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Habitual Sleep Duration and Insomnia and the Risk of Cardiovascular Events and All-cause Death: Report from a Community-Based Cohort
Open accessAbstract
STUDY OBJECTIVES: To investigate the relationship between sleep duration and insomnia severity and the risk of all-cause death and cardiovascular disease (CVD) events. DESIGN: Prospective cohort study. SETTING: Community-based. PARTICIPANTS: A total of 3,430 adults aged 35 years or older. INTERVENTION: None. MEASUREMENTS AND RESULTS: During a median 15.9 year (interquartile range, 13.1 to 16.9) follow-up period, 420 cases developed cardiovascular disease and 901 cases died. A U-shape association between sleep duration and all-cause death was found: the age and gender-adjusted relative risks (95% confidence interval [CI]) of all-cause death (with 7 h of daily sleep being considered for the reference group) for individuals reporting < or = 5 h, 6 h, 8 h, and > or = 9 h were 1.15 (0.91-1.45), 1.02 (0.85-1.25), 1.05 (0.88-1.27), and 1.43 (1.16-1.75); P for trend, 0.019. However, the relationship between sleep duration and risk of CVD were linear. The multivariate-adjusted relative risk (95% CI) for all-cause death (using individuals without insomnia) were 1.02 (0.86-1.20) for occasional insomnia, 1.15 (0.92-1.42) for frequent insomnia, and 1.70 (1.16-2.49) for nearly everyday insomnia (P for trend, 0.028). The multivariate adjusted relative risk (95% CI) was 2.53 (1.71-3.76) for all-cause death and 2.07 (1.11-3.85) for CVD rate in participants sleeping > or = 9 h and for those with frequent insomnia. CONCLUSIONS: Sleep duration and insomnia severity were associated with all-cause death and CVD events among ethnic Chinese in Taiwan. Our data indicate that an optimal sleep duration (7-8 h) predicted fewer deaths.
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“A study in the US of over 3,400 men and women 35 years of age or older reported a significant increase of cardiovascular disease events in those who complained of insomnia every day compared to those without any insomnia complaint (RR: 1.78, 95%CI 1.03–3.08) [214].”
From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [214]
In the citing paper
“A few studies have examined cardiovascular disease mortality in relation to self-reported sleep duration, but none found a significant association in fully adjusted models [212–214].”
From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [214]
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Mortality Associated With Sleep Duration and Insomnia
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Why Sleep Is Important for Health: A Psychoneuroimmunology Perspective
Irwin, M. R. (2015) · Annual Review of Psychology · doi:10.1146/annurev-psych-010213-115205 · Cited by 1,325
“…less than seven hours per night entailed increased risk of cardiovascular mortality (Heslop et al. 2002), with a linear relationship between sleep duration and prospective risk of cardiovascular disease (Chien et al. 2010) that indicates an optimal sleep duration between seven and eight hours.”
BackgroundShort sleep duration and health outcomes: a systematic review, meta-analysis, and meta-regression
Itani, O., Jike, M., Watanabe, N., & Kaneita, Y. (2017) · Sleep Medicine · doi:10.1016/j.sleep.2016.08.006 · Cited by 1,252
“3 ≤5/day 7/day ☆★☆★/★★/★★★ Chien et al 2010 [75] 3,430 47.”
BackgroundPanel, C. C., Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D., Dinges, D. F., Gangwisch, J., Grandner, M. A., et al. (2015) · Sleep · doi:10.5665/sleep.4886 · Cited by 906
Long sleep duration and health outcomes: A systematic review, meta-analysis and meta-regression
Jike, M., Itani, O., Watanabe, N., Buysse, D. J., & Kaneita, Y. (2017) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2017.06.011 · Cited by 772
Yin, J., Jin, X., Shan, Z., Li, S., Huang, H., Li, P., Peng, X., Peng, Z., Yu, K., Bao, W., et al. (2017) · Journal of the American Heart Association · doi:10.1161/jaha.117.005947 · Cited by 721
“Study quality of studies included in the analysis of sleep duration and all-cause mortality Author, publication year, country Study Selection Comparability Outcome Total Score Nisha Aurora et al, 2016, US1 Sleep Heart Health Study *** ** *** 8 Wei-Ju Lee et al, 2016, Taiwan2 The Social Environment and Biomarkers of Ag…”
Influential
Metadata
- Authors
- Chien, K.-L., Chen, P.-C., Hsu, H.-C., Su, T.-C., Sung, F.-C., Chen, M.-F., & Lee, Y.-T.
- Affiliations
- National Taiwan University (TW)
- National Taiwan University Hospital (TW)
- China Medical University (TW)
- China Medical University Hospital (TW)
- Corresponding author
- Lee, Yuan-Teh
- Venue
- SLEEP
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-02
- Volume
- 33
- Issue
- 2
- Pages
- 177-184
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC2817905
- OpenAlex
- W2190946050
- Cited by
- 350
- References
- 46
- Citations by year
- 2026: 4 · 2025: 13 · 2024: 23 · 2023: 24 · 2022: 31 · 2021: 16 · 2020: 21 · 2019: 17 · 2018: 27 · 2017: 20 · 2016: 27 · 2015: 25 · 2014: 28 · 2013: 35 · 2012: 18
- FWCI
- 30.79
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- SLEEP (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Science Council
- National Taiwan University Hospital
- 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 › Physiology (medical) › Obstructive Sleep Apnea Research
- Keywords
- sleep duration, insomnia, all-cause mortality, cardiovascular disease, cardiovascular events, U-shaped relationship, ethnic Chinese, optimal sleep duration, long sleep
- MeSH terms
- Adult, Aged, Cardiovascular Diseases, Cause of Death, Female, Habits, Health Surveys, Humans, Disorders of Excessive Somnolence, Sleep Initiation and Maintenance Disorders, Life Style, Male, Middle Aged, Prospective Studies, Risk, Sleep, Sleep Deprivation, Statistics as Topic, Taiwan, Cohort Studies, Health Behavior, Multivariate Analysis
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