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Multidimensional Sleep Health Problems Across Middle and Older Adulthood Predict Early Mortality

S. Lee, CX. Mu, ML. Wallace, R. Andel, DM. Almeida, OM. Buxton, SR. Patel

. 2024 ; 79 (3) : . [pub] 20240301

Language English Country United States

Document type Journal Article

Persistent link   https://www.medvik.cz/link/bmc24006986

Grant support
U01 AG077928 NIA NIH HHS - United States
F31 HL165898 NHLBI NIH HHS - United States
R44 AG056250 NIA NIH HHS - United States
P01 AG020166 NIA NIH HHS - United States
U19 AG051426 NIA NIH HHS - United States
R43 AG056250 NIH HHS - United States
R43 AG056250 NIA NIH HHS - United States
P01-AG020166 NIA NIH HHS - United States
U19-AG051426 NIA NIH HHS - United States

BACKGROUND: Having multiple sleep problems is common in adulthood. Yet, most studies have assessed single sleep variables at one timepoint, potentially misinterpreting health consequences of co-occurring sleep problems that may change over time. We investigated the relationship between multidimensional sleep health across adulthood and mortality. METHODS: Participants from the Midlife in the United States Study reported sleep characteristics in 2004-2006 (MIDUS-2; M2) and in 2013-2014 (MIDUS-3; M3). We calculated a composite score of sleep health problems across 5 dimensions: Regularity, Satisfaction, Alertness, Efficiency, and Duration (higher = more problems). Two separate models for baseline sleep health (n = 5 140; median follow-up time = 15.3 years) and change in sleep health (n = 2 991; median follow-up time = 6.4 years) to mortality were conducted. Cox regression models controlled for sociodemographics and key health risk factors (body mass index, smoking, depressive symptoms, diabetes, and hypertension). RESULTS: On average, 88% of the sample reported having one or more sleep health problems at M2. Each additional sleep health problem at M2 was associated with 12% greater risk of all-cause mortality (hazard ratio [HR] = 1.12, 95% confidence interval [CI] = 1.04-1.21), but not heart disease-related mortality (HR = 1.14, 95% CI = 0.99-1.31). An increase in sleep health problems from M2 to M3 was associated with 27% greater risk of all-cause mortality (HR = 1.27, 95% CI = 1.005-1.59), and 153% greater risk of heart disease mortality (HR = 2.53, 95% CI = 1.37-4.68). CONCLUSIONS: More sleep health problems may increase the risk of early mortality. Sleep health in middle and older adulthood is a vital sign that can be assessed at medical checkups to identify those at greater risk.

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$a BACKGROUND: Having multiple sleep problems is common in adulthood. Yet, most studies have assessed single sleep variables at one timepoint, potentially misinterpreting health consequences of co-occurring sleep problems that may change over time. We investigated the relationship between multidimensional sleep health across adulthood and mortality. METHODS: Participants from the Midlife in the United States Study reported sleep characteristics in 2004-2006 (MIDUS-2; M2) and in 2013-2014 (MIDUS-3; M3). We calculated a composite score of sleep health problems across 5 dimensions: Regularity, Satisfaction, Alertness, Efficiency, and Duration (higher = more problems). Two separate models for baseline sleep health (n = 5 140; median follow-up time = 15.3 years) and change in sleep health (n = 2 991; median follow-up time = 6.4 years) to mortality were conducted. Cox regression models controlled for sociodemographics and key health risk factors (body mass index, smoking, depressive symptoms, diabetes, and hypertension). RESULTS: On average, 88% of the sample reported having one or more sleep health problems at M2. Each additional sleep health problem at M2 was associated with 12% greater risk of all-cause mortality (hazard ratio [HR] = 1.12, 95% confidence interval [CI] = 1.04-1.21), but not heart disease-related mortality (HR = 1.14, 95% CI = 0.99-1.31). An increase in sleep health problems from M2 to M3 was associated with 27% greater risk of all-cause mortality (HR = 1.27, 95% CI = 1.005-1.59), and 153% greater risk of heart disease mortality (HR = 2.53, 95% CI = 1.37-4.68). CONCLUSIONS: More sleep health problems may increase the risk of early mortality. Sleep health in middle and older adulthood is a vital sign that can be assessed at medical checkups to identify those at greater risk.
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$a Mu, Christina X $u School of Aging Studies, University of South Florida, Tampa, Florida, USA $1 https://orcid.org/0000000235280482
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$a Wallace, Meredith L $u Department of Psychiatry, Statistics, and Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA $1 https://orcid.org/000000033951890X
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$a Almeida, David M $u Department of Human Development and Family Studies, Pennsylvania State University, University Park, Pennsylvania, USA
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$a Buxton, Orfeu M $u Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania, USA $1 https://orcid.org/000000015057633X
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