Investigation of the Relationships Between Sleep Behaviors and Risk of Health Lifespan Termination: A Prospective Cohort Study Based on 323,373 UK-Biobank Participants

Abstract Objectives: To examine the associations between insomnia, napping, daytime sleepiness, and getting up from bed with the risk of health lifespan termination using a prospective cohort design based on the UK-Biobank (UKB) database. Methods: Our study population consisted of 323,373 UKB participants enrolled in the UKB study from 2006 to 2010 and followed up to 2016. The outcome variable was health lifespan that was characterized by eight events strongly associated with ageing. Multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for risk of terminated health lifespan were computed in Cox proportional hazards models. Furthermore, we collapsed each of the four sleep behavior factors into binary categories (high vs. low-risk groups) to explore the Population Attributable Risk percentages (PAR%).Results: Participants in the high-risk subgroups of the four sleep behaviors had a significantly higher risk of terminated health lifespan; that is, 'usually insomnia' (HR=1.05, 95% CI: 1.03-1.07; P<0.001), 'usually napping' (HR=1.22, 95% CI: 1.18-1.26; P<0.01), 'excessive daytime sleepiness' (HR=1.25, 95% CI: 1.19-1.32; P<0.001), and 'difficult getting up from bed' (HR=1.08, 95% CI: 1.05-1.10; P<0.001). The corresponding PAR% indicated that about 7% of the terminated health lifespan events in this cohort would have been eliminated if all people were in the low-risk sleep groups.Conclusion: We observed that frequent insomnia, napping, daytime sleepiness, and 'difficult getting up from bed' are associated with increased risk of terminated health lifespan. Therefore adherence to healthy sleep behavior is significant for healthy lifespan.