American Journal of Epidemiology Advance Access originally published online on October 22, 2008
American Journal of Epidemiology 2008 168(12):1353-1364; doi:10.1093/aje/kwn337
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ORIGINAL CONTRIBUTIONS |
Correlates of Short and Long Sleep Duration: A Cross-Cultural Comparison Between the United Kingdom and the United States
The Whitehall II Study and the Western New York Health Study
Correspondence to Dr. Saverio Stranges, Cardiovascular Medicine and Epidemiology Group, Clinical Sciences Research Institute, University of Warwick Medical School, University Hospital–Warwickshire and Coventry Campus, Clifford Bridge Road, Coventry CV2 2DX, United Kingdom (e-mail: S.Stranges{at}warwick.ac.uk).
Received for publication April 14, 2008. Accepted for publication August 7, 2008.
The authors examined sociodemographic, lifestyle, and comorbidity factors that could confound or mediate U-shaped associations between sleep duration and health in 6,472 United Kingdom adults from the Whitehall II Study (1997–1999) and 3,027 US adults from the Western New York Health Study (1996–2001). Cross-sectional associations between short (<6 hours) and long (>8 hours) durations of sleep across several correlates were calculated as multivariable odds ratios. For short sleep duration, there were significant, consistent associations in both samples for unmarried status (United Kingdom: adjusted odds ratio (AOR) = 1.49, 95% confidence interval (CI): 1.15, 1.94; United States: AOR = 1.49, 95% CI: 1.10, 2.02), body mass index (AORs were 1.04 (95% CI: 1.01, 1.07) and 1.02 (95% CI: 1.00, 1.05)), and Short Form-36 physical (AORs were 0.96 (95% CI: 0.95, 0.98) and 0.97 (95% CI: 0.96, 0.98)) and mental (AORs were 0.95 (95% CI: 0.94, 0.96) and 0.98 (95% CI: 0.96, 0.99)) scores. For long sleep duration, there were fewer significant associations: age among men (AORs were 1.08 (95% CI: 1.01, 1.14) and 1.05 (95% CI: 1.02, 1.08)), low physical activity (AORs were 1.75 (95% CI: 0.97, 3.14) and 1.60 (95% CI: 1.09, 2.34)), and Short Form-36 physical score (AORs were 0.96 (95% CI: 0.93, 0.99) and 0.97 (95% CI: 0.95, 0.99)). Being unmarried, being overweight, and having poor general health are associated with short sleep and may contribute to observed disease associations. Long sleep may represent an epiphenomenon of comorbidity.
comorbidity; confounding factors (epidemiology); cross-cultural comparison; life style; sleep
Abbreviations: SF-36, Short Form-36; UK, United Kingdom
Editor's note: An invited commentary on this article appears on page 1365.
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Related articles in Am. J. Epidemiol.:
- Invited Commentary: Cross-Cultural Influences on Sleep—Broadening the Environmental Landscape
- Donald L. Bliwise
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