Most previous studies on sleep duration and coronary heart disease (CHD) have been small and have inadequately controlled for cardiovascular risk factors and chronic diseases. Therefore, our aim was to prospectively examine the associations of sleep duration with CHD while accounting for these factors.
Prospective cohort study of 392 164 adults at age 20 years or older who attended a health check-up program from 1994 to 2011 in Taiwan and who have information on sleep duration, sleep medications and potential confounders. Participants answered the question: “How long do you sleep for?”—there were four response categories: (a) 0–4 h; (b) 4–6 h; (c) 6–8 h and (d) >8 h. The participants were then followed for CHD mortality from the Taiwanese cause-of-death register.
When compared to those who slept 6–8 h per night, the risk of dying from CHD was increased by 34% (HR 1.34, 95% Confidence Interval [CI] 0.87–2.07) and 35% (HR 1.35, 95% CI 1.11–1.65) in those who slept less than 4 h per night and more than 8 h per night, respectively. When stratifying by sex and age, we found some evidence for a stronger U-shaped association in females than in males and in older adults than in younger adults (p for interaction = 0.01 and 0.13, respectively).
Adequate sleep duration should be considered an important component of a healthy lifestyle. Further studies are needed to better elucidate the underlying mechanisms.
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- Insomnia: definition, prevalence, etiology, and consequences.J. Clin. Sleep Med. 2007; 3: S7
- Sleep duration in the United States: a cross-sectional population-based study.Am. J. Epidemiol. 2009; 169: 1052-1063
- Increased prevalence of insomnia and changes in hypnotics use in England over 15 years: analysis of the 1993, 2000, and 2007 national psychiatric morbidity surveys.Sleep. 2012; 35: 377
- Sleep disturbances, work stress and work hours: a cross-sectional study.J. Psychosom. Res. 2002; 53: 741-748
- Insomnia and risk of cardiovascular disease: a meta-analysis.Eur. J. Prev. Cardiol. 2012; 21: 57-64
- Association of sleep duration with mortality from cardiovascular disease and other causes for Japanese men and women: the JACC study.Sleep. 2009; 32: 295
- Association of usual sleep duration with hypertension: the sleep heart health study.Sleep. 2006; 29: 1009
- Sleep duration and cardiovascular disease: results from the National Health Interview Survey.Sleep. 2010; 33: 1037
- Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies.Eur. Heart J. 2011; 32: 1484-1492
- Sleep duration and mortality: the effect of short or long sleep duration on cardiovascular and all-cause mortality in working men and women.Sleep Med. 2002; 3: 305-314
- A prospective study of change in sleep duration: associations with mortality in the Whitehall II cohort.Sleep. 2007; 30: 1659
- Adiposity, its related biologic risk factors, and suicide: a cohort study of 542,088 Taiwanese adults.Am. J. Epidemiol. 2012; 175: 804-815
- Mortality associated with sleep duration and insomnia.Arch. Gen. Psychiatry. 2002; 59: 131
- Epidemiology of insomnia: what we know and what we still need to learn.Sleep Med. Rev. 2002; 6: 97-111
- Sleep duration and sleep complaints and risk of myocardial infarction in middle-aged men and women from the general population: the MONICA/KORA Augsburg cohort study.Sleep. 2007; 30: 1121-1127
- A prospective study of sleep duration and coronary heart disease in women.Arch. Intern. Med. 2003; 163: 205-209
- A prospective cohort study on the relationship of sleep duration with all-cause and disease-specific mortality in the Korean multi-center cancer cohort study.J. Prev. Med. Public Health. 2013; 46: 271
- Sleep duration and coronary heart disease mortality among Chinese adults in Singapore: a population-based cohort study.Am. J. Epidemiol. 2008; 168: 1367-1373
- A prospective study of sleep duration and mortality risk in women.Sleep. 2004; 27: 440-444
- Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study.Lancet. 2011; 378: 1244-1253
- On the interactions of the hypothalamic–pituitary-adrenal (HPA) axis and sleep: normal HPA axis activity and circadian rhythm, exemplary sleep disorders.J. Clin. Endocrinol. Metab. 2005; 90: 3106-3114
- Nocturnal catecholamines and immune function in insomniacs, depressed patients, and control subjects.Brain Behav. Immun. 2003; 17: 365-372
- Heart rate and heart rate variability modification in chronic insomnia patients.Behav. Sleep Med. 2013; 1–17
- Insomnia with objective short sleep duration is associated with a high risk for hypertension.Sleep. 2009; 32: 491
- Adverse effects of modest sleep restriction on sleepiness, performance, and inflammatory cytokines.J. Clin. Endocrinol. Metab. 2004; 89: 2119
- Role of sleep duration in the regulation of glucose metabolism and appetite.Best Pract. Res. Clin. Endocrinol. Metab. 2010; 24: 687-702
- Sleep duration as a risk factor for the development of type 2 diabetes or impaired glucose tolerance: analyses of the Quebec family study.Sleep Med. 2009; 10: 919-924
- A prospective study of self-reported sleep duration and incident diabetes in women.Diabetes Care. 2003; 26: 380-384
- Light-at-night, circadian disruption and breast cancer: assessment of existing evidence.Int. J. Epidemiol. 2009; 38: 963-970
- Secular trends in coronary heart disease mortality, hospitalization rates, and major cardiovascular risk factors in Taiwan, 1971–2001.Int. J. Cardiol. 2005; 100: 47-52
- Mortality from ischaemic heart disease by country, region, and age: statistics from World Health Organisation and United Nations.Int. J. Cardiol. 2013; 168: 934-945
- Depression and the risk of coronary heart disease: a meta-analysis of prospective cohort studies.BMC Psychiatry. 2014; 14
- Association of sleep apnoea with myocardial infarction in men.Lancet. 1990; 336: 261-264
- Comorbidity between sleep apnea and insomnia.Sleep Med. Rev. 2009; 13: 287-293
- Place of chronic insomnia in the course of depressive and anxiety disorders.J. Psychiatry Res. 2003; 37: 9-15
- Smoking behaviour in Taiwan, 2001.Tob. Control. 2005; 14: i51-i52
Published online: January 06, 2016
Accepted: January 1, 2016
Received in revised form: November 28, 2015
Received: October 19, 2015
☆Statement of authorship: “All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation”.
© 2016 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.