Rumbea, Denisse A

Abstract Studies on the association between pineal gland calcification (PGC) and non-breathing sleep-related symptoms are inconclusive. The present study aims to evaluate this association in middle-aged and older adults living in rural villages located in coastal Ecuador. Community-dwellers aged ≥ 40 years enrolled in the Three Villages Study cohort were interviewed with the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality and received head computed tomography for automated measurement of PGC volumes. Generalized linear and logistic regression models were used to assess the association between PGC volumes (exposure) and the PSQI score and sleep quality (as separate dependent variables), after adjusting for age and sex. The study included 1,009 participants (mean age: 56.5 ± 12.6 years; 57% women). The mean volume of PGC was 51 ± 53.5 µL. The mean score of the PSQI was 5.3 ± 2.8 points, with 399 (40%) participants having poor sleep quality. Locally-Weighted Scatterplot Smoothing showed a linear relationship between continuous PGC volumes and PSQI scores. An unadjusted generalized linear regression model showed a significant association between PGC volumes stratified in tertiles and the continuous PSQI score. However, this association lost statistical significance after adjustment for age and sex. The association between tertiles of PGC and poor sleep quality was non-significant in both unadjusted and multivariate logistic regression models. Study results did not find an association between increased PGC and sleep quality after adjusting for demographics, suggesting that PGC may not necessarily indicate pineal dysfunction but could reflect adaptive physiological mechanisms.

Background: Sleep-related symptoms are known to influence cardiovascular health (CVH), but the relative importance of sleep duration versus quality remains uncertain. This study evaluates whether a combined measure – “satisfactory sleep health,” incorporating both adequate sleep duration and good sleep quality – better correlates with CVH status in middle-aged and older adults living near the Equator. Methods: In this population-based, cross-sectional study, 1781 middle-aged and older adults living in rural villages of coastal Ecuador were assessed for sleep duration and quality using structured interviews and the Pittsburgh Sleep Quality Index (PSQI). Satisfactory sleep health was defined as 7- to 8 h of sleep plus a PSQI score ≤5 points. CVH status was evaluated using the American Heart Association’s Life’s Simple 7 construct. Multivariate logistic regression models were used to determine the investigated associations, after adjustment for relevant confounders. Results: While adequate sleep duration alone showed no significant association with CVH, good sleep quality, and satisfactory sleep health were inversely associated with poor CVH in unadjusted models. After adjustment for demographics, level of education, and symptoms of depression, satisfactory sleep health was associated with a 21% reduction in the odds of poor CVH status (OR = 0.79; 95% CI = 0.64-0.99; P < 0.05). Conclusions: A combined assessment of sleep duration and quality provides a more robust predictor of CVH than either component alone. These findings support the inclusion of multidimensional sleep metrics in public health frameworks evaluating cardiovascular risk and highlight their potential utility in guiding targeted prevention strategies.