1 
 
Sleep and Breast and Prostate Cancer Risk in the MCC-Spain Study 
 
Michelle C Turner1-3, Esther Gracia-Lavedan1-3, Kyriaki Papantoniou4, Nuria 
Aragonés3,5, Gemma Castaño-Vinyals1-3,6, Trinidad Dierssen-Sotos3,7,8, Pilar 
Amiano3,9,10, Eva Ardanaz3,11, Alba Marcos Delgado12, Ana Molina Barceló13, Juan 
Alguacil3,14, Yolanda Benavente3,15, Thalia Belmonte16, José J Jiménez-Moleón3,17,18, 
Rafael Marcos-Gragera3,19-22, Beatriz Pérez23, Inés Gómez-Acebo3,7,8, Marina Pollán3,23, 
Manolis Kogevinas1-3,6 
 
 
2 
 
Supplemental Table 1.  Distribution of participant characteristics, breast cancer controls (n = 1,609), by categories of habitual sleep duration (hours), and siesta, MCC-Spain, 
2008–2013. 
 
<6h 
(n=213) 
% 
6h 
(n=313) 
% 
7h 
(n=490) 
% 
8h 
(n=445) 
% 
9h+ 
(n=148) 
% 
p value 
Never 
Siesta 
(n=883) 
% 
Ever  
Siesta 
(n=726) 
% p value 
Age (Years), Mean (SD) 62.7 (12.4) 58.3 (12.7) 55.7 (12.5) 57.2 (14.1) 64.0 (12.8) <0.001 57.6 (13.2) 59.2 (13.4) 0.01 
Centre                                                             <0.001                         0.001 
    Asturias    7.5%       9.6%       5.9%       7.2%       4.7%        7.6%       6.5%     
    Barcelona    16.9%       16.3%       12.2%       12.4%       20.3%        15.1%       13.6%     
    Cantabria    6.6%       12.1%       10.8%       15.5%       4.1%        12.1%       10.1%     
    Girona    1.4%       1.6%       5.1%       3.6%       4.1%        3.9%       2.9%     
    Granada - - - - -  - -  
    Guipuzcoa    9.9%       10.5%       15.1%       14.2%       11.5%        10.8%       15.6%     
    Huelva    3.3%       3.8%       4.3%       4.3%       5.4%        3.4%       5.1%     
    Leon    15.5%       8.0%       9.4%       12.6%       18.2%        13.0%       9.9%     
    Madrid    24.4%       24.9%       22.7%       15.5%       18.9%        22.4%       19.3%     
    Navarra    10.8%       9.9%       9.8%       10.6%       9.5%        8.4%       12.3%     
    Valencia    3.8%       3.2%       4.7%       4.3%       3.4%        3.40%       4.8%     
Education                                                             <0.001                         0.85 
    < Primary     27.7%       13.7%       9.0%       14.8%       37.2%        17.2%       15.8%     
    Primary     37.6%       39.6%       25.7%       30.1%       29.7%        31.8%       31.3%     
    Secondary     23.0%       26.8%       36.7%       31.9%       21.6%        29.7%       31.0%     
    University    11.7%       19.8%       28.6%       23.1%       11.5%        21.3%       21.9%     
Socioeconomic Score                                                             <0.001                         0.84 
    Low (0-2)    45.1%       33.5%       22.4%       29.9%       47.3%        30.9%       33.2%     
    Medium (3-5)    46.5%       48.9%       53.5%       48.5%       39.9%        48.9%       49.2%     
    High (6-7)    6.6%       15.7%       23.3%       20.2%       8.1%        17.2%       17.5%     
3 
 
Cigarette Smoking       <0.001   0.31 
    Never    67.1%       56.5%       52.0%       59.8%       75.7%        60.4%       57.9%     
    Former     15.0%       18.2%       23.7%       18.2%       17.6%        19.6%       19.1%     
    Current     17.8%       24.9%       24.3%       21.8%       6.8%        19.8%       23.0%     
Family History of 
Breast Cancer       
0.68   0.98 
    None    88.7%       86.9%       88.0%       88.3%       85.8%        87.8%       87.7%     
    Any     8.0%       8.3%       9.8%       7.2%       10.1%        8.49%       8.68%     
BMI (kg/m2)      <0.001   0.78 
    <25    41.3%       44.4%       59.0%       51.2%       42.6%        50.4%       49.9%     
    25-<30    36.2%       33.5%       28.6%       31.7%       31.8%        31.0%       32.5%     
    >=30    22.5%       22.0%       12.4%       17.1%       25.7%        18.6%       17.6%     
Physical activity                                                              0.10                         0.59 
   Inactive    46.5%       45.0%       35.7%       37.8%       47.3%        41.7%       39.3%     
   Slightly active    15.5%       15.3%       21.4%       19.3%       14.9%        18.7%       17.8%     
   Moderately active    10.8%       11.2%       12.9%       12.6%       14.2%        11.7%       13.1%     
   Very Active    27.2%       28.4%       30.0%       30.3%       23.6%        28.0%       29.9%     
Alcohol consumptiona                               <0.001                         <0.001 
   <median 50.2% 44.7% 38.6% 43.4% 54.1%     47.7%       39.7%     
   ≥median 34.7% 43.5% 50.4% 44.3% 32.4%     39.0%       49.3%     
Parity      <0.001   0.15 
   Nulliparous 11.7% 19.2% 20.6% 23.1% 14.2%     17.7%       21.2%     
   1-2 chilldren 50.7% 57.8% 58.0% 55.1% 45.9%     56.9%       52.9%     
   3+ children 36.6% 23.0% 21.2% 21.1% 39.9%     25.0%       25.6%     
Age  at First Child       <0.001   0.01 
    Nulliparous 11.7% 19.2% 20.6% 23.1% 14.2%     17.7%       21.2%     
    <20 years 3.3% 4.5% 3.7% 3.6% 6.76%     5.6%       2.2%     
    20-24 years 36.6% 27.2% 19.2% 20.4% 28.4%     24.2%       24.2%     
4 
 
    25-29 years 30.5% 30.7% 32.4% 32.1% 35.1%     32.3%       31.7%     
    >29 years 16.9% 18.2% 23.7% 20.0% 14.9%     19.7%       20.1%     
Age at menarche      0.33   0.88 
   <12 years 20.7% 20.4% 19.8% 16.9% 14.2%     18.9%       18.5%     
   12-13 years 21.1% 21.7% 25.9% 24.3% 18.9%     22.9%       24.0%     
   14+ years 55.4% 55.6% 52.4% 56.6% 61.5%     54.5%       56.6%     
Oral Contraceptive Use      <0.001   0.42 
    Never 57.3% 48.6% 45.3% 53.9% 63.5%     50.6%       52.8%     
    Ever 42.3% 51.4% 54.7% 45.8% 36.5%     49.3%       47.1%     
Hormone Replacement 
Therapy      
0.32   0.33 
    Never 85.9% 89.8% 89.0% 91.7% 90.5%     90.3%       88.8%     
    Ever 7.5% 5.1% 8.8% 6.5% 5.4%     6.3%       7.7%     
Menopausal Status      <0.001   0.12 
    Premenopausal 85.0% 70.0% 59.4% 67.6% 79.7%     67.3%       71.1%     
    Postmenopausal 15.0% 30.0% 40.4% 32.4% 20.3%     32.6%       28.9%     
Night Shift Work      <0.001   0.23 
   Never  67.1% 69.3% 77.8% 70.3% 60.1%     71.7%       70.2%     
   Ever 11.7% 12.8% 11.6% 10.6% 6.8%     10.0%       12.5%     
   Housewife 15.5% 13.4% 7.8% 15.3% 22.3%     12.6%       14.2%     
Chronotype      0.62   0.88 
    Morning 35.7% 33.5% 34.1% 29.9% 28.4%     32.4%       32.6%     
    Neither 29.1% 35.1% 32.2% 33.7% 23.6%     32.0%       32.0%     
    Evening 16.9% 15.3% 18.6% 19.1% 16.9%     18.2%       17.1%     
Outdoor blue light 
spectrumb      
0.37 
  
0.68 
< median (0.15)  51.3% 53.7% 50.6% 50.0% 36.2%  49.1% 51.5%  
≥ median (0.15)  48.7% 46.3% 49.4% 49.0% 63.8%  50.9% 48.5%  
Note in some cases the sum does not equal the total due to missing data.   
5 
 
a Median = 1.63 ethanol g/day in women. 
b Participants in Barcelona and Madrid only, n=491 included breast cancer controls, current address 
  
6 
 
Supplemental Table 2.  Distribution of participant characteristics, prostate cancer controls (n = 1,179), by categories of habitual sleep duration (hours), and ever siesta, MCC-
Spain, 2008–2013. 
 
 
<6h 
(n=152) 
% 
6h 
(n=242) 
% 
7h 
(n=352) 
% 
8h 
(n=302) 
% 
9h+ 
(n=131) 
% 
p value 
Never 
Siesta 
(n=405) 
% 
Ever  
Siesta 
(n=774) 
% p value 
Age (Years), Mean (SD) 66.1 (7.85) 65.4 (8.40) 64.4 (8.89) 67.7 (7.33) 71.1 (6.79) <0.001 66.6 (9.01) 66.3 (7.92) 0.53 
Centre                                                             <0.001                         <0.001  
    Asturias    6.6%       3.7%       5.4%       8.3%       17.6%        10.9%       5.4%     
    Barcelona    30.3%       37.2%       26.7%       30.5%       25.2%        29.6%       30.4%     
    Cantabria    4.6%       11.6%       17.6%       18.9%       10.7%        17.8%       12.4%     
    Girona - - - - -  - -  
    Granada    14.5%       7.4%       10.5%       7.3%       10.7%        7.7%       10.6%     
    Guipuzcoa - - - - -  - -  
    Huelva    11.2%       6.2%       5.4%       6.6%       8.4%        3.0%       9.0%     
    Leon - - - - -  - -  
    Madrid    25.0%       27.3%       28.4%       22.8%       22.1%        26.9%       24.9%     
    Navarra - - - - -  - -  
    Valencia    7.9%       6.6%       6.0%       5.6%       5.3%        4.2%       7.2%     
Education                                                             <0.001                         0.11 
    < Primary     23.0%       16.5%       14.2%       18.2%       32.8%        22.7%       16.9%     
    Primary     37.5%       31.8%       34.9%       32.8%       42.0%        33.1%       35.8%     
    Secondary     27.0%       27.3%       30.1%       28.8%       19.1%        26.9%       27.9%     
    University    12.5%       24.4%       20.7%       20.2%       6.1%        17.3%       19.4%     
Socioeconomic Score                                                             <0.001                         0.31 
    Low (0-2)    38.8%       32.6%       36.6%       31.5%       53.4%        38.3%       35.8%     
    Medium (3-5)    50.0%       46.3%       49.1%       48.7%       38.9%        43.2%       49.6%     
    High (6-7)    9.21%       17.4%       13.4%       17.2%       5.3%        13.1%       14.1%     
7 
 
Cigarette Smoking       0.04   0.04 
    Never    29.6%       18.6%       31.5%       27.5%       30.5%        31.9%       25.2%     
    Former     44.7%       55.4%       48.6%       48.0%       49.6%        47.4%       50.5%     
    Current     25.7%       26.0%       19.3%       24.2%       19.8%        20.2%       24.2%     
Family History of 
Prostate Cancer       0.97   0.66 
    None    90.8%       85.5%       88.9%       87.4%       90.1%        87.9%       88.4%     
    Any     5.3%       6.6%       6.3%       5.6%       6.9%        6.7%       5.8%     
BMI (kg/m2)      0.14   0.08 
    <25    28.3%       20.7%       23.3%       28.5%       21.4%        28.4%       22.5%     
    25-<30    47.4%       53.3%       55.4%       48.0%       47.3%        49.1%       52.2%     
    >=30    24.3%       26.0%       21.3%       23.5%       31.3%        22.5%       25.3%     
Physical activity                                                              0.30                         0.21 
   Inactive    43.4%       39.7%       38.6%       42.4%       42.7%        42.5%       40.1%     
   Slightly active    13.8%       14.5%       9.4%       14.6%       9.2%        9.6%       13.7%     
   Moderately active    9.2%       12.8%       13.9%       8.3%       11.5%        10.9%       11.6%     
   Very Active    33.6%       33.1%       38.1%       34.8%       36.6%        37.0%       34.6%     
Alcohol consumptiona                                                             0.34                         0.09 
   <median    46.7%       46.3%       42.3%       41.1%       43.5%        47.4%       41.5%     
   ≥median    34.9%       41.7%       46.9%       45.0%       43.5%        40.7%       44.8%     
Night Shift Work      0.003   0.25 
   Never    77.6%       71.9%       75.3%       72.2%       58.8%        67.4%       74.8%     
   Ever    20.4%       24.4%       23.3%       24.8%       38.9%        26.4%       24.7%     
Chronotype      0.16   0.23 
    Morning    43.4%       43.0%       41.5%       37.7%       29.0%        40.7%       39.1%     
    Neither    19.7%       24.8%       30.1%       31.8%       30.5%        24.2%       30.2%     
    Evening    7.9%       9.5%       12.2%       9.9%       9.9%        9.6%       10.6%     
Outdoor blue light 
spectrumb      0.14   1.00 
8 
 
< median (0.15)  62.3% 50.3% 45.9% 47.1% 54.4%  50.2% 50.0%  
≥ median (0.15)  37.7% 49.7% 54.1% 52.9% 45.6%  49.8% 50.0%  
Note in some cases the sum does not equal the total due to missing values.   
a Median = 18.8 ethanol g/day in men. 
b Participants in Barcelona and Madrid only, n=623 included prostate cancer controls, current address 
9 
 
Supplemental Table 3.  Associations of specific types of habitual sleep problems and breast and prostate 
cancer risk, MCC-Spain, 2008–2013. 
 
Breast 
Cancer 
Cases 
n=1,543 
Breast 
Cancer 
Controls 
n=1,560 ORa LCI UCI 
Prostate 
Cancer 
Cases 
n=1,008 
Prostate 
Cancer 
Controls 
n=1,150 ORb LCI UCI 
Problems Falling 
Asleep 
          
    No 923 891 1.00 - - 758 840 1.00 - - 
    Yes 447 481 0.96 0.81 1.13 153 177 1.00 0.78 1.28 
Waking Up in the 
Middle of the Night 
          
    No 923 891 1.00 - - 758 840 1.00 - - 
    Yes 485 522 0.96 0.82 1.13 194 225 0.99 0.79 1.24 
Taking Medication 
to Fall Asleep 
          
    No 923 891 1.00 - - 758 840 1.00 - - 
    Yes 411 414 1.07 0.89 1.27 123 151 0.94 0.71 1.23 
Frequent Changes 
in Time of Sleep 
          
    No 1,344 1,334 1.00 - - 733 863 1.00 - - 
    Yes 199 226 0.91 0.73 1.13 275 287 1.13 0.92 1.39 
Note the sum does not equal the total due to missing data.  
a Models adjusted for age, centre, education, socioeconomic status, cigarette smoking status, family 
history of breast cancer in first degree relatives, BMI, physical activity, alcohol consumption, parity, age 
at first child, oral contraceptive, hormone replacement therapy, age at menarche, menopausal status. 
Categories for missing values were created for family history of breast cancer in first degree relatives, 
alcohol consumption, and hormone replacement therapy. 
b Models adjusted for age, centre, education, socioeconomic status, cigarette smoking status, family 
history of prostate cancer in first degree relatives, BMI, physical activity, alcohol consumption. 
Categories for missing values were created for family history of prostate cancer in first degree relatives 
and alcohol consumption  
Supplemental Table 4.  Associations of siesta and breast and prostate cancer risk adjusted for other 
habitual sleep characteristics, MCC-Spain, 2008–2013. 
 
Breast 
Cancer 
Cases 
n=1,270 
Breast 
Cancer 
Controls 
n=1,273 ORa LCI UCI 
Prostate 
Cancer 
Cases 
n=832 
Prostate 
Cancer 
Controls 
n=963 ORb LCI UCI 
Siesta           
    Never 616 669 1.00 - - 257 332 1.00 - - 
    Ever 654 604 1.22 1.03 1.43 575 631 1.22 0.98 1.51 
Frequency of Siesta 
(Days Per Week)      
     
    Never 616 669 1.00 - - 257 332 1.00 - - 
    <3 144 132 1.08 0.82 1.43 95 82 1.28 0.89 1.85 
    3-5 103 80 1.40 1.01 1.94 54 59 1.34 0.87 2.07 
    6-7 407 392 1.23 1.02 1.48 426 490 1.19 0.95 1.49 
Duration of Siesta 
(Minutes)      
     
    Never 616 669 1.00 - - 257 332 1.00 - - 
    <15 95 106 1.07 0.78 1.46 62 74 1.07 0.72 1.60 
    15-29 140 149 1.06 0.81 1.38 127 130 1.27 0.93 1.74 
    30-59 196 176 1.18 0.93 1.51 162 175 1.25 0.94 1.67 
    60+ 223 173 1.49 1.17 1.89 224 252 1.21 0.93 1.57 
Note the sum does not equal the total due to missing data. 
a Models adjusted for age, centre, education, socioeconomic status, cigarette smoking status, family 
history of breast cancer in first degree relatives, BMI, physical activity, alcohol consumption, parity, age 
10 
 
at first child, oral contraceptive, hormone replacement therapy, age at menarche, menopausal status, sleep 
duration, ever sleep problems, timing of sleep.  Categories for missing values were created for family 
history of breast cancer in first degree relatives, alcohol consumption, and hormone replacement therapy. 
b Models adjusted for age, centre, education, socioeconomic status, cigarette smoking status, family 
history of prostate cancer in first degree relatives, BMI, physical activity, alcohol consumption, sleep 
duration, ever sleep problems, timing of sleep.  
Categories for missing values were created for family history of prostate cancer in first degree relatives 
and alcohol consumption.
11 
 
Supplemental Table 5.  Associations of siesta and other habitual sleep characteristics and breast and prostate cancer risk, MCC-Spain, 2008–2013. 
 
Breast 
Cancer 
Cases 
n=1,543 
Breast 
Cancer 
Controls 
n=1,560 ORa LCI UCI p value  
Prostate 
Cancer 
Cases 
n=1,008 
Prostate 
Cancer 
Controls 
n=1,150 ORb LCI UCI p value 
Sleep Duration (h)      0.05      0.47 
    <7             
      Never Siesta 252 277 1.00 - -  117 125 1.00 - -  
      Ever Siesta 216 233 1.00 0.76 1.31  225 257 0.93 0.67 1.30  
    7             
      Never Siesta 241 250 1.00 - -  85 116 1.00 - -  
      Ever Siesta 242 229 1.14 0.87 1.50  203 231 1.17 0.81 1.70  
    7+             
      Never Siesta 268 317 1.00 - -  114 140 1.00 - -  
      Ever Siesta 324 254 1.49 1.17 1.91  264 281 1.24 0.89 1.73  
Ever Sleep 
Problems 
     0.42      0.87 
    No             
      Never Siesta 453 491 1.00 - -  245 287 1.00 - -  
      Ever Siesta 470 400 1.29 1.07 1.57  513 553 1.12 0.90 1.41  
    Yes             
      Never Siesta 308 353 1.00 - -  71 94 1.00 - -  
      Ever Siesta 312 316 1.10 0.87 1.39  179 216 1.19 0.79 1.80  
Timing of Sleep      0.36      0.07 
    Sleep Before 00h             
      Never Siesta 306 309 1.00 - -  150 184 1.00 - -  
      Ever Siesta 321 302 1.15 0.91 1.46  324 293 1.40 1.04 1.87  
    Sleep After 00h             
      Never Siesta 455 535 1.00 - -  166 197 1.00 - -  
      Ever Siesta 461 414 1.31 1.08 1.59  368 476 0.93 0.72 1.24  
Note the sum does not equal the total due to missing data.  
a Models adjusted for age, centre, education, socioeconomic status, cigarette smoking status, family history of breast cancer in first degree relatives, BMI, physical activity, 
alcohol consumption, parity, age at first child, oral contraceptive, hormone replacement therapy, age at menarche, menopausal status.  Categories for missing values were 
created for family history of breast cancer in first degree relatives, alcohol consumption, and hormone replacement therapy. 
12 
 
b Models adjusted for age, centre, education, socioeconomic status, cigarette smoking status, family history of prostate cancer in first degree relatives, BMI, physical activity, 
alcohol consumption.  Categories for missing values were created for family history of prostate cancer in first degree relatives and alcohol consumption.
13 
 
Supplemental Table 6.  Associations of selected habitual sleep characteristics and breast cancer risk by 
menopausal status, MCC-Spain, 2008–2013. 
 
Premeno
pausal 
Cases 
n=561 
Premeno
pausal 
Controls 
n=489 ORa LCI UCI 
Postmen
opausal 
Cases 
n=982 
Postmeno
pausal 
Controls 
n=1,071 ORa LCI UCI 
p 
value 
Sleep Duration (h)           0.93 
    <7 132 125 0.96 0.69 1.34 336 385 0.95 0.75 1.20  
    7 218 197 1.00 - - 265 282 1.00 - -  
    >7 211 167 1.14 0.85 1.54 381 404 0.98 0.78 1.23  
Ever Sleep 
Problems 
  
   
     0.45 
    No 383 336 1.00 - - 540 555 1.00 - -  
    Yes 178 153 0.94 0.71 1.25 442 516 0.93 0.78 1.12  
Timing of Sleep           0.81 
    Sleep Before 00h 228 195 1.00 - - 399 416 1.00 - -  
    Sleep After 00h 333 294 0.96 0.73 1.26 583 655 0.88 0.73 1.06  
Siesta           0.75 
    Never 297 280 1.00 - - 464 564 1.00 - -  
    Ever 264 209 1.17 0.90 1.52 518 507 1.26 1.05 1.51  
Note the sum does not equal the total due to missing data.  
a Models adjusted for age, centre, education, socioeconomic status, cigarette smoking status, family 
history of breast cancer in first degree relatives, BMI, physical activity, alcohol consumption, parity, age 
at first child, oral contraceptive, age at menarche.  Categories for missing values were created for family 
history of breast cancer in first degree relatives, and alcohol consumption. 
14 
 
Supplemental Table 7.  Associations of various habitual sleep characteristics and breast cancer risk by night shift work history and chronotype, MCC-Spain, 2008–2013.  
 Never night shift  Ever night shift  Always housewife  
 
Cases 
n=1,175 
Controls 
n=1,129 ORa LCI UCI 
Cases 
n=205 
Controls 
n=176 ORa LCI UCI 
Cases 
n=132 
Controls 
n=209 ORa LCI UCI p value 
Sleep Duration (h)                0.95 
    <7 345 357 0.95 0.76 1.18 67 64 1.07 0.61 1.88 47 73 0.72 0.33 1.55  
    7 386 375 1.00 - - 62 56 1.00 - - 24 38 1.00 - -  
    >7 444 397 1.06 0.86 1.30 76 56 1.18 0.68 1.05 61 98 0.75 0.36 1.58  
Ever Sleep 
Problems 
               0.47 
    No 726 653 1.00 - - 115 100 1.00 - - 69 111 1.00 - -  
    Yes 449 476 0.89 0.74 1.06 90 76 1.18 0.74 1.89 63 98 1.16 0.69 1.96  
Timing of Sleep                0.65 
    Sleep Before 00h 491 459 1.00 - - 80 59 1.00 - - 46 73 1.00 - -  
    Sleep After 00h 684 670 0.90 0.76 1.08 125 117 0.85 0.53 1.37 86 136 0.79 0.46 1.34  
Siesta                0.79 
    Never 582 624 1.00 - - 98 86 1.00 - - 67 109 1.00 - -  
    Ever 593 505 1.26 1.06 1.49 107 90 1.15 0.73 1.81 65 100 1.13 0.68 1.86  
 Morning Chronotype Neither Chronotype Evening Chronotype  
 Cases 
n=458 
Controls 
n=504 ORa LCI UCI 
Cases 
n=494 
Controls 
n=504 ORa LCI UCI 
Cases 
n=203 
Controls 
n=282 ORa LCI UCI p value 
Sleep Duration (h)                0.48 
    <7 148 173 0.92 0.67 1.28 126 169 0.74 0.52 1.06 89 84 1.00 0.63 1.60  
    7 160 164 1.00 - - 165 156 1.00 - - 92 90 1.00 - -  
    >7 150 167 0.97 0.70 1.35 203 179 1.03 0.74 1.42 122 108 1.14 0.73 1.78  
Ever Sleep 
Problems 
               0.99 
    No 283 297 1.00 - - 298 284 1.00 - - 183 159 1.00 - -  
    Yes 175 207 0.92 0.70 1.22 196 220 0.94 0.71 1.24 120 123 0.87 0.60 1.27  
Timing of Sleep                0.79 
    Sleep Before 00h 269 289 1.00 - - 175 160 1.00 - - 61 51 1.00 - -  
    Sleep After 00h 189 215 0.93 0.71 1.23 319 344 0.74 0.56 1.00 242 231 0.92 0.58 1.45  
Siesta                0.44 
    Never 243 269 1.00 - - 233 275 1.00 - - 148 159 1.00 - -  
    Ever 215 235 1.00 0.76 1.31 261 229 1.33 1.02 1.75 155 123 1.45 1.00 2.08  
15 
 
Note the sum does not equal the total due to missing data.  
a Models adjusted for age, centre, education, socioeconomic status, cigarette smoking status, family history of breast cancer in first degree relatives, BMI, physical activity, 
alcohol consumption, parity, age at first child, oral contraceptive, hormone replacement therapy, age at menarche, menopausal status. Categories for missing values were 
created for family history of breast cancer in first degree relatives, alcohol consumption, and hormone replacement therapy. 
 
  
16 
 
Supplemental Table 8.  Associations of various habitual sleep characteristics and prostate cancer risk by night shift work history and chronotype, MCC-Spain, 2008–2013.  
 Never night shift  Ever night shift    
 
Cases 
n=710 
Controls 
n=851 ORa LCI UCI 
Cases 
n=296 
Controls 
n=297 ORa LCI UCI      p value 
Sleep Duration (h)                0.30 
    <7 237 292 0.97 0.75 1.26 105 90 1.28 0.81 2.04       
    7 213 265 1.00 - - 75 81 1.00 - -       
    >7 260 294 1.19 0.91 1.54 116 126 1.05 0.67 1.65       
Ever Sleep 
Problems 
               0.35 
    No 534 627 1.00 - - 223 211 1.00 - -       
    Yes 176 224 0.94 0.74 1.20 73 86 0.77 0.51 1.15       
Timing of Sleep                0.05 
    Sleep Before 00h 346 344 1.00 - - 126 131 1.00 - -       
    Sleep After 00h 364 507 0.70 0.57 0.87 170 166 1.13 0.78 1.63       
Siesta                0.42 
    Never 215 273 1.00 - - 100 106 1.00 - -       
    Ever 495 578 1.13 0.90 1.42 196 191 1.10 0.75 1.62       
 Morning Chronotype Neither Chronotype Evening Chronotype  
 Cases 
n=426 
Controls 
n=460 ORa LCI UCI 
Cases 
n=280 
Controls 
n=328 ORa LCI UCI 
Cases 
n=110 
Controls 
n=117 ORa LCI UCI p value 
Sleep Duration (h)                0.39 
    <7 153 167 1.15 0.81 1.62 91 90 1.20 0.78 1.85 39 33 1.47 0.69 3.11  
    7 122 144 1.00 - - 89 106 1.00 - - 39 43 1.00 - -  
    >7 151 149 1.29 0.90 1.84 100 132 0.85 0.56 1.29 32 41 0.80 0.38 1.71  
Ever Sleep 
Problems 
               0.19 
    No 327 341 1.00 - - 213 247 1.00 - - 72 87 1.00 - -  
    Yes 99 119 0.91 0.66 1.27 67 81 0.99 0.66 1.48 38 30 1.54 0.79 2.98  
Timing of Sleep                0.53 
    Sleep Before 00h 261 258 1.00 - - 93 96 1.00 - - 21 14 1.00 - -  
    Sleep After 00h 165 202 0.81 0.61 1.08 187 232 0.78 0.54 1.14 89 103 0.54 0.24 1.25  
Siesta                0.35 
    Never 135 158 1.00 - - 78 97 1.00 - - 45 36 1.00 - -  
    Ever 291 302 1.23 0.91 1.67 202 231 1.11 0.76 1.64 65 81 0.76 0.41 1.42  
17 
 
Note the sum does not equal the total due to missing data.  
a Models adjusted for age, centre, education, socioeconomic status, cigarette smoking status, family history of breast cancer in first degree relatives, BMI, physical activity, 
alcohol consumption. Categories for missing values were created for family history of prostate cancer in first degree relatives and alcohol consumption. 
 
  
18 
 
Supplemental Table 9.  Associations of various sleep characteristics at around age 40 years and breast and prostate cancer risk, MCC-Spain, 2008–2013. 
 Around age 40 years Around age 40 years 
 
Breast 
Cancer 
Cases 
n=1,052 
Breast 
Cancer 
Controls 
n=1,093 ORa LCI UCI 
Prostate 
Cancer 
Cases 
n=751 
Prostate 
Cancer 
Controls 
n=827 ORb LCI UCI 
Sleep Durationc 
Weekdays (h) 
          
    <6 59 64 0.82 0.55 1.22 65 70 1.07 0.72 1.58 
    6 157 183 0.76 0.58 0.99 152 171 1.01 0.76 1.34 
    7 371 339 1.00 - - 291 332 1.00 - - 
    8 333 366 0.86 0.69 1.06 192 195 1.22 0.93 1.6 
    9+ 131 141 0.87 0.65 1.17 50 57 1.05 0.68 1.64 
    Per 1 hour   1.03 0.95 1.11   1.01 0.93 1.09 
Sleep Durationc 
Weekends (h) 
  
   
  
   
    <6 23 19 1.28 0.66 2.49 14 20 0.80 0.38 1.69 
    6 46 53 0.90 0.56 1.43 48 53 1.07 0.66 1.71 
    7 156 165 1.00 - - 129 148 1.00 - - 
    8 337 376 0.92 0.7 1.21 210 238 1.07 0.78 1.47 
    9+ 490 480 1.07 0.81 1.4 350 368 1.14 0.85 1.54 
    Per 1 hour   1.02 0.94 1.09   1.07 0.99 1.16 
Timing of Sleep 
Weekdays 
  
   
  
   
    Sleep Before 23h 135 132 1.00 - - 214 198 1.00 - - 
    Sleep at 23-00h 391 427 0.88 0.66 1.17 291 321 0.85 0.65 1.11 
    Sleep at 00-01h 483 486 0.96 0.72 1.27 216 260 0.84 0.63 1.13 
    Sleep After 01h 42 48 0.79 0.48 1.3 29 46 0.54 0.32 0.92 
Timing of Sleep 
Weekends 
  
   
  
   
    Sleep Before 23h 30 42 1.00 - - 82 51 1.00 - - 
    Sleep at 23-00h 158 174 1.15 0.67 1.98 200 224 0.55 0.36 0.83 
    Sleep at 00-01h 719 744 1.20 0.72 1.99 416 470 0.57 0.38 0.85 
    Sleep After 01h 145 133 1.26 0.72 2.21 53 82 0.40 0.23 0.67 
Social Jetlagd           
    0-1h     239 268 1.00 - - 196 193 1.00 - - 
19 
 
    1-2h 491 540 0.95 0.75 1.19 243 293 0.88 0.67 1.17 
    2+h 309 275 1.14 0.88 1.49 299 324 0.89 0.68 1.18 
Note the sum does not equal the total due to missing data  
a Models adjusted for age, centre, education, socioeconomic status, cigarette smoking status, family history of breast cancer in first degree relatives, BMI, physical activity, 
alcohol consumption, parity, age at first child, oral contraceptive, hormone replacement therapy, age at menarche, menopausal status. Categories for missing values were 
created for family history of breast cancer in first degree relatives, alcohol consumption, and hormone replacement therapy. 
b Models adjusted for age, centre, education, socioeconomic status, cigarette smoking status, family history of prostate cancer in first degree relatives, BMI, physical activity, 
alcohol consumption. Categories for missing values were created for family history of prostate cancer in first degree relatives and alcohol consumption. 
c Based on responses to questions for the time the participant usually turns off the lights to go to sleep and the time the participant usually wakes up.  
d The absolute difference in hours of midpoints of sleep between weekdays and weekends.