Sleep Duration, Morbidity, and Mortality

  • Shawn D. Youngstedt
  • Daniel F. Kripke
  • Shelli James


Dozens of epidemiologic studies spanning over 50 years have established that both short sleep (<6 h of self-reported sleep) and long sleep (≥8 h of self-reported sleep) have been associated with increased mortality and multiple morbidities. Consistently, long sleep has been associated with greater risks than short sleep. Although epidemiologic studies cannot completely prove causality, the magnitude and consistency of evidence makes a strong case for causality. Randomized controlled trials are recognized as the best evidence for causality. Consistent with epidemiologic evidence, experimental sleep restriction has had hazardous effects, but studies have been limited predominately to profound short-term sleep deprivation under restrictive laboratory conditions which provoke sleepiness. Studies involving extending sleep in short sleepers via spending more time in bed (TIB) or hypnotics have not generally produced positive effects. Experimental restriction of sleep in long sleepers has been well tolerated. Further experimental studies are needed. Since sleep duration is to a considerable extent heritable, a genetic strategy based on Mendelian randomization offers a new pathway to exploring causality.


Epidemiology Long sleep Short sleep Randomized controlled trials Mendelian randomization 


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Shawn D. Youngstedt
    • 1
    • 2
    • 3
  • Daniel F. Kripke
    • 4
  • Shelli James
    • 5
  1. 1.College of Nursing and Health InnovationArizona State UniversityPhoenixUSA
  2. 2.School of Nutrition and Health PromotionArizona State UniversityPhoenixUSA
  3. 3.Phoenix VA Health Care SystemPhoenixUSA
  4. 4.Scripps Clinic Viterbi Family Sleep CenterLa JollaUSA
  5. 5.Department of Exercise ScienceUniversity of South CarolinaColumbiaUSA

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