Associations of sleep quality and exercise frequency and the risk of coronary heart disease in Chinese urban elderly: a secondary analysis of cross-sectional data

Jiujing Lin; Huichen Yao; Jia Li; Shoufeng Tian; Xiaoliang Li; Qingzhi Hou

doi:10.1186/s12889-023-17077-6

Associations of sleep quality and exercise frequency and the risk of coronary heart disease in Chinese urban elderly: a secondary analysis of cross-sectional data

BMC Public Health. 2023 Nov 8;23(1):2199. doi: 10.1186/s12889-023-17077-6.

Authors

Jiujing Lin^#^{1

2}, Huichen Yao^#³, Jia Li^#^{1

2}, Shoufeng Tian⁴, Xiaoliang Li¹, Qingzhi Hou^{5

6}

Affiliations

¹ School of Public Health and Health Management, Shandong First Medical University and Shandong Academy of Medical Sciences, 6699 Qingdao Rd, Jinan, 250117, Shandong, China.
² Medical Science and Technology Innovation Center, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China.
³ Cardiology Department, The Third Affiliated Hospital of Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China.
⁴ Disease Control and Prevention Center of Jinan Shi Zhong District, Jinan, Shandong, China.
⁵ School of Public Health and Health Management, Shandong First Medical University and Shandong Academy of Medical Sciences, 6699 Qingdao Rd, Jinan, 250117, Shandong, China. qzhou@sdfmu.edu.cn.
⁶ Medical Science and Technology Innovation Center, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China. qzhou@sdfmu.edu.cn.

^# Contributed equally.

Abstract

Background: Sleep quality and exercise frequency are closely associated with coronary heart disease (CHD). Few studies focused on the joint effect of initiating sleep, sleep disorders, and exercise frequency on the risk of CHD in the elderly. We used a secondary data analysis based on Boshan Elderly cross-sectional study. We explored the sleep quality, exercise frequency, and their joint effects on the risk of CHD.

Methods: We collected 678 participants whose age ≥ 60 years old from Boshan District Hospital. We used the Pittsburgh Sleep Quality Index to evaluate the sleep quality and obtained physical examination information from the hospital.

Results: Compared with the non-CHD group, patients with CHD spent more time in initiating sleep (time ≥ 60 min, 34.59% vs. 22.93%, P = 0.025) and less time exercising (exercise frequency < 1 times/week, 23.90% vs. 17.15%, P = 0.024). In multiple logistic regression analysis, sleep latency ≥ 60 min was associated with CHD risk (adjusted OR = 1.83; 95% CI: 1.11, 2.99; P-trend = 0.008). The adjusted OR (95% CI) of CHD was 2.24 (1.16, 4.34) for sleep duration < 5 h versus 5-9 h. Compared with exercise frequency < 1 times/week, the adjusted OR for exercise frequency ≥ 1 times/week was 0.46 (95% CI: 0.26, 0.83; P = 0.010). In addition, the joint effects of long sleep latency (≥ 60 min) and sleep disorders were associated with CHD (adjusted OR = 3.36; 95% CI: 1.41, 8.02). The joint effect of exercise frequency ≥ 1 times/week and sleep onset latency within normal limits (< 30 min) was also associated with CHD, and the adjusted OR (95% CI) was 0.42 (0.21, 0.87).

Conclusions: Long sleep latency, high frequency of initiating sleep difficulty, sleep disorders, and short sleep duration were positively associated with CHD. In addition, the joint effects of long sleep latency and sleep disorders were positively correlated with CHD incidence. However, the joint effects of exercise frequency ≥ 1 times/week and normal sleep onset latency were negatively associated CHD.

Keywords: Coronary heart disease; Elderly; Exercise frequency; Initiating sleep; Sleep disorder; Sleep duration.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Coronary Disease* / epidemiology
Coronary Disease* / etiology
Cross-Sectional Studies
East Asian People
Humans
Middle Aged
Risk Factors
Sleep
Sleep Initiation and Maintenance Disorders*
Sleep Quality