Table 4. Association Between Sleep Duration Trajectory Groups and the Composite of First CVEs and All-Cause Mortality, Stratified by Age, Sex, and Baseline Comorbidities.
| Variable | Sleep duration trajectory groupa | P value for interaction | |||
|---|---|---|---|---|---|
| Normal | Low | ||||
| Stable | Decreasing | Increasing | Stable | ||
| Age, y | |||||
| <65 (n = 44 766) | .46 | ||||
| Incidence rateb | 1967/237 614 | 416/46 802 | 170/18 133 | 47/4425 | |
| Fully adjusted model HR (95% CI)c | 1 [Reference] | 1.22 (1.05-1.41) | 1.12 (0.95-1.33) | 1.60 (1.15-2.24) | |
| ≥65 (n = 7833) | |||||
| Incidence rateb | 1332/34 332 | 279/7854 | 162/4525 | 45/1423 | |
| Fully adjusted model HR (95% CI)c | 1 [Reference] | 1.28 (1.06-1.53) | 1.01 (0.85-1.21) | 1.39 (0.97-2.00) | |
| Sex | |||||
| Male (n = 40 087) | .65 | ||||
| Incidence rateb | 293/204 580 | 615/42 876 | 291/18 220 | 69/4318 | |
| Fully adjusted model HR (95% CI)c | 1 [Reference] | 1.24 (1.10-1.41) | 1.06 (0.93-1.21) | 1.38 (1.04-1.82) | |
| Female (n = 12 512) | |||||
| Incidence rateb | 366/67 357 | 80/11 780 | 41/4438 | 23/1533 | |
| Fully adjusted model HR (95% CI)c | 1 [Reference] | 1.23 (0.87-1.74) | 1.07 (0.76-1.52) | 2.03 (1.14-3.61) | |
| BMI | |||||
| <25.0 (n = 27 346) | .68 | ||||
| Incidence rateb | 1513/142 634 | 339/28 259 | 143/11 331 | 48/3206 | |
| Fully adjusted model HR (95% CI)c | 1 [Reference] | 1.32 (1.11-1.56) | 0.99 (0.83-1.19) | 1.49 (1.05-2.12) | |
| ≥25.0 (n = 25253) | |||||
| Incidence rateb | 1786/129 293 | 356/26 393 | 189/11 321 | 44/2645 | |
| Fully adjusted model HR (95% CI)c | 1 [Reference] | 1.18 (1.01-1.39) | 1.13 (0.96-1.33) | 1.50 (1.06-2.12) | |
| Hypertension | |||||
| Yes (n = 7790) | .20 | ||||
| Incidence rateb | 732/33 668 | 224/11 047 | 113/4405 | 38/1602 | |
| Fully adjusted model HR (95% CI)c | 1 [Reference] | 1.07 (0.87-1.32) | 1.12 (0.91-1.39) | 1.35 (0.91-2.01) | |
| No (n = 44 775) | |||||
| Incidence rateb | 2567/238 106 | 470/43 564 | 219/18 226 | 54/4243 | |
| Fully adjusted model HR (95% CI)c | 1 [Reference] | 1.35 (1.17-1.54) | 1.04 (0.90-1.21) | 1.58 (1.15-2.16) | |
| Diabetes | |||||
| Yes (n = 2256) | .15 | ||||
| Incidence rateb | 250/9692 | 86/3141 | 29/1249 | 19/447 | |
| Fully adjusted model HR (95% CI)c | 1 [Reference] | 1.16 (0.81-1.67) | 0.87 (0.56-1.36) | 2.23 (1.16-4.29) | |
| No (n = 50 336) | |||||
| Incidence rateb | 3049/262 202 | 609/51 498 | 303/21 401 | 73/5404 | |
| Fully adjusted model HR (95% CI)c | 1 [Reference] | 1.26 (1.11-1.42) | 1.09 (0.97-1.24) | 1.37 (1.05-1.79) | |
| Hyperlipidemia | |||||
| Yes (n = 2862) | .22 | ||||
| Incidence rateb | 158/12 634 | 76/4469 | 20/1453 | 13/610 | |
| Fully adjusted model HR (95% CI)c | 1 [Reference] | 1.25 (1.11-1.41) | 1.08 (0.96-1.23) | 1.51 (1.16-1.96) | |
| No (n = 49 736) | |||||
| Incidence rateb | 3141/259 263 | 619/50 185 | 312/21 200 | 79/5240 | |
| Fully adjusted model HR (95% CI)c | 1 [Reference] | 1.17 (0.79-1.72) | 0.89 (0.50-1.40) | 1.10 (0.52-2.34) | |
| Kidney function | |||||
| eGFR<60 mL/min/1.73 m2 (n = 3314) | .60 | ||||
| Incidence rateb | 462/18 037 | 51/1904 | 41/1334 | 9/226 | |
| Fully adjusted model HR (95% CI)c | 1 [Reference] | 1.94 (1.12-3.3 6) | 1.15 (0.74-1.77) | 4.17 (1.60-10.83) | |
| eGFR≥60 mL/min/1.73 m2 (n = 49 285) | |||||
| Incidence rateb | 2837/253 787 | 644/52 748 | 291/21 323 | 83/5624 | |
| Fully adjusted model HR (95% CI)c | 1 [Reference] | 1.22 (1.08-1.37) | 1.05 (0.92-1.19) | 1.41 (1.09-1.82) | |
Abbreviations: BMI, body mass index (calculated as weight in kilograms divided by height in square meters); CVE, cardiovascular event; eGFR, estimated glomerular filtration rate; HR, hazard ratio.
The normal-stable sleep duration pattern ranged from 7.4 to 7.5 hours per night; low-increasing pattern, mean increase from 4.9 to 6.9 hours per night; normal-decreasing pattern, mean decrease from 7.0 to 5.5 hours per night; and low-stable pattern, range of 4.9 to 4.2 hours per night.
Indicates per 100 000 person-years.
Adjusted for age, sex, marital status (single, married, or divorced), occupation (blue collar or white collar), mean income (<50, 500-3000, or ≥3000 renminbi/mo), educational attainment (illiteracy or elementary, middle school, or college/university), physical activity (never, 1-2 times/wk, or ≥3 times/wk), smoking status (never, past, or current), alcohol consumption status (never, past, or current), salt intake (<6, 6-10, or >10 g/d), family history of stroke (yes or no), family history of myocardial infarction (yes or no), hypertension (yes or no), hyperlipidemia (yes or no), diabetes (yes or no), snoring frequency (never/rare, occasionally, or frequently), sleep duration in 2010, antihypertensive use (yes or no), hypoglycemic use (yes or no), use of agents to lower lipid levels (yes or no), body mass index (calculated as weight in kilograms divided by height in square meters; <18.5, 18.5 to <25.0, 25.0 to <30.0, or ≥30.0), fasting blood glucose level (<72, 72 to <101, 101 to <110, 110 to <126, or ≥126 mg/dL [to convert to mmol/L, multiply by 0.0555]), high-sensitivity C-reactive protein (<.10, .10 to <.30, .30 to <1.0, or ≥1.0 mg/dL [to convert to mg/L, multiply by 10]), systolic blood pressure (<120, 120 to <140, or ≥140 mm Hg), diastolic blood pressure (<80, 80 to <90, or ≥90 mm Hg), and estimated glomerular filtration rate (<30, 30 to <60, 60 to <90, or ≥90 mL/min/1.73 m2).