Interventions aiming at increasing the compatibility of work and private life may substantially help to decrease burnout risk of professionals working in a health care setting.

ObjectiveThere is controversy regarding the effect of napping on cardiovascular disease (CVD), with most studies failing to consider napping frequency. We aimed to assess the relationship of napping frequency and average nap duration with fatal and non-fatal CVD events.Methods3462 subjects of a Swiss population based cohort with no previous history of CVD reported their nap frequency and daily nap duration over a week, and were followed over 5.3 years. Fatal and non-fatal CVD events were adjudicated. Cox regressions were performed to obtain HRs adjusted for major cardiovascular risk factors and excessive daytime sleepiness or obstructive sleep apnoea.Results155 fatal and non-fatal events occurred. We observed a significantly lower risk for subjects napping 1–2 times weekly for developing a CVD event (HR 0.52, 95% CI 0.28 to 0.95) compared with non-napping subjects, in unadjusted as well as adjusted models. The increased HR (1.67, 95% CI 1.10 to 2.55) for subjects napping 6–7 times weekly disappeared in adjusted models (HR 0.89, 95% CI 0.58 to 1.38). Neither obstructive sleep apnoea nor excessive daytime sleepiness modified this lower risk. No association was found between nap duration and CVD events.ConclusionSubjects who nap once or twice per week have a lower risk of incident CVD events, while no association was found for more frequent napping or napping duration. Nap frequency may help explain the discrepant findings regarding the association between napping and CVD events.

Background In Switzerland, two distinct algorithms are recommended for cardiovascular prevention: (a) Arbeitsgruppe Lipide und Atherosklerose (AGLA); and (b) European Society of Cardiology (ESC). We validated and determined which algorithm better predicts incident atherosclerotic cardiovascular disease and assessed statin eligibility in Switzerland. Design A prospective population-based cohort. Methods We employed longitudinal data of the CoLaus study involving 6733 individuals, aged 35–75 years, with a 10-year follow-up. Using discrimination and calibration, we evaluated the predictive performance of the AGLA and ESC algorithms for the prediction of atherosclerotic cardiovascular disease. Results From the 6733 initial participants, 5529 were analysed with complete baseline and follow-up data. Mean age (SD) was 52.4 (10.6) years and 54% were women. During an average follow-up (SD) of 10.2 years (1.7), 370 (6.7%) participants developed an incident atherosclerotic cardiovascular disease. The sensitivity of AGLA and ESC algorithms to predict atherosclerotic cardiovascular disease was 51.6% (95% confidence interval (CI) 46.4–56.8) and 58.6% (53.4–63.7), respectively. Discrimination and calibration were similar between the AGLA and ESC algorithms, with area under the receiver operating characteristic curve values of 0.78 (95% CI 0.76–0.80) and 0.79 (0.76–0.81), and Brier scores of 0.059 and 0.041, respectively. Among 370 individuals developing incident atherosclerotic cardiovascular disease, only 278 (75%) were eligible for statin therapy at baseline, including 210 (57%) according to both algorithms, 4 (1%) to AGLA only and 64 (17%) to ESC only. Conclusion AGLA and ESC algorithms presented similar accuracy to predict atherosclerotic cardiovascular disease in Switzerland. A quarter of adults developing atherosclerotic cardiovascular disease were not identified by preventive algorithms to be eligible for statin therapy.

Study objectives. The temporal relationship between nocturnal sleep and daytime napping has only been assessed in small non-representative samples, and suggest that nocturnal sleep and napping are interdependent, although mixed results exist. We investigate the temporal relationship between nocturnal sleep and napping (and vice versa). Methods. A population-based sample of middle-aged adults (N=683, mean age 60.7 [SD 9.5]) completed seven days of ecological momentary assessment reporting sleep and nap characteristics. Multilevel random-effects models were used to assess the temporal relationship between sleep duration and quality and nap occurrence and duration (and vice versa). Results. 64% of the study population took at least one nap during seven days. Poor subjective sleep quality and shorter sleep duration increased the likelihood and duration of next-day napping. No effect of nap occurrence or duration was found on same-day nocturnal sleep duration and quality was found. However, when considering the timing of nap, afternoon naps, but neither morning nor evening naps, decreased same-day nocturnal sleep duration. Conclusion. Naps seem to compensate for poor subjective sleep quality, and to some extent for short sleep duration. As only afternoon naps reduced same-day nocturnal sleep duration, timing of the daytime nap seems to matter with respect to same-day nocturnal sleep duration.

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