Long Sleep Duration is Associated With Serum Cholesterol in the Elderly: The Rotterdam Study

Objective: Epidemiological studies have repeatedly found increased mortality associated with both habitual short and long sleep duration. The mechanisms behind these associations are unclear. We investigated whether objectively measured sleep duration, time in bed, and sleep fragmentation were associated with total cholesterol and high density lipoprotein (HDL) cholesterol in community-dwelling elderly. Methods: This cross-sectional study was conducted among 768 participants of the Rotterdam Study, aged 57 to 97 years. Sleep parameters were assessed with actigraphy, a validated method that infers wakefulness and sleep from arm movement. Cholesterol levels in serum were determined in fasting blood samples. All regression analyses were adjusted for age, gender, body mass index, smoking, depressive symptoms, and heart failure. Results: Sleep duration was positively associated with total cholesterol level: beta = 0.11 (95% confidence interval = 0.03-0.18) mmol/1 per hour of sleep. Persons who slept longer, and spent more time in bed, also had a higher total/HDL cholesterol ratio. A less fragmented sleep was also associated with higher total cholesterol. Some of these associations showed significant interactions with age. The association between time in bed and total/HDL ratio was mainly driven by persons aged <65, whereas the relationship between sleep fragmentation and total cholesterol level was most prominent in persons aged >= 70. Conclusions: A longer sleep duration was related to higher total cholesterol level and a higher total/HDL cholesterol ratio. Two separate mechanisms, a longer time in bed and sleep fragmentation, seem to explain these associations in different age categories.