Increased rapid eye movement (REM) sleep is associated with lower risks of several chronic diseases
1. In a large cohort study, greater rapid eye movement (REM) sleep was associated with lower risks of several chronic diseases including heart failure, dementia, atrial fibrillation, and Alzheimer’s disease.
Evidence Rating Level: 2 (Good)
Sleep duration and quality have been associated with numerous chronic diseases, but much of the existing epidemiologic literature relies on self-reported sleep rather than objectively measured sleep patterns. This study investigated whether objectively measured sleep stages, duration, irregularity, and fragmentation were associated with subsequent development of a broad range of diseases. The investigators conducted a prospective cohort study using 95,559 UK Biobank participants who had worn wrist-based accelerometers for 7 days, with sleep stages estimated using the SleepNet algorithm. Participants had a mean age of 56.2 years, 43.7% were male, and median follow-up was 8.9 years. The researchers performed a phenome-wide association analysis examining associations between sleep characteristics and 1,049 incident health outcomes, using Cox proportional hazards models adjusted for demographic, lifestyle, and environmental factors. After Bonferroni correction, 156 disease associations remained significant, including 83 associated with REM sleep and 7 with deep sleep. Greater REM sleep was associated with lower risk of heart failure (HR 0.74, 95% CI 0.68-0.80; P<.001), atrial fibrillation (HR 0.83, 95% CI 0.79-0.86; P<.001), dementia (HR 0.54, 95% CI 0.47-0.62; P<.001), and Alzheimer disease (HR 0.69, 95% CI 0.57-0.81; P<.001). Greater deep sleep was also associated with lower risk of type 2 diabetes (HR 0.89, 95% CI 0.85-0.93; P<.001) and Parkinson disease (HR 0.70, 95% CI 0.62-0.80; P<.001), whereas greater sleep irregularity and wakefulness after sleep onset were associated with increased disease risk. Sleep duration demonstrated significant nonlinear associations with 86 disease phenotypes (P for nonlinearity <.05), with the lowest observed risks for 69 phenotypes concentrated around 6–8 hours of sleep. Overall, longer uninterrupted sleep was measured to decrease the risk of several chronic diseases, while interruptions and wakefulness after sleep onset is associated with increased disease risk.
Click here to read this study in PLOS Medicine
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