Department of Epidemiology, University of Washington, 380 15th Ave NE, Seattle, WA, 98195, USA.
Department of Population Science, American Cancer Society, Atlanta, GA, USA.
Cancer Causes Control. 2024 Dec;35(12):1541-1555. doi: 10.1007/s10552-024-01910-3. Epub 2024 Sep 6.
Sleep is a multi-dimensional human function that is associated with cancer outcomes. Previous work on sleep and cancer mortality have not investigated how this relationship varies by sex and cancer site. We investigated the association of sleep duration and perceived insomnia with site-specific and overall cancer mortality among participants in the Cancer Prevention Study-II.
Sleep was collected at baseline in 1982 among 1.2 million cancer-free US adults. Cancer-specific mortality was determined through 2018. We used multivariable Cox proportional hazard models to calculate hazard ratios and 95% confidence intervals for overall and site-specific cancer mortality, stratified by sex.
Among 983,105 participants (56% female) followed for a median of 27.9 person-years, there were 146,911 primary cancer deaths. Results from the adjusted model showed short (6 h/night) and long (8 h/night and 9-14 h/night) sleep duration, compared to 7 h/night, were associated with a modest 2%, 2%, and 5% higher risk of overall cancer mortality, respectively, and there was a significant non-linear trend (p-trend < 0.01). This non-linear trend was statistically significant among male (p-trend < 0.001) but not female (p-trend 0.71) participants. For male participants, short and long sleep were associated with higher risk of lung cancer mortality and long sleep was associated with higher risk of colorectal cancer mortality. Perceived insomnia was associated with a 3-7% lower risk of overall cancer mortality.
Sleep is important to consider in relation to sex- and site-specific cancer mortality. Future research should investigate other components of sleep in relation to cancer mortality.
睡眠是人类的一项多维功能，与癌症结局有关。以前关于睡眠与癌症死亡率的研究尚未调查这种关系在性别和癌症部位上的差异。我们研究了在癌症预防研究 II 中参与者的睡眠持续时间和感知失眠与特定部位和总体癌症死亡率之间的关系。
1982 年，在 120 万无癌症的美国成年人中在基线时收集了睡眠数据。通过 2018 年确定癌症特异性死亡率。我们使用多变量 Cox 比例风险模型，按性别分层，计算总体和特定部位癌症死亡率的风险比和 95%置信区间。
在 983105 名参与者（56%为女性）中，中位随访时间为 27.9 人年，有 146911 人死于原发性癌症。调整模型的结果显示，与每晚 7 小时相比，睡眠时间较短（每晚 6 小时）和较长（每晚 8 小时和 9-14 小时）与总体癌症死亡率分别增加 2%、2%和 5%的风险相关，并且存在显著的非线性趋势（p 趋势 <0.01）。这种非线性趋势在男性（p 趋势 <0.001）但不是女性（p 趋势 0.71）参与者中具有统计学意义。对于男性参与者，短睡眠和长睡眠与肺癌死亡率增加相关，而长睡眠与结直肠癌死亡率增加相关。感知失眠与总体癌症死亡率降低 3-7%相关。
睡眠与性别和特定部位的癌症死亡率有关，应予以考虑。未来的研究应调查睡眠的其他成分与癌症死亡率的关系。
