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Introduction <p>There is a complex relationship between sleep duration and the risk of developing cardiovascular diseases. This study aimed to identify sleep duration trajectories in a healthy population and examine their associations with incident cardiovascular disease (CVDs) in the Eastern Mediterranean Region (EMR).</p> Methods <p>This prospective population-based cohort study included 5,432 participants free of cardiovascular disease at baseline (2001–2013). The associations between sleep duration trajectories and CVD risk were analyzed using multivariable Cox proportional hazards models. Cubic and restricted cubic spline models were applied to identify the optimal sleep duration associated with the lowest CVD risk and to examine the shape of the relationship between total daily sleep duration and CVD hazard ratios.</p> Results <p>We observed a U-shaped association between total daily sleep duration and incident CVD after adjusting for demographic characteristics, lifestyle factors, and health status. Compared with individuals sleeping below 5&#xa0;h, adjusted hazard ratios (HRs) for CVD were as follows: 5–6&#xa0;h (HR = 0.930, 95%CI: 0.70–1.22, p-value = 0.61), 6–7&#xa0;h (HR = 0.772, 95%CI: 0.59–0.99, p-value = 0.04), 7–8&#xa0;h (HR = 0.764, 95%CI: 0.60–0.97, p-value = 0.03), 8–9&#xa0;h (HR = 0.701, 95%CI: 0.53–0.91, p-value = 0.01), 9–10&#xa0;h (HR = 0.755, 95%CI: 0.54–1.05, p-value = 0.10], and &gt; 10&#xa0;h (HR = 0.816, 95%CI: 0.54–1.22, p-value = 0.01). According to the results of the cubic spline curves, the lowest risk was identified at a sleep duration of 8.38&#xa0;h.</p> Conclusions <p>The internationally recommended sleep duration may not be ideal for Middle Eastern populations. In this Iranian cohort, approximately 8.4&#xa0;h of total daily sleep was associated with the lowest CVD risk.</p>

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Optimal sleep duration for cardiovascular prevention in Eastern Mediterranean populations: insights from a prospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月16日

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  • Danial Habibi,
  • Maryam Kazemi Naeini,
  • Shaghyegh Haghjooy Javanmard,
  • Noushin Mohamadifard,
  • Razieh Hassannejad,
  • Taha Rafiei,
  • Jamshid Najafian,
  • Mahdi Akbarzadeh,
  • Hamid Reza Marateb,
  • Marjan Mansourian,
  • Miguel Ángel Mañanas,
  • Nizal Sarrafzadegan

摘要

Introduction

There is a complex relationship between sleep duration and the risk of developing cardiovascular diseases. This study aimed to identify sleep duration trajectories in a healthy population and examine their associations with incident cardiovascular disease (CVDs) in the Eastern Mediterranean Region (EMR).

Methods

This prospective population-based cohort study included 5,432 participants free of cardiovascular disease at baseline (2001–2013). The associations between sleep duration trajectories and CVD risk were analyzed using multivariable Cox proportional hazards models. Cubic and restricted cubic spline models were applied to identify the optimal sleep duration associated with the lowest CVD risk and to examine the shape of the relationship between total daily sleep duration and CVD hazard ratios.

Results

We observed a U-shaped association between total daily sleep duration and incident CVD after adjusting for demographic characteristics, lifestyle factors, and health status. Compared with individuals sleeping below 5 h, adjusted hazard ratios (HRs) for CVD were as follows: 5–6 h (HR = 0.930, 95%CI: 0.70–1.22, p-value = 0.61), 6–7 h (HR = 0.772, 95%CI: 0.59–0.99, p-value = 0.04), 7–8 h (HR = 0.764, 95%CI: 0.60–0.97, p-value = 0.03), 8–9 h (HR = 0.701, 95%CI: 0.53–0.91, p-value = 0.01), 9–10 h (HR = 0.755, 95%CI: 0.54–1.05, p-value = 0.10], and > 10 h (HR = 0.816, 95%CI: 0.54–1.22, p-value = 0.01). According to the results of the cubic spline curves, the lowest risk was identified at a sleep duration of 8.38 h.

Conclusions

The internationally recommended sleep duration may not be ideal for Middle Eastern populations. In this Iranian cohort, approximately 8.4 h of total daily sleep was associated with the lowest CVD risk.