title: Habitual sleep duration and insomnia and the risk of cardiovascular events and all-cause death: report from a community-based cohort.
abstract: OBJECTIVE
  To investigate the relationship between sleep duration and insomnia severity and the risk of all-cause death and cardiovascular disease (CVD) events.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Community-based.
  
  
  METHODS
  A total of 3,430 adults aged 35 years or older.
  
  
  METHODS
  None.
  
  
  RESULTS
  During a median 15.9 year (interquartile range, 13.1 to 16.9) follow-up period, 420 cases developed cardiovascular disease and 901 cases died. A U-shape association between sleep duration and all-cause death was found: the age and gender-adjusted relative risks (95% confidence interval [CI]) of all-cause death (with 7 h of daily sleep being considered for the reference group) for individuals reporting < or = 5 h, 6 h, 8 h, and > or = 9 h were 1.15 (0.91-1.45), 1.02 (0.85-1.25), 1.05 (0.88-1.27), and 1.43 (1.16-1.75); P for trend, 0.019. However, the relationship between sleep duration and risk of CVD were linear. The multivariate-adjusted relative risk (95% CI) for all-cause death (using individuals without insomnia) were 1.02 (0.86-1.20) for occasional insomnia, 1.15 (0.92-1.42) for frequent insomnia, and 1.70 (1.16-2.49) for nearly everyday insomnia (P for trend, 0.028). The multivariate adjusted relative risk (95% CI) was 2.53 (1.71-3.76) for all-cause death and 2.07 (1.11-3.85) for CVD rate in participants sleeping > or = 9 h and for those with frequent insomnia.
  
  
  CONCLUSIONS
  Sleep duration and insomnia severity were associated with all-cause death and CVD events among ethnic Chinese in Taiwan. Our data indicate that an optimal sleep duration (7-8 h) predicted fewer deaths.
authors.affiliation: Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Kuo-Liong
authors.initials: KL
authors.lastname: Chien
authors.forename: Pei-Chung
authors.initials: PC
authors.lastname: Chen
authors.forename: Hsiu-Ching
authors.initials: HC
authors.lastname: Hsu
authors.forename: Ta-Chen
authors.initials: TC
authors.lastname: Su
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
authors.forename: Ming-Fong
authors.initials: MF
authors.lastname: Chen
authors.forename: Yuan-Teh
authors.initials: YT
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D015331:Cohort Studies; D006970:Disorders of Excessive Somnolence / Q000401:mortality; D005260:Female; D006184:Habits; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012306:Risk; D012890:Sleep; D012892:Sleep Deprivation / Q000401:mortality; D007319:Sleep Initiation and Maintenance Disorders / Q000401:mortality*; D013223:Statistics as Topic; D013624:Taiwan