A Prospective Study of Sleep Duration and Coronary Heart Disease in Women
Abstract
Background Long-term sleep deprivation is common in today's society. Recent experiments have demonstrated that short-term sleep deprivation in healthy subjects results in adverse physiologic changes, including a decreased glucose tolerance and an increased blood pressure. However, the long-term health consequences of long-term sleep deprivation are unclear. The objective of this study was to determine whether decreased sleep duration (from self-reports) is associated with an increased risk of coronary events. Methods We studied a cohort of 71 617 US female health professionals (aged 45-65 years), without reported coronary heart disease (CHD) at baseline, who were enrolled in the Nurses' Health Study. Subjects were mailed a questionnaire in 1986 asking about daily sleep duration. Subjects were followed up until June 30, 1996, for the occurrence of CHD-related events. We assessed the relationship between self-reported sleep duration and incident CHD. Results A total of 934 coronary events were documented (271 fatal and 663 nonfatal) during the 10 years of follow up. Age-adjusted relative risks (95% confidence intervals) of CHD (with 8 hours of daily sleep being considered the reference group) for individuals reporting 5 or fewer, 6, and 7 hours of sleep were 1.82 (1.34-2.41), 1.30 (1.08-1.57), and 1.06 (0.89-1.26), respectively. The relative risk (95% confidence interval) for 9 or more hours of sleep was 1.57 (1.18-2.11). After adjusting for various potential confounders, including snoring, body mass index, and smoking, the relative risks of CHD (95% confidence intervals) for individuals reporting 5 or fewer, 6, and 7 hours of sleep were 1.45 (1.10-1.92), 1.18 (0.98-1.42), and 1.09 (0.91-1.30), respectively. The relative risk (95% confidence interval) for 9 or more hours of sleep was 1.38 (1.03-1.86). Conclusion Short and long self-reported sleep durations are independently associated with a modestly increased risk of coronary events.
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Accumulating evidence points to an association between sleep curtailment and obesity and type 2 diabetes.
“Accumulating evidence has pointed to an association between sleep curtailment and obesity,4,5 type 2 diabetes,6–9 and possibly mortality (see Ref. 10 for a review).”
From Interacting epidemics? Sleep curtailment, insulin resistance, and obesity (2012) · cites this paper as [6]
In the Nurses' Health Study, long (≥9 hours per night) self-reported sleep duration was associated with increased risk of incident coronary heart disease over 10 years (RR 1.38; 95% CI 1.03-1.86) compared to sleeping 8 hours per night.
“The Nurses’ Health Study found a significantly increased risk of incident coronary heart disease over 10 years associated with short (≤5 hours per night) self-reported sleep duration (risk ratio 1.45; 95% CI: 1.1–1.92) and long (≥9 hours per night) self-reported sleep duration (risk ratio 1.38; 95% CI: 1.03–1.86) compared to those sleeping 8 hours per night [211].”
From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [211]
In the Nurses' Health Study, short (≤5 hours per night) self-reported sleep duration was associated with increased risk of incident coronary heart disease over 10 years (RR 1.45; 95% CI 1.1-1.92) compared to sleeping 8 hours per night.
“The Nurses’ Health Study found a significantly increased risk of incident coronary heart disease over 10 years associated with short (≤5 hours per night) self-reported sleep duration (risk ratio 1.45; 95% CI: 1.1–1.92) and long (≥9 hours per night) self-reported sleep duration (risk ratio 1.38; 95% CI: 1.03–1.86) compared to those sleeping 8 hours per night [211].”
From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [211]
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- Authors
- Ayas, N. T., White, D. P., Manson, J. E., Stampfer, M. J., Speizer, F. E., Malhotra, A., & Hu, F. B.
- Affiliations
- Vancouver General Hospital (CA)
- Corresponding author
- Ayas, Najib T.
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2003-01-27
- Volume
- 163
- Issue
- 2
- Pages
- 205
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W1996391039
- Cited by
- 1,155
- References
- 14
- Citations by year
- 2026: 15 · 2025: 42 · 2024: 23 · 2023: 25 · 2022: 50 · 2021: 57 · 2020: 40 · 2019: 51 · 2018: 48 · 2017: 59 · 2016: 50 · 2015: 88 · 2014: 62 · 2013: 82 · 2012: 69
- FWCI
- 40.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (HL24074, HL34594, R01HL048531)
- National Cancer Institute (CA-87969)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- sleep duration, coronary artery disease, women, short sleep duration, excessive sleep, coronary events, Nurses' Health Study, self-reported sleep
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