While some studies have found a positive association between both short and long sleep durations and cardiovascular disease (CVD), others have found an association only with a long or short sleep duration. In addition, there are limited data from non-Western populations on this topic. The authors examined the association between sleep duration and coronary heart disease (CHD) mortality among Chinese adults in Singapore (1993-2006), performing a prospective cohort study among 58,044 participants aged > or =45 years (55.9% women) without preexisting CVD. The main outcome of interest was CHD mortality (n = 1,416). The authors found both short and long sleep durations to be positively associated with CHD mortality, independent of smoking, alcohol intake, and body mass index. Compared with persons with a sleep duration of 7 hours (referent), the multivariable relative risk of CHD mortality for a sleep duration of < or =5 hours was 1.57 (95% confidence interval: 1.32, 1.88); for a sleep duration of > or =9 hours, it was 1.79 (95% confidence interval: 1.48, 2.17). This association persisted in subgroup analyses by sex and body mass index. In a population-based cohort of Chinese adults from Singapore, sleep durations of < or =5 hours and > or =9 hours (versus 7 hours) were modestly associated with CHD mortality. These results suggest that sleep duration may be an important marker for CVD.