The association between nighttime sleep, daytime napping, and cardiovascular disease: a longitudinal analysis using...

Sleep patterns, including nighttime sleep, daytime napping, and their relationship with the risk of cardiovascular disease (CVD) remain unclear, particularly when psychological factors are considered. This study aims to investigate the influence of depressive symptoms on the association between sleep patterns and the incidence of CVD risk.

A longitudinal analysis using CHARLS data included 4,912 participants, with a mean age of 68.13 (SD = 8.91). Sleep patterns and CVD were assessed by self-reported data. Multivariable logistic regression models were used to examine the associations. Stratified analyses based on depressive symptoms were conducted to assess potential effect modification. Mediation analyses were performed to explore potential pathways linking sleep patterns to incident CVD.

In all participants of fully adjusted model (Model 3), short nighttime sleep (< 7 h) was significantly associated with higher CVD risk (OR = 1.53, 95% CI: 1.15-2.03), while moderate daytime napping (31-60 min) demonstrated a protective effect (OR = 0.67, 95% CI: 0.46-0.97) and short daytime napping (≤ 30 min) lost its significance. Among participants with depressive symptoms, only short nighttime sleep remained significantly associated with elevated CVD risk. For participants without depressive symptoms, moderate daytime napping was protective against CVD occurrence. Mediation analysis confirmed depressive symptoms as a significant mediator in the pathway between nighttime sleep and CVD development.

Divergent nighttime and daytime sleep durations exert differential effects on the incidence of CVD. Our findings have clarified that interventions specifically targeting different sleep durations in population with and without depressive symptoms are warranted to mitigate their elevated CVD risk.

The online version contains supplementary material available at https://doi.org/10.1007/s41105-026-00670-8.