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

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 ≤ 5 hours (HR, 1.21; 95% CI, 1.03 to 1.41) and of ≥ 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 ≥ 60 years. Risk of cardiovascular disease-specific mortality was associated with a sleep duration of ≤ 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 ( ≤ 5 and ≥ 10 hours). Conclusions: Sleep durations of 7 to 8 hours may be recommended to the public for a general healthy lifestyle in Korea. Copyright © 2013 The Korean Society for Preventive Medicine.