Browsing by Author "Hass, Zachary"

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    Association Between Sleep-Related Leg Movements and Diabetes Prevalence: A Cohort Study From the United States
    (Springer Nature, 2025-05-23) Ding, Qinglan; Xie, Yuting; Koo, Brian B.; Hass, Zachary; Wojeck, Brian; Sico, Jason J.; Murray-Kolb, Laura E.; Bravata, Dawn M.; Zinchuk, Andrey; Medicine, School of Medicine
    Background: Sleep is integral to cardiometabolic health. While there is emerging evidence linking sleep-related leg movements (SRLM) to diabetes mellitus (DM), the underlying mechanisms remain unclear. This study investigates the association between SRLM and DM prevalence in a national population-based cohort study in the United States (US), considering potential mediators like short sleep duration and inflammation and examining variations across age, sex, and race/ethnicity. Methods: We analyzed data from 9,191 adults (aged ≥18 years) from the National Health and Nutrition Examination Survey (NHANES) 2005-2008. We assessed the frequency of SRLM (leg jerks and leg cramps) and diabetes prevalence (self-reported diagnosis, diabetes medication use, or glycosylated hemoglobin (HbA1c) ≥ 6.5%). Weighted logistic regression models were used to evaluate the associations, adjusting for demographic and clinical-related confounders. Mediation analyses were conducted to explore the roles of short sleep duration and inflammation (C-reactive protein levels). Results: The study revealed that 1,278 (14%) participants have DM. SRLM was associated with a 72% increase in the odds of diabetes (OR=1.72, 95% CI: 1.06-2.81). The association is more pronounced in non-Hispanic White individuals, females, and adults aged 18-65. Short sleep duration and inflammation mediated 5.0% and 3.9% of this association, respectively. Conclusions: SRLM is independently and linearly associated with increased prevalence of diabetes in a representative sample of the US adult population. Short sleep duration and inflammation mediated a small part of this association. Confirming the association in other samples and further investigation into its mechanisms are warranted to better understand the roles of the SRLM in the risk of diabetes.
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    The Complexity of Determining Whether a Nursing Home Transfer Is Avoidable at Time of Transfer
    (Wiley, 2018-05) Unroe, Kathleen T.; Carnahan, Jennifer L.; Hickman, Susan E.; Sachs, Greg A.; Hass, Zachary; Arling, Greg; Medicine, School of Medicine
    Objectives To describe the relationship between nursing facility resident risk conditions and signs and symptoms at time of acute transfer and diagnosis of conditions associated with potentially avoidable acute transfers (pneumonia, urinary tract infection, congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD) or asthma, dehydration, pressure sores). Design As part of a demonstration project to reduce potentially avoidable hospital transfers, Optimizing Patient Transfers, Impacting Medical Quality, Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project clinical staff collected data on residents who transferred to the emergency department (ED) or hospital. Cross‐tabulations were used to identify associations between risk conditions or symptoms and hospital diagnoses or death. Mixed‐effects logistic regression models were used to describe the significance of risk conditions, signs, or symptoms as predictors of potentially avoidable hospital diagnoses or death. Setting Indiana nursing facilities (N=19). Participants Long‐stay nursing facility residents (N=1,174), who experienced 1,931 acute transfers from November 2014 to July 2016. Measurements Participant symptoms, transfers, risk factors, and hospital diagnoses. Results We found that 44% of acute transfers were associated with 1 of 6 potentially avoidable diagnoses. Symptoms before transfer did not discriminate well among hospital diagnoses. Symptoms mapped into multiple diagnoses and most hospital diagnoses had multiple associated symptoms. For example, more than two‐thirds of acute transfers of residents with a history of CHF and COPD were for reasons other than exacerbations of those two conditions. Conclusion Although it is widely recognized that many transfers of nursing facility residents are potentially avoidable, determining “avoidability” at time of transfer is complex. Symptoms and risk conditions were only weakly predictive of hospital diagnoses.