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Sleep Duration and Mortality According to Health Status in Older Adults

Authors

  • Arthur Eumann Mesas MPH,

    1. From the Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ—Biomedical Research Centre Network for Epidemiology and Public Health, Madrid, Spain.
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  • Esther López-García PhD,

    1. From the Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ—Biomedical Research Centre Network for Epidemiology and Public Health, Madrid, Spain.
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  • Luz Ma León-Muñoz PhD,

    1. From the Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ—Biomedical Research Centre Network for Epidemiology and Public Health, Madrid, Spain.
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  • Pilar Guallar-Castillón MD, PhD,

    1. From the Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ—Biomedical Research Centre Network for Epidemiology and Public Health, Madrid, Spain.
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  • Fernando Rodríguez-Artalejo MD, PhD

    1. From the Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ—Biomedical Research Centre Network for Epidemiology and Public Health, Madrid, Spain.
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Address correspondence to Dr. Fernando Rodríguez-Artalejo, Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina. Universidad Autónoma de Madrid, C/Arzobispo Morcillo, 2, 28029 Madrid, Spain. E-mail: fernando.artalejo@uam.es

Abstract

OBJECTIVES: To examine the association between usual sleep duration and mortality according to physical and mental health status in older adults.

DESIGN: Prospective study conducted from 2001 to 2008.

SETTING: Community-based study.

PARTICIPANTS: Cohort study of 3,820 persons representative of the noninstitutionalized population aged 60 and older in Spain.

MEASUREMENTS: Sleep duration was self-reported at baseline. Analyses were performed using Cox regression and adjusted for the main confounders. The analyses were then stratified according to numerous indicators of health status.

RESULTS: During follow-up, 897 persons died. Mortality was higher in those who slept 8 hours (relative risk (RR)=1.34, 95% confidence interval (CI)=1.02–1.76), 9 hours (RR 1.48, 95% CI=1.12–1.96), 10 hours (RR 1.73, 95% CI=1.30–2.29) and 11 hours or more (RR 1.66, 95% CI=1.23–2.24) than in those who slept 7 hours (P for trend <.001). The association between long sleep duration (≥10 vs 7 hours) and mortality was observed even in persons with good health status: optimal perceived health, good cognitive function (Mini-Mental State Examination score >27), no depression, quality of life better than the cohort median (Medical Outcomes Study 36-item Short Form Survey Physical Component Summary score ≥46 and Mental Component Summary score ≥52), and without disability in instrumental activities of daily living. Sleeping 6 hours or less was not associated with higher mortality than sleeping 7 hours in persons with good health status.

CONCLUSION: Self-reported sleep duration was associated with 7-year mortality in this cohort of older adults, even when adjusted for health status. Further research is needed to determine the mechanisms and clinical implications of these findings.

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