Longer Sleep Duration and Midday Napping Are Associated with a Higher Risk of CHD Incidence in Middle-Aged and Older Chinese: the Dongfeng-Tongji Cohort Study

Yang, Liangle; Yang, Handong; He, Meian; Pan, An; Li, Xiulou; Min, Xinwen; Zhang, Ce; Xu, Chengwei; Zhu, Xiaoyan; Yuan, Jing; Wei, Sheng; Miao, Xiaoping; Hu, Frank B.; Wu, Tangchun; Zhang, Xiaomin

doi:10.5665/sleep.5544

Cited by 71 publications

(67 citation statements)

References 37 publications

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“…To date, the results of prospective studies on the relationship between sleep duration and risk of CHD have been inconsistent [42,46,50]. Several possible reasons are contributed to it, for example, the categories of sleep duration differed across studies [46,47].…”

Section: Discussionmentioning

confidence: 91%

“…Studies were controlled for a group of covariates except one [53] adjusted for age only. Eight studies reported results for both male and female [43,44,[47][48][49][50]52,54], five studies reported results for male and female separately [39][40][41][42]53], three studies reported results for female only [38,45,46], and the remaining one study reported results for male only [51]. Results of quality assessment ranged from 6 to 9, with a mean score of 7.2.…”

Section: Study Characteristicsmentioning

confidence: 92%

“…All the studies were prospective cohort studies and published between 1997 and 2015. Of which, four were conducted in the US [38,45,46,54], three in Japan [41,42,49], two in Sweden [47,53], one in Germany [39], Singapore [40], England [43], Netherlands [48], Europe [44], Denmark [51], Canada [52], and China [50]. The sample size of studies ranged from 1870 to 98,634, with a total of 517,440, and the number of CHD cases ranged from 80 to 5359, with a total of 17,841.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…After reviewing the full text of these 21 articles, 4 articles [19,20,36,37] were excluded owing to a lack of sufficient data. Finally, 17 articles [38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] with 22 independent reports were included in our meta-analysis.…”

Section: Literature Searchmentioning

confidence: 99%

“…Eight prospective studies [40][41][42]44,46,[48][49][50] with eleven reports were included in the long sleep duration meta-analysis. For the semiparametric method, the pooled relative risk were 1.25 (95% CI = 1.04-1.50, I 2 = 65.0%, P heterogeneity = 0.001) and 1.02 (95% CI = 0.96-1.09, I 2 = 41.4%, P heterogeneity = 0.07) for the longest and second longest group respectively.…”

Section: Long Sleep Duration and Risk Of Coronary Heart Diseasementioning

confidence: 99%

See 4 more Smart Citations

Sleep duration and risk of coronary heart disease: A systematic review and meta-analysis of prospective cohort studies

Wang

Cui

et al. 2016

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 91%

Section: Study Characteristicsmentioning

confidence: 92%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Literature Searchmentioning

confidence: 99%

Section: Long Sleep Duration and Risk Of Coronary Heart Diseasementioning

confidence: 99%

See 3 more Smart Citations

Sleep duration and risk of coronary heart disease: A systematic review and meta-analysis of prospective cohort studies

Wang

Cui

et al. 2016

International Journal of Cardiology

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Changes in Sleep Patterns, Genetic Susceptibility, and Incident Cardiovascular Disease in China

Diao,

Liu,

Lyu

et al. 2024

JAMA Netw Open

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ImportanceThe associations of changes in sleep patterns with incident cardiovascular disease (CVD) are not fully elucidated, and whether these associations are modified by genetic susceptibility remains unknown.ObjectivesTo investigate the associations of 5-year changes in sleep patterns with incident CVD and whether genetic susceptibility modifies these associations.Design, Setting, and ParticipantsThis prospective cohort study of the Dongfeng-Tongji cohort was conducted from 2008 to 2018 in China. Eligible participants included those with complete sleep information at baseline survey (2008-2010) and the first follow-up survey (2013); participants who had no CVD or cancer in 2013 were prospectively assessed until 2018. Statistical analysis was performed in November 2023.ExposuresFive-year changes in sleep patterns (determined by bedtime, sleep duration, sleep quality, and midday napping) between 2008 and 2013, and polygenic risk scores (PRS) for coronary heart disease (CHD) and stroke.Main Outcomes and MeasuresIncident CVD, CHD, and stroke were identified from 2013 to 2018. Cox proportional hazards regression models were applied to estimate hazard ratios (HRs) and 95% CIs.ResultsAmong 15 306 individuals (mean [SD] age, 65.8 [7.4] years; 8858 [57.9%] female and 6448 male [42.1%]), 5474 (35.78%) had persistent unfavorable sleep patterns and 3946 (25.8%) had persistent favorable sleep patterns. A total of 3669 incident CVD cases were documented, including 2986 CHD cases and 683 stroke cases, over a mean (SD) follow-up of 4.9 (1.5) years. Compared with those with persistent unfavorable sleep patterns, individuals with persistent favorable sleep patterns over 5 years had lower risks of incident CVD (HR, 0.80; 95% CI, 0.73-0.87), CHD (HR, 0.84; 95% CI, 0.76-0.92), and stroke (HR, 0.66; 95% CI, 0.54-0.82) in the subsequent 5-year period. No significant effect modification by PRS was observed for sleep pattern change and CHD or stroke risk. However, sleep pattern changes and PRS were jointly associated with the CHD and stroke risk in a dose-dependent manner, with the lowest risk being among those with persistent favorable sleep patterns combined with low PRS (HR for CHD, 0.65; 95% CI, 0.52-0.82 and HR for stroke, 0.48; 95% CI, 0.29-0.79).Conclusions and RelevanceIn this cohort study of middle-aged and older Chinese adults, individuals with persistent favorable sleep patterns had a lower CVD risk, even among those with higher genetic risk. These findings highlight the importance of maintaining favorable sleep patterns for CVD prevention.

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Napping characteristics and cognitive performance in older adults

Owusu

Wennberg

Holingue

et al. 2018

Int J Geriat Psychiatry

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Objectives: To determine the association of napping intention, frequency, and duration with cognition in a nationally-representative sample of U.S. older adults. Methods: We performed a cross-sectional analysis of community-dwelling Medicare beneficiaries aged ≥65 years from Rounds 3 or 4 (2013–2014) of the National Health and Aging Trends Study (N=2,549). Participants reported past-month napping intention (intentional/unintentional), napping frequency (rarely/never [non-nappers], some days [infrequent nappers], most days/every day [frequent nappers]), and average nap duration (we categorized as ≤30 minutes [short]; 31–60 minutes [moderate]; and >60 minutes [long]). Cognitive outcomes were performance on immediate and delayed word recall tests (IWR and DWR, respectively), the Clock Drawing Test (CDT), and self-rated memory (score: 1[excellent]-5[very poor]). Results: After adjustment for potential confounders, unintentional nappers had poorer immediate word recall test performance than non-nappers (B=−0.23, p<0.01) and intentional nappers (B=−0.26, p<0.01). After further adjustment for daytime sleepiness, frequent nappers reported poorer self-rated memory than non-nappers (B=0.14, p<0.05). Compared to short nappers, long nappers had poorer IWR (B=−0.26, p<0.05) and CDT scores (B=−0.17, p<0.05). Except for the association of nap duration with IWR and CDT, these associations remained after excluding participants with dementia and/or proxy respondents. Among participants undiagnosed with dementia or proxies, moderate-duration naps were associated with better DWR than short naps (B=0.24, p<0.05). Neither napping intentionality nor frequency were associated with CDT performance. Conclusions: Among older adults, distinct aspects of napping are associated with cognitive performance. Prospective research, with objective measures of napping, is needed to elucidate the link between napping and cognitive trajectories.

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Longer Sleep Duration and Midday Napping Are Associated with a Higher Risk of CHD Incidence in Middle-Aged and Older Chinese: the Dongfeng-Tongji Cohort Study

Abstract: Both longer sleep duration and midday napping were independently and jointly associated with a higher risk of CHD incidence, and altered lipid profile and waist circumference may partially explain the relationships.

Cited by 71 publications

References 37 publications

Sleep duration and risk of coronary heart disease: A systematic review and meta-analysis of prospective cohort studies

Sleep duration and risk of coronary heart disease: A systematic review and meta-analysis of prospective cohort studies

Changes in Sleep Patterns, Genetic Susceptibility, and Incident Cardiovascular Disease in China

Napping characteristics and cognitive performance in older adults

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