Effects of nocturnal sleep duration on new-onset cardiovascular and cerebrovascular diseases in middle-aged and elderly patients with chronic comorbidities

Wang Degang; Chen Guohua; Mei Junhua; Wang Junli; Zheng Li

doi:10.12307/2026.092

Abstract：BACKGROUND:Existing studies have clearly demonstrated a strong association between nocturnal sleep duration and the incidence of cardiovascular and cerebrovascular diseases in the general population.However,in the specific group of patients with chronic comorbidities,the role of nocturnal sleep duration warrants further in-depth exploration. OBJECTIVE:To comprehensively analyze the intricate relationship between nocturnal sleep duration and cardiovascular and cerebrovascular diseases among elderly Chinese patients with chronic comorbidities and to precisely investigate whether body mass index plays a potential mediating role in this relationship. METHODS:This study enrolled middle-aged and elderly individuals aged 45 years and above from the China Health and Retirement Longitudinal Study(CHARLS)in 2011 and 2020 as the research subjects.The Logistic regression model was employed to meticulously analyze the potential impact of nocturnal sleep duration on cardiovascular and cerebrovascular diseases(including heart diseases,strokes,emotional and mental disorders,and memory-related diseases).Furthermore,a mediation analysis was conducted to accurately evaluate the role of body mass index in the relationship between nocturnal sleep duration and cardiovascular and cerebrovascular events. RESULTS AND CONCLUSION:(1)There was a significant association between age,body mass index,and the incidence of new-onset cardiovascular and cerebrovascular diseases among patients with chronic comorbidities(all P＜0.05).Moreover,there were highly significant differences in factors such as sex,marital status,educational level,and region among different sleep duration groups(all P＜0.001).Specifically,in individuals with chronic comorbidities,being female,married,having an educational level of primary school or below,and living in urban areas were all identified as risk factors for new-onset cardiovascular and cerebrovascular diseases.(2)Further analyses indicated that when the sleep duration reached 6.9 hours,the risk of developing cardiovascular and cerebrovascular diseases was significantly reduced(P＜0.05).Additionally,as the nocturnal sleep duration increased by one interquartile range,the risk of new-onset cardiovascular and cerebrovascular events gradually decreased,with a statistically significant difference(P＜0.05).(3)Moreover,the impact of nocturnal sleep duration on cardiovascular and cerebrovascular diseases was mainly mediated by body mass index,and this mediating effect was highly significant(P＜0.001).Meanwhile,nocturnal sleep duration also had a direct negative effect on cardiovascular and cerebrovascular diseases,and this effect was also statistically significant(P＜0.05).In conclusion,an appropriate amount of sleep can significantly reduce the incidence of cardiovascular and cerebrovascular diseases in this population,and body mass index plays a crucial partial mediating role.