Nighttime sleep duration, 24-hour sleep duration and risk of all-cause mortality among adults: a meta-analysis of prospective cohort studies

Shen, Xiaoli; Wu, Yili; Zhang, Dongfeng

doi:10.1038/srep21480

Cited by 91 publications

(70 citation statements)

References 51 publications

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“…In addition to shorter sleep duration (#5 hours), this study identified longer sleep duration (.8.0 hours) as a significant predictor of ESKD, indicating a U-shaped association between sleep duration and incidence of ESKD (Table 3). A similar U-shaped association between sleep duration and cardiovascular and all-cause mortality was observed in many large cohort studies, identifying short (,6-or 7-hour) and long (.8-or 9-hour) sleep durations as risk factors of cardiovascular (13) and allcause mortality (15,43,44). Interestingly, some systematic reviews have suggested that the elderly population ($60 years) (15,43) and the Asian population (15,43,44) are vulnerable to the detrimental effects of long sleep duration.…”

Section: Discussionsupporting

confidence: 74%

“…The most extensively studied sleep component is sleep duration (8). Systematic reviews identified shorter and/or longer sleep duration as associated with a wide variety of clinical outcomes, including obesity (9), metabolic syndrome (10), diabetes (11), hypertension (12), cardiovascular disease (13), stroke (14), and mortality (15). Regarding CKD, a few cohort studies identified shorter sleep duration to be associated with proteinuria (16) and GFR decline (17,18) in the general population.…”

Section: Introductionmentioning

confidence: 99%

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Sleep Quality and Sleep Duration with CKD are Associated with Progression to ESKD

Yamamoto

Shinzawa

Isaka

et al. 2018

CJASN

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Background and objectives Shorter or longer sleep duration and poor sleep quality are risk factors for numerous cardio-metabolic diseases, cardiovascular disease, and mortality in subjects with normal kidney function. The association of sleep duration and sleep quality with health outcomes in patients with CKD remains uncertain.Design, setting, participants, & measurements A 4-year prospective cohort study in 17 nephrology centers in Japan, the CKD Japan Cohort (CKD-JAC) Study, assessed an association of self-reported sleep duration and sleep quality, on the basis of the Pittsburgh Sleep Quality Index (PSQI) questionnaire, with incidence of ESKD in 1601 patients with eGFR 10-59 ml/min per 1.73 m 2 using multivariable-adjusted Cox proportional hazards models.Results Baseline sleep duration and PSQI global score for the 1601 patients were mean6SD 7.061.3 hours and median 4 (interquartile range, 3-7), respectively. Poor sleep quality (PSQI global score $6) was common (n=588 [37%]). During a median of 4.0 (2.6-4.3) years of the follow-up period, 282 (18%) patients progressed to ESKD. After adjusting for age, sex, eGFR, urinary albumin excretion, smoking status, body mass index, history of diabetes and cardiovascular disease, systolic BP, blockade of the renin-angiotensin system, use of hypnotics, and Beck depression inventory score, both shorter (#5 hour) and longer (.8 hour) sleep duration were associated with ESKD (adjusted hazard ratios [95% confidence intervals] for #5.0, 5.1-6.0, 6.1-7.0, 7.1-8.0, and $8.0 hours were 2.05 [1.31 to3.21], 0.98 [0.67 to 1.44], 1.00 [reference], 1.22 [0.89 to 1.66], and 1.48 [1.01 to 2.16]), suggesting a U-shaped relationship between sleep duration and ESKD. PSQI global score $6 was also associated with incidence of ESKD (adjusted hazard ratios [95% confidence intervals] for PSQI global score #5 and $6 were 1.00 [reference] and 1.33 [1.03 to 1.71]).Conclusions Shorter (#5 hour) and longer (.8 hour) sleep duration and poor sleep quality (PSQI global score $6) were associated with ESKD in patients with CKD.

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Section: Discussionsupporting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Sleep Quality and Sleep Duration with CKD are Associated with Progression to ESKD

Yamamoto

Shinzawa

Isaka

et al. 2018

CJASN

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“…Clinicians should be aware that both insomnia and hypersomnia are associated with poor sleep quality [37] and that persistently short sleep duration and insomnia are great risks for higher morbidity and mortality [36], [38], [39]. Moreover, our results suggest that more efforts should be undertaken to ensure individually recommended, age-specific sleep durations during hospitalization in patients with psychiatric disorders.…”

Section: Discussionmentioning

confidence: 81%

“…Converging evidence suggests that short - but also excessively long – nighttime sleep durations bear the risk of mental and physical health problems in adults at least until reaching the age of 65 [15], [16], [36]. Accordingly, associations between sleep duration and daytime functioning are assumed to be associated in a curvilinear fashion with very low and excessively high sleep durations bearing the highest risk of impairment [13].…”

Section: Discussionmentioning

confidence: 99%

Subjective sleep quality and sleep duration of patients in a psychiatric hospital

et al. 2016

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Sleep complaints and sleep disturbances are highly prevalent in patients with psychiatric disorders. During hospitalization the patients’ condition may be even worse but little is known about the subjective sleep quality in psychiatric hospitals. Thus, we have investigated subjective sleep quality and mean sleep duration in patients with different psychiatric disorders at the end of hospitalization. For a period of one year, inpatients of a psychiatric hospital with diagnosis of substance use disorder (SUD), schizophrenia (SCZ), or anxiety/depressive disorders (AND) were routinely asked to fill in an easily comprehensible sleep quality questionnaire at the end of their hospitalization. Age, gender, subjective sleep quality, and sleep duration were analyzed; sleep duration was classified according to age-specific recommendations. Data of n=309 patients (age 52.1±17.9y, 56.1% women) were analyzed (n=63 SUD, n=50 SCZ, n=196 AND). Mean sleep duration was 7.0±2.0 h; 20.7% of patients had sleep durations below and 4.5% above age-specific recommendations. Non-restorative sleep during hospitalization was reported “almost always” in 38.2% (n=118), and “occasionally” in 30.1% (n=93). Subjective sleep quality was significantly associated with sleep duration (rs=−0.31, P<0.0005), but not with age, gender or diagnostic subgroup. The study showed that a great proportion of patients reported poor subjective sleep quality during hospitalization, regardless of age, gender and psychiatric diagnosis. As sleep quality was significantly associated with short sleep duration, a first step could be to take care to achieve recommended age-specific sleep durations in psychiatric hospitals.

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“…Several recent studies have shown that the relation between the duration of nocturnal sleep and the risk of type 2 diabetes12, CVD3, stroke4, or all-cause mortality56 is described by a U-shaped curve. These findings suggest that a moderate amount of sleep, neither too short nor too long, promotes good health.…”

mentioning

confidence: 99%

J-curve relation between daytime nap duration and type 2 diabetes or metabolic syndrome: A dose-response meta-analysis

Yamada

Shojima

Yamauchi

et al. 2016

Sci Rep

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Adequate sleep is important for good health, but it is not always easy to achieve because of social factors. Daytime napping is widely prevalent around the world. We performed a meta-analysis to investigate the association between napping (or excessive daytime sleepiness: EDS) and the risk of type 2 diabetes or metabolic syndrome, and to quantify the potential dose-response relation using cubic spline models. Electronic databases were searched for articles published up to 2016, with 288,883 Asian and Western subjects. Pooled analysis revealed that a long nap (≥60 min/day) and EDS were each significantly associated with an increased risk of type 2 diabetes versus no nap or no EDS (odds ratio 1.46 (95% CI 1.23–1.74, p < 0.01) for a long nap and 2.00 (1.58–2.53) for EDS). In contrast, a short nap (<60 min/day) was not associated with diabetes (p = 0.75). Dose-response meta-analysis showed a J-curve relation between nap time and the risk of diabetes or metabolic syndrome, with no effect of napping up to about 40 minutes/day, followed by a sharp increase in risk at longer nap times. In summary, longer napping is associated with an increased risk of metabolic disease. Further studies are needed to confirm the benefit of a short nap.

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Nighttime sleep duration, 24-hour sleep duration and risk of all-cause mortality among adults: a meta-analysis of prospective cohort studies

Cited by 91 publications

References 51 publications

Sleep Quality and Sleep Duration with CKD are Associated with Progression to ESKD

Sleep Quality and Sleep Duration with CKD are Associated with Progression to ESKD

Subjective sleep quality and sleep duration of patients in a psychiatric hospital

J-curve relation between daytime nap duration and type 2 diabetes or metabolic syndrome: A dose-response meta-analysis

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