韩国成年人的睡眠时间与死亡率：一项基于人群的前瞻性队列研究。
Sleep duration and mortality in Korean adults: a population-based prospective cohort study.
机构信息
Interdisciplinary Program in Precision Public Health, Department of Public Health Science, Graduate School of Korea University, 145 Anam-ro, Hana Science Building B, Seongbuk-gu, Seoul, Republic of Korea.
Department of Statistics, Graduate School of Korea University, 145 Anam-ro, Woodang Hall, Seongbuk-gu, Seoul, Republic of Korea.
出版信息
BMC Public Health. 2020 Oct 28;20(1):1623. doi: 10.1186/s12889-020-09720-3.
BACKGROUND
Increasing evidence suggests that sleep duration is associated with risks of various diseases including type 2 diabetes, cardiovascular disease (CVD), and certain types of cancer. However, the relationship with mortality is not clear, particularly in non-European populations. In this study, we investigated the association between sleep duration and mortality in a population-based prospective cohort of Korean adults.
METHODS
This analysis included 34,264 participants (14,704 men and 19,560 women) of the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2013 who agreed to mortality follow-up through December 31, 2016. Sleep duration was self-reported at baseline and was categorized into four groups: ≤4, 5-6, 7-8, and ≥ 9 h/day. Cox proportional hazards models were performed to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the associations with mortality (all-cause as well as CVD- and cancer-specific), adjusting for potential confounders.
RESULTS
During up to 9.5 years of follow-up, we identified a total of 1028 deaths. We observed the lowest mortality at 5-6 h/day sleep. Compared with 7-8 h/day of sleep, short (≤4 h/day) and long (≥9 h/day) sleep were associated with a 1.05-fold (95% CI = 0.79-1.39) and 1.47-fold (95% CI = 1.15-1.87) higher all-cause mortality, respectively. After additional adjustment for self-rated health, the positive association with short sleep disappeared (HR = 0.99, 95% CI = 0.75-1.32) and the association with long sleep was slightly attenuated (HR = 1.38, 95% CI = 1.08-1.76). Long sleep was also nonsignificantly positively associated with both cancer-mortality (HR = 1.30, 95% CI = 0.86-1.98) and CVD-mortality (HR = 1.27, 95% CI = 0.73-2.21). There was no statistically significant evidence for nonlinearity in the relationships between sleep duration and mortality (all-cause as well as CVD- and cancer-specific). Effect modification by age, sex, education, and occupation were not statistically significant.
CONCLUSIONS
Our findings suggest that long sleep duration is associated with an increased all-cause mortality in Korean adults.
背景
越来越多的证据表明，睡眠时间与多种疾病的风险有关，包括 2 型糖尿病、心血管疾病（CVD）和某些类型的癌症。然而，其与死亡率之间的关系尚不清楚，特别是在非欧洲人群中。在这项研究中，我们调查了在韩国成年人的基于人群的前瞻性队列中，睡眠时间与死亡率之间的关系。
方法
本分析包括韩国国家健康与营养检查调查（KNHANES）2007-2013 年的 34264 名参与者（14704 名男性和 19560 名女性），他们同意通过 2016 年 12 月 31 日进行死亡率随访。在基线时自我报告睡眠时间，并分为四组：≤4、5-6、7-8 和≥9 小时/天。使用 Cox 比例风险模型估计与死亡率（全因以及 CVD 和癌症特异性）相关的风险比（HR）和 95%置信区间（CI），并调整了潜在混杂因素。
结果
在长达 9.5 年的随访期间，我们共确定了 1028 例死亡。我们观察到 5-6 小时/天的睡眠时间死亡率最低。与 7-8 小时/天的睡眠时间相比，短睡（≤4 小时/天）和长睡（≥9 小时/天）与全因死亡率分别增加 1.05 倍（95%CI=0.79-1.39）和 1.47 倍（95%CI=1.15-1.87）相关。在进一步调整自我评估健康状况后，短睡与全因死亡率之间的正相关关系消失（HR=0.99，95%CI=0.75-1.32），而长睡与全因死亡率之间的关联则略有减弱（HR=1.38，95%CI=1.08-1.76）。长睡也与癌症死亡率（HR=1.30，95%CI=0.86-1.98）和 CVD 死亡率（HR=1.27，95%CI=0.73-2.21）呈正相关，但无统计学意义。睡眠时间与死亡率（全因以及 CVD 和癌症特异性）之间没有统计学意义的非线性关系的证据。年龄、性别、教育程度和职业的效应修饰无统计学意义。
结论
我们的研究结果表明，在韩国成年人中，长睡眠时间与全因死亡率增加有关。
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