Habitual Sleep Duration and All-Cause Mortality in a General Community Sample
Open accessAbstract
STUDY OBJECTIVES: The current study sought to determine whether sleep duration and change in sleep duration are associated with all-cause mortality in a community sample of middle-aged and older adults while accounting for several confounding factors including prevalent sleep-disordered breathing (SDB). METHODS: Habitual sleep duration was assessed using self-report (< 7, 7-8, ≥ 9 h/night) at the baseline and at the follow-up visits of the Sleep Heart Health Study. Techniques of survival analysis were used to relate habitual sleep duration and change in sleep duration to all-cause mortality after adjusting for covariates such as age, sex, race, body mass index, smoking history, prevalent hypertension, diabetes, cardiovascular disease, antidepressant medication use, and SDB severity. RESULTS: Compared to a sleep duration of 7-8 h/night, habitually long sleep duration (≥ 9 h/night), but not short sleep duration (< 7 h/night), was associated with all-cause mortality with an adjusted hazards ratio of 1.25 (95% confidence interval [CI]: 1.05, 1.47). Participants who progressed from short or normal sleep duration to long sleep duration had increased risk for all-cause mortality with adjusted hazard ratios of 1.75 (95% CI: 1.08, 2.78) and 1.63 (95% CI: 1.26, 2.13), respectively. Finally, a change from long to short sleep duration was also associated with all-cause mortality. CONCLUSION: Long sleep duration or a shift from long to short sleep duration are independently associated with all-cause mortality.
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In addition to infectious and chronic inflammatory conditions that involve a clear immunopathology, numerous other diseases have mild systemic elevations of inflammatory markers, including cardiovascular and metabolic diseases, certain forms of chronic pain, certain cancers, and neurodegenerative diseases.
“In addition to infectious and chronic inflammatory conditions that involve a clear immunopathology (e.g., HIV, RA), numerous other diseases emerged in the last decades for which mild systemic elevations of inflammatory markers are characteristic, including cardiovascular (481) and metabolic diseases (153), certain forms of chronic pain (23), certain cancers (165), and neurodegenerative diseases (9”
From The Sleep-Immune Crosstalk in Health and Disease (2019) · cites this paper as [23]
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The Sleep-Immune Crosstalk in Health and Disease
Besedovsky, L., Lange, T., & Haack, M. (2019) · Physiological Reviews · doi:10.1152/physrev.00010.2018 · Cited by 1,479 · see citing works
“However, longer sleep may not be directly linked to increased mortality; it is thought that confounding variables such as (subclinical) disease mediate this association (22, 88, 340).”
BackgroundYin, 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 · see citing works
Kwok, C. S., Kontopantelis, E., Kuligowski, G., Gray, M., Muhyaldeen, A., Gale, C. P., Peat, G. M., Cleator, J., Chew‐Graham, C., Loke, Y. K., et al. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.118.008552 · Cited by 506 · see citing works
- Authors
- Aurora, R. N., Kim, J. S., Crainiceanu, C., O'Hearn, D., & Punjabi, N. M.
- Affiliations
- Johns Hopkins University (US)
- Department of Medicine, Oregon Health Sciences University, Portland, Oregon
- Corresponding author
- Punjabi, Naresh M.
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-11-01
- Volume
- 39
- Issue
- 11
- Pages
- 1903-1909
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC5070744
- OpenAlex
- W2520372603
- Cited by
- 66
- References
- 32
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 8 · 2023: 5 · 2022: 14 · 2021: 9 · 2020: 3 · 2019: 5 · 2018: 7 · 2017: 8
- FWCI
- 9.46
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- SLEEP (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (7k23hl118414-06, 5u01hl053934-14)
- National Heart, Lung, and Blood Institute (U01HL053941, R01HL075078, U01HL053938, K23-HL118414, U01HL053937, U01HL064360, R01HL123407, U01HL053916, R01HL117167, U01HL063463, U01HL063429, U01-HL-053934)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- sleep duration, all-cause mortality, long sleep, short sleep duration, sleep-disordered breathing, middle-aged and older adults, Sleep Heart Health Study, cardiovascular disease, diabetes mellitus, hypertension
- MeSH terms
- Adult, Aged, Aged, 80 and over, Cause of Death, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Sleep, Sleep Deprivation, Time Factors, United States, Survival Analysis, Self Report
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