Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Diagnostic Radiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Sleep. 2021 Mar 12;44(3). doi: 10.1093/sleep/zsaa192.
To prospectively examine the association between sleep quality and incident cancer risk in the elderly.
A total of 10,036 participants aged ≥50 years free of cancer at baseline from the English Longitudinal Study of Ageing at wave 4 (2008) were included, and followed up until 2016. The primary endpoint was new onset physician-diagnosed cancer. Sleep quality was assessed by four questions regarding the frequency of sleep problems and overall subjective feeling of sleep quality in the last month, with higher score denoting poorer sleep quality. The multivariable Cox regression model was used to calculate hazard ratio (HR) with 95% confidence interval (CI) for incident cancer risk according to sleep quality.
At 8-year follow-up, a total of 745 (7.4%) participants developed cancer. Compared with good sleep quality at baseline, HR (95% CI) for incident cancer risk was 1.328 (1.061, 1.662) for intermediate quality, 1.586 (1.149, 2.189) for poor quality. Similarly, compared with maintaining good sleep quality in the first 4 years, HR (95% CI) for incident cancer risk was 1.615 (1.208, 2.160) for maintaining intermediate quality and 1.608 (1.043, 2.480) for maintaining poor quality. The exclusion of participants with family history of cancer or abnormal sleep duration yielded consistent results.
Poor sleep quality is positively associated with the long-term risk of developing cancer in an elderly cohort. Both medical staffs and the general public should pay more attention to improving sleep hygiene.
前瞻性研究老年人睡眠质量与癌症发病风险的关系。
共纳入 10036 名基线时无癌症的年龄≥50 岁的英国老龄化纵向研究 4 期（2008 年）参与者，并随访至 2016 年。主要终点为新确诊的癌症。睡眠质量通过四个问题评估，包括过去一个月中睡眠问题的频率和整体主观睡眠质量，得分越高表示睡眠质量越差。多变量 Cox 回归模型用于计算根据睡眠质量计算的癌症发病风险的风险比（HR）和 95%置信区间（CI）。
在 8 年的随访中，共有 745 名（7.4%）参与者发生了癌症。与基线时睡眠质量良好相比，睡眠质量中等者（95%CI：1.061-1.662）和睡眠质量差者（95%CI：1.149-2.189）发生癌症的风险较高。同样，与前 4 年保持良好睡眠质量相比，睡眠质量中等（95%CI：1.208-2.160）和睡眠质量差（95%CI：1.043-2.480）者发生癌症的风险也较高。排除有癌症家族史或睡眠异常持续时间的参与者后，结果仍然一致。
较差的睡眠质量与老年人群癌症发生的长期风险呈正相关。医护人员和公众都应更加重视改善睡眠卫生。
