A Prospective Study of Sleep Duration and Coronary Heart Disease in Women

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Abstract
ACCORDING TO a recent National Sleep Foundation poll,1 many Americans have long-term sleep deprivation. Only about one third of the population (37%) obtain 8 hours of sleep per night, and 31% report 6 or fewer hours of sleep each night. The long-range adverse health consequences of long-term sleep restriction are unclear. Most previous studies2-4 that have attempted to address this question lacked adequate power to assess clinical end points or were unable to control for potential confounders. However, short-term sleep restriction causes adverse physiologic effects. Short-term partial sleep deprivation (ie, 4 hours per night for 6 nights) imposed on a group of healthy subjects increased cortisol levels, decreased glucose tolerance, and increased sympathetic nervous system activity.5 In another study,6 partial sleep deprivation for one night (3.6 hours of sleep) in healthy subjects increased blood pressure and sympathetic activity compared with a night of normal sleep duration. Therefore, we hypothesized that sustained partial sleep deprivation could lead to adverse cardiovascular consequences. To test this possibility, we investigated the association between reported sleep duration and the incidence of major coronary heart disease (CHD)–related events during 10 years of follow-up among women enrolled in the Nurses' Health Study.