Is Less than 6 Hours of Sleep Associated with Increased Mortality in Individuals with Diabetes or Hypertension?
BACKGROUND AND PURPOSE:
Fernandez-Mendoza et al. (Journal of the American Heart Association, 2019) investigated whether objective short sleep duration increased the risk of mortality in individuals with diabetes, hypertension, heart disease and stroke
Longitudinal, population-based cohort study
Data derived from the Penn State Adult Cohort
Participants and Study Design
Adults, 20 to 74 years
Phase 1: Telephone interviews with 16,583 individuals (1990 to 1991)
Phase 2: 741 men and 1000 women were randomly selected and studied in the sleep laboratory (1990 to 1999)
Cause of death: Data extracted yearly from (2014 to 2017) CDC National Death Index
Cerebrovascular diseases (CBVD): Diagnosis or treatment for heart disease and/or stroke
Objective short sleep duration: Total sleep time <6 hours
Hazard models were used to estimated multivariable-adjusted hazard ratios (HRs) and 95% CIs
1,654 adults were included in the study
Mean age 47.5 years | 52.5% women | 89.8% white
Risk of all-cause mortality associated with CMR or CBVD was significantly higher with <6 hours of sleep (p<0.05)
HR 3.17 (95% CI, 2.16 to 4.65)
<6 hours sleep
CMR was associated with a 1.83 higher risk of CBVD mortality (95% CI, 1.07 to 3.13)
CBVD was associated with a 2.92 higher risk of cancer mortality (95% CI, 1.28 to 6.65)
≥6 hours sleep
CMR was not significantly associated with CBVD mortality
HR 1.35 (95% CI, 0.70 to 2.63)
CBVD was not significantly associated with cancer mortality
HR 0.55 (95% CI, 0.18 to 1.64)
Short sleep duration (<6 hours) in middle-age
adults can predict
All-cause and cancer specific mortality
prognosis among individuals with CMR
The authors note the following clinical
Clinicians should become aware that the risk of all‐cause and cancer mortality associated with hypertension, diabetes mellitus, heart disease, or stroke is greater in patients with objective short sleep duration, a potentially modifiable risk factor
Patients with hypertension, diabetes mellitus, heart disease, or stroke, who sleep objectively short, may benefit from targeted treatments to lengthen sleep and improve their long-term prognosis
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