Abstract
BACKGROUND: Emerging evidence has linked daytime napping with the risk of cardiovascular events. Cardiac arrhythmias are considered as early-stage clinical stage for cardiovascular diseases. However, whether napping frequency is associated with incident arrhythmias remains unknown.</p>
OBJECTIVE: This study aims to prospectively investigate the association between napping frequency and cardiac arrhythmias.</p>
METHODS: Daytime napping frequency was self-reported in response to touchscreen questionnaires. The primary outcomes were incident arrhythmias, including atrial fibrillation/flutter (AF/Af), ventricular arrhythmias, and bradyarrhythmia. Cox regression analysis was conducted based on 491,117 participants free of cardiac arrhythmias from UK Biobank (UKB). The two-sample Mendelian randomization (MR) and one-sample MR were used to ensure a causal effect of genetically predicted daytime napping on the risk of arrhythmias.</p>
RESULTS: During a median follow-up of 11.91 years, 28,801 incident AF/Af, 4,132 incident ventricular arrhythmias, and 11,616 incident bradyarrhythmia were documented. Compared with never/rarely napping, usually napping was significantly associated with higher risks of AF/Af (HR: 1.141; 95% CI: 1.083-1.203)) and bradyarrhythmia (HR: 1.138; 95% CI: 1.049-1.235), but not ventricular arrhythmias, after adjustment for various covariates. The two-sample MR and one-sample MR analysis showed that increased daytime napping frequency was likely to be a potential causal risk factor for AF/Af in FinnGEN (OR, 1.626; 95% CI, 1.061-2.943) and bradyarrhythmia in UKB (OR, 1.005, 95% CI, 1.002-1.008).</p>
CONCLUSIONS: The results of this study add to the burgeoning evidence of an association between daytime napping frequency and an increased risk of cardiac arrhythmias including AF/Af, ventricular arrhythmias, and bradyarrhythmia.</p>