13Evidence A

Getting about 7 hours of sleep each night with a consistent schedule

For people who consistently sleep less than 7 hours, the probability of death during the same period is approximately 10% higher. The more irregular the routine, the higher the risk. Compared to the group with the most irregular routines, others have a risk that is 20% to nearly 50% lower. The irregularity of the routine is a better indicator of mortality risk than the duration of sleep.

Cost

No cost involved. You simply need to allocate time for sle…

Benefit

A pooled analysis of 16 longitudinal studies — involving 1.38 million participants and 113 000 deaths — shows…

Cost

No cost involved. You simply need to allocate time for sleep — most people achieve this by cutting back on phone usage. The real challenge is maintaining a fixed bedtime and wake‑time.

Benefit

A pooled analysis of 16 longitudinal studies — involving 1.38 million participants and 113 000 deaths — shows that short sleepers face a 12% higher risk of death (RR 1.12), while long sleepers face a 30% higher risk (RR 1.30). When sleep duration is grouped into categories, the 7‑hour bracket shows the lowest risk; each additional hour beyond 7 raises risk by about 13% (RR 1.13), and each hour less than 7 raises it by roughly 6% (RR 1.06). In the UK Biobank, wrist‑watch data from ~61 000 participants were used to rank them into five groups based on schedule regularity; the four more regular groups had a 20%–48% lower mortality risk than the least regular group. Another UK Biobank study tracked 51 562 individuals for new cardiovascular events; those with a social jet‑lag of 2 hours or more faced a 30% higher risk (HR 1.30, 95% CI 1.11–1.54), and this link persisted even among people getting a normal amount of sleep.

Original sources

Cappuccio FP 等 (2010). Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep. https://doi.org/10.1093/sleep/33.5.585;Yin J 等 (2017). Relationship of Sleep Duration With All-Cause Mortality and Cardiovascular Events: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. JAHA. https://doi.org/10.1161/JAHA.117.005947;Windred DP 等 (2024). Sleep regularity is a stronger predictor of mortality risk than sleep duration: A prospective cohort study. Sleep. https://doi.org/10.1093/sleep/zsad253;Kumar N, Krishnamurthy S (2026). Social jet lag is associated with incident cardiovascular disease independent of sleep duration and cardiac genetic risk. Journal of Internal Medicine. https://doi.org/10.1111/joim.70133

Open source link
Book note

What needs to be changed are the two aspects of sleeping too little and an irregular routine; there is no need to deliberately compress sleep time. People who sleep for long periods are at high risk, but most likely the causality is reversed: depression, chronic diseases, and sleep apnea cause people to sleep more. Additionally, regarding the point of a regular routine, there are currently two follow-up studies supporting this, both of which are observational without grouping, and viewed individually, they constitute Class B evidence. For how to compensate after staying up late, see item 38 of this section (catch up on sleep the following night after staying up late). For how to treat long-term insomnia, see Section 3, article 26 (for long-term insomnia, perform cognitive behavioral therapy first).

My note