Associations Between Self-Reported Sleep Duration and Mortality in Employed Individuals: Systematic Review and Meta-Analysis

Paula R. Pienaar*, Tracy L. Kolbe-Alexander, Willem van Mechelen, Cecile R. L. Boot, Laura C. Roden, Estelle V. Lambert, Dale E. Rae

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    15 Citations (Scopus)
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    Sleeping less or more than the 7-8 h has been associated with mortality in the general population, which encompasses diversity in employment status, age and community settings. Since sleep patterns of employed individuals may differ to those of their unemployed counterparts, the nature of their sleep-mortality relationship may vary. We therefore investigated the association between self-reported sleep duration and all-cause mortality (ACM) or cardiovascular disease mortality (CVDM) in employed individuals.

    Data sources:

    Based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses, searches between January 1990 and May 2020 were conducted in PubMed, Web of Science and Scopus. Inclusion/exclusion criteria: Included were prospective cohort studies of 18-64-year-old disease-free employed persons with sleep duration measured at baseline, and cause of death recorded prospectively as the outcome. Gray literature, case-control or intervention design studies were excluded.

    Data Extraction:

    Characteristics of the studies, participants, and study outcomes were extracted. The quality and risk of bias were assessed using the Newcastle-Ottawa Scale.

    Data synthesis:

    The pooled relative risks (RR) with 95% confidence intervals (CI) were obtained with a random-effects model and results presented as forest plots. Heterogeneity and sensitivity analysis were assessed.


    Shorter sleep duration (= 8 h) and ACM (RR: 1.18, 95% CI:1.12 -1.23, P < 0.001) needs to be interpreted cautiously owing to high heterogeneity (I-2 = 86.0%, P < 0.001).


    Interventions and education programs targeting sleep health in the workplace may be warranted, based on our findings that employed individuals who report shorter sleep appear to have a higher risk for ACM and CVDM.

    Original languageEnglish
    Pages (from-to)853-865
    Number of pages13
    JournalAmerican Journal of Health Promotion
    Issue number6
    Early online date11-Feb-2021
    Publication statusPublished - Jul-2021


    • sleep quantity
    • short sleep
    • heart disease
    • employed
    • workplace

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