G-2065

Association Between Daytime Napping and Cardiovascular Mortality: A Systematic Review and Meta-analysis of Prospective Cohort Studies

 Fatemeh Bostan ¹ © ℗, Ali Askari ¹, Masoumeh Sadeghi ², Afshin Heidari ¹, Golsa Ghasemi ³, Ghazaal Alavi Tabatabaei ¹, Ghazal Siroos Najafabadi ¹, Hamed Rafiee ¹, Hamidreza Roohafza ⁴   

 
Abstract

Daytime napping mostly begins in the earlier decades of life and increases in adulthood with a higher prevalence in men. Napping is considered as a healthy habbit in many cultures. As napping can be different in duration and frequency, it may also be associated with many disorders and higher rate of all-cause mortality. However, a conclusive association between napping and CVD mortality has not been revealed, as there are many controversial studies in this topic. This systematic review and meta-analysis is conducted to evaluate the definite association of daytime napping and CVD mortality. Many electronic databases such as MEDLINE, Embase, Scopus, Web of Science, and grey literature were searched in February 2024 using a constructed search syntax, to find prospective cohort studies concentrating on the nappers as the exposure group, non-nappers as the control group, and CVD mortality as the outcome. Additionally, forward and backward citation searching was performed. A total of 3547 initial records were found and narrowed down to 10 studies based on the eligibility criteria: any adults with no history of pre-existing heart disease or stroke. The meta-analysis was performed on the data of 10 studies and 133446 participants. The primary outcome, CVD mortality, was established using International Classification of Diseases (ICD) codes or equivalents. The pooled hazard ratio (HR) of 1.18 [95% CI: 1.04; 1.33] proved a significant relevance between napping and CVD mortality. The studies were substantially heterogenous with the I2 value of 73.6% (p = 0.000). The secondary outcome, all-cause mortality, was also significantly associated with napping with a pooled HR of 1.20 [95% CI: 1.13; 1.27]. Substantial heterogeneity was perceived among the studies with an I2 value of 65.1% (p = 0.005). This study suggests that there is a significant association between daytime napping and an increased risk of all-cause and CVD mortality. Notably, Asian individuals, women, and individuals of higher age are three groups for whom napping is associated with the greatest CVD mortality risk. Despite these findings, caution is warranted in interpreting the results, as napping might reflect undiagnosed health conditions rather than being a direct cause of increased mortality.

Keywords: Daytime Napping; Cardiovascular Mortality; All-cause Mortality