Objective Assessment of Daytime Napping and Incident Heart Failure in 1140 Community-Dwelling Older Adults: A Prospective, Observational Cohort Study.
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ABSTRACT:
SUBMITTER: Li P
PROVIDER: S-EPMC8477879 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:To examine the association of orthostatic hypotension with incident heart failure (HF) in older adults.Of the 5,273 community-dwelling adults aged 65 years and older free of baseline prevalent HF in the Cardiovascular Health Study, 937 (18%) had orthostatic hypotension, defined as ?20 mmHg drop in systolic or ?10 mmHg drop in diastolic blood pressure from supine to standing position at 3 minutes. Of the 937, 184 (20%) had symptoms of dizziness upon standing and were considered to have symptomatic orthostatic hypotension. Propensity scores for orthostatic hypotension were estimated for each of the 5,273 participants and were used to assemble a cohort of 3,510 participants (883 participants with and 2,627 participants without orthostatic hypotension) who were balanced on 40 baseline characteristics. Cox regression models were used to estimate the association of orthostatic hypotension with centrally adjudicated incident HF and other outcomes during 13 years of follow-up.Participants (n = 3,510) had a mean (±standard deviation) age of 74 (±6) years, 58% were women, and 15% nonwhite. Incident HF occurred in 25% and 21% of matched participants with and without orthostatic hypotension, respectively (hazard ratio, 1.24; 95% confidence interval, 1.06-1.45; p = .007). Among matched participants, hazard ratios for incident HF associated with symptomatic (n = 173) and asymptomatic (n = 710) orthostatic hypotension were 1.57 (95% confidence interval, 1.16-2.11; p = .003) and 1.17 (95% confidence interval, 0.99-1.39; p = .069), respectively.Community-dwelling older adults with orthostatic hypotension have higher independent risk of developing new-onset HF, which appeared to be more pronounced in those with symptomatic orthostatic hypotension.
| S-EPMC4038247 | biostudies-literature
Project description:We aimed to examine the longitudinal associations between daytime napping and nighttime sleep duration with the risk of diabetes mellitus (DM) among Chinese elderly using data from the China Health and Retirement Longitudinal Study (CHARLS). A cohort study was conducted among 2620 participants aged 60 years or above. Information on daytime napping and nighttime sleep duration was self-reported during the 2011 baseline survey. DM status during the 2015 follow-up survey was confirmed according to the American Diabetes Association criteria. Individuals with long daytime napping (>1 h/day) had increased risk of developing DM than non-nappers (adjusted RR = 1.52, 95%CI: 1.10, 2.10). In addition, we observed a U-shaped association between nighttime sleep duration and incident DM risk. We further found that nappers with <4 h of nighttime sleep, and those with >1 h of daytime napping and >6 h nighttime sleep had approximately two-fold elevated risk of DM, compared to non-nappers with 6-8 h of nighttime sleep. Long daytime napping and extreme nighttime sleep duration were associated with increased DM risk among Chinese elderly. There was a joint effect of long daytime napping and nighttime sleep duration on the risk of DM.
| S-EPMC8125963 | biostudies-literature
Project description:BackgroundBeneficial effects of napping on cognition have been suggested in cross-sectional studies. This study aimed to clarify longitudinal associations between cognitive decline and sleep characteristics, particularly daytime napping, over a 5-year period in older adults.MethodsStudy participants were 389 community-dwelling individuals aged ≥65 years living in Ojiya City, Niigata, Japan. Baseline and follow-up examinations were conducted in 2011-2013 and 2016-2018, respectively. Trained nurses visited and interviewed participants to collect the following information at baseline and follow-up: demographic characteristics, disease history, lifestyle habits including bedtime, sleeping hours, and daytime nap duration, and cognitive function. The assessment of cognitive function was performed using the revised Hasegawa's dementia scale (HDS-R), with cognitive decline defined as a change in the HDS-R of ≤ - 3 over 5 years. Odds ratios (ORs) for cognitive decline were calculated using multiple logistic regression analysis.ResultsMean age of participants was 74.6 years (SD 6.4), and the cumulative incidence of cognitive decline was 106/389 (27.3%). The adjusted OR for 1-29 min daytime napping was significantly lower compared to that for no napping (OR = 0.47, 95%CI: 0.23-0.96). Earlier bedtime was associated with cognitive decline (adjusted P for trend = 0.0480).ConclusionShort daytime napping (< 30 min) reduces the risk of cognitive decline over 5 years for community-dwelling older people. A future study will be necessary to confirm the effect of short napping on the reduction of risk for clinically diagnosed dementia.
| S-EPMC8401113 | biostudies-literature
Project description:BackgroundWe have identified a strong association between daytime napping and increased mortality risk from respiratory diseases, but little is known about the relationship between daytime napping and respiratory morbidity.MethodsData were drawn from the European Prospective Investigation into Cancer and Nutrition-Norfolk cohort. Participants reported napping habits during 1998-2000 and were followed up for respiratory disease hospital admissions until March 2009. Cox proportional hazards regression was used to examine the association between daytime napping and respiratory disease incidence risk.ResultsThe study sample included 10,978 men and women with a mean age of 61.9 years, and a total of 946 incident respiratory disease cases were recorded. After adjustment for age, sex, social class, education, marital status, employment status, nightshift work, body mass index, physical activity, smoking, alcohol intake, self-reported general health, hypnotic drug use, habitual sleep duration, and preexisting health conditions, daytime napping was associated with an increase in the overall respiratory disease incidence risk (hazard ratio (HR)?=?1.32, 95% confidence interval (CI) 1.15, 1.52 for napping <1?h; HR?=?1.54, 95% CI 1.14, 2.09 for napping ?1?h). This association was more pronounced for lower respiratory diseases, especially for the risk of chronic lower respiratory diseases (HR?=?1.52, 95% CI: 1.18, 1.96 for napping <1?h; HR?=?1.72, 95% CI: 1.01, 2.92 for napping ?1?h, overall p?=?0.003).ConclusionsExcessive daytime napping might be a useful marker of future respiratory disease incidence risk. Further studies are required to confirm these findings and help understand potential mechanisms.
| S-EPMC5066369 | biostudies-literature
Project description:BackgroundNo studies have assessed the association between daytime napping and obesity in China. The study aimed to examine the association between daytime napping and obesity among Chinese middle-aged and older adults, and to evaluate the difference between the aforementioned association in men and women.MethodsOverall, 14 685 participants aged 45 years and older were included by using data from China Health and Retirement Longitudinal Study (CHARLS) in 2015. A multivariable logistic regression model was used to investigate the relationship between daytime napping and obesity after adjusting for potential confounders. Stratified analyses were performed to examine the association differences by sex. Besides, the Cochran-Armitage test for trend was used to detect if there was a significant dose-response relationship between daytime napping and obesity.ResultsThe mean age of participants was 60.32, and the mean daytime napping duration was 38.97 minutes. In the sample, compared with no daytime napping group, the risks of being obese were higher in both moderate daytime napping group (1-60 minute/d) (odds ratio OR = 1.27, 95% confidence interval (CI) = 1.13-1.44) and extend long daytime napping group (>60 minute/d) (OR = 1.34, 95% CI = 1.15-1.56). In sex stratification, these significant correlations only existed in women but not in men. Compared with no daytime napping, women who napped 1-60 minute/d and over 60 minute/d were more likely to be obese (OR = 1.37, 95% CI = 1.18-1.59 and OR = 1.49, 95% CI = 1.23-1.81, respectively). Besides, the Cochran-Armitage trend test revealed that the prevalence rate of obesity increased as the daytime napping duration increased (P < 0.001).ConclusionsThe study established the relationship between daytime napping and obesity in a general Chinese population. The association, however, was only detected among women. Furthermore, there was a dose-response relationship between daytime napping and obesity among women. Future studies may verify this association by using a longitudinal design and focus on the mechanisms behind such association.
| S-EPMC7719355 | biostudies-literature
Project description:ObjectivesThis study examined the association between urinary albumin excretion and incident heart failure (HF) hospitalization.BackgroundExcess urinary albumin excretion is more strongly associated with incident stroke and coronary heart disease risk in black than in white individuals. Whether similar associations extend to HF is unclear.MethodsThis study examined the associations between the urinary albumin-to-creatinine ratio (ACR) and incident hospitalization for HF overall in 24,433 REGARDS (Reasons for Geographic and Racial Differences in Stroke) study participants free of suspected HF at baseline; findings were stratified by race and HF subtype (preserved vs. reduced ejection fraction). Models were adjusted for sociodemographic, clinical, and laboratory variables including estimated glomerular filtration rate, and multiple imputation was used to account for missing covariate data.ResultsAfter a median follow-up of 9.2 years, 881 incident HF events (332 preserved ejection fraction, 447 reduced ejection fraction, 102 unspecified) were observed. Compared to the lowest ACR category (<10 mg/g), the risk of incident HF increased with increasing ACR categories (10 to 29 mg/g hazard ratio [HR]: 1.49; 95% confidence interval [CI]: 1.26 to 1.78; 30 to 300 mg/g HR: 2.32; 95% CI: 1.93 to 2.78; >300 mg/g HR: 4.42; 95% CI: 3.36 to 5.83) in the fully adjusted model. Results did not differ by race. The magnitude of the association between ACR and HF with preserved ejection fraction was greater than with HF with reduced ejection fraction (HR comparing highest vs. lowest ACR category: 6.20; 95% CI: 4.15 to 9.26 vs. HR: 4.37; 95% CI: 3.00 to 6.25, respectively; p = 0.05).ConclusionsHigher ACR was associated with greater risk of incident HF hospitalization in community-dwelling black and white adults.
| S-EPMC6544368 | biostudies-literature
Project description:Preliminary evidence suggests that daytime sleepiness may predate clinical diagnosis of Parkinson disease. The authors examined daytime napping and nighttime sleeping durations, reported in 1996-1997 by 220,934 US NIH-AARP Diet and Health Study participants, in relation to Parkinson disease diagnoses at 3 clinical stages: established (cases diagnosed before 1995, n = 267), recent (1995-1999, n = 396), and prediagnostic (2000 and after, n = 770). Odds ratios and 95% confidence intervals were derived from multivariate logistic regression models. Longer daytime napping was associated with higher odds of Parkinson disease at all 3 clinical stages: the odds ratios comparing long nappers (>1 hour/day) with nonnappers were 3.9 (95% confidence interval: 2.8, 5.6) for established cases, 2.2 (95% confidence interval: 1.7, 3.0) for recent cases, and 1.5 (95% confidence interval: 1.2, 1.9) for prediagnostic cases. Further control for health status or nighttime sleeping duration attenuated the association for established cases but made little difference for recent or prediagnostic cases. In the nighttime sleeping analysis, a clear U-shaped association with Parkinson disease was observed for established cases; however, this association was attenuated markedly for recent cases and disappeared for prediagnostic cases. This study supports the notion that daytime sleepiness, but not nighttime sleeping duration, is one of the early nonmotor symptoms of Parkinson disease.
| S-EPMC3121222 | biostudies-literature
Project description:ObjectiveDaytime napping has been associated with poor health outcomes in adults. It is not known whether daytime napping is similarly linked to adverse health in adolescents, although many report napping. The present study evaluated associations between daytime napping and 2 markers of increased inflammation, high-sensitivity C-reactive protein and interleukin-6 (IL-6), in healthy high school students.MethodsTwo hundred thirty-four Black and White high school students completed a week of actigraph and diary measures of sleep and napping and provided a fasting blood sample. Napping measures were the proportion of days napped and the average minutes napped across 1 week during the school year.ResultsLinear regressions adjusted for age, sex, race, average nocturnal sleep duration, time between sleep protocol and blood draw, and body mass index percentile demonstrated that proportion of days napped measured by actigraphy, B(SE) = .41(.19), p < .05, across the full week was positively associated with IL-6. Higher proportions of school days napped between 2 p.m. and 6 p.m., B(SE) = .40(.20), p < .05, and between 6 p.m. and 10 p.m., B(SE) = .57(.28), p < .05, were associated with increased IL-6. No associations emerged between average actigraphy-assessed nap duration and either study outcome. Diary-reported napping was unrelated to either study outcome.ConclusionsActigraphy-assessed napping and IL-6 are associated but the direction of the relationship remains to be determined. Overall, napping is an important factor to consider to better understand the relationship between short sleep and cardiovascular health in adolescents. (PsycINFO Database Record
| S-EPMC5118199 | biostudies-literature
Project description:BackgroundThe relationship between stage of chronic kidney disease (CKD) and incident heart failure (HF) remains unclear.MethodsOf the 5,795 community-dwelling adults ?65 years in the Cardiovascular Health Study, 5,450 were free of prevalent HF and had baseline estimated glomerular filtration rate (eGFR: ml/min/1.73 m(2)) data. Of these, 898 (16%) had CKD 3A (eGFR 45-59 ml/min/1.73 m(2)) and 242 (4%) had CKD stage ?3B (eGFR <45 ml/min/1.73 m(2)). Data on baseline proteinuria were not available and 4,310 (79%) individuals with eGFR ?60 ml/min/1.73 m(2) were considered to have no CKD. Propensity scores estimated separately for CKD 3A and ?3B were used to assemble two cohorts of 1,714 (857 pairs with CKD 3A and no CKD) and 557 participants (148 CKD ?3B and 409 no CKD), respectively, balanced on 50 baseline characteristics.ResultsDuring 13 years of follow-up, centrally-adjudicated incident HF occurred in 19, 24 and 38% of pre-match participants without CKD (reference), with CKD 3A [unadjusted hazard ratio (HR) 1.40; 95% confidence interval (CI) 1.20-1.63; p < 0.001] and with CKD ?3B (HR 3.37; 95% CI 2.71-4.18; p < 0.001), respectively. In contrast, among matched participants, incident HF occurred in 23 and 23% of those with CKD 3A and no CKD, respectively (HR 1.03; 95% CI 0.85-1.26; p = 0.746), and 36 and 28% of those with CKD ?3B and no CKD, respectively (HR 1.44; 95% CI 1.04-2.00; p = 0.027).ConclusionsAmong community-dwelling older adults, CKD is a marker of incident HF regardless of stage; however, CKD ?3B, not CKD 3A, has a modest independent association with incident HF.
| S-EPMC3136373 | biostudies-literature
Project description:Background and purposeHypertension significantly contributes to stroke. Previous research has indicated a connection between daytime napping and stroke. Research on the connection between daytime napping duration and first stroke in hypertensive individuals is lacking nevertheless.MethodsThis research, which ran from 24 August 2013 to 31 December 2022, recruited 11,252 individuals with hypertension and without a history of stroke from the China Stroke Primary Prevention Trial. To determine the relationship between daytime napping duration and stroke onset in hypertensive individuals, we conducted analyses for threshold effects, multivariate-adjusted Cox proportional hazard regression models, and Kaplan-Meier survival curves.ResultsThe duration of daytime napping (<75 min) was positively correlated with stroke risk; beyond 75 min, the risk did not increase further. When compared to hypertensive individuals who napped for 1-30 min, daytime napping 31-60 min (hazard ratio [HR] = 1.27, 95% confidence interval [CI] = 1.06-1.53) and >60 min (HR = 1.37, 95% CI = 1.14-1.65) were substantially related with a greater risk of first stroke. Additionally, this correlation was absent in cases of hemorrhagic stroke, but present in cases of ischemic stroke, specifically for hypertensive individuals who napped for 31-60 min or >60 min (p < 0.05). Kaplan-Meier survival curves displayed that hypertensive individuals who extended daytime napping had an elevated incidence of stroke.ConclusionsHypertensive individuals who take longer daytime naps (>30 min) are at an elevated risk of stroke onset, particularly ischemic stroke, irrespective of other factors.
| S-EPMC11295159 | biostudies-literature