Long-term sleep habits and risk of breast cancer among Chinese women: a case-control study
Long-term sleep habits and risk of breast cancer among Chinese women: a case-control study
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中国女性长期睡眠习惯与乳腺癌风险：病例对照研究
DOI：
10.1097/cej.0000000000000458
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发表时间：
--
影响因子：
2.4
通讯作者：
Wang Xin
中科院分区：
文献类型：
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作者：
Yang Wanshui;Shi Yingfang;Ke Xiumei;Sun Haina;Guo Jianchao;Wang Xin
之前的观察性研究不一致地表明睡眠不佳是乳腺癌 (BC) 的一个新的危险因素。然而，这些研究主要集中在睡眠持续时间上，其他睡眠领域的报道很少。本研究的目的是评估广泛的睡眠领域与 BC 发病风险的关联。我们采用基于社区的 1:1 个体匹配病例对照设计，其中包括中国九江的 401 名 BC 女性患者和 401 名年龄和地区匹配的女性对照。使用经过验证的 17 项睡眠因素问卷 (SFQ) 全面评估长期睡眠习惯。使用条件逻辑回归计算调整后的比值比 (aOR) 和 95% 置信区间 (CI)。夜间光照（最高与最低水平，aOR=1.19，95% CI：1.06–2.68）、习惯性睡眠时间（午夜 12 点之后与下午 22 点之前，aOR=1.12，95% CI：1.03–2.62）、夜班/轮班工作（是与否，aOR=1.38，95% CI： 1.04–2.71)，以及夜间醒来的频率 (>2 在相互调整其他睡眠参数后，每晚睡眠与从不睡眠（aOR=1.21，95% CI：1.10-2.96）与 BC 风险增加相关。无论绝经状态和肿瘤雌激素受体状态如何，这些正相关性都持续存在。睡眠时间、睡眠质量、睡眠药物的使用、失眠频率、白天小睡和 BC 风险之间没有关联。我们的研究结果表明，睡眠问题（包括夜间光照、夜班/轮班工作、晚睡和频繁夜醒）可能会增加患乳腺癌的风险，而与其他睡眠因素无关。
Previous observational studies have inconsistently suggested that poor sleep is a novel risk factor for breast cancer (BC). However, these studies mainly focused on sleep duration, other sleep domains were rarely reported. The aim of this study was to evaluate the association of a broad range of sleep domains with the risk of BC incidence. We used a community-based 1:1 individual matched case-control design that included 401 female patients with incident BC and 401 age- and area-matched female controls in Jiujiang, China. Long-term sleep habits were comprehensively assessed using a validated 17-item Sleep Factors Questionnaire (SFQ). Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression. Light exposure at night (highest vs. lowest level, aOR=1.19, 95% CI: 1.06–2.68), habitual timing of sleep (after 12 AM midnight vs. before 22 PM, aOR=1.12, 95% CI: 1.03–2.62), night/shift work (yes vs. no, aOR=1.38, 95% CI: 1.04–2.71), and frequency of nighttime wakings (>2 per night vs. never, aOR=1.21, 95% CI: 1.10–2.96) were associated with an increased risk of BC, after mutually adjusting for other sleep parameters. These positive associations persisted regardless of menopausal status and tumor estrogen receptor status. There was no association between sleep duration, sleep quality, sleep medication use, insomnia frequency, daytime nap, and the risk of BC. Our results indicate that sleep problems including light exposure at night, night/shift work, late sleeping, and frequent night waking could increase the risk of breast cancer development, independent of other sleep factors.