QJM. 2024 Mar 27;117(3):177-186. doi: 10.1093/qjmed/hcad237.

Affiliations

• 1 Department of Cardiac Surgery, Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

• 2 Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.

• 3 Section of Cardiovascular Medicine, Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.

• 4 Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.

• 5 Medical Research Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

• 6 Neuroscience Department, Washington University in Saint Louis, St. Louis, MO, USA.

• 7 Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.

• 8 Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

• 9 Beijing Lab for Cardiovascular Precision Medicine, Beijing, China.

• PMID: 37831896

• DOI: 10.1093/qjmed/hcad237

Abstract

** Background: ** The importance of sleep on cardiovascular health has been increasingly acknowledged. However, the effect of combined sleep behaviors on life expectancy remains understudied.

** Aim: ** To investigate the association between sleep patterns with total and cause-specific mortality and life expectancy, using a nationally representative sample of US adults.

** Design: ** Population-based cohort study.

** Methods: ** This cohort study included 172 321 adults aged 18 years or older in the National Health Interview Survey (2013-18) with linkage to the National Death Index records up to 31 December 2019. The life expectancy at the age of 30 years by the number of low-risk sleep scores was estimated using a flexible parametric survival model.

** Results: ** During a median follow-up of 4.3 years, of the 172 321 adults (50.9% women; mean [SE] age, 46.98 [0.10] years), 8681 individuals died. The adjusted hazard ratios (95% confidence intervals [CI]) of participants with five vs. 0-1 low-risk sleep factors for all-cause, cardiovascular, and cancer mortality were 0.70 (0.63-0.77), 0.79 (0.67-0.93) and 0.81 (0.66-0.98), respectively. Nearly 8% (population attributable fraction 7.9%, 95% CI: 5.5-10.4) of mortality in this cohort could be attributed to suboptimal sleep patterns. When compared to those with 0-1 low-risk sleep factors, life expectancy at the age of 30 years for individuals with all five low-risk sleep factors was 4.7 (95% CI: 2.7-6.7) years greater for men and 2.4 (95% CI: 0.4-4.4) years greater for women.

** Conclusions: ** Our findings suggest that greater adherence to a low-risk sleep pattern may lead to significant gains in life expectancy among US adults.

© The Author(s) 2023. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For permissions, please email: journals.permissions@oup.com.

MeSH terms

• Adult
• Cohort Studies
• Female
• Humans
• Life Expectancy*
• Male
• Middle Aged
• Proportional Hazards Models
• Risk Factors
• Sleep*

Grants and funding

• 8210120410/National Natural Science Foundation of China
• KZ202210025015/R&D Program of Beijing Municipal Education Commission
• CYJZ202101/Golden Seed Program of Beijing Chaoyang Hospital