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Sleep. 2013 Aug 1;36(8):1187-98. doi: 10.5665/sleep.2884.

A nine-year follow-up study of sleep patterns and mortality in community-dwelling older adults in Taiwan.

Author information

1
Department of Psychiatry & Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan.

Erratum in

  • Sleep. 2013 Oct;36(10):1573.

Abstract

STUDY OBJECTIVES:

To simultaneously explore the associations between mortality and insomnia, sleep duration, and the use of hypnotics in older adults.

DESIGN:

A fixed cohort study.

SETTING:

A community in Shih-Pai area, Taipei, Taiwan.

PARTICIPANTS:

A total of 4,064 participants over the age of 65 completed the study.

INTERVENTION:

N/A.

MEASUREMENTS AND RESULTS:

Insomnia was classified using an exclusionary hierarchical algorithm, which categorized insomnia as "no insomnia," "subjective poor sleep quality," "Pittsburgh Sleep Quality Index > 5 insomnia," "1-month insomnia disorder," and "6-month insomnia disorder." The main outcome variables were 9-year all-cause mortality rates. In the all-cause mortality analyses, when hypnotic use, depressive symptoms and total sleep time were excluded from a proportional hazards regression model, subjects with "Pittsburgh Sleep Quality Index > 5 insomnia" had a higher mortality risk (HR: 1.21, 95% CI: 1.01-1.45). In the full model, frequent hypnotic use and long sleep duration predicted higher mortality rates. However, the increased mortality risk for subjects with "Pittsburgh Sleep Quality Index > 5 insomnia" was not observed in the full model. On the contrary, individuals with a 6-month DSM-IV insomnia disorder had a lower risk for premature death (HR: 0.64, 95% CI: 0.43-0.96).

CONCLUSIONS:

Long sleep duration and frequent hypnotics use predicted an increased mortality risk within a community-dwelling sample of older adults. The association between insomnia and mortality was affected by insomnia definition and other parameters related to sleep patterns.

KEYWORDS:

Insomnia; older adults; sleep duration; sleep pattern; use of hypnotics

PMID:
23904679
PMCID:
PMC3700716
DOI:
10.5665/sleep.2884
[Indexed for MEDLINE]
Free PMC Article
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