![]() ![]() Third, none of the previous studies provided results stratified by BMI, an important potential confounder. ![]() Second, in some previous studies, researchers found a significant association between sleep duration and CVD mortality in men only, not in women ( 24, 32). First, while investigators in some previous studies reported a positive association with both short and long sleep durations and CVD or total mortality ( 22– 28), others found an independent association only with either a short ( 29, 30) or a long ( 31, 32) duration. However, relatively few epidemiologic studies have examined the association between sleep duration and CVD morbidity or mortality, and several questions regarding this putative association remain unanswered. In epidemiologic studies, compared with persons reporting 7 hours of sleep per night, shorter or longer sleep durations were found to be related to increased body mass index (BMI) ( 12– 14), diabetes mellitus ( 15, 16), and hypertension ( 17– 20)-all strong predictors of subsequent development of CVD ( 21). It is possible that long and short sleep durations may be related to underlying sleep-disordered breathing and obstructive sleep apnea ( 9), a syndrome independently related to hypertension ( 10) and increased CVD risk ( 11). Both long and short usual sleep durations are found to be associated with snoring, metabolic disturbances, abnormalities in lipid profile, and elevated markers of inflammation ( 7, 8). In contrast, the long-term cardiovascular consequences of sleep deprivation are less clear. Short-term sleep deprivation results in elevations in levels of C-reactive protein, an inflammatory marker that is independently related to cardiovascular disease (CVD) ( 6). Factors responsible for this change may include increases in environmental light, longer workdays/commuting time, an increase in shift work and night work, and the advent of television, radio, and the Internet ( 3).Įxperiments have demonstrated that short-term sleep deprivation in healthy subjects results in adverse physiologic changes, including decreased glucose tolerance and increased insulin resistance, sympathetic tone, and blood pressure ( 4, 5). Nearly one-third of adults report sleeping less than 6 hours per night, leading some people to suggest that we live in a sleep-deprived society ( 2). Sleep loss, long-term sleep deprivation, and alterations in sleep duration are common in modern society ( 1, 2). These results suggest that sleep duration may be an important marker for CVD. In a population-based cohort of Chinese adults from Singapore, sleep durations of ≤5 hours and ≥9 hours (versus 7 hours) were modestly associated with CHD mortality. This association persisted in subgroup analyses by sex and body mass index. Compared with persons with a sleep duration of 7 hours (referent), the multivariable relative risk of CHD mortality for a sleep duration of ≤5 hours was 1.57 (95% confidence interval: 1.32, 1.88) for a sleep duration of ≥9 hours, it was 1.79 (95% confidence interval: 1.48, 2.17). The authors found both short and long sleep durations to be positively associated with CHD mortality, independent of smoking, alcohol intake, and body mass index. ![]() The main outcome of interest was CHD mortality ( n = 1,416). The authors examined the association between sleep duration and coronary heart disease (CHD) mortality among Chinese adults in Singapore (1993–2006), performing a prospective cohort study among 58,044 participants aged ≥45 years (55.9% women) without preexisting CVD. In addition, there are limited data from non-Western populations on this topic. While some studies have found a positive association between both short and long sleep durations and cardiovascular disease (CVD), others have found an association only with a long or short sleep duration. ![]()
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