Association of bedtime with mortality and major cardiovascular events: an analysis of 112,198 individuals from 21 countries in the PURE study

Wang, Chuangshi and Hu, Bo and Rangarajan, Sumathy and Bangdiwala, Shrikant I and Lear, Scott A and Mohan, V and Gupta, Rajeev and Alhabib, Khalid F and Soman, Biju and Abat, Marc Evans M and Rosengren, Annika and Lanas, Fernando and Avezum, Alvaro and Lopez-Jaramillo, Patricio and Diaz, Rafael and Yusoff, Khalid and Iqbal, Romaina and Chifamba, Jephat and Yeates, Karen and Zatońska, Katarzyna and Kruger, Iolanthé M and Bahonar, Ahmad and Yusufali, A and Li, W and Yusuf, S (2021) Association of bedtime with mortality and major cardiovascular events: an analysis of 112,198 individuals from 21 countries in the PURE study. Sleep Medicine, 80 . p. 265. ISSN 13899457

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Abstract

Objectives: This study aimed to examine the association of bedtime with mortality and major cardiovascular events. Methods: Bedtime was recorded based on self-reported habitual time of going to bed in 112,198 participants from 21 countries in the Prospective Urban Rural Epidemiology (PURE) study. Participants were prospectively followed for 9.2 years. We examined the association between bedtime and the composite outcome of all-cause mortality, non-fatal myocardial infarction, stroke and heart failure. Participants with a usual bedtime earlier than 10PM were categorized as 'earlier' sleepers and those who reported a bedtime after midnight as 'later' sleepers. Cox frailty models were applied with random intercepts to account for the clustering within centers. Results: A total of 5633 deaths and 5346 major cardiovascular events were reported. A U-shaped association was observed between bedtime and the composite outcome. Using those going to bed between 10PM and midnight as the reference group, after adjustment for age and sex, both earlier and later sleepers had a higher risk of the composite outcome (HR of 1.29 [1.22, 1.35] and 1.11 [1.03, 1.20], respectively). In the fully adjusted model where demographic factors, lifestyle behaviors (including total sleep duration) and history of diseases were included, results were greatly attenuated, but the estimates indicated modestly higher risks in both earlier (HR of 1.09 [1.03-1.16]) and later sleepers (HR of 1.10 [1.02-1.20]). Conclusion: Early (10 PM or earlier) or late (Midnight or later) bedtimes may be an indicator or risk factor of adverse health outcomes.

Item Type:Article
Official URL/DOI:http://dx.doi.org/10.1016/j.sleep.2021.01.057
Uncontrolled Keywords:Bedtime; Cardiovascular events; Mortality.
Subjects:Diabetes Epidemiology
Diabetes
Divisions:Department of Epidemiology
Department of Diabetology
ID Code:1186
Deposited By:surendar radha
Deposited On:11 Mar 2021 15:44
Last Modified:11 Mar 2021 15:44

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