Volume 57, Issue 4 p. 604-611

Self-Reported Sleep and Nap Habits and Risk of Mortality in a Large Cohort of Older Women

Katie L. Stone PhD

Katie L. Stone PhD

From the * Research Institute, California Pacific Medical Center, San Francisco, California Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California Department of Psychiatry, University of California at San Diego, San Diego, California § Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota # Center for Clinical Investigation and Department of Medicine, Case Western Reserve University, Cleveland, Ohio ** Department of Medicine, University of California at San Francisco, San Francisco, California †† Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; and ‡‡ Kaiser Permanente Center for Health Research, Portland, Oregon.

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Susan K. Ewing MS

Susan K. Ewing MS

From the * Research Institute, California Pacific Medical Center, San Francisco, California Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California Department of Psychiatry, University of California at San Diego, San Diego, California § Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota # Center for Clinical Investigation and Department of Medicine, Case Western Reserve University, Cleveland, Ohio ** Department of Medicine, University of California at San Francisco, San Francisco, California †† Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; and ‡‡ Kaiser Permanente Center for Health Research, Portland, Oregon.

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Sonia Ancoli-Israel PhD

Sonia Ancoli-Israel PhD

From the * Research Institute, California Pacific Medical Center, San Francisco, California Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California Department of Psychiatry, University of California at San Diego, San Diego, California § Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota # Center for Clinical Investigation and Department of Medicine, Case Western Reserve University, Cleveland, Ohio ** Department of Medicine, University of California at San Francisco, San Francisco, California †† Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; and ‡‡ Kaiser Permanente Center for Health Research, Portland, Oregon.

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Kristine E. Ensrud MD

Kristine E. Ensrud MD

From the * Research Institute, California Pacific Medical Center, San Francisco, California Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California Department of Psychiatry, University of California at San Diego, San Diego, California § Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota # Center for Clinical Investigation and Department of Medicine, Case Western Reserve University, Cleveland, Ohio ** Department of Medicine, University of California at San Francisco, San Francisco, California †† Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; and ‡‡ Kaiser Permanente Center for Health Research, Portland, Oregon.

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Susan Redline MD

Susan Redline MD

From the * Research Institute, California Pacific Medical Center, San Francisco, California Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California Department of Psychiatry, University of California at San Diego, San Diego, California § Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota # Center for Clinical Investigation and Department of Medicine, Case Western Reserve University, Cleveland, Ohio ** Department of Medicine, University of California at San Francisco, San Francisco, California †† Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; and ‡‡ Kaiser Permanente Center for Health Research, Portland, Oregon.

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Douglas C. Bauer MD

Douglas C. Bauer MD

From the * Research Institute, California Pacific Medical Center, San Francisco, California Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California Department of Psychiatry, University of California at San Diego, San Diego, California § Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota # Center for Clinical Investigation and Department of Medicine, Case Western Reserve University, Cleveland, Ohio ** Department of Medicine, University of California at San Francisco, San Francisco, California †† Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; and ‡‡ Kaiser Permanente Center for Health Research, Portland, Oregon.

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Jane A. Cauley DrPH

Jane A. Cauley DrPH

From the * Research Institute, California Pacific Medical Center, San Francisco, California Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California Department of Psychiatry, University of California at San Diego, San Diego, California § Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota # Center for Clinical Investigation and Department of Medicine, Case Western Reserve University, Cleveland, Ohio ** Department of Medicine, University of California at San Francisco, San Francisco, California †† Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; and ‡‡ Kaiser Permanente Center for Health Research, Portland, Oregon.

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Teresa A. Hillier MD

Teresa A. Hillier MD

From the * Research Institute, California Pacific Medical Center, San Francisco, California Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California Department of Psychiatry, University of California at San Diego, San Diego, California § Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota # Center for Clinical Investigation and Department of Medicine, Case Western Reserve University, Cleveland, Ohio ** Department of Medicine, University of California at San Francisco, San Francisco, California †† Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; and ‡‡ Kaiser Permanente Center for Health Research, Portland, Oregon.

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Steven R. Cummings MD

Steven R. Cummings MD

From the * Research Institute, California Pacific Medical Center, San Francisco, California Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California Department of Psychiatry, University of California at San Diego, San Diego, California § Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota # Center for Clinical Investigation and Department of Medicine, Case Western Reserve University, Cleveland, Ohio ** Department of Medicine, University of California at San Francisco, San Francisco, California †† Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; and ‡‡ Kaiser Permanente Center for Health Research, Portland, Oregon.

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First published: 02 April 2009
Citations: 107
Address correspondence to Katie L. Stone, San Francisco Coordinating Center, California Pacific Medical Center Research Institute, 185 Berry Street, Lobby 5, 5th floor, Suite 5700, San Francisco, CA 94107. E-mail: [email protected]

Abstract

OBJECTIVES: To determine the association between self-reported sleep and nap habits and mortality in a large cohort of older women.

DESIGN: Study of Osteoporotic Fractures prospective cohort study.

SETTING: Four communities within the United States.

PARTICIPANTS: Eight thousand one hundred one Caucasian women aged 69 and older (mean age 77.0).

MEASUREMENTS: Sleep and nap habits were assessed using a questionnaire at the fourth clinic visit (1993/94). Deaths during 7 years of follow-up were confirmed with death certificates. Underlying cause of death was assigned according to the International Classification of Diseases, Ninth Revision, Clinical Modification.

RESULTS: In multivariate models, women who reported napping daily were 44% more likely to die from any cause (95% confidence interval (CI)=1.23–1.67), 58% more likely to die from cardiovascular causes (95% CI=1.25–2.00), and 59% more likely to die from noncardiovascular noncancer causes (95% CI=1.24–2.03) than women who did not nap daily. This relationship remained significant in relatively healthy women (those who reported no comorbidities). Women who slept 9 to 10 hours per 24 hours were at greater risk of death from cardiovascular and other (noncardiovascular, noncancer) causes than those who reported sleeping 8 to 9 hours.

CONCLUSION: Older women who reported napping daily or sleeping at least 9 hours per 24 hours are at greater risk of death from all causes except cancer. Future research could determine whether specific sleep disorders contribute to these relationships.