Sleep duration associated with mortality in elderly, but not middle-aged, adults in a large US sample.
Sleep duration associated with mortality in elderly, but not middle-aged, adults in a large US sample.
复制标题
DOI：
10.5665/sleep/31.8.1087
复制
发表时间：
2008-08
期刊：
影响因子：
5.6
通讯作者：
James E. Gangwisch;S. Heymsfield;B. Boden-Albala;R. Buijs;F. Kreier;M. Opler;T. Pickering;A. Rundle;G. Zammit;D. Malaspina
中科院分区：
文献类型：
--
作者：
James E. Gangwisch;S. Heymsfield;B. Boden-Albala;R. Buijs;F. Kreier;M. Opler;T. Pickering;A. Rundle;G. Zammit;D. Malaspina
研究目的通过年龄分层分析，探讨睡眠时间与死亡率之间关系的年龄差异。研究发现，睡眠时间长短都与死亡率有关。睡眠时间短与负面健康结果有关，但几乎没有证据表明睡眠时间长对健康有不利影响。没有流行病学研究发表过按年龄分层的多变量分析，尽管预期寿命为75岁，大多数死亡发生在老年人身上。设计：采用Cox比例风险模型对首次全国健康与营养调查进行多变量纵向分析。背景1982年至1992年间美国非收容平民人口的概率样本（n = 9789）。参与者年龄在32 - 86岁之间。测量与结果在控制许多协变量的多变量分析中，未发现中年受试者短睡5小时及以下与死亡率（危险比[HR] = 0.67, 95%可信区间[CI] 0.43-1.05）或长睡9小时及以上与死亡率（危险比[HR] = 1.04, 95%可信区间[CI] 0.66-1.65）相关。仅在老年受试者中发现u型关系，短睡眠时间（HR = 1.27, 95% CI 1.06-1.53）和长睡眠时间（HR = 1.36, 95% CI 1.15-1.60）的HR显著较高。结论睡眠时间与死亡率的关系在很大程度上受老年受试者死亡和死亡前睡眠时间测量的影响。长时间睡眠不太可能导致死亡，相反，它是医疗条件和与年龄相关的睡眠变化的结果。
STUDY OBJECTIVES To explore age differences in the relationship between sleep duration and mortality by conducting analyses stratified by age. Both short and long sleep durations have been found to be associated with mortality. Short sleep duration is associated with negative health outcomes, but there is little evidence that long sleep duration has adverse health effects. No epidemiologic studies have published multivariate analyses stratified by age, even though life expectancy is 75 years and the majority of deaths occur in the elderly. DESIGN Multivariate longitudinal analyses of the first National Health and Nutrition Examination Survey using Cox proportional hazards models. SETTING Probability sample (n = 9789) of the civilian noninstitutionalized population of the United States between 1982 and 1992. PARTICIPANTS Subjects aged 32 to 86 years. MEASUREMENTS AND RESULTS In multivariate analyses controlling for many covariates, no relationship was found in middle-aged subjects between short sleep of 5 hours or less and mortality (hazards ratio [HR] = 0.67, 95% confidence interval [CI] 0.43-1.05) or long sleep of 9 hours or more and mortality (HR = 1.04, 95% CI 0.66-1.65). A U-shaped relationship was found only in elderly subjects, with both short sleep duration (HR = 1.27, 95% CI 1.06-1.53) and long sleep duration (HR = 1.36, 95% CI 1.15-1.60) having significantly higher HRs. CONCLUSIONS The relationship between sleep duration and mortality is largely influenced by deaths in elderly subjects and by the measurement of sleep durations closely before death. Long sleep duration is unlikely to contribute toward mortality but, rather, is a consequence of medical conditions and age-related sleep changes.