Objectives: The purpose of this study was to determine the extent to which anxiety and obesity-related, and whether it is in fact the issue of poor eating habits, to determine the prevalence of anxiety among the topics of people seeking to obesity and the study of anxiety and social relationship symptoms of anxiety with age treatment, and the duration of obesity , body mass index (BMI) and binge eating (BE). Study DesignThe study is a cross-sectional descriptive study conducted in Baghdad city during the period from November 2014 to November 2015, which assess mental health and psychosocial situation patient Committed to diet , BMI, physical and socio demographics for both obese males and females who live in the Baghdad city and attending Obesity research and therapy center in Alkindy college of Baghdad university medicine The sample of the study is a judgmental sample .The data were collected during a four months period since beginning of December 2014 to the end of March 2015.The total number of patient involved in the study is (320) Person, 20 were selected for a pilot study which were excluded from the main sample (16) patients from female and (four) males refuse to participate in the study .and remain(300) sample which classificated to females It is the largest in the sample estimates 74% and males It is the smallest in the sample estimates26%. Setting of the Study The setting of the study in Baghdad city.Baghdad University.Kindy College of Medicine Obesity research and therapy center. Subjects and Methods This study included both patients male and female aged 20-60, living in the Baghdad city, the data were gathered through structured direct interview technique and developed questionnaire that include many questions about personal and demographic information, health status, psychosocial status, and food intake method .measure body mass index (BMI) (weight[kg]/height[m2]), through measuring height , weight and waist. In this study during the interview the questions about anxiety Patients were asked to clarify the concern has to do with weight gain and not worry in general show that the age group of 20-40yrs categories concern linked to the appearance of the body shape change either age group above 40yrs is increasing concern concurrently chronic diseases related to obese such as high blood pressure and joint pain , take period asked to each patient about anxiety only 15 minutes knowing that the data collection was all days of the week except Friday and Saturday begin at 8:30 A.m and continue until 1:30 p.m, The questionnaire are standard only Translated is divided into two parts. Part 1: primary information, which includes personal and social (demographic) information, and also indirect information related to the study. Personal and demographic information. Part 2: specialized information which includes four domains and illustrated as follows: Health status, Psychological status, and physical activity and Food intake.

BACKGROUND: Insufficient sleep in adolescents has been shown to be associated with a wide variety of adverse outcomes, from poor mental and physical health to behavioral problems and lower academic grades. However, most high school students do not get sufficient sleep. Delaying school start times for adolescents has been proposed as a policy change to address insufficient sleep in this population and potentially to improve students' academic performance, reduce engagement in risk behaviors, and improve health.METHODS: This article reviews 38 reports examining the association between school start times, sleep, and other outcomes among adolescent students.RESULTS: Most studies reviewed provide evidence that delaying school start time increases weeknight sleep duration among adolescents, primarily by delaying rise times. Most of the studies saw a significant increase in sleep duration even with relatively small delays in start times of half an hour or so. Later start times also generally correspond to improved attendance, less tardiness, less falling asleep in class, better grades, and fewer motor vehicle crashes.CONCLUSIONS: Although additional research is necessary, research results that are already available should be disseminated to stakeholders to enable the development of evidence-based school policies.

To promote optimal health and well-being, adults aged 18-60 years are recommended to sleep at least 7 hours each night (1). Sleeping <7 hours per night is associated with increased risk for obesity, diabetes, high blood pressure, coronary heart disease, stroke, frequent mental distress, and all-cause mortality (2-4). Insufficient sleep impairs cognitive performance, which can increase the likelihood of motor vehicle and other transportation accidents, industrial accidents, medical errors, and loss of work productivity that could affect the wider community (5). CDC analyzed data from the 2014 Behavioral Risk Factor Surveillance System (BRFSS) to determine the prevalence of a healthy sleep duration (≥ 7 hours) among 444,306 adult respondents in all 50 states and the District of Columbia. A total of 65.2% of respondents reported a healthy sleep duration; the age-adjusted prevalence of healthy sleep was lower among non-Hispanic blacks, American Indians/Alaska Natives, Native Hawaiians/Pacific Islanders, and multiracial respondents, compared with non-Hispanic whites, Hispanics, and Asians. State-based estimates of healthy sleep duration prevalence ranged from 56.1% in Hawaii to 71.6% in South Dakota. Geographic clustering of the lowest prevalence of healthy sleep duration was observed in the southeastern United States and in states along the Appalachian Mountains, and the highest prevalence was observed in the Great Plains states. More than one third of U.S. respondents reported typically sleeping <7 hours in a 24-hour period, suggesting an ongoing need for public awareness and public education about sleep health; worksite shift policies that ensure healthy sleep duration for shift workers, particularly medical professionals, emergency response personnel, and transportation industry personnel; and opportunities for health care providers to discuss the importance of healthy sleep duration with patients and address reasons for poor sleep health.

INTRODUCTION:Many studies have estimated national chronic disease costs, but state-level estimates are limited. The Centers for Disease Control and Prevention developed the Chronic Disease Cost Calculator (CDCC), which estimates state-level costs for arthritis, asthma, cancer, congestive heart failure, coronary heart disease, hypertension, stroke, other heart diseases, depression, and diabetes.METHODS:Using publicly available and restricted secondary data from multiple national data sets from 2004 through 2008, disease-attributable annual per-person medical and absenteeism costs were estimated. Total state medical and absenteeism costs were derived by multiplying per person costs from regressions by the number of people in the state treated for each disease. Medical costs were estimated for all payers and separately for Medicaid, Medicare, and private insurers. Projected medical costs for all payers (2010 through 2020) were calculated using medical costs and projected state population counts.RESULTS:Median state-specific medical costs ranged from $410 million (asthma) to $1.8 billion (diabetes); median absenteeism costs ranged from $5 million (congestive heart failure) to $217 million (arthritis).CONCLUSION:CDCC provides methodologically rigorous chronic disease cost estimates. These estimates highlight possible areas of cost savings achievable through targeted prevention efforts or research into new interventions and treatments.

Objective: We assessed the relationship between active duty status and daily insufficient sleep in a telephone survey. Methods: U.S. military service status (recent defined as past 12 months and past defined as >12 months ago) and daily insufficient sleep in the past 30 days were assessed among 566,861 adults aged 18 to 64 years and 271,202 adults aged ≥65 years in the 2009 to 2010 Behavioral Risk Factor Surveillance System surveys. Results: Among ages 18 to 64 years, 1.1% reported recent active duty and 7.1% had past service; among ages ≥65 years, 0.6% reported recent and 24.6% had past service. Among ages 18 to 64 years, prevalence of daily insufficient sleep was 13.7% among those reporting recent duty, 12.6% for those with past service, and 11.2% for those with no service. Insufficient sleep did not vary significantly with active duty status among ages ≥65 years. After adjustment for sociodemographic characteristics, health behaviors, and frequent mental distress in multivariate logistic regression models, respondents aged 18 to 64 years with recent active duty were 34% more likely and those with past service were 23% more likely to report daily insufficient sleep than those with no service (p < 0.05, both). Conclusions: Adults with either recent or past active duty have a greater risk for daily insufficient sleep.

CONTEXT:Health insurance benefits for mental health services typically have paid less than benefits for physical health services, resulting in potential underutilization or financial burden for people with mental health conditions. Mental health benefits legislation was introduced to improve financial protection (i.e., decrease financial burden) and to increase access to, and use of, mental health services. This systematic review was conducted to determine the effectiveness of mental health benefits legislation, including executive orders, in improving mental health. EVIDENCE ACQUISITION:Methods developed for the Guide to Community Preventive Services were used to identify, evaluate, and analyze available evidence. The evidence included studies published or reported from 1965 to March 2011 with at least one of the following outcomes: access to care, financial protection, appropriate utilization, quality of care, diagnosis of mental illness, morbidity and mortality, and quality of life. Analyses were conducted in 2012. EVIDENCE SYNTHESIS:Thirty eligible studies were identified in 37 papers. Implementation of mental health benefits legislation was associated with financial protection (decreased out-of-pocket costs) and appropriate utilization of services. Among studies examining the impact of legislation strength, most found larger positive effects for comprehensive parity legislation or policies than for less-comprehensive ones. Few studies assessed other mental health outcomes. CONCLUSIONS:Evidence indicates that mental health benefits legislation, particularly comprehensive parity legislation, is effective in improving financial protection and increasing appropriate utilization of mental health services for people with mental health conditions. Evidence was limited for other mental health outcomes.

ion and Evaluation of Studies Two reviewers evaluated each study using an adaptation of a standardized abstraction form, which included a quality assessment (www.thecommunityguide.org/methods/abstractionform. pdf). Disagreements were resolved by discussion and team consensus. DistillerSR, version 1, was used to manage references, screen citations, and abstract data. Microsoft Excel 2010 was used for effect size calculation and other analyses. Papers based on the same study data set were linked; only the paper with the most complete data (e.g., longest follow-up) was included in analyses. See Appendix C (available online) for more details. Summarizing the Body of Evidence on Effectiveness Effect measurement and data synthesis. Effect estimates of absolute percentage point (pct pt) change or relative percentage change were calculated with corresponding 95% CIs and adjusted for baseline data when possible. Regression coefficients or ORs were used as the effect estimates when reported. Summary effect estimates (medians); interquartile intervals (IQIs); and number of studies are reported when outcomes contained five or more data points. Results for most outcomes of interest were synthesized descriptively and p-values are reported when available. Tables illustrating the effect direction are used to display effects based on methods developed by Thomson and Thomas (see Appendix C, available online, for formulas and details on data synthesis). Analyses were conducted in 2012. Figure 2. Flow chart showing number of studies identified, revie Subgroup analyses. Two comparisons were assessed qualitatively: (1) stronger parity legislation versus no or weak parity legislation and (2) mutually exclusive categories of parity versus no or weak parity legislation. Categories of parity were based on primary author’s definitions. Subgroup analyses were also planned to compare outcomes by settings (e.g., U.S. states); clients (e.g., age group, racial and ethnic group, type of mental illness); employer size; and health plan type (e.g., public vs. private).

Objective. Prior studies have documented disparities in short and long sleep duration, excessive daytime sleepiness, and insomnia by educational attainment and race/ethnicity separately. We examined both independent and interactive effects of these factors with a broader range of sleep indicators in a racially/ethnically diverse sample.Methods. We analyzed 2012 National Health Interview Survey data from 33,865 adults aged >= 18 years. Sleep-related symptomatology included short sleep duration (<= 6 h), long sleep duration (>= 9 h), fatigue >3 days, excessive daytime sleepiness, and insomnia. Bivariate analyses with chi-square tests and log-linear regression were performed.Results. The overall age-adjusted prevalence was 29.1% for short sleep duration, 8.5% for long sleep duration, 15.1% for fatigue, 12.6% for excessive daytime sleepiness, and 18.8% for insomnia. Educational attainment and race/ethnicity were independently related to the five sleep-related symptoms. Among Whites, the likelihood of most sleep indicators increased as educational attainment decreased; relationships varied for the other racial/ethnic groups. For short sleep duration, the educational attainment-by-race/ethnicity interaction effect was significant for African Americans (p <0.0001), Hispanics (p <0.0001), and Asians (p = 0.0233) compared to Whites. For long sleep duration, the interaction was significant for Hispanics only (p = 0.0003).Conclusions. Our results demonstrate the importance of examining both educational attainment and race/ethnicity simultaneously to more fully understand disparities in sleep health. Increased understanding of the mechanisms linking sociodemographic factors to sleep health is needed to determine whether policies and programs to increase educational attainment may also reduce these disparities within an increasingly diverse population. Published by Elsevier Inc.

Introduction Housing insecurity and food insecurity may be psychological stressors associated with insufficient sleep. Frequent mental distress may mediate the relationships between these variables. The objective of this study was to examine the relationships between housing insecurity and food insecurity, frequent mental distress, and insufficient sleep. Methods We analyzed data from the 2009 Behavioral Risk Factor Surveillance System in 12 states. Housing insecurity and food insecurity were defined as being worried or stressed “sometimes,” “usually,” or “always” during the previous 12 months about having enough money to pay rent or mortgage or to buy nutritious meals. Results Of 68,111 respondents, 26.4% reported frequent insufficient sleep, 28.5% reported housing insecurity, 19.3% reported food insecurity, and 10.8% reported frequent mental distress. The prevalence of frequent insufficient sleep was significantly greater among those who reported housing insecurity (37.7% vs 21.6%) or food insecurity (41.1% vs 22.9%) than among those who did not. The prevalence of frequent mental distress was also significantly greater among those reporting housing insecurity (20.1% vs 6.8%) and food insecurity (23.5% vs 7.7%) than those who did not. The association between housing insecurity or food insecurity and frequent insufficient sleep remained significant after adjustment for other sociodemographic variables and frequent mental distress. Conclusion Sleep health and mental health are embedded in the social context. Research is needed to assess whether interventions that reduce housing insecurity and food insecurity will also improve sleep health and mental health.

Background: There is limited information from population-based investigations of the associations between sleep duration and sleep disorders and parameters of glucose homeostasis. The objective of the present study was to examine cross-sectional associations between sleep duration and sleep disordered breathing with concentrations of insulin, fasting and 2-h glucose, and HbA1c.Methods: Data from 11 815 adults aged >= 20 years without diagnosed diabetes (5002 with an oral glucose tolerance test) from the National Health and Nutrition Examination Survey 2005-2010 were used. Information about sleep duration (2005-2010) and sleep apnea and sleep-disordered breathing (20052008) was obtained via questionnaire.Results: An estimated 36.0% of participants reported sleeping <= 6 h/night, 62.0% reported sleeping 7-9 h/night, and 2.0% reported sleeping >= 10 h/night. In 2005-2008, 33.0% reported snoring >= 5 nights per week, 5.9% reported they snorted, gasped, or stopped breathing >= 5 nights/week, and 4.2% reported sleep apnea. Sleep duration was significantly associated with fasting concentrations of insulin and concentrations of HbA1c only in models that did not adjust for body mass index (BMI). Concentrations of fasting and 2-h glucose were significantly associated with sleep duration in models that adjusted only for age. Snoring frequency was positively associated with concentrations of insulin and HbA1c. Frequency of snorting or stopping breathing and sleep apnea status were associated with concentrations of insulin and of HbA1c only when BMI was not accounted for.Conclusion: In a representative sample of US adults, concentrations of insulin and HbA1c were significantly associated with short sleep duration, possibly mediated by BMI.

Findings in published reports have suggested that drowsy driving is a factor each year in as many as 7,500 fatal motor vehicle crashes (approximately 25%) in the United States. CDC previously reported that, in 2009-2010, 4.2% of adult respondents in 19 states and the District of Columbia reported having fallen asleep while driving at least once during the previous 30 days. Adults who reported usually sleeping ≤6 hours per day, snoring, or unintentionally falling asleep during the day were more likely to report falling asleep while driving compared with adults who did not report these sleep patterns. However, limited information has been published on the association between drowsy driving and other risk behaviors that might contribute to crash injuries or fatalities. Therefore, CDC analyzed responses to survey questions regarding drowsy driving among 92,102 respondents in 10 states and Puerto Rico to the 2011-2012 Behavioral Risk Factor Surveillance System (BRFSS) surveys. The results showed that 4.0% reported falling asleep while driving during the previous 30 days. In addition to known risk factors, drowsy driving was more prevalent among binge drinkers than non-binge drinkers or abstainers and also more prevalent among drivers who sometimes, seldom, or never wear seatbelts while driving or riding in a car, compared with those who always or almost always wear seatbelts. Drowsy driving did not vary significantly by self-reported smoking status. Interventions designed to reduce binge drinking and alcohol-impaired driving, to increase enforcement of seatbelt use, and to encourage adequate sleep and seeking treatment for sleep disorders might contribute to reductions in drowsy driving crashes and related injuries.

Study Objective: To examine recent national trends in outpatient visits for sleep related difficulties in the United States and prescriptions for sleep medications.Design: Trend analysis.Setting: Data from the National Ambulatory Medical Care Survey from 1999 to 2010.Participants: Patients age 20 y or older.Measurements and Results: The number of office visits with insomnia as the stated reason for visit increased from 4.9 million visits in 1999 to 5.5 million visits in 2010 (13% increase), whereas the number with any sleep disturbance ranged from 6,394,000 visits in 1999 to 8,237,000 visits in 2010 (29% increase). The number of office visits for which a diagnosis of sleep apnea was recorded increased from 1.1 million visits in 1999 to 5.8 million visits in 2010 (442% increase), whereas the number of office visits for which any sleep related diagnosis was recorded ranged from 3.3 million visits in 1999 to 12.1 million visits in 2010 (266% increase). The number of prescriptions for any sleep medication ranged from 5.3 in 1999 to 20.8 million in 2010 (293% increase). Strong increases in the percentage of office visits resulting in a prescription for nonbenzodiazepine sleep medications (similar to 350%), benzodiazepine receptor agonists (similar to 430%), and any sleep medication (similar to 200%) were noted.Conclusions: Striking increases in the number and percentage of office visits for sleep related problems and in the number and percentage of office visits accompanied by a prescription for a sleep medication occurred from 1999-2010.

Objective: To examine the form of the relationship between sleep duration and anthropometric measures and possible differences in these relationships by gender and race or ethnicity.\Design and Methods: Data for 13,742 participants aged >= 20 years from the National Health and Nutrition Examination Survey 2005-2010 were used. Sleep duration was categorized as <= 6 (short sleepers), 79, and >= 10 hours (long sleepers).Results: Short sleepers were as much as 1.7 kg/m(2) (SE 0.4) heavier and had 3.4 cm (SE 1.0) more girth than long sleepers. Among participants without depression or a diagnosed sleep disorder, sleep duration was significantly associated with body mass index (BMI) and waist circumference in an inverse linear association in the entire sample, men, women, whites, African Americans, and participants aged 20-39 years. No evidence for statistical interaction by gender and race or ethnicity was observed. Regression coefficients were notably stronger among adults aged 20-39 years. Compared to participants who reported sleeping 7-9 hours per night, short sleepers were more likely to be obese and have abdominal obesity.Conclusions: In this nationally representative sample of US adults, an inverse linear association most consistently characterized the association between sleep duration and BMI and waist circumference.

OBJECTIVE:This investigation examined the association of anxiety or depressive disorder and frequent insufficient sleep.METHODS:Data were obtained from a 2010 telephone survey of a population-based sample of 113,936 adults in 20 states. Respondents were asked how often they did not get enough rest or sleep and if they had ever received a diagnosis of an anxiety or depressive disorder. Frequent insufficient sleep was defined as insufficient rest or sleep during ≥ 14 of the past 30 days.RESULTS:Frequent insufficient sleep was reported by 27.0% of the sample and was significantly more common (p<.05) among respondents who reported both anxiety and depressive disorders (48.6%), depressive disorders only (39.0%), or anxiety only (37.5%) than among adults who reported neither disorder (23.1%).CONCLUSIONS:Frequent insufficient sleep is associated with depressive and anxiety disorders, and the odds of the sleep disorder are increased when both classes of psychiatric disorders are diagnosed.

STUDY OBJECTIVE To examine the effects of obesity and frequent mental distress (FMD) on the relationship of sleep duration with coronary heart disease (CHD), stroke, and diabetes. DESIGN Cross-sectional study. SETTING Population-based surveillance. PARTICIPANTS There were 54,269 adults age 45 y or older who completed the 2010 Behavioral Risk Factor Surveillance System survey in 14 states. RESULTS Nearly one third (31.1% or an estimated 11.1 million) of respondents age 45 y and older reported being short sleepers (≤ 6 h), 64.8% being optimal sleepers (7-9 h), and 4.1% being long sleepers (≥ 10 h) in a 24-h period. Compared with the optimal sleep duration, both short and long sleep durations were significantly associated with obesity, FMD (mental health was not good ≥ 14 days during the past 30 days), CHD, stroke, and diabetes after controlling for sex, age, race/ethnicity, and education. The U-shaped relationships of sleep duration with CHD, stroke, and diabetes were moderately attenuated by FMD. The relationship between sleep duration and diabetes was slightly attenuated by obesity. CONCLUSIONS Sleep duration had U-shaped relationships with leading chronic diseases. Further prospective studies are needed to determine how mental health and maintenance of a normal weight may interact with sleep duration to prevent chronic diseases.

Study Objective: To determine if self-reported sleep duration was associated with weight-control behaviors among US high school students.Design: National Youth Risk Behavior Survey.Setting: United States, 2007.Participants: US high school students (N = 12,087).Measurements: Students were asked if they had engaged in several weight-control behaviors during the 30 days before the survey to lose or maintain weight. Self-reported sleep duration categories included very short (= 5 h), short (6 or 7 h), referent moderate (8 or 9 h), and long (= 10 h). Sex-specific logistic regression analyses with race/ethnicity, grade, and body mass index category as covariates were conducted using SUDAAN to account for complex study design.Results: Approximately half the students reported short sleep duration (51.8% of males and 54.3% of females), whereas very short sleep durations were reported by another 14.8% of males and 16.9% of females. Among males, very short sleepers were significantly (P < 0.05) more likely than moderate sleepers to report dieting (36.3% versus 26.1%), fasting (14.2% versus 4.3%), and purging (4.3% versus 1.1%) to lose or maintain weight during the 30 days before the survey. Among females, the respective very short, short, and moderate sleepers varied (P < 0.05) in dieting (59.9%, 55.0%, and 47.5% respectively), fasting (28.3%, 15.2%, and 10.3%, respectively), and taking diet pills (13.3%, 6.8%, and 4.3%, respectively). Prevalence of purging was significantly higher only for very short sleepers (12.3%, 6.0%, and 3.9%, respectively).Conclusion: Self-reported short sleep duration was associated with dieting and three unhealthy weight-control behaviors in this population. If our findings are confirmed, intervention studies should be conducted to examine the effect of educational interventions.