Problems associated with short sleep: Bridging the gap between laboratory and epidemiological studies
Open accessAbstract
Existing data from laboratory studies suggest a number of negative consequences of acute reductions in sleep time. Also, epidemiological data suggest links between shorter self-reported sleep duration and negative health outcomes. These bodies of work are growing, revealing several key points of convergence and opportunities for future exploration. In addition, they begin to highlight possible problems experienced by "short sleepers," who sleep approximately 6h or less per night. While it is likely that this group is heterogeneous, comprised both of individuals with less need for sleep and those not sleeping enough, the laboratory and epidemiological findings point towards directions that can be more fully explored in verified short sleepers. This paper discusses problems associated with the terminology used to describe "short sleep," summarizes laboratory studies exploring neurobehavioral performance, metabolism and obesity, and psychological health and epidemiological studies exploring mortality risk, obesity and metabolism, cardiovascular disease, and general health/psychosocial stress, describes studies of verified short sleepers and explores areas of convergence, laying out possible future directions.
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Short sleep duration and subjective sleep insufficiency may represent partly overlapping, but separate physiological entities.
“these variables may represent partly overlapping, but separate physiological entities6970.”
From Prolonged sleep restriction induces changes in pathways involved in cholesterol metabolism and inflammatory responses (2016) · cites this paper as [69]
Sleep duration as a measure of sleep cannot differentiate sleep insufficiency-inducing short sleep from natural short sleep.
“While sleep duration as a measure of sleep has many advantages, in evaluation of sleep insufficiency it has one considerable disadvantage: it cannot differentiate sleep insufficiency-inducing short sleep from natural short sleep69.”
From Prolonged sleep restriction induces changes in pathways involved in cholesterol metabolism and inflammatory responses (2016) · cites this paper as [69]
The precision of measurement of sleep in mortality studies is often poor.
“For example, the precision of measurement of sleep in these studies is often poor.17,27,35”
From Sleep, Health, and Society (2017) · cites this paper as [35]
Even among survey methods, there is systematic variation.
“Even among survey methods, there seems to be systematic variation.35”
From Sleep, Health, and Society (2017) · cites this paper as [35]
Epidemiologic studies carry methodological limitations such as inconsistent definitions of short and long sleep duration categories, inconsistent assessments, variable measurement techniques, and occasionally non-representative samples.
“Epidemiologic studies, while typically more generalizable, carry methodological limitations such as inconsistent definitions of ‘short’ and ‘long’ sleep duration categories, inconsistent assessments (e.g., differently-worded survey items)[17], variable measurement techniques (e.g., diaries, actigraphy, polysomnography)[38], and occasionally non-representative samples”
From Habitual sleep duration associated with self-reported and objectively determined cardiometabolic risk factors (2014) · cites this paper as [17]
The study used previously established categories of self-reported sleep duration.
“previously established categories of self-reported sleep duration[2, 17, 47, 48]”
From Habitual sleep duration associated with self-reported and objectively determined cardiometabolic risk factors (2014) · cites this paper as [17]
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Self-citationInterindividual Variation in Sleep Duration and Its Association With Sleep Debt in Young Adults
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Psychological Differences Between Long and Short Sleepers
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Self-citationA sleep diary and questionnaire study of naturally short sleepers
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Risk-Taking Behavior: Effects of Ethanol, Caffeine, and Basal Sleepiness
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Light exposure is related to social and emotional functioning and to quality of life in older women
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St-Onge, M.-P., Grandner, M. A., Brown, D., Conroy, M. B., Jean-Louis, G., Coons, M., & Bhatt, D. L. (2016) · Circulation · doi:10.1161/cir.0000000000000444 · Cited by 1,044 · see citing works
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Self-citationSleep disparity, race/ethnicity, and socioeconomic position
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Short sleep duration and cardiometabolic risk: from pathophysiology to clinical evidence
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Sleep disturbance is associated with cardiovascular and metabolic disorders
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“, differently worded survey items) [17], variable measurement techniques (e.”
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Persistent Insomnia is Associated with Mortality Risk
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Self-citationSleep duration versus sleep insufficiency as predictors of cardiometabolic health outcomes
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Epidemiology of sleep and sleep disorders in The Netherlands
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Sleep duration and health outcomes: an umbrella review
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Social and behavioral determinants of perceived insufficient sleep
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Sleep Duration and Diabetes Risk: Population Trends and Potential Mechanisms
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Relationship between sleep duration and body mass index depends on age
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Self-citationSleep duration and incidence of colorectal cancer in postmenopausal women
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Perceived racial discrimination as an independent predictor of sleep disturbance and daytime fatigue
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Sleep deprivation amplifies striatal activation to monetary reward
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Effect of Sleep Disturbances on Blood Pressure
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Sleep duration, mortality and the influence of age
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Caffeine consumption, insomnia, and sleep duration: Results from a nationally representative sample
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Common Sleep Disorders: Management Strategies and Pregnancy Outcomes
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Association between self-reported sleep duration and dietary quality in European adolescents
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Addressing sleep disturbances: an opportunity to prevent cardiometabolic disease?
Grandner, M. A. (2014) · International Review of Psychiatry · doi:10.3109/09540261.2014.911148 · Cited by 88 · see citing works
“Short or long sleep duration and insuffi cient sleep For approximately 50 years and across approximately 50 studies, both short and long sleep duration have been associated with increased mortality risk (Cappuccio et al., 2010; Gallicchio & Kalesan, 2009; Grandner et al., 2010c).”
BackgroundMethodInfluentialSelf-citationUpdate on Energy Homeostasis and Insufficient Sleep
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Self-citationSleep behaviors in traditional‐age college students
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Self-citationAssociations between insomnia, sleep duration and poor work ability
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Cognitive Function in a Sleep Clinic Cohort of Patients with Obstructive Sleep Apnea
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Sleep disturbances in caregivers of patients with advanced cancer: A systematic review.
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Sleep problems are associated with binge eating in women
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Obesity and Altered Sleep: A Pathway to Metabolic Derangements in Children?
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Social and behavioral predictors of insufficient sleep among African Americans and Caucasians
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Sleep-Related Behaviors and Beliefs Associated With Race/Ethnicity in Women
Grandner, M. A., Patel, N. P., Jean‐Louis, G., JACKSON, N. J., Gehrman, P., Perlis, M. L., & Gooneratne, N. S. (2013) · Journal of the National Medical Association · doi:10.1016/s0027-9684(15)30080-8 · Cited by 73 · see citing works
Self-citationAssociation between sleep duration, weight gain, and obesity for long period
Nagai, M., Tomata, Y., Watanabe, T., Kakizaki, M., & Tsuji, I. (2013) · Sleep Medicine · doi:10.1016/j.sleep.2012.09.024 · Cited by 67 · see citing works
Grandner, M. A., Smith, T. E., JACKSON, N. J., Jackson, T. D., Burgard, S. A., & Branas, C. C. (2015) · Sleep Health · doi:10.1016/j.sleh.2015.06.003 · Cited by 67 · see citing works
Self-citationChildhood obesity and sleep: relatives, partners, or both?—a critical perspective on the evidence
Gozal, D., & Kheirandish‐Gozal, L. (2012) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2012.06723.x · Cited by 66 · see citing works
Obesity and sleep disturbances: The “chicken or the egg” question
Rodrigues, G. D., Fiorelli, E. M., Furlan, L., Montano, N., & Tobaldini, E. (2021) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2021.04.017 · Cited by 73 · see citing works
Hoggard, L. S., & Hill, L. K. (2016) · Behavioral Sleep Medicine · doi:10.1080/15402002.2016.1228648 · Cited by 65 · see citing works
Abe, T., Aoki, T., Yata, S., & Okada, M. (2011) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2011.02.029 · Cited by 59 · see citing works
Adjei, N. K., & Brand, T. (2018) · BMC Public Health · doi:10.1186/s12889-017-4979-z · Cited by 59 · see citing works
Obesity, diabetes, and exercise associated with sleep-related complaints in the American population
Grandner, M. A., Patel, N. P., Perlis, M. L., Gehrman, P. R., Xie, D., Sha, D., Pigeon, W. R., Teff, K., Weaver, T., & Gooneratne, N. S. (2011) · Journal of Public Health · doi:10.1007/s10389-011-0398-2 · Cited by 58 · see citing works
Self-citationImpact of the Metabolic Syndrome on Mortality is Modified by Objective Short Sleep Duration
Fernández‐Mendoza, J., He, F., Lagrotte, C. A., Vgontzas, A. N., Liao, D., & Bixler, E. O. (2017) · Journal of the American Heart Association · doi:10.1161/jaha.117.005479 · Cited by 58 · see citing works
Vestibular Rehabilitation and Factors That Can Affect Outcome
Whitney, S. L., Sparto, P. J., & FURMAN, J. M. R. (2019) · Seminars in Neurology · doi:10.1055/s-0039-3402062 · Cited by 58 · see citing works
The impact of sleep duration on self-rated health
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The Development of a Questionnaire to Assess Sleep-Related Practices, Beliefs, and Attitudes
Grandner, M. A., JACKSON, N. J., Gooneratne, N. S., & Patel, N. P. (2013) · Behavioral Sleep Medicine · doi:10.1080/15402002.2013.764530 · Cited by 53 · see citing works
Self-citationEpidemiology of insufficient sleep and poor sleep quality
Grandner, M. A. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-815373-4.00002-2 · Cited by 52 · see citing works
Self-citationPhysical activity and sleep profiles in Finnish men and women
Wennman, H., Kronholm, E., Partonen, T., Tolvanen, A. J., Peltonen, M., Vasankari, T. J., & Borodulin, K. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-82 · Cited by 50 · see citing works
Grandner, M. A. (2017) · Sleep Health · doi:10.1016/j.sleh.2017.07.014 · Cited by 48 · see citing works
Self-citationFurihata, R., Uchiyama, M., Suzuki, M., Konno, C., Konno, M., Takahashi, S., Kaneita, Y., Ohida, T., Akahoshi, T., Hashimoto, S., et al. (2015) · Sleep and Biological Rhythms · doi:10.1111/sbr.12096 · Cited by 47 · see citing works
Zhao, B., Meng, Y., Jin, X., Xi, W., Ma, Q., Yang, J., Ma, X., & Yan, B. (2023) · Journal of the American Heart Association · doi:10.1161/jaha.122.027832 · Cited by 48 · see citing works
Sleep and daily functioning during androgen deprivation therapy for prostate cancer
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Insomnia in the context of short sleep increases suicide risk
Hedström, A. K., Hössjer, O., Bellocco, R., Ye, W., Lagerros, Y. T., & Åkerstedt, T. (2020) · SLEEP · doi:10.1093/sleep/zsaa245 · Cited by 44 · see citing works
State and Regional Prevalence of Sleep Disturbance and Daytime Fatigue
Grandner, M. A., JACKSON, N. J., Pigeon, W. R., Gooneratne, N. S., & Patel, N. P. (2012) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.1668 · Cited by 43 · see citing works
Self-citationA Time to Rest, a Time to Dine: Sleep, Time-Restricted Eating, and Cardiometabolic Health
Gupta, C. C., Vincent, G. E., Coates, A. M., Khalesi, S., Irwin, C. G., Dorrian, J., & Ferguson, S. A. (2022) · Nutrients · doi:10.3390/nu14030420 · Cited by 44 · see citing works
Risk of chronic kidney disease in patients with obstructive sleep apnea
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Long-term effects of sleep deprivation on neuronal activity in four hypothalamic areas
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Rich and slim, but relatively short Explaining the halt in the secular trend in JapanPreprint
Bassino, J.-P., & Kato, N. (2010) · RePEc: Research Papers in Economics · Cited by 42 · see citing works
Sleep Duration, Chronotype, and Insomnia and the Risk of Lung Cancer: United Kingdom Biobank Cohort
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Cross-Cultural Comparison of Maternal Sleep
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Short Sleep, Insomnia, and Cardiovascular Disease
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Circadian and Homeostatic Modulation of Multi-Unit Activity in Midbrain Dopaminergic Structures
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Longitudinal trajectories of sleep duration in the general population
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Sleep duration across the lifespan: Implications for health
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Self-citation
- Authors
- Grandner, M. A., Patel, N. P., Gehrman, P. R., Perlis, M. L., & Pack, A. I.
- Affiliations
- University of Pennsylvania (US)
- Corresponding author
- Grandner, Michael A.
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2010-08
- Volume
- 14
- Issue
- 4
- Pages
- 239-247
- ISSN
- 1087-0792 (ISSN-L)
- PMC
- PMC2888649
- OpenAlex
- W2077014575
- Cited by
- 291
- References
- 137
- Citations by year
- 2026: 13 · 2025: 11 · 2024: 18 · 2023: 20 · 2022: 25 · 2021: 17 · 2020: 20 · 2019: 20 · 2018: 18 · 2017: 22 · 2016: 24 · 2015: 17 · 2014: 12 · 2013: 26 · 2012: 17
- FWCI
- 1.37
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Sleep Medicine Reviews (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (T32HL007713)
- National Center for Research Resources (UL1RR024134)
- 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 › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- short sleep duration, short sleepers, sleep duration, sleep deprivation, neurobehavioral performance, metabolism, obesity, mortality risk, cardiovascular disease, mental health, psychosocial stress, sleep need
- MeSH terms
- Cardiovascular Diseases, Cause of Death, Cross-Sectional Studies, Feeding Behavior, Female, Health Surveys, Homeostasis, Humans, Sleep Initiation and Maintenance Disorders, Male, Neuropsychological Tests, Obesity, Sleep Deprivation, Sleep Wake Disorders, Survival Rate, Mind-Body Relations, Metaphysical, Metabolic Syndrome
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