Self-reported sleep duration and coronary heart disease mortality: A large cohort study of 400,000 Taiwanese adults

Linn B Strand, Kuang Tsai Min , David Gunnell, Imre Janszky, Wen Chi Pang, Shu-Sen Chang

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Background Most previous studies on sleep duration and coronary heart disease (CHD) have been small and have inadequately controlled for cardiovascular risk factors and chronic diseases. Therefore, our aim was to prospectively examine the associations of sleep duration with CHD while accounting for these factors. Methods Prospective cohort study of 392 164 adults at age 20 years or older who attended a health check-up program from 1994 to 2011 in Taiwan and who have information on sleep duration, sleep medications and potential confounders. Participants answered the question: “How long do you sleep for?”—there were four response categories: (a) 0–4 h; (b) 4–6 h; (c) 6–8 h and (d) > 8 h. The participants were then followed for CHD mortality from the Taiwanese cause-of-death register. Results When compared to those who slept 6–8 h per night, the risk of dying from CHD was increased by 34% (HR 1.34, 95% Confidence Interval [CI] 0.87–2.07) and 35% (HR 1.35, 95% CI 1.11–1.65) in those who slept less than 4 h per night and more than 8 h per night, respectively. When stratifying by sex and age, we found some evidence for a stronger U-shaped association in females than in males and in older adults than in younger adults (p for interaction = 0.01 and 0.13, respectively). Conclusions Adequate sleep duration should be considered an important component of a healthy lifestyle. Further studies are needed to better elucidate the underlying mechanisms.
Original languageEnglish
Pages (from-to)246-251
Number of pages6
JournalInternational Journal of Cardiology
Early online date7 Jan 2016
Publication statusPublished - 15 Mar 2016


  • Sleep duration
  • Coronary heart disease
  • cardiovascular disease


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