Data_Sheet_1_Does tinnitus amplify the effects of healthy eating patterns and physical activity on the sleep disturbance or sleep insufficiency, based on the case study of NHANES survey in the United States.pdf

ObjectiveExploring whether the presence of tinnitus amplifies the effects of an individual’s dietary patterns and physical activity on sleep disturbance or sleep insufficiency.
Study designThis study extracted data from the five National Health and Nutrition Examination Surveys (NHANES) between 2009 and 2018, including individuals who had undergone complete questionnaires on tinnitus, dietary habits, physical activity, and sleep. Multivariate logistic regression, restricted cubic spline (RCS) and subgroup analyses were conducted to explore the associations of dietary habits, physical activity, and tinnitus with sleep disturbance and sleep insufficiency.
ResultsA total of 7,440 participants were enrolled in this study, of whom 1,795 participants were evaluated as sleep disturbance (24.13%), and 2,281 were sleep insufficiency (30.66%). With adjusting confounding factors of demographic and socioeconomic variables, among overall population, participants with tinnitus showed a significantly increased risk of sleep disturbance [adjusted odds ratio (aOR) = 2.08, 95% confidence interval (CI): 1.83–2.36), and sleep insufficiency (aOR = 1.31, 95% CI: 1.15–1.49). Poor dietary habits also increased the risk of sleep disturbance (aOR = 1.08, 95% CI: 1.04–1.12), as does lack of physical activity (aOR = 1.14, 95% CI: 1.03–1.27); but neither exposure factors significantly increased the risk of sleep insufficiency. The non-linear trend analyses of RCS found that the influence of exposure factors on sleep disturbance experiencing a steady or small decline trend after rising. In addition, the results of the subgroup analysis showed that in tinnitus patients, poor dietary habits and lack of physical activity both significantly increased the risk of sleep disturbance, and poor dietary habits also increased the risk of sleep insufficiency remarkable, but lack of physical activity did not. In healthy participants, poor dietary habits were only significantly associated the sleep disturbance, while lack of physical inactivity even had a protective effect against sleep insufficiency.
ConclusionCompared to the general population, tinnitus significantly amplified the effects of poor dietary patterns and physical inactivity on sleep disturbance and sleep insufficiency. For tinnitus patients, adjusting a healthy diet and increasing exercise could more effectively promote their sleep health.

研究目的：探讨耳鸣是否会放大个体饮食模式与体力活动对睡眠障碍或睡眠不足的影响。
研究设计：本研究提取了2009至2018年五项全国健康与营养检查调查（National Health and Nutrition Examination Surveys, NHANES）的数据，纳入完成耳鸣、饮食习惯、体力活动及睡眠相关完整问卷的受试者。采用多元logistic回归、限制性立方样条（restricted cubic spline, RCS）与亚组分析，探究饮食习惯、体力活动及耳鸣与睡眠障碍、睡眠不足之间的关联。
研究结果：本研究共纳入7440名受试者，其中1795名被评估为存在睡眠障碍（占比24.13%），2281名存在睡眠不足（占比30.66%）。在校正人口学与社会经济变量等混杂因素后，总体人群中伴耳鸣受试者的睡眠障碍风险显著升高[校正后比值比（adjusted odds ratio, aOR）=2.08，95%置信区间（confidence interval, CI）：1.83~2.36]，睡眠不足风险亦显著升高（aOR=1.31，95%CI：1.15~1.49）。不良饮食习惯会增加睡眠障碍风险（aOR=1.08，95%CI：1.04~1.12），缺乏体力活动同样如此（aOR=1.14，95%CI：1.03~1.27）；但上述两类暴露因素均未显著升高睡眠不足风险。限制性立方样条的非线性趋势分析显示，暴露因素对睡眠障碍的影响呈现先上升后趋于平稳或小幅下降的趋势。此外，亚组分析结果显示：在耳鸣患者中，不良饮食习惯与缺乏体力活动均会显著升高睡眠障碍风险，且不良饮食习惯还会显著增加睡眠不足风险，但缺乏体力活动无此效应；在健康受试者中，不良饮食习惯仅与睡眠障碍显著相关，而缺乏体力活动甚至对睡眠不足具有保护作用。
研究结论：与普通人群相比，耳鸣会显著放大不良饮食模式与体力活动不足对睡眠障碍及睡眠不足的影响。对于耳鸣患者而言，调整健康饮食与增加运动可更有效地改善其睡眠健康。