Association between Sleep Duration and Mortality Is Mediated by Markers of Inflammation and Health in Older Adults: The Health, Aging and Body Composition Study
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STUDY OBJECTIVES: Inflammation may represent a common physiological pathway linking both short and long sleep duration to mortality. We evaluated inflammatory markers as mediators of the relationship between sleep duration and mortality in community-dwelling older adults. DESIGN: Prospective cohort with longitudinal follow-up for mortality outcomes. SETTING: Pittsburgh, Pennsylvania, and Memphis, Tennessee. PARTICIPANTS: Participants in the Health, Aging and Body Composition (Health ABC) Study (mean age 73.6 ± 2.9 years at baseline) were sampled and recruited from Medicare listings. MEASUREMENTS AND RESULTS: Baseline measures of subjective sleep duration, markers of inflammation (serum interleukin-6, tumor necrosis factor-α, and C-reactive protein) and health status were evaluated as predictors of all-cause mortality (average follow-up = 8.2 ± 2.3 years). Sleep duration was related to mortality, and age-, sex-, and race-adjusted hazard ratios (HR) were highest for those with the shortest (< 6 h HR: 1.30, CI: 1.05-1.61) and longest (> 8 h HR: 1.49, CI: 1.15-1.93) sleep durations. Adjustment for inflammatory markers and health status attenuated the HR for short (< 6 h) sleepers (HR = 1.06, 95% CI = 0.83-1.34). Age-, sex-, and race-adjusted HRs for the > 8-h sleeper group were less strongly attenuated by adjustment for inflammatory markers than by other health factors associated with poor sleep with adjusted HR = 1.23, 95% CI = 0.93-1.63. Inflammatory markers remained significantly associated with mortality. CONCLUSION: Inflammatory markers, lifestyle, and health status explained mortality risk associated with short sleep, while the mortality risk associated with long sleep was explained predominantly by lifestyle and health status.
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In human and animal models, sleep disturbances pre- and post-surgery have been shown to be associated with prolonged postoperative recovery time and increased pain.
“In human and animal models, sleep disturbances pre- and post-surgery have been shown to be associated with prolonged postoperative recovery time and increased pain (reviewed in Refs. 110, 229, 571), one of the cardinal signs of inflammation.”
From The Sleep-Immune Crosstalk in Health and Disease (2019) · cites this paper as [229]
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- Authors
- Hall, M. H., Smagula, S. F., Boudreau, R. M., Ayonayon, H. N., Goldman, S. E., Harris, T. B., Naydeck, B. L., Rubin, S. M., Samuelsson, L., Satterfield, S., Stone, K. L., Visser, M., & Newman, A. B.
- Affiliations
- University of Pittsburgh Medical Center (US)
- University of Pittsburgh (US)
- University of California, San Francisco (US)
- National Institutes of Health (US)
- University of Tennessee Health Science Center (US)
- California Pacific Medical Center (US)
- Amsterdam Public Health (NL)
- Corresponding author
- Newman, Anne B.
- ORCID
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-02-01
- Volume
- 38
- Issue
- 2
- Pages
- 189-195
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC4288599
- OpenAlex
- W2021634825
- Cited by
- 155
- References
- 47
- Citations by year
- 2026: 8 · 2025: 20 · 2024: 15 · 2023: 14 · 2022: 16 · 2021: 10 · 2020: 18 · 2019: 13 · 2018: 14 · 2017: 10 · 2016: 14 · 2015: 3
- FWCI
- 21.16
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- SLEEP (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- National Institute on Aging (R01AG028050, N01AG62106, 01-AG-6-2101, N01-AG-62103, P30AG024827, T32AG000181)
- National Institute of Nursing Research (R01NR012459)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- sleep duration, mortality, inflammation, interleukin-6, TNF-α, C-reactive protein, mediation analysis, older adults, short sleep duration, long sleep, health status, lifestyle factors, Health ABC Study
- MeSH terms
- Aged, Aging, Body Composition, C-Reactive Protein, Female, Follow-Up Studies, Health Status, Humans, Inflammation, Sleep Initiation and Maintenance Disorders, Life Style, Longitudinal Studies, Male, Mortality, Pennsylvania, Prospective Studies, Residence Characteristics, Sleep, Tennessee, Time Factors, Tumor Necrosis Factor-alpha, Biomarkers, Interleukin-6, Survival Analysis, Racial Groups
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