Evidence map›Paper›PMID 42700048›Full record

ArticleMedicine2026

Association of eight urinary metals and trouble sleeping: A cross-sectional study.

Qiong Ma, Jian-Zheng Liu, Xiu-E Shi, Li-Li Li, Xiao-Wei Feng, Xiang Fan, Mi Fu, Jian-Min Lv

Abstract read
In one paragraph

Article in Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Qiong MaHealth Department, Northwest Women's and Children's Hospital, Xi'an, Shaanxi, P.R. China.ORCID 0000-0002-3460-8343
Jian-Zheng LiuDepartment of Cardiology, Xijing Hospital, Xi'an, Shaanxi, P.R. China.ORCID 0009-0008-4419-2477
Xiu-E ShiRehabilitation Science Institute, Shaanxi Provincial Rehabilitation Hospital, Xi'an, Shaanxi, P.R. China.
Li-Li LiRehabilitation Science Institute, Shaanxi Provincial Rehabilitation Hospital, Xi'an, Shaanxi, P.R. China.
Xiao-Wei FengRehabilitation Science Institute, Shaanxi Provincial Rehabilitation Hospital, Xi'an, Shaanxi, P.R. China.
Xiang FanRehabilitation Science Institute, Shaanxi Provincial Rehabilitation Hospital, Xi'an, Shaanxi, P.R. China.
Mi FuHealth Department, Northwest Women's and Children's Hospital, Xi'an, Shaanxi, P.R. China.
Jian-Min LvRehabilitation Science Institute, Shaanxi Provincial Rehabilitation Hospital, Xi'an, Shaanxi, P.R. China.ORCID 0000-0001-9693-4200

Funding

Xi’an Science and Technology Plan Project 23YXYJ0122
6 · The paper itself

Abstract

While toxic heavy metals have been linked to sleep disorders, the role of less-studied metals remains unclear. We aimed to explore the associations of 8 urinary metals with trouble sleeping and to identify potential gender-specific patterns. This study included 10,012 adults from the National Health and Nutrition Examination Survey 2005-2018. Urinary concentrations of tungsten, arsenic, thallium, cesium, antimony, molybdenum, cobalt, and cadmium were measured. Trouble sleeping was self-reported. We employed weighted logistic regression, restricted cubic spline models, and weighted quantile sum regression to evaluate single and mixed-metal effects. Among participants, 50.2% were male and 25.3% reported trouble sleeping. Higher urinary tungsten levels were associated with increased likelihood of trouble sleeping in males (odds ratios: 1.28-1.30). Arsenic, thallium, and cesium showed inverse associations, with notable gender differences. Weighted quantile sum analysis supported the positive association of tungsten and the inverse associations of arsenic and cesium. No significant associations were found for antimony, molybdenum, cobalt, or cadmium. Urinary tungsten is cross-sectionally associated with trouble sleeping in males, while arsenic, thallium, and cesium show inverse associations, with gender-specific patterns. Further research using validated tools is warranted to validate these associations, elucidate the underlying biological mechanisms, and highlight the significance of assessing combined metal exposures in relation to sleep health.

Indexed as

Metals, HeavySleep Wake DisordersAdultAntimonyArsenicCadmiumCesiumCross-Sectional StudiesFemaleHumansMaleMiddle AgedMolybdenumNutrition SurveysSex FactorsThalliumAntimonyArsenicCadmiumCesiumMetals, HeavyMolybdenumThalliumTungstencross-sectional studyNHANES (National Health and Nutrition Examination Survey)trouble sleepingurine metals

Identifiers

PMID42700048
PMCPMC13549585

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.