Background
Methods
Search strategy
Inclusion/exclusion criteria
Data extraction
Statistical analysis
Results
Eligible studies
Study characteristics
First author (year) | Baseline year | Country | Age (years) | Ascertainment of sleep | TST | Comparison | Mortality ascertainment | Adjustment |
---|---|---|---|---|---|---|---|---|
Kaplan (1987) | 1965 | USA | 60–94 | Questionnaire | Nighttime sleep | 7-8 h vs. ≤7 h | Death certificate | YES |
7-8 h vs. > 8 h | All-cause | |||||||
Seki (2001) | 1990 | Japan | 60–74 | Questionnaire | 24 h sleep | 7 h vs. ≤6 h | Death certificate | YES |
7 h vs. ≥9 h | All-cause | |||||||
Goto (2003) | 1987 | Japan | ≥65 | Questionnaire | Nighttime sleep | 6-7 h vs. < 6 h | Death certificate | YES |
6-7 h vs. ≥7 h | All-cause | |||||||
Lan (2007) | 1993 | China | ≥64 | Questionnaire | Nighttime sleep | 7–7.9 h vs. < 7 h | Death certificate | YES |
7–7.9 h vs. ≥10 h | All-cause, CVD, cancer | |||||||
Gangwisch (2008) | 1982 | USA | 60–86 | Questionnaire | Nighttime sleep | 7 h vs. ≤5 h | Death certificate and proxy interviews | YES |
7 h vs. ≥9 h | All-cause | |||||||
Stone (2009) | 1986 | USA | ≥68 | Questionnaire | Nighttime sleep | 6-8 h vs. < 6 h | Death certificate | YES |
6-8 h vs. ≥8 h | All-cause, CVD, cancer and other | |||||||
Suzuki (2009) | 1999 | Japan | 65–85 | Questionnaire | 24 h sleep | 7 h vs. ≤5 h | Death certificate | YES |
7 h vs. ≥10 h | All-cause and CVD | |||||||
Castro-Costa (2011) | 1997 | Brazil | > 60 | Questionnaire | 24 h sleep | 7–7.9 h vs. < 6 h | Death certificate and proxy interviews | YES |
7–7.9 h vs. ≥9 h | All-cause | |||||||
Kripke (2011) | 1995 | USA | 60–81 | Questionnaire & actigraphy | Nighttime sleep | 7 h vs. ≤5 h | Proxy interviews and social security death index | NO |
7 h vs. ≥9 h | All-cause | |||||||
Kronholm (2011) | 1972 | Finland | 60–64 | Questionnaire | Nighttime sleep | 7-8 h vs. ≤5 h | Death certificate and hospital discharge register | NO |
7-8 h vs. ≥10 h | All-cause and CVD | |||||||
Qiu (2011) | 2005 | China | ≥65 | Questionnaire | 24 h sleep | 6-8 h vs. ≤5 h | Death certificate | YES |
6-8 h vs. ≥9 h | All-cause | |||||||
Werle (2011) | 1994 | Brazil | ≥80 | Questionnaire | Nighttime sleep & 24 h sleep | ≤8 h vs. > 8 h | Death certificate, proxy interviews and patient records | YES |
All-cause and CVD | ||||||||
Cohen-Mansfield (2012) | 1989 | Israel | 75–94 | Questionnaire | Nighttime sleep | 7-9 h vs. < 7 h | Death certificate | YES |
7-9 h vs. ≥9 h | All-cause | |||||||
Chen (2013) | 1999 | China | > 65 | Questionnaire | Nighttime sleep | 7 h vs. ≤4 h | Death certificate | YES |
7 h vs. ≥9 h | All-cause, CVD, cancer | |||||||
Jung (2013) | 1984 | USA | 60–96 | Questionnaire | Nighttime sleep | 7-9 h vs. < 6 h | Death certificate or notice from a family member or published obituary | YES |
7-9 h vs. ≥9 h | All-cause | |||||||
Kakizaki (2013) | 1994 | Japan | ≥70 | Questionnaire | 24 h sleep | 7 h vs. ≤6 h | Death certificate | YES |
7 h vs. ≥10 h | All-cause, CVD, cancer and the other | |||||||
Kim (2013) | 1990 | USA | ≥65 | Questionnaire | 24 h sleep | 7 h vs. ≤5 h | Death certificate | YES |
7 h vs. ≥9 h | All-cause and CVD | |||||||
Yeo (2013) | 1993 | Korea | ≥60 | Questionnaire | 24 h sleep | 7 h vs. ≤5 h | Death certificate | YES |
7 h vs. ≥10 h | All-cause, CVD, cancer | |||||||
Lee (2014) | 2001 | China | > 65 | Questionnaire | Nighttime sleep | < 10 h vs. ≥10 h | Death certificate | YES |
All-cause | ||||||||
Hall (2015) | – | USA | 70–79 | Questionnaire | Nighttime sleep | 7 h vs. < 6 h | Death certificates, hospital records, informant interviews and autopsy data | YES |
7 h vs. > 8 h | All-cause | |||||||
Zuurbier (2015) | 2004 | Holland | 60–98 | Questionnaire & actigraphy | 24 h sleep | 6–7.5 hvs. < 6 h | Death certificate and patient records | YES |
6–7.5 hvs. > 7.5 h | All-cause | |||||||
Smagula (2016) | 2003 | USA | ≥65 | Questionnaire & actigraphy | 24 h sleep | 5-8 h vs. < 5 h | Death certificate | YES |
5-8 h vs. > 8 h | All-cause, CVD, cancer | |||||||
Akersted (2017) | 1997 | Swedish | ≥65 | Questionnaire | Nighttime sleep | 7 h vs. ≤5 h | Death certificate | YES |
7 h vs. ≥8 h | All-cause, CVD, cancer | |||||||
Beydoun (2017) | 2005 | USA | ≥65 | Questionnaire | Nighttime sleep | 7 h vs. < 7 h | Death certificate | YES |
7 h vs. > 8 h | All-cause | |||||||
Brostrom (2018) | 2003 | Sweden | 65–82 | Questionnaire | Nighttime sleep | 7-8 h vs. ≤6 h | Death certificate | NO |
7-8 h vs. ≥9 h | All-cause | |||||||
Cheng (2018) | 2009 | Singapore | ≥60 | Questionnaire | Nighttime sleep | 7-8 h vs. ≤6 h | Death certificate | YES |
7-8 h vs. ≥9 h | All-cause | |||||||
Akersted (2019) | 1997 | Swedish | ≥65 | Questionnaire | Nighttime sleep | 7 h vs. ≤4 h | Death certificate, | YES |
7 h vs. ≥8 h | All-cause, CVD, cancer | |||||||
Morgan (2019) | 1985 | UK | ≥65 | Questionnaire | Nighttime sleep | 7 h vs. ≤4 h | Death certificate | YES |
7 h vs. ≥9 h | All-cause | |||||||
4–9.9 h vs. ≥10 h | All-cause |
Published year | First author | Gender | Sample size | Age | Men | Women | Follow up (years) | Total deaths | Men deaths | Women deaths | Exposure (h) | Ref (h) | Adjusted | HR, 95% CI |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1987 | Kaplan | Men, Women | 4174 | 60–94 | – | – | 17 | – | – | – | > 8 | 7–8 | YES | 1.02, 0.87–1.19 |
1987 | Kaplan | Men, Women | 4174 | 60–94 | – | – | 17 | – | – | – | < 7 | 7–8 | YES | 1.02, 0.87–1.19 |
1987 | Kaplan | Men, Women | 4174 | 60–94 | – | – | 17 | – | – | – | > 8 | 7–8 | NO | 1.02, 0.87–1.21 |
1987 | Kaplan | Men, Women | 4174 | 60–94 | – | – | 17 | – | – | – | < 7 | 7–8 | NO | 1.02, 0.87–1.21 |
2011 | Kronholm | Men, Women | 1210 | 60–64 | – | – | 35 | 1065 | – | – | ≥10 | 7–8 | NO | 1.11, 1.05–1.18 |
2011 | Kronholm | Men, Women | 1210 | 60–64 | – | – | 35 | 1065 | – | – | ≤5 | 7–8 | NO | 1.07, 1.01–1.14 |
2008 | Gangwisch | Men, Women | 3983 | 60–86 | – | – | 10 | 1604 | – | – | ≥9 | 7 | YES | 1.36, 1.15–1.6 |
2008 | Gangwisch | Men, Women | 3983 | 60–86 | – | – | 10 | 1604 | – | – | ≤5 | 7 | YES | 1.27, 1.06–1.53 |
2008 | Gangwisch | Men, Women | 3983 | 60–86 | – | – | 10 | 1604 | – | – | ≥9 | 7 | NO | 1.98, 1.68–2.32 |
2008 | Gangwisch | Men, Women | 3983 | 60–86 | – | – | 10 | 1604 | – | – | ≤5 | 7 | NO | 1.72, 1.44–2.06 |
2013 | Jung | Men | 2001 | 60–96 | 889 | 1112 | 19 | 1224 | 632 | 592 | ≥9 | 7 | YES | 1.09, 0.82–1.45 |
2013 | Jung | Women | 2001 | 60–96 | 889 | 1112 | 19 | 1224 | 632 | 592 | ≥9 | 7 | YES | 1.51, 1.05–2.18 |
2013 | Jung | Men | 2001 | 60–96 | 889 | 1112 | 19 | 1224 | 632 | 592 | ≤5 | 7 | YES | 0.98, 0.67–1.43 |
2013 | Jung | Women | 2001 | 60–96 | 889 | 1112 | 19 | 1224 | 632 | 592 | ≤5 | 7 | YES | 1.11, 0.77–1.6 |
2013 | Jung | Men | 2001 | 60–96 | 889 | 1112 | 19 | 1224 | 632 | 592 | ≥9 | 7 | NO | 1.18, 0.92–1.52 |
2013 | Jung | Women | 2001 | 60–96 | 889 | 1112 | 19 | 1224 | 632 | 592 | ≥9 | 7 | NO | 1.50, 1.12–2.00 |
2013 | Jung | Men | 2001 | 60–96 | 889 | 1112 | 19 | 1224 | 632 | 592 | ≤5 | 7 | NO | 1.10, 0.79–1.55 |
2013 | Jung | Women | 2001 | 60–96 | 889 | 1112 | 19 | 1224 | 632 | 592 | ≤5 | 7 | NO | 1.07, 0.79–1.44 |
2019 | Morgan | Men, Women | 960 | ≥65 | 375 | 585 | 27 | 927 | – | – | ≥9 | 7 | YES | 1.18, 0.85–1.63 |
2019 | Morgan | Men, Women | 960 | ≥65 | 375 | 585 | 27 | 927 | – | – | ≤4 | 7 | YES | 1.08, 0.83–1.40 |
2019 | Morgan | Men, Women | 960 | ≥65 | 375 | 585 | 27 | 927 | – | – | ≥9 | 7 | NO | 1.40, 1.08–1.83 |
2019 | Morgan | Men, Women | 960 | ≥65 | 375 | 585 | 27 | 927 | – | – | ≤4 | 7 | NO | 1.02, 0.80–1.29 |
2009 | Stone | Women | 8101 | ≥68 | 0 | 8101 | 6.9 | 1922 | 0 | 1922 | > 8 | 6–8 | YES | 1.16, 0.97–1.39 |
2009 | Stone | Women | 8101 | ≥68 | 0 | 8101 | 6.9 | 1922 | 0 | 1922 | < 6 | 6–8 | YES | 1.02, 0.87–1.19 |
2009 | Stone | Women | 8101 | ≥68 | 0 | 8101 | 6.9 | 1922 | 0 | 1922 | ≥10 | 8–9 | YES | 1.58, 1.27–1.95 |
2009 | Stone | Women | 8101 | ≥68 | 0 | 8101 | 6.9 | 1922 | 0 | 1922 | < 6 | 8–9 | YES | 0.95, 0.76–1.18 |
2003 | Goto | Men | 724 | ≥65 | 251 | 473 | 12 | 305 | 139 | 166 | > 7 | 6–7 | YES | 1.54, 0.92–2.58 |
2003 | Goto | Women | 724 | ≥65 | 251 | 473 | 12 | 305 | 139 | 166 | > 7 | 6–7 | YES | 1.40, 0.91–2.15 |
2003 | Goto | Men | 724 | ≥65 | 251 | 473 | 12 | 305 | 139 | 166 | < 6 | 6–7 | YES | 1.29, 0.50–3.34 |
2003 | Goto | Women | 724 | ≥65 | 251 | 473 | 12 | 305 | 139 | 166 | < 6 | 6–7 | YES | 2.62, 1.36–5.07 |
2003 | Goto | Men | 724 | ≥65 | 251 | 473 | 12 | 305 | 139 | 166 | > 7 | 6–7 | NO | 1.62, 0.99–2.66 |
2003 | Goto | Women | 724 | ≥65 | 251 | 473 | 12 | 305 | 139 | 166 | > 7 | 6–7 | NO | 1.60, 1.06–2.42 |
2003 | Goto | Men | 724 | ≥65 | 251 | 473 | 12 | 305 | 139 | 166 | < 6 | 6–7 | NO | 1.42, 0.61–3.27 |
2003 | Goto | Women | 724 | ≥65 | 251 | 473 | 12 | 305 | 139 | 166 | < 6 | 6–7 | NO | 2.65, 1.42–4.95 |
2012 | Cohen-Mansfield | Men, Women | 1166 | ≥75 | – | – | 20 | 1108 | – | – | > 9 | 7–9 | YES | 1.32, 1.09–1.58 |
2012 | Cohen-Mansfield | Men, Women | 1166 | ≥75 | – | – | 20 | 1108 | – | – | < 7 | 7–9 | YES | 0.98, 0.84–1.13 |
2012 | Cohen-Mansfield | Men, Women | 1166 | ≥75 | – | – | 20 | 1108 | – | – | > 9 | 7–9 | NO | 1.29, 1.11–1.52 |
2012 | Cohen-Mansfield | Men, Women | 1166 | ≥75 | – | – | 20 | 1108 | – | – | < 7 | 7–9 | NO | 0.81, 0.71–0.93 |
2013 | Kim | Men, Women | – | 65–69 | – | – | 12.9 | 4764 | – | – | ≥9 | 7 | YES | 1.25, 1.14–1.38 |
2013 | Kim | Men, Women | – | 65–69 | – | – | 12.9 | 4764 | – | – | ≤5 | 7 | YES | 1.13, 1.02–1.26 |
2013 | Kim | Men, Women | – | ≥70 | – | – | 12.9 | 6444 | – | – | ≥9 | 7 | YES | 1.14, 1.05–1.24 |
2013 | Kim | Men, Women | – | ≥70 | – | – | 12.9 | 6444 | – | – | ≤5 | 7 | YES | 1.09, 0.99–1.19 |
2001 | Seki | Men, Women | 1065 | 60–74 | 440 | 625 | 7.5 | 123 | 77 | 46 | ≥9 | 7 | YES | 0.97, 0.50–1.90 |
2001 | Seki | Men, Women | 1065 | 60–74 | 440 | 625 | 7.5 | 123 | 77 | 46 | < 6 | 7 | YES | 1.74, 0.72–4.24 |
2001 | Seki | Men, Women | 1065 | 60–74 | 440 | 625 | 7.5 | 123 | 77 | 46 | ≥9 | 7 | NO | 1.00, 0.52–1.96 |
2001 | Seki | Men, Women | 1065 | 60–74 | 440 | 625 | 7.5 | 123 | 77 | 46 | < 6 | 7 | NO | 2.17, 0.91–5.21 |
2007 | Lan | Men | 3079 | ≥64 | 1748 | 1331 | 10 | 1338 | 816 | 522 | ≥10 | 7–7.9 | YES | 1.51, 1.19–1.92 |
2007 | Lan | Women | 3079 | ≥64 | 1748 | 1331 | 10 | 1338 | 816 | 522 | ≥10 | 7–7.9 | YES | 2.06, 1.50–2.83 |
2007 | Lan | Men | 3079 | ≥64 | 1748 | 1331 | 10 | 1338 | 816 | 522 | < 7 | 7–7.9 | YES | 0.98, 0.76–1.25 |
2007 | Lan | Women | 3079 | ≥64 | 1748 | 1331 | 10 | 1338 | 816 | 522 | < 7 | 7–7.9 | YES | 1.14, 0.77–1.67 |
2007 | Lan | Men | 3079 | ≥64 | 1748 | 1331 | 10 | 1338 | 816 | 522 | ≥10 | 7–7.9 | NO | 1.86, 1.48–2.34 |
2007 | Lan | Women | 3079 | ≥64 | 1748 | 1331 | 10 | 1338 | 816 | 522 | ≥10 | 7–7.9 | NO | 2.49, 1.84–3.37 |
2007 | Lan | Men | 3079 | ≥64 | 1748 | 1331 | 10 | 1338 | 816 | 522 | < 7 | 7–7.9 | NO | 0.97, 0.76–1.23 |
2007 | Lan | Women | 3079 | ≥64 | 1748 | 1331 | 10 | 1338 | 816 | 522 | < 7 | 7–7.9 | NO | 1.04, 0.71–1.51 |
2013 | Yeo | Men, Women | 5538 | ≥60 | – | – | 9.4 | 1223 | – | – | ≥10 | 7 | YES | 1.48, 1.13–1.93 |
2013 | Yeo | Men, Women | 5538 | ≥60 | – | – | 9.4 | 1223 | – | – | ≤5 | 7 | YES | 1.23, 1.03–1.47 |
2013 | Kakizaki | Men, Women | 9690 | ≥70 | – | – | 10.8 | 3960 | – | – | ≥9 | 7–7.9 | YES | 1.33, 1.24–1.43 |
2013 | Kakizaki | Men, Women | 9690 | ≥70 | – | – | 10.8 | 3960 | – | – | < 6 | 7–7.9 | YES | 0.98, 0.87–1.10 |
2011 | Werle | Men, Women | 187 | ≥80 | 68 | 119 | 8.7 | 141 | 56 | 85 | > 8 | 7 | YES | 0.95, 0.89–1.02 |
2011 | Werle | Men, Women | 187 | ≥80 | 68 | 119 | 8.7 | 141 | 56 | 85 | > 8 | 7 | NO | 0.95, 0.90–1.01 |
2011 | Kripke | Women | 355 | 60–81 | – | – | 10.5 | 79 | – | – | ≥9 | 7–7.9 | NO | 0.93, 0.37–2.35 |
2011 | Kripke | Women | 355 | 60–81 | – | – | 10.5 | 79 | – | – | ≤5 | 7 | NO | 0.83, 0.4–1.73 |
2017 | Akersted | Men, Women | 8089 | ≥65 | 3879 | 4210 | 13 | 2337 | – | – | ≥8 | 7 | YES | 1.01, 0.90–1.14 |
2017 | Akersted | Men, Women | 8089 | ≥65 | 3879 | 4210 | 13 | 2337 | – | – | ≤5 | 7 | YES | 1.05, 0.90–1.22 |
2017 | Akersted | Men, Women | 8089 | ≥65 | 3879 | 4210 | 13 | 2337 | – | – | ≥8 | 7 | NO | 1.06, 0.96–1.19 |
2017 | Akersted | Men, Women | 8089 | ≥65 | 3879 | 4210 | 13 | 2337 | – | – | ≤5 | 7 | NO | 1.02, 0.90–1.16 |
2011 | Castro-Costa | Men, Women | 1512 | > 60 | – | – | 7.5 | 440 | – | – | ≥9 | 7–7.9 | YES | 1.56, 1.12–2.18 |
2011 | Castro-Costa | Men, Women | 1512 | > 60 | – | – | 7.5 | 440 | – | – | < 6 | 7–7.9 | YES | 0.88, 0.61–1.28 |
2011 | Castro-Costa | Men, Women | 1512 | > 60 | – | – | 7.5 | 440 | – | – | ≥9 | 7–7.9 | NO | 1.84, 1.40–2.43 |
2011 | Castro-Costa | Men, Women | 1512 | > 60 | – | – | 7.5 | 440 | – | – | < 6 | 7–7.9 | NO | 1.01, 0.75–1.37 |
2013 | Chen | Men, Women | 4064 | > 65 | 2269 | 1795 | 9 | 1004 | 336 | 668 | ≥9 | 7 | YES | 1.66, 1.28–2.17 |
2013 | Chen | Men, Women | 4064 | > 65 | 2269 | 1795 | 9 | 1004 | 336 | 668 | ≤4 | 7 | YES | 1.00, 0.75–1.33 |
2009 | Suzuki | Men, Women | 11,395 | 65–85 | 5825 | 5570 | 7 | 1004 | 689 | 315 | ≥10 | 7 | YES | 1.96, 1.49–2.57 |
2009 | Suzuki | Men, Women | 11,395 | 65–85 | 5825 | 5570 | 7 | 1004 | 689 | 315 | ≤5 | 7 | YES | 0.92, 0.66–1.28 |
2009 | Suzuki | Men | 11,395 | 65–85 | 5825 | 5570 | 7 | 1004 | 689 | 315 | ≥10 | 7 | YES | 1.86, 1.34–2.56 |
2009 | Suzuki | Women | 11,395 | 65–85 | 5825 | 5570 | 7 | 1004 | 689 | 315 | ≥10 | 7 | YES | 2.27, 1.37–3.76 |
2009 | Suzuki | Men | 11,395 | 65–85 | 5825 | 5570 | 7 | 1004 | 689 | 315 | ≤5 | 7 | YES | 1.08, 0.72–1.61 |
2009 | Suzuki | Women | 11,395 | 65–85 | 5825 | 5570 | 7 | 1004 | 689 | 315 | ≤5 | 7 | YES | 0.71, 0.39–1.29 |
2009 | Suzuki | Men, Women | 11,395 | 65–85 | 5825 | 5570 | 7 | 1004 | 689 | 315 | ≥10 | 7 | NO | 2.29, 1.75–3.00 |
2009 | Suzuki | Men, Women | 11,395 | 65–85 | 5825 | 5570 | 7 | 1004 | 689 | 315 | ≤5 | 7 | NO | 1.03, 0.74–1.43 |
2009 | Suzuki | Men | 11,395 | 65–85 | 5825 | 5570 | 7 | 1004 | 689 | 315 | ≥10 | 7 | NO | 2.16, 1.57–2.98 |
2009 | Suzuki | Women | 11,395 | 65–85 | 5825 | 5570 | 7 | 1004 | 689 | 315 | ≥10 | 7 | NO | 2.65, 1.61–4.37 |
2009 | Suzuki | Men | 11,395 | 65–85 | 5825 | 5570 | 7 | 1004 | 689 | 315 | ≤5 | 7 | NO | 1.16, 0.78–1.73 |
2009 | Suzuki | Women | 11,395 | 65–85 | 5825 | 5570 | 7 | 1004 | 689 | 315 | ≤5 | 7 | NO | 0.82, 0.46–1.48 |
2014 | Lee | Men | 3427 | > 65 | 1745 | 1682 | 5 | 297 | 221 | 76 | ≥10 | < 10 | YES | 1.75, 1.09–2.81 |
2014 | Lee | Women | 3427 | > 65 | 1745 | 1682 | 5 | 297 | 221 | 76 | ≥10 | < 10 | YES | 2.88, 1.01–8.20 |
2014 | Lee | Men | 3427 | > 65 | 1745 | 1682 | 5 | 297 | 221 | 76 | ≥10 | < 10 | NO | 2.10, 1.33–3.33 |
2014 | Lee | Women | 3427 | > 65 | 1745 | 1682 | 5 | 297 | 221 | 76 | ≥10 | < 10 | NO | 2.70, 0.98–7.46 |
2018 | Brostrom | Men | 630 | 65–82 | 301 | 329 | 6 | 144 | 86 | 58 | ≥9 | 7–8 | YES | 1.10, 0.1–10.30 |
2018 | Brostrom | Women | 630 | 65–82 | 301 | 329 | 6 | 144 | 86 | 58 | ≥9 | 7–8 | YES | 0.35, 0.10–26.90 |
2018 | Brostrom | Men | 630 | 65–82 | 301 | 329 | 6 | 144 | 86 | 58 | ≤6 | 7–8 | YES | 0.60, 0.10–2.90 |
2018 | Brostrom | Women | 630 | 65–82 | 301 | 329 | 6 | 144 | 86 | 58 | ≤6 | 7–8 | YES | 0.34, 0.10–1.90 |
2016 | Smagula | Men | 2531 | ≥65 | 2531 | 0 | 7.4 | 628 | 628 | 0 | > 8 | 5–8 | YES | 0.83, 0.71–1.31 |
2016 | Smagula | Men | 2531 | ≥65 | 2531 | 0 | 7.4 | 628 | 628 | 0 | < 5 | 5–8 | YES | 1.12, 0.89–1.42 |
2016 | Smagula | Men | 2531 | ≥65 | 2531 | 0 | 7.4 | 628 | 628 | 0 | > 8 | 5–8 | NO | 1.02, 0.76–1.37 |
2016 | Smagula | Men | 2531 | ≥65 | 2531 | 0 | 7.4 | 628 | 628 | 0 | < 5 | 5–8 | NO | 1.28, 1.02–1.62 |
2015 | Zuurbier | Men, Women | 1073 | 60–98 | – | – | 7.3 | 142 | – | – | > 7.5 | 6–7.5 | YES | 1.24, 0.73–2.10 |
2015 | Zuurbier | Men, Women | 1073 | 60–98 | – | – | 7.3 | 142 | – | – | < 6 | 6–7.5 | YES | 1.12, 0.75–1.68 |
2011 | Qiu | Men, Women | 12,671 | ≥65 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≥10 | 8 | YES | 1.09, 1.00–1.180 |
2011 | Qiu | Men, Women | 12,671 | ≥65 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≤5 | 8 | YES | 0.97, 0.88–1.08 |
2011 | Qiu | Men | 12,671 | ≥65 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≥10 | 8 | YES | 1.22, 1.08–1.38 |
2011 | Qiu | Women | 12,671 | ≥65 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≥10 | 8 | YES | 1.00, 0.90–1.11 |
2011 | Qiu | Men | 12,671 | ≥65 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≤5 | 8 | YES | 1.17, 1.01–1.38 |
2011 | Qiu | Women | 12,671 | ≥65 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≤5 | 8 | YES | 0.85, 0.75–0.98 |
2011 | Qiu | Men, Women | 12,671 | 65–79 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≥10 | 8 | YES | 1.17, 0.88–1.54 |
2011 | Qiu | Men, Women | 12,671 | 65–79 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≤5 | 8 | YES | 1.00, 0.74–1.35 |
2011 | Qiu | Men, Women | 12,671 | ≥80 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≥10 | 8 | YES | 1.08, 0.99–1.18 |
2011 | Qiu | Men, Women | 12,671 | ≥80 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≤5 | 8 | YES | 0.97, 0.87–1.08 |
2011 | Qiu | Men, Women | 12,671 | ≥65 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≥10 | 8 | NO | 1.22, 1.13–1.32 |
2011 | Qiu | Men, Women | 12,671 | ≥65 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≤5 | 8 | NO | 1.19, 1.08–1.32 |
2011 | Qiu | Men | 12,671 | ≥65 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≥10 | 8 | NO | 1.36, 1.20–1.54 |
2011 | Qiu | Women | 12,671 | ≥65 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≥10 | 8 | NO | 1.12, 1.02–1.25 |
2011 | Qiu | Men | 12,671 | ≥65 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≤5 | 8 | NO | 1.47, 1.26–1.71 |
2011 | Qiu | Women | 12,671 | ≥65 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≤5 | 8 | NO | 1.03, 0.90–1.17 |
2011 | Qiu | Men, Women | 12,671 | 65–79 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≥10 | 8 | NO | 1.46, 1.11–1.91 |
2011 | Qiu | Men, Women | 12,671 | 65–79 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≤5 | 8 | NO | 1.32, 0.98–1.77 |
2011 | Qiu | Men, Women | 12,671 | ≥80 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≥10 | 8 | NO | 1.21, 1.12–1.32 |
2011 | Qiu | Men, Women | 12,671 | ≥80 | 5421 | 7250 | 3 | 5199 | 2067 | 3132 | ≤5 | 8 | NO | 1.18, 1.06–1.31 |
2017 | Beydoun | Men, Women | 2173 | ≥65 | – | – | 4.5 | – | – | – | > 8 | 7–8 | YES | 1.30, 0.73–2.29 |
2017 | Beydoun | Men, Women | 2173 | ≥65 | – | – | 4.5 | – | – | – | < 7 | 7–8 | YES | 0.96, 0.68–1.35 |
2017 | Beydoun | Men, Women | 2173 | ≥65 | – | – | 4.5 | – | – | – | > 8 | 7–8 | NO | 1.90, 1.44–2.50 |
2017 | Beydoun | Men, Women | 2173 | ≥65 | – | – | 4.5 | – | – | – | < 7 | 7–8 | NO | 1.20, 0.94–1.52 |
2018 | Cheng | Men, Women | 2448 | ≥60 | 1167 | 1281 | 4 | 274 | – | – | ≥9 | 7–8 | YES | 2.24, 1.05–4.77 |
2018 | Cheng | Men, Women | 2448 | ≥60 | 1167 | 1281 | 4 | 274 | – | – | ≤6 | 7–8 | YES | 2.14, 1.12–4.11 |
2018 | Cheng | Men, Women | 2448 | ≥60 | 1167 | 1281 | 4 | 274 | – | – | ≥9 | 7–8 | NO | 2.87, 1.36–6.05 |
2018 | Cheng | Men, Women | 2448 | ≥60 | 1167 | 1281 | 4 | 274 | – | – | ≤6 | 7–8 | NO | 2.69, 1.44–5.03 |
2015 | Hall | Men, Women | 3013 | ≥70 | 1463 | 1550 | 8.2 | 953 | – | – | > 8 | 7 | YES | 1.23, 0.93–1.63 |
2015 | Hall | Men, Women | 3013 | ≥70 | 1463 | 1550 | 8.2 | 953 | – | – | < 6 | 7 | YES | 1.06, 0.83–1.34 |
2015 | Hall | Men, Women | 3013 | ≥70 | 1463 | 1550 | 8.2 | 953 | – | – | > 8 | 7 | NO | 1.49, 1.15–1.93 |
2015 | Hall | Men, Women | 3013 | ≥70 | 1463 | 1550 | 8.2 | 953 | – | – | < 6 | 7 | NO | 1.30, 1.05–1.61 |
2019 | Akersted | Men, Women | – | ≥65 | – | – | 13 | – | – | – | ≥9 | 7 | YES | 0.99, 0.84–1.09 |
2019 | Akersted | Men, Women | – | ≥65 | – | – | 13 | – | – | – | ≤4 | 7 | YES | 0.97, 0.81–1.18 |
2019 | Akersted | Men, Women | – | ≥65 | – | – | 13 | – | – | – | ≥9 | 7 | YES | 0.91, 0.66–1.25 |
Quality assessment
First author | Published year | Representative of the exposed cohort | Selection of the non-exposed cohort | Ascertainment of exposed | Demonstration that outcome of interest was no present at start of study | Control for important cohort | Additional factors | Assessment of outcome | Follow up | Adequacy of follow up | Score |
---|---|---|---|---|---|---|---|---|---|---|---|
Kaplan | 1987 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 8 |
Seki | 2001 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 8 |
Goto | 2003 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 7 |
Lan | 2007 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 7 |
Gangwisch | 2008 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 7 |
Stone | 2009 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 8 |
Suzuki | 2009 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 8 |
Kronholm | 2011 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 6 |
Werle | 2011 | 1 | 1 | 0 | 1 | 0 | 1 | 1 | 1 | 0 | 6 |
Kripke | 2011 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 1 | 8 |
Castro-Costa | 2011 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 7 |
Qiu | 2011 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 8 |
Cohen-Mansfield | 2012 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 8 |
Jung | 2013 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 8 |
Kim | 2013 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 7 |
Yeo | 2013 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 7 |
Kakizaki | 2013 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 8 |
Chen | 2013 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 8 |
Lee | 2014 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 7 |
Zuurbier | 2015 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 9 |
Hall | 2015 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 7 |
Smagula | 2016 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 9 |
Akersted | 2017 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 7 |
Beydoun | 2017 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 7 |
Brostrom | 2018 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 1 | 7 |
Cheng | 2018 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 7 |
Morgan | 2019 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 8 |
Akersted | 2019 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 7 |
Overall analyses
Group | Number of qualified studies | Short sleep duration | Long sleep duration | ||
---|---|---|---|---|---|
HR (95% CI); P | I2 | HR (95% CI); P | I2 | ||
Overall analyses | |||||
Mortality (unadjusted) | 23/26 | 1.15 (1.06–1.25); <.001 | 71.5% | 1.43 (1.30–1.58); <.001 | 88.6% |
Mortality (adjusted) | 32/36 | 1.04 (1.00–1.09); .033 | 16.1% | 1.24 (1.16–1.33); <.001 | 76.2% |
Subgroup analyses based on adjusted mortality | |||||
By gender | |||||
Both genders | 20/23 | 1.04 (0.99–1.08); .096 | 11.1% | 1.20 (1.11–1.29); <.001 | 79.0% |
Men | 8/8 | 1.13 (1.04–1.24); .007 | 0.0% | 1.31 (1.10–1.58); .003 | 62.3% |
Women | 8/9 | 1.00 (0.85–1.18); .999 | 58.6% | 1.48 (1.18–1.86); .001 | 80.4% |
By country | |||||
America | 12/13 | 1.08 (1.03–1.14); .002 | 0.0% | 1.19 (1.07–1.31); .001 | 78.2% |
Europe | 6/7 | 1.03 (0.93–1.14); .627 | 0.0% | 1.01 (0.93–1.09); .823 | 0.0% |
Asia | 14/16 | 1.04 (0.96–1.12); .384 | 40.6% | 1.41 (1.26–1.57); <.001 | 75.4% |
By total sleep time | |||||
Nighttime | 19/23 | 1.05 (0.99–1.13); .113 | 17.8% | 1.25 (1.13–1.38); <.001 | 73.7% |
24 h | 13/13 | 1.04 (0.99–1.10); .146 | 19.9% | 1.25 (1.14–1.36); <.001 | 76.2% |
By ascertainment of sleep | |||||
Questionnaire | 30/34 | 1.04 (1.00–1.09); .055 | 20.5% | 1.26 (1.17–1.35); <.001 | 76.8% |
Actigraphy | 1/1 | 1.12 (0.89–1.42); .342 | ─* | 0.83 (0.61–1.13); .233 | ─ |
Both | 1/1 | 1.12 (0.75–1.68); .582 | ─ | 1.24 (0.73–2.10); .425 | ─ |
By follow-up (years) | |||||
≥ 7.5 | 20/22 | 1.07 (1.02–1.12); .006 | 15.2% | 1.24 (1.14–1.34); <.001 | 80.2% |
< 7.5 | 13/14 | 0.99 (0.93–1.05); .736 | 0.0% | 1.27 (1.12–1.45); <.001 | 68.3% |
By age | |||||
< 65 | 11/11 | 1.21 (1.02–1.23); .018 | 18.2% | 1.38 (1.19–1.60); <.001 | 61.5% |
≥ 65 | 21/25 | 1.03 (0.99–1.07); .193 | 4.2% | 1.20 (1.11–1.30); <.001 | 78.2% |
Dose-analysis | |||||
≤ 5 h | 15 | 1.06 (1.01–1.11); .014 | 12.3% | ─ | ─ |
≤ 6 h | 27 | 1.05 (1.01–1.10); .031 | 26.7% | ─ | ─ |
≤ 7 h | 32 | 1.04 (1.00–1.09); .033 | 16.1% | ─ | ─ |
≥ 8 h | 33 | ─ | ─ | 1.24 (1.16–1.33); <.001 | 77.9% |
≥ 9 h | 26 | ─ | ─ | 1.31 (1.21–1.41); <.001 | 71.9% |
≥ 10 h | 10 | ─ | ─ | 1.45 (1.24–1.70); <.001 | 82.6% |