Correlates of long sleep duration
Correlates of long sleep duration
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DOI：
10.1093/sleep/29.7.881
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发表时间：
2006-07-01
期刊：
影响因子：
5.6
通讯作者：
Hu, Frank B.
中科院分区：
文献类型：
--
作者：
Patel, Sanjay R.;Malhotra, Atul;Hu, Frank B.
研究目的：每天睡眠超过7 - 8小时与死亡率增加相关。这种关联是否是因果关系，以及什么途径解释这种关联尚不清楚。我们试图找出可能解释长时间睡眠与死亡率之间关系的因素。设计：横断面流行病学调查。参与者：中年妇女（n = 60，028）参与护士健康研究II，报告习惯性睡眠持续时间为7小时或更长。多发性硬化（比值比[OR] = 3.7，95%置信区间[3.0-4.5]），抗抑郁药使用（OR = 3.1，[2.9-3.3]）、苯二氮卓类药物使用（OR = 3.0 [2.6-3.3]）和系统性红斑狼疮（OR = 2.9，[2.3-3.61]）是与睡眠时间延长最密切相关的因素。将这些数据与患病率信息和一系列与死亡率的合理关联相结合，估计混杂率比。该参数是未校正的长时间睡眠死亡率比率与针对该因素校正的比率的比率，并测量该因素可以通过混杂或作为因果中间体改变长时间睡眠死亡率关联的程度。根据这个参数，精神和社会经济因素对长期睡眠-死亡率关系的影响潜力最大。假设每个因素的死亡风险都增加一倍，抑郁症、抗抑郁药使用和失业的混杂率比分别为1.10、1.18和1.12。较小的影响因素是苯二氮卓类药物的使用，贫困，低社会地位，久坐的生活方式，和obesity.Conclusion：抑郁症和低社会经济地位是强有力的候选人长时间睡眠和死亡率之间的统计关联，无论是作为混杂因素或作为因果中间体。未来关于长时间睡眠影响的因果关系研究应该包括对精神疾病和社会经济状况的详细评估。
Study Objective: Sleeping more than 7 to 8 hours per day has been consistently associated with increased mortality. Whether this association is causal and what pathways explain this association are unknown. We sought to identify factors that could potentially explain the association between long sleep and mortality.Design: Cross-sectional epidemiologic survey.Participants: Middle-aged women (n = 60,028) participating in the Nurses Health Study II who reported a habitual sleep duration of 7 hours or more.Results: Multiple sclerosis (odds ratio [OR] = 3.7, 95% confidence interval [3.0-4.5]), antidepressant use (OR = 3.1, [2.9-3.3]), benzodiazepine use (OR = 3.0 [2.6-3.3]), and systemic lupus erythematosus (OR = 2.9, [2.3-3.61) were the factors most strongly associated with prolonged sleep. Combining these data with prevalence information and a range of plausible associations with mortality, the confounding rate ratio was estimated. This parameter is the ratio of the unadjusted long sleep-mortality rate ratio to the rate ratio adjusted for the factor and measures the extent that the factor can alter the long sleep-mortality association, either through confounding or as a causal intermediate. Based on this parameter, psychiatric and socioeconomic factors have the greatest potential to influence the long sleep-mortality relationship. Assuming each factor doubles mortality risk, the confounding rate ratios for depression, antidepressant use, and unemployment were 1.10, 1.18, and 1.12. Lesser influential factors were benzodiazepine use, poverty, low societal status, sedentary lifestyle, and obesity.Conclusion: Depression and low socioeconomic status are strong candidates for producing the statistical association between long sleep and mortality, either as confounders or as causal intermediates. Future causal research on the effects of long sleep should include a detailed assessment of psychiatric disease and socioeconomic status.