Sleep Duration and Risk of Fatal Coronary Heart Disease, Sudden Cardiac Death, Cancer Death, and All-Cause Mortality

Am J Med. 2018 Dec;131(12):1499-1505.e2. doi: 10.1016/j.amjmed.2018.07.010. Epub 2018 Aug 1.


Background: Sleep duration has been shown to be associated with all-cause mortality; however, its relationship with cause-specific fatal events remains uncertain. We examined the relationship between sleep duration and risk of fatal coronary heart disease, sudden cardiac death, cancer-related death, and all-cause mortality.

Methods: Sleep duration was self-reported at baseline examinations performed between March 20, 1984, and December 5, 1989, in 2361 men aged 42-61 years from the Kuopio Ischemic Heart Disease study. Of these, 1734 (73.4%) men were free from coronary heart disease and cancer at baseline.

Results: A total of 802 all-cause deaths, 202 fatal coronary heart disease events, 141 sudden cardiac events, and 229 cancer-related deaths were reported during a median follow-up of 25.9 (interquartile range, 20.6-28.2) years. Multivariable adjusted hazard ratios comparing the top quartile (>10 hours) of sleep duration vs the bottom quartile (<8 hours) was 1.19 (95% confidence interval [CI], 1.01-1.43) for all-cause mortality, 1.27 (95% CI, 0.88-1.84) for fatal coronary heart disease, 1.20 (95% CI, 0.78-1.86) for sudden cardiac death, and 1.29 (95% CI, 0.92-1.80) for cancer death. No differences in association of sleep duration with outcomes were found in clinically relevant subgroups, including age, history of coronary heart disease, body mass index, physical activity, and C-reactive protein levels.

Conclusions: Longer duration of sleep was associated with significantly increased all-cause mortality. The mechanistic link between these findings remains to be explored further.

Keywords: Cancer death; Coronary heart disease; Sleep duration; Sudden cardiac death.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cause of Death
  • Coronary Disease / etiology*
  • Coronary Disease / mortality*
  • Death, Sudden, Cardiac / etiology*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Neoplasms / etiology*
  • Neoplasms / mortality*
  • Risk Factors
  • Sleep Deprivation / complications*