Association Between Abnormal Sleep and Mortality Risk: A Nationwide Prospective Cohort Study of All-Cause and Cardiovascular disease Mortality
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Background
The American Heart Association’s Life’s Essential 8 construct of ideal cardiovascular health now includes sleep duration, emphasizing the need to understand the implications of suboptimal sleep patterns. Recent studies have demonstrated that Life’s Essential 8 is correlated with the risk of all-cause mortality and CVD-specific mortality. However, although sleep duration being one of the components of Life’s Essential 8, the relationship between an individual’s sleep patterns and the risk of all-cause and CVD- specific mortality remains unclear.
Methods
The 2005–2018 National Health and Nutrition Examination Survey (NHANES) included 38,006 adults aged ≥20 years. The definitions of normal sleep duration (7–8 hours per night), short sleep duration (< 7 hours), and long sleep duration (> 8 hours) were based on the current literature. To evaluate the association between abnormal sleep patterns and both all-cause mortality and CVD mortality, a multinomial Cox regression analysis was conducted, adjusting for demographic and clinical factors.
Results
The study utilized three models (Model I–III), first unadjusted and then adjusted for sociodemographic, lifestyle, and chronic disease factors. In the fully adjusted model, both short sleep (OR=1.25, 95% CI: 1.12–1.39, P<0.001) and long sleep (OR=1.30, 95% CI: 1.18–1.44, P<0.001) were found to be associated with an increased risk of all-cause mortality. Regarding CVD mortality, after full adjustment (Model III), only long sleep remained statistically significant (OR=1.28, 95% CI: 1.07–1.52, P=0.006), while the association for short sleep was no longer significant (OR=1.16, 95% CI: 0.94–1.43, P=0.176).
Conclusions
Abnormal sleep duration (both short and long) was independently associated with an increased risk of all-cause mortality. Long sleep duration was associated with an increased risk of CVD mortality.
