Association of Objective and Self‐Reported Sleep Duration With All‐Cause and Cardiovascular Disease Mortality: A Community‐Based Study

Abstract

Background Previous studies found an association between self‐reported sleep duration and mortality. This study aimed to compare the effects of objective and self‐reported sleep duration on all‐cause and cardiovascular disease (CVD) mortality. Methods and Results A total of 2341 men and 2686 women (aged 63.9±11.1 years) were selected from the SHHS (Sleep Heart Health Study). Objective sleep duration was acquired using in‐home polysomnography records, and self‐reported sleep duration on weekdays and weekends was based on a sleep habits questionnaire. The sleep duration was categorized as ≤4 hours, 4 to 5 hours, 5 to 6 hours, 6 to 7 hours, 7 to 8 hours, and >8 hours. Multivariable Cox regression analysis was used to investigate the association of objective and self‐reported sleep duration with all‐cause and CVD mortality. During a mean follow‐up period of 11 years, 1172 (23.3%) participants died, including 359 (7.1%) deaths from CVD. All‐cause and CVD mortality rates decreased gradually with increasing objective sleep duration. In multivariable Cox regression analysis, the greatest association for all‐cause and CVD mortality was with an objective sleep duration of 5 hours or shorter. In addition, we found a J‐shaped association of self‐reported sleep duration on both weekdays and weekends with all‐cause and CVD mortality. Self‐reported short (≤4 hours) and long (>8 hours) sleep duration on weekdays and weekends were associated with an increased risk of all‐cause and CVD mortality compared with 7 to 8 hours sleep duration. Furthermore, a weak correlation was observed between objective and self‐reported sleep duration. Conclusions This study showed that both objective and self‐reported sleep duration were associated with all‐cause and CVD mortality, but with different characteristics. Registration URL: https://clinicaltrials.gov/ct2/show/NCT00005275 ; Unique identifier: NCT00005275.

Sleep regularity is a stronger predictor of mortality risk than sleep duration: A prospective cohort study

“…Higher risk of mortality by cardiometabolic causes was associated with both irregular sleep and short sleep duration in our study. These findings are consistent with experimental and epidemiological evidence linking sleep regularity and duration with cardiometabolic health [ 4 , 8 , 12 , 21 , 41–46 ]. Experimental evidence in humans indicates that cardiometabolic risk factors, including arterial blood pressure, inflammatory markers, and insulin sensitivity are altered with reduced sleep duration [ 41 ], and under experimental conditions that disrupt circadian rhythms [ 42 ].…”

“…Experimental evidence in humans indicates that cardiometabolic risk factors, including arterial blood pressure, inflammatory markers, and insulin sensitivity are altered with reduced sleep duration [ 41 ], and under experimental conditions that disrupt circadian rhythms [ 42 ]. Epidemiological studies show that the risks of cardiovascular events and mortality are higher in short sleepers [ 4 , 8 , 43 , 44 ] across both objective and subjective measures of sleep duration. For sleep regularity, epidemiological studies using actigraphy have linked more variable sleep timing and duration with incident fatal and non-fatal cardiovascular disease [ 45 ] and metabolic abnormalities [ 46 ], and SRI-measured sleep regularity with cardiometabolic risk factors [ 12 ].…”

Sleep duration and mortality in patients with chronic noncommunicable disease: a population-based cohort study

“…Meta-analyses indicated that divergence from the recommended 7 to 8 hours (7–8 h/day) of sleep was linked to increased risks of cardiovascular events and mortality [ 7 , 8 ]. It has been supported by accumulating evidence that adherence to a healthy sleep pattern including an adequate sleep duration (7–8 h/day) is associated with lower risks of all-cause and cardiovascular mortality [ 9 – 11 ].…”

Objective Sleep Duration and All-Cause Mortality Among People With Obstructive Sleep Apnea

“…Sleep duration is the most important biomarker of sleep quantity and has effects on various systems . Short sleep duration was reported to be associated with multiple cardiovascular and endocrine diseases as well as all-cause mortality in the general population . In recent years, short sleep duration in people with OSA was found to be associated with insulin resistance, visceral obesity, and hypertension .…”

“…[14][15][16] Short sleep duration was reported to be associated with multiple cardiovascular and endocrine diseases [16][17][18][19] as well as all-cause mortality in the general population. [20][21][22] In recent years, short sleep duration in people with OSA was found to be associated with insulin resistance, visceral obesity, and hypertension. [23][24][25] Nevertheless, the association between sleep duration and all-cause mortality in OSA was rarely investigated.…”