Sleep duration, physical activity and cardiometabolic multimorbidity: Findings from the English Longitudinal Study of Ageing

BackgroundU-shaped relationships have been demonstrated between sleep duration and several cardiometabolic conditions. However, the association between sleep duration and cardiometabolic multimorbidity (CMM) and the interrelationship with physical activity has not been previously investigated. We aimed to assess the prospective associations of sleep habits (duration and quality) with CMM and the interplay with physical activity. Methods and ResultsWe included 3,428 participants (mean age 63 years at baseline, 44.8% male) free of hypertension, coronary heart disease, diabetes, and stroke at wave 4 from the English Longitudinal Study of Ageing. Sleep habits were assessed by self-reports. Cardiometabolic multimorbidity was defined as the presence of at least two multiple long-term conditions (hypertension, cardiovascular disease, diabetes, and stroke) at wave 10. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using logistic regression models adjusted for established cardiometabolic risk factors including physical activity. At 15 years follow-up, 206 participants developed CMM. There was an approximate U-shaped trend between sleep duration and the risk of CMM. Compared to participants with sleep duration of 7-8 hrs/day, the multivariable OR (95% CI) for CMM was 1.39 (1.03-1.90) for sleep duration [≤]6 hrs/day and 1.05 (0.55-2.00) for sleep duration [≥] 9 hrs/day. The odds of CMM modestly decreased for each additional hour increase in sleep duration in participants with sleep duration [≤]6 hrs/day (OR, 0.78, 95% CI: 0.59-1.02). Sleep quality or physical activity was not associated with CMM. ConclusionsShort sleep duration is associated with an increased risk of CMM, which is independent of established cardiometabolic risk factors including physical activity. Importantly, each additional hour of sleep among those with short sleep durations appeared to mitigate CMM risk, underscoring the potential benefits of optimizing sleep duration.