The DOI matches its Crossref record; 105 of the 105 references it cites were found in a registry or an index.
Long sleep and mortality: rationale for sleep restriction
Abstract
Epidemiologic studies have consistently shown that sleeping >8 h per night is associated with increased mortality. Indeed, the most recent American Cancer Society data of 1.1 million respondents showed that sleeping longer than 7.5 h was associated with approximately 5% of the total mortality of the sample. The excess mortality was found even after controlling for 32 potentially confounding risk factors. Although epidemiologic data cannot prove that long sleep duration causes mortality, there is sufficient evidence to warrant future testing of the hypothesis that mild sleep restriction would decrease mortality in long sleepers. Sleep restriction might resemble dietary restriction as a potential aid to survival. Sleep restriction has several potential benefits besides possible enhanced survival. Acute sleep restriction can have dramatic antidepressant effects. Also, chronic sleep restriction is perhaps the most effective treatment for primary insomnia. Conversely, spending excessive time in bed can elicit daytime lethargy and exacerbate sleep fragmentation, resulting in a vicious cycle of further time in bed and further sleep fragmentation. Sleep restriction may be most beneficial for older adults, who tend to spend excessive time in bed and have more sleep fragmentation compared with young adults.
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“Sleep duration and mortality are associated in a U-shaped fashion, where lowest risk is usually found in those who sleep between 7-8 hours, and mortality risk increasing with further deviation on either end of the range.”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [13]
In the citing paper
“Also, there is still a lack of clarity on the biological plausibility of the long sleep relationship, although some ideas have been proposed.37,38”
From Sleep, Health, and Society (2017) · cites this paper as [37]
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BackgroundMethodInfluentialLong sleep duration in elders without dementia increases risk of dementia mortality (NEDICES)
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“Because sleep duration is potentially modifiable, this has practical implications for the primary prevention of dementing disorders.(9) Another currently unexplored method to assess this possible relationship is to study sleep patterns among deaths for which dementia has been assigned as a contributory cause (hereafte…”
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Self-reported long sleep in older adults is closely related to objective time in bed
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“As men are at a higher risk than women for obstructive sleep apnea [7], potential explanations [33] for an association between long sleep duration and cardiovascular risk can include sleep apnea that could increase sleep duration to compensate for sleep fragmentation.”
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“Considering its prevalence among older adults, frailty might be a reversible syndrome, and sleep duration is modifiable (32-33); thus, this study has important implications for health care practice and research.”
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“In the healthy diet group, the mean HEI total score was 67.78[6.27] (mean [SD]), while in the unhealthy diet group, it was 46.38[8.32] (mean [SD]).”
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“Excessive daytime sleep, however, interrupts circadian rhythm and shortens nighttime sleeping, resulting in sleep fragmentation and reduced sleep time and vice versa.(29,49) In the Redeker and Hilkert(54) study, the finding that sleep duration was not associated with functional performance differs from the view of oth…”
BackgroundU‐shaped association between sleep duration and biological aging: Evidence from the UK Biobank study
Wang, X., Yan, X., Li, M., Cheng, L., Qi, X., Zhang, J., Pan, S., Xu, X., Wei, W., & Li, Y. (2024) · Aging Cell · doi:10.1111/acel.14159 · Cited by 35
“…which highlight the potential mechanisms that have been reported in previous studies for the detrimental health implications of excessive sleep, such as sleep fragmentation (Youngstedt & Kripke, 2004), persistent tiredness (Grandner & Kripke, 2004), or depressive symptoms (Tamakoshi & Ohno, 2004).”
BackgroundSleep and cognitive failures improved by a three-month stress management intervention.
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“Normal duration of sleep in Western societies is estimated as 7–8 hr per night; duration of sleep below 6 and above 9 hr per night has been found to be associated with increased mortality (Youngstedt & Kripke, 2004).”
BackgroundSleep and inflammation in resilient aging
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Short sleep duration in association with CT-scanned abdominal fat areas: the Hitachi Health Study
Yi, S., Nakagawa, T., Yamamoto, S., Mizoue, T., Takahashi, Y., Noda, M., & Matsushita, Y. (2012) · International Journal of Obesity · doi:10.1038/ijo.2012.17 · Cited by 27
Sleep Duration and Stroke: A Mendelian Randomization Study
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“Spending excessive time in bed can elicit daytime lethargy and exacerbate sleep fragmentation (27), which was considered to be associated with more severe arteriolosclerosis and subcortical macroscopic infarcts (4).”
BackgroundTolerance of Chronic 90-Minute Time-In-Bed Restriction in Older Long Sleepers
Youngstedt, S. D., Kline, C. E., Zielinski, M. R., Kripke, D. F., Devlin, T. M., Bogan, R., Wilcox, S., & Hardin, J. W. (2009) · SLEEP · doi:10.1093/sleep/32.11.1467 · Cited by 27
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“Excessive sleep may elevate depression risk by disrupting sleep cycles, leading to increased wakefulness and reduced energy (37, 38).”
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“Both long (>9 h) and short (<6 h) sleep durations are linked to increased mortality [2,3].”
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Self-Reported Sleep Duration in Patients with Neovascular Age-Related Macular Degeneration
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Hao, Q., Xie, M., Zhu, L., Dou, Y., Dai, M., Wu, Y., Tang, X., & Wang, Q. (2020) · International Urology and Nephrology · doi:10.1007/s11255-020-02488-w · Cited by 25
Sleep duration is an independent factor in nocturia: analysis of bladder diaries
Udo, Y., Nakao, M., Honjo, H., Ukimura, O., Kitakoji, H., & Miki, T. (2009) · British Journal of Urology · doi:10.1111/j.1464-410x.2009.08379.x · Cited by 24
Kuo, T. B. J., Lai, C. T., Hsu, F., Tseng, Y.-J., Li, J.-Y., Shieh, K., Tsai, S.-C., & Yang, C. C. H. (2010) · Endocrinology · doi:10.1210/en.2009-1410 · Cited by 24
Cole, H. V. S., Owusu‐Dabo, E., Iwelunmor, J., Newsome, V., Meeks, K. A. C., Agyemang, C. O., & Jean‐Louis, G. (2017) · Sleep Medicine · doi:10.1016/j.sleep.2017.03.008 · Cited by 23
Astronauts well-being and possibly anti-aging improved during long-duration spaceflight
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Epidemiology of Sleep Disorders
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Association between sleep disturbance with motoric cognitive risk syndrome in Chinese older adults
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“Sleep-related factors are potentially modifiable [18].”
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“Sleeping disorders may contribute to longer sleeping duration to obtain more quality sleep time.(26) A prior study found that reduced sleep efficiency and increased sleep fragmentation (characterized by cycles of waking up during the night) may cause reduced periods of deep sleep and an increased frequency of waking u…”
BackgroundAn epidemiological perspective on one tale of a two-tailed hypothesis
Foley, D. J. (2004) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2004.02.002 · Cited by 21
Temporal Analysis of Chronic Musculoskeletal Pain and Sleep in Postmenopausal Women
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“16 44 Part of our sample was composed of longer sleepers, as the CMP and CMP+INS groups had sleep durations (hours:minutes) of 8:03 and 8:58, respectively, compared to the 7:33 of the CTRL group, and the 7:17 of the INS groups.”
Chung, J., Goodman, M. O., Huang, T., Castro‐Diehl, C., Chen, J. T., Sofer, T., Bertisch, S. M., Purcell, S., & Redline, S. S. (2023) · Journal of Sleep Research · doi:10.1111/jsr.14048 · Cited by 20
Associations between Metabolic Syndrome and Inadequate Sleep Duration and Skipping Breakfast
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Sleep duration and cancer risk: time to use a “sleep-years” index?
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Prolonged sleep increases the risk of intracerebral haemorrhage: a nationwide case−control study
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“Secondly, possible confounding effects of depression [18,21,24], sleep quality, daytime sleepiness and obstructive sleep apnoea, which are related to ICH and sleep duration, could not be ruled out using validated screening questionnaires [30–33], although an attempt was made to incorporate the self-reported sleep info…”
BackgroundEmotional Effects on Factors Associated with Chronic Low Back Pain
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“Correspondingly, those who sleep for long periods often experience sleep fragmentation, excessive daytime sleepiness, poor sleep quality, and a sedentary lifestyle [98 , 99 ].”
BackgroundThe Benefits of Physical Activity for Older People
Koster, A., Stenholm, S., & Schrack, J. A. (2018) · Springer eBooks · doi:10.1007/978-3-319-71291-8_3 · Cited by 17
Spielmanns, M., Bost, D., Windisch, W., Alter, P. J., Greulich, T., Nell, C., Storre, J. H., Koczulla, A. R., & Boeselt, T. (2019) · Journal of Clinical Medicine Research · doi:10.14740/jocmr4026 · Cited by 17
“Otherwise studies have shown that prolonged or shortened sleep is associated with an increased risk of morbidity and mortality [3-5].”
BackgroundLONG SLEEP A GREATER MORTALITY RISK THAN SHORT SLEEP IN OLDER ADULTS
Youngstedt, S. D., & Jean‐Louis, G. (2011) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2011.03396.x · Cited by 17
Divergent biological pathways linking short and long sleep durations to mental and physical health
Li, Y., Gong, W., Sahakian, B. J., Huang, S., Zhang, W., Zhao, Y., Ma, L., Naismith, S. L., Yu, J., Jia, T., et al. (2025) · Nature Mental Health · doi:10.1038/s44220-025-00395-6 · Cited by 18
“In contrast, for long sleep duration, the association between sleep and increased levels of CRP may be attributed to confounding factors such as obesity or a consequence of underlying diseases 24 .”
Shi, F., Liu, C., Liu, K., Sun, L., Yang, H., Cao, J., & Chen, Q. (2020) · Sleep Medicine · doi:10.1016/j.sleep.2020.05.026 · Cited by 16
Sleep Duration and Health Care Expenditures in the United States
Jasani, F., Seixas, A. A., Madondo, K., Li, Y., Jean‐Louis, G., & Pagán, J. A. (2020) · Medical Care · doi:10.1097/mlr.0000000000001351 · Cited by 17
The potential impact of sleep duration on lipid biomarkers of cardiovascular disease
Araghi, M., Thomas, G. N., & Taheri, S. (2012) · Clinical Lipidology · doi:10.2217/clp.12.43 · Cited by 13
Liu, F., Zhang, H., Liu, Y., Sun, X., Yin, Z., Li, H., Deng, K., Zhao, Y., Wang, B., Ren, Y., et al. (2018) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.7124 · Cited by 14
“43 Mortality caused by long sleep duration could result from sleep fragmentation and sympathetic nervous system activation, 15,44,45 which are considered to influence the physiological reduction of the photope - riod 46 and then change the physical condition and physiological cycle.”
Algarve, T. D., Assmann, C. E., Aigaki, T., & da Cruz, I. B. M. (2018) · Drug and Chemical Toxicology · doi:10.1080/01480545.2018.1485689 · Cited by 15
“…we observed that MeHg exposure disrupts Drosophila circadian activity that seems to have longer sleep duration and lower daily activity, behavior compatible to bipolar disorder (Salvatore et al. 2008, Etain et al. 2011) and depression (Youngstedt and Kripke 2004, Stranges et al. 2008) in humans.”
BackgroundPoceta, J. S., & Rains, J. C. (2008) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2008.04.003 · Cited by 15
Sleep Duration and Quality of Life in Young Rural Chinese Residents
Chiu, H. F. K., Xiang, Y., Dai, J., Chan, S. S. M., Yu, X., Ungvari, G. S., & Caine, E. D. (2013) · Behavioral Sleep Medicine · doi:10.1080/15402002.2013.764524 · Cited by 14
“Compared with those who sleep 7 to 8 hr daily, both short and long sleepers have an increased total mortality risk (Heslop, Smith, Metcalfe, Macleod, & Hart, 2002; Youngstedt & Kripke, 2004), sleep complaints (Grandner & Kripke, 2004; Kripke et al., 2001), and depression (Grandner & Drummond, 2007).”
BackgroundWang, Y., Li, W., Shen, L., Song, L., Li, H., Liu, B., Yuan, J., & Wang, Y. (2017) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/ggi.12984 · Cited by 14
Metadata
- Authors
- Youngstedt, S. D., & Kripke, D. F.
- Affiliations
- University of South Carolina (US)
- University of California San Diego (US)
- Corresponding author
- Youngstedt, Shawn D.
- ORCID
- Kripke, Daniel F.
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2004-06
- Volume
- 8
- Issue
- 3
- Pages
- 159-174
- ISSN
- 1087-0792 (ISSN-L)
- OpenAlex
- W2081485580
- Cited by
- 324
- References
- 105
- Citations by year
- 2026: 4 · 2025: 15 · 2024: 12 · 2023: 9 · 2022: 15 · 2021: 8 · 2020: 21 · 2019: 17 · 2018: 17 · 2017: 23 · 2016: 19 · 2015: 13 · 2014: 13 · 2013: 21 · 2012: 17
- FWCI
- 13.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sleep Medicine Reviews (publishedVersion)
- PubMed (publishedVersion)
- Scholar Commons (University of South Carolina) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging (R01AG012364, AG-12364)
- National Heart, Lung, and Blood Institute (HL-71560, R01HL071560)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- long sleep, mortality, sleep restriction, excessive sleep, time in bed, sleep fragmentation, insomnia treatment, dietary restriction, older adults
- MeSH terms
- Aging, Antidepressive Agents, Circadian Rhythm, Humans, Sleep Wake Disorders, Time Factors, Polysomnography
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