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Sanjay R. Patel, MD, MS

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Naska et al¹ report that siesta or daytime napping is associated with reduced coronary mortality and has stronger protective effects among those who work. They demonstrate that this effect is independent of potential confounders such as differences in physical activity or diet. Unfortunately, Naska et al¹ fail to consider overall sleep habits in their work. Short-term sleep deprivation has been shown to have important effects on inflammatory, metabolic, and neuronal pathways including elevations in C-reactive peptide level, insulin resistance, and sympathetic activity, which may promote development of coronary disease.^2-3 In addition, long-term studies suggest that sleep duration is an independent predictor for both incident cardiovascular disease and mortality, exhibiting a U-shaped association, with the minimum risk in those obtaining 7 to 8 hours of sleep.^4-5 Thus, the protective effects of daytime naps may be mediated by increasing total sleep time among those who do not . . . [Full Text of this Article]

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