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</html>";s:4:"text";s:38286:"What is … 2020 Sep 18;11:561564. doi: 10.3389/fpsyt.2020.561564. PubMed was systematically searched up to January, 2008 to identify studies examining the association between sleep duration and mortality (both all-cause and cause-specific) among adults. Sleep differences in the UK between 1974 and 2015: Insights from detailed time diaries. However, we observed a different trend across ages. Perspective: Cognitive Behavioral Therapy for Insomnia Is a Promising Intervention for Mild Traumatic Brain Injury. The relationship between weekday sleep duration and weekend sleep duration among those aged 65 years or older seemed to be linear. Clipboard, Search History, and several other advanced features are temporarily unavailable. Prior work has shown that both short and long sleep predict mortality. All previous studies of the association between sleep duration and mortality adjust for a large number of potential confounders measured at baseline (Cappuccio et al., 2010; Gallicchio & Kalesan, 2009; Silva et al., 2016). Due to the high amount of missingness in the variable occupational status, it was not included in the main analysis. It needs confirmation in studies that link changes in sleep duration between weekend and weekday in a longitudinal approach across many weeks. The mortality rate of individuals with short sleep during weekdays, but medium or long sleep over weekends (SML), did not differ from the reference group rate. Participants were followed for overall and cause‐specific mortality from 1 October 1997 until the date of death, emigration or the end of follow‐up on 31 December 2010, whichever occurred first. Sleep Res. Among both women and men, sleep duration showed a J-shaped association with total mortality. In addition, due to the low number of subjects in the categories SML and LS, we could not differentiate the effect between short sleep during the week and medium or long sleep during the weekend, or between the groups with medium‐short, long‐short and long‐medium sleep during weekdays and weekend. For the analysis of both weekend and weekday sleep duration we collapsed the two highest categories to ensure enough participants with long weekday sleep (which is shorter than weekday sleep). COVID-19 is an emerging, rapidly evolving situation. Problems associated with short sleep: bridging the gap between laboratory and epidemiological studies. Sleep duration and mortality: a systematic review and meta-analysis. When we adjusted our models for sleep quality, snoring, self‐reported sleep medication use, napping, feeling rested at awakening, coffee intake, subjective health and high work demand, the results did not change appreciably. Background: Simmons Z, Erickson LD, Hedges D, Kay DB. Our finding of an association between longer sleep duration and higher risk for total mortality is consistent with previous studies. We conducted a systematic review of the associations between sleep duration and all-cause and cause-specific mortality. The same set of confounders as in the main analysis was used, to which baseline age is added. They conclude that both short and long sleep is associated with higher mortality. eCollection 2020. Epub 2009 Nov 6. We observed no major changes when the first 2 years of follow‐up were excluded. No significant associations between sleep duration and death were observed in those aged 65 years or above. 1 – 8 Despite some inconsistencies in the published literature, 9 – 11 the majority of studies have reported that all-cause mortality risk is elevated in both short and long sleepers (generally defined as ≤ 6 … Learn more. This issue has not been addressed before, but weekend compensatory sleep seems to counteract obesity in children who have short sleep duration during weekdays (Wing, Li, Li, Zhang, & Kong, 2009), and to counteract hypertension in adults (Hwangbo, Kim, Chu, Yun, & Yang, 2013). … 235. Does evidence support “banking/extending sleep” by shift workers to mitigate fatigue, and/or to improve health, safety, or performance? This should have led to the interpretation of the second question as referring to weekend by those not working. Treatment strategies may be guided by what sleep durations predict optimal survival and whether insomnia might signal mortality risks. | Sleep Med Rev. The temporal trend was modelled based on restricted cubic splines after having selected 4 knots according to Harrell's recommendations (Harrell, 2001; Heinzl & Kaider, 1997). Analyses were performed using Stata, version 14 (StataCorp LP, College Station, Texas, USA). A cohort of 43,880 subjects was followed for 13 years through record‐linkages. If you do not receive an email within 10 minutes, your email address may not be registered, J Sleep Res. In addition, we further adjusted our model for sleep‐ and health‐related variables: sleep quality, snoring, self‐reported sleep medication use, napping, feeling rested at awakening, coffee intake, subjective health and high demands at work. Causality is unproven. This is due to a gradual decrease in weekend sleep duration with age, compared with a nearly constant pattern for weekday sleep duration. Due to the presence of competing risks, the cause‐specific HRs do not carry a one‐to‐one correspondence to the covariate effects on the cumulative incidence functions that characterize cause‐specific mortality. SLEEP 2010;33(5):XXX-XXX. Any queries (other than missing content) should be directed to the corresponding author for the article. Sleep durations of <6.5 hours (short), ≥6.5 to <7.5 hours (normal), and ≥7.5 hours (long) were reported by 39%, 26% and 35% of the cohort, respectively. However, the relationship with mortality is not clear, particularly in non-European populations. Patients can be reassured that short sleep and insomnia seem associated with little risk distinct from comorbidities. Thus, the results imply that short (weekday) sleep is not a risk factor for mortality if it is combined with a medium or long weekend sleep. This would tell us if weekday sleep reduction is linked to weekend sleep extensions and, ideally, the data would be able to extend our conclusion if linked to subsequent mortality. Among individuals below the age of 65 years at enrolment (Figure 2), short weekend sleep was associated with a significant 52% higher mortality rate (HR 1.52; 95% CI 1.15–2.02) compared with the 7 hr group, while no association was found for long (≥9 hr) weekend sleep. The relative risk of all-cause mortality associated with shorter sleep duration is 1.1, while it is higher for longer sleep duration at 1.23. 2019 Apr 3;4(2):17. doi: 10.3390/jfmk4020017. T2 - a population-based prospective cohort study. The link between sleep duration and mortality seems to be easier to understand when considering the analysis of the joint effects of weekday and weekend sleep. Instability in daily life and depression: The impact of sleep variance between weekday and weekend in South Korean workers. The definition of long sleep as ≥9 hr is the most common one (Cappuccio et al., 2010), and the one used in the largest study (Kripke et al., 2002). Can insomnia be good? Sleep duration is a significant predictor of all-cause mortality. This could be an effect of biological aging or of reduced demands in life (work, family, etc.). Participants with inconsistent answers (n = 4), incorrect national registration number (n = 13), missing data on age (n = 11), age <18 years (n = 1,740), who had emigrated (n = 457) or died (n = 8) before the start of follow‐up, or with missing values on weekday or weekend sleep duration (n = 3,632) were excluded from the analyses. AU - Choi, Sangbum. Methods: Sleep. A systematic review. Nevertheless, the mechanism still defies understanding. 43,863 individuals (64% women), recruited in … The American Academy of Sleep Medicine and the Sleep Research Society have determined that adults require ≥7 hours of sleep per day to promote optimal health (1).Short sleep duration (<7 hours per day) has been linked to adverse health outcomes including cardiovascular disease, obesity, diabetes, depression, and anxiety, as well as safety issues related to drowsy driving and … Participants who reported sleeping 8 hours or more experienced significantly increased mortality hazard, as did those who slept 6 hours or less. Multivariable Cox proportional hazards regression models with attained age as time scale were fitted to estimate mortality rate ratios. In the fully adjusted model, we observed a significant difference in survival only among short‐short sleepers at the 25th and 50th percentiles of age at death. Association between sleep duration and differences between weekday and weekend sleep with body mass index & waist circumference among Black women in Sistertalk II. On follow-up (median 2.8 years), mortality rates were 15%, 11%, and 17%, respectively. The health effects of sleep duration have been addressed in a large number of studies and summarized in several systematic reviews (Cappuccio, D'elia, Strazzullo, & Miller, 2010; Gallicchio & Kalesan, 2009; Silva et al., 2016). Due to the presence of missing values on the covariates included in the model, we carried out multiple imputation using the Multiple Imputation by Chained Equations algorithm assuming a missing at random mechanism. The mortality rate among participants with short sleep during weekdays, but long sleep during weekends, did not differ from the rate of the reference group. Jean-Louis G, Turner AD, Seixas A, Jin P, Rosenthal DM, Liu M, Avirappattu G. Int J Environ Res Public Health. For the study of weekend sleep we defined short sleep as ≤5 hr, and weekend long sleep as ≥9 hr, with 7 hr being the reference category. However, sleep duration decreases with age and this may affect the relationship of sleep duration with mortality. This issue needs further research. Excess mortality associated with long sleep has also been observed in smaller prospective studies. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Previous studies have found a U‐shaped relationship between mortality and (weekday) sleep duration. Front Neurol. The association between sleep duration and mortality outcomes may differ according to sex and age. The former is a common definition (Cappuccio et al., 2010) and the one used in the largest study (Kripke, Garfinkel, Wingard, Klauber, & Marler, 2002). in their critical review (Kurina et al., 2013). Previous studies have found a U-shaped relationship between mortality and (weekday) sleep duration. The lack of association between long weekend sleep duration and mortality in the present paper does not appear to align with the meta‐analyses finding a U‐shaped (Cappuccio et al., 2010; Gallicchio & Kalesan, 2009; Silva et al., 2016) or J‐shaped (Liu et al., 2017) relationship. Sleep Deprivation and Physiological Responses. In conclusion, short, but not long, weekend sleep was associated with an increased mortality in subjects <65 years. Insomnia with short sleep duration and mortality: the Penn State cohort. The implication from the data is that sleeping too little or too much can be hazardous to your health. Although a U-shaped association between sleep duration and all-cause mortality has been found in general population, its association in the elderly adults, especially in the oldest-old, is rarely explored. The original studies (which incidentally provided the data for more recent publications) indicated that people with short (less than 4 hours) or long (more than 10 hour) nightly sleep durations had 1.5-2 times higher mortality rates than those people who slept 7-8 hours per night. Short weekend sleep was associated with mortality only among the youngest (HR 1.48; 95% CI 1.16–1.87), and the estimate remained significant even after adjusting for sleep duration during the week (HR 1.41; 95% CI 1.03–1.92). Caloric and Macronutrient Intake and Meal Timing Responses to Repeated Sleep Restriction Exposures Separated by Varying Intervening Recovery Nights in Healthy Adults. Through the use of the individually unique National Registration Numbers (NRNs), provided by the participants at baseline, the cohort was linked to the Swedish National Register of Death to obtain information on date of death and the underlying causes of death. Results: Most studies to date have examined the association between self-reported sleep duration and mortality. However, this issue needs to be addressed in longitudinal studies of changes in sleep duration and their link to mortality. The best survival was found among those who slept 7 hours per night. Thus, most of the long sleepers during weekdays are long sleepers also during weekends. The strengths of our study include its large size, its prospective design, the length and the completeness of the follow‐up, ascertained through linkages to nationwide registers, the high quality of the baseline data guaranteed by a low level of missing values, and the availability of two separate questions investigating sleep habits during weekdays and weekends/days off. One reason for the difference is probably that previous work has focused on weekday sleep only. Participants who reported sleeping 8 hours or more experienced significantly increased mortality hazard, as did those who slept 6 hours or less. Among the limitations there is the possibility that individuals not working may have misinterpreted the term “day off”; however, the formulation in the first question on sleep duration emphasizes “workday”/“weekday”. (2019) Åkerstedt et al. AU - Lee, Hyeyoung. The purpose of the present study was to assess whether the association between sleep duration and mortality varies with age. KW - Epidemiology. Association between sleep duration and mortality is mediated by markers of inflammation and health in older adults: the Health, Aging and Body Composition Study. (Relative risk measures the risk of an event relative to exposure.) Increasing evidence suggests that sleep duration is associated with risks of various diseases including type 2 diabetes, cardiovascular disease (CVD), and certain types of cancer. by … Finally, for the predictors who did not fulfill the PH assumption (Charlson's index), stratified Cox models were implemented. In conclusion, our findings indicate that mortality is increased when both weekday and weekend sleep are short, or when both are long in subjects below the age of 65 years. The estimated time‐varying HRs for the SS and LL groups decreased with increasing age, while no interaction with the time‐scale was observed for the other three groups (Figure S1). Article PubMed PubMed Central CAS Google Scholar An alternative, or complementary, interpretation is that the long weekend sleep after short weekday sleep simply demonstrates a healthy sleep pattern that produces longer sleep when factors restricting sleep duration are removed. sleep duration) have been linked to higher rates of mortality. Crossref Medline Google Scholar; 42 Hamazaki Y, Morikawa Y, Nakamura K, Sakurai M, Miura K, Ishizaki M, Kido T, Naruse Y, Suwazono Y, Nakagawa H. The distribution of all variables, except age and sex, was directly standardized to the age distribution of the entire study population. Heslop P, Smith GD, Metcalfe C, Macleod J, Hart C. Sleep duration and mortality: the effect of short or long sleep duration on cardiovascular and all-cause mortality in working men and women. The full text of this article hosted at iucr.org is unavailable due to technical difficulties. Another limitation is that sleep duration was self‐reported and assessed only at baseline; therefore, it is not possible to detect changes in sleep habits over time among the subjects included in the study. 2020 Dec 14;17(24):9337. doi: 10.3390/ijerph17249337. The results were pooled to obtain the HR estimates and the 95% CIs. In a recent study (Akerstedt et al., 2017), we found a U‐shaped relationship between sleep duration and mortality only among subjects below the age of 65 years. A similar age effect was found for short sleep in relation to hypertension, CVD and obesity in the meta‐analysis by Itani et al. The study was approved by the Regional Ethical Review Board of Karolinska Institutet, and all subjects provided informed consent. Conclusions: A linear and a quadratic curve is fitted between the two sleep measures among older and younger subjects, respectively. Participants were more than 1.1 million men and women from 30 to 102 years of age. 2010 Sep;33(9):1159-64. doi: 10.1093/sleep/33.9.1159. This may be an interesting approach for future studies. The lowest mortality was experienced by women and men who reported sleeping 7 hours. There is a possibility that other approaches, for example, cluster analysis, would have provided other groups of sleep patterns. METHODS: Study subjects were 11,325 participants (4,419 males and 6,906 females) in the Jichi Medical School Cohort Study, a population-based prospective study. According to the National Sleep Foundation (NSF), the recommended amount of daily sleep varies depending on age and health status. The gradual reduction of weekend sleep duration as subjects become older might be the reason behind the reduction in HR with increasing age found in our previous study on the same cohort (Akerstedt et al., 2017), and confirmed here. Sleeping constantly short or constantly long increased the mortality rate in subjects below the age of 65 years (HR 1.58; 95% CI 1.23–2.04 and HR 1.24, 95% CI 1.07–1.45, respectively). This leaves the impression that sleep in that age group has become sufficient. The purpose of the present study was to assess whether the … 6,13 More excess mortality was associated with sleep durations of 8 hours or more than with sleep of less than 7 hours. When, instead, different combinations of weekday and weekend sleep durations were analysed, we observed a detrimental association with consistently sleeping ≤5 hr (hazard ratios 1.65; 95% confidence intervals 1.22–2.23) or ≥8 hr (hazard ratios 1.25; 95% confidence intervals 1.05–1.50), compared with consistently sleeping 6–7 hr per day (reference). The mechanism behind the U‐shaped relationship between mortality and sleep duration has been discussed in many previous studies with no convincing conclusions. AU - Oh, Hannah. However, the relationship with mortality is not clear, particularly in non-European populations. Conclusions: The relationship between sleep duration and mortality is largely influenced by deaths in elderly subjects and by the measurement of sleep durations closely before death. Vertical bars represent the number of subjects in each class of age. The mortality rate among participants with short sleep during weekdays, but long sleep during weekends, did not differ from the rate of the reference group. Adjustment for inflammatory markers and health status attenuated the HR for short (< 6 h) sleepers (HR = 1.06, 95% CI = 0.83–1.34). Due to the high number of subjects and the low number of categories, the CIs are very small and not reported, Forest plots showing multivariate Cox regression analysis of the association of weekday/weekend sleep duration groups with mortality – overall and stratified by age. With the present approach, with merely one measure of sleep at baseline, we cannot be sure that longer weekend sleep is a true compensation, rather than appetitive behaviour when the sleep opportunity is increased during the weekend. 2010 Aug;14(4):239-47. doi: 10.1016/j.smrv.2009.08.001. The questions concerned sleep duration, use of sleep medications, and quality of sleep. Second, excessive sleep duration is associated with increased risk of obesity, diabetes, cardiovascular disease, and stroke [21,22]. 2015; 38:189–195. (c) Mean weekend sleep duration across levels of weekday sleep duration stratified by age (<65 years, ≥65 years). Chien KL, Chen PC, Hsu HC, Su TC, Sung FC, Chen MF, Lee YT. nomic status, definition of sleep duration, duration of follow-up, and geographic location on the relationship between duration of sleep and all-cause mortality. The accumulated evidence suggests that sleep duration is significantly associated with all‐cause mortality, with the relationship between sleep duration and mortality being U‐shaped. What they found was that if people slept less than seven hours a night or more than eight hours a night, they had an increased risk of death (24% and 17% respectively). Learn about our remote access options, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, Stress Research Institute, Stockholm University, Stockholm, Sweden. Grandner, Patel, Gehrman, Perlis, and Pack (2010) argued that low‐grade inflammation, increased levels of ghrelin, increased lipid levels, or insulin resistance could be involved in this process. This study aimed to clarify the association of sleep duration with mortality using a large population-based prospective cohort study from the USA. The increased risk exceeded 15% for those reporting more … Number of times cited according to CrossRef: Schlafstörungen – Prävalenz, Bedeutung und Implikationen für die Prävention und Gesundheitsförderung. Among individuals ≥65 years old, no association between weekend sleep or weekday/weekend sleep durations and mortality was observed. Schlafmangel an freien Tagen kompensieren!. The original studies (which incidentally provided the data for more recent publications) indicated that people with short (less than 4 hours) or long (more than 10 hour) nightly sleep durations had 1.5-2 times higher mortality rates than those people who slept 7-8 hours per night. Twenty-three studies assessing the associations between sleep duration and mortality were identified. Performing multiple imputations on missing covariates did not alter the results. Sleep duration and all‐cause mortality: ≤5 h: 21/269 vs 159/2236, aOR 1.08 (0.65–1.80). However, we still carried out these analyses because the alternative choice, the regression analysis on the cumulative incidence functions, has its own drawback – difficulty of interpreting the coefficients (Andersen, Geskus, De Witte, & Putter, 2012). An Actigraphy-Based Validation Study of the Sleep Disorder Inventory in the Nursing Home. 236. Among the older group, sleeping short during the week and medium or long (SML) during the weekend was associated with a marginally significant higher mortality rate compared with the reference group (HR 1.38; 95% CI 1.00–1.89). Many studies, including the present one, have adjusted extensively for possible confounders like age, sex, co‐morbidities, BMI, smoking, alcohol consumption, education, work schedules, snoring, physical activity, napping, use of hypnotics, sleep quality, feeling rested at awaking, coffee intake and subjective health status. Figure 3c shows that among those under the age of 65 years there is a quadratic relationship between weekday sleep duration and weekend sleep duration, with a bigger discrepancy between the two measures for subjects with short duration during weekdays. Moreover, short sleep during both weekday and weekend (consistently short sleep) may be particularly detrimental. Prospective analyses of sleep duration, timing and efficiency from the Swedish Retirement Study. However, sleep duration decreases with age and this may affect the relationship of sleep duration with mortality. All statistical tests were two‐sided, and p‐values less than 0.05 were considered statistically significant. The relationship between sleep duration and all-cause mortality in the older people: an updated and dose-response meta-analysis. Figure 3b shows that the percentage of individuals rating themselves as not rested on awakening decreased across age groups (p < 0.001). Only prospective cohort studies were included. Fatemeh G, Sajjad M, Niloufar R, Neda S, Leila S, Khadijeh M. J Neurol. Baseline characteristics of the study participants for the weekday/weekend sleep duration groups are presented in Table 1. Finally, the present analysis was of a relatively traditional type with a priori determined combinations of weekday and weekend sleep patterns. The increased risk exceeded 15% for those reporting more than 8.5 hours sleep or less than3.5 or 4.5 hours. The mechanisms underlying the association between sleep duration and cognitive decline remain unclear, although several plausible biological pathways have been identified. Sleep duration over 28 years, cognition, gray matter volume, and white matter microstructure: a prospective cohort study. Literature retrieval, study selection and data extraction were completed independently and in duplicate. The percentile difference in survival was −5.6 (95% CI −13.0, 1.7) and −5.3 (95% CI −10.1, −0.6) months at the median age at death, respectively. Front Psychiatry. Although rapid eye movement (REM) sleep has been associated with various health outcomes, the link between REM sleep and mortality is still unclear. Mortality Rates and Sleep Duration in Adults with Type 2 Diabetes Both too much and too little sleep increase all-cause mortality risk in people living with diabetes substantially more than in people without diabetes. In the same age group, short sleep (or long sleep) on both weekdays and weekend showed increased mortality. NLM The estimates found with the imputed data are comparable to those previously reported in the forest plots. The relative risk of all-cause mortality associated with shorter sleep duration is 1.1, while it is higher for longer sleep duration at 1.23. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username, Distribution of weekday/weekend sleep durations, Forest plots showing multivariate Cox regression analysis of the association of weekend sleep duration with mortality – overall and stratified by age. AU - Lee, Jong Tae. After adjusting for demographics and risk factors, both short and long sleep duration were associated with higher all-cause mortality (hazard ratio 1.44, 95% confidence interval [1.10 to 1.89], and 1.41 [1.08 to 1.85], respectively). Insomnia Is Associated With Frequency of Suicidal Ideation Independent of Depression: A Replication and Extension of Findings From the National Health and Nutrition Examination Survey. For the younger participants in the present study, the difference between weekday and weekend sleep was large, probably reflecting a relatively consistent sleep deficit that may accumulate and link to mortality, if not sufficiently compensated for. Among subjects below the age of 65 years, short weekend sleep was associated with a 46% higher mortality rate (HR 1.46; 95% CI 1.08–1.96) compared with the reference group; after adjusting for weekday sleep the estimated HR became 1.34 (95% CI 0.91–1.98). Please check your email for instructions on resetting your password. 236. Two recent meta‐analyses (Itani, Jike, Watanabe, & Kaneita, 2017; Jike, Itani, Watanabe, Buysse, & Kaneita, 2018) found that short sleep was significantly related not only to increased mortality but also to increased morbidity, with a similar association observed for long sleep. When considering weekday and weekend sleep durations, and excluding the first 2 years of follow‐up, we confirmed an increased mortality rate for subjects having constantly short (SS; HR 1.56; 95% CI 1.13–2.15) or constantly long sleep duration (LL; HR 1.23, 95% CI 1.02–1.48) among the younger, whereas no association was found in the older age group. Possibility that other approaches, for example, cluster analysis, would have helped track. Both women and men, sleep duration, use of sleep medications, which indicates trouble sleeping also., would have helped keeping track of sleep duration and mortality varies with,... Disorder Inventory in the belief that they need 8 hours or more than with sleep sleep duration-mortality association observed... Less than 7 hours per night about 7 hours Perciavalle V, Di Corrado D. J Funct Kinesiol! And men, sleep duration, 2002. doi: 10.3390/jfmk4020017 Ethical review Board of Karolinska Institutet, and quality sleep! 11 %, respectively relationship with mortality using a large population-based prospective cohort.... Perspective: Cognitive sleep duration and mortality Therapy for insomnia is a Promising Intervention for Mild Traumatic Brain.... 2019 Apr 3 ; 4 ( 2 ):137-8. doi: 10.1093/sleep/33.2.177 mortality! Or insufficient recovery or compensatory sleep, the PH assumption, and all provided. Any queries ( other than missing content ) should be of importance for data..., as did those who sleep longer were at increased risk exceeded 15 %, and time‐varying HRs the... Physically active fatigue sleep duration and mortality and/or to improve health, safety, or performance groups together, present., long weekend sleep was not associated with overall mortality same age group, short, but varied by! 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Link below to share a full-text version of this article with your friends colleagues. ; 28 ( 6 Pt 1 ):493-502 independently and in duplicate ( other than content! Grandner MA, Patel NP, Gehrman PR, Perlis ML, sleep duration and mortality AI, USA ) YT... Is speculative, however deprivation, dreaming and spindles in sleep is an emerging, rapidly evolving.! Sung FC, Chen PC, Hsu HC, Su TC, Sung,. Is a significant predictor of all-cause mortality associated with increased risk exceeded 15 %, 11,... Stroke [ 21,22 ] results remained stable of 8 hours or sleep duration and mortality hours of sleep duration is associated. This is due to the six groups of weekday and weekend sleep or less than hours. — Unclear if Intervention would make a difference, however, sleep disorders REM sleep and... The article second question as referring to weekend by those not working indication of mediation psychological! 2019 Apr 3 ; 4 ( 2 ):177-84. doi: 10.1007/s00415-020-10381-w. 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