Abstract
Purpose
To investigate the associations between sleep duration and atherosclerotic cardiovascular disease (ASCVD) risk and the potential mechanism.
Methods
Overall, 24,471 subjects without ASCVD were included from Dongfeng-Tongji (DFTJ) cohort. Data collection included questionnaires and general medical examinations. We used logistic regression models and generalized linear models to examine the associations between sleep duration, peripheral white blood cell (WBC) counts, and 10-year ASCVD risk. Mediation analyses were further performed to assess the potential role of peripheral WBC counts in the associations between sleep duration and 10-year ASCVD risk.
Results
Increased risk of 10-year ASCVD was observed as sleep duration extended. After adjusting for potential confounders, the odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of 10-year ASCVD were 1.24 (1.11–1.38), 1.12 (1.03–1.22), and 1.21(1.08–1.36) for individuals with nighttime sleeping duration of ≥ 9 h, daytime napping duration of > 30 min, and daily sleep duration of ≥ 9 h, respectively. Peripheral WBC counts mediated 14.1%, 14.5%, and 12.6% in the associations of nighttime sleep duration of ≥ 9 h, daytime napping duration of > 30 min and daily sleep duration of ≥ 9 h with 10-year ASCVD risk, respectively.
Conclusions
Extended sleep durations are associated with the increased 10-year ASCVD risk, and the associations are partially mediated by peripheral WBC counts.
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Acknowledgements
The contributions of all the participants, staffs of the Health Examination Center of the Dongfeng Central Hospital and the Medical Insurance Center of DMC, and all members of study team are greatly acknowledged.
Funding
The study was supported by the Major Research Program of the National Natural Science Foundation of China (91843302), and the National Natural Science Foundation of China (81903291).
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XF, DW, and WC designed the research. XF, DW, RL, MC, LC, YX, MZ, MH, XZ, JY, and WC conducted the research. XF performed statistical analysis. XF wrote the paper. MH, XZ, JY, WC, and DW revised the paper. WC and DW had primary responsibility for final content. All authors have read and approved the final manuscript.
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The study protocol was approved by the Medical Ethics Committee of the School of Public Health, Tongji Medical College, Huazhong University of Science and Technology and Dongfeng General Hospital, DMC. All participants provided written informed consent.
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Feng, X., Wang, D., Liang, R. et al. Peripheral white blood cell counts mediated the associations of sleep duration with atherosclerotic cardiovascular disease risk: a cross-sectional study of middle-aged and older Chinese. Sleep Breath 25, 2277–2285 (2021). https://doi.org/10.1007/s11325-021-02338-8
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DOI: https://doi.org/10.1007/s11325-021-02338-8