Association of healthy sleep patterns with risk of mortality and life expectancy at age of 30 years: a population-based cohort study

Author:

Li H12ORCID,Qian F34,Han L5,Feng W6,Zheng D7,Guo X27ORCID,Zhang H89

Affiliation:

1. Department of Cardiac Surgery, Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University , Beijing, China

2. Beijing Municipal Key Laboratory of Clinical Epidemiology , Beijing, China

3. Section of Cardiovascular Medicine, Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine , Boston, MA, USA

4. Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School , Boston, MA, USA

5. Medical Research Center, Beijing Chaoyang Hospital, Capital Medical University , Beijing, China

6. Neuroscience Department, Washington University in Saint Louis , St. Louis, MO, USA

7. Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University , Beijing, China

8. Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University , Beijing, China

9. Beijing Lab for Cardiovascular Precision Medicine , Beijing, China

Abstract

Summary Background The importance of sleep on cardiovascular health has been increasingly acknowledged. However, the effect of combined sleep behaviors on life expectancy remains understudied. Aim To investigate the association between sleep patterns with total and cause-specific mortality and life expectancy, using a nationally representative sample of US adults. Design Population-based cohort study. Methods This cohort study included 172 321 adults aged 18 years or older in the National Health Interview Survey (2013–18) with linkage to the National Death Index records up to 31 December 2019. The life expectancy at the age of 30 years by the number of low-risk sleep scores was estimated using a flexible parametric survival model. Results During a median follow-up of 4.3 years, of the 172 321 adults (50.9% women; mean [SE] age, 46.98 [0.10] years), 8681 individuals died. The adjusted hazard ratios (95% confidence intervals [CI]) of participants with five vs. 0–1 low-risk sleep factors for all-cause, cardiovascular, and cancer mortality were 0.70 (0.63–0.77), 0.79 (0.67–0.93) and 0.81 (0.66–0.98), respectively. Nearly 8% (population attributable fraction 7.9%, 95% CI: 5.5–10.4) of mortality in this cohort could be attributed to suboptimal sleep patterns. When compared to those with 0–1 low-risk sleep factors, life expectancy at the age of 30 years for individuals with all five low-risk sleep factors was 4.7 (95% CI: 2.7–6.7) years greater for men and 2.4 (95% CI: 0.4–4.4) years greater for women. Conclusions Our findings suggest that greater adherence to a low-risk sleep pattern may lead to significant gains in life expectancy among US adults.

Funder

National Natural Science Foundation of China

R&D Program of Beijing Municipal Education Commission

Golden Seed Program of Beijing Chaoyang Hospital

Publisher

Oxford University Press (OUP)

Subject

General Medicine

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