Influence of race and age in sleep duration and mortality relationship among adults in the United States: results from the 2004 NHIS-NDI record linkage study

Limited information exists on age and racial disparities in sleep duration and mortality in the United States (US) population. This study compared the association between mortality and sleep duration within distinct races and age groups in the US. This study used data on 26,915 US citizens (≥ 18 years) from the 2004 wave of the National Health Interview Survey, linked to the National Death Index prospective mortality through 2019. Cox proportional hazard models were used to obtain hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality by sleep duration, race (Whites, Black/African Americans, and Others (AIAN, Asian, and Native Hawaiian or other Pacific Islander)), and age (< 40, 40–60, and ≥ 60 years), while controlling for covariates such as sex, education, smoking status, disease history, and other vital factors. Race and age significantly modified the sleep duration-mortality relationship. Compared to other races, White participants exhibited higher mortality risks at all hours except at 5–6 h [HR: 0.993, 95% CI: 0.923–1.069]. Likewise, sleep duration associated mortality risks varied by age. Those at greater risk included < 40 years sleeping for 1–4 h [HR: 2.461, 95% CI: 1.446–4.187], 40–< 60 years sleeping for less than 7 h and more than 8 h, and ≥ 60 years sleeping for 9 h [HR: 1.309, 95% CI: 1.162–1.475] and ≥ 10 h [HR: 1.662, 95% CI: 1.486–1.858]. Age and race were significant effect modifiers in the sleep duration-mortality relationship. Thus, it is important to consider these factors when evaluating mortality risks associated with sleep patterns.