Assoication between self-reported sleep duration, physcial activity and the risk of all cause and cardiovascular diseases mortality from the NHANES database

Objective The purpose of this study was to investigate the combined effect of self-reported sleep durations and physical activity (PA) on all cause and cardiovascular diseases mortality. Methods Twenty-nine thousand fifty-eight participants (48.5% male, median age 49 years) from the National Health and Nutrition Examination Survey cycles 2007 to 2016 were included. We classified sleep duration into five categories (< 5.5 h/d,5.5–6.5 h/d,6.5–7.5 h/d,7.5–8.5 h/d, ≥ 8.5 h/d) and classified PA levels into three groups (high, medium and low). PA information and self-reported sleep duration were obtained by questionnaire. We derived 15 PA–sleep duration combinations. The primary endpoint was all-cause mortality, and the major secondary endpoint was cardiovascular diseases (CVD) mortality as of December 2022. Results Median follow-up was 91 months. Compared with standard sleep duration (6.5–7.5 h/d), both shorter (< 5.5 h/d) and longer (≥ 8.5 h/d) sleep durations increased risks of all-cause mortality and CVD mortality in low PA. The deleterious associations of sleep duration with all outcomes was amplified by lower PA. There was no significant reduction in CVD mortality risk associated with increased physical activity during short sleep duration (< 6.5 h/d). During standard sleep, low PA significantly increased CVD mortality risk. At medium physical activity, both short and long sleep increased cardiovascular mortality. It was also found that sleep duration (≥ 8.5 h/d) was associated with a increase in all-cause and cardiovascular mortality at both low and high PA levels. Conclusions This study suggested that low PA significantly increased the association of self-reported long and short sleep durations with all-cause and CVD mortality. All cause mortality appears to benefit from medium physical activity, while medium PA did not. Physical activity did not significantly reduce the risk of CVD mortality.