Department of Gastrointestinal Surgery and Clinical Nutrition, Beijing Shijitan Hospital, Beijing, China.
National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China.
JMIR Public Health Surveill. 2024 Feb 7;10:e50836. doi: 10.2196/50836.
Baseline sleep duration is associated with cancer risk and cancer-specific mortality; however, the association between longitudinal patterns of sleep duration and these risks remains unknown.
This study aimed to elucidate the association between sleep duration trajectory and cancer risk and cancer-specific mortality.
The participants recruited in this study were from the Kailuan cohort, with all participants aged between 18 and 98 years and without cancer at baseline. The sleep duration of participants was continuously recorded in 2006, 2008, and 2010. Latent mixture modeling was used to identify shared sleep duration trajectories. Furthermore, the Cox proportional risk model was used to examine the association of sleep duration trajectory with cancer risk and cancer-specific mortality.
A total of 53,273 participants were included in the present study, of whom 40,909 (76.79%) were men and 12,364 (23.21%) were women. The average age of the participants was 49.03 (SD 11.76) years. During a median follow-up of 10.99 (IQR 10.27-11.15) years, 2705 participants developed cancers. Three sleep duration trajectories were identified: normal-stable (44,844/53,273, 84.18%), median-stable (5877/53,273, 11.03%), and decreasing low-stable (2552/53,273, 4.79%). Compared with the normal-stable group, the decreasing low-stable group had increased cancer risk (hazard ratio [HR] 1.39, 95% CI 1.16-1.65) and cancer-specific mortality (HR 1.54, 95% CI 1.18-2.06). Dividing the participants by an age cutoff of 45 years revealed an increase in cancer risk (HR 1.88, 95% CI 1.30-2.71) and cancer-specific mortality (HR 2.52, 95% CI 1.22-5.19) only in participants younger than 45 years, rather than middle-aged or older participants. Joint analysis revealed that compared with participants who had a stable sleep duration within the normal range and did not snore, those with a shortened sleep duration and snoring had the highest cancer risk (HR 2.62, 95% CI 1.46-4.70).
Sleep duration trajectories and quality are closely associated with cancer risk and cancer-specific mortality. However, these associations differ with age and are more pronounced in individuals aged <45 years.
Chinese Clinical Trial Registry ChiCTR-TNRC-11001489; http://tinyurl.com/2u89hrhx.
基础睡眠时长与癌症风险和癌症特异性死亡率相关；然而，睡眠时长的纵向变化模式与这些风险之间的关系仍不清楚。
本研究旨在阐明睡眠时长轨迹与癌症风险和癌症特异性死亡率之间的关系。
本研究的参与者来自开滦队列，所有参与者年龄在 18 岁至 98 岁之间，基线时均无癌症。在 2006 年、2008 年和 2010 年连续记录参与者的睡眠时长。采用潜在混合模型识别共享的睡眠时长轨迹。此外，采用 Cox 比例风险模型检验睡眠时长轨迹与癌症风险和癌症特异性死亡率的关联。
本研究共纳入 53273 名参与者，其中 40909 名（76.79%）为男性，12364 名（23.21%）为女性。参与者的平均年龄为 49.03（SD 11.76）岁。在中位随访 10.99（IQR 10.27-11.15）年期间，2705 名参与者发生癌症。确定了三种睡眠时长轨迹：正常稳定型（44844/53273，84.18%）、中位稳定型（5877/53273，11.03%）和逐渐减少的稳定型（2552/53273，4.79%）。与正常稳定型组相比，逐渐减少的稳定型组癌症风险增加（风险比[HR] 1.39，95%CI 1.16-1.65）和癌症特异性死亡率（HR 1.54，95%CI 1.18-2.06）。以 45 岁为年龄界限将参与者分组后，发现年轻参与者（年龄<45 岁）的癌症风险（HR 1.88，95%CI 1.30-2.71）和癌症特异性死亡率（HR 2.52，95%CI 1.22-5.19）均升高，而中年或老年参与者则不然。联合分析显示，与睡眠时长稳定且不打鼾的参与者相比，睡眠时长缩短且打鼾的参与者癌症风险最高（HR 2.62，95%CI 1.46-4.70）。
睡眠时长轨迹和质量与癌症风险和癌症特异性死亡率密切相关。然而，这些关联因年龄而异，在年龄<45 岁的个体中更为明显。
中国临床试验注册中心 ChiCTR-TNRC-11001489；http://tinyurl.com/2u89hrhx。
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