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Andrew Steptoe, PhD, DSc; Victoria Peacey, MSc; Jane Wardle, PhD

Arch Intern Med. 2006;166:1689-1692.

Background  Both long and short sleep durations have been associated with negative health outcomes in middle-aged and older adults. This study assessed the relationship between sleep duration and self-rated health in young adults.

Methods  Using anonymous questionnaires, data were collected from 17 465 university students aged 17 to 30 years who were taking non–health-related courses at 27 universities in 24 countries. The response rate was greater than 90%. Sleep duration was measured by self-report; the health outcome was self-rated health; and age, sex, socioeconomic background, smoking, alcohol consumption, body mass index, physical activity, depression (Beck Depression Inventory), recent use of health services, and country of origin were included as covariates.

Results  Sixty-three percent of respondents slept for 7 to 8 hours; 21% were short sleepers (6%, <6 hours; 15%, 6-7 hours); and 16% were long sleepers (10%, 8-10 hours; 6%, >10 hours). Compared with the reference category (7-8 hours), the adjusted odds ratio of poor health was 1.56 (95% confidence interval [CI], 1.22-1.99) for respondents sleeping 6 to 7 hours and 1.99 (95% CI, 1.31-3.03) for those sleeping less than 6 hours. The same significant pattern was seen when the results were analyzed separately by sex. When respondents from Japan, Korea, and Thailand (characterized by relatively short sleep durations) were excluded, the adjusted odds ratios were 1.33 (95% CI 1.03-1.73) and 1.62 (95% CI, 1.06-2.48) for those sleeping 6 to 7 hours and less than 6 hours, respectively. There were no significant associations between self-rated health and long sleep duration.

Conclusion  Our data suggest that short sleep may be more of a concern than long sleep in young adults.

Author Affiliations: Psychobiology Group (Dr Steptoe) and Health Behaviour Unit (Ms Peacey and Dr Wardle), Department of Epidemiology and Public Health, University College London, London, England.

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