Sleep and Mortality: A Population-Based 22-Year Follow-Up Study

Hublin, Christer; Partinen, Markku; Koskenvuo, Markku; Kaprio, Jaakko

doi:10.1093/sleep/30.10.1245

Cited by 375 publications

(319 citation statements)

References 25 publications

(31 reference statements)

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“…Previous studies have been inconsistent, with some studies observing significant relationships between hypnotic prescriptions and mortality [16,[20][21][22][23][24][25]37] and others not [16][17][18][19]. Our findings suggest that these differences are probably largely due to failure to take into account confounding associations, notably common affective symptoms and sleep complaints, although other factors such as study design, participant age, and class of hypnotics probably also influence study outcome.…”

Section: Discussioncontrasting

confidence: 53%

Hypnotics and mortality in an elderly general population: A 12-year prospective study

et al. 2013

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Background: Hypnotics are widely used by the elderly, and their impact on mortality remains controversial. The inconsistent findings could be due to methodological limitations, notably the lack of control for underlying sleep symptoms or illness associated with hypnotic use, for example, insomnia symptoms and excessive daytime sleepiness, depression and anxiety. Our objective was to examine the association between the use of hypnotics and mortality risk in a large cohort of community-dwelling elderly, taking into account a wide range of potential competing risks including sociodemographic characteristics, lifestyle, and chronic disorders as well as underlying psychiatric disorders and sleep complaints. Methods: Analyses were carried out on 6,696 participants aged 65 years or older randomly recruited from three French cities and free of dementia at baseline. Adjusted Cox proportional hazards models with delayed entry, and age of the participants as the time scale, were used to determine the association between hypnotic use and 12-year survival. Results: At baseline, 21.7% of the participants regularly used at least one hypnotic. During follow-up, 1,307 persons died, 480 from cancer and 344 from cardiovascular disease. Analyses adjusted for study center, age and gender showed a significantly greater risk of all-cause and cardiovascular-related mortality with hypnotics, particularly benzodiazepines, and this increased with the number of hypnotics used. None of these associations were significant in models adjusting for sociodemographic and lifestyle characteristics, chronic disorders including cardiovascular pathologies, sleep and psychiatric disorders. Results remained unchanged when duration of past hypnotic intake or persistent versus intermittent use during follow-up were taken into account. Conclusions: When controlling for a large range of potential confounders, the risk of mortality was not significantly associated with hypnotic use regardless of the type and duration. Underlying psychiatric disorders appear to be the principal confounders of the observed association.

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Section: Discussioncontrasting

confidence: 53%

Hypnotics and mortality in an elderly general population: A 12-year prospective study

et al. 2013

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“…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,...…”

Section: Resultsmentioning

confidence: 99%

“…** 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.…”

Section: Notesmentioning

confidence: 99%

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

Kwok

Kontopantelis

Kuligowski

et al. 2018

JAHA

283

207

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BackgroundThere is growing evidence that sleep duration and quality may be associated with cardiovascular harm and mortality.Methods and ResultsWe conducted a systematic review, meta‐analysis, and spline analysis of prospective cohort studies that evaluate the association between sleep duration and quality and cardiovascular outcomes. We searched MEDLINE and EMBASE for these studies and extracted data from identified studies. We utilized linear and nonlinear dose‐response meta‐analysis models and used DerSimonian–Laird random‐effects meta‐analysis models of risk ratios, with inverse variance weighting, and the I2 statistic to quantify heterogeneity. Seventy‐four studies including 3 340 684 participants with 242 240 deaths among 2 564 029 participants who reported death events were reviewed. Findings were broadly similar across both linear and nonlinear dose‐response models in 30 studies with >1 000 000 participants, and we report results from the linear model. Self‐reported duration of sleep >8 hours was associated with a moderate increased risk of all‐cause mortality, with risk ratio, 1.14 (1.05–1.25) for 9 hours, risk ratio, 1.30 (1.19–1.42) for 10 hours, and risk ratio, 1.47 (1.33–1.64) for 11 hours. No significant difference was identified for periods of self‐reported sleep <7 hours, whereas similar patterns were observed for stroke and cardiovascular disease mortality. Subjective poor sleep quality was associated with coronary heart disease (risk ratio, 1.44; 95% confidence interval, 1.09–1.90), but no difference in mortality and other outcomes.ConclusionsDivergence from the recommended 7 to 8 hours of sleep is associated with a higher risk of mortality and cardiovascular events. Longer duration of sleep may be more associated with adverse outcomes compared with shorter sleep durations.

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“…Prospective data from the US, Europe and Asia indicate that short sleep (< 7 h sleep a night) could contribute to chronic health conditions such as diabetes, cardiovascular disease and obesity (Kripke et al, 2002, Heslop et al, 2003, Tamakoshi and Ohno, 2004, Ferrie et al, 2007, Hublin et al, 2007and Shankar et al, 2008. These findings are concerning because short sleep is increasingly common and is currently reported by approximately 30% of US adults (Kripke et al, 1979, Kripke et al, 2002, Nunes et al, 2008and Krueger and Friedman, 2009).…”

Section: Introductionmentioning

confidence: 99%

“…These findings are concerning because short sleep is increasingly common and is currently reported by approximately 30% of US adults (Kripke et al, 1979, Kripke et al, 2002, Nunes et al, 2008and Krueger and Friedman, 2009). Long sleep (≥ 9 h sleep a night) has also been associated with increased morbidity and mortality in adult populations (Tamakoshi and Ohno, 2004, Ferrie et al, 2007, Hublin et al, 2007and Shankar et al, 2008. Therefore, interventions targeting sleep duration may have implications for the prevention and management of chronic disease.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with short and long sleep

Magee

Iverson

Caputi

2009

Preventive Medicine

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Objective: Short (< 7 h) and long sleep durations (≥ 9 h) have recently been linked with increased mortality in the US, Europe and Asia, but little is known about the sleep patterns of Australian adults. The present study examined the sleep habits of Australian adults and identified socio-demographic and health-related factors associated with short and long sleep. Methods: This study analyzed cross-sectional and self-reported data from 49,405 Australian adults aged 45 to 65 years collected between 2006 and 2008. Socio-demographic and health-related factors were entered into multinomial logistic regression models predicting self-reported sleep duration. Results: Short and long sleep were reported by 16.6% and 13.9% of participants respectively. Short sleep was associated with long working hours (odds ratio [OR] = 1.17, 95% confidence interval (CI): 1.08, 1.28) and obesity (OR = 1.29, 95% CI: 1.19, 1.41); long sleep was associated with recent treatment for cancer (OR = 1.64, 95% CI: 1.34, 2.02) and heart attack/angina (OR = 1.58, 95% CI: 1.19, 2.09). Conclusions: Short and long sleep were common in this sample of middle aged Australian adults. The determinants of short sleep have potential public health implications and could be targeted to prevent morbidity and mortality associated with short sleep. confidence interval (CI): 1.08, 1.28) and obesity (OR = 1.29, 95% CI: 1.19, 1.41); long sleep was associated with recent treatment for cancer (OR = 1.64, 95% CI: 1.34, 2.02) and heart attack/angina (OR = 1.58, 95% CI: 1.19, 2.09). Conclusions: Short and long sleep were common in this sample of middle aged Australian adults. The determinants of short sleep have potential public health implications and could be targeted to prevent morbidity and mortality associated with short sleep.

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Sleep and Mortality: A Population-Based 22-Year Follow-Up Study

Cited by 375 publications

References 25 publications

Hypnotics and mortality in an elderly general population: A 12-year prospective study

Hypnotics and mortality in an elderly general population: A 12-year prospective study

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

Factors associated with short and long sleep

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