Later bedtime is associated with angina pectoris in middle-aged and older adults: results from the Sleep Heart Health Study

Objectives: Sleep timing is related to several risk factors for angina pectoris (AP), such as obesity and diabetes. This study was designed to evaluate the relationship between sleep timing and AP, specifically whether later bedtime was associated with AP in middle-aged and older adults. Methods: This community-based study was based on the Sleep Heart Health Study cohort and included 4710 participants (45.9% men, aged 63.3 ± 11.0 years). Lifestyle and epidemiological information were obtained from baseline records. Self-reported sleep measures provided information on bedtime and wake-up time of weekdays and weekends. Individuals were divided into three categories according to bedtime (≤22:00, 22:01–23:00, and >23:00). Odds ratios (OR) and 95% confidence intervals (CIs) of AP for bedtimes were estimated with multivariate logistic regression analysis. Results: The prevalence of AP was 44.2% and the distribution of weekday bedtimes ≤22:00, 22:01–23:00_, and >23:00 were 36.6%, 47.5% and 46.0%, respectively. After adjusting for potential confounders, weekday bedtimes >23:00 (OR 1.34; 95% CI 1.13–1.60; P = 0.001) and 22:01–23:00 (OR 1.54; 95% CI 1.29–1.82; P < 0.001) were significantly associated with an increased risk of AP compared with the reference group (≤22:00). In addition, weekend bedtimes >23:00 (OR 1.44; 95% CI 1.20–1.73; P < 0.001) and 22:01–23:00 (OR 1.70; 95% CI 1.40–2.05; P < 0.001) increased the risk of AP. Conclusions: Later bedtimes on both weekdays and weekends were significantly associated with an increased prevalence of AP. Early bedtimes may help people decrease the risk of AP.