TY - JOUR
T1 - The association of sleep duration and quality with all-cause and cause-specific mortality in the Women's Health Initiative
AU - Kabat, Geoffrey C.
AU - Xue, Xiaonan
AU - Kamensky, Victor
AU - Zaslavsky, Oleg
AU - Stone, Katie L.
AU - Johnson, Karen C.
AU - Wassertheil-Smoller, Sylvia
AU - Shadyab, Aladdin H.
AU - Luo, Juhua
AU - Hale, Lauren
AU - Qi, Lihong
AU - Cauley, Jane A.
AU - Brunner, Robert L.
AU - Manson, Jo Ann E.
AU - Rohan, Thomas E.
N1 - Publisher Copyright:
© 2018 Elsevier B.V.
PY - 2018/10
Y1 - 2018/10
N2 - Background/Objective: Many studies have shown a U-shaped association of sleep duration with mortality; however, this association is difficult to interpret owing to possible reverse causation, residual confounding, and measurement issues. We used data from the Women's Health Initiative to examine the associations of sleep duration, insomnia, and use of sleep aids with death from cardiovascular disease (CVD), cancer, “other” causes, and all causes combined. Methods: Cox proportional hazards models were used in the analysis of baseline data and in time-dependent analyses of repeated measures to estimate associations of sleep-related factors with mortality. Among 158,203 women with information regarding sleep, 30,400 total deaths, 8857 CVD deaths, 9284 cancer deaths, and 11,928 other deaths were ascertained over a median of 17.8 years. Results: In both baseline and time-dependent analyses, both short (≤5 h) and long sleep (≥9 h) durations were associated with increased risk of total, CVD, and “other” deaths, but not with cancer deaths. Insomnia showed no association with mortality, whereas use of sleep medications was associated with an increased mortality risk. Conclusions: While our findings showed a small but robust association of sleep duration with mortality in postmenopausal women, studies including objective measurements of sleep quality and efficiency are needed to clarify these associations.
AB - Background/Objective: Many studies have shown a U-shaped association of sleep duration with mortality; however, this association is difficult to interpret owing to possible reverse causation, residual confounding, and measurement issues. We used data from the Women's Health Initiative to examine the associations of sleep duration, insomnia, and use of sleep aids with death from cardiovascular disease (CVD), cancer, “other” causes, and all causes combined. Methods: Cox proportional hazards models were used in the analysis of baseline data and in time-dependent analyses of repeated measures to estimate associations of sleep-related factors with mortality. Among 158,203 women with information regarding sleep, 30,400 total deaths, 8857 CVD deaths, 9284 cancer deaths, and 11,928 other deaths were ascertained over a median of 17.8 years. Results: In both baseline and time-dependent analyses, both short (≤5 h) and long sleep (≥9 h) durations were associated with increased risk of total, CVD, and “other” deaths, but not with cancer deaths. Insomnia showed no association with mortality, whereas use of sleep medications was associated with an increased mortality risk. Conclusions: While our findings showed a small but robust association of sleep duration with mortality in postmenopausal women, studies including objective measurements of sleep quality and efficiency are needed to clarify these associations.
KW - Cardiovascular mortality
KW - Duration
KW - Insomnia rating scale
KW - Sleep
KW - Time-dependent analysis
KW - Total mortality
KW - characteristics
UR - http://www.scopus.com/inward/record.url?scp=85049529401&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85049529401&partnerID=8YFLogxK
U2 - 10.1016/j.sleep.2018.05.015
DO - 10.1016/j.sleep.2018.05.015
M3 - Article
C2 - 29982090
AN - SCOPUS:85049529401
SN - 1389-9457
VL - 50
SP - 48
EP - 54
JO - Sleep Medicine
JF - Sleep Medicine
ER -