Multi-dimensional sleep and mortality: The Multi-Ethnic Study of Atherosclerosis.
Sleep
; 46(9)2023 09 08.
Article
in En
| MEDLINE
| ID: mdl-37523657
ABSTRACT
STUDY OBJECTIVES:
Multiple sleep characteristics are informative of health, sleep characteristics cluster, and sleep health can be described as a composite of positive sleep attributes. We assessed the association between a sleep score reflecting multiple sleep dimensions, and mortality. We tested the hypothesis that more favorable sleep (higher sleep scores) is associated with lower mortality.METHODS:
The Multi-Ethnic Study of Atherosclerosis (MESA) is a racially and ethnically-diverse multi-site, prospective cohort study of US adults. Sleep was measured using unattended polysomnography, 7-day wrist actigraphy, and validated questionnaires (2010-2013). 1726 participants were followed for a median of 6.9 years (Q1-Q3, 6.4-7.4 years) until death (171 deaths) or last contact. Survival models were used to estimate the association between the exposure of sleep scores and the outcome of all-cause mortality, adjusting for socio-demographics, lifestyle, and medical comorbidities; follow-up analyses examined associations between individual metrics and mortality. The exposure, a sleep score, was constructed by an empirically-based Principal Components Analysis on 13 sleep metrics, selected a priori.RESULTS:
After adjusting for multiple confounders, a 1 standard deviation (sd) higher sleep score was associated with 25% lower hazard of mortality (Hazard Ratio [HR] 0.75; 95% Confidence interval [0.65, 0.87]). The largest drivers of this association were night-to-night sleep regularity, total sleep time, and the Apnea-Hypopnea Index.CONCLUSION:
More favorable sleep across multiple characteristics, operationalized by a sleep score, is associated with lower risk of death in a diverse US cohort of adults. Results suggest that interventions that address multiple dimensions may provide novel approaches for improving health.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Ethnicity
/
Atherosclerosis
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Humans
Language:
En
Journal:
Sleep
Year:
2023
Document type:
Article
Affiliation country:
United States