Joint associations of accelerometer-measured sleep duration and physical activity with cardiovascular disease and...

To investigate the joint associations of sleep duration and physical activity with incident cardiovascular disease (CVD) and all-cause mortality.

This study utilized data from the UK Biobank. Accelerometers were used to assess sleep duration (categorized into insufficient [<7 h/day], optimal [≥7, <10 h/day], and prolonged [≥10 h/day]) and physical activity (moderate-to-vigorous physical activity [MVPA] and light physical activity [LPA]). Restricted cubic spline and the Cox proportional hazard models were used to investigate the independent and joint associations. A total of 87,879 participants were included. Significant additive interactions between sleep duration and PA on all outcomes were observed, as indicated by the relative excess risk due to interaction. Among participants with low MVPA, compared with optimal sleep duration, suboptimal sleep duration was associated with elevated risk of CVD (prolonged: [HR: 1.17, 95% CI: 1.01, 1.36]) and all-cause mortality (insufficient: [HR: 1.51, 95% CI: 1.21, 1.89]; prolonged: [HR: 1.20, 95% CI: 1.05, 1.36]). When increasing MVPA to a high level, participants with suboptimal sleep had a lower risk of CVD (prolonged: [HR: 0.76, 95% CI: 0.60, 0.97]) and all-cause mortality (insufficient: [HR: 0.59, 95% CI: 0.40, 0.85]; prolonged: [HR: 0.70, 95% CI: 0.56, 0.88]) compared with those with optimal sleep duration and low MVPA. Results for LPA showed similar patterns.

Suboptimal sleep duration and low PA were synergistically associated with an increased risk of CVD and all-cause mortality. Higher levels of MVPA and LPA were associated with an attenuation in the elevated risk related to suboptimal sleep duration.