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Am J Epidemiol. 2019 May 30. pii: kwz134. doi: 10.1093/aje/kwz134. [Epub ahead of print]

A Cross-Sectional Analysis of Telomere Length and Sleep in the Women's Health Initiative.

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Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York.
Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.
Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York.
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Program in Public Health, Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, New York.
Division of Research, Kaiser Permanente Northern California, Oakland, California.
Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California.
Department of Epidemiology, University of Washington, Seattle, Washington.


Telomere length is a heritable marker of cellular age that is associated with morbidity and mortality. Poor sleep behaviors, which are also associated with adverse health events, may be related to leukocyte telomere length (LTL). We studied a sub-population of 3,145 postmenopausal women enrolled 1993-1998 to the Women's Health Initiative (1,796 European American (EA), 1,349 African American (AA)) with Southern-blot measured LTL and self-reported usual sleep duration and sleep disturbance. LTL-sleep associations were analyzed separately for duration and disturbance using weighted and confounder-adjusted linear regression models in the entire sample (AA+EA; race-adjusted) and in race strata, as LTL differs by ancestry. Each additional hour of sleep beyond 5 hours, approximately, was associated with a 27 base pair (95% confidence interval (CI): 6, 48) longer LTL in AA+EA after covariate adjustment. Seep duration-LTL associations were strongest among AA (adjusted β = 37, 95% CI: 4, 70); a similar non-significant association was observed for EA (adjusted β = 20, 95% CI: -7, 48). Sleep disturbance was not associated with LTL in our study. Our models did not show departure from linearity (quadratic sleep terms P ≥ 0.55). Our results suggest that longer sleep duration is associated with longer LTL in postmenopausal women.


Telomere length; Women's Health Initiative; sleep; sleep disturbance; sleep duration


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