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

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

Circadian Biology Weekly Brief ↗PubMed ↗DOI ↗

Updated Mar 31, 2026

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.

Simplified

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

Funding

Competing interests

All authors have seen and approved the manuscript. This study was supported by The National Key Research and Development Program of China (Grant No. 2020YFC2008002), the Science and Technology Innovation Program of Hunan Province (Grant No. 2020RC4006, 2021RC2014), and the Project of Innovation-Driven Plan in Central South University (Grant No. 2020CX017). The authors report no conflicts of interest.

PubMed

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

Abstract

Funding

Competing interests

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