Correlates of short and long sleep duration: a cross-cultural comparison between the United Kingdom and the United States: the Whitehall II Study and the Western New York Health Study
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The authors examined sociodemographic, lifestyle, and comorbidity factors that could confound or mediate U-shaped associations between sleep duration and health in 6,472 United Kingdom adults from the Whitehall II Study (1997-1999) and 3,027 US adults from the Western New York Health Study (1996-2001). Cross-sectional associations between short (<6 hours) and long (>8 hours) durations of sleep across several correlates were calculated as multivariable odds ratios. For short sleep duration, there were significant, consistent associations in both samples for unmarried status (United Kingdom: adjusted odds ratio (AOR) = 1.49, 95% confidence interval (CI): 1.15, 1.94; United States: AOR = 1.49, 95% CI: 1.10, 2.02), body mass index (AORs were 1.04 (95% CI: 1.01, 1.07) and 1.02 (95% CI: 1.00, 1.05)), and Short Form-36 physical (AORs were 0.96 (95% CI: 0.95, 0.98) and 0.97 (95% CI: 0.96, 0.98)) and mental (AORs were 0.95 (95% CI: 0.94, 0.96) and 0.98 (95% CI: 0.96, 0.99)) scores. For long sleep duration, there were fewer significant associations: age among men (AORs were 1.08 (95% CI: 1.01, 1.14) and 1.05 (95% CI: 1.02, 1.08)), low physical activity (AORs were 1.75 (95% CI: 0.97, 3.14) and 1.60 (95% CI: 1.09, 2.34)), and Short Form-36 physical score (AORs were 0.96 (95% CI: 0.93, 0.99) and 0.97 (95% CI: 0.95, 0.99)). Being unmarried, being overweight, and having poor general health are associated with short sleep and may contribute to observed disease associations. Long sleep may represent an epiphenomenon of comorbidity.
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Depressive symptoms, low socioeconomic status, low level of physical activity, unemployment, undiagnosed health conditions, poor general health, and cancer-related fatigue have all been shown to be associated with long sleep.
“In particular, depressive symptoms, low socioeconomic status, low level of physical activity, unemployment, undiagnosed health conditions, poor general health, and cancer-related fatigue have all been shown to be associated with long sleep (64).”
From Sleep Duration/Quality with Health Outcomes: An Umbrella Review of Meta-Analyses of Prospective Studies (2022) · cites this paper as [64]
The association between a long duration of sleep and mortality may be explained by residual confounding and comorbidities.
“The association between a long duration of sleep and mortality may be explained by residual confounding and comorbidities (64).”
From Sleep Duration/Quality with Health Outcomes: An Umbrella Review of Meta-Analyses of Prospective Studies (2022) · cites this paper as [64]
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Self-citation
- Authors
- Stranges, S., Dorn, J. M., Shipley, M. J., Kandala, N.-B., Trevisan, M., Miller, M. A., Donahue, R. P., Hovey, K. M., Ferrie, J. E., Marmot, M. G., & Cappuccio, F. P.
- Affiliations
- University of Warwick (GB)
- University Hospitals Coventry and Warwickshire NHS Trust (GB)
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-10-22
- Volume
- 168
- Issue
- 12
- Pages
- 1353-1364
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- PMC
- PMC2727192
- OpenAlex
- W2086258247
- Cited by
- 344
- References
- 43
- Citations by year
- 2026: 9 · 2025: 14 · 2024: 17 · 2023: 15 · 2022: 20 · 2021: 19 · 2020: 25 · 2019: 18 · 2018: 30 · 2017: 20 · 2016: 24 · 2015: 26 · 2014: 20 · 2013: 27 · 2012: 23
- FWCI
- 15.88
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- U.S. Department of Health and Human Services
- John D. and Catherine T. MacArthur Foundation (HS06516)
- National Institute for Health and Care Research
- British Heart Foundation (HS06516, RG/07/008/23674)
- University of Warwick
- University College London
- Health and Safety Executive
- National Institutes of Health (NIH-R01)
- Agency for Healthcare Research and Quality (HS06516)
- Medical Research Council (HS06516, G8802774)
- Warwick Medical School
- National Institute on Alcohol Abuse and Alcoholism (P50AA009802, 5 P50 AA0980)
- National Institute on Aging (AG 13196, R37AG013196, R01AG013196)
- National Heart, Lung, and Blood Institute (HS06516, HL36310, NIH R01, R01HL036310)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK060587, R01 DK60587)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- sleep duration, short sleep duration, long sleep, U-shaped relationship, marital status, body mass index, physical activity, physical function, mental health, cross-cultural comparison, Whitehall II study, sociodemographic factors, lifestyle factors, comorbidities, United Kingdom, United States, age differences, sex differences
- MeSH terms
- Age Factors, Aged, Cross-Cultural Comparison, Female, Follow-Up Studies, United Kingdom, Health Status, Humans, Life Style, Male, Middle Aged, New York, Retrospective Studies, Risk Factors, Sex Factors, Sleep, Sleep Wake Disorders
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