Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.
Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, New South Wales, Australia.
Br J Sports Med. 2022 Jul;56(13):718-724. doi: 10.1136/bjsports-2021-104046. Epub 2021 Jun 29.
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.
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.
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.
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.
尽管身体活动不足和睡眠质量差都与死亡率呈负相关，但这两种行为的综合影响尚不清楚。本研究旨在调查身体活动（PA）和睡眠与全因和特定原因死亡率风险的联合关联。
纳入了来自英国生物库的 380055 名年龄为 55.9（8.1）岁（55%为女性）的参与者。根据当前的公共卫生指南，将基线 PA 水平分为高、中、低和无中度至剧烈 PA（MVPA）。我们将睡眠分为健康、中等和较差，并采用已建立的复合睡眠评分，包括睡眠类型、睡眠时间、失眠、打鼾和白天嗜睡。因此，我们得出了 12 种 PA-睡眠组合。所有原因、全因心血管疾病（CVD）、CVD 亚型（冠心病、出血性中风、缺血性中风）以及总癌症和肺癌的死亡率均随访至 2020 年 5 月。
平均随访 11.1 年后，睡眠评分与全因、全因 CVD 和缺血性中风死亡率呈剂量反应关系。与高 PA-健康睡眠组（参照组）相比，无 MVPA-较差睡眠组的全因死亡率最高（HR（95%CI），（1.57（1.35 至 1.82）），全因 CVD（1.67（1.27 至 2.19）），总癌症（1.45（1.18 至 1.77））和肺癌（1.91（1.30 至 2.81）））。较差睡眠与除中风以外的所有结果的有害关联，在 PA 较低时会加剧。
较差睡眠与全因和特定原因死亡率风险的有害关联因 PA 较低而加剧，表明可能存在协同作用。我们的研究支持在研究和临床实践中需要同时针对这两种行为。
