Association of sleep duration at age 50, 60, and 70 years with risk of multimorbidity in the UK: 25-year follow-up of the Whitehall II cohort study
Sleep duration has been shown to be associated with individual chronic diseases but its association with multimorbidity, common in older adults, remains poorly understood. We examined whether sleep duration is associated with incidence of a first chronic disease, subsequent multimorbidity and mortal...
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| Veröffentlicht in: | PLoS medicine 2022-10, Vol.19 (10), p.e1004109-e1004109 |
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| creator | Sabia, Séverine Dugravot, Aline Léger, Damien Ben Hassen, Céline Kivimaki, Mika Singh-Manoux, Archana |
| description | Sleep duration has been shown to be associated with individual chronic diseases but its association with multimorbidity, common in older adults, remains poorly understood. We examined whether sleep duration is associated with incidence of a first chronic disease, subsequent multimorbidity and mortality using data spanning 25 years.
Data were drawn from the prospective Whitehall II cohort study, established in 1985 on 10,308 persons employed in the London offices of the British civil service. Self-reported sleep duration was measured 6 times between 1985 and 2016, and data on sleep duration was extracted at age 50 (mean age (standard deviation) = 50.6 (2.6)), 60 (60.3 (2.2)), and 70 (69.2 (1.9)). Incidence of multimorbidity was defined as having 2 or more of 13 chronic diseases, follow-up up to March 2019. Cox regression, separate analyses at each age, was used to examine associations of sleep duration at age 50, 60, and 70 with incident multimorbidity. Multistate models were used to examine the association of sleep duration at age 50 with onset of a first chronic disease, progression to incident multimorbidity, and death. Analyses were adjusted for sociodemographic, behavioral, and health-related factors. A total of 7,864 (32.5% women) participants free of multimorbidity had data on sleep duration at age 50; 544 (6.9%) reported sleeping ≤5 hours, 2,562 (32.6%) 6 hours, 3,589 (45.6%) 7 hours, 1,092 (13.9%) 8 hours, and 77 (1.0%) ≥9 hours. Compared to 7-hour sleep, sleep duration ≤5 hours was associated with higher multimorbidity risk (hazard ratio: 1.30, 95% confidence interval = 1.12 to 1.50; p < 0.001). This was also the case for short sleep duration at age 60 (1.32, 1.13 to 1.55; p < 0.001) and 70 (1.40, 1.16 to 1.68; p < 0.001). Sleep duration ≥9 hours at age 60 (1.54, 1.15 to 2.06; p = 0.003) and 70 (1.51, 1.10 to 2.08; p = 0.01) but not 50 (1.39, 0.98 to 1.96; p = 0.07) was associated with incident multimorbidity. Among 7,217 participants free of chronic disease at age 50 (mean follow-up = 25.2 years), 4,446 developed a first chronic disease, 2,297 progressed to multimorbidity, and 787 subsequently died. Compared to 7-hour sleep, sleeping ≤5 hours at age 50 was associated with an increased risk of a first chronic disease (1.20, 1.06 to 1.35; p = 0.003) and, among those who developed a first disease, with subsequent multimorbidity (1.21, 1.03 to 1.42; p = 0.02). Sleep duration ≥9 hours was not associated with these transitions. No association was found |
| doi_str_mv | 10.1371/journal.pmed.1004109 |
| format | Article |
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Data were drawn from the prospective Whitehall II cohort study, established in 1985 on 10,308 persons employed in the London offices of the British civil service. Self-reported sleep duration was measured 6 times between 1985 and 2016, and data on sleep duration was extracted at age 50 (mean age (standard deviation) = 50.6 (2.6)), 60 (60.3 (2.2)), and 70 (69.2 (1.9)). Incidence of multimorbidity was defined as having 2 or more of 13 chronic diseases, follow-up up to March 2019. Cox regression, separate analyses at each age, was used to examine associations of sleep duration at age 50, 60, and 70 with incident multimorbidity. Multistate models were used to examine the association of sleep duration at age 50 with onset of a first chronic disease, progression to incident multimorbidity, and death. Analyses were adjusted for sociodemographic, behavioral, and health-related factors. A total of 7,864 (32.5% women) participants free of multimorbidity had data on sleep duration at age 50; 544 (6.9%) reported sleeping ≤5 hours, 2,562 (32.6%) 6 hours, 3,589 (45.6%) 7 hours, 1,092 (13.9%) 8 hours, and 77 (1.0%) ≥9 hours. Compared to 7-hour sleep, sleep duration ≤5 hours was associated with higher multimorbidity risk (hazard ratio: 1.30, 95% confidence interval = 1.12 to 1.50; p < 0.001). This was also the case for short sleep duration at age 60 (1.32, 1.13 to 1.55; p < 0.001) and 70 (1.40, 1.16 to 1.68; p < 0.001). Sleep duration ≥9 hours at age 60 (1.54, 1.15 to 2.06; p = 0.003) and 70 (1.51, 1.10 to 2.08; p = 0.01) but not 50 (1.39, 0.98 to 1.96; p = 0.07) was associated with incident multimorbidity. Among 7,217 participants free of chronic disease at age 50 (mean follow-up = 25.2 years), 4,446 developed a first chronic disease, 2,297 progressed to multimorbidity, and 787 subsequently died. Compared to 7-hour sleep, sleeping ≤5 hours at age 50 was associated with an increased risk of a first chronic disease (1.20, 1.06 to 1.35; p = 0.003) and, among those who developed a first disease, with subsequent multimorbidity (1.21, 1.03 to 1.42; p = 0.02). Sleep duration ≥9 hours was not associated with these transitions. No association was found between sleep duration and mortality among those with existing chronic diseases. The study limitations include the small number of cases in the long sleep category, not allowing conclusions to be drawn for this category, the self-reported nature of sleep data, the potential for reverse causality that could arise from undiagnosed conditions at sleep measures, and the small proportion of non-white participants, limiting generalization of findings.
In this study, we observed short sleep duration to be associated with risk of chronic disease and subsequent multimorbidity but not with progression to death. There was no robust evidence of an increased risk of chronic disease among those with long sleep duration at age 50. Our findings suggest an association between short sleep duration and multimorbidity.</description><identifier>ISSN: 1549-1676</identifier><identifier>ISSN: 1549-1277</identifier><identifier>EISSN: 1549-1676</identifier><identifier>DOI: 10.1371/journal.pmed.1004109</identifier><identifier>PMID: 36256607</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Aged ; Arthritis ; Biology and Life Sciences ; Cancer ; Cardiovascular disease ; Chronic diseases ; Chronic illnesses ; Cohort analysis ; Cohort Studies ; Comorbidity ; Data collection ; Dementia ; Diabetes ; Electronic health records ; Ethnicity ; Evaluation ; Female ; Follow-Up Studies ; Health aspects ; Health services ; Humans ; Kidney cancer ; Liver cancer ; London - epidemiology ; Male ; Medicine and Health Sciences ; Middle Aged ; Mortality ; Multimorbidity ; Prospective Studies ; Questionnaires ; Risk Factors ; Sleep ; Sleep Wake Disorders - epidemiology ; Sociodemographics</subject><ispartof>PLoS medicine, 2022-10, Vol.19 (10), p.e1004109-e1004109</ispartof><rights>COPYRIGHT 2022 Public Library of Science</rights><rights>2022 Sabia et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 Sabia et al 2022 Sabia et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c764t-53d19003f8af9c1eb1c1933ac523b528c4c904e6a2d630fe0b99346818426e903</citedby><cites>FETCH-LOGICAL-c764t-53d19003f8af9c1eb1c1933ac523b528c4c904e6a2d630fe0b99346818426e903</cites><orcidid>0000-0001-7884-2986 ; 0000-0002-1244-5037 ; 0000-0003-1168-480X ; 0000-0003-3109-9720 ; 0000-0002-4699-5627 ; 0000-0002-4546-0970</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9578599/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9578599/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,729,782,786,866,887,2104,2930,23873,27931,27932,53798,53800</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36256607$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Basu, Sanjay</contributor><creatorcontrib>Sabia, Séverine</creatorcontrib><creatorcontrib>Dugravot, Aline</creatorcontrib><creatorcontrib>Léger, Damien</creatorcontrib><creatorcontrib>Ben Hassen, Céline</creatorcontrib><creatorcontrib>Kivimaki, Mika</creatorcontrib><creatorcontrib>Singh-Manoux, Archana</creatorcontrib><title>Association of sleep duration at age 50, 60, and 70 years with risk of multimorbidity in the UK: 25-year follow-up of the Whitehall II cohort study</title><title>PLoS medicine</title><addtitle>PLoS Med</addtitle><description>Sleep duration has been shown to be associated with individual chronic diseases but its association with multimorbidity, common in older adults, remains poorly understood. We examined whether sleep duration is associated with incidence of a first chronic disease, subsequent multimorbidity and mortality using data spanning 25 years.
Data were drawn from the prospective Whitehall II cohort study, established in 1985 on 10,308 persons employed in the London offices of the British civil service. Self-reported sleep duration was measured 6 times between 1985 and 2016, and data on sleep duration was extracted at age 50 (mean age (standard deviation) = 50.6 (2.6)), 60 (60.3 (2.2)), and 70 (69.2 (1.9)). Incidence of multimorbidity was defined as having 2 or more of 13 chronic diseases, follow-up up to March 2019. Cox regression, separate analyses at each age, was used to examine associations of sleep duration at age 50, 60, and 70 with incident multimorbidity. Multistate models were used to examine the association of sleep duration at age 50 with onset of a first chronic disease, progression to incident multimorbidity, and death. Analyses were adjusted for sociodemographic, behavioral, and health-related factors. A total of 7,864 (32.5% women) participants free of multimorbidity had data on sleep duration at age 50; 544 (6.9%) reported sleeping ≤5 hours, 2,562 (32.6%) 6 hours, 3,589 (45.6%) 7 hours, 1,092 (13.9%) 8 hours, and 77 (1.0%) ≥9 hours. Compared to 7-hour sleep, sleep duration ≤5 hours was associated with higher multimorbidity risk (hazard ratio: 1.30, 95% confidence interval = 1.12 to 1.50; p < 0.001). This was also the case for short sleep duration at age 60 (1.32, 1.13 to 1.55; p < 0.001) and 70 (1.40, 1.16 to 1.68; p < 0.001). Sleep duration ≥9 hours at age 60 (1.54, 1.15 to 2.06; p = 0.003) and 70 (1.51, 1.10 to 2.08; p = 0.01) but not 50 (1.39, 0.98 to 1.96; p = 0.07) was associated with incident multimorbidity. Among 7,217 participants free of chronic disease at age 50 (mean follow-up = 25.2 years), 4,446 developed a first chronic disease, 2,297 progressed to multimorbidity, and 787 subsequently died. Compared to 7-hour sleep, sleeping ≤5 hours at age 50 was associated with an increased risk of a first chronic disease (1.20, 1.06 to 1.35; p = 0.003) and, among those who developed a first disease, with subsequent multimorbidity (1.21, 1.03 to 1.42; p = 0.02). Sleep duration ≥9 hours was not associated with these transitions. No association was found between sleep duration and mortality among those with existing chronic diseases. The study limitations include the small number of cases in the long sleep category, not allowing conclusions to be drawn for this category, the self-reported nature of sleep data, the potential for reverse causality that could arise from undiagnosed conditions at sleep measures, and the small proportion of non-white participants, limiting generalization of findings.
In this study, we observed short sleep duration to be associated with risk of chronic disease and subsequent multimorbidity but not with progression to death. There was no robust evidence of an increased risk of chronic disease among those with long sleep duration at age 50. Our findings suggest an association between short sleep duration and multimorbidity.</description><subject>Age</subject><subject>Aged</subject><subject>Arthritis</subject><subject>Biology and Life Sciences</subject><subject>Cancer</subject><subject>Cardiovascular disease</subject><subject>Chronic diseases</subject><subject>Chronic illnesses</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Data collection</subject><subject>Dementia</subject><subject>Diabetes</subject><subject>Electronic health records</subject><subject>Ethnicity</subject><subject>Evaluation</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health aspects</subject><subject>Health services</subject><subject>Humans</subject><subject>Kidney cancer</subject><subject>Liver cancer</subject><subject>London - epidemiology</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multimorbidity</subject><subject>Prospective Studies</subject><subject>Questionnaires</subject><subject>Risk Factors</subject><subject>Sleep</subject><subject>Sleep Wake Disorders - epidemiology</subject><subject>Sociodemographics</subject><issn>1549-1676</issn><issn>1549-1277</issn><issn>1549-1676</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNqVk2-L1DAQxoso3nn6DUQDgijYNUmbtPGFsBz-WTw8UE9fhmw63eYu26xJ6rmfwy9s6u4dt7IvlFJaJr9nZjLDk2UPCZ6QoiIvz93ge2UnqyU0E4JxSbC4lR0SVoqc8IrfvvF_kN0L4RxjKrDAd7ODglPGOa4Os1_TEJw2KhrXI9eiYAFWqBn8JqIiUgtADL9APL2qb1CF0RqUD-jSxA55Ey5G3XKw0Sydn5vGxDUyPYodoLMPrxBl-cij1lnrLvNhNeLj4bfOROiUtWg2Q9p1zkcU4tCs72d3WmUDPNh-j7Kzt2--HL_PT07fzY6nJ7mueBlzVjREYFy0tWqFJjAnmoiiUJrRYs5orUstcAlc0YYXuAU8F6IoeU3qknIQuDjKHm_yrqwLcjvPIGmVxluwuhKJmG2IxqlzufJmqfxaOmXkn4DzC6l8NNqC5KkeJzXHQEWpSauoqsqWAqs4p6lsyvV6W22Yp5Vp6KNXdifp7klvOrlwP6RgVc3E2MyzbQLvvg8QolyaoMFa1YMbxr7TUllaMk3ok7_Q_bfbUguVLmD61qW6ekwqpxUtK1bXvEhUvodaQA-pSddDa1J4h5_s4dPTwNLovYLnO4LERPgZF2oIQc4-f_oP9uO_s6dfd9mnN9gOlI1dcHYYTRB2wXIDau9C8NBeL5BgOfryatJy9KXc-jLJHt1c_rXoyojFbzuoLl4</recordid><startdate>20221018</startdate><enddate>20221018</enddate><creator>Sabia, Séverine</creator><creator>Dugravot, Aline</creator><creator>Léger, Damien</creator><creator>Ben Hassen, Céline</creator><creator>Kivimaki, Mika</creator><creator>Singh-Manoux, Archana</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISN</scope><scope>ISR</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><scope>CZK</scope><orcidid>https://orcid.org/0000-0001-7884-2986</orcidid><orcidid>https://orcid.org/0000-0002-1244-5037</orcidid><orcidid>https://orcid.org/0000-0003-1168-480X</orcidid><orcidid>https://orcid.org/0000-0003-3109-9720</orcidid><orcidid>https://orcid.org/0000-0002-4699-5627</orcidid><orcidid>https://orcid.org/0000-0002-4546-0970</orcidid></search><sort><creationdate>20221018</creationdate><title>Association of sleep duration at age 50, 60, and 70 years with risk of multimorbidity in the UK: 25-year follow-up of the Whitehall II cohort study</title><author>Sabia, Séverine ; Dugravot, Aline ; Léger, Damien ; Ben Hassen, Céline ; Kivimaki, Mika ; Singh-Manoux, Archana</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c764t-53d19003f8af9c1eb1c1933ac523b528c4c904e6a2d630fe0b99346818426e903</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Age</topic><topic>Aged</topic><topic>Arthritis</topic><topic>Biology and Life Sciences</topic><topic>Cancer</topic><topic>Cardiovascular disease</topic><topic>Chronic diseases</topic><topic>Chronic illnesses</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Comorbidity</topic><topic>Data collection</topic><topic>Dementia</topic><topic>Diabetes</topic><topic>Electronic health records</topic><topic>Ethnicity</topic><topic>Evaluation</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Health aspects</topic><topic>Health services</topic><topic>Humans</topic><topic>Kidney cancer</topic><topic>Liver cancer</topic><topic>London - epidemiology</topic><topic>Male</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multimorbidity</topic><topic>Prospective Studies</topic><topic>Questionnaires</topic><topic>Risk Factors</topic><topic>Sleep</topic><topic>Sleep Wake Disorders - epidemiology</topic><topic>Sociodemographics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sabia, Séverine</creatorcontrib><creatorcontrib>Dugravot, Aline</creatorcontrib><creatorcontrib>Léger, Damien</creatorcontrib><creatorcontrib>Ben Hassen, Céline</creatorcontrib><creatorcontrib>Kivimaki, Mika</creatorcontrib><creatorcontrib>Singh-Manoux, Archana</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Canada</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><collection>PLoS Medicine</collection><jtitle>PLoS medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sabia, Séverine</au><au>Dugravot, Aline</au><au>Léger, Damien</au><au>Ben Hassen, Céline</au><au>Kivimaki, Mika</au><au>Singh-Manoux, Archana</au><au>Basu, Sanjay</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of sleep duration at age 50, 60, and 70 years with risk of multimorbidity in the UK: 25-year follow-up of the Whitehall II cohort study</atitle><jtitle>PLoS medicine</jtitle><addtitle>PLoS Med</addtitle><date>2022-10-18</date><risdate>2022</risdate><volume>19</volume><issue>10</issue><spage>e1004109</spage><epage>e1004109</epage><pages>e1004109-e1004109</pages><issn>1549-1676</issn><issn>1549-1277</issn><eissn>1549-1676</eissn><abstract>Sleep duration has been shown to be associated with individual chronic diseases but its association with multimorbidity, common in older adults, remains poorly understood. We examined whether sleep duration is associated with incidence of a first chronic disease, subsequent multimorbidity and mortality using data spanning 25 years.
Data were drawn from the prospective Whitehall II cohort study, established in 1985 on 10,308 persons employed in the London offices of the British civil service. Self-reported sleep duration was measured 6 times between 1985 and 2016, and data on sleep duration was extracted at age 50 (mean age (standard deviation) = 50.6 (2.6)), 60 (60.3 (2.2)), and 70 (69.2 (1.9)). Incidence of multimorbidity was defined as having 2 or more of 13 chronic diseases, follow-up up to March 2019. Cox regression, separate analyses at each age, was used to examine associations of sleep duration at age 50, 60, and 70 with incident multimorbidity. Multistate models were used to examine the association of sleep duration at age 50 with onset of a first chronic disease, progression to incident multimorbidity, and death. Analyses were adjusted for sociodemographic, behavioral, and health-related factors. A total of 7,864 (32.5% women) participants free of multimorbidity had data on sleep duration at age 50; 544 (6.9%) reported sleeping ≤5 hours, 2,562 (32.6%) 6 hours, 3,589 (45.6%) 7 hours, 1,092 (13.9%) 8 hours, and 77 (1.0%) ≥9 hours. Compared to 7-hour sleep, sleep duration ≤5 hours was associated with higher multimorbidity risk (hazard ratio: 1.30, 95% confidence interval = 1.12 to 1.50; p < 0.001). This was also the case for short sleep duration at age 60 (1.32, 1.13 to 1.55; p < 0.001) and 70 (1.40, 1.16 to 1.68; p < 0.001). Sleep duration ≥9 hours at age 60 (1.54, 1.15 to 2.06; p = 0.003) and 70 (1.51, 1.10 to 2.08; p = 0.01) but not 50 (1.39, 0.98 to 1.96; p = 0.07) was associated with incident multimorbidity. Among 7,217 participants free of chronic disease at age 50 (mean follow-up = 25.2 years), 4,446 developed a first chronic disease, 2,297 progressed to multimorbidity, and 787 subsequently died. Compared to 7-hour sleep, sleeping ≤5 hours at age 50 was associated with an increased risk of a first chronic disease (1.20, 1.06 to 1.35; p = 0.003) and, among those who developed a first disease, with subsequent multimorbidity (1.21, 1.03 to 1.42; p = 0.02). Sleep duration ≥9 hours was not associated with these transitions. No association was found between sleep duration and mortality among those with existing chronic diseases. The study limitations include the small number of cases in the long sleep category, not allowing conclusions to be drawn for this category, the self-reported nature of sleep data, the potential for reverse causality that could arise from undiagnosed conditions at sleep measures, and the small proportion of non-white participants, limiting generalization of findings.
In this study, we observed short sleep duration to be associated with risk of chronic disease and subsequent multimorbidity but not with progression to death. There was no robust evidence of an increased risk of chronic disease among those with long sleep duration at age 50. Our findings suggest an association between short sleep duration and multimorbidity.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>36256607</pmid><doi>10.1371/journal.pmed.1004109</doi><orcidid>https://orcid.org/0000-0001-7884-2986</orcidid><orcidid>https://orcid.org/0000-0002-1244-5037</orcidid><orcidid>https://orcid.org/0000-0003-1168-480X</orcidid><orcidid>https://orcid.org/0000-0003-3109-9720</orcidid><orcidid>https://orcid.org/0000-0002-4699-5627</orcidid><orcidid>https://orcid.org/0000-0002-4546-0970</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1549-1676 |
| ispartof | PLoS medicine, 2022-10, Vol.19 (10), p.e1004109-e1004109 |
| issn | 1549-1676 1549-1277 1549-1676 |
| language | eng |
| recordid | cdi_plos_journals_2737135879 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Age Aged Arthritis Biology and Life Sciences Cancer Cardiovascular disease Chronic diseases Chronic illnesses Cohort analysis Cohort Studies Comorbidity Data collection Dementia Diabetes Electronic health records Ethnicity Evaluation Female Follow-Up Studies Health aspects Health services Humans Kidney cancer Liver cancer London - epidemiology Male Medicine and Health Sciences Middle Aged Mortality Multimorbidity Prospective Studies Questionnaires Risk Factors Sleep Sleep Wake Disorders - epidemiology Sociodemographics |
| title | Association of sleep duration at age 50, 60, and 70 years with risk of multimorbidity in the UK: 25-year follow-up of the Whitehall II cohort study |
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