Rod Naja Hulvej, Kumari Meena, Lange Theis, Kivimäki Mika, Shipley Martin, Ferrie Jane
Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Copenhagen Stress Research Center, Copenhagen, Denmark.
Department of Epidemiology and Public Health, University College London, London, England.
PLoS One. 2014 Apr 3;9(4):e91965. doi: 10.1371/journal.pone.0091965. eCollection 2014.
Both sleep duration and sleep quality are related to future health, but their combined effects on mortality are unsettled. We aimed to examine the individual and joint effects of sleep duration and sleep disturbances on cause-specific mortality in a large prospective cohort study.
We included 9,098 men and women free of pre-existing disease from the Whitehall II study, UK. Sleep measures were self-reported at baseline (1985-1988). Participants were followed until 2010 in a nationwide death register for total and cause-specific (cardiovascular disease, cancer and other) mortality.
There were 804 deaths over a mean 22 year follow-up period. In men, short sleep (≤ 6 hrs/night) and disturbed sleep were not independently associated with CVD mortality, but there was an indication of higher risk among men who experienced both (HR = 1.57; 95% CI: 0.96-2.58). In women, short sleep and disturbed sleep were independently associated with CVD mortality, and women with both short and disturbed sleep experienced a much higher risk of CVD mortality (3.19; 1.52-6.72) compared to those who slept 7-8 hours with no sleep disturbances; equivalent to approximately 90 additional deaths per 100,000 person years. Sleep was not associated with death due to cancer or other causes.
Both short sleep and disturbed sleep are independent risk factors for CVD mortality in women and future studies on sleep may benefit from assessing disturbed sleep in addition to sleep duration in order to capture health-relevant features of inadequate sleep.
睡眠时间和睡眠质量均与未来健康相关，但其对死亡率的综合影响尚无定论。我们旨在通过一项大型前瞻性队列研究，探讨睡眠时间和睡眠障碍对特定病因死亡率的个体及联合影响。
我们纳入了英国白厅II研究中9098名无既往疾病的男性和女性。睡眠指标在基线时（1985 - 1988年）通过自我报告获得。参与者被随访至2010年，通过全国死亡登记册获取全因及特定病因（心血管疾病、癌症和其他病因）的死亡率。
在平均22年的随访期内，共有804例死亡。在男性中，短睡眠（≤6小时/晚）和睡眠障碍与心血管疾病死亡率无独立关联，但同时经历这两者的男性有风险升高的迹象（风险比=1.57；95%置信区间：0.96 - 2.58）。在女性中，短睡眠和睡眠障碍与心血管疾病死亡率独立相关，与睡眠7 - 8小时且无睡眠障碍的女性相比，同时存在短睡眠和睡眠障碍的女性心血管疾病死亡风险更高（3.19；1.52 - 6.72）；相当于每10万人年额外增加约90例死亡。睡眠与癌症或其他病因导致的死亡无关。
短睡眠和睡眠障碍均是女性心血管疾病死亡的独立危险因素，未来关于睡眠的研究除睡眠时间外，评估睡眠障碍可能有助于捕捉睡眠不足与健康相关的特征。
