Articlegreen2012

Midday Naps and the Risk of Coronary Artery Disease: Results of the Heinz Nixdorf Recall Study

Andreas Stang · Nico Dragano · Susanne Moebus · Stefan Möhlenkamp · Axel Schmermund · Hagen Kälsch +2 more

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Abstract

STUDY OBJECTIVES: Several studies have assessed the association between midday nap and cardiovascular outcomes and reported heterogenous results. Concern exists that confounding might have distorted these results and contributed to discrepancies among them. This study prospectively examines the association between midday nap habits and the occurrence of coronary artery disease in a non-Mediterranean population. PARTICIPANTS: The baseline examination of 4,123 participants aged 45-75 years. MEASUREMENTS: Measurements included interviews, physical examinations, laboratory tests, and electron beam computed tomography. We studied the influence of midday nap habits on risk of coronary artery disease. We adjusted for several potential confounders including measures of subclinical atherosclerosis-such as coronary calcium score and ankle brachial index-at baseline. Cardiac events during a median follow-up of 8.1 years were defined as nonfatal myocardial infarction and sudden cardiac death. RESULTS: Overall, 135 of 4,123 subjects (3.3%) either suffered from acute myocardial infarction (81 subjects) or died due to a sudden cardiac death (54 subjects) during follow-up. After adjustment for several confounders including measures of subclinical atherosclerosis, regular long (> 60 min) midday nap was associated with an increased hazard ratio of cardiac events (hazard ratio 2.12, 95% confidence interval 1.11-4.05). CONCLUSIONS: As our detailed confounder analyses showed, confounding is not the sole explanation for this finding. Future research on midday naps should focus on biological mechanisms that may be responsible for increasing the risk of coronary artery disease among subjects taking regular long midday naps.

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References

1977The CES-D Scale 2004Sleep disturbances and chronic disease in older adults 2007Siesta in Healthy Adults and Coronary Mortality in the General Population 2005Baseline recruitment and analyses of nonresponse of the Heinz Nixdorf recall study: Identifiability of phone numbers as the major determinant of response 1999The Siesta in the Elderly 2009Daytime napping and mortality, with a special reference to cardiovascular disease: the JACC study 2003Siesta and Mortality in a Mediterranean Population: A Community Study in Jerusalem 2002The Siesta and Mortality in the Elderly: Effect of Rest Without Sleep and Daytime Sleep Duration

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