Sleep and Biological Rhythms

, Volume 16, Issue 2, pp 253–258 | Cite as

Simple sleep questions can predict 12-year mortality in a rural population

  • Christina Darviri
  • Artemios Artemiadis
  • Xanthi Tigani
  • Panagiota Darvyri
  • Charalambos Gnardellis
Original Article


There is apt evidence in favor of a significant association between sleep and mortality. So far, most studies examine sleep problems using comprehensive, time-consuming tools and questions. In this study, we investigated the ability of four simple “yes” or “no” answered questions (i.e. easiness to fall asleep, restful upon awakening, sleep satisfaction and presence of insomnia) to predict 12-year all-cause and cardiovascular mortality in a rural population of 1519 citizens. The sample consisted of 652 males and 867 females, with a mean age of 56.9 years old (range 15–102 years old). Age, gender, education, smoking, body mass index and health status were used as confounders in the Cox proportional hazard models. 293 (19.3%) deaths were recorded. After adjusting for confounders, difficulty to fall asleep was significantly related to an increased risk of cardiovascular death in smokers (aHR 3.71, 95% CI 1.01–13.62). Male individuals, not feeling restful upon awakening were at a significantly increased risk of all-cause (aHR 2.08, 95% CI 1.33–3.24) and cardiovascular mortality (aHR 6.24, 95% CI 1.90–20.49), in the latter case only if they were non-smokers. Smokers, not satisfied with their sleep, were at a significantly increased risk of cardiovascular death (aHR 5.44, 95% CI 1.73–17.09). The presence of insomnia significantly increased the risk of all-cause mortality (aHR 8.10, 95% CI 1.66–39.57) in smokers of basic education and cardiovascular mortality (aHR 26.68 95% CI 4.78–148.49) in smokers. In conclusion, simple sleep questions can predict mortality, at least in rural populations. Future studies should expand these results to other populations.


Sleep Mortality Cardiovascular Questions Insomnia 



The study received no funding.

Compliance with ethical standards

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


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Copyright information

© Japanese Society of Sleep Research 2018

Authors and Affiliations

  • Christina Darviri
    • 1
  • Artemios Artemiadis
    • 1
    • 2
  • Xanthi Tigani
    • 1
  • Panagiota Darvyri
    • 1
  • Charalambos Gnardellis
    • 3
  1. 1.Postgraduate Course “Stress Science and Health Promotion”, School of MedicineNational and Kapodistrian University of AthensAthensGreece
  2. 2.Department of Neurology417 Army Share Fund Hospital (417 NIMTS Hospital)AthensGreece
  3. 3.Department of Fisheries and Aquaculture TechnologyTechnological Educational Institute of Western GreeceMessolonghiGreece

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