Farzad Masoudkabir
1,2 
, Zahra Mohammadi
3, Mohammad Alirezaei
4, Bahman Cheraghian
5, Zahra Rahimi
6, Pegah Roayaei
1, Mohammad Reza Naderian
7, Leila Danehchin
8, Yousef Paridar
9, Farhad Abolnezhadian
10,11, Ali Vasheghani-Farahani
1,2, Mohammad Noori
12, Seyed Ali Mard
13, Sahar Masoudi
3 , Ali Akbar Shayesteh
13* , Hossein Poustchi
3* 1 Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
2 Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
3 Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
4 Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
5 Alimentary Tract Research Center, Clinical Sciences Research Institute, Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
6 Department of Epidemiology, School of Public Health Iran University of Medical Sciences, Tehran, Iran
7 Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
8 Behbahan Faculty of Medical Sciences, Behbahan, Iran
9 School of Medicine, Dezful University of Medical Sciences, Dezful, Iran
10 Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
11 Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
12 Abadan Faculty of Medical Sciences, Abadan, Iran
13 Alimentary Tract Research center, Clinical sciences Research Institute, Ahvaz jundishapur University of Medical sciences, Ahvaz, Iran
*Corresponding Authors: *Corresponding Author: Ali Akbar Shayesteh, MD; Alimentary Tract Research Center, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Tel:+98-613-2921839; Email: , Email:
shayestehaliakbar5@gmail.com; *Corresponding Author: Hossein Poustchi, MD, PhD; North Kargar St., Shariati Hospital, Digestive Diseases Research Institute, Tehran, 1411713135, Iran. Tel:+98-21-82415141 ; Fax:+98-21-82415400 ; E-mail: , Email:
h.poustchi@gmail.com
Abstract
Background: Little is known regarding the impact of quantity and quality of sleep on the incidence of cardiovascular disease. The aim of this study was to investigate the possible independent association of late bedtime and premature coronary artery disease (PCAD).
Methods: Between October 2016 and November 2019, we conducted a cross-sectional population-based study on 30101 participants aged 20–65 years in Khuzestan Comprehensive Health Study (KCHS). Data on major risk factors of cardiovascular disease, habit history, physical activity, and sleep behavior was gathered and participants underwent blood pressure, anthropometric, and serum lipid and glucose profile measurements. PCAD was defined as documented history of developing obstructive coronary artery disease before 45 years in men and before 55 years in women.
Results: Of a total of 30101 participants (64.1% female, mean age: 41.7±11.7 years) included in this study, 1602 (5.3%, 95% confidence interval: 5.1%–5.6%) had PCAD. Late bedtime was reported in 7613 participants (25.3%, 95% confidence interval: 24.9%–25.8%). Age-sex standardized prevalence for PCAD and late bedtime were 3.62 (3.43-3.82) and 27.8 (27.2–28.4), respectively. There was no significant difference (P=0.558) regarding prevalence of PCAD between those with late bedtime (5.5%, 95% CI: 4.9%–6.0%) and those with early bedtime (5.3%, 95% CI: 5.0%–5.6%). However, after adjustment for potential confounders, late bedtime was independently associated with PCAD (OR=1.136, 95% CI=1.002–1.288, P=0.046).
Conclusion: In this study, late bedtime was significantly associated with presence of PCAD. Future prospective studies should elucidate the exact role of late bedtime in developing coronary atherosclerosis prematurely.