Mortality associated with short sleep duration: The evidence, the possible mechanisms, and the future

Grandner, Michael A.; Hale, Lauren; Moore, Melisa; Patel, Nirav P.

doi:10.1016/j.smrv.2009.07.006

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Volume 14, Issue 3 , Pages 191-203, June 2010

Mortality associated with short sleep duration: The evidence, the possible mechanisms, and the future

Michael A. Grandner
- Center for Sleep and Respiratory Neurobiology, Division of Sleep Medicine, Department of Medicine, University of Pennsylvania, 125 South 31st Street, Philadelphia, PA 19104, USA
- Corresponding author. Tel.: +1 215 615 1756; fax: +1 215 746 4814.
Lauren Hale
- Graduate Program in Public Health, Department of Preventive Medicine, State University of New York, Stony Brook, NY, USA
Melisa Moore
- Center for Sleep and Respiratory Neurobiology, Division of Sleep Medicine, Department of Medicine, University of Pennsylvania, 125 South 31st Street, Philadelphia, PA 19104, USA
- The Sleep Center, Division of Pulmonary Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
Nirav P. Patel
- Center for Sleep and Respiratory Neurobiology, Division of Sleep Medicine, Department of Medicine, University of Pennsylvania, 125 South 31st Street, Philadelphia, PA 19104, USA
- Division of Allergy and Respiratory Critical Care, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA

Summary

This review of the scientific literature examines the widely observed relationship between sleep duration and mortality. As early as 1964, data have shown that 7-h sleepers experience the lowest risks for all-cause mortality, whereas those at the shortest and longest sleep durations have significantly higher mortality risks. Numerous follow-up studies from around the world (e.g., Japan, Israel, Sweden, Finland, the United Kingdom) show similar relationships. We discuss possible mechanisms, including cardiovascular disease, obesity, physiologic stress, immunity, and socioeconomic status. We put forth a social–ecological framework to explore five possible pathways for the relationship between sleep duration and mortality, and we conclude with a four-point agenda for future research.

Keywords: Sleep duration, Mortality, Epidemiology, Health