The individual and joint associations of depression and sleep duration with cardiometabolic diseases and mortality: A prospective cohort study

Depression and sleep duration were only mutually adjusted in a few studies, and it is unknown whether these two factors are independent or overlapping risk factors for cardiometabolic diseases (CMDs) and mortality. This study aimed to evaluate the individual and joint associations of depression and sleep duration with CMDs and mortality. A total of 261,297 participants who were free of CMD at baseline were included. Sleep duration was divided into three groups (short: 9 h/day; ages 65+ years: >8 h/day). The main outcomes were hypertension, stroke, CHD, DM, all-cause mortality, and cardiovascular mortality. Among the 261,297 participants, depression and short or long sleep duration were independently associated with increased risk of CMDs and mortality (hazard ratio [HR], 1.10–1.38) when they were mutually adjusted, except for the association between short sleep duration and stroke (HR, 1.03; 95% confidence interval [CI], 0.97–1.10). We documented significant additive interactions between depression and short sleep duration in relation to all-cause mortality (relative excess risk due to interaction [RERI], 0.19; 95% CI, 0.02–0.37) and CHD (RERI, 0.30; 95% CI, 0.11–0.48). In this study, depression and short or long sleep duration were independently associated with an increased risk of CMDs and mortality. We also observed significant additive interactions between depression and short sleep duration in relation to all-cause mortality and CHD. [Display omitted] •Depression and sleep duration were mutually adjusted in only a few studies.•Depression and short or long sleep duration were independently associated with increased risk of cardiovascular health.•Additive interactions were found between depression and short sleep duration.