Link to Media Story: http://www.cbsnews.com/8301-504763_162-20012475-10391704.html
Summary of Media Story
This brief news story reports that seven hours is the optimal time for adults to sleep to avoid increasing risk of heart disease. The article also notes that sleeping either shorter than 7 hours or longer than 9 hours on a regular basis resulted in an increased risk of cardiovascular disease (CVD). The authors of the reported study claimed that the increased risk existed even after correcting for factors such as age, sex, race, ethnicity, smoking, and alcohol intake.
According to the report, regularly sleeping less than five hours a day including naps doubled the risk of heart disease , while sleeping more than nine hours a day resulted in 150% of the risk of heart disease as sleeping 7 hours a day. Although the study authors did not claim to be able to explain why they got these results, they did suggest that discussing sleep habits with your doctor was a good idea.
The focus of this article was on a single element of the cited study, the number of hours of sleep that minimized the risk of CVD. All other aspects of the study were ignored in this article.
Critique of Study as Reported in Media
This story presented limited details about the study under question., including a link to the original study being described (Sabanayagam & Shankar, 2010). They also described the number of participants in the study (>30,000), all healthy at the start of the study, but did not specify the duration of monitoring the participants, nor whether the data were corrected for other existing co-morbidities.
The results as reported seem reasonable, but it’s hard to tell solely from the article itself. For example, the article author did not describe the sampling method for the study, nor describe the methodology of the study. Thus, study limitations are almost impossible to determine based on this brief report, except for noting that the study authors do not have an explanation for why the association between sleep and CVD.
Another key problem in this article is that it does not specify the absolute magnitude of the increased risk. For example, if for every 1000 people sleeping 7 hours a night, 100 develop CVD (a made-up number), doubling that to 200 or increasing it to 150 is a significant increase. But if for every 1000 people sleeping 7 hours a night only 2 people develop CVD, doubling that to 4 or increasing it to 3 is far less significant. This lack of absolute risk assessment is a serious drawback to the article report. A solution would be to represent the risk in terms of numbers of CVD cases per 1000 for those who sleep 7 hours, as compared to those who sleep 5 hours or less, or who sleep 9 hours or more. That type of absolute assessment of the risk gives a more realistic way of determining the true importance of the study results.
Another issue is that the article didn’t really describe the types of participants in the study. Although the article author alludes to the study correcting for age, gender, ethnicity, etc., it is not clear how prevalent various population segments were in the study.
Related Peer Reviewed Article: http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0004589
Van Leeuwen et al (2009) reported on a laboratory study of young men in a sleep lab who underwent specific sleep regimens, and who underwent testing for various immune markers, specifically proinflammatory cytokines. The study noted that these young men’s immune system were negatively impacted by restricted sleep cycles, and that impacts remained even when they were given the opportunity to experience “recovery” sleep periods. The authors concluded that this may be a mechanism by which alterations in sleep patterns may stimulate greater experience of CVD.
Crosspost Article Posted: http://thechart.blogs.cnn.com/2012/01/18/new-study-finds-fewer-abortions-worldwide-many-remain-unsafe/?iref=allsearch
Alternative Journal Article Links:
Shah & Ahman (2010): https://ecampus.southalabama.edu/access/content/attachment/73f6f445-9b86-47f1-bee5-0c15b86d322f/Forums/08f85216-f012-4b88-8134-9b64a63add78/Unsafe%20abortions%20in%202008.pdf
The Wadas-Willlingham (2012) article presents statistics on abortion rates and unsafe abortions worldwide in 2008, comparing those numbers to equivalent statistics from 2003. While the overall rate of abortions stayed approximately constant between 2003 and 2008, the article cites an unspecified study in The Lancet which notes that the absolute numbers of abortions increased worldwide.
The focus of the article is on the “alarming” data that unsafe abortions—those that are performed by untrained personnel or in unsanitary environments—are an increasing percentage of all abortions, putting substantially more women at risk for complications and death. A featured quotation in the article of the Lancet editor notes that this increase in unsafe abortion is a result of condemnation, stigmatization, and criminalization of abortions by countries seeking to use those techniques to reduce overall numbers of abortions. The Lancet editor calls such policies “cruel and failed strategies.” The article also cites the (unspecified) study authors as asserting that the abortion rate changes between 1995 and 2008 were consistent with the inaccessibility of contraceptives to women worldwide, and the increasing desire to have smaller families.
The most severe issue with this article is that it does not provide any specific citation to the original study, not even providing the title, date of publication, or study authors. Without that information, the average reader would have no way to track down the original research paper. Instead of quoting the authors, the article quotes the editor of the journal. And while the study authors are indirectly referred to, they are never mentioned by name. It is possible that since The Lancet is not a journal that is readily accessible online by the general public, that the article author felt this was unnecessary; however it seems an important piece of missing data.
One of the good points of the article (Wadas-Willingham, 2010) is that it provides absolute numbers of abortions by presenting the statistics in terms of rates per 1000 women. The article noted that while the number of abortions worldwide increased from 2003 to 2008, the rate of abortion in terms of number per 1000 women is about the same. Although not explicitly stated, this implies that the increase in total number of abortions between the two periods was primarily due to an overall increase in the world population of women; more women means more abortions (Wadas-Willingham, 2010).
In terms of consistency of Wadas-Willingham (2010) with the peer-reviewed journal articles by Shah and Ahman (2010), the statistics seem very consistent between the two, and the general conclusions agree, although the journal paper has far more detail about the statistics and breaks them down by region and level of development of countries. Both sets of statistics appear to be taken from WHO studies, and thus the numbers cited and the conclusions drawn from them are quite similar. Thus, while one could wish for more details of the study in the media article, the results seem well presented and seem to accurately represent the data from the studies. In addition, many of the conclusions on the impact of governmental and societal policies on abortion described in the article, are supported in Shah and Ahman (2010). In Shah and Ahman (2010), the authors do have a somewhat stronger conclusion than that presented in Wadas-Willingham (2010), in that the journal authors claim that nearly all of the 47,000 women who fall victim to complication of unsafe abortions could be spared those medical issues if women worldwide had better sex education, fertility awareness, and access to both effective contraception and safe abortions.
Freeman, D. W. (3 Aug. 2010). Sleep heart risk: Seven hours of sleep best for your heart. CBS News. Retrieved from: http://www.cbsnews.com/2102-504763_162-20012475.html?tag=contentMain;contentBody
Sabanayagam, C., Shankar, A. (2010). Sleep duration and cardiovascular disease: Results from the National Health Interview Survey. Sleep, 33 (8), 1037-1042.
Van Leeuwen. W. M., Lehto, M., Karisola, P., Lindholm, H. Luukkonen, R., Sallinen, M., Harma, M., Porkka-Heiskanen, T., Alenius, H. (2009). Sleep restriction increases the risk of developing cardiovascular diseases by augmenting proinflammatory responses through IL-17 and CRP. PLoS ONE, 4 (2), e4589. DOI: 10.1371/jounral/pone.0004589. Retrieved from: http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0004589
References: Abortion Crosspost
Shah, I., Ahman, E. (2010). Unsafe abortions in 2008: Global and regional levels and trends. Reproductive Health Matters, 18 (36), 90-101. Retrieved from: https://ecampus.southalabama.edu/access/content/attachment/73f6f445-9b86-47f1-bee5-0c15b86d322f/Forums/08f85216-f012-4b88-8134-9b64a63add78/Unsafe%20abortions%20in%202008.pdf
Wadas-Willingham, V. (18 Jan 2018) New study finds fewer abortions worldwide; increase in unsafe abortions. The Chart, CNN.com. Retrieved from: http://thechart.blogs.cnn.com/2012/01/18/new-study-finds-fewer-abortions-worldwide-many-remain-unsafe/?iref=allsearch