Examining The Role Of Sleep Duration On The Risk Of Hypertension, Stroke, And Mortality
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2021
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University of Hawaii at Manoa
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Sleep duration and quality have been recently gaining interest as modifiable risk factors for morbidity and mortality. Many epidemiological studies suggest that sleep duration, both short and long hours, is an important risk factor for type 2 diabetes, obesity, cancer, cardiovascular disease, hypertension, stroke, and mortality. While the exact mechanism linking sleep and disease is unclear, it is believed to involve complex interactions between metabolic, endocrine, and immune pathways. The three studies presented in this dissertation examined the association between sleep duration and hypertension, stroke, and mortality and informed the hypotheses that sleep durations deviating from the recommended 7 to 8 hours would be associated with increased risk for these outcomes. In each of these studies, the potential for demographic characteristics and medical conditions to modify the relationship between sleep duration and the main study outcomes were investigated. All three study aims in this dissertation used data from the Multiethnic Cohort (MEC) study, a large, ethnically diverse prospective cohort study of middle-aged and elderly adults in Hawai’i and Los Angeles. In the first study, sleep duration was found to be weakly associated with prevalent hypertension, but not incident hypertension. There was also no evidence of effect modification by age, sex, ethnicity, or BMI. In the second study, sleep duration was associated with a 13% and 39% increased risk of incident stroke in those who reported ≤5 and ≥10 hours of sleep, respectively. There were no significant differences across age, sex, ethnicity, BMI, hypertension status, or diabetes status. In the third study, sleep duration was associated with an increased risk of all-cause, cardiovascular, and stroke mortality. Those reporting ≥10 hours of sleep were at a 43%, 48%, 66% increased risk of all-cause, cardiovascular, and stroke mortality, respectively.
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Epidemiology
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