Sleep Duration, Chronotype, and Mortality in Parkinson’s Disease: A Prospective Cohort Study

Mar 20, 2026Nature and science of sleep

Sleep Length, Daily Activity Patterns, and Risk of Death in Parkinson's Disease

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Abstract

Self-reported longer sleep duration was associated with higher mortality in 435 patients with Parkinson's disease over a mean follow-up time of 4.3 years.

In a univariable analysis, longer sleep duration had a hazard ratio of 1.31, indicating a significant association with increased mortality.
After adjusting for various factors, the hazard ratio for longer sleep duration was 1.17, suggesting it remains linked to higher mortality.
Older age, male gender, longer duration of Parkinson's disease, and depression were also associated with increased mortality.
Higher body mass index (BMI) and increased physical activity were correlated with lower mortality rates.
Short sleep duration did not show a significant association with mortality after multivariable adjustment.

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AIM: Sleep disturbances are a common non-motor symptoms in Parkinson's disease (PD) and may occur already in the prodromal phase. In the general population, shorter sleep duration is linked to higher mortality, while longer sleep duration has been associated with an increased risk of developing PD. We examined the relationships between sleep duration, , and mortality in patients with PD.

METHODS: A total of 855 randomly selected patients with PD completed a structured questionnaire including self-reported sleep duration and chronotype. Mortality data were collected from the national death registry.

RESULTS: Altogether 435 subjects (238 men; 54.7%) were included. The mean follow-up time was 4.3 (0.3-7.0) years, during which 99 participants had died. In a univariable model, longer sleep duration was associated with higher mortality [HR 1.31, 95% confidence interval (1.15-1.49), P<0.0001]. In a fully adjusted model, longer sleep duration [HR 1.17 (1.01-1.35), P=0.035], older age, male gender, PD duration and depression were associated with higher mortality. BMI and high physical activity were associated with lower mortality. Although short sleep showed an association with mortality in univariable analyses, this association did not persist after multivariable adjustment [HR 0.82 (0.52-1.30), P=0.401]. Chronotype was not associated with mortality. Long sleepers were older, had lower mean levodopa-dose, took more naps, and were sleepier than short sleepers.

CONCLUSION: Self-reported longer sleep duration was associated with higher mortality in patients with Parkinson's disease, whereas chronotype was not associated with mortality. This does not imply a protective effect of shorter sleep duration. Further studies are needed to clarify whether sleep duration reflects disease-related factors, behavioral patterns, or progression of Parkinson's disease.

Key numbers

1.31

Increase in Mortality Risk

Hazard ratio for longer sleep duration in univariable models.

0.82

Short Sleep Duration Mortality Risk

Hazard ratio for short sleep duration in fully adjusted models.

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Sleep Duration, Chronotype, and Mortality in Parkinson’s Disease: A Prospective Cohort Study

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