A Prospective Cohort Study on the Relationship of Sleep Duration With All-cause and Disease-specific Mortality in the Korean Multi-center Cancer Cohort Study

Abstract

ObjectivesEmerging evidence indicates that sleep duration is associated with health outcomes. However, the relationship of sleep duration with long-term health is unclear. This study was designed to determine the relationship of sleep duration with mortality as a parameter for long-term health in a large prospective cohort study in Korea.MethodsThe study population included 13 164 participants aged over 20 years from the Korean Multi-center Cancer Cohort study. Information on sleep duration was obtained through a structured questionnaire interview. The hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality were estimated using a Cox regression model. The non-linear relationship between sleep duration and mortality was examined non-parametrically using restricted cubic splines.ResultsThe HRs for all-cause mortality showed a U-shape, with the lowest point at sleep duration of 7 to 8 hours. There was an increased risk of death among persons with sleep duration of ≤5 hours (HR, 1.21; 95% CI, 1.03 to 1.41) and of ≥10 hours (HR, 1.36; 95% CI, 1.07 to 1.72). In stratified analysis, this relationship of HR was seen in women and in participants aged ≥60 years. Risk of cardiovascular disease-specific mortality was associated with a sleep duration of ≤5 hours (HR, 1.40; 95% CI, 1.02 to 1.93). Risk of death from respiratory disease was associated with sleep duration at both extremes (≤5 and ≥10 hours).ConclusionsSleep durations of 7 to 8 hours may be recommended to the public for a general healthy lifestyle in Korea.

Self‐Reported Sleep Duration and Quality and Cardiovascular Disease and Mortality: A Dose‐Response Meta‐Analysis

“…Spline analysis using linear models did not shown any difference in events with shorter duration than 7 hours for both cardiovascular mortality (8 studies)11, 25, 44, 47, 49, 71, 87, 88 and CVD (7 studies) 8, 12, 22, 33, 38, 42, 74. However, longer self‐reported sleep duration >7 hours appeared to be associated with a moderate increase in greater stroke mortality (cubic model shown in Data S8).…”

“…A total of 74 studies met the inclusion criteria; the process of study selection is shown in Figure 1 8, 9, 11, 12, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89,...…”

“…** References 11, 21, 23, 25, 26, 27, 29, 32, 33, 34, 36, 39, 40, 41, 44, 46, 47, 48, 49, 51, 52, 53, 54, 56, 57, 61, 64, 66, 68, 70, 71, 72, 77, 79, 80, 84, 86, 87, 88.…”

Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion

“…20,21 Sleep is also critically involved in systemic physiology, including metabolism, [22][23][24][25][26] appetite regulation, 27,28 immune and hormone function, [29][30][31][32][33] and cardiovascular systems. [34][35][36][37] Sleep duration is associated with mortality risk [38][39][40] and with illnesses ranging from cardiovascular 41 and cerebrovascular 42 disease to obesity, 43 diabetes, 44 cancer, 45,46 and depression. In 2013, the American Academy of Sleep Medicine and Sleep Research Society received a one year grant, renewable annually for up to five years, from the CDC entitled the "National Healthy Sleep Awareness Project."…”

Self-reported sleep duration and coronary heart disease mortality: A large cohort study of 400,000 Taiwanese adults

“…17 They found that the U-shaped relationship was stronger in older adults (≥ 60 years) than in younger adults (< 60 years). A study including almost 60 000 Chinese participants living in Singapore, found no difference in risk of CHD deaths from short or long sleep duration between younger and older adults.…”