3.1 Population baseline
Between 2017 and 2020, a cohort of 7051 individuals was analyzed for demographic characteristics. Among these, gallstones were detected in 724 individuals, accounting for 10.27% of the study population. Significant differences were observed between the gallstone group and the control group with respect to snore, snort, trouble sleeping, overly sleepy, sex, age, and race (all P<0.05) (Table 1).
Table 1 Baseline characteristics of the patients in the model
Characteristic
|
No
N=6327
|
Yes
N=724
|
P-value
|
Sleep hours (workdays)
|
|
|
0.403
|
7-9
<7
≥9
Sleep hours (weekends)
7-9
<7
≥9
Snore
Never
1-2 nights a week
3-4 nights a week
5 or more nights a week
Snort or stop breathing
Never
1-2 nights a week
3-4 nights a week
5 or more nights a week
Trouble sleeping
No
Yes
Overly sleepy
Never
1 times a month
2-4 times a mouth
5-15 times a mouth
16-30 times a mouth
Sex
Male
Female
Age
<65
≥65
Race:
Mexican American
Non-Hispanic Black
Non-Hispanic White
Other Hispanic
Other Race
Alcohol consumption
No
Yes
Cigarette smoking
No
Yes
Diabetes status
No
Yes
Borderline
Hypertension status
No
Yes
BMI
BMI<25
BMI= [25, 30)
BMI= [30, 35)
BMI≥35
|
2966
2646
715
3160
1711
1456
1739
1684
1164
1740
4766
809
401
351
4707
1620
1151
1560
2116
1043
457
3256
3071
5002
1325
730
625
2152
1688
1132
5741
586
2605
3722
938
5207
182
2353
3974
1635
1983
1361
1269
|
332
298
94
357
216
151
172
158
165
229
515
98
56
55
424
300
91
155
248
162
68
205
519
450
274
94
82
310
135
103
662
62
299
425
94
611
19
283
441
168
228
151
165
|
0.199
<0.001
0.037
<0.001
<0.001
<0.001
<0.001
<0.001
0.584
0.980
0.369
0.584
0.232
|
The Kruskal‒Wallis rank sum test was employed for continuous variables, while Fisher’s exact probability test was utilized for count variables. BMI, body mass index.
3.2 Sleep disorders and gallstone formation risk in the logistic regression model
Multivariate regression models were built to assess the associations of sleep disorders with the prevalence of gallstones. Table 2 indicates that individuals with trouble sleeping had a significantly stronger association with the prevalence of gallstones compared to those who never experienced trouble sleeping. In Model 1, which was not adjusted for covariates, the odds ratio (OR) was 1.88 (95% CI: 1.59-2.22, P<0.001), indicating a significant association between trouble sleeping and the risk of gallstone formation. In Model 2, adjusted for all covariates, the risk of gallstone formation was 1.67 times higher in the trouble sleeping group compared to the control group (OR = 1.67, 95% CI: 1.42-2.01, P<0.001). However, sleep hours (workdays), sleep hours (weekends), and snort were not significantly associated with the risk of gallstone formation (all P>0.05). Furthermore, in Model 1, individuals experiencing overly sleepy were more likely to be associated with gallstone formation (2-4 times a month: OR: 1.34, 95% CI: 1.04-1.73; 5-15 times a month: OR: 1.62, 95% CI: 1.22-2.14; 16-30 times a month: OR: 1.44, 95% CI: 1.02-2.04). Similarly, in Model 2, individuals with overly sleepy showed a higher likelihood of gallstone formation (2-4 times a month: OR: 1.31, 95% CI: 1.01-1.71; 5-15 times a month: OR: 1.50, 95% CI: 1.12-2.01). Compared to never snore, 3-4 nights a week and 5 or more nights a week were linked with a higher risk of gallstones prevalence (Model 2: OR1: 1.47, 95% CI: 1.16-1.87; OR2: 1.38, 95% CI: 1.09-1.75).
Table 2 Multivariable analysis model of the association between sleep disorders and the prevalence of gallstones.
Characteristics
|
Model 1
OR(95%CI)
|
P-value
|
Model 2
OR(95%CI)
|
P-value
|
Sleep hours (workdays)
|
|
|
|
|
7-9
<7
≥9
Sleep hours (weekends)
7-9
<7
≥9
Snore
Never
1-2 nights a week
3-4 nights a week
5 or more nights a week
Snort or stop breathing
Never
1-2 nights a week
3-4 nights a week
5 or more nights a week
Trouble sleeping
No
Yes
Overly sleepy
Never
1 times a month
2-4 times a mouth
5-15 times a mouth
16-30 times a mouth
|
Reference
0.90(0.75-1.09)
1.26(0.96-1.66)
Reference
1.14(0.93-1.40)
0.84(0.67-1.05)
Reference
0.93(0.73-1.17)
1.37(1.08-1.73)
1.21(0.96-1.52)
Reference
0.97(0.77-1.23)
0.96(0.70-1.30)
0.98(0.70-1.36)
Reference
1.88(1.59-2.22)
Reference
1.21(0.92-1.59)
1.34(1.04-1.73)
1.62(1.22-2.14)
1.44(1.02-2.04)
|
0.284
0.096
0.202
0.121
0.511
0.008
0.107
0.811
0.780
0.897
<0.001
0.172
0.023
<0.001
0.036
|
Reference
1.06(0.87-1.30)
1.14(0.85-1.52)
Reference
1.17(0.94-1.46)
0.85(0.67-1.08)
Reference
1.01(0.79-1.28)
1.47(1.16-1.87)
1.38(1.09-1.75)
Reference
1.08(0.85-1.39)
1.00(0.73-1.39)
1.13(0.80-1.60)
Reference
1.67(1.42-2.01)
Reference
1.17(0.88-1.55)
1.31(1.01-1.71)
1.50(1.12-2.01)
1.21(0.84-1.72)
|
0.554
0.385
0.152
0.195
0.954
0.002
0.008
0.517
0.986
0.483
<0.001
0.275
0.043
0.006
0.302
|
Model 1 was not adjusted for any covariates. Model 2 was adjusted for all covariates. OR: odds ratio; CI: confidence interval.
3.4 The association of sleep disorders with risk of gallstone by ages and sex
Additionally, a subgroup analysis was conducted to examine whether the relationship between sleep disorders and gallstones varied by age and gender. After controlling for confounding factors, experiencing overly sleepy five or more nights a week was associated with a greater risk of gallstone formation in males over 65 years of age. Furthermore, in females under 65 years of age, snoring was associated with an increased risk of gallstone formation. Significant correlations were detected between gallstone formation and trouble sleeping when stratified by age and gender in the examined subgroups (Table 3).
Table 3 Subgroup analysis
Characteristics
|
OR(95%CI)
|
P-value
|
Sex
|
|
|
Male
Trouble sleeping
No
Yes
Female
Trouble sleeping
No
Yes
Overly sleepy
Never
1-2 nights a week
3-4 nights a week
5 or more nights a week
16-30 times a mouth
Snore
Never
1-2 nights a week
3-4 nights a week
5 or more nights a week
Age
<65
Trouble sleeping
No
Yes
Snore
Never
1-2 nights a week
3-4 nights a week
5 or more nights a week
≥65
Trouble sleeping
No
Yes
Overly sleepy
Never
1-2 nights a week
3-4 nights a week
5 or more nights a week
16-30 times a mouth
|
Reference
1.98(1.44-2.72)
Reference
1.59(1.29-1.95)
Reference
1.06(0.75-1.50)
1.29(0.93-1.78)
1.49(1.05-2.12)
1.14(0.75-1.75)
Reference
1.15(0.87-1.53)
1.67(1.25-2.24)
1.72(1.29-2.30)
Reference
1.88(1.51-2.33)
Reference
1.11(0.83-1.50)
1.53(1.11-2.10)
1.54(1.13-2.09)
Reference
1.41(1.05-1.89)
Reference
1.22(0.77-1.94)
1.64(1.07-2.51)
1.97(1.23-3.17)
1.15(0.63-2.08)
|
<0.001
<0.001
0.751
0.127
0.025
0.537
0.332
<0.001
<0.001
<0.001
0.486
0.009
0.006
0.023
0.395
0.024
0.005
0.655
|