
- Authors
- MOKHLESI, B., PANNAIN, S., GHODS, F., & KNUTSON, K. L.
- Affiliations
- University of Chicago (US)
- Corresponding author
- KNUTSON, KRISTEN L.
- Venue
- Journal of Sleep Research
- Publisher
- Wiley
- Published
- 2011-09-28
- Volume
- 21
- Issue
- 2
- Pages
- 170-175
- ISSN
- 0962-1105 (ISSN-L)
- 1365-2869
- PMC
- PMC3321544
- OpenAlex
- W1932430239
- Cited by
- 28
- References
- 39
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 4 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 2 · 2016: 2 · 2015: 3 · 2014: 3 · 2012: 3
- FWCI
- 2.47
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Sleep Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (P30HL101859)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- slow-wave sleep, obstructive sleep apnea, African Americans, racial disparities, obesity, overweight, age and sex differences, sleep apnea severity, diabetes risk, hypertension risk, polysomnography
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Black or African American, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Sex Factors, Sleep, Time Factors, Linear Models, Polysomnography, White People, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
