1. Physical activity levels at or above the WHO guidelines threshold eliminated most of the negative effects of poor sleep on mortality.
2. The negative effects of poor sleep were further amplified with lower levels of physical activity.
Evidence Rating Level: 2 (Good)
Beyond the independent health effects that physical activity and sleep have on health, there has been a lack of studies examining their effect in combination. As such, the goal of this study was to investigate the impact of these two variables on all-cause, cardiovascular and cancer mortality.
This prospective cohort study recruited 380,055 participants from the UK Biobank between 2006-2010. The study included adults aged 37-73 years from 22 recruitment centers within the UK. Participants with a past history of cardiovascular disease (CVD), cancer, obstructive sleep apnea, or class III obesity at baseline were excluded. Participants completed questionnaires and interviews with respect to their physical activity levels and sleep patterns. Participants were followed up on health outcomes to the date of death or censorship (May 2020), whichever came first.
Compared with participants who had high physical activity and health sleep patterns, those who had both poor sleep and low physical activity had the highest mortality risk for all-cause, total cardiovascular and cancer death. Compared with no physical activity, levels that were above the World Health Organization (WHO) recommended threshold appeared to eliminate the negative associations of poor sleep and mortality. The strengths of this paper included its large sample size, long follow-up of 11 years and collection of a wide range of variables. The limitations included the self-reported nature of physical activity and sleep patterns, as well as the various exclusion criteria which may limit the study’s generalizability. This study’s findings not only suggested that a focus on both physical activity and sleep may lead to greater protective effects on health outcomes; but that there may be potential to further explore this association with future trials.
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