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

• Published in: American journal of epidemiology Vol. 168; no. 12; pp. 1353 - 1366
• Main Authors: STRANGES, Saverio, DORN, Joan M, CAPPUCCIO, Francesco P, SHIPLEY, Martin J, KANDALA, Ngianga-Bakwin, TREVISAN, Maurizio, MILLER, Michelle A, DONAHUE, Richard P, HOVEY, Kathleen M, FERRIE, Jane E, MARMOT, Michael G
• Format: Journal Article
• Language: English
• Published: Cary, NC Oxford University Press 15.12.2008; Oxford Publishing Limited (England)
• Subjects: Age Factors; Aged; Analysis. Health state; Biological and medical sciences; Cross cultural studies; Cross-Cultural Comparison; Demographics; Epidemiology; Female; Follow-Up Studies; General aspects; Health Status; Humans; Life Style; Male; Medical sciences; Middle Aged; Miscellaneous; New York - epidemiology; Original Contributions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Retrospective Studies; Risk Factors; Sex Factors; Sleep - physiology; Sleep deprivation; Sleep Wake Disorders - epidemiology; Sleep Wake Disorders - physiopathology; United Kingdom - epidemiology; New York; United Kingdom; United States; North America; Europe; America; United Kingdom > UK; United States > US; Human; confounding factors (epidemiology); cross-cultural comparison; Duration; Confounding factor; Epidemiology; Prospective; Concomitant disease; Sleep; comorbidity; Polypathology; Cohort study; Sleep wake cycle; Cultural aspect; Comparative study; Public health; Life style
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/aje/kwn337

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.