The association between sleep characteristics and the risk of all-cause mortality among individuals with cardiometabolic multimorbidity: a prospective study of UK Biobank

Jan 16, 2023Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

How Sleep Patterns Are Linked to Death Risk in People with Multiple Heart and Metabolic Conditions

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Abstract

Among 35,757 participants, a healthy sleep score was associated with a 10% lower risk of all-cause mortality for each point increase.

Early chronotype, sleeping 7-8 hours per day, no frequent excessive daytime sleepiness, and being free of insomnia are associated with reduced all-cause mortality risk.
A 1-point increase in the healthy sleep score corresponds to a hazard ratio of 0.90 for all-cause mortality.
Participants with intermediate and healthy sleep patterns have 9% and 23% lower risks of all-cause death, respectively, compared to those with poor sleep patterns.
These findings suggest that adopting a healthy sleep pattern may contribute to improved longevity in individuals with cardiometabolic multimorbidity.

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STUDY OBJECTIVES: To investigate the implications of both sleep factors and sleep patterns on the prognosis of cardiometabolic multimorbidity.

METHODS: From UK Biobank, individuals with cardiometabolic multimorbidity , defined as the coincidence of at least 2 cardiometabolic diseases (hypertension, diabetes mellitus, coronary heart disease, and stroke) were included in this study. Four low-risk sleep factors, including early chronotype, sleep 7-8 h/d, free of insomnia, and no frequent excessive daytime sleepiness, were used to generate a healthy sleep score ranging from 0 to 4. Participants with a score of 0-1, 2, 3-4 were clustered into groups with poor, intermediate, and healthy sleep pattern, respectively. We assessed the adjusted hazard ratios and 95% confidence intervals for all-cause mortality using the Cox proportional hazards model.

RESULTS: Among included 35,757 participants, the mean age (standard deviation)) was 61.82 (6.3) years. After full adjustment, early chronotype, sleep 7-8 h/d, no frequent excessive daytime sleepiness, and free of insomnia were independently associated with 8%, 12%, 11%, and 8% lower risk of all-cause mortality among all persons with cardiometabolic multimorbidity. We found the fully adjusted hazard ratio (95% confidence interval) for all-cause mortality was 0.90 (0.88-0.92) for a 1-point increase in the healthy sleep score. Compared with the reference group, participants with the intermediate and healthy sleep pattern had 9% and 23% lower risk of all-cause death, respectively, in the fully adjusted model.

CONCLUSIONS: A healthy sleep pattern combining 4 low-risk sleep factors could be regarded as a healthy lifestyle for individuals with cardiometabolic multimorbidity to lower the risk of all-cause mortality.

CITATION: He L, Ma T, Cheng X, Bai Y. The association between sleep characteristics and the risk of all-cause mortality among individuals with cardiometabolic multimorbidity: a prospective study of UK Biobank.. 2023;19(4):651-658. J Clin Sleep Med

The association between sleep characteristics and the risk of all-cause mortality among individuals with cardiometabolic multimorbidity: a prospective study of UK Biobank

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