High Physical Activity Levels May Counter Serious Health Harms of Poor Sleep

Dawn O'Shea

June 30, 2021

Physical activity levels at or above the weekly recommended amounts may counter the serious health harms associated with poor sleep quality, suggests a large long-term study, published online in the British Journal of Sports Medicine.

Those who had both the poorest sleep quality and who exercised the least were most at risk of death from heart disease, stroke, and cancer, the findings indicate, prompting the researchers to suggest a likely synergy between the two activities.

The research drew on information provided by 380,055 middle-aged (average age 55) men and women participating in the UK Biobank study.

Participants supplied information on their normal weekly physical activity levels, which were measured in Metabolic Equivalent of Task (MET) minutes. Physical activity levels were categorised as: high (≥1200 MET minutes/week); medium (600-1200); or low (1 to ≤600); and no moderate to vigorous physical activity.

Sleep quality was categorised using a 0-5 sleep score derived from chronotype, sleep duration, insomnia, snoring and daytime sleepiness: healthy (4+); intermediate (2-3); or poor (0-1). A dozen physical activity and sleep pattern combinations were created.

Participants’ health was tracked over an average of 11 years up to May 2020 or death, whichever came first.

During the study period, 15,503 participants died. A total of 4,095 deaths were due to cardiovascular disease and 9,064 were from cancer. Of these, 1932 people died from coronary heart disease, 359 from haemorrhagic stroke, 450 from ischaemic stroke and 1,595 from lung cancer.

Fifty-nine per cent of participants were in the high physical activity group; 15 per cent in the medium group; 10 per cent in the low group; and 16 per cent in the no moderate to vigorous physical activity group. 

More than half (56%) of participants had a healthy sleep pattern; 42 per cent were classified as having intermediate quality sleep; and 3 per cent were classified as poor sleepers.

Lower sleep scores were associated with higher risk of all-cause mortality, as well as death from cardiovascular disease and ischaemic stroke.

Compared with those with the high physical activity and healthy sleep score combination, those at the other end of the scale, with the no moderate to vigorous physical activity and poor sleep combination, had the highest risks of all-cause (57% higher), CVD (67% higher), and cancer (45% higher) mortality, particularly for lung cancer (91% higher).

Lower levels of physical activity amplified the unfavourable associations between poor sleep and all health outcomes, with the exception of stroke.

The study has a number of limitations. It is observational in design and used self-reported measurements. Also, exposures and confounders were collected at recruitment and were assumed to be relatively constant over time.

Huang BH, Duncan MJ, Cistulli PA, Nassar N, Hamer M, Stamatakis E. Sleep and physical activity in relation to all-cause, cardiovascular disease and cancer mortality risk.  Br J Sports Med. doi 10.1136/bjsports-2021-104046

This article originally appeared on Univadis, part of the Medscape Professional Network.

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