SLEEP DURATION, SNORING AND COLORECTAL CANCER RISK
Associations of Self-Reported Sleep Duration and Snoring with Colorectal Cancer Risk in Men and Women
Xuehong Zhang, MD, ScD1; Edward L. Giovannucci, MD, ScD1,2,3; Kana Wu, PhD2; Xiang Gao, MD, PhD1,2; Frank Hu, MD, PhD1,2,3; Shuji Ogino, MD, PhD, MS4,5; Eva S. Schernhammer, MD, DrPH1; Charles S. Fuchs, MD1,4; Susan Redline, MD, MPH6; Walter C. Willett, MD, DrPH1,2,3; Jing Ma, MD, PhD1
1Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; 2Department of Nutrition, Harvard School of Public Health, Boston, MA; 3Department of Epidemiology, Harvard School of Public Health, Boston, MA; 4Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA; 5Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; 6Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Boston, MA
We assessed the relationship between sleep duration, snoring and colorectal cancer risk.
Prospective cohort studies.
A total of 30,121 men aged 41 to 79 years in the Health Professionals Follow-up Study and 76,368 women aged 40 to 73 years in the Nurses' Health Study.
Measurements and Results:
We queried information on sleep duration and snoring in 1986/87. Cox proportional hazards regression models were used to estimate multivariable hazard ratios (HRs, 95% CIs). We documented 1,973 incident colorectal cancer cases (709 men and 1,264 women) over a 22-year follow-up period. Compared to sleep an average 7 h, ≥ 9 h of sleep was significantly associated with a higher risk of colorectal cancer among men (HR = 1.35, 95% CI: 1.00, 1.82), and to a lesser degree, among women (HR = 1.11, 95% CI: 0.85, 1.44). The risk associated with longer sleep was restricted to individuals who regularly snored (men: HR = 1.80, 95% CI: 1.14, 2.84; women: HR = 2.32, 95% CI: 1.24, 4.36) and to overweight individuals (i.e., BMI ≥ 25 kg/m2) (men: HR = 1.52, 95% CI: 1.04, 2.21; women: HR = 1.37, 95% CI: 0.97, 1.94). Short sleep duration (≤ 5 h) was not associated with an increased risk of colorectal cancer in the entire sample or in subgroups stratified by snoring or BMI.
Longer sleep duration was associated with an increased risk of developing colorectal cancer among individuals who were overweight or snored regularly. This observation raises the possibility that sleep apnea and its attendant intermittent hypoxemia may contribute to cancer risk.
Zhang X; Giovannucci EL; Wu K; Gao X; Hu F; Ogino S; Schernhammer ES; Fuchs CS; Redline S; Willett WC; Ma J. Associations of self-reported sleep duration and snoring with colorectal cancer risk in men and women. SLEEP 2013;36(5):681-688.