Sleep Patterns and Total Mortality: A 12-Year Follow-up Study in Japan

Kojima, Masayo; Wakai, Kenji; Kawamura, Takashi; Tamakoshi, Akiko; Aoki, Rie; Lin, Yingsong; Nakayama, Toshiko; Horibe, Hiroshi; Aoki, Nobuo; Ohno, Yoshiyuki

doi:10.2188/jea.10.87

Cited by 204 publications

(161 citation 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%

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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%

“…Four observational studies in young adults [16,17] and elderly people [18,19] found no significant associations between hypnotics and all-cause mortality. Other studies reported a significant association with excessive all-cause deaths in adults [20][21][22].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2013

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“…Such high rates of insufficient sleep duration are of particular concern given increasing reports of prospective associations between short sleep duration and increased risk of adverse health outcomes, including cardiovascular diseases, diabetes, and mortality. [23][24][25] Roughly half of the population reported "fairly bad or very bad" sleep quality in the past month, suggesting that poor sleep quality is a highly salient problem in this population. Notably, poor sleep quality and insomnia-related symptoms have also been prospectively linked with adverse cardiometabolic outcomes in communitybased population studies.…”

Section: Discussionmentioning

confidence: 99%

Sleep Disturbances and Nocturnal Symptoms: Relationships with Quality of Life in a Population-Based Sample of Women with Interstitial Cystitis/Bladder Pain Syndrome

Troxel

Booth

Buysse

et al. 2014

Journal of Clinical Sleep Medicine

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Study Objectives: To characterize the nature and impact of sleep disturbances on quality of life (QOL) in women with interstitial cystitis/bladder pain syndrome (IC/BPS). Methods: Participants were 3,397 women from a telephone probability survey who met IC/BPS symptom criteria. Sleep quality, duration, and IC/BPS nocturnal symptoms (i.e., trouble sleeping due to bladder pain, urgency, or needing to use the bathroom), general QOL (mental and physical health and sexual functioning), and IC/BPS QOL impairment were assessed via self-report during telephone interview. Results: Over half of the sample reported poor sleep quality, sleep duration ≤ 6 hours, or trouble sleeping due to IC/BPS symptoms. After covariate adjustment, short sleep duration was signifi cantly associated with greater IC/BPS QOL impairment (β = -0.04; p < 0.001) and poorer self-reported physical health (β = 1.86; p < 0.001). Poor sleep quality was signifi cantly associated with greater IC/BPS QOL impairment (β = 0.06; p < 0.001), poorer self-reported physical health (β = -2.86; p < 0.001), and greater sexual dysfunction (β = -0.04; p < 0.05).IC/BPS nocturnal symptoms were signifi cantly associated with greater IC/BPS impairment (β = 0.14; p < 0.001), poorer physical health (β = -2.76; p < 0.001) and mental health (β = 0.52; p < 0.01), and greater sexual dysfunction (β = -0.10; p < 0.001), after covariate adjustment. After further adjustment for IC/BPS nocturnal symptoms, we found that poor sleep quality and short sleep duration were independent correlates of poor self-reported physical health. Conclusions: Poor sleep quality and short sleep duration, as well as disorder-specifi c sleep disturbances, are highly prevalent in women with IC/BPS and are associated with poorer disease-specifi c and general QOL. S C I E N T I F I C I N V E S T I G A T I O N SI nterstitial cystitis (IC)/ bladder pain syndrome (BPS) is a chronic pain syndrome which disproportionately affects women and is characterized by symptoms of urinary urgency and frequency, pelvic pain, and nocturia.1 The etiology and pathophysiology of IC/BPS are currently unknown; however, prevailing theories implicate chronic or subclinical infection, autoimmunity, neurogenic infl ammation, or bladder urothelial defects (i.e., epithelial lining of the urinary tract) as potential mechanisms. 2In the absence of known or measurable pathophysiological biomarkers, the clinical diagnosis of IC/BPS is based on patient-reported symptoms, and many cases remain undiagnosed. For instance, in the RAND Interstitial Cystitis Epidemiology (RICE) Study (from which the current data are drawn), a nationally representative population survey, up to 6.5% of US women reported experiencing IC/BPS symptoms according to established case criteria, but less than 10% of these women had an IC/BPS diagnosis.3 Adding to the diagnostic uncertainty is the considerable symptom overlap and comorbidity between IC/BPS and other chronic pain conditions, such as fi bromyalgia, chronic fatigue syndrome, and irritable bowel syndrome (IB...

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“…Actually, it was reported that sleep disturbance was a significant correlate of depression (20)(21)(22) and was even associated with an increased risk of mortality (23). In these days of new media like computers and videos being spread rapidly and widely, the potential impact of the observed short and poor nocturnal sleep on work productivity and health among young adults deserves further study.…”

Section: Discussionmentioning

confidence: 99%

Sleep Duration, Subjective Sleep Disturbances and Associated Factors Among University Students in Korea

Ban

Lee

2001

J Korean Med Sci

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Objective of this study was to look into sleep patterns of university students in association with their lifestyle, specifically to examine mean sleep duration, prevalence of sleep disturbances and their correlates. This study also aimed to examine a possible association of sleep patterns of young adults with new media like computers and videos, which were supposed to have a great influence on their lifestyle. Self-reported sleep data were derived from questionnaires administered to a total of 1,414 students of one university located in Chullabuk-do, Korea. Statistical methods such as t-test, analyses of variance, chi-square test and multivariate logistic regression were used for analysis. The mean sleep duration of the respondents was 6.7+/-1.3 hr. Of the respondents, 30.2% reported having insufficient sleep. About one third of them pointed to visual media including computers as the primary reason. The proportion of those having some types of sleep disturbances was 36.2%. The risk of subjective sleep disturbances was significantly lower among those perceiving themselves healthy than among those perceiving themselves unhealthy (OR=0.44; 95% CI: 0.34-0.57).

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Sleep Patterns and Total Mortality: A 12-Year Follow-up Study in Japan

Cited by 204 publications

References 35 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

Sleep Disturbances and Nocturnal Symptoms: Relationships with Quality of Life in a Population-Based Sample of Women with Interstitial Cystitis/Bladder Pain Syndrome

Sleep Duration, Subjective Sleep Disturbances and Associated Factors Among University Students in Korea

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