Sleep duration as a predictor and prognosticator for cancer survivors in the community
preprint
OA: closed
CC-BY-4.0
Abstract
Objective Sleep and cancer are intricately interconnected. We used a nationally representative sample to study the effect of sleep duration on cancer incidence and prognosis, aiming to propose an optimal sleep duration and generalize it to community populations. Methods Data from participants aged ≥18 years in the National Health and Nutrition Examination Survey (NHANES, 2005-2018) were analyzed (n=37,338). Self-reported sleep duration was analyzed alongside mortality data from the National Death Index as of 12/31/2019. Primary outcomes included all-cause mortality, cancer-specific mortality, and non-cancer mortality. Odds ratios (OR), hazard ratios (HR), and corresponding 95% confidence intervals (CI) were calculated using logistic regression and Cox proportional hazards regression, respectively. Restricted cubic spline (RCS) analysis was used to explore potential non-linear associations. Results The prevalence of cancer was 10.12%. After adjusting for confounders, >7 hours of sleep was strongly associated with an increased OR for cancer incidence (1.18 (1.04,1.33) for (7-8] and 1.54 (1.28,1.86) for (8-14.5]). During a median follow-up of 6.1 years, 341 cancer-related deaths and 661 non-cancer-related deaths occurred. fully adjusted models, compared with 7 hours of sleep, >7 hours of sleep significantly increased the HR of all-cause mortality (1.40 (1.06,1.84) for (7-8] and 1.90 (1.42,2.54) for (8-14.5]); cancer mortality (1.20 (0.77,1.87) for (7-8] and 1.70 (1.05,2.73) for (8- 14.5], 1.70 (1.05,2.73)) and non-cancer mortality (1.50 (1.07,2.12) for (7-8], 2.03 (1.42,2.90) for (8-14.5]). Stratified analysis, RCS analysis and sensitivity analysis yielded consistent results. Conclusions This study suggests that the optimal sleep duration should be 7 hours, as excessive sleep may increase cancer risk and mortality risk in cancer survivors. Our findings should be useful for health education and promotion in primary care and clinical practice.
Full text
3,693 characters
· extracted from
oa-doi-fallback
· 4 sections
· click to expand
Abstract
Objective Sleep and cancer are intricately interconnected. We used a nationally representative sample to study the effect of sleep duration on cancer incidence and prognosis, aiming to propose an optimal sleep duration and generalize it to community populations.
Methods
Data from participants aged ≥18 years in the National Health and Nutrition Examination Survey (NHANES, 2005-2018) were analyzed (n=37,338). Self-reported sleep duration was analyzed alongside mortality data from the National Death Index as of 12/31/2019. Primary outcomes included all-cause mortality, cancer-specific mortality, and non-cancer mortality. Odds ratios (OR), hazard ratios (HR), and corresponding 95% confidence intervals (CI) were calculated using logistic regression and Cox proportional hazards regression, respectively. Restricted cubic spline (RCS) analysis was used to explore potential non-linear associations.
Results
The prevalence of cancer was 10.12%. After adjusting for confounders, >7 hours of sleep was strongly associated with an increased OR for cancer incidence (1.18 (1.04,1.33) for (7-8] and 1.54 (1.28,1.86) for (8-14.5]). During a median follow-up of 6.1 years, 341 cancer-related deaths and 661 non-cancer-related deaths occurred. fully adjusted models, compared with 7 hours of sleep, >7 hours of sleep significantly increased the HR of all-cause mortality (1.40 (1.06,1.84) for (7-8] and 1.90 (1.42,2.54) for (8-14.5]); cancer mortality (1.20 (0.77,1.87) for (7-8] and 1.70 (1.05,2.73) for (8- 14.5], 1.70 (1.05,2.73)) and non-cancer mortality (1.50 (1.07,2.12) for (7-8], 2.03 (1.42,2.90) for (8-14.5]). Stratified analysis, RCS analysis and sensitivity analysis yielded consistent results.
Conclusions
This study suggests that the optimal sleep duration should be 7 hours, as excessive sleep may increase cancer risk and mortality risk in cancer survivors. Our findings should be useful for health education and promotion in primary care and clinical practice.
Competing Interest Statement
The authors have declared no competing interest.
Funding Statement
The author(s) received no specific funding for this work.
Author Declarations
I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
The research protocol received approval from the Institutional Review Board of the National Center for Health Statistics (NCHS)
I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.
Yes
I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).
Yes
I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.
Yes
Data Availability
The data used for all analyses are sourced from the public database NHANES, available at:[https://www.cdc.gov/nchs/nhanes/index.htm].
Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.
My notes (saved in your browser only)
Ask this paper
Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works
Citation neighborhood (no data yet)
We don't have any in-corpus citations linked to this paper yet. This is a recent paper (2025) — citers typically take a year or two to land, and the OpenAlex reference graph may still be filling in.
Source provenance
- europepmc
- last seen: 2026-05-20T01:45:00.602351+00:00
- unpaywall
- last seen: 2026-05-22T02:00:06.705733+00:00
License: CC-BY-4.0