The Interaction Between Self-Reported Sleep Duration and Physical Activity on Peripheral Artery Disease in Chinese Adults: A Cross-Sectional Analysis in the Tianning Cohort Study

Shujing Huang; Hongyan Sun; Jia Yu; Hongfei Shi; Liyun Ren; Yan He; Mingzhi Zhang; Hao Peng; Heng Guo

doi:10.2147/RMHP.S332098

The Interaction Between Self-Reported Sleep Duration and Physical Activity on Peripheral Artery Disease in Chinese Adults: A Cross-Sectional Analysis in the Tianning Cohort Study

Risk Manag Healthc Policy. 2021 Sep 29:14:4063-4072. doi: 10.2147/RMHP.S332098. eCollection 2021.

Authors

Shujing Huang^#¹, Hongyan Sun^#², Jia Yu³, Hongfei Shi², Liyun Ren³, Yan He³, Mingzhi Zhang³, Hao Peng^{3

4}, Heng Guo¹

Affiliations

¹ Department of Public Health, School of Medicine, Shihezi University, Shihezi, People's Republic of China.
² Center for Disease Prevention and Control of Tianning District, Changzhou, People's Republic of China.
³ Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China.
⁴ Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: Sleep duration was associated with large artery atherosclerosis, but its association with atherosclerosis in lower extremity arteries was not well studied. Together with sleep, physical activity constitutes main component of our daily life and influences sleep. Here, we aimed to examine the independent and joint associations of sleep duration and physical activity with peripheral artery disease (PAD) in Chinese adults.

Patients and methods: In Tianning cohort, night-time sleep duration and physical activity were assessed by the Pittsburgh Sleep Quality Index and the Global Physical Activity Questionnaire, respectively, for 5130 participants (51.0±15.6 years, 58.7% female). PAD was defined as ankle-brachial index (ABI) <0.9. General linear, and logistic regression models were used to assess the associations of sleep duration and physical activity with PAD. The biological interaction between sleep duration and physical activity on PAD was examined using additive model.

Results: Compared to participants sleeping 6-8.9 h, those sleeping ≥9 h had a 0.02 lower ABI (β=-0.02, P=0.007) and 38% higher odds of PAD (OR=1.38, P=0.035). Compared to physically active participants sleeping 6-8.9 h, among ≥9 h group, physically inactive individuals had significantly increased odds of PAD (OR=2.40, P<0.001), whereas physically active individuals did not (OR=1.15, P=0.472). On additive scale, attributable proportion due to interaction (0.40, 95% CI: 0.07, 0.73) indicated a significant interaction between sleep duration and physical activity on PAD.

Conclusion: Being physically active may attenuate the detrimental association between prolonged sleep duration and PAD. Moreover, we found a significant interaction between prolonged sleep duration and physical inactivity in the prevalence of PAD.

Keywords: Tianning cohort; joint association; lower extremity disease; physical activity; sleep duration.

Grants and funding

This work has been funded by the National Natural Science Foundation of China (NO. 81903384 and 81872690), the Natural Science Foundation of Jiangsu Province (NO. BK20180841), the Suzhou Municipal Science and Technology Bureau (NO. SS201853 and SYS2020091), a Project of the Priority Academic Program Development of Jiangsu Higher Education Institutions, and the Science and Technology Project of Xinjiang Production and Construction Corps (NO. 2021AB030). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.