Mortality associated with sleep duration and insomnia
Mortality associated with sleep duration and insomnia
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DOI：
10.1001/archpsyc.59.2.131
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发表时间：
2002-02-01
影响因子：
--
通讯作者：
Marler, MR
中科院分区：
文献类型：
--
作者：
Kripke, DF;Garfinkel, L;Marler, MR
背景：患者经常抱怨睡眠不足或慢性失眠，认为他们需要8小时的睡眠。治疗策略可以通过睡眠时间预测最佳生存时间以及失眠是否可能预示死亡风险来指导。方法：1982年，美国癌症协会的癌症预防研究II询问了参与者的睡眠时间和失眠频率。计算COX财产风险生存模型，以确定睡眠时间或失眠频率是否与1988年以前的超额死亡率有关，同时控制人口统计学、习惯、健康因素和各种药物的使用。结果：参与者超过110万人，年龄从30岁到102岁。每晚睡眠7小时的人存活率最高。报告睡眠8小时或更长时间的参与者和睡眠6小时或更少的参与者一样，经历了显著的死亡风险增加。那些报告睡眠超过8.5小时或少于3.5或4.5小时的人，风险增加超过15%。相反，有关“失眠”的报告与过量死亡风险无关。如前所述，在控制了报告的睡眠时间和失眠后，处方安眠药的使用与显著增加的死亡率有关。z结论：患者可以放心，睡眠不足和失眠似乎与与合并症不同的风险很小。与8小时或更长时间睡眠和服用安眠药相关的轻微风险需要进一步研究。因果关系未经证实。
Background: Patients often complain about insufficient sleep or chronic insomnia in the belief that they need 8 hours of sleep. Treatment strategies may be guided by what sleep durations predict optimal survival and whether insomnia might signal mortality risks.Methods: In 1982, the Cancer Prevention Study II of the American Cancer Society asked participants about their sleep duration and frequency of insomnia. Cox propertional hazards survival models were computed to determine whether sleep duration or frequency of insomnia was associated with excess mortality up to 1988, controlling simultaneously for demographics, habits, health factors, and use of various medications.Results: Participants were more than 1.1 million men and women from 30 to 102 years of age. The best survival was found among those who slept 7 hours per night. Participants who reported sleeping 8 hours or more experienced significantly increased mortality hazard, as did those who slept 6 hours or less. The increased risk exceeded 15% for those reporting more than 8.5 hours sleep or less than 3.5 or 4.5 hours. in contrast, reports of "insomnia" were not associated with excess mortality hazard. As previously described, prescription sleeping pill use was associated with significantly increased mortality after control for reported sleep durations and insomnia.zConclusions: Patients can be reassured that short sleep and insomnia seem associated with little risk distinct from comorbidities. Slight risks associated with 8 or more hours of sleep and sleeping pill use need further study. Causality is unproven.