Sleep Duration and Mortality: A Prospective Study of 113,138 Middle-Aged and Elderly Chinese Men and Women
Sleep Duration and Mortality: A Prospective Study of 113,138 Middle-Aged and Elderly Chinese Men and Women
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DOI：
10.5665/sleep.4564
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发表时间：
2015-04-01
期刊：
影响因子：
5.6
通讯作者：
Zheng, Wei
中科院分区：
文献类型：
--
作者：
Cai, Hui;Shu, Xiao-Ou;Zheng, Wei
目的：评价睡眠时间与中国人群总死亡率和疾病死亡率的关系。设计：1996年(女性)/2002年(男性)至2010年进行的前瞻性研究。地点：在中国上海进行一项基于人群的队列研究。干预：无。测量和结果：共有113,138名参加上海男女健康研究的参与者，年龄分别为44-79岁和40-75岁(女性和男性)，进行睡眠时间评估。面对面的访谈被用来收集有关睡眠时间、社会经济状况、生活条件、慢性病病史、定期锻炼的参与情况以及家族病史的信息。通过一年两次的面对面访谈和与上海人口死亡登记的记录链接相结合的方式，对该队列进行了跟踪。研究结果包括受试者在2010年12月31日的生存状况。使用COX比例模型计算相对风险，按性别和合并症得分分层。共有4,277例死亡(女性2,356例，男性1,921例)，平均随访时间女性为7.12年，男性为6.07年。在女性和男性中，睡眠时间与总死亡率呈J型关系。女性的危险比(95%可信区间)分别为1.15(1.01~1.32)、1.06(0.94~1.20)、1.17(1.04~1.32)、1.36(1.13~1.64)、2.11(1.77~2.52)和1.06(0.90~1.25)、1.07(0.94~1.23)、1.13(1.00~1.28)、1.34(1.10~1.62)。睡4-5、6、8、9和>的男性为1.55(1.29-1.86)；=每天10小时，与每天睡眠7小时的人相比。与特定疾病死亡率的关系，包括心血管疾病、中风、糖尿病和癌症，通常也遵循相同的J形模式。睡眠时间与死亡率的关系在患有合并症的参与者中更为明显，但性别差异较小。结论：在我们研究的中国成年人人群中，睡眠时间较短和较长与死亡风险增加独立相关。但睡眠时间较长的人患心血管疾病和糖尿病的死亡风险高于睡眠时间较短的人。
Objectives: To evaluate associations of sleep duration with total mortality and disease-specific mortality in a Chinese population.Design: Prospective study conducted from 1996 (for women)/2002 (for men) to 2010.Setting: A population-based cohort study in Shanghai, China.Intervention: None.Measurements and Results: A total of 113,138 participants (68,548 women and 44,590 men) of the Shanghai Women's and Men's Health Studies, aged 44-79 y and 40-75 y (women and men, respectively) at sleep duration assessment, were included in the study. In-person interviews were conducted to collect information on sleep duration, socioeconomic status, living conditions, history of chronic disease, participation in regular exercise, and family history of disease. The cohort has been followed using a combination of biannual in-person interviews and record linkages with Shanghai's population-based death registry. Survival status of participants on December 31, 2010 was included as the study outcome. Relative risks were calculated using a Cox proportional model stratified by sex and comorbidity score. There were 4,277 deaths (2,356 among women; 1,921 among men) during a median follow-up time of 7.12 y for women and 6.07 y for men. Among both women and men, sleep duration showed a J-shaped association with total mortality. Hazard ratios (95% confidence intervals) were 1.15 (1.01-1.32), 1.06 (0.94-1.20), 1.17 (1.04-1.32), 1.36 (1.13-1.64), and 2.11 (1.77-2.52) for women and 1.06 (0.90-1.25), 1.07 (0.94-1.23), 1.13 (1.00-1.28), 1.34 (1.10-1.62), and 1.55 (1.29-1.86) for men who slept 4-5, 6, 8, 9, and >= 10 h per day, respectively, compared with those who slept 7 h per day. Associations for disease-specific mortality, including cardiovascular disease, stroke, diabetes, and cancer, also generally followed the same J-shaped pattern. The sleep duration-mortality association was more evident among participants with comorbidities, but varied little by sex.Conclusion: In our study population of Chinese adults, shorter and longer sleep durations were independently associated with increased risk of mortality. But longer sleep duration had a higher mortality risk of cardiovascular disease and diabetes than short sleep.