U-shaped curve links sleep duration with chronic disease

Oct 28 2013

By Joanna Lyford, Senior medwireNews Reporter

A large US population survey has found a U-shaped relationship between sleep duration and heart disease, stroke, and diabetes in adults aged 45 years and older.

The association means that people who sleep for much less or much more than the “optimal” duration of 7-9 hours per night face an increased risk for these leading chronic diseases.

A team led by Yong Lui (Centers for Disease Control and Prevention, Atlanta, Georgia, USA) analyzed data from the 2010 Behavioral Risk Factor Surveillance System survey, an annual nationwide random-digital-dialing telephone survey conducted by the US federal government.

For the present analysis, Lui et al included information provided by 54,269 adults living in 14 US states.

When asked to estimate their average sleep duration in a 24-hour period, 31.1% of respondents said 6 hours or less (“short”), 4.1% said 10 hours or more (“long”), and the remainder said between 7 and 9 hours (“optimal”).

When asked about comorbidities, 28.8% of respondents said they were obese, 9.7% reported suffering frequent mental distress (FMD, defined as 14 or more days of poor mental health in the previous 30 days), 10.9% had coronary heart disease (CHD), 4.3% had a history of stroke, and 13.2% had diabetes mellitus.

Compared with the “optimal” sleepers, both long and short sleepers had a significantly higher prevalence of obesity, FMD, CHD, stroke, and diabetes, report Lui et al in Sleep.

Using logistic regression analysis to control for gender, age, race/ethnicity, and education, both long and short sleep durations were associated with significantly increased risks for each of these five health outcomes, with adjusted odds ratios ranging from 1.23 to 3.64.

The associations were moderately attenuated, although still significant, after adjusting for obesity and FMD. Each of the associations was more pronounced with long sleep duration than with short sleep duration.

Noting that this is the largest study to date to address potential mediators in the relationship between sleep duration and chronic diseases, the authors write: “These results suggest that physicians should monitor mental well-being and body weight in addition to sleep health for patients with chronic disease.”

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