Joint association of physical activity and night sleep duration with the risk of atherosclerotic cardiovascular disease

Abstract

Objectives

To investigate the joint association of physical activity (PA) and sleep duration with the risk of atherosclerotic cardiovascular disease (ASCVD).

Methods

A total of 111,714 participants who participated in health examinations were enrolled from the Kailuan Study between June 2006 and December 2009. Sleep duration was divided into three groups (short, healthy, and long). PA was categorized into physically inactive and physically active. Restricted cubic splines were used to analyze the associations of PA and sleep duration with ASCVD. Cox proportional hazards models were conducted to investigate the effects of PA and sleep duration on ASCVD risk, with their cross-product interaction terms tested on both multiplicative and additive scales.

Results

During 13.05 ± 3.16 years of follow-up, 10,408 participants developed ASCVD. Restricted cubic spline analysis revealed a nonlinear dose-response relationship between sleep duration and ASCVD risk among physically inactive participants (P_nonlinear <0.05). Both additive and multiplicative interactions between physical activity and sleep duration were observed in their effects on ASCVD risk (P_interaction < 0.05). Compared with participants who had healthy sleep duration and were physically active, those with unhealthy sleep duration and physical inactivity exhibited a significantly higher risk of ASCVD [short sleep duration: HR (95 %CI) = 1.19 (1.09, 1.30); long sleep duration: HR (95 % CI) = 1.10 (0.90, 1.34)]. However, physically active participants in both the short and long sleep duration groups exhibited a reduced risk of ASCVD.

Conclusions

Engaging in sufficient PA can reduce the risk of ASCVD in individuals with short sleep duration. Therefore, simultaneously maintaining healthy sleep duration and engaging in PA may effectively prevent ASCVD.