The Effect of Short Sleep Duration on Coronary Heart Disease Risk is Greatest Among Those with Sleep Disturbance: A Prospective Study from the Whitehall II Cohort
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STUDY OBJECTIVES: Short sleep duration is associated with increased CHD (coronary heart disease) mortality and morbidity, although some evidence suggests that sleep disturbance is just as important. We investigated whether a combination of short sleep duration and sleep disturbance is associated with a higher risk of CHD than their additive effects. SETTING: The Whitehall II study. PATIENTS OR PARTICIPANTS: The Whitehall II study recruited 10,308 participants from 20 civil service departments in London, England. Participants were between the ages of 35 and 55 years at baseline (1985-1988) and were followed up for an average of 15 years. INTERVENTIONS: N/A. MEASUREMENTS: Sleep hours and sleep disturbance (from the General Heath Questionnaire-30) were obtained from the baseline survey. CHD events included fatal CHD deaths or incident nonfatal myocardial infarction or angina (ICD-9 codes 410-414 or ICD-10 120-25). RESULTS: Short sleep duration and sleep disturbance were both associated with increased hazards for CHD in women as well as in men, although, after we adjusted for confounders, only those reporting sleep disturbance had a raised risk. There was some evidence for an interaction between sleep duration and sleep disturbance. Participants with short sleep duration and restless disturbed nights had the highest hazard ratios (HR) of CHD (relative risk:1.55, 95% confidence interval:1.33-1.81). Among participants who did not report any sleep disturbance, there was little evidence that short sleep hours increased CHD risk. CONCLUSION: The effect of short sleep (< or = 6 hours) on increasing CHD risk is greatest among those who reported some sleep disturbance. However, among participants who did not report any sleep disturbance, there was little evidence that short sleep hours increased CHD risk.
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Insomnia symptoms are generally associated with coronary heart disease, with some evidence that the association is stronger in women.
“Studies that have investigated the association between insomnia symptoms and CHD have generally found an association, although sex differences may exist.”
From Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association (2016) · cites this paper as [117]
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- Authors
- Chandola, T., Ferrie, J. E., Perski, A., Akbaraly, T., & Marmot, M. G.
- Affiliations
- University College London (GB)
- Stockholm University (SE)
- Inserm (FR)
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-06
- Volume
- 33
- Issue
- 6
- Pages
- 739-744
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC2880242
- OpenAlex
- W1482238014
- Cited by
- 284
- References
- 39
- Citations by year
- 2026: 2 · 2025: 20 · 2024: 19 · 2023: 17 · 2022: 20 · 2021: 11 · 2020: 19 · 2019: 17 · 2018: 14 · 2017: 23 · 2016: 22 · 2015: 10 · 2014: 29 · 2013: 26 · 2012: 19
- FWCI
- 24.99
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- SLEEP (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research
- British Heart Foundation (HS06516, RG/07/008/23674)
- Health and Safety Executive
- Academy of Finland (117604, 124322)
- National Institutes of Health (-0001)
- Agency for Healthcare Research and Quality (HS06516)
- Medical Research Council (HS06516)
- Economic and Social Research Council (RES 596-28-0001)
- National Institute on Aging (AG 13196, R37AG013196, R01AG013196)
- National Heart, Lung, and Blood Institute (HS06516, 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
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- short sleep duration, sleep disorders, coronary artery disease, myocardial infarction, angina pectoris, restless sleep, cardiovascular risk, Whitehall II cohort
- MeSH terms
- Adult, Angina Pectoris, Coronary Disease, Female, Follow-Up Studies, Humans, London, Longitudinal Studies, Male, Middle Aged, Myocardial Infarction, Prospective Studies, Surveys and Questionnaires, Risk Factors, Sleep Deprivation, Sleep Wake Disorders, Time Factors, Cohort Studies, Comorbidity, Sex Distribution
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