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The association of short and long sleep with mortality in men and women
Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology. Karolinska Institutet, Sweden.ORCID iD: 0000-0001-8049-8504
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Number of Authors: 72024 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 33, no 2, article id e13931Article in journal (Refereed) Published
Abstract [en]

Both short (< 6 hr) and long (> 8 hr) sleep are associated with increased mortality. We here investigated whether the association between sleep duration and all-cause, cardiovascular disease and cancer mortality differs between men and women. A cohort of 34,311 participants (mean age and standard deviation = 50.5 ± 15.5 years, 65% women), with detailed assessment of sleep at baseline and up to 20.5 years of follow-up (18 years for cause-specific mortality), was analysed using Cox proportional hazards model to estimate HRs with 95% confidence intervals. After adjustment for covariates, all-cause, cardiovascular disease and cancer mortalities were increased for both < 5 hr and ≥ 9 hr sleep durations (with 6 hr as reference). For all-cause mortality, women who slept < 5 hr had a hazard ratio = 1.54 (95% confidence interval = 1.32–1.80), while the corresponding hazard ratio was 1.05 (95% confidence interval = 0.88–1.27) for men, the interaction being significant (p < 0.05). For cardiovascular disease mortality, exclusion of the first 2 years of exposure, as well as competing risk analysis eliminated the originally significant interaction. Cancer mortality did not show any significant interaction. Survival analysis of the difference between the reference duration (6 hr) and the short duration (< 5 hr) during follow-up showed a gradually steeper reduction of survival time for women than for men for all-cause mortality. We also observed that the lowest cancer mortality appeared for the 5-hr sleep duration. In conclusion, the pattern of association between short sleep duration and all-cause mortality differed between women and men, and the difference between men and women increased with follow-up time.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024. Vol. 33, no 2, article id e13931
Keywords [en]
cancer, cardiovascular, gender, sex, sleep duration, survival
National Category
Public Health, Global Health, Social Medicine and Epidemiology Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:su:diva-219565DOI: 10.1111/jsr.13931ISI: 000987333700001PubMedID: 37192602Scopus ID: 2-s2.0-85159280776OAI: oai:DiVA.org:su-219565DiVA, id: diva2:1785291
Note

The present study was supported by The Tercentenary Fund of Bank of Sweden. Ylva Trolle Lagerros was supported by Region Stockholm (clinical research appointment).

Available from: 2023-08-02 Created: 2023-08-02 Last updated: 2024-04-25Bibliographically approved

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Åkerstedt, Torbjörn

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