Association between sleep duration and all-cause mortality in old age: 9-year follow-up of the Bambui Cohort Study, Brazil
Association between sleep duration and all-cause mortality in old age: 9-year follow-up of the Bambui Cohort Study, Brazil
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DOI：
10.1111/j.1365-2869.2010.00884.x
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发表时间：
2011-06-01
影响因子：
4.4
通讯作者：
Stewart, Robert
中科院分区：
文献类型：
--
作者：
Castro-Costa, Erico;Dewey, Michael E.;Stewart, Robert
这项研究调查了睡眠持续时间与巴西老年人的全因死亡率的风险，使用了9年基于人群的队列研究的数据，并使用COX的比例危害模型应用了多变量的纵向分类和连续分析。该分析使用了Bambui健康与老化研究（BHAS）的数据，该研究在巴西东南部在Bambui市（约15 000居民）进行。该研究人群包括1742名老年居民中的1512（每千份）1512（每千份）。在多变量分析中，使用睡眠持续时间作为分类变量并控制多种社会人口统计学和健康状况，发现每晚睡9小时或以上的人比睡觉7 h（危险比（hr）（hr） ）：1.53;每千置信区间（CI）95零件：1.12-2.09]。不包括进入后2年内死亡的人，该关联仍然显着（HR：1.56；每千CI：1.12-2.18的95个零件）。在使用睡眠持续时间作为连续变量的分析中，在整个样本中所有调整后的模型中，在睡眠持续时间和死亡率之间发现线性相关性（HR：1.08; 95个零件每千CI：1.02-1.15）与排除死亡的人的死亡相关性进入后2年内发生（HR：1.13；每千CI：1.06-1.21）。线性和二次术语都显着，反映了预测的关系，死亡率主要与长时间的睡眠持续时间相关，但随着睡眠持续时间较短的添加略有下降。总之，在该样本中，长时间而不是短睡眠持续时间主要与全因死亡率有关。因此，可以合理地建议临床医生应意识到与长时间睡眠有关的潜在不良预后。
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 Cox's proportional hazards models. This analysis used data from the Bambui Health and Ageing Study (BHAS), conducted in Bambui city (approximately 15 000 inhabitants) in southeastern Brazil. The study population comprised 1512 (86.8 parts per thousand) of all eligible 1742 elderly residents. In multivariable analysis, using sleep duration as categorical variable and controlling for multiple measures of sociodemographic and health status, those who slept 9 h or more per night were found to be at higher risk of mortality than those who slept 7 h [hazard ratio (HR): 1.53; 95 parts per thousand confidence interval (CI): 1.12-2.09]. Excluding those whose deaths occurred within 2 years after entry, this association remained significant (HR: 1.56; 95 parts per thousand CI: 1.12-2.18). In analyses using sleep duration as a continuous variable, a linear correlation was found between sleep duration and mortality in all adjusted models in the whole sample (HR: 1.08; 95 parts per thousand CI: 1.02-1.15) and following exclusion of those whose deaths occurred within 2 years after entry (HR: 1.13; 95 parts per thousand CI: 1.06-1.21). Both linear and quadratic terms were significant, reflecting a predicted relationship, with mortality predominantly increasing in association with long sleep duration but with the addition of a slight decrease in association with shorter sleep duration. In conclusion, long rather than short sleep duration was associated principally with all-cause mortality in this sample. It is therefore reasonable to suggest that clinicians should be aware of the potential adverse prognosis associated with prolonged sleep.