{"doi":"10.1016/j.jhepr.2023.100819","title":"Daytime napping, nighttime sleeping duration, and risk of hepatocellular carcinoma and liver disease-related mortality","abstract":"BackgroundSleep duration have been linked to metabolic dysfunction and chronic inflammation, which may contribute to the development of liver cancer and chronic liver disease (CLD). However, little is known about the relationship between sleep or napping duration and hepatocellular carcinoma (HCC) risk and CLD mortality.MethodsWe followed 295,837 individuals in the NIH–AARP Diet and Health Study. We examined the associations of nighttime sleep duration and daytime napping duration with risk of HCC incidence and CLD mortality. Cox proportional hazards regression was used to calculate multivariable hazard ratios (HRs) and 95% confidence intervals (95%CIs).ResultsA total of 357 incident HCC cases and 578 CLD deaths were identified after a median follow-up time of 15.5 years. After adjusted for confounder factors, we found U-shaped associations of nighttime sleep duration with the incidence of HCC (Hazard ratio [HR]<5 vs 7-8 hours=2.00, 95% confidence interval [CI]: 1.22 to 3.26 and HR≥9 vs 7-8 hours=1.63, 95% CI: 1.04 to 2.65) and CLD mortality (HR<5 vs 7-8 hours=1.78, 95%CI: 1.18 to 2.69 and HR≥9 vs 7-8 hours=1.91, 95%CI: 1.35 to 2.70). Daytime napping was associated with higher risk of HCC (HR≥1 vs nonnappers=1.46, 95%CI: 1.04 to 2.06) and higher CLD mortality (HR≥1 hour vs nonnappers=1.54, 95%CI: 1.18 to 2.01) compared to no napping.ConclusionWe observed U-shaped associations for nighttime sleeping and risk of HCC and CLD mortality. Additionally, longer daytime napping duration was associated with higher risk of HCC and CLD death. Our study suggests that clinical follow-up of individuals at risk for liver cancer or living with a liver disease should include information on nighttime and daytime sleep.Impact and implicationsSleep or napping duration may play a role in the development of liver cancer and chronic liver disease, but little is known about the relationship between them. In addition, abnormal sleep patterns in patients with chronic liver disease may further promote the development of liver disease, creating a vicious cycle. Our study suggests that clinical follow-up of individuals at risk for liver cancer or living with a liver disease should include information on nighttime and daytime sleep, as they can be potentially important factors in the development and progression of liver disease.","journal":"JHEP Reports","year":2023,"id":338516,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":17,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9494,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":542357,"name":"Longgang Zhao","orcid":"0000-0001-9254-1952","position":1,"is_corresponding":false},{"id":217920,"name":"Jessica L. Petrick","orcid":"0000-0001-6580-450X","position":2,"is_corresponding":false},{"id":240805,"name":"Linda M. Liao","orcid":"0000-0002-1923-5294","position":3,"is_corresponding":false},{"id":17009,"name":"Tianyi Huang","orcid":"0000-0001-8420-9167","position":4,"is_corresponding":false},{"id":764669,"name":"Aaron Hakim","orcid":"0000-0002-9752-8826","position":5,"is_corresponding":false},{"id":347942,"name":"Wanshui Yang","orcid":"0000-0002-7365-2689","position":6,"is_corresponding":false},{"id":251142,"name":"Peter T. Campbell","orcid":"0000-0002-5549-2036","position":7,"is_corresponding":false},{"id":86230,"name":"Edward L. Giovannucci","orcid":"0000-0002-6123-0219","position":8,"is_corresponding":false},{"id":217919,"name":"Katherine A. McGlynn","orcid":"0000-0003-2329-9933","position":9,"is_corresponding":false},{"id":269896,"name":"Xuehong Zhang","orcid":"0000-0002-8260-8508","position":10,"is_corresponding":false},{"id":568770,"name":"Lu Long","orcid":"0000-0003-2511-0858","position":0,"is_corresponding":true}],"reference_count":41,"raw_metadata":null,"created_at":"2026-07-19T01:10:35.973121Z","pmid":"37691690","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}