Sleep duration and quality, physical activity and cardiometabolic multimorbidity: findings from the English Longitudinal study of Ageing.

Objectives: We aimed to assess the prospective associations of sleep duration and quality with the risk of cardiometabolic multimorbidity (CMM) and the interplay with physical activity. Design: Sleep duration and quality and physical activity were self-reported using standardized questionnaires. Cardiometabolic multimorbidity was defined as the presence of at least two multiple long-term conditions (hypertension, diabetes, coronary heart disease, stroke, and other cardiovascular diseases) at follow-up. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using logistic regression models adjusted for cardiometabolic risk factors including physical activity. Results: We included 3,428 participants [mean (SD) age 63 (9) years, 44.8% male] free of hypertension, coronary heart disease, diabetes, and stroke at baseline. At 15 years follow-up, 206 participants developed CMM. There was an approximate U-shaped trend between sleep duration and CMM risk. Compared to 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 appeared to decrease with each additional hour of sleep among participants with short sleep duration (≤6 hrs/day), although this association did not reach statistical significance (OR, 0.78, 95% CI: 0.59-1.02). Sleep quality or physical activity was not associated with CMM. Conclusions: Short sleep duration is associated with an increased CMM risk independent of physical activity. The observed trend suggests that increasing sleep duration among short sleepers may help mitigate CMM risk.