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Huang BH, Duncan MJ, Cistulli PA, et al. Sleep and physical activity in relation to all-cause, cardiovascular disease and cancer mortality risk. Br J Sports Med. 2021;doi: 10.1136/bjsports-2021-104046.
Huang, B. H., Duncan, M. J., Cistulli, P. A., Nassar, N., Hamer, M., & Stamatakis, E. (2021). Sleep and physical activity in relation to all-cause, cardiovascular disease and cancer mortality risk. British journal of sports medicine, . https://doi.org/10.1136/bjsports-2021-104046
Huang, Bo-Huei, et al. "Sleep and physical activity in relation to all-cause, cardiovascular disease and cancer mortality risk." British journal of sports medicine vol. (2021). doi: https://doi.org/10.1136/bjsports-2021-104046
Huang BH, Duncan MJ, Cistulli PA, Nassar N, Hamer M, Stamatakis E. Sleep and physical activity in relation to all-cause, cardiovascular disease and cancer mortality risk. Br J Sports Med. 2021 Jun 29; doi: 10.1136/bjsports-2021-104046. Epub 2021 Jun 29. PMID: 34187783.
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Br J Sports Med. 2021 Jun 29; doi: 10.1136/bjsports-2021-104046. Epub 2021 Jun 29.

Sleep and physical activity in relation to all-cause, cardiovascular disease and cancer mortality risk.

British journal of sports medicine

Bo-Huei Huang, Mitch J Duncan, Peter A Cistulli, Natasha Nassar, Mark Hamer, Emmanuel Stamatakis

Affiliations

  1. Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.
  2. Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, New South Wales, Australia.
  3. School of Medicine & Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia.
  4. Charles Perkins Centre, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.
  5. Institute Sport Exercise Health, Division of Surgery and Interventional Science, University College London, London, UK.
  6. Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia [email protected].

PMID: 34187783 DOI: 10.1136/bjsports-2021-104046

Abstract

OBJECTIVES: Although both physical inactivity and poor sleep are deleteriously associated with mortality, the joint effects of these two behaviours remain unknown. This study aimed to investigate the joint association of physical activity (PA) and sleep with all-cause and cause-specific mortality risks.

METHODS: 380 055 participants aged 55.9 (8.1) years (55% women) from the UK Biobank were included. Baseline PA levels were categorised as high, medium, low and no moderate-to-vigorous PA (MVPA) based on current public health guidelines. We categorised sleep into healthy, intermediate and poor with an established composited sleep score of chronotype, sleep duration, insomnia, snoring and daytime sleepiness. We derived 12 PA-sleep combinations, accordingly. Mortality risks were ascertained to May 2020 for all-cause, total cardiovascular disease (CVD), CVD subtypes (coronary heart disease, haemorrhagic stroke, ischaemic stroke), as well as total cancer and lung cancer.

RESULTS: After an average follow-up of 11.1 years, sleep scores showed dose-response associations with all-cause, total CVD and ischaemic stroke mortality. Compared with high PA-healthy sleep group (reference), the no MVPA-poor sleep group had the highest mortality risks for all-cause (HR (95% CIs), (1.57 (1.35 to 1.82)), total CVD (1.67 (1.27 to 2.19)), total cancer (1.45 (1.18 to 1.77)) and lung cancer (1.91 (1.30 to 2.81))). The deleterious associations of poor sleep with all outcomes, except for stroke, was amplified with lower PA.

CONCLUSION: The detrimental associations of poor sleep with all-cause and cause-specific mortality risks are exacerbated by low PA, suggesting likely synergistic effects. Our study supports the need to target both behaviours in research and clinical practice.

© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords: cohort study; risk factor; sleep

Conflict of interest statement

Competing interests: None declared.

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