Self-reported sleep duration and coronary heart disease mortality: A large cohort study of 400,000 Taiwanese adults

  • Author Footnotes
    1 Grant support: Linn B. Strand received a research fellowship grant from the Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology.
    Linn B. Strand
    Footnotes
    1 Grant support: Linn B. Strand received a research fellowship grant from the Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology.
    Affiliations
    Department of Public Health and General Practice, Norwegian University of Science and Technology, Hakon Jarls gate 11, 7495 Trondheim, Norway
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  • Min Kuang Tsai
    Affiliations
    Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli County 35053, Taiwan
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  • David Gunnell
    Affiliations
    School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, United Kingdom
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  • Imre Janszky
    Affiliations
    Department of Public Health and General Practice, Norwegian University of Science and Technology, Hakon Jarls gate 11, 7495 Trondheim, St Olav Hospital, Prinsesse Kristinas gate 3, Norway and Center for Health Care Research, 7030 Trondheim, Norway
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  • Chi Pang Wen
    Correspondence
    Correspondence to: C.P. Wen, China Medical University Hospital, 91 Hsueh-Shih Road, Taichung City 40402, Taiwan; and Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli County 35053, Taiwan
    Affiliations
    China Medical University Hospital, 91 Hsueh-Shih Road, Taichung City 40402, Taiwan; and Institute of Population Health Science, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli County 35053, Taiwan
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  • Shu-Sen Chang
    Correspondence
    Correspondence to: S.S. Chang, National Taiwan University, No.17, Xu-zhou Road, Taipei City 10055, Taiwan.
    Affiliations
    Institute of Health Behaviors and Community Sciences and Department of Public Health, College of Public Health, National Taiwan University, No.17, Xu-zhou Road, Taipei City 10055, Taiwan
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  • Author Footnotes
    1 Grant support: Linn B. Strand received a research fellowship grant from the Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology.
Published:January 06, 2016DOI:https://doi.org/10.1016/j.ijcard.2016.01.044

      Abstract

      Background

      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.

      Methods

      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.

      Results

      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).

      Conclusions

      Adequate sleep duration should be considered an important component of a healthy lifestyle. Further studies are needed to better elucidate the underlying mechanisms.

      Keywords

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