Association of estimated sleep duration and naps with mortality and cardiovascular events: a study of 116 632 people from 21 countries
Chuangshi Wang
1, 2
,
S I Bangdiwala
1
,
Sumathy Rangarajan
1
,
Scott A. Lear
3
,
Khalid F. Alhabib
4
,
V. Mohan
5
,
Koon K. Teo
1
,
Paul P. Poirier
6
,
Lap-Ah Tse
7
,
ZHIGUANG LIU
7
,
Annika Rosengren
8
,
Rajiv Kumar
9
,
P. Lopez-Jaramillo
10
,
Khalid Yusoff
11
,
Nahed Monsef
12
,
Krishnapillai Vijayakumar
13
,
Noorhassim Ismail
14
,
Pamela Seron
15
,
Antonio L. Dans
16
,
Lanthe Kruger
17
,
Karen Yeates
18
,
L. Leach
19
,
Rita Yusuf
20
,
Andrés Orlandini
21
,
Maria Wolyniec
22
,
Ahmad Bahonar
23
,
Indu Mohan
24
,
Rasha Khatib
25
,
Ahmet Temizhan
26
,
Wei Li
2
,
Salim Yusuf
1
5
Madras Diabetes Research Foundation, Dr Mohan’s Diabetes Specialities Centre, No. 6B, Conran Smith Road, Gopalapuram, Chennai, India
|
8
10
Research Institute, FOSCAL, Department of Medicine, Medical School, UDES, Calle 158 #20-95, local 101–102, Floridablanca, Colombia
|
12
20
School of Life Sciences, Independent University, Academic Building, Room 10002, Plot #16, Block B, Aftabuddin Ahmed Road, Bashundhara R/A, Dhaka-1229, Bangladesh
|
21
ECLA Foundation, Paraguay 160, Rosario, Santa Fe, Argentina
|
24
Department of Clinical Research, EHCC, Jawahar Circle, Jaipur, India
|
Publication type: Journal Article
Publication date: 2018-12-05
scimago Q1
wos Q1
SJR: 4.987
CiteScore: 40.3
Impact factor: 35.6
ISSN: 0195668X, 15229645
PubMed ID:
30517670
Cardiology and Cardiovascular Medicine
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, P trend < 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.
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GOST
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Wang C. et al. Association of estimated sleep duration and naps with mortality and cardiovascular events: a study of 116 632 people from 21 countries // European Heart Journal. 2018. Vol. 40. No. 20. pp. 1620-1629.
GOST all authors (up to 50)
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Wang C., Bangdiwala S. I., Rangarajan S., Lear S. A., Alhabib K. F., Mohan V., Teo K. K., Poirier P. P., Tse L., LIU Z., Rosengren A., Kumar R., Lopez-Jaramillo P., Yusoff K., Monsef N., Vijayakumar K., Ismail N., Seron P., Dans A. L., Kruger L., Yeates K., Leach L., Yusuf R., Orlandini A., Wolyniec M., Bahonar A., Mohan I., Khatib R., Temizhan A., Li W., Yusuf S. Association of estimated sleep duration and naps with mortality and cardiovascular events: a study of 116 632 people from 21 countries // European Heart Journal. 2018. Vol. 40. No. 20. pp. 1620-1629.
Cite this
RIS
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TY - JOUR
DO - 10.1093/eurheartj/ehy695
UR - https://doi.org/10.1093/eurheartj/ehy695
TI - Association of estimated sleep duration and naps with mortality and cardiovascular events: a study of 116 632 people from 21 countries
T2 - European Heart Journal
AU - Wang, Chuangshi
AU - Bangdiwala, S I
AU - Rangarajan, Sumathy
AU - Lear, Scott A.
AU - Alhabib, Khalid F.
AU - Mohan, V.
AU - Teo, Koon K.
AU - Poirier, Paul P.
AU - Tse, Lap-Ah
AU - LIU, ZHIGUANG
AU - Rosengren, Annika
AU - Kumar, Rajiv
AU - Lopez-Jaramillo, P.
AU - Yusoff, Khalid
AU - Monsef, Nahed
AU - Vijayakumar, Krishnapillai
AU - Ismail, Noorhassim
AU - Seron, Pamela
AU - Dans, Antonio L.
AU - Kruger, Lanthe
AU - Yeates, Karen
AU - Leach, L.
AU - Yusuf, Rita
AU - Orlandini, Andrés
AU - Wolyniec, Maria
AU - Bahonar, Ahmad
AU - Mohan, Indu
AU - Khatib, Rasha
AU - Temizhan, Ahmet
AU - Li, Wei
AU - Yusuf, Salim
PY - 2018
DA - 2018/12/05
PB - Oxford University Press
SP - 1620-1629
IS - 20
VL - 40
PMID - 30517670
SN - 0195-668X
SN - 1522-9645
ER -
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@article{2018_Wang,
author = {Chuangshi Wang and S I Bangdiwala and Sumathy Rangarajan and Scott A. Lear and Khalid F. Alhabib and V. Mohan and Koon K. Teo and Paul P. Poirier and Lap-Ah Tse and ZHIGUANG LIU and Annika Rosengren and Rajiv Kumar and P. Lopez-Jaramillo and Khalid Yusoff and Nahed Monsef and Krishnapillai Vijayakumar and Noorhassim Ismail and Pamela Seron and Antonio L. Dans and Lanthe Kruger and Karen Yeates and L. Leach and Rita Yusuf and Andrés Orlandini and Maria Wolyniec and Ahmad Bahonar and Indu Mohan and Rasha Khatib and Ahmet Temizhan and Wei Li and Salim Yusuf},
title = {Association of estimated sleep duration and naps with mortality and cardiovascular events: a study of 116 632 people from 21 countries},
journal = {European Heart Journal},
year = {2018},
volume = {40},
publisher = {Oxford University Press},
month = {dec},
url = {https://doi.org/10.1093/eurheartj/ehy695},
number = {20},
pages = {1620--1629},
doi = {10.1093/eurheartj/ehy695}
}
Cite this
MLA
Copy
Wang, Chuangshi, et al. “Association of estimated sleep duration and naps with mortality and cardiovascular events: a study of 116 632 people from 21 countries.” European Heart Journal, vol. 40, no. 20, Dec. 2018, pp. 1620-1629. https://doi.org/10.1093/eurheartj/ehy695.