Physical exercise can mitigate the negative effects of insufficient or excessive sleep on lifespan, according to a study of more than 90,000 adults. The research suggests that promoting both physical activity and adequate sleep duration is more effective in preventing early death than focusing on just one behavior.
Inadequate or excessive sleep is associated with decreased lifespan, yet researchers have discovered that physical exercise can mitigate some of these negative consequences. The study, which examined more than 90,000 adults, was published in European Journal of Preventive CardiologyJournal of the European Society of Cardiology (ESC).
“The study showed that increased levels of physical activity reduced the risk of mortality associated with short or long sleep,” said study author Dr. Jihui Zhang, from the Brain Hospital Affiliated with Guangzhou Medical University, China.
Sufficient exercise and proper sleep are both essential to extending life expectancy. However, the relationship between physical activity and sleep duration in health promotion has remained uncertain. Previous studies were limited primarily by their reliance on self-reported data of physical activity and sleep, which may be inaccurate. Instead, the accelerometer tracks movement, offering a more objective and reliable way to estimate both activity levels and sleep duration.
This study was the first to examine the combined effects of physical activity and sleep duration on mortality risk using accelerometers. The study included 92,221 adults aged 40 to 73 in a UK Biobank who wore an accelerometer wristband for one week between 2013 and 2015.
Sleep duration per night was categorized as short (less than six hours), normal (six to eight hours), or long (more than eight hours). The total volume of physical activity was divided into triads (low, medium, and high). Moderate-to-vigorous physical activity is rated as whether or not it meets World Health Organization (WHO) guidelines. 2 Mortality data was collected from death registries. The primary outcome was death from all causes. The secondary endpoints were death from cardiovascular disease and death from cancer.
The average age of the participants was 62 years and 56% were women. During a seven-year follow-up, 3,080 participants died — 1,074 from cardiovascular disease and 1,871 from cancer.
The researchers looked at how physical activity affected the effect of sleep on mortality — they looked first at volume of activity and secondly at moderate to vigorous physical activity. Analyzes were adjusted for factors that could influence the relationship including age, gender, race, deprivation, education level, sleep season, body mass index, diet, smoking, alcohol intake, and shift work.
In terms of activity volume, in subjects with lower amounts, short and long sleep were associated with a 16% and 37% increased risk of all-cause mortality, respectively. For participants who exercised on moderate amounts, only short sleep was detrimental, with a 41% increased risk of all-cause death. For those who did a great deal of exercise, sleep duration was not associated with risk of death. For cardiovascular death, short sleepers with a low volume of exercise had a 69% elevated risk, which disappears when exercise is increased to moderate or high volumes. For cancer death, people who sleep for long periods combined with low amounts of exercise have a 21% increased risk which goes away with moderate or high amounts of exercise.
Similar results were found for moderate to vigorous physical activity. In participants who did not meet WHO recommendations, short and long sleep were associated with a 31% and 20% increased risk of all-cause mortality, respectively. These risks disappeared in those who met WHO advice. For cardiovascular death, short sleepers who failed to meet the advice on exercise intensity had a 52% elevated risk, which disappeared for those who carried out the recommendations. For cancer death, long sleepers who didn’t adhere to the advice had a 21% risk that disappeared from those who followed WHO guidelines.
“Our findings suggest that health promotion efforts that target both physical activity and sleep duration may be more effective in preventing or delaying premature death in middle-aged and older adults than focusing on just one behavior,” said Dr. Chang. “People will always get healthy amounts of sleep and physical activity. However, our study suggests that getting enough exercise may partially offset the detrimental effect of missing out on a good night’s sleep.”
Reference: “Co-association of physical activity and sleep duration with risk of all-cause and cause-specific mortality: a population-based cohort study using accelerometer” by Yannis Yan Liang, Hongliang Feng, Lin Chen, Xi Jin, Huaxin Xu, Mingqing Zhou, Huan Ma, Sizhi Ai, Yun-Kwok Wing, Qingshan Geng, and Jihui Zhang, March 29, 2023, Available here. European Journal of Preventive Cardiology.
The study was funded by the National Research and Development Program of China, the National Natural Science Foundation of China, and the Guangdong Provincial People’s Hospital Senior Hospital Construction Project.