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
Leary EB, Stone KL, Mignot E. Living to Dream—Reply. JAMA Neurol. 2021;78(4):495–496. doi:10.1001/jamaneurol.2021.0056
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