Abstract
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. METHOD: Participants from the Midlife in the United States Study reported sleep characteristics in 2004-2006 (MIDUS-2; M2) and in 2013-2016 (MIDUS-3; M3).
We calculated a composite score of sleep health problems across five 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, 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 check-ups to identify those at greater risk.