Midday Napping, Nighttime Sleep, and Mortality: Prospective Cohort Evidence in China.

Ke Wang; Lan HU; Lu Wang; Hai Nan Shu; Yi Ting Wang; Yang Yuan; Hong Ping Cheng; Yun Quan Zhang

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Midday Napping, Nighttime Sleep, and Mortality: Prospective Cohort Evidence in China.

Author: Ke WANG ¹ ; Lan HU ² ; Lu WANG ³ ; Hai Nan SHU ³ ; Yi Ting WANG ³ ; Yang YUAN ³ ; Hong Ping CHENG ⁴ ; Yun Quan ZHANG ^{4
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Author Information

1. College of Medicine and Health Sciences, China Three Gorges University, Yichang 443002, Hubei, China.
2. Department of Head and Neck Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei, China.
3. School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, Hubei, China.
4. Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan 442000, Hubei, China.
5. College of Medicine and Health Sciences, China Three Gorges University, Yichang 443002, Hubei, China
6. School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, Hubei, China
Publication Type:Journal Article
Keywords: All-cause mortality; CHARLS; Chinese; Cohort; Midday napping; Nighttime sleep
MeSH: Adult; Middle Aged; Humans; Aged; Longitudinal Studies; Prospective Studies; Sleep; Sleep Duration; China/epidemiology*
From: Biomedical and Environmental Sciences 2023;36(8):702-714
CountryChina
Language:English
Abstract: OBJECTIVE:In developed countries, midday napping and nighttime sleep duration have been linked to long-term survival; however, little is known about such effects in less developed regions. Therefore, this study aimed to assess the associations of midday napping and nocturnal sleep with mortality in middle-aged and older Chinese adults.
METHODS:A nationwide cohort of 15,524 adults aged ≥ 45 years was enrolled from 28 provincial regions across mainland China and followed up from 2011 to 2018, using data from the Chinese Health and Retirement Longitudinal Study. Midday napping and nighttime sleep duration were assessed using standardized questionnaires. Cox proportional hazards models with random intercepts for the surveyed provinces were used to estimate hazard ratios ( HRs) of all-cause mortality, adjusting for sociodemographic characteristics, behavioral factors, and health status.
RESULTS:A total of 1,745 deaths occurred during a median follow-up of 7.1 years, and the mean (standard deviation) age was 59 (10.1) years at baseline. Compared with non-nappers, over 60 min nappers had a higher risk of all-cause mortality [ HR: 1.35, 95% confidence interval ( CI): 1.17-1.56], while no significant associations were observed among < 30 min nappers. Compared with sleep duration of 6-8 h/night, both short (< 6 h) and long (≥ 8 h) sleep duration were significantly associated with increased mortality, with corresponding HR (95% CI) estimates of 1.21 (1.05-1.38) and 1.26 (1.10-1.44), respectively. We observed significant patterns for greater risks associated with longer nap duration, with a P _trend value < 0.001 for all-cause mortality. No significant evidence of an additive interaction was identified between midday napping and nighttime sleep.
CONCLUSION:Long midday napping and inappropriate nighttime sleep were independently associated with an increased risk of all-cause mortality in middle-aged and older Chinese populations. Biological studies are needed to validate our findings and clarify the mechanisms underlying this association.