Journal of Preventive Medicine and Public Health  2013;46(5):271-281

A Prospective Cohort Study on the Relationship of Sleep Duration With All-cause and Disease-specific Mortality in the Korean Multi-center Cancer Cohort Study.

Yohwan YEO 1 ; Seung Hyun MA ; Sue Kyung PARK ; Soung Hoon CHANG ; Hai Rim SHIN ; Daehee KANG ; Keun Young YOO

Affiliations

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Keywords

Sleep duration; Mortality; Prospective cohort

Country

Republic of Korea

Language

English

Abstract

OBJECTIVES: Emerging evidence indicates that sleep duration is associated with health outcomes. However, the relationship of sleep duration with long-term health is unclear. This study was designed to determine the relationship of sleep duration with mortality as a parameter for long-term health in a large prospective cohort study in Korea. METHODS: The study population included 13 164 participants aged over 20 years from the Korean Multi-center Cancer Cohort study. Information on sleep duration was obtained through a structured questionnaire interview. The hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality were estimated using a Cox regression model. The non-linear relationship between sleep duration and mortality was examined non-parametrically using restricted cubic splines. RESULTS: The HRs for all-cause mortality showed a U-shape, with the lowest point at sleep duration of 7 to 8 hours. There was an increased risk of death among persons with sleep duration of < or =5 hours (HR, 1.21; 95% CI, 1.03 to 1.41) and of > or =10 hours (HR, 1.36; 95% CI, 1.07 to 1.72). In stratified analysis, this relationship of HR was seen in women and in participants aged > or =60 years. Risk of cardiovascular disease-specific mortality was associated with a sleep duration of < or =5 hours (HR, 1.40; 95% CI, 1.02 to 1.93). Risk of death from respiratory disease was associated with sleep duration at both extremes (< or =5 and > or =10 hours). CONCLUSIONS: Sleep durations of 7 to 8 hours may be recommended to the public for a general healthy lifestyle in Korea.