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Cited by 587Sleep and related disordersSleep and Wakefulness ResearchCircadian rhythm and melatonin

Healthy Older Adults’ Sleep Predicts All-Cause Mortality at 4 to 19 Years of Follow-Up

Dew, Mary Amanda, Hoch, Carolyn C., Buysse, Daniel J., Monk, Timothy H., Begley, Amy E., Houck, Patricia R., Hall, Martica, Kupfer, David J. +1 more·2003·Psychosomatic Medicine
DOI 10.1097/01.psy.0000039756.23250.7c
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Abstract

OBJECTIVE: Evidence concerning whether sleep disturbances in older adults predict mortality is mixed. However, data are limited to self-reported sleep problems and may be confounded with other comorbidities. We examined whether electroencephalographic (EEG) sleep parameters predicted survival time independently of known predictors of all-cause mortality. METHODS: A total of 185 healthy older adults, primarily in their 60s through 80s, with no history of mental illness, sleep complaints, or current cognitive impairment, were enrolled in one of eight research protocols between October 1981 and February 1997 that included EEG sleep assessments. At follow-up (mean [SD] = 12.8 [3.7] years after baseline, range = 4.1-19.5), 66 individuals were positively ascertained as deceased and 118 remained alive (total N = 184). RESULTS: Controlling for age, gender, and baseline medical burden, individuals with baseline sleep latencies greater than 30 minutes were at 2.14 times greater risk of death (p =.005, 95% CI = 1.25-3.66). Those with sleep efficiency less than 80% were at 1.93 times greater risk (p =.014, CI = 1.14-3.25). Individuals with rapid eye movement (REM) sleep percentages in the lowest 15% or highest 15% of the total sample's distribution (percentage of REM <16.1 or >25.7) were at 1.71 times greater risk (p =.045, CI = 1.01-2.91). Percentage of slow-wave sleep was associated with time to death at the bivariate level, but not after controlling for potential confounders. CONCLUSIONS: Older adults with specific EEG sleep characteristics have an excess risk of dying beyond that associated with age, gender, or medical burden. The findings suggest that interventions to optimize and protect older adults' sleep initiation, continuity, and quality may be warranted.

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Crossref · 10.1097/01.psy.0000039756.23250.7c

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  • Lower quality or quantity of sleep is linked to poorer physical health, including elevated risks for cardiovascular disease, hypertension, and early mortality.

    “A substantial body of evidence indicates that lower quality or quantity of sleep is linked to poorer physical health,20–22 including elevated risks for cardiovascular disease,23 hypertension,24 and early mortality.25”

    From Social Media Use and Its Link to Physical Health Indicators (2022) · cites this paper as [20]

  • Disruption of sleep continuity is uniquely associated with increased mortality rates.

    “disruption of sleep continuity is uniquely associated with increased rates of mortality (Dew et al, 2003).”

    From Sleep health: Reciprocal regulation of sleep and innate immunity (2017) · cites this paper as Dew et al, 2003

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Authors
Dew, M. A., Hoch, C. C., Buysse, D. J., Monk, T. H., Begley, A. E., Houck, P. R., Hall, M., Kupfer, D. J., & Reynolds, C. F.
Affiliations
University of Pittsburgh (US)
ORCID
Venue
Psychosomatic Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2003-01
Volume
65
Issue
1
Pages
63-73
ISSN
0033-3174 (ISSN-L)
DOI
10.1097/01.psy.0000039756.23250.7c
OpenAlex
W1966475943
Cited by
587
References
74
Citations by year
2026: 9 · 2025: 19 · 2024: 20 · 2023: 23 · 2022: 35 · 2021: 27 · 2020: 29 · 2019: 43 · 2018: 25 · 2017: 33 · 2016: 28 · 2015: 28 · 2014: 31 · 2013: 47 · 2012: 22
FWCI
19.06
Type
journal article
Language
en
Open access
closed
Locations
  • Psychosomatic Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r01ag015138-03, 5r01mh052266-03, 5r01ag015136-04)
  • National Institute on Aging (AG15136, AG 00972, R01AG013396, AG13396, AG-15138)
  • National Institute of Mental Health (MH-52247, P30MH052247, MH-00295, MH52266, MH-37869, MH-43832, R01MH037869, MH30915)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Keywords
sleep, all-cause mortality, older adults, sleep latency, sleep efficiency, REM sleep, slow-wave sleep, sleep quality, sleep initiation
MeSH terms
Aged, Aged, 80 and over, Cause of Death, Female, Follow-Up Studies, Humans, Male, Middle Aged, Mortality, Risk Factors, Severity of Illness Index, Sleep Wake Disorders, Life Tables, Proportional Hazards Models, Survival Analysis, Polysomnography

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