Exercise, Increased Physical Activity Can Blunt the Effects of Poor Sleep Health

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The first study to examine joint effects of physical activity and sleep duration on mortality risk using accelerometry, results indicate increase activity could negate the effects of short or long sleep duration on cardiovascular and all-cause mortality.

New research suggests increased levels of physical activity could negate the negative effects associated with unhealthy sleep duration.1

An analysis leveraging 7-day accelerometer recordings from more than 90,000 individuals, results of the study provide evidence suggesting a higher volume of physical activity or recommended moderate-to-vigorous physical activity dampened the detriment effects of unhealthy sleep, regardless of whether individuals received too much or too little sleep.1

“The study showed that increased physical activity levels weakened the mortality risks associated with short or long sleep duration,” said study investigator Jihui Zhang, PhD, of The Affiliated Brain Hospital of Guangzhou Medical University.2

The effects of sleep on cardiovascular health has become a prominent focus of many research efforts in recent years. In contrast, the impact of increased physical activity has been well elucidated. In the current study, investigators sought to examine the impact of physical activity levels on the associations between sleep duration and mortality risk.1

With this in mind, Zhang and a team of colleagues designed their study as an analysis of adults within the UK Biobank cohort who wore an accelerometer wristband for at least one week between 2013-2015. In their release, the European Society of Cardiology noted this is the first study to examine the joint effects of physical activity and sleep duration on mortality risk using accelerometry. Using the aforementioned criteria, investigators identified 92,221 adults aged 40-73 years for inclusion in the current study.1

For the purpose of analysis, investigators divided into sleep duration into 3 groups, total volume of physical activity into 3 levels according to tertiles, and moderate-to-vigorous physical activity (MVPA) into 2 groups based on the World Health Organization guidelines.1

The study cohort had a mean age of 62.4 (SD, 7.8) years and n56.4% were women. When examining sleep, results indicate 73.2% of participants had a normal sleep duration, with 19.7% having a long sleep duration and 7.1% having a short sleep duration. For physical activity, 33.4% had a low volume of physical activity and 39.1% did not meet MVPA recommendations. During a follow-up period lasting a median of 7.0 years, a total of 3080 adults died, with 1074 classified as a cardiovascular death and 1871 classified as a cancer death.1

Upon analysis, results indicated associations of physical activity and sleep duration with mortality risk were all in a curvilinear dose-response pattern (P nonlinearity <.001). Investigators pointed out physical activity and sleep duration had additive and multiplicative interactions on mortality risk (P <.001).1

When compared to their counterparts meeting MVPA guideline recommendations and with a normal sleep duration, results suggested those without recommended MVPA but having short (Hazard ratio [HR], 1.88 [95% confidence interval [CI], 1.61-2.20]) or long (HR, 1.69 [95% CI, 1.49-1.90]) sleep duration were at a greater risk for all-cause mortality. Further analysis demonstrated increased volume of physical activity or meeting MVPA guidelines mitigated the detrimental effects of short or long sleep duration on all-cause and cardiovascular mortality risks.1

“Our findings suggest that health promotion efforts targeting both physical activity and sleep duration may be more effective in preventing or delaying premature death in middle-aged and older adults than focusing on one behaviour alone,” Zhang added.2 “In an ideal scenario, people would always get healthy amounts of both sleep and physical activity. However, our study indicates that getting sufficient exercise may partially offset the detrimental impact of missing a good night’s sleep.”


  1. Liang YY, Feng H, Chen Y, et al. Joint association of physical activity and sleep duration with risk of all-cause and cause-specific mortality: a population-based cohort study using accelerometry [published online ahead of print, 2023 Mar 29]. Eur J Prev Cardiol. 2023;zwad060. doi:10.1093/eurjpc/zwad060
  2. European Society of Cardiology. Exercise may reduce negative effects of unhealthy sleep duration on longevity. European Society of Cardiology. Published March 30, 2023. Accessed March 31, 2023.