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Updated: Mar 10, 2026

Assessing the Accuracy of Fitness Smartwatch Data for Cardiovascular and Physical Activity Monitoring: A Validation Study in Digital Health
Published on: February 21, 2025
Physical Activity Contributes to Several Sleep-Cardiometabolic Health Relationships
Thirumagal Kanagasabai1, Michael C Riddell1, Chris I Ardern1
1School of Kinesiology and Health Science, York University , Toronto, Canada .
Purpose:
To estimate the contribution of accelerometer-derived physical activity to the relationship between sleep and cardiometabolic health.
Methods:
Data from the 2005 to 2006 US National Health and Nutritional Examination Survey were used (N = 1226; 20 years+). Metabolic syndrome (MetS) was defined by the Joint Interim Statement, and sleep quality and quantity by the Sleep Disorders Questionnaire. Physical activity intensities were defined by activity thresholds (counts per minute) as sedentary activity (0-99), light intensity (100-759), lifestyle activity (760-2019), moderate intensity (2020-5996), and vigorous intensity (≥5999). Outcomes were MetS, number of MetS components, waist circumference (WC), systolic and diastolic blood pressure (BP), triglycerides, HDL-cholesterol, fasting plasma glucose, and fasting insulin concentration. The bootstrap method was used to estimate the amount of mediation or contribution of activity intensities (ab) to the sleep-cardiometabolic health relationships, which were quantified as large (≥0.25) or moderate (≥0.09).
Results:
Lifestyle activity level contributes to several sleep duration and cardiometabolic health relationships, most notably for WC (ab: 0.28), systolic BP (0.39), and fasting insulin concentration (0.85). While moderate intensity and lifestyle activity intensities were large contributors to the sleep quality-fasting insulin concentration relationship (0.47 and 0.48, respectively), light intensity activity only moderately contributed to the relationship between sleep duration and quality with abdominal obesity (0.15).
Conclusion:
Lifestyle and moderate intensity physical activity have a large effect on the relationship between sleep and cardiometabolic health, including WC, BP, and fasting insulin concentration. Appropriate sleep hygiene, in combination with regular physical activity should be considered mutually beneficial targets for cardiometabolic health.
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