A prospective study of change in sleep duration: Associations with mortality in the Whitehall II Cohort
A prospective study of change in sleep duration: Associations with mortality in the Whitehall II Cohort
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DOI：
10.1093/sleep/30.12.1659
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发表时间：
2007-12-01
期刊：
影响因子：
5.6
通讯作者：
Marmot, Michael G.
中科院分区：
文献类型：
--
作者：
Ferrie, Jane E.;Shipley, Martin J.;Marmot, Michael G.
研究目的：虽然睡眠缩短在工业化社会中已经变得普遍，但很少有研究调查睡眠时间变化对死亡率的影响。我们调查了睡眠时间和睡眠时间变化与全因、心血管和非心血管死亡率的关系。设计：前瞻性队列研究。数据来自基线（第1阶段，1985 - 88）和第3阶段（1991-93），死亡率随访分别为17年和12年。第一阶段的分析包括9,781名具有完整数据的参与者，第三阶段的分析和睡眠时间变化分析包括7,729名相同的参与者。干预措施：在第1阶段和第3阶段的睡眠时间（≥ 9小时）与随后的全因、心血管和非心血管死亡率之间观察到U形关联。在基线睡眠时间为6、7或8小时的参与者中，睡眠时间的减少与心血管死亡率相关，风险比为2.4（95%置信区间为1.4-4.1）。然而，在基线睡眠7或8小时的患者中，睡眠时间的增加与非心血管死亡率相关，风险比为2.1（1.4-3.1）。调整的社会人口因素，现有的发病率，和健康相关的行为测量离开这些协会在很大程度上unchanged.Conclusions这是第一个研究表明，减少睡眠时间和增加睡眠时间与增加死亡率通过影响心血管死亡和非心血管死亡分别。
Study Objectives: Although sleep curtailment has become widespread in industrialised societies, little work has examined the effects on mortality of change in sleep duration. We investigated associations of sleep duration and change in sleep duration with all-cause, cardiovascular, and non-cardiovascular mortality.Design: Prospective cohort study. Data are from baseline (Phase 1, 198588) and Phase 3 (1991-93), with mortality follow-up of 17 and 12 years respectively.Setting: The Whitehall 11 study of 10,308 white-collar British civil servants aged 35-55 at baseline.Participants: 9,781 participants with complete data were included in the analyses at Phase 1, and 7,729 of the same participants were included in the analyses at Phase 3 and the analyses of change in sleep duration.Interventions: None.Measurements and Results U-shaped associations were observed between sleep (= 9 hours) at Phase 1 and Phase 3 and subsequent all-cause, cardiovascular, and non-cardiovascular mortality. A decrease in sleep duration among participants sleeping 6, 7, or 8 hours at baseline was associated with cardiovascular mortality, hazard ratio 2.4 (95% confidence intervals 1.4-4.1). However, an increase in sleep duration among those sleeping 7 or 8 hours at baseline was associated with non-cardiovascular mortality, hazard ratio 2.1 (1.4-3.1). Adjustment for the socio-demographic factors, existing morbidity, and health-related behaviours measured left these associations largely unchanged.Conclusions This is the first study to show that both a decrease in sleep duration and an increase in sleep duration are associated with an increase in mortality via effects on cardiovascular death and non-cardiovascular death respectively.