The Relationship Between Sleep duration, Physical Activity and Incidence of Multimorbidity: A Prospective Study of UK Biobank

Purpose: The prevention of multimorbidity epidemics has emerged as a significant challenge in both clinical and public health domains worldwide. This study aimed to comprehensively investigate the complex relationships between sleep duration, physical activity (PA), and the incidence of multimorbidity, with the objective of providing evidence-based behavioral recommendations for clinical practice. Patients and methods: A total of 178,933 participants from the UK Biobank, who were free from 17 diseases at the baseline, were enrolled. Sleep duration and PA levels were self-reported. Multimorbidity was defined as the presence of two or more diseases. Both the Cox risk regression model and the isochronous substitution model were employed for analysis. Results: Over a mean follow-up period of 14.578 years, 7,318 individuals developed multimorbidity. The findings revealed that short sleep (<7 hours) and low levels of PA were significantly linked to an elevated risk of multimorbidity. Notably, the combinations of “short sleep-low PA” and “short sleep-high PA” carried a higher risk compared to “good sleep-moderate PA”. Subgroup analysis and sensitivity analysis confirmed the initial findings.No significant results were observed in the isochronous substitution model. Conclusion: Ensuring a sleep duration of 7 to 8 hours is optimal for minimizing the risk of multimorbidity. Individuals with poor sleep patterns are advised to adjust their sleep duration to 7-8 hours to decrease the likelihood of multimorbidity and enhance their long-term quality of life.