Naska Androniki, Oikonomou Eleni, Trichopoulou Antonia, Psaltopoulou Theodora, Trichopoulos Dimitrios
Department of Hygiene and Epidemiology, University of Athens Medical School, Athens, Greece.
Arch Intern Med. 2007 Feb 12;167(3):296-301. doi: 10.1001/archinte.167.3.296.
Midday napping (siesta) is common in populations with low coronary mortality, but epidemiological studies have generated conflicting results. We have undertaken an analysis based on a sizable cohort with a high frequency of napping and information on potentially confounding variables including reported comorbidity, physical activity, and diet.
Among participants in a general population cohort (the Greek European Prospective Investigation into Cancer and Nutrition [EPIC] cohort), 23 681 individuals who at enrollment had no history of coronary heart disease, stroke, or cancer and had complete information on frequency and duration of midday napping, as well as on potentially confounding variables, were followed up for a mean of 6.32 years. Data were modeled through Cox regression, using time to coronary death and treating deaths from other causes as censoring events as outcomes.
Among men and women, when controlling for potential confounders and using those not taking siesta as a referent category, those taking a siesta of any frequency or duration had a coronary mortality ratio (MR) of 0.66 (95% confidence interval [CI], 0.45-0.97). Specifically, those occasionally napping had a 12% lower coronary mortality (MR, 0.88; 95% CI, 0.48-1.60), whereas those systematically napping had a 37% lower coronary mortality (MR, 0.63; 95% CI, 0.42-0.93). Among men, the inverse association was stronger when the analysis was restricted to those who were currently working at enrollment, whereas among women, a similar analysis was not possible because of the small number of deaths.
After controlling for potential confounders, siesta in apparently healthy individuals is inversely associated with coronary mortality, and the association was particularly evident among working men.
午睡在冠心病死亡率较低的人群中很常见,但流行病学研究结果相互矛盾。我们基于一个规模较大、午睡频率较高且包含潜在混杂变量(包括报告的合并症、身体活动和饮食)信息的队列进行了分析。
在一般人群队列(希腊欧洲癌症与营养前瞻性调查[EPIC]队列)的参与者中,对23681名在入组时无冠心病、中风或癌症病史且拥有午睡频率和时长以及潜在混杂变量完整信息的个体进行了平均6.32年的随访。数据通过Cox回归建模,将冠心病死亡时间作为观察指标,并将其他原因导致的死亡作为删失事件。
在男性和女性中,在控制潜在混杂因素并以不午睡者作为参照类别时,任何频率或时长午睡者的冠心病死亡率比(MR)为0.66(95%置信区间[CI],0.45 - 0.97)。具体而言,偶尔午睡者的冠心病死亡率降低12%(MR,0.88;95%CI,0.48 - 1.6),而经常午睡者的冠心病死亡率降低37%(MR,0.63;95%CI,0.42 - 0.93)。在男性中,当分析仅限于入组时在职者时,这种负相关更强,而在女性中,由于死亡人数较少,无法进行类似分析。
在控制潜在混杂因素后,明显健康个体的午睡与冠心病死亡率呈负相关,且这种关联在在职男性中尤为明显。