A Prospective Study of Change in Sleep Duration: Associations with Mortality in the Whitehall II Cohort
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STUDY OBJECTIVES: Although sleep curtailment has become widespread in industrialised societies, little work has examined the effects on mortality of change in sleep duration. We investigated associations of sleep duration and change in sleep duration with all-cause, cardiovascular, and non-cardiovascular mortality. DESIGN: Prospective cohort study. Data are from baseline (Phase 1, 1985-88) and Phase 3 (1991-93), with mortality follow-up of 17 and 12 years respectively. SETTING: The Whitehall II study of 10,308 white-collar British civil servants aged 35-55 at baseline. PARTICIPANTS: 9781 participants with complete data were included in the analyses at Phase 1, and 7729 of the same participants were included in the analyses at Phase 3 and the analyses of change in sleep duration. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: U-shaped associations were observed between sleep (< or =5, 6, 7, 8, > or =9 hours) at Phase 1 and Phase 3 and subsequent all-cause, cardiovascular, and non-cardiovascular mortality. A decrease in sleep duration among participants sleeping 6, 7, or 8 hours at baseline was associated with cardiovascular mortality, hazard ratio 2.4 (95% confidence intervals 1.4-4.1). However, an increase in sleep duration among those sleeping 7 or 8 hours at baseline was associated with non-cardiovascular mortality, hazard ratio 2.1 (1.4-3.1). Adjustment for the socio-demographic factors, existing morbidity, and health-related behaviours measured left these associations largely unchanged. CONCLUSIONS: This is the first study to show that both a decrease in sleep duration and an increase in sleep duration are associated with an increase in mortality via effects on cardiovascular death and non-cardiovascular death respectively.
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Self-reported sleep duration is widely used in epidemiologic studies and is the basis of research on the relation between sleep duration and mortality.
“Self-reported sleep duration is widely used in epidemiologic studies and is the basis of research on the relation between sleep duration and mortality (13)(14)(15)(16)(17)(18)(19).”
From Sleep Duration in the United States: A Cross-sectional Population-based Study (2009) · cites this paper as [19]
Older ages, current smoking and former smoking, and alcohol consumption are associated with short sleep in prior work, but they are also associated with long sleep in our data.
“Older ages (7,20,21), current smoking and former smoking, and alcohol consumption (19,36,38,39) are associated with short sleep in prior work, but they are also associated with long sleep in our data”
From Sleep Duration in the United States: A Cross-sectional Population-based Study (2009) · cites this paper as [19]
Young children, being unmarried, working long hours, overweight and obesity, and measures of poor health including acute and chronic respiratory conditions, pain, and anxiety increase the odds of short sleep and have a null or inverse association with long sleep.
“Young children, being unmarried (19,26), working long hours (11,27,28), overweight and obesity (3-5), and measures of poor health (13,14,16,20,37,38,40) including acute and chronic respiratory conditions, pain, and anxiety increase the odds of short sleep and have a null or inverse association with long sleep.”
From Sleep Duration in the United States: A Cross-sectional Population-based Study (2009) · cites this paper as [19]
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Xie, D., Li, W., Wang, Y., Gu, H., Teo, K., Liu, L., & Yusuf, S. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-531 · Cited by 32 · see citing works
Sleep and mortality: cause, consequence, or symptom?
Cappuccio, F. P., & Miller, M. A. (2013) · Sleep Medicine · doi:10.1016/j.sleep.2013.04.001 · Cited by 21 · see citing works
Self-citationAre short bad sleep nights a hindrance to a healthy heart?
Cappuccio, F. P., & Miller, M. A. (2011) · SLEEP · doi:10.5665/sleep.1372 · Cited by 16 · see citing works
Self-citationInflammation Through a Psychoneuroimmunological Lens
Bennett, J. M., Gillie, B. L., Lindgren, M. E., Fagundes, C. P., & Kiecolt-Glaser, J. K. (2013) · Handbook of Systems and Complexity in Health · doi:10.1007/978-1-4614-4998-0_19 · Cited by 15 · see citing works
- Authors
- Ferrie, J. E., Shipley, M. J., Cappuccio, F. P., Brunner, E., Miller, M. A., Kumari, M., & Marmot, M. G.
- Affiliations
- University College London (GB)
- University of Warwick (GB)
- Corresponding author
- Ferrie, Jane E.
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-12
- Volume
- 30
- Issue
- 12
- Pages
- 1659-1666
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC2276139
- OpenAlex
- W2097837926
- Cited by
- 515
- References
- 35
- Citations by year
- 2026: 8 · 2025: 15 · 2024: 28 · 2023: 21 · 2022: 27 · 2021: 24 · 2020: 18 · 2019: 15 · 2018: 32 · 2017: 27 · 2016: 35 · 2015: 33 · 2014: 36 · 2013: 42 · 2012: 26
- FWCI
- 36.82
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- SLEEP (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- British Heart Foundation (RG/07/008/23674)
- University College London
- Health and Safety Executive
- Agency for Healthcare Research and Quality (HS06516)
- Medical Research Council
- National Institute on Aging (AG 13196, R37AG013196, R01AG013196)
- National Heart, Lung, and Blood Institute (HL36310, R01HL036310)
- 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
- sleep duration, sleep extension, all-cause mortality, cardiovascular mortality, non-cardiovascular mortality, Whitehall II cohort, U-shaped relationship
- MeSH terms
- Analysis of Variance, Cause of Death, England, Health Surveys, Humans, Mortality, Prospective Studies, Sleep, Cohort Studies, Health Behavior, Proportional Hazards Models
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