Longer and more frequent napping among older individuals is associated with increased mortality

1. Older individuals with actigraphy-assessed longer nap duration, more frequent naps, and a tendency to nap in the morning was associated with a higher all-cause mortality.

Evidence Rating Level: 2 (Good)

Excessive napping in late life is associated with adverse health outcomes including mortality. As previous studies mainly relied on self-reported napping habits, objective measurements are needed for more reliable findings. There also lacks research on some daytime nap characteristics, such as timing and variability of nap duration across days. This study thus examined whether actigraphy-measured daytime nap duration, frequency, variability, and timing were associated with all-cause mortality. This prospective cohort study used data from the Rush Memory and Aging Project and included community-dwelling adults aged >56 years in the U.S., with up to 19 years of follow-up. The analytic baseline was initiated in August 2005. Participants wore the actigraphy device continuously for up to 14 days. The primary outcome was daytime napping, defined as sleep episodes between 9 am and 7 pm. Participants were categorized as morning nappers (peak window: 9 am to 12 pm or 10 am to 1 pm), early afternoon nappers (peak window: 11 am to 2 pm, 12-3 pm, 1-4 pm, or 2-5 pm), or late afternoon nappers (peak window: 3-6 pm or 4-7 pm). In total, 1,338 participants (mean [SD] age, 81.4 [7.4] years; 1018 [76.0%] female) were included over a mean (SD) follow-up of 8.3(4.78) years. At a mean (SD) of 7.54 (4.52) years after analytic baseline, 926 (69.2%) deaths were reported. Longer daytime nap duration (adjusted hazard ratio [AHR] per 1-hour increase, 1.13; 95% CI, 1.04-1.23) and higher nap frequency (AHR per additional daily nap, 1.07; 95% CI, 1.02-1.13) at baseline were associated with a 13% and 7% increased risk of mortality, respectively. The risk of mortality was higher among morning nappers compared with early afternoon nappers (AHR, 1.30; 95% CI, 1.03-1.64). There was no association between variability in daytime nap duration and mortality (AHR per 1-hour increase, 1.01; 95% CI, 0.89-1.14). Overall, this study found that older individuals with longer nap duration, more frequent naps, and a tendency to nap in the morning was associated with a higher all-cause mortality. These findings highlight the potential of wearable device-based daytime nap assessments in identifying high-risk individuals for sleep interventions to improve sleep health and longevity.

Click here to read the study in JAMA Network Open

Image: PD

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