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000011178 02470 $$ahttps://doi.org/10.1001/jamanetworkopen.2021.22837$$2doi
000011178 037__ $$aTEXTUAL
000011178 037__ $$bArticle
000011178 041__ $$aeng
000011178 245__ $$aAssociation of Sleep Duration with All- And Major-Cause Mortality among Adults in Japan, China, Singapore, and Korea
000011178 269__ $$a2021-09-03
000011178 336__ $$aArticle
000011178 520__ $$a<p>Importance: The association between long sleep duration and mortality appears stronger in East Asian populations than in North American or European populations.</p><p>Objectives: To assess the sex-specific association between sleep duration and all-cause and major-cause mortality in a pooled longitudinal cohort and to stratify the association by age and body mass index.</p><p>Design, Setting, and Participants: This cohort study of individual-level data from 9 cohorts in the Asia Cohort Consortium was performed from January 1, 1984, to December 31, 2002. The final population included participants from Japan, China, Singapore, and Korea. Mean (SD) follow-up time was 14.0 (5.0) years for men and 13.4 (5.3) years for women. Data analysis was performed from August 1, 2018, to May 31, 2021. Exposures: Self-reported sleep duration, with 7 hours as the reference category.</p><p>Main Outcomes and Measures: Mortality, including deaths from all causes, cardiovascular disease, cancer, and other causes. Sex-specific hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards regression with shared frailty models adjusted for age and the key self-reported covariates of marital status, body mass index, smoking status, alcohol consumption, physical activity, history of diabetes and hypertension, and menopausal status (for women).</p><p>Results: For 322721 participants (mean [SD] age, 54.5 [9.2] years; 178542 [55.3%] female), 19419 deaths occurred among men (mean [SD] age of men, 53.6 [9.0] years) and 13768 deaths among women (mean [SD] age of women, 55.3 [9.2] years). A sleep duration of 7 hours was the nadir for associations with all-cause, cardiovascular disease, and other-cause mortality in both men and women, whereas 8 hours was the mode sleep duration among men and the second most common sleep duration among women. The association between sleep duration and all-cause mortality was J-shaped for both men and women. The greatest association for all-cause mortality was with sleep durations of 10 hours or longer for both men (hazard ratio [HR], 1.34; 95% CI, 1.26-1.44) and women (HR, 1.48; 95% CI, 1.36-1.61). Sex was a significant modifier of the association between sleep duration and mortality from cardiovascular disease (χ<sup>2</sup><sub>5</sub> = 13.47, P =.02), cancer (χ<sup>2</sup><sub>5</sub> = 16.04, P =.007), and other causes (χ<sup>2</sup><sub>5</sub> = 12.79, P =.03). Age was a significant modifier of the associations among men only (all-cause mortality: χ<sup>2</sup><sub>5</sub> = 41.49, P <.001; cancer: χ25= 27.94, P <.001; other-cause mortality: χ<sup>2</sup><sub>5</sub> = 24.51, P <.001).</p><p>Conclusions and Relevance: The findings of this cohort study suggest that sleep duration is a behavioral risk factor for mortality in both men and women. Age was a modifier of the association between sleep duration in men but not in women. Sleep duration recommendations in these populations may need to be considered in the context of sex and age.</p>
000011178 536__ $$oKyowa Pharmaceutical
000011178 536__ $$oMochida Pharmaceutical
000011178 536__ $$oMylan EPD
000011178 536__ $$oNippon Chemipher
000011178 536__ $$oShire Japan
000011178 536__ $$oTakeda Yakuhin
000011178 536__ $$oYoshitomi Yakuhin
000011178 536__ $$oNational Cancer Institute$$cUM1CA182910
000011178 536__ $$oPfizer
000011178 536__ $$oMeso Scale Diagnostics
000011178 536__ $$oNational Cancer Center
000011178 536__ $$oNovartis Pharma
000011178 536__ $$oJanssen Pharmaceuticals
000011178 536__ $$oNihon Medi-Physics
000011178 536__ $$oDaiichi-Sankyo
000011178 540__ $$a<p>© 2021 Svensson T et al.</p> <p>This is an open access article distributed under the terms of the <a href=”https://jamanetwork.com/pages/cc-by-license-permissions”>CC-BY</a> License.</p>
000011178 542__ $$fCC BY
000011178 593__ $$aDue to the large number of authors, only the first 20 and the University of Chicago authors are included on the above author list. Please download the article for the complete list of authors.
000011178 690__ $$aBiological Sciences Division
000011178 691__ $$aPublic Health Sciences
000011178 7001_ $$aSvensson, Thomas$$uNational Cancer Center
000011178 7001_ $$aSaito, Eiko$$uNational Cancer Center
000011178 7001_ $$aSvensson, Akiko Kishi$$uUniversity of Tokyo
000011178 7001_ $$aMelander, Olle$$uLund University
000011178 7001_ $$aOrho-Melander, Marju$$uLund University
000011178 7001_ $$aMimura, Masaru$$uKeio University
000011178 7001_ $$aRahman, Shafiur$$uNational Cancer Center
000011178 7001_ $$aSawada, Norie$$uNational Cancer Center
000011178 7001_ $$aKoh, Woon-Puay$$uNational University of Singapore
000011178 7001_ $$aShu, Xiao-Ou$$uVanderbilt University Medical Center
000011178 7001_ $$aTsuji, Ichiro$$uTohoku University
000011178 7001_ $$aKanemura, Seiki$$uTohoku University
000011178 7001_ $$aPark, Sue K.$$uSeoul National University
000011178 7001_ $$aNagata, Chisato$$uGifu University
000011178 7001_ $$aTsugane, Shoichiro$$uNational Cancer Center
000011178 7001_ $$aCai, Hui$$uVanderbilt University Medical Center
000011178 7001_ $$aYuan, Jian-Min$$uUniversity of Pittsburgh
000011178 7001_ $$aMatsuyama, Sanae$$uTohoku University
000011178 7001_ $$aSugawara, Yumi$$uTohoku University
000011178 7001_ $$aWada, Keiko$$uGifu University
000011178 7001_ $$aYoo, Keun-Young$$uSeoul National University
000011178 7001_ $$aChia, Kee Seng$$uNational University of Singapore
000011178 7001_ $$aBoffetta, Paolo$$uStony Brook University
000011178 7001_ $$aAhsan, Habibul$$uUniversity of Chicago
000011178 773__ $$tJAMA Network Open
000011178 8564_ $$yArticle$$91128d5de-f763-4766-9ff4-597d5d59c5d6$$s1038664$$uhttps://knowledge.uchicago.edu/record/11178/files/svensson_2021_oi_210675_1630074119.85352.pdf$$ePublic
000011178 8564_ $$ySupplemental files$$9f9ac01bb-1004-45e7-ba37-255143c35103$$s569520$$uhttps://knowledge.uchicago.edu/record/11178/files/zoi210675supp1_prod_1630074119.85851.pdf$$ePublic
000011178 908__ $$aI agree
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000011178 983__ $$aArticle