Cited by 345Sleep and related disordersPhysical Activity and HealthCircadian rhythm and melatonin

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Sleep and physical activity in relation to all-cause, cardiovascular disease and cancer mortality risk

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Huang, Bo-Huei, Duncan, Mitch J, Cistulli, Peter A, Nassar, Natasha, Hamer, Mark, Stamatakis, Emmanuel·2022·British Journal of Sports Medicine

DOI 10.1136/bjsports-2021-104046

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Abstract

OBJECTIVES: Although both physical inactivity and poor sleep are deleteriously associated with mortality, the joint effects of these two behaviours remain unknown. This study aimed to investigate the joint association of physical activity (PA) and sleep with all-cause and cause-specific mortality risks. METHODS: 380 055 participants aged 55.9 (8.1) years (55% women) from the UK Biobank were included. Baseline PA levels were categorised as high, medium, low and no moderate-to-vigorous PA (MVPA) based on current public health guidelines. We categorised sleep into healthy, intermediate and poor with an established composited sleep score of chronotype, sleep duration, insomnia, snoring and daytime sleepiness. We derived 12 PA-sleep combinations, accordingly. Mortality risks were ascertained to May 2020 for all-cause, total cardiovascular disease (CVD), CVD subtypes (coronary heart disease, haemorrhagic stroke, ischaemic stroke), as well as total cancer and lung cancer. RESULTS: After an average follow-up of 11.1 years, sleep scores showed dose-response associations with all-cause, total CVD and ischaemic stroke mortality. Compared with high PA-healthy sleep group (reference), the no MVPA-poor sleep group had the highest mortality risks for all-cause (HR (95% CIs), (1.57 (1.35 to 1.82)), total CVD (1.67 (1.27 to 2.19)), total cancer (1.45 (1.18 to 1.77)) and lung cancer (1.91 (1.30 to 2.81))). The deleterious associations of poor sleep with all outcomes, except for stroke, was amplified with lower PA. CONCLUSION: The detrimental associations of poor sleep with all-cause and cause-specific mortality risks are exacerbated by low PA, suggesting likely synergistic effects. Our study supports the need to target both behaviours in research and clinical practice.

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Sudlow, C., Gallacher, J., Allen, N., Beral, V., Burton, P., Danesh, J., Downey, P., Elliott, P., Green, J., Landray, M., et al. (2015) · PLOS Medicine · doi:10.1371/journal.pmed.1001779 · Cited by 12,728
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Fry, A., Littlejohns, T. J., Sudlow, C., Doherty, N., Adamska, L., Sprosen, T., Collins, R., & Allen, N. E. (2017) · American Journal of Epidemiology · doi:10.1093/aje/kwx246 · Cited by 3,979
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Huang, L., Li, Y., Xu, X., Chen, W., Zhang, Z., Sun, L., & Gao, X. (2024) · Sleep Medicine · doi:10.1016/j.sleep.2024.06.004 · Cited by 3
Global cancer burdens related to human behaviors in 1990–2044: a population-based cross-sectional and forecast study
Jin, W., Huang, K., Zhang, M., Jiang, L., Huang, Y., Wang, H., Tian, Y., Zhu, H., Zou, N., Pan, H., et al. (2024) · Journal of the National Cancer Center · doi:10.1016/j.jncc.2024.06.008 · Cited by 4
Developing a co-designed, culturally responsive physical activity program for Pasifika communities in Western Sydney, Australia
Lederman, O., Moors-Mailei, A., Peacock, Y., McKeon, G., Llana, A., Burns, D., Rosenbaum, S., & Caperchione, C. M. (2025) · Health Promotion International · doi:10.1093/heapro/daae197 · Cited by 3
Associations between sugar-sweetened beverage consumption, moderate-to-vigorous-intensity physical activity levels, and depressive symptoms: a cross-sectional study based on Tibetan university students at high altitude in China
Zhang, Z., Tang, N., Yao, M., & Li, T. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1582167 · Cited by 3
Effects of a physical activity intervention on sleep among cancer survivors in a randomized controlled trial within the Cancer Prevention Study-3 cohort
Zhong, C., Landry, M., Whalen, S., Grant, A., Reddy, A. G., Donzella, S. M., Peoples, A. R., Patel, A. V., & Rees‐Punia, E. (2025) · Journal of Cancer Survivorship · doi:10.1007/s11764-025-01837-x · Cited by 3
Joint association of physical activity and sleep duration with all-cause and cause-specific mortality: A prospective study of 153,866 Mexican adults
da Silva, W. A., Christófaro, D. G. D., Martín, P. D. V., Marques, A., Peralta, M., Cristi‐Montero, C., Rezende, L. F. M., Chiappa, G. R., & Ferrari, G. (2025) · Maturitas · doi:10.1016/j.maturitas.2025.108656 · Cited by 3
Healthy sleep patterns and risk of incident cardiovascular disease, liver-related events, and all-cause mortality among individuals with metabolic dysfunction--associated steatotic liver disease: A large prospective cohort study
Wang, S., Liao, Y., Deng, Y., Yu, C., Chen, X., Liu, X., Yang, Q., Chen, X., Chen, X., & Xue, H. (2025) · Sleep Health · doi:10.1016/j.sleh.2025.07.007 · Cited by 3
Effects of a structured after-school physical activity program on physical fitness, body composition, and sleep in primary school students: a pilot quasi-experimental study
Huang, G., Yao, J., Deng, L., Huang, P., Hong, P., & Li, X. (2025) · BMC Public Health · doi:10.1186/s12889-025-25843-x · Cited by 3
“A substantial body of evidence has demonstrated the positive effects of school-based PA interventions on improving body composition, enhancing cardiorespiratory fitness, and increasing fundamental movement skills in children and adolescents [8–11].”
Sleep as a possible mediator in the association of mental health parameters with cardiovascular health indices in women: exploratory analyses from the Heart SCORE Study
Fonkoue, I. T., Silva, M., Racette, S. B., Safo, S. E., Fuentes, L. D. L., Lowe, D. A., Ebong, I., Buysse, D. J., Reís, S. E., & Saeed, A. (2025) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0000000000002461 · Cited by 3
Habitual sleep duration, healthy eating, and digestive system cancer mortality
Nôga, D. A., Meth, E. M. S., Pacheco, A. P., Cedernaes, J., Xue, P., & Benedict, C. (2025) · BMC Medicine · doi:10.1186/s12916-025-03882-w · Cited by 3
“This inclusion was based on previous evidence suggesting that elevated levels of regular physical activity can reduce cancer mortality [41].”
Joint association of physical activity and night sleep duration with the risk of atherosclerotic cardiovascular disease
Yang, Y., Guo, L., Li, M., Li, Z., Xiao, Y., Wang, Y., Li, Y., Deng, J., Wu, S., & Zhang, H. (2025) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2025.108258 · Cited by 3
Detecting Older Adults’ Behavior Changes During Adverse External Events Using Ambient Sensing: Longitudinal Observational Study
Fritz, R., & Cook, D. J. (2025) · JMIR Nursing · doi:10.2196/69052 · Cited by 3
“Poor sleep quality is associated with increased risk for all-cause cardiovascular mortality [44].”
How Much Time to Spend in Physical Activity, Sleep and be Sedentary in 24 h to Achieve Good Health?
Singh, T. D., & Sharma, H. B. (2022) · Sleep and Vigilance · doi:10.1007/s41782-022-00213-4 · Cited by 3
“Low physical activity exacerbates the detrimental health effect of poor sleep, whereas meeting the recommended minimum physical activity guideline, and doing regular exercise eliminates the deleterious effect of poor sleep to some extent [29].”
Background
Physical Activity and Patient-Reported Outcomes in Monoclonal Plasma Cell Disorders
Joseph, J. M., Hillengaß, M., Sweeney, N. W., MOLINA, T. H., Ahlstrom, J. M., Moysich, K. B., Cannioto, R. A., & Hillengaß, J. (2023) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000003246 · Cited by 3
Exercise may not just be good for sleep; It can also help lower cardiovascular event risk
Wu, J., Yang, D., & Yang, F. (2023) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2023.102166 · Cited by 5
A programme evaluation of ‘First Steps’: A peer-conceived, developed and led self-management intervention for people after a Parkinson's diagnosis
Collett, J., Lawrie, S., Bromley, S., Harling, P., Reed, A., Brusco, N. K., Coe, S., Coebergh, J. A., Carroll, C., Roberts, H. C., et al. (2023) · Clinical Rehabilitation · doi:10.1177/02692155231210969 · Cited by 3
“…be noted that both groups were physically active at baseline, particularly the control group, with average PA levels consistent with those that accrue health bene ﬁ ts. 26 Indeed, the population in the current study were from areas of low deprivation which are associated with healthier lifestyles.”
Background
Exploring acupuncture as a treatment for insomnia in perimenopausal women with stable angina pectoris: A protocol for a randomized, double-blind, placebo-controlled clinical trial
Shi, R., Liu, Z., Meng, W., Chang, L., Lu, R., Xue, W., Chen, X., Deng, Y., & Song, Z. (2024) · PLoS ONE · doi:10.1371/journal.pone.0301827 · Cited by 3
Insomnia is an factor aggravaging the course of cardiovascular diseases: modern understanding of the problem and ways of solution
Esin, R. G., Esin, O. R., & Erkinova, D. E. (2024) · Meditsinskiy sovet = Medical Council · doi:10.21518/ms2024-292 · Cited by 3
Design, Content and Ecological Validity and Reliability of the Physical Activity and Sport Habits Questionnaire for Children Aged 8–12 Years in the Province of Gipuzkoa (Spain)
Badiola, A., Ibañez, I., Fuentes, M., Yanci, J., Arruabarrena, O. U., & Iturricastillo, A. (2025) · Children · doi:10.3390/children12010100 · Cited by 4
Multi-task exercise increases delta power in non-rapid eye movement sleep among older female adults: A randomized crossover trial
Lee, J., Nagata, K., Seol, J., Park, I., Tokuyama, K., Yanagisawa, M., & Okura, T. (2025) · NeuroImage · doi:10.1016/j.neuroimage.2025.121105 · Cited by 4
Healthy lifestyle and risk of incidence, mortality and life expectancy of mental disorders
Tian, S., Wang, Q., Wu, T., Chang, S., Dun, W.-W., Zhang, L., Li, A., & Wang, G. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.119592 · Cited by 4
Does dispositional self-control moderate the association between stress at work and physical activity after work? A real-life study with police officers
Schilling, R., Cody, R., Ludyga, S., Brand, S., Faude, O., Pühse, U., & Gerber, M. (2022) · German Journal of Exercise and Sport Research · doi:10.1007/s12662-022-00810-5 · Cited by 3
“Evidence further suggests that physical inactivity is positively related to a variety ofdiseases andhigher risks forpremature death (Huang et al., 2021b).”
Background
Associations between Physical Activity and the Incidence of Cerebrovascular Disease or All-Cause Mortality among 146,742 Older Adults: A 13-Year Prospective Cohort Study
Yang, Q., Zhang, Y.-H., Wong, A. Y. L., Xu, H.-R., Bi, X., Ching, Y.-L., Du, S.-H., Wang, Y.-C., & Wang, X. (2024) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2024.03.121 · Cited by 2
The Effects of Self-Acupressure on Pain and Sleep Quality in Patients With Coronary Artery Disease: A Randomised Controlled Trial
Başak, S., Turan, G. B., & Özer, Z. (2024) · Pain Management Nursing · doi:10.1016/j.pmn.2024.07.013 · Cited by 2
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Wang, Y., Zhao, X., Wang, X., Wang, X., Zhang, T., & Wang, Y. (2025) · Medicine · doi:10.1097/md.0000000000042205 · Cited by 2
A causal relationship model of urban environmental factors affecting the subjective well-being of Japanese immigrant workers in Thailand
Uemura, M., Laosee, O. C., Rattanapan, C., & Janmaimool, P. (2025) · City and Environment Interactions · doi:10.1016/j.cacint.2025.100218 · Cited by 2
Joint associations of restless sleep and loneliness with cardiovascular diseases in middle-aged and older Chinese adults: A national prospective cohort study
Liu, Y., Zhai, L., Huo, R., & Ma, C. (2025) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2025.07.002 · Cited by 2
Independent and joint associations of physical activity and a body shape index with sleep disorders in older adults with cardiometabolic multimorbidity: a cross-sectional study
Li, Y., Zhou, H., Xu, D., Wang, H., Zhao, Y., & Jiang, H. (2025) · BMC Geriatrics · doi:10.1186/s12877-025-06170-7 · Cited by 2
“Critically, untreated sleep disorders may cascade into poor self-management adherence in CMM patients, accelerating cardiometabolic risk accumulation and cardiovascular mortality [18, 19].”
Association of a Healthy Lifestyle With All-Cause and Cause-Specific Mortality Among Individuals With Probable Sarcopenia: Population-Based Cohort Study
Wang, N., Zhang, Y., Xie, J., Lu, N., Zheng, A., Li, C., Wei, J., Zeng, C., Lei, G., & Wang, Y. (2025) · JMIR Aging · doi:10.2196/65374 · Cited by 2
“…the intercon-nectedness among different lifestyle factors thereby potentially influencing the underlying association between lifestyle factors and mortality risk; and (2) sleep quality, such as chronotype, insomnia, snoring, and daytime sleepiness, can also affect the health outcomes [36].”
Sleep-stage dynamics predict current sleep-disordered breathing and future cardiovascular risk
Bechný, M., Scutari, M., Tomita, Y., van der Meer, J., Schmidt, M. H., Bassetti, C. L., Tzovara, A., Faraci, F., & Kishi, A. (2026) · Scientific Reports · doi:10.1038/s41598-026-69352-2 · Cited by 2
Cardiovascular Disease Meets Cancer: Exploring the Epidemiology in China and Homotherapy Targeting Intersectional Mechanisms
Xiang, S., Shan, Y., Shi-hong, X., Wang, J., Luo, M., Zhou, J., & Chen, Q. (2025) · Advanced Science · doi:10.1002/advs.202501820 · Cited by 2
Effects of aromatherapy on sleep quality in hospitalized cardiac patients: A systematic review and meta-analysis of randomized controlled trials
Cui, Y., Huang, X., Wang, Z., Zuo, S., & Lü, L. (2025) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2025.103247 · Cited by 4
Contribution of sleep disturbances to cognitive changes in vascular cognitive impairment
Luo, J. K., Li, F., Zhao, P., Xu, J., & Hu, H. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.106832 · Cited by 2
Effects of Dexmedetomidine Nasal Sprays on Postoperative Sleep Quality in Patients Who Underwent Laparoscopic Gynaecological Surgery: A Single-Centre, Double-Blind, Randomized Controlled Study
Fan, K., Ma, J., Liu, W., & Chen, X. (2025) · Drug Design Development and Therapy · doi:10.2147/dddt.s545452 · Cited by 2
Interaction between physical frailty and sleep quality on risk of migraine in later life: a cohort study of over 350,000 participants
Hu, W., Zhang, T., Jia, C.-X., Xue, F., & Liu, B.-P. (2025) · BMC Public Health · doi:10.1186/s12889-025-25061-5 · Cited by 2
“Huang et al., utilizing the same cohort data as our study, discovered that healthy sleep reduced the heightened risk of mortality associated with low PA (a component of frailty) [32].”
Effects of exercise-based prehabilitation programs on sleep in patients with cancer undergoing surgery: a systematic review and meta-analysis
Fernández-Escabías, M., Miron, B., Flor‐Alemany, M., Carrilho-Candeias, S., Orellana-Jaen, A., Fernandez-Escabias, R., Tomas-Garcia, M., Jiménez‐Moleón, J. J., Carneiro‐Barrera, A., & Amaro‐Gahete, F. J. (2025) · European Journal of Surgical Oncology · doi:10.1016/j.ejso.2025.111314 · Cited by 2
Risk factors, physical activity behavior, and hand grip strength of adults with atherosclerotic cardiovascular disease in Arar city, Saudi Arabia: A cross-sectional study
Alotaibi, M. M., Almutairi, A. B., Alhowaish, M. A., Alqahtani, M. Μ., ALMUTAIRI, M. K., Siddig, A. S., Alenazi, W., Alenazi, A. A., Albanagi, A. S., Alenazi, A. S., et al. (2025) · Medicine · doi:10.1097/md.0000000000045977 · Cited by 2
“Evidence suggests that low physical activity levels is a modifiable risk factor for CVD. [32] This is alarming due to the lack of proportion meeting the recommended volumes of moderate-to-vigorous physical activity and increased sedentary behavior and time spent on screen among people in Saudi…”
Acupuncture for insomnia in people with cancer
Ma, Q., Liu, C., Zhao, G., Guo, S., Li, H., Zhang, B., Li, B., & Cai, Z. (2025) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd015177.pub2 · Cited by 2
Improving sleep health through sleep hygiene education in adults aged 50–80 years
Pfeiffer, A. M., Triplett, C., & Schaefers, O. (2026) · Frontiers in Sleep · doi:10.3389/frsle.2025.1722557 · Cited by 2
How We Sleep, How We Move, How Long We Expect to Live: An Integrative Review of Lifestyle Behaviors and Subjective Life Expectancy
Pătru, O., Păunescu, A., Bena, A., Luca, S. A., Văcărescu, C., Ciornei, A.-I., Vîrtosu, M., Enache, B., Luca, C. T., & Crișan, S. (2026) · Nutrients · doi:10.3390/nu18030515 · Cited by 2
“Sleep duration, sleep continuity, and circadian rhythm stability have been consistently associated with cardiometabolic health, cognitive functioning, emotional regulation, and mortality risk [1–3].”
Physical Exercise, Sleep, and the Brain
Brewer‐Smyth, K. (2022) · Springer eBooks · doi:10.1007/978-3-031-08801-8_13 · Cited by 2
Obesity, Physical Activity, and Cancer Incidence in Two Geographically Distinct Populations; The Gulf Cooperation Council Countries and the United Kingdom—A Systematic Review and Meta-Analysis
Gaskell, C., Lutimba, S., Bendriss, G., & Aleem, E. A. (2024) · Cancers · doi:10.3390/cancers16244205 · Cited by 2
Physical activity and risk of cancer mortality in patients with and without cancer: is there a dose–response relationship?
Dong, X., Ding, M., Yi, N., Hou, X., Zhou, C., & Yi, X. (2025) · Supportive Care in Cancer · doi:10.1007/s00520-025-09288-x · Cited by 2
Factors Contributing to Sleep Disturbance in Inpatients With Cancer
Cabrera‐Jaime, S., Martí‐Dillet, M. M., Roura-Martí, P., Hosa-Salor, S., Grabalosa-Valderas, M., & Cabrera-Jaime, L. (2025) · Cancer Nursing · doi:10.1097/ncc.0000000000001513 · Cited by 2

Authors: Huang, B.-H., Duncan, M. J., Cistulli, P. A., Nassar, N., Hamer, M., & Stamatakis, E.
Affiliations: The University of Sydney (AU)
University of Newcastle Australia (AU)
University College London (GB)
Corresponding author: Stamatakis, Emmanuel
ORCID: Huang, Bo-Huei
Duncan, Mitch J
Cistulli, Peter A
Nassar, Natasha
Hamer, Mark
Stamatakis, Emmanuel
Venue: British Journal of Sports Medicine
Publisher: BMJ
Published: 2021-06-29
Volume: 56
Issue: 13
Pages: 718-724
ISSN: 0306-3674 (ISSN-L)
1473-0480
DOI: 10.1136/bjsports-2021-104046
OpenAlex: W3173761420
Cited by: 345
References: 33
Citations by year: 2026: 57 · 2025: 111 · 2024: 87 · 2023: 52 · 2022: 36 · 2021: 2
FWCI: 42.77
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: other-oa
Locations: British Journal of Sports Medicine (publishedVersion, other-oa)
PubMed (publishedVersion)
UCL Discovery (University College London) (submittedVersion)
NOVA (University of Newcastle Australia) (submittedVersion)
Funders: National Health and Medical Research Council (APP1141606, APP1194510)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Keywords: sleep, physical activity, all-cause mortality, cardiovascular mortality, cancer mortality, lung cancer, ischemic stroke, coronary artery disease, hemorrhagic stroke, moderate-to-vigorous physical activity, insomnia, snoring, daytime sleepiness, chronotype, sleep duration, synergistic effect, older adults
MeSH terms: Ischemic Stroke, Cardiovascular Diseases, Brain Ischemia, Female, Humans, Sleep Initiation and Maintenance Disorders, Lung Neoplasms, Male, Prospective Studies, Risk Factors, Sleep, Exercise, Stroke

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Sleep and physical activity in relation to all-cause, cardiovascular disease and cancer mortality risk

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