Abstract
BackgroundGrowing evidence indicates that poor sleep harms health. Early to bed and early to rise is considered as a healthy lifestyle in Chinese population. The current study aimed to examine the effects of sleep habits on acute myocardial infarction (AMI) risk and severity of coronary artery disease (CAD) in Chinese population from two centers.MethodsA total of 873 patients including 314 AMI cases and 559 controls were recruited from the inpatient cardiology department of the Affiliated Jiangning Hospital and the First Affiliated Hospital of Nanjing Medical University. 559 controls included 395 CAD cases and 164 non-CAD cases. We used a 17-item sleep factors questionnaire (SFQ) to evaluate sleep habits comprehensively by face-to-face interview. The severity of CAD was assessed by Gensini score in AMI and CAD groups. The effects of sleep factors on AMI risk and Gensini score were examined by unconditional logistic regression.ResultsAfter mutually adjustment for other sleep factors and demographic characteristics, the timing of sleep (24:00 and after) and morning waking (after 7:00) and sleep duration (< 6 h) were associated with increased risk of AMI (OR = 4.005, P < 0.001, OR = 2.544, P = 0.011 and OR = 2.968, P < 0.001, respectively). Lower level of light exposure at night was correlated with reduced risk of AMI (OR = 0.243, P = 0.009). In subgroup analysis by age, both late sleep timing and short sleep duration were associated with increased risk of AMI regardless of age. In subjects with age ≤ 65 years, daytime napping was related to reduced risk of AMI (OR = 0.645, P = 0.046). In subjects with age > 65 years, the frequency of night-time waking (3 times) was associated with increased risk of AMI (OR = 3.467, P = 0.035). Short sleep duration was correlated with increased risk of high Gensini score (OR = 2.374, P < 0.001).ConclusionSleep insufficiency is an important risk factor both for AMI risk and CAD severity. Late sleeping is also associated with increased risk of AMI. In young and middle-aged people, regular naps may have a protective effect.Graphic abstract
Highlights
It has been reported that sleeping between 7 and 9 h per night is the best choice for adults [1]
The median age was lower and the proportion of men were significantly higher in the acute myocardial infarction (AMI) group than in the control and coronary artery disease (CAD) groups
The education level, hypertension, use of Angiotensin converting enzyme inhibitor (ACEI) or Angiotensin receptor blocker (ARB), smoking, drinking, diet and regular exercise of the AMI group significantly differed from the control group
Summary
It has been reported that sleeping between 7 and 9 h per night is the best choice for adults [1]. Growing evidence indicates that poor sleep harms health, either physical or psychological. Short sleep and poor sleep quality increase the risk of cardiovascular disease mainly through influencing glucose metabolism and blood pressure and leading to insulin resistance and metabolic syndrome [2]. A longitudinal study proved that sleep for 6 h or less per night lost less weight and increased the risk of type 2 diabetes mellitus [3]. The relationship between sleep duration and coronary artery disease (CAD) displays a U-shaped curve, which means that short or long sleep is associated with a high risk of CAD. Growing evidence indicates that poor sleep harms health. The current study aimed to examine the effects of sleep habits on acute myocardial infarction (AMI) risk and severity of coronary artery disease (CAD) in Chinese population from two centers
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