What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Chest pain (n=13274). Intervention: Sleep duration vs. Different sleep durations. Primary outcome: Chest pain incidence per 1 hour increase in sleep duration (OR 0.95, 95% CI 0.93-0.98, p=0.0004).

August 19, 2022Open Access

Association between sleep duration and chest pain in US adults: A cross-sectional study

Key Result

Sleep duration demonstrated a U-shaped relationship with chest pain incidence, where both insufficient (<6.5 hours) and excessive (≥6.5 hours) sleep increased the risk of chest pain.

Study Design

Type

Cross-Sectional (n=13,274)

Structured PICO

Does sleep duration affect the incidence of chest pain in US adults?

Population

13,274 US adults aged 18 and older from the NHANES 2011-2018 database were evaluated for the association between self-reported sleep duration and chest pain.

Exposure

Sleep duration (self-reported, categorized as <6 h, 6-8 h, ≥8 h, or continuous)

Comparator

Different sleep duration categories (e.g., comparing <6.5 h and ≥6.5 h, or mid-range/long vs short)

Outcome

Incident chest pain (self-reported via Rose questionnaire)patient reported

Both insufficient (<6.5 hours) and excessive (≥6.5 hours) sleep durations are independently associated with an increased risk of self-reported chest pain in US adults, forming a U-shaped relationship.

Main Result

Odds Ratio: 0.95 (95% CI 0.93–0.98)

p-value: p=0.0004

Limitations

Cross-sectional design prevents inferring causation due to a potential bi-directional link between sleep time and chest pain.
Data from the Rose Questionnaire could be affected by interviewer bias.
Unable to investigate the reasons behind people's short or long sleep or the various types of sleep disorders they suffer from.

Abstract

Objective Herein, we purposed to explore the association of sleep duration with chest pain among adults in US. Methods This research work enrolled 13,274 subjects in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018. The association of sleep duration with chest pain among adults in US was evaluated by Multivariable logistic regression. Results To elucidate the association, we made adjustments for gender, BMI, diabetes, smoking status, drinking status, race, marital status, annual family income, hyperlipoidemia, Hypertension. Chest pain incidence decreased by 5% OR = 0.95 (0.93, 0.98), p = 0.0004 for an increase in sleep duration by 1 h. A generalized additive model (GAM) was used to reseal a U-shaped relationship of sleep duration with incident chest pain. When duration of sleep was 6.5 h, chest pain incidence negatively correlated to sleep duration OR = 0.77 (0.72, 0.82) P 0.0001. However, when sleep duration was ≥6.5 h, chest pain incidence rose with escalating sleep duration OR = 1.07 (1.03, 1.11) p = 0.0014. Conclusions Duration of sleep was established to be independently linked with an increase in the occurrence of chest pain. Excessive sleep, as much as insufficient sleep, increases the risk of chest pain. Both excessive sleep and insufficient sleep are associated with an increased risk of chest pain.

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