• Kathryn E Royse, Hashem B El-Serag, Liang Chen, Donna L White, Lauren Hale, Haleh Sangi-Haghpeykar, and Li Jiao.
• 1 Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine , Houston, Texas.
• J Womens Health (Larchmt). 2017 Dec 1; 26 (12): 127012771270-1277.

BackgroundSleep duration has been associated with nonalcoholic fatty liver disease, but its association with liver cancer remains unknown.Material And MethodsIn the prospective Women's Health Initiative Study, 139,368 postmenopausal women reported sleep habits at baseline (1993-1998). We ascertained 175 incident liver cancer cases during an average 13.8 years of follow-up through August 2014. We used multivariable Cox proportional hazard regression models to estimate a hazard ratio (HR) and its 95% confidence interval (95% CI) for risk of liver cancer in association with nocturnal sleep duration.ResultsCompared to women reporting 6-8 hours of sleep, the HR for liver cancer was 1.94 (95% CI 1.07-3.53) for women reporting ≥9 hours of sleep. Among the obese women, the HR associated with ≥9 hours of sleep was 3.18 (95% CI 1.84-8.60). The HR was 0.93 (95% CI 0.34-2.53) among nonobese women (p value for interaction = 0.18). Short sleep duration (≤5 hours) was not associated with liver cancer risk.ConclusionLong sleep duration was associated with a moderate increase in liver cancer risk in obese postmenopausal women in the United States. Larger study is needed to confirm our observation on effect modification by adiposity status.

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