Effects of sleep habits on acute myocardial infarction risk and severity of coronary artery disease in Chinese population

Abstract

Background Growing 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. Methods A 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. Results After 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). Conclusion Sleep 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

Association between insomnia and the incidence of myocardial infarction: A systematic review and meta‐analysis

“…Our study showed that regardless of age, insomniacs are associated with a higher risk of MI. Lian et al 32 cross‐sectional study reinforce our findings; they concluded that short sleep duration is associated with a higher risk of MI in patients <65 and >65 years old. Older age is usually associated with a higher risk of MI 33 ; this is supported by the findings in our study.…”

Associations between sleep duration and cardiovascular diseases: A meta-review and meta-analysis of observational and Mendelian randomization studies

“…Moreover, short sleep duration was associated with several cardiovascular risk factors, such as type 2 diabetes and overweight (48-50). Evidence obtained by the meta-analyses of the observational studies further confirmed that short sleep duration may be an independent risk factor for CHD, all-cause and cardiovascular mortalities (51)(52)(53)(54). As for Meta-analysis results for the association between per hour longer sleep duration and CVDs in MR studies.…”

The association between sleep deprivation and the risk of cardiovascular diseases: A systematic meta‑analysis

“…Additionally, short sleep duration has been linked to various cardiovascular risk factors, including type 2 diabetes and overweight (43)(44)(45)(46). Moreover, meta-analyses of observational studies have further confirmed that short sleep duration could serve as an independent risk factor for CHD and is associated with higher risks of all-cause and cardiovascular mortalities (47)(48)(49). Regarding stroke, observational studies have suggested that short sleep duration is associated with an elevated risk of stroke (50)(51)(52)(53), and a meta-analysis of such studies further substantiated this finding (54).…”