Can physical activity eliminate the mortality risk associated with poor sleep? A 15-year follow-up of 341,248 MJ cohort participants
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BACKGROUND: This study examined the joint associations of sleep patterns and physical activity (PA) with all-cause, cardiovascular disease (CVD), and cancer mortality. METHODS: A total of 341,248 adults (mean age = 39.7 years; men: 48.3%) were included in the study, with a 15-year follow-up. Participants reported sleep duration and disturbances (difficulty falling asleep, easily awakened, or use of sleeping medication). PA was classified into 4 levels: <7.5, 7.5-14.9, 15.0-29.9, and ≥30.0 metabolic equivalent hours per week (MET-h/week). To understand the joint associations of sleep patterns and PA with mortality, Cox proportional hazard models were conducted, with exposure variables combining sleep duration/disturbances and PA. RESULTS: Compared with the reference group (sleeping 6-8 h/day), individuals who slept >8 h/day had higher risk for all-cause mortality (hazard ratio (HR) = 1.307, 95% confidence interval (95%CI): 1.248-1.369), CVD mortality (HR = 1.298, 95%CI: 1.165-1.445), and cancer mortality (HR = 1.128, 95%CI: 1.042-1.220). Short sleep duration was not associated with mortality risk. Increased risk of all-cause and CVD mortality was found in participants who had difficulty falling asleep (HR = 1.120, 95%CI: 1.068-1.175; HR = 1.163, 95%CI: 1.038-1.304, respectively), and used sleeping medication (HR = 1.261, 95%CI: 1.159-1.372; HR = 1.335, 95%CI: 1.102-1.618, respectively) compared with those who slept well. Long sleep duration and sleep disturbances were not associated with risk of all-cause and CVD mortality among individuals achieving a PA level of ≥15 MET-h/week, and in particular among those achieving ≥30 MET-h/week. CONCLUSION: Long sleep duration, difficulty falling asleep, and use of sleeping medication were related to a higher risk of death. Being physically active at a moderate intensity for 25-65 min/day eliminated these detrimental associations.
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The threshold of 150 min/week for moderate-to-vigorous physical activity also nearly approached the turning point reported by the Taiwanese cohort study (15 metabolic equivalent of task-hours per week).
“This threshold also nearly approached the turning point, as reported by the Taiwanese cohort study (15 MET-h/week).25”
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- Authors
- Chen, L.-J., Hamer, M., Lai, Y.-J., Huang, B.-H., Ku, P.-W., & Stamatakis, E.
- Affiliations
- National Taiwan University of Sport (TW)
- University College London (GB)
- Taichung Veterans General Hospital (TW)
- The University of Sydney (AU)
- National Tsing Hua University (TW)
- Corresponding author
- Ku, Po-Wen
- Venue
- Journal of Sport and Health Science
- Publisher
- Elsevier BV
- Published
- 2022-09
- Volume
- 11
- Issue
- 5
- Pages
- 596-604
- ISSN
- 2213-2961 (ISSN-L)
- 2095-2546
- PMC
- PMC9532590
- OpenAlex
- W3134940951
- Cited by
- 82
- References
- 60
- Citations by year
- 2026: 9 · 2025: 20 · 2024: 22 · 2023: 20 · 2022: 8 · 2021: 3
- FWCI
- 12.81
- Type
- journal article
- Language
- en
- Update notices
- erratum (2023-01-01)
- Open access
- diamond
- doi.org
- Licence
- Locations
- Journal of sport and health science/Journal of Sport and Health Science (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- OPUS - Open Publications of UTS Scholars (University of Technology Sydney) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Ministry of Science and Technology of the People's Republic of China (108-2410-H-018-028-MY3)
- Ministry of Health and Welfare
- National Health and Medical Research Council
- Health and Welfare Data Science Center
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- physical activity, sleep duration, sleep disorders, all-cause mortality, cardiovascular mortality, cancer mortality, long sleep, difficulty falling asleep, sleep medication, metabolic equivalent hours, mortality risk reduction, physical activity promotion, cancer prevention, cardiovascular disease prevention, sleep health promotion
- MeSH terms
- Adult, Cardiovascular Diseases, Follow-Up Studies, Humans, Male, Neoplasms, Sleep, Exercise
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