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Comment & Response
March 1, 2021

Living to Dream—Reply

Author Affiliations
  • 1Jazz Pharmaceuticals Inc, Palo Alto, California
  • 2University of California, San Francisco, San Francisco
  • 3California Pacific Medical Center Research Institute, San Francisco
  • 4Stanford University, Palo Alto, California
JAMA Neurol. 2021;78(4):495-496. doi:10.1001/jamaneurol.2021.0056

In Reply We thank Bliwise and Trotti for their interest in our findings showing that lower amounts of rapid eye movement (REM) sleep were associated with increased rates of mortality in 2 distinct population-based studies.1 Since this article1 was published, we have tested our findings in a third cohort, the Sleep Heart Health Study, and observed consistent outcomes (hazard ratio, 1.13 [95% CI, 1.07-1.18]). The Sleep Heart Health Study includes 5550 participants (47.6% men; 84.6% white) of a mean (SD) age of 63.0 (11.2) years at baseline who were monitored for a median of 11.9 years. A meta-analysis of all 3 cohorts yielded an overall hazard ratio of 1.13 (95% CI, 1.10-1.17; overall effect P < .001) for all-cause mortality in more than 10 000 participants, making it an extraordinarily robust finding across a broad age range and diverse racial/ethnic groups.2

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