Meta-analysis of self-reported daytime napping and risk of cardiovascular or all-cause mortality.
BACKGROUND
Whether self-reported daytime napping is an independent predictor of cardiovascular or all-cause mortality remains unclear. The aim of this study was to investigate self-reported daytime napping and risk of cardiovascular or all-cause mortality by conducting a meta-analysis.


METHODS
A computerized literature search of PubMed, Embase, and Cochrane Library was conducted up to May 2014. Only prospective studies reporting risk ratio (RR) and corresponding 95% confidence intervals (CI) of cardiovascular or all-cause mortality with respect to baseline self-reported daytime napping were included.


RESULTS
Seven studies with 98,163 subjects were included. Self-reported daytime napping was associated with a greater risk of all-cause mortality (RR 1.15; 95% CI 1.07-1.24) compared with non-nappers. Risk of all-cause mortality appeared to be more pronounced among persons with nap duration >60 min (RR 1.15; 95% CI 1.04-1.27) than persons with nap duration <60 min (RR 1.10; 95% CI 0.92-1.32). The pooled RR of cardiovascular mortality was 1.19 (95% CI 0.97-1.48) comparing daytime nappers to non-nappers.


CONCLUSIONS
Self-reported daytime napping is a mild but statistically significant predictor for all-cause mortality, but not for cardiovascular mortality. However, whether the risk is attributable to excessive sleep duration or napping alone remains controversial. More prospective studies stratified by sleep duration, napping periods, or age are needed.
Department of Cardiology, Tangshan Gongren Hospital, Tangshan, Hebei, China (mainland).
Xiaokun
X
Liu
Department of Cardiology, Tangshan Gongren Hospital, Tangshan, Hebei, China (mainland).
Qi
Q
Zhang
Department of Cardiology, Tangshan Gongren Hospital, Tangshan, Hebei, China (mainland).
Xiaoming
X
Shang
D000367:Age Factors; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D003469:Culture; D003644:Death Certificates; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology; D005260:Female; D006184:Habits; D006801:Humans; D008297:Male; D008499:Medical Records; D009026:Mortality; D064887:Observational Studies as Topic / Q000706:statistics & numerical data; D011446:Prospective Studies; D057566:Self Report; D012890:Sleep; D012892:Sleep Deprivation