Causal relationships of excessive daytime napping with atherosclerosis and cardiovascular diseases: a Mendelian randomization study

Oct 27, 2022Sleep

Links between too much daytime napping and artery hardening and heart diseases

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Abstract

A genetic predisposition to more frequent daytime napping is significantly associated with higher odds of coronary atherosclerosis (odds ratio = 1.55).

Daytime napping could be causally linked to an increased risk of cardiovascular diseases (CVD).
An odds ratio of 1.63 indicates that napping is associated with a higher risk of myocardial infarction.
Heart failure risk may be elevated by habitual daytime napping, with an odds ratio of 1.80.
Napping for more than 60 minutes a day is associated with a summary relative risk of 1.98 for developing CVD compared to non-nappers.
The findings suggest that excessive daytime napping may primarily contribute to the development of coronary atherosclerosis.

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STUDY OBJECTIVES: Previous observational studies have found conflicting evidence on the relationship between daytime napping and incident cardiovascular diseases (CVDs), but it remains unclear whether these associations present causality. This study aims to verify whether and why there is a causal relationship between these parameters, and whether there is an etiological basis.

METHODS: A two-sample Mendelian randomization analysis was performed using 79 single nucleotide polymorphisms associated with daytime napping. Summary-level data for coronary atherosclerosis, peripheral atherosclerosis, total CVD, and five CVD outcomes were obtained from the FinnGen study. Meta-analyses were aimed at investigating the relationships of excessive daytime napping with total CVD, coronary heart disease, myocardial infarction (MI), and stroke incidence. Subgroup, network meta-analysis (NMA) and trial sequential analysis (TSA) were also performed in this study.

RESULTS: The inverse-variance weighted method demonstrated that a genetic predisposition to more frequent daytime napping was significantly associated with higher odds of coronary atherosclerosis (odds ratio [OR] = 1.55, 95% confidence interval [CI]: 1.11 to 2.17), MI (OR = 1.63, 95% CI: 1.06 to 2.50), and heart failure (OR = 1.80, 95%CI: 1.28 to 2.52). In NMA, an increased risk of developing CVD in people who napped for more than 60 min a day than those who did not nap was demonstrated and then supported by TSA results (summary relative risk = 1.98, 95% CI: 1.39 to 2.82).

CONCLUSION: Habitual daytime napping is causally associated with an increased risk of incident CVD primarily via the development of coronary atherosclerosis. An average napping duration of more than 60 min is associated with an elevated risk of CVD in all participants.

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Causal relationships of excessive daytime napping with atherosclerosis and cardiovascular diseases: a Mendelian randomization study

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