Insufficient Sleep and Risk of Prostate Cancer in a Large Swedish Cohort

Abstract

Study objective: There are some data to suggest that insufficient sleep, including short sleep duration and sleep disruption, may be associated with an increased risk of cancer. We investigated the association between sleep duration and sleep disruption and risk of prostate cancer.

Design: Prospective cohort study.

Setting: Sweden.

Participants: A total of 14,041 men in the Swedish National March Cohort.

Interventions: None.

Measurements and results: Habitual sleep duration and sleep disruption were self-reported in 1997. Prostate cancer diagnoses, including lethal (metastases at diagnosis or death from prostate cancer) and advanced (stage T4, N1, or M1 at diagnosis or death from prostate cancer), were determined from linkage to nationwide cancer registries through 2010. We conducted Cox proportional hazards regression adjusted for potential confounding variables. During 13 years of follow-up, we identified 785 cases of incident prostate cancer, including 118 lethal and 127 advanced cases. Four percent of men reported sleeping 5 h or less a night, and 2% reported sleeping 9 h or more per night. We found no association between sleep duration and risk of prostate cancer overall or for advanced/lethal disease. We also did not find an association between prostate cancer and sleep disruption, as defined by difficulty falling asleep, difficulty maintaining sleep, sleep quality, and restorative power of sleep.

Conclusions: In this large prospective study from Sweden, we found no association between habitual sleep duration or sleep disruption and risk of prostate cancer.

Keywords: prostate cancer; sleep disruption; sleep duration.

Figure 1

Risk of prostate cancer associated with combinations of sleep duration and restorative power of sleep among participants in the Swedish National March Cohort, Sweden, 1997–2010. *Hazard ratios (HRs) are compared to 6–8 h of sleep duration and good restorative power of sleep. HRs are adjusted for: age (as time scale, body mass index (BMI) (continuous), employment status (employed, unemployed, retired, other), snoring (frequently, infrequently, uncertain), smoking (never, former, current), alcohol use (none, ≤ 218 g, 219–513 g, ≥ 514 g), depressive symptoms (yes, no), physical activity (≤ 34.3 metabolic equivalent (MET-h), 34.3–46.4 MET-h, ≥ 46.4 MET-h), coffee intake (none, one to three cups/day, four to six cups/day, seven or more cups/day), multivitamin use (yes, no), and diabetes (yes, no).