Available online 21 July 2022

Not meeting sleep duration and activity guidelines increased mortality risk

Mortality risks of short or long sleep are reduced by meeting activity guidelines

Interventions targeting physical activity and sleep duration may be beneficial

To examine the joint associations between meeting guidelines for physical activity (PA) and sleep duration and all-cause mortality risk among adults.

Participants were adults (n = 282,473) aged 18–84 years who participated in the 2004–2014 U.S. National Health Interview Survey. Mortality status was ascertained using the National Death Index through December 2015. Self-reported PA (Active: meeting both aerobic (AER) and muscle-strengthening (MSA) guidelines, AER only (AER), MSA only, or not meeting either AER or MSA (Inactive)) and sleep duration (Short, recommended (Rec), or Long) were classified according to guidelines, and 12 PA–sleep categories were derived. Adjusted hazard ratios and 95% confidence intervals for all-cause mortality risk were estimated using Cox proportional hazards regression models.

A total of 282,473 participants (55% female) were included; 18,793 deaths (6.7%) occurred over an average follow-up of 5.4 years. Relative to the Active–Rec group, all other PA-sleep groups were associated with increased mortality risk except for the Active–Short group (hazard ratio = 1.08; 95% confidence interval: 0.92–1.26). The combination of long sleep with either MSA or Inactive appeared to be synergistic. For a given sleep duration, mortality risk progressively increased among participants classified as AER, MSA, and Inactive. Within each activity level, the mortality risk was greatest among adults with long sleep.

Relative to adults meeting guidelines for both PA and sleep duration, adults who failed to meet guidelines for both AER and muscle strengthening PA and who also failed to meet sleep duration guidelines had elevated all-cause mortality risks. These results support interventions targeting both PA and sleep duration to reduce mortality risk.

Activity–sleep patterns

All-cause mortality

Prospective

Resistance training

© 2022 Published by Elsevier B.V. on behalf of Shanghai University of Sport.