In men, mortality risk was significantly increased in insomniacs who slept less than 6 hours compared to the “normal sleep duration, no insomnia” group, (OR = 4.00, CI 1.14-13.99) after adjusting for diabetes, hypertension, and other confounders. Among individuals ≥65 years old, no association between weekend sleep or weekday/weekend sleep durations and mortality was observed. The mortality rate among participants with short sleep during weekdays, but long sleep during weekends, did not differ from the rate of the reference group. Sleep duration was self‐reported through two questions at baseline: “How many hours, approximately, do you usually sleep during a workday/weekday night?” and “How many hours, approximately, do you usually sleep per night on days off?” The response alternatives were: <5, 5, 6, 7, 8 or ≥9 hr. Previous studies have found a U‐shaped relationship between mortality and (weekday) sleep duration. On follow-up (median 2.8 years), mortality rates were 15%, 11%, and 17%, respectively. Participants who reported sleeping 8 hours or more experienced significantly increased mortality hazard, as did those who slept 6 hours or less. 2002 Feb;59(2):137-8. doi: 10.1001/archpsyc.59.2.137. Adjustment for inflammatory markers and health status attenuated the HR for short (< 6 h) sleepers (HR = 1.06, 95% CI = 0.83–1.34). The strengths of our study include its large size, its prospective design, the length and the completeness of the follow‐up, ascertained through linkages to nationwide registers, the high quality of the baseline data guaranteed by a low level of missing values, and the availability of two separate questions investigating sleep habits during weekdays and weekends/days off. Short or long sleep duration is proposed as a potential risk factor for all-cause mortality in the older people, yet the results of published studies are not often reproducible. For the younger participants in the present study, the difference between weekday and weekend sleep was large, probably reflecting a relatively consistent sleep deficit that may accumulate and link to mortality, if not sufficiently compensated for. This interpretation of results on sleep duration in terms of sufficient or insufficient recovery or compensatory sleep is speculative, however. Cox proportional hazards regression models with attained age as time‐scale were fitted to estimate multivariable‐adjusted hazard ratios and 95% confidence intervals for mortality; stratified analyses on age (<65 years, ≥65 years) were conducted. The accumulated evidence suggests that sleep duration is significantly associated with all‐cause mortality, with the relationship between sleep duration and mortality being U‐shaped. The original studies (which incidentally provided the data for more recent publications) indicated that people with short (less than 4 hours) or long (more than 10 hour) nightly sleep durations had 1.5-2 times higher mortality rates than those people who slept 7-8 hours per night. 2021 Jan 8. doi: 10.1007/s00415-020-10381-w. Online ahead of print. However, recent studies suggest the risk of death is lower in those sleeping 7 hours. Working off-campus? The same set of confounders as in the main analysis was used, to which baseline age is added. Most studies of sleep duration and its consequences ask for the “usual” or “habitual” duration. Sara Seitz September 1, 2020. 2010 Aug;14(4):239-47. doi: 10.1016/j.smrv.2009.08.001. Learn more. Epub 2009 Nov 6. sleep durations of 8 hours or more than with sleep of less than 7 hours. and S.K. In conclusion, short, but not long, weekend sleep was associated with an increased mortality in subjects <65 years. A sleep duration of ≥7 hours is associated with lower prevalence estimates of cigarette smoking, leisure-time physical inactivity, and obesity compared with a short sleep duration. Design: Prospective observational study. Sleep duration and all‐cause mortality: ≤5 h: 21/269 vs 159/2236, aOR 1.08 (0.65–1.80). Setting: Community-based. The study was approved by the Regional Ethical Review Board of Karolinska Institutet, and all subjects provided informed consent. Simmons Z, Erickson LD, Hedges D, Kay DB. Crossref Medline Google Scholar; 42 Hamazaki Y, Morikawa Y, Nakamura K, Sakurai M, Miura K, Ishizaki M, Kido T, Naruse Y, Suwazono Y, Nakagawa H. Sleep duration and all-cause mortality: a systematic review and meta-analysis of pro-spective studies. Sleeping constantly short or constantly long increased the mortality rate in subjects below the age of 65 years (HR 1.58; 95% CI 1.23–2.04 and HR 1.24, 95% CI 1.07–1.45, respectively). Prospective analyses of sleep duration, timing and efficiency from the Swedish Retirement Study. A Case Report. Learn about our remote access options, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, Stress Research Institute, Stockholm University, Stockholm, Sweden. The model was adjusted for sex, body mass index, smoking status, alcohol consumption, educational level, physical activity shift work and Charlson index, orcid.org/http://orcid.org/0000-0001-8049-8504, I have read and accept the Wiley Online Library Terms and Conditions of Use, Compendium of physical activities: Classification of energy costs of human physical activities, Sleep duration, mortality and the influence of age, Competing risks in epidemiology: Possibilities and pitfalls, Sleep duration and survival percentiles across categories of physical activity, Association between sleep characteristics and incident dementia accounting for baseline cognitive status: A prospective population‐based study, Sleep duration and all‐cause mortality: A systematic review and meta‐analysis of prospective studies, A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation, Proportional hazards regression in epidemiologic follow‐up studies: An intuitive consideration of primary time scale, Sleep duration and mortality: A systematic review and meta‐analysis, Proportional hazards tests and diagnostics based on weighted residuals, Problems associated with short sleep: Bridging the gap between laboratory and epidemiological studies, Regression modeling stratigies: With applications to linear models, logistic regression, and surival analysis, Gaining more flexibility in Cox proportional hazards regression models with cubic spline functions, Association between weekend catch‐up sleep duration and hypertension in Korean adults, Short sleep duration and health outcomes: A systematic review, meta‐analysis, and meta‐regression, Long sleep duration and health outcomes: A systematic review, meta‐analysis and meta‐regression, Healthy work: Stress, productivity, and the reconstruction of working life, Mortality associated with sleep duration and insomnia, Sleep duration and all‐cause mortality: A critical review of measurement and associations, Left‐truncated data with age as time scale: An alternative for survival analysis in the elderly population, Sleep duration and risk of all‐cause mortality: A flexible, non‐linear, meta‐regression of 40 prospective cohort studies, Sleep duration and mortality in the elderly: A systematic review with meta‐analysis, Cohort profile: The Swedish National March Cohort, The effect of weekend and holiday sleep compensation on childhood overweight and obesity. The former is a common definition (Cappuccio et al., 2010) and the one used in the largest study (Kripke, Garfinkel, Wingard, Klauber, & Marler, 2002). Sleep Med Rev. The American Academy of Sleep Medicine and the Sleep Research Society have determined that adults require ≥7 hours of sleep per day to promote optimal health (1).Short sleep duration (<7 hours per day) has been linked to adverse health outcomes including cardiovascular disease, obesity, diabetes, depression, and anxiety, as well as safety issues related to drowsy driving and … In contrast, reports of "insomnia" were not associated with excess mortality hazard. Results: Epidemiologic studies have shown that sleep duration is associated with overall mortality. But longer sleep duration had a higher mortality risk of cardiovascular disease and diabetes than short sleep. This site needs JavaScript to work properly. Treatment strategies may be guided by what sleep durations predict optimal survival and whether insomnia might signal mortality risks. sleep or weekday/weekend sleep durations and mortality was observed. The relative risk of all-cause mortality associated with shorter sleep duration is 1.1, while it is higher for longer sleep duration at 1.23. The estimates found with the imputed data are comparable to those previously reported in the forest plots. Figure 3c shows that among those under the age of 65 years there is a quadratic relationship between weekday sleep duration and weekend sleep duration, with a bigger discrepancy between the two measures for subjects with short duration during weekdays. J Sleep Res. Does evidence support “banking/extending sleep” by shift workers to mitigate fatigue, and/or to improve health, safety, or performance? After applying the exclusion criteria, the final cohort consisted of 38,015 subjects. Sleep duration and mortality: <7 h: aHR 0.98 (0.84–1.13), 7 to 9 h: 1.00, >9 h: aHR 1.32 (1.09–1.58). by … The relationship between weekday sleep duration and weekend sleep duration among those aged 65 years or older seemed to be linear. We here address the association of both weekday and weekend sleep duration with overall mortality. The lack of association between long weekend sleep duration and mortality in the present paper does not appear to align with the meta‐analyses finding a U‐shaped (Cappuccio et al., 2010; Gallicchio & Kalesan, 2009; Silva et al., 2016) or J‐shaped (Liu et al., 2017) relationship. Perspective: Cognitive Behavioral Therapy for Insomnia Is a Promising Intervention for Mild Traumatic Brain Injury. Fatemeh G, Sajjad M, Niloufar R, Neda S, Leila S, Khadijeh M. J Neurol. Participants were followed for overall and cause‐specific mortality from 1 October 1997 until the date of death, emigration or the end of follow‐up on 31 December 2010, whichever occurred first. Changes in sleep duration over time might occur also due to health, work or life cycle changes occurring after the enrollment into the study. When we adjusted our models for sleep quality, snoring, self‐reported sleep medication use, napping, feeling rested at awakening, coffee intake, subjective health and high work demand, the results did not change appreciably. Only prospective cohort studies were included. eCollection 2020. … Thus, it is of interest to investigate the relationship between weekend sleep duration and mortality, as well as the different patterns of sleep duration between weekday and weekend sleep. Effect of melatonin supplementation on sleep quality: a systematic review and meta-analysis of randomized controlled trials. AU - Choi, Sangbum. A linear and a quadratic curve is fitted between the two sleep measures among older and younger subjects, respectively. Acute sleep loss induces signs of visual discomfort in young men. For the analysis of both weekend and weekday sleep duration we collapsed the two highest categories to ensure enough participants with long weekday sleep (which is shorter than weekday sleep). The relative risk of all-cause mortality associated with shorter sleep duration is 1.1, while it is higher for longer sleep duration at 1.23. Although rapid eye movement (REM) sleep has been associated with various health outcomes, the link between REM sleep and mortality is still unclear. Number of times cited according to CrossRef: Schlafstörungen – Prävalenz, Bedeutung und Implikationen für die Prävention und Gesundheitsförderung. The reason may be that there is no need for compensatory sleep at sleep durations of 8 hr and above, but this needs empirical support from studies with another design. Performing multiple imputations on missing covariates did not alter the results. Age‐ and sex‐adjusted incidence rates of dementia and all‐cause mortality were significantly greater in subjects with daily sleep duration of less than 5.0 hours and 10.0 hours and more than in those with daily sleep duration of 5.0 to 6.9 hours. Interventions: None. The best survival was found among those who slept 7 hours per night. The sleep duration-mortality association was more evident among participants with comorbidities, but varied little by sex. However, sleep duration decreases with age and this may affect the relationship of sleep duration with mortality. Chronotype and Social Jetlag: A (Self-) Critical Review. Ref. Sleep. 235. Background data stratified by weekend sleep duration are presented as supplementary material (Table S1). METHODS: Study subjects were 11,325 participants (4,419 males and 6,906 females) in the Jichi Medical School Cohort Study, a population-based prospective study. The mechanism behind the U‐shaped relationship between mortality and sleep duration has been discussed in many previous studies with no convincing conclusions. Further, studies have reported both short and long-sleep duration to increase total mortality risk , , , , . 2009; 18(2):148-58 (ISSN: 1365-2869) Gallicchio L; Kalesan B. Epidemiologic studies have shown that sleep duration is associated with overall mortality. 1 – 8 Despite some inconsistencies in the published literature, 9 – 11 the majority of studies have reported that all-cause mortality risk is elevated in both short and long sleepers (generally defined as ≤ 6 … Multivariate Cox models were also fitted to study cancer mortality and CVD mortality. Participants with inconsistent answers (n = 4), incorrect national registration number (n = 13), missing data on age (n = 11), age <18 years (n = 1,740), who had emigrated (n = 457) or died (n = 8) before the start of follow‐up, or with missing values on weekday or weekend sleep duration (n = 3,632) were excluded from the analyses. SLEEP 2010;33(5):XXX-XXX. When weekend sleep duration was the main exposure of interest, we further adjusted for weekday sleep duration categorized as ≤5, 6, 7 and ≥8 hr. COVID-19 is an emerging, rapidly evolving situation. Methods We used data from the National Health Interview Survey (2004–2014) linked to … Professor Torbjörn Åkerstedt, Department of Clinical Neuroscience, Karolinska Institute, 17177 Stockholm, Sweden. Arch Gen Psychiatry. Background: Some of these issues are discussed below. A systematic review. Finally, for the predictors who did not fulfill the PH assumption (Charlson's index), stratified Cox models were implemented. Sleep duration over 28 years, cognition, gray matter volume, and white matter microstructure: a prospective cohort study. AU - Lee, Jong Tae. This may be an interesting approach for future studies. We fitted multivariable‐adjusted Cox proportional hazards (PHs) models with attained age as time‐scale to estimate overall mortality hazard ratios (HRs) and 95% confidence intervals (95% CIs) for both weekend sleep duration and the weekday/weekend sleep duration groups (Figure 1); stratified analyses on age (<65 years, ≥65 years) were conducted. In fully adjusted models, no significant association was detected between weekend sleep duration and cause‐specific hazards for cancer or CVD mortality neither in the younger, nor in the older age group (data not shown). Most studies to date have examined the association between self-reported sleep duration and mortality. Social Jetlag and Its Association With Screen Time and Nighttime Texting Among Adolescents in Sweden: A Cross-Sectional Study. Short weekend sleep was associated with mortality only among the youngest (HR 1.48; 95% CI 1.16–1.87), and the estimate remained significant even after adjusting for sleep duration during the week (HR 1.41; 95% CI 1.03–1.92). Sleep Med 3: 305–314, 2002. doi: 10.1016/S1389-9457(02)00016-3. Sixty‐five years represents the common retirement age in Sweden; we therefore assumed that weekday sleep duration is no longer restricted by working hours after retirement, and may thus permit extended sleep. Schoenfeld's residuals (Grambsch & Therneau, 1994) were used to assess whether the underlying PHs assumption of the Cox model was met, both for sleep duration and for the confounders. In conclusion, short, but not long, weekend sleep was associated with an increased mortality in subjects <65 years. Sleep duration and mortality: a systematic review and meta-analysis. Nevertheless, the mechanism still defies understanding. Conclusions Our study indicates that both short (≤6 hours/day) and long (≥8 hours/day) sleep durations increase the risk of mortality compared with sleep of 7 hours/day. ing 7 hours.6,13 More excess mortality was associated with sleep durations of 8 hours or more than with sleep of less than 7 hours. The results were pooled to obtain the HR estimates and the 95% CIs. Prior work has shown that both short and long sleep predict mortality. Conclusions: This study investigates the association of sleep duration with risk of all-cause mortality among elderly Brazilians using data from a 9-year population-based cohort study and applying a multivariable longitudinal categorical and continuous analysis using Coxs proportional hazards models. To assess whether the population longitudinal evidence supports the presence of a relationship between duration of sleep and all-cause mortality, to investigate both short and long sleep duration and to obtain an estimate of the risk. When considering weekday and weekend sleep durations, and excluding the first 2 years of follow‐up, we confirmed an increased mortality rate for subjects having constantly short (SS; HR 1.56; 95% CI 1.13–2.15) or constantly long sleep duration (LL; HR 1.23, 95% CI 1.02–1.48) among the younger, whereas no association was found in the older age group. Among individuals above the age of 65 years, no association between sleep durations and mortality was found. However, sleep duration decreases with age and this may affect the relationship of sleep duration with mortality. We conducted a systematic review of the associations between sleep duration and all-cause and cause-specific mortality. This is due to a gradual decrease in weekend sleep duration with age, compared with a nearly constant pattern for weekday sleep duration. However, we still carried out these analyses because the alternative choice, the regression analysis on the cumulative incidence functions, has its own drawback – difficulty of interpreting the coefficients (Andersen, Geskus, De Witte, & Putter, 2012). 236. Short sleep duration (<7 hours per night) is associated with greater likelihoods of obesity, high blood pressure, diabetes, coronary heart disease, stroke, frequent mental distress, and death. However, the relationship with mortality is not clear, particularly in non-European populations. The questions concerned sleep duration, use of sleep medications, and quality of sleep. Both sleep deprivation and excessive sleep duration may be independent risk factors for premature death in patients with T2DM. Problems associated with short sleep: bridging the gap between laboratory and epidemiological studies. Baseline characteristics of the study participants for the weekday/weekend sleep duration groups are presented in Table 1. Vgontzas AN, Liao D, Pejovic S, Calhoun S, Karataraki M, Basta M, Fernández-Mendoza J, Bixler EO. An Actigraphy-Based Validation Study of the Sleep Disorder Inventory in the Nursing Home. Front Neurol. In case of departures from proportionality, interactions between the time‐scale and the exposures were investigated (Cologne et al., 2012; Lamarca, Alonso, Gomez, & Munoz, 1998). Demands at work (Karasek & Theorell, 1990) were assessed by five questions (working fast, working hard, too much efforts, enough time and conflicting demands) and split at the median value. 6,13 More excess mortality was associated with sleep durations of 8 hours or more than with sleep of less than 7 hours. However, in a study with community-living adults aged more than 65 years, long sleep duration (≥ 10 hours) was associated with higher risk of mortality in both female and male [ 20 ]. Relationship between nutrition and sleep quality, focusing on the melatonin biosynthesis. 2019 Apr 3;4(2):17. doi: 10.3390/jfmk4020017. Because there are 5 weekdays and 2 weekend days, it is likely that self‐reports of typical sleep duration more strongly reflect weekday sleep.