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Investigation of the relationships between sleep behaviors and risk of healthspan termination: a prospective cohort study based on 323,373 UK-Biobank participants

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To examine the associations between four sleep behaviors and the risk of healthspan termination.


This study included 323,373 participants, free of terminated healthspan at baseline, from the UK-Biobank (UKB). We applied multivariable-adjusted Cox regression models to estimate the risk of terminated healthspan based on four sleep behaviors (insomnia/sleeplessness, napping, daytime sleepiness, and difficulty getting up from bed), which were self-reported and measured on Likert scales from “usually” to “never/rarely” experiences. In this study, healthspan was defined based on eight events that are strongly associated with longevity (congestive heart failure, myocardial infarction, chronic obstructive pulmonary disease, stroke, dementia, diabetes, cancer, and death).


Participants who reported the following unhealthy sleep behaviors had a significantly higher risk of terminated healthspan: “usually experience sleeplessness/insomnia” (HR = 1.05, 95% CI: 1.03–1.07; P < 0.001); “usually nap” (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 population attributable risk percentage (PAR%) indicated that about 7% of healthspan termination in this cohort would have been eliminated if all participants had healthy sleep behaviors.


Participants who reported “usually experience sleeplessness/insomnia,” “usually nap,” “excessive daytime sleepiness,” and “difficult getting up from bed” had increased risk of shortened healthspan. Therefore, adherence to healthy sleep behavior is significant for the extension of healthspan.

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We thank the study participants and research staff for their contributions and commitment to this study.


This study was conducted using the UK-Biobank resource (Application Number 64689). This work was supported by the National Natural Science of China (81941020).

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Authors and Affiliations



MLS and XZ conducted the statistical analysis and wrote the first draft. TH, AS, and TBB helped apply for permission to use data and offered technical support during the study. GJ, ELH, and MN critically revised the manuscript for important intellectual content. All authors reviewed and approved the final manuscript.

Corresponding authors

Correspondence to Muhammed Lamin Sambou or Juncheng Dai.

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Research involving human participants and/or animals

The UKB adhered to ethical guidelines as stated in the Helsinki declaration, and the ethical approval for the study was issued by the North West Multicenter Research Ethical Committee.

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We utilized the UKB dataset, and participants gave written informed consent during the study.

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The authors declare no competing interests.

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Sambou, M.L., Zhao, X., Hong, T. et al. Investigation of the relationships between sleep behaviors and risk of healthspan termination: a prospective cohort study based on 323,373 UK-Biobank participants. Sleep Breath 26, 205–213 (2022).

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