Association of Sleep Duration at Age 50, 60, and 70 Years With Risk of Multimorbidity in the UK: 25-year Follow-up of Whitehall II Cohort Study
Conclusions
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.
Author summary
Why was this study done?
- The prevalence of multimorbidity is on the rise as reflected in over half of older adults having at least 2 chronic diseases in high-income countries, making multimorbidity a major challenge for public health.
- Both short and long sleep duration has been shown to be associated with individual chronic diseases, but their associations with multimorbidity and subsequent mortality risk remain unclear.
What did the researchers do and find?
- We used data on more than 7,000 men and women from the Whitehall II cohort study to extract sleep duration at age 50, 60, and 70 and examined its association with incident multimorbidity over 25 years of follow-up. Role of sleep duration at age 50 in transitions from a healthy state to a first chronic disease, multimorbidity, and mortality was also examined using a multistate model.
- We found a robust association of sleep duration ≤5 hours at age 50, 60, and 70 (separate analyses) with higher risk of incident multimorbidity, while the association with sleep duration ≥9 hours was observed only when measured at age 60 and 70.
- Analysis of transitions in health states showed short sleep duration at age 50 to be associated with 20% increased risk of a first chronic disease, and with a similar increased risk of subsequent multimorbidity, but within this framework there was no clear evidence of associations with mortality.
- There was no robust association between sleep duration ≥9 hours at age 50 and risk of 1 chronic disease or multimorbidity. However, in those with a chronic condition there was some evidence of higher risk of multimorbidity.
What do these findings mean?
- Our comprehensive analyses of the association of sleep duration with multimorbidity and the natural course of chronic disease show short sleep duration to be associated with the onset of chronic disease and multimorbidity but not with subsequent mortality in those with chronic disease(s).
- There was no clear evidence for an association between long sleep duration at age 50 and risk of chronic disease. Rather the increased risk of multimorbidity associated with long sleep duration at older ages and in those with existing disease might reflect the need for longer sleep in those with underlying chronic conditions.
Academic Editor: Sanjay Basu, Harvard Medical School, UNITED STATES
Received: March 23, 2022; Accepted: September 13, 2022; Published: October 18, 2022
Copyright: © 2022 Sabia et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: Data cannot be made publicly available because of ethics and IRB restrictions. However, the data are available to bona fine researchers at small fee - to cover data management costs - via a data sharing portal allowing access to undertake analyses within a secure portal, https://portal.dementiasplatform.uk/. For general data sharing enquiries, please contact whitehall2@ucl.ac.uk.