Association of healthy sleep patterns with risk of mortality and life expectancy at age of 30 years: a population-based cohort study

Summary Background The importance of sleep on cardiovascular health has been increasingly acknowledged. However, the effect of combined sleep behaviors on life expectancy remains understudied. Aim To investigate the association between sleep patterns with total and cause-specific mortality and life expectancy, using a nationally representative sample of US adults. Design Population-based cohort study. Methods This cohort study included 172 321 adults aged 18 years or older in the National Health Interview Survey (2013–18) with linkage to the National Death Index records up to 31 December 2019. The life expectancy at the age of 30 years by the number of low-risk sleep scores was estimated using a flexible parametric survival model. Results During a median follow-up of 4.3 years, of the 172 321 adults (50.9% women; mean [SE] age, 46.98 [0.10] years), 8681 individuals died. The adjusted hazard ratios (95% confidence intervals [CI]) of participants with five vs. 0–1 low-risk sleep factors for all-cause, cardiovascular, and cancer mortality were 0.70 (0.63–0.77), 0.79 (0.67–0.93) and 0.81 (0.66–0.98), respectively. Nearly 8% (population attributable fraction 7.9%, 95% CI: 5.5–10.4) of mortality in this cohort could be attributed to suboptimal sleep patterns. When compared to those with 0–1 low-risk sleep factors, life expectancy at the age of 30 years for individuals with all five low-risk sleep factors was 4.7 (95% CI: 2.7–6.7) years greater for men and 2.4 (95% CI: 0.4–4.4) years greater for women. Conclusions Our findings suggest that greater adherence to a low-risk sleep pattern may lead to significant gains in life expectancy among US adults.