Sleep Duration and Sleep Complaints and Risk of Myocardial Infarction in Middle-aged Men and Women from the General Population: The MONICA/KORA Augsburg Cohort Study

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Abstract
To examine gender-specific associations between sleep duration and sleep complaints and incident myocardial infarction (MI). Cohort study. A representative population sample of middle-aged subjects in Germany. The study was based on 3508 men and 3388 women (aged 45 to 74 years) who participated in one of the 3 MONICA (Monitoring trends and determinants on cardiovascular diseases) Augsburg surveys between 1984 and 1995, who were free of MI and angina pectoris at baseline and were followed up until 2002. N/A A total of 295 cases of incident MI among men and 85 among women occurred during a mean follow-up period of 10.1 years. Compared with women sleeping 8 hours, the multivariable adjusted hazard ratio (HR) of MI among women sleeping ≤5 hours was 2.98 (95% CI, 1.48–6.03), and among women sleeping ≥9 hours 1.40 (95% CI, 0.74–2.64); the corresponding HRs among men were 1.13 (95% CI, 0.66–1.92) and 1.07 (95% CI, 0.75–1.53). In multivariable analysis the relative risk of an incident MI for men and women with difficulties maintaining sleep was 1.12 (95% CI, 0.84–1.48) and 1.53 (95% CI, 0.99–2.37), respectively, and for men and women with difficulties initiating sleep the relative risk was 1.16 (95% CI, 0.82–1.63) and 1.30 (95% CI, 0.81–2.06), respectively. Modest associations between short sleep duration and difficulties maintaining sleep and incident MI were seen in middle-aged women but not men from the general population.