The Healthspan Map · Sleep (Ch6)

Sleep duration

What this is linked to

Where Sleep duration is linked — 32 sources.In the order the Map holds them: strongest evidence first. That is a statement about the evidence, not about what matters most.
Nutrient or lever	Direction	Strength	Evidence type	What was found	Source
Sleep duration	Watch this	Moderate	RCT / meta-analysis	Sleep deprivation significantly raises state anxiety (meta-analysis) via heightened amygdala reactivity; short sleep predicts anxiety.	Sleep deprivation & state anxiety meta (opens in a new tab)
Sleep duration	Watch this	Moderate	Cohort / observational	Short sleep (≤5 h → 1.8× falls in women; <6 h → recurrent falls) and, in meta-analysis, long sleep too raise fall risk — a U-shaped relationship.	Sleep quality & falls nationwide study (PMC8566001) (opens in a new tab)
Sleep duration	Watch this	Strong	Systematic review	Sleep deprivation impairs attention and working memory; 7-8 h is optimal for cognition.	Sleep-cognition overview 2023 (opens in a new tab)
Sleep duration	Watch this	Strong	Established clinical	Sleep deprivation is the single most common cause of daytime sleepiness and fatigue; symptoms appear after even mild sleep restriction.	Excessive daytime sleepiness review (AFP) (opens in a new tab)
Sleep duration	Watch this	Moderate	RCT / meta-analysis	Insomnia roughly doubles the risk of developing depression (OR 2.60); a core modifiable risk factor.	Baglioni et al. 2011 (opens in a new tab)
Sleep duration	Watch this	Moderate	RCT / meta-analysis	Poor/short sleep worsens IBS and functional GI symptom severity.	Sleep & gut-brain axis (opens in a new tab)
Sleep duration	Watch this	Moderate	RCT / meta-analysis	Irregular sleep is a major migraine trigger; consistent sleep-wake schedules are a cornerstone of prevention.	Robblee & Starling 2019, Cleveland Clinic J Med; lifestyle-migraine meta 2024 (opens in a new tab)
Sleep duration	Watch this	Moderate	Review / narrative	Irregular sleep is a major migraine trigger; consistent sleep-wake schedules are a cornerstone of prevention.	Robblee & Starling, "SEEDS for success: Lifestyle management in migraine", Cleve Clin J Med 2019 (opens in a new tab)
Sleep duration	Watch this	Moderate	RCT / meta-analysis	Irregular sleep is a major migraine trigger; consistent sleep-wake schedules are a cornerstone of prevention.	"The relationship between lifestyle behaviors and tension-type headache and migraine: a systematic review and meta-analysis", Medicine 2025 (opens in a new tab)
Sleep duration	Watch this	Moderate	RCT / meta-analysis	Short sleep is associated with higher hypertension risk (OR ~1.36).	Short sleep & hypertension meta (opens in a new tab)
Sleep duration	Watch this	Strong	RCT / trial	Sleep is when muscle repairs: one night of deprivation cut muscle protein synthesis ~18% and shifted the body catabolic (cortisol up, growth hormone/testosterone down); poor sleep also lowers the pain threshold.	Sleep & muscle protein synthesis (Saner/Lamon 2021) (opens in a new tab)
Sleep duration	Watch this	Strong	RCT / meta-analysis	Short sleep raises obesity risk via lower leptin and higher ghrelin; about 1 h more sleep links to ~0.35 kg/m2 lower BMI.	Short sleep & central obesity meta (opens in a new tab)
Sleep duration	Watch this	Moderate	Cohort / observational	Short sleep (<=5 h) is linked to lower BMD and higher osteoporosis odds (hip OR 1.63); sleep loss raises cortisol and curbs bone-protective melatonin.	Short sleep & osteoporosis (WHI) (opens in a new tab)
Sleep duration	Watch this	Emerging	RCT / trial	Neuropathic pain and poor sleep reinforce each other; short sleep worsens pain, and easing pain improves sleep.	Neuropathic pain & sleep (opens in a new tab)
Sleep duration	Watch this	Moderate	Cohort / observational	One week of 5-hour nights cut daytime testosterone ~10-15% in healthy young men; short sleep also reduces fecundability, with fertility U-shaped to sleep duration.	Sleep restriction & testosterone (PMC6917985) (opens in a new tab)
Sleep duration	Watch this	Strong	RCT / trial	Actigraphy-measured short sleep sharply raised cold risk after rhinovirus challenge: <5 h → OR 4.50 and 5-6 h → OR 4.24 vs >7 h.	Behaviourally-assessed sleep & the common cold (Prather, Sleep 2015) (opens in a new tab)
Sleep duration	Watch this	Moderate	Review / narrative	Collagen synthesis, cellular repair and wound healing peak during sleep; short sleep impairs all three.	Sleep & skin repair (opens in a new tab)
Sleep duration	Watch this	Moderate	RCT / trial	Sleep loss raises basal cortisol and heightens stress reactivity and amygdala response, making stress harder to regulate.	Sleep deprivation & stress vulnerability (opens in a new tab)
Sleep duration	Watch this	Moderate	RCT / meta-analysis	Sleep loss raises basal cortisol and heightens stress reactivity and amygdala response, making stress harder to regulate.	"The effect of acute sleep deprivation on cortisol level: a systematic review and meta-analysis", Endocr J 2024 (opens in a new tab)
Sleep duration	Watch this	Moderate	Systematic review	Sleep normally inhibits TSH; sleep deprivation nearly doubles nocturnal TSH, and poor sleep is associated with subclinical hypothyroidism.	Thyroid & sleep patterns systematic review (PMC11285688) (opens in a new tab)
Sleep duration	Watch this	Moderate	Cohort / observational	Tinnitus is strongly linked to sleep disturbance (about double the odds); short sleep and tinnitus reinforce each other.	Tinnitus & sleep (opens in a new tab)
Sleep duration	Watch this	Strong	RCT / meta-analysis	Short sleep (under 6 h vs 7 h) raises type 2 diabetes risk ~30% via insulin resistance, cortisol and appetite-hormone disruption.	Short sleep & T2D meta (opens in a new tab)
Sleep duration	Watch this	Moderate	Cohort / observational	Obstructive sleep apnea raised AMD risk (HR 1.36) in a 67,000-patient cohort via repetitive nighttime oxygen deprivation; short/disrupted sleep is implicated across retinal disease.	OSA & AMD national cohort (PMC12211732) (opens in a new tab)
Sleep duration	Watch this	Strong	RCT / meta-analysis	Sleeping under 6 h raises cold susceptibility 4.2x, cuts vaccine antibody response ~50%, and drops NK-cell activity ~70%; AASM recommends >=7 h citing immunity.	Sleep duration & immunity (opens in a new tab)
Sleep duration	Watch this	Strong	RCT / meta-analysis	Sleep duration has a U-shaped link with type 2 diabetes; risk is lowest at 7-8 h and rises for both short and long sleep.	Shan et al., Diabetes Care 2015 (meta-analysis) (opens in a new tab)
Sleep duration	Watch this	Strong	Cohort / observational	Sleeping <6 h vs 7 h raised incident type 2 diabetes risk by ~30%, independent of baseline health.	45 and Up Study + meta-analysis (n=447,124) (opens in a new tab)
Sleep duration	Watch this	Moderate	RCT / meta-analysis	Both short and long sleep are associated with coronary artery disease, heart failure, stroke, and cardiovascular and all-cause mortality.	Sleep-duration and cardiovascular disease meta-review + Mendelian randomization (opens in a new tab)
Sleep duration	Watch this	Moderate	RCT / meta-analysis	Both short and long habitual sleep were associated with higher all-cause mortality.	Cappuccio et al., Sleep 2010 (all-cause mortality meta-analysis) (opens in a new tab)
Sleep duration	Watch this	Moderate	Established clinical	Insufficient sleep impairs cognition and mood regulation.	Sleep-cognition/mood literature (AHA statement) (opens in a new tab)
Sleep duration	Watch this	Moderate	Established clinical	Short sleep raises systemic inflammation and lowers infection resistance.	Sleep-restriction and immune literature (opens in a new tab)
Sleep duration	Watch this	Moderate	RCT / meta-analysis	Both short and long habitual sleep were associated with higher all-cause mortality (a U-shaped relationship).	Cappuccio et al., Sleep 2010 (all-cause mortality meta-analysis) (opens in a new tab)
Sleep duration	Watch this	Moderate	Systematic review	Short sleep (<=5 h, RR 1.46) and long sleep both raise incident CKD risk across 2.5 million people; short sleep also raises fatty-liver risk (OR 1.15).	Sleep duration & CKD meta-analysis (PMC11304598) (opens in a new tab)