Table 1. Longitudinal Studies of Sleep, Depression, & Cardiovascular Disease.

Reference	Sample and Follow-Up	Sleep Measure(s)	Depression Measure	CVD Outcome	Sleep Findings	Depression Findings
King (29)	n = 495; 41% M age: 35-47 FU: 5 yrs	- actigraphy over 6 nights and self-reported habitual sleep duration	- CES-D - Cook-Medley Hostility Scale	coronary artery calcification	actigraphy: decreasing duration = ↑ calcification self-reported duration: NS	Not Reported
Mallon (30)	n = 1870; 48% M age: 45-65 FU: 12 yrs	- DIS & DMS severity - avg. duration (< 6, 6-8*, > 8)	‘Do you feel depressed?’ (Yes/No)	CVD mortality	MEN: DIS = ↑ CVD mortality   duration = NS WOMEN: ALL NS	MEN: Depression = ↑ CVD mortality WOMEN: Depression = NS
Ayas (31)	n = 71,617; 100% W age: 45-65 FU: 10 yrs	avg. duration in 24-hr (≤5, 6, 7, 8*, ≥9)	≤ 52 MHI (assessed 6 yrs after sleep)	nonfatal MI or fatal CHD	≤ 5, ≥ 9 = ↑ CHD	Not Reported
Chen (32)	n = 93,175; 100%W age: 50-79 FU: 7.5 yrs	avg. duration over past 4 weeks (≤5, 6, 7*, 8, 9, ≥10)	5-item CES-D scores (sleep item excluded) and history of depression	fatal/nonfatal ischemic stroke	adjusted for demographics + depression: ≤ 6, 8, ≥ 9 = ↑ stroke adjusted for CV risk factors: ≤ 6 = NS; 8, ≥ 9 = ↑ stroke excluding baseline CVD: ≤ 6, 8, ≥ 9 = ↑ stroke	Not Reported
Ferrie (33)	n = 9,781; 68% W age: 35-55 FU1: 17 yrs FU2: 12 yrs	avg. weeknight duration, assessed at Phase 1 and Phase 3 (~6 yrs later) (≤ 5, 6, 7*, 8, ≥ 9)	GHQ scores (sleep item excluded)	CVD mortality	Phase 1: all NS Phase 3: ≤ 5 = ↑CVD mortality decrease from 6, 7, or 8 hrs. b/w Phase 1-Phase 3 = ↑ CVD mortality	Not Reported
Gangwisch (34)	n = 4913, 36% M age: 32-86 FU: 8-10 yrs	- avg. duration (≤ 5, 6, 7-8*, ≥ 9) -frequency of DIS & DMS (combined in 1 scale)	≥ 16 on CES-D, antidepressant use	HT (self or hospital report, or cause of death)	Total Sample: ≤ 5 = ↑ HT  - DIS/DMS = ↑ HT  - with ≤ 5 & DIS/DMS in  same model, both NS ages 32-59: ≤ 5 = ↑ HT  - DIS/DMS = ↑ HT ages 60-86: all NS	Total Sample: Depression = ↑ HT ages 32-59: -Depression = ↑ HT -NS after adjusting for ≤ 5 & DIS/DMS ages 60-86: Depression = NS
Ikehara (35)	n = 98,634; 42% M age: 40-79 FU: 14.3 yrs	avg. weekday duration (< 4.5, 5, 6, 7*, 8, 9, ≥ 9.5)	4 study-specific depressive items	CVD mortality	MEN: 8, 9, ≥ 9.5 = ↑ CVD mortality WOMEN: 5, 8, 9, ≤ 9.5 = ↑ CVD mortality	Not Reported
Meisinger (36)	n = 6896; 51% M age: 45-74 FU: 10.1 yrs	avg. duration (≤5, 6, 7, 8*, ≥9)	Zerssen affective symptom checklist	fatal/nonfatal MI, sudden cardiac death	MEN: All NS WOMEN: ≤ 5 = ↑ MI    DIS = ↑ MI	Not Reported
Cappuccio (37)	n = 5766; 73% M FU: 3 yrs	avg. weeknight duration (≤ 5, 6, 7*, 8, ≥ 9)	SF-36 MHI & GHQ scores	BP ≥ 140/90 or HT medication	MEN: all NS WOMEN: ≤ 5 = ↑ HT; NS after adjusting for CVD risk factors & depression	Not Reported
Patel (38)	n = 82,969; 100% W Mean age: 53 FU: 14 yrs	avg. duration in 24-hr (≤ 5, 6, 7*, 8, ≥ 9)	≤ 52 MHI (assessed 6 yrs after sleep)	CVD mortality	≥ 9 = ↑ CVD mortality	Not Reported
Stone (39)	n = 8101; 100% W age: 69+ FU: 7 yrs	avg. duration in 24-hr (including naps) (<6, 6-<8, 8-<9*, 9-<10, ≥10)	≥ 6 Geriatric Depression Scale	CVD mortality	9-<10, ≥ 10 = ↑ CVD mortality	Not Reported
Lan (40)	n = 3079; 57% M age: 64+ FU: 10 yrs	avg. duration (< 7, < 8*, < 9, < 10, ≥ 10)	≥ 5 on abridged CES-D (possible scores 0-24)	CVD mortality	MEN: ≥ 10 = ↑ CVD mortality WOMEN: < 9, < 10, ≥ 10 = ↑ CVD mortality	Not Reported
Lopez- Garcia (41)	n = 890, 48% M Mean age: 70 FU: 2 yrs	avg. duration (4-5, 6, 7*, 8, 9, 10-15)	‘Depression with need for treatment’ (yes/no)	self-reported hypertension	All NS	Not Reported
Nicholson (42)	n = 5449; 100% M age: 32-86 FU: 6.8 yrs	sleep subscale from the GHQ, classified as new, former, or persistent disturbances	Distress/anxiety & depression GHQ subscales, classified as new, former, or persistent	CVD events: CHD death, nonfatal MI, angina	-Persistent & former sleep disturbances = ↑ CVD events -New sleep disturbance = NS	persistent distress/anxiety subscale = ↑ CVD depression subscale = NS
Newman (43)	n = 5888; 42% M age: 65+ FU: 4.9 yrs	occurrence of DIS, DMS, daytime sleepiness, & snoring (‘yes/no’)	10-item CES-D	1.CVD death and morbidity (MI, angina, CHF, stroke) 2. incident MI 3. CHF	MEN: all symptoms = NS WOMEN: daytime sleepiness =  ↑ CVD death/morbidity  -all complaints = NS for MI  -daytime sleepiness combined  with DMS = ↑ CHF	CES-D = NS
Phillips (44)	CVD sample n = 11,863; 44% M age: 35-55 FU: 6 yrs	occurrence of DIS, DMS, & nonrestorative sleep (‘yes/no’)	Maastricht Questionnaire	fatal/ nonfatal MI or other cardiac event	All 3 sleep symptoms = ↑ CV events Individual sleep complaints = NS	Not Reported
	HT sample n = 8757; 45% M age: 45-65 FU: 6 yrs	occurrence of DIS, DMS, & nonrestorative sleep (‘yes/no’)	Maastricht Questionnaire	SBP > 160, DBP > 95, or HT medication	DIS = ↑ HT DMS = ↑ HT	Not Reported
Phillips (45)	n = 1419; 41% M age: 64-91 FU: 6 yrs	occurrence of DIS & DMS (‘yes’/’no’)	≥ 10 on modified CES-D (0-30 range)	SBP ≥ 140, DBP ≥ 90, or history of HT + medication	non-AA Men: DIS = ↓HT AA WOMEN: DIS = ↑ HT (trend) AA men, non-AA WOMEN: all NS	Not Reported
Schwartz (46)	n = 2960 ; 34% M age: 65+ FU: 3 yrs	frequency of DIS, DMS, restless sleep, combined in a continuous scale	modified CES-D	fatal/nonfatal MI	Adjusted for demographics & education: DIS, restless sleep, & sleep scale = ↑ MI Adjusted for above + self-rated health & depression: DIS, restless sleep, & sleep scale = NS	CES-D = ↑ MI

X* = reference group. CES-D = Center for Epidemiological Studies Depression Scale; CHD = coronary heart disease; CHF = coronary heart failure; CV = cardiovascular; CVD = cardiovascular disease; DBP = diastolic blood pressure; DIS = difficulty initiating sleep; DMS = difficulty maintaining sleep; GHQ = General Health Questionnaire; HT = hypertension; FU = follow-up; M = men; MI = myocardial infarction; NS = non-significant; MHI = Mental Health Index of the Short Form-36; SBP = systolic blood pressure; W = women.