It remains to be determined whether and in which individuals weekend catch-up sleep (CUS) promotes health. The health effects of weekend CUS could differ depending on both the ability to obtain sufficient sleep during weekdays and amount of weekend CUS required to compensate for sleep lost during the week. We examined the longitudinal association of these two aspects of sleep with all-cause mortality.
• We defined one’s ability to obtain sufficient sleep as normal when one gets a ≥ 360 min sleep on an objective measure (e.g., polysomnography).
• We defined one’s weekend CUS as no, short (1 h), and long (2 h or more) according to self-reported sleep durations on weekdays and weekends.
Overnight polysomnograms of 3,128 adults aged between 40 and 64 enrolled in the Sleep Heart Health Study (SHHS).
• Short weekend CUS with normal sleep duration (≥ 360 min) was associated with lower mortality compared to no CUS with normal sleep duration (HR, 0.48; 95% CI 0.27–0.83).
• When stricter cutoffs were applied for short and normal sleep durations, while the protective effect of short CUS with normal sleep duration (≥ 390 min) was strengthened (HR, 0.36; 95% CI 0.17–0.78), the harmful effect of short CUS with short sleep duration (< 330 min) emerged (HR, 1.84; 95% CI 1.08–3.14).
• Results highlight the importance of balancing one’s sleep ability (“main” sleep) and weekend CUS (“compensatory” sleep).
• Sufficient sleep may reduce weekday sleep debt and only a short CUS would be required on weekends, improving mortality in middle-aged adults.
• Weekend CUS may substantially benefit individuals who maintain their sleep ability and thus require a small amount of CUS.
In a prospective community-based cohort that followed up 3,128 middle-aged adults (40–64 years) for 12 years for mortality outcomes, we addressed the longitudinal association of the habit of weekend CUS and the ability to obtain sufficient sleep with all-cause mortality. We revealed that individuals who reported extending their sleep on weekends by only a short period of time (1 h) had a lower mortality risk, compared to those who reported not extending their sleep on weekends, if they slept for a normal duration (≥ 360 min) on baseline PSG, whereas no protective effect was found among those who slept for a short duration (< 360 min). When objectively short and normal sleep durations were more strictly defined, whereas the protective effect of short weekend CUS on mortality became more obvious among those with objectively normal sleep duration (≥ 390 min), this short weekend CUS was associated with a higher mortality risk among those with an objectively short sleep duration (< 330 min). There was no increase in the mortality risk among those who reported extending their sleep on weekends by a long period of time (2 h or more), even when they only slept for a short duration on PSG.
Our results emphasize the importance of balancing between the extent of weekend CUS required to compensate for sleep debt that accumulates during weekdays and one’s ability to obtain sufficient sleep that could minimize the accumulation of nightly sleep loss among middle-aged adults. Weekend CUS may substantially benefit individuals who maintain their sleep ability and thus require a small amount of CUS. Further studies are needed to confirm these findings and examine underlying mechanisms.
Guest Blogger: Dr. Takuya Yoshiike
Paper authors: Takuya Yoshiike1 , Aoi Kawamura1 , Tomohiro Utsumi1 , Kentaro Matsui1,2 , Kenichi Kuriyama1
1 Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan 2 Department of Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan