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      A three-phase epidemiological study of short and long sleepers in a middle-aged Chinese population: prevalence and characteristics

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          Abstract

          Epidemiological studies of short and long sleepers have not been conducted previously. We collected socioeconomic, psychological, and polysomnographic characteristics of 6501 parents (3252 men and 3249 women) of 4036 primary school children in Guangzhou city. The study data were collected in three phases. The overall prevalence of short (5 h or less) and long (10 h or more) sleep duration was 0.52 and 0.64%, respectively. Long sleepers had higher Eysenck Personality Questionnaire neuroticism scores [odds ratio (OR)=1.224, 95% confidence interval (CI)=1.047-1.409] and lower education levels (OR=0.740, 95%CI=0.631-0.849) than short sleepers. In the polysomnographic assessment, short, long, and normal sleepers (7-8 h) shared similar durations of Stage 3 sleep (short=25.7±10.7, long=20.3±7.9, and normal=28.0±12.8 min, F=1.402, P=0.181). In daytime multiple sleep latency tests, short sleepers (10/19, 52.6%) were more prone to have a short sleep latency (≤8 min) than long sleepers (2/23, 8.7%). In addition to different sleep durations, neuroticism might also contribute to differences between short and long sleepers in social achievements. Stage 3 sleep might be essential for humans. The short sleep latency (≤8 min) of short sleepers in multiple sleep latency tests should be interpreted cautiously, since it was of the same severity as required for a diagnosis of narcolepsy or idiopathic hypersomnia.

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          Most cited references40

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          Reliability and factor analysis of the Epworth Sleepiness Scale.

          The Epworth Sleepiness Scale (ESS) is a self-administered eight-item questionnaire that has been proposed as a simple method for measuring daytime sleepiness in adults. This investigation was concerned with the reliability and internal consistency of the ESS. When 87 healthy medical students were tested and retested 5 months later, their paired ESS scores did not change significantly and were highly correlated (r = 0.82). By contrast, ESS scores that were initially high in 54 patients suffering from obstructive sleep apnea syndrome returned to more normal levels, as expected, after 3-9 months' treatment with nasal continuous positive airway pressure. The questionnaire had a high level of internal consistency as measured by Cronbach's alpha (0.88). Factor analysis of item scores showed that the ESS had only one factor for 104 medical students and for 150 patients with various sleep disorders. The ESS is a simple and reliable method for measuring persistent daytime sleepiness in adults.
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            Mortality associated with sleep duration and insomnia.

            Patients often complain about insufficient sleep or chronic insomnia in the belief that they need 8 hours of sleep. Treatment strategies may be guided by what sleep durations predict optimal survival and whether insomnia might signal mortality risks. In 1982, the Cancer Prevention Study II of the American Cancer Society asked participants about their sleep duration and frequency of insomnia. Cox proportional hazards survival models were computed to determine whether sleep duration or frequency of insomnia was associated with excess mortality up to 1988, controlling simultaneously for demographics, habits, health factors, and use of various medications. Participants were more than 1.1 million men and women from 30 to 102 years of age. The best survival was found among those who slept 7 hours per night. Participants who reported sleeping 8 hours or more experienced significantly increased mortality hazard, as did those who slept 6 hours or less. The increased risk exceeded 15% for those reporting more than 8.5 hours sleep or less than 3.5 or 4.5 hours. In contrast, reports of "insomnia" were not associated with excess mortality hazard. As previously described, prescription sleeping pill use was associated with significantly increased mortality after control for reported sleep durations and insomnia. Patients can be reassured that short sleep and insomnia seem associated with little risk distinct from comorbidities. Slight risks associated with 8 or more hours of sleep and sleeping pill use need further study. Causality is unproven.
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              The happy personality: a meta-analysis of 137 personality traits and subjective well-being.

              This meta-analysis used 9 literature search strategies to examine 137 distinct personality constructs as correlates of subjective well-being (SWB). Personality was found to be equally predictive of life satisfaction, happiness, and positive affect, but significantly less predictive of negative affect. The traits most closely associated with SWB were repressive-defensiveness, trust, emotional stability, locus of control-chance, desire for control, hardiness, positive affectivity, private collective self-esteem, and tension. When personality traits were grouped according to the Big Five factors, Neuroticism was the strongest predictor of life satisfaction, happiness, and negative affect. Positive affect was predicted equally well by Extraversion and Agreeableness. The relative importance of personality for predicting SWB, how personality might influence SWB, and limitations of the present review are discussed.
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                Author and article information

                Journal
                Braz J Med Biol Res
                Braz. J. Med. Biol. Res
                Brazilian Journal of Medical and Biological Research
                Associação Brasileira de Divulgação Científica
                0100-879X
                1414-431X
                17 February 2014
                March 2014
                : 47
                : 2
                : 157-165
                Affiliations
                [1 ] Department of Human Anatomy, Guangzhou Medical University, Guangzhou, China, Department of Human Anatomy, Guangzhou Medical University, Guangzhou, China
                [2 ] Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Mental Health Centre, Guangzhou, China, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Mental Health Centre, Guangzhou, China
                [3 ] Zhongshan The Third People's Hospital, Zhongshan, China, Zhongshan The Third People's Hospital, Zhongshan, China
                Author notes
                Correspondence: B. Zhang, Guang Dong General Hospital, Guang Dong Academy of Medical Science, Guang Dong Mental Health Centre, No. 123, Hui Fu Xi Road, Guangzhou, 510120, China. Fax: +86-20-8186-2664. E-mail: zhang73bin@ 123456hotmail.com
                Article
                10.1590/1414-431X20133430
                4051176
                24519132
                9df3214f-0cc6-4dc9-82c0-d475cd753d13

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 6 August 2013
                : 29 October 2013
                Page count
                Figures: 1, Tables: 3, References: 37, Pages: 9
                Categories
                Clinical Investigation

                short sleeper,long sleeper,prevalence,characteristics,chinese

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