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2015 ; 38
(4
): 529-36
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Sleep duration and mortality: a prospective study of 113 138 middle-aged and
elderly Chinese men and women
#MMPMID25348122
Cai H
; Shu XO
; Xiang YB
; Yang G
; Li H
; Ji BT
; Gao J
; Gao YT
; Zheng W
Sleep
2015[Apr]; 38
(4
): 529-36
PMID25348122
show ga
OBJECTIVES: To evaluate associations of sleep duration with total mortality and
disease-specific mortality in a Chinese population. DESIGN: Prospective study
conducted from 1996 (for women)/2002 (for men) to 2010. SETTING: A
population-based cohort study in Shanghai, China. INTERVENTION: None.
MEASUREMENTS AND RESULTS: A total of 113,138 participants (68,548 women and
44,590 men) of the Shanghai Women's and Men's Health Studies, aged 44-79 y and
40-75 y (women and men, respectively) at sleep duration assessment, were included
in the study. In-person interviews were conducted to collect information on sleep
duration, socioeconomic status, living conditions, history of chronic disease,
participation in regular exercise, and family history of disease. The cohort has
been followed using a combination of biannual in-person interviews and record
linkages with Shanghai's population-based death registry. Survival status of
participants on December 31, 2010 was included as the study outcome. Relative
risks were calculated using a Cox proportional model stratified by sex and
comorbidity score. There were 4,277 deaths (2,356 among women; 1,921 among men)
during a median follow-up time of 7.12 y for women and 6.07 y for men. Among both
women and men, sleep duration showed a J-shaped association with total mortality.
Hazard ratios (95% confidence intervals) were 1.15 (1.01-1.32), 1.06 (0.94-1.20),
1.17 (1.04-1.32), 1.36 (1.13-1.64), and 2.11 (1.77-2.52) for women and 1.06
(0.90-1.25), 1.07 (0.94-1.23), 1.13 (1.00-1.28), 1.34 (1.10-1.62), and 1.55
(1.29-1.86) for men who slept 4-5, 6, 8, 9, and ? 10 h per day, respectively,
compared with those who slept 7 h per day. Associations for disease-specific
mortality, including cardiovascular disease, stroke, diabetes, and cancer, also
generally followed the same J-shaped pattern. The sleep duration-mortality
association was more evident among participants with comorbidities, but varied
little by sex. CONCLUSION: In our study population of Chinese adults, shorter and
longer sleep durations were independently associated with increased risk of
mortality. But longer sleep duration had a higher mortality risk of
cardiovascular disease and diabetes than short sleep.