Chen Ruyan, Han Jianglong, Li Si, Deng Haiyu, Jian Tingting, Huang Zheyu, Wei Yuxuan, Fu Zhenming
Cancer Center, Renmin Hospital of Wuhan University, Wuhan, China.
Front Public Health. 2025 Jan 17;13:1532320. doi: 10.3389/fpubh.2025.1532320. eCollection 2025.
Sleep duration and physical activity (PA) are critical factors influencing mortality risk. However, the interaction between sleep duration and PA with mortality risk among cancer survivors has not been well explored.
This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 2007-2018. Multivariable Cox regression analysis and restricted cubic splines were employed to evaluate the hazard ratios (HRs) and 95% confidence intervals (CIs) of the association of sleep duration and PA with mortality risk in cancer survivors. Multiplicative and additive interaction terms were constructed to assess interaction effects.
The study included a total of 2,528 adult cancer survivors (aged≥20 years). Sleep duration exhibited a U-shaped association with all-cause and cancer-specific mortality, while demonstrating an inverted L-shaped association with cardiovascular disease (CVD) mortality. Compared to physically inactive participants, those with adequate PA had lower risks of all-cause mortality (HR = 0.542, 95% CI: 0.540-0.543), cancer mortality (HR = 0.486, 95% CI: 0.484-0.488), and CVD mortality (HR = 0.759, 95% CI: 0.755-0.763) among cancer survivors. A significant additive interaction was found between extreme sleep duration and PA on all-cause mortality risk among cancer survivors (long sleep duration: relative excess risk due to interaction (RERI) = 1.514, 95% CI: 1.504-1.525; short sleep duration: RERI = 0.725, 95% CI: 0.713-0.737).
Extreme sleep duration and lack of PA were associated with mortality risk in cancer survivors independently and jointly. Maintain appropriate sleep duration and doing regular PA may synergistically improve cancer survival among cancer survivors.
睡眠时间和身体活动（PA）是影响死亡风险的关键因素。然而，癌症幸存者中睡眠时间和PA与死亡风险之间的相互作用尚未得到充分研究。
这项横断面研究利用了2007 - 2018年美国国家健康与营养检查调查（NHANES）的数据。采用多变量Cox回归分析和受限立方样条来评估癌症幸存者中睡眠时间和PA与死亡风险关联的风险比（HRs）和95%置信区间（CIs）。构建乘法和加法交互项以评估交互作用。
该研究共纳入2528名成年癌症幸存者（年龄≥20岁）。睡眠时间与全因死亡率和癌症特异性死亡率呈U形关联，而与心血管疾病（CVD）死亡率呈倒L形关联。与身体不活动的参与者相比，PA充足的癌症幸存者全因死亡率（HR = 0.542，95% CI：0.540 - 0.543）、癌症死亡率（HR = 0.486，95% CI：0.484 - 0.488）和CVD死亡率（HR = 0.759，95% CI：0.755 - 0.763）风险更低。在癌症幸存者中，极端睡眠时间和PA之间在全因死亡风险上存在显著的加法交互作用（睡眠时间长：交互作用导致的相对超额风险（RERI）= 1.514，95% CI：1.504 - 1.525；睡眠时间短：RERI = 0.725，95% CI：0.713 - 0.737）。
极端睡眠时间和缺乏PA分别独立且共同与癌症幸存者的死亡风险相关。保持适当的睡眠时间并进行规律的PA可能协同改善癌症幸存者的生存率。
