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To the Editor: Dr Banks and colleagues¹ found a significant difference between the prevalence of diabetes, hypertension, and cardiovascular diseases between the United States and England, even when using biomarkers to control for differences in diagnosis or self-reported disease. Short sleep duration has been implicated as a risk factor for hypertension,² increased C-reactive protein,³ and glucose intolerance,⁴ all biomarkers that showed a difference between populations.

In one study, sleep was postulated as an explanation for part of the relationship between low-socioeconomic status and increased incidence of chronic conditions, and National Health and Examination Survey sleep data were available for that study.⁵ If comparable data are available for British individuals, it would be interesting to know whether part of the health disparities between the United States and England might be explained by differences in sleep habits.

Financial Disclosures: None reported.

Caroline F. Thorn, PhD
thorn@helix.stanford.edu
Stanford University School of Medicine
Stanford, Calif

1. Banks J, Marmot M, Oldfield Z, Smith JP. Disease and disadvantage in the United States and in England. JAMA. 2006;295:2037-2045. FREE FULL TEXT 2. Gangwisch JE, Heymsfield SB, Boden-Albala B, et al. Short sleep duration as a risk factor for hypertension: analyses of the first National Health and Nutrition Examination Survey. Hypertension. 2006;47:833-839. FREE FULL TEXT 3. Meier-Ewert HK, Ridker PM, Rifai N, et al. Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk. J Am Coll Cardiol. 2004;43:678-683. FREE FULL TEXT 4. Spiegel K, Leproult R, Van Cauter E. Impact of sleep debt on metabolic and endocrine function. Lancet. 1999;354:1435-1439. FULL TEXT | ISI | PUBMED 5. Van Cauter E, Spiegel K. Sleep as a mediator of the relationship between socioeconomic status and health: a hypothesis. Ann N Y Acad Sci. 1999;896:254-261. FREE FULL TEXT

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2006;296:2312.

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