Association of estimated sleep duration and naps with mortality and cardiovascular events: a study of 116 632 people from 21 countries Academic Article uri icon

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abstract

  • AIMS: To investigate the association of estimated total daily sleep duration and daytime nap duration with deaths and major cardiovascular events. METHODS AND RESULTS: We estimated the durations of total daily sleep and daytime naps based on the amount of time in bed and self-reported napping time and examined the associations between them and the composite outcome of deaths and major cardiovascular events in 116 632 participants from seven regions. After a median follow-up of 7.8 years, we recorded 4381 deaths and 4365 major cardiovascular events. It showed both shorter (≤6 h/day) and longer (>8 h/day) estimated total sleep durations were associated with an increased risk of the composite outcome when adjusted for age and sex. After adjustment for demographic characteristics, lifestyle behaviours and health status, a J-shaped association was observed. Compared with sleeping 6-8 h/day, those who slept ≤6 h/day had a non-significant trend for increased risk of the composite outcome [hazard ratio (HR), 1.09; 95% confidence interval, 0.99-1.20]. As estimated sleep duration increased, we also noticed a significant trend for a greater risk of the composite outcome [HR of 1.05 (0.99-1.12), 1.17 (1.09-1.25), and 1.41 (1.30-1.53) for 8-9 h/day, 9-10 h/day, and >10 h/day, Ptrend < 0.0001, respectively]. The results were similar for each of all-cause mortality and major cardiovascular events. Daytime nap duration was associated with an increased risk of the composite events in those with over 6 h of nocturnal sleep duration, but not in shorter nocturnal sleepers (≤6 h). CONCLUSION: Estimated total sleep duration of 6-8 h per day is associated with the lowest risk of deaths and major cardiovascular events. Daytime napping is associated with increased risks of major cardiovascular events and deaths in those with >6 h of nighttime sleep but not in those sleeping ≤6 h/night.

authors

  • Wang, Chuangshi
  • Bangdiwala, Shrikant
  • Rangarajan, Sumathy
  • Lear, Scott A
  • AlHabib, Khalid F
  • Mohan, Viswanathan
  • Teo, Koon
  • Poirier, Paul
  • TSE, Lap Ah
  • Liu, Zhiguang
  • Rosengren, Annika
  • Kumar, Rajesh
  • Lopez-Jaramillo, Patricio
  • Yusoff, Khalid
  • Monsef, Nahed
  • Krishnapillai, Vijayakumar
  • Ismail, Noorhassim
  • Seron, Pamela
  • Dans, Antonio L
  • Kruger, Lanthé
  • Yeates, Karen
  • Leach, Lloyd
  • Yusuf, Rita
  • Orlandini, Andres
  • Wolyniec, Maria
  • Bahonar, Ahmad
  • Mohan, Indu
  • Khatib, Rasha
  • Temizhan, Ahmet
  • Li, Wei
  • Yusuf, Salim

publication date

  • May 21, 2019