4.6 Article

A Longitudinal Study of Sleep Habits and Leukemia Incidence Among Postmenopausal Women

期刊

AMERICAN JOURNAL OF EPIDEMIOLOGY
卷 192, 期 8, 页码 1315-1325

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OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwad118

关键词

Cox proportional hazards regression; leukemia; postmenopausal women; sleep; sleep disturbance; sleep duration; women

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This study aimed to evaluate the relationship between sleep duration, sleep disturbance, and leukemia incidence in postmenopausal women. A total of 130,343 postmenopausal women aged 50-79 years were included in the Women's Health Initiative (WHI) from 1993-1998. Sleep duration and disturbance information were obtained through questionnaires, and sleep disturbance levels were defined using the Women's Health Initiative Insomnia Rating Scale (WHIIRS). After a 16.4-year follow-up period, it was found that higher sleep disturbance levels were associated with an increased risk of leukemia, especially myeloid leukemia, among postmenopausal women.
We sought to assess the relationship between sleep duration, sleep disturbance, and leukemia incidence among postmenopausal women. This study included 130,343 postmenopausal women aged 50-79 years who were enrolled in the Women's Health Initiative (WHI) during 1993-1998. Information on self-reported typical sleep duration and sleep disturbance was obtained by questionnaire at baseline, and sleep disturbance level was defined according to the Women's Health Initiative Insomnia Rating Scale (WHIIRS). WHIIRS scores of 0-4, 5-8, and 9-20 comprised 37.0%, 32.6%, and 30.4% of all women, respectively. After an average of 16.4 years (2,135,109 cumulative person-years) of follow-up, 930 of the participants were identified as having incident leukemia. Compared with women with the lowest level of sleep disturbance (WHIIRS score 0-4), women with higher sleep disturbance levels (WHIIRS scores of 5-8 and 9-20) had 22% (95% confidence interval (CI): 1.04, 1.43) and 18% (95% CI: 1.00, 1.40) excess risks of leukemia, respectively, after multivariable adjustment. A significant dose-response trend was found for the association between sleep disturbance and leukemia risk (P for trend = 0.048). In addition, women with the highest level of sleep disturbance had a higher risk of myeloid leukemia (for WHIIRS score 9-20 vs. WHIIRS score 0-4, hazard ratio = 1.39, CI: 1.05, 1.83). Higher sleep disturbance level was associated with increased risk of leukemia, especially for myeloid leukemia among postmenopausal women.

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