U-shaped association between sleep duration and the risk of respiratory diseases mortality: a large prospective cohort study from UK Biobank

Abstract

Study Objectives: Our cohort study aimed to study the association between sleep duration and risk of mortality due to respiratory diseases. Methods: We included 498,200 participants from UK Biobank (2006–2021). We classified sleep duration as short sleep duration (< 7 hours), long sleep duration (> 9 hours for adults, > 8 hours for older adults), and midrange sleep duration (7–9 hours). We used the Cox proportional hazards model and restricted cubic spline analysis to explore the association between sleep duration and respiratory diseases mortality. Results: During a median follow-up of 12.49 years, 2,477 deaths due to respiratory diseases were recorded, of which 1,099 were deaths due to chronic lower respiratory diseases. Cox models with penalized splines showed U-shaped associations of sleep duration with mortality due to total respiratory diseases and chronic lower respiratory diseases. Compared with midrange sleep duration, short sleep duration was associated with 14% higher risk of total respiratory diseases mortality (hazard ratio = 1.14; 95% confidence interval: 1.04, 1.25), and long sleep duration was associated with 35% higher risk of total respiratory diseases mortality (hazard ratio = 1.35; 95% confidence interval: 1.19, 1.55), after adjustment of baseline characteristics, health status, and lifestyle habits. Similarly, the hazard ratios for chronic lower respiratory diseases mortality were 1.20 (95% confidence interval: 1.04, 1.38) and 1.44 (95% confidence interval: 1.19, 1.74), respectively. Conclusions: There was a U-shaped association between sleep duration and respiratory diseases mortality. Appropriate sleep duration may improve the progress of respiratory diseases.