{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T09:04:08Z","timestamp":1768554248177,"version":"3.49.0"},"posted":{"date-parts":[[2022,10,30]]},"group-title":"Epidemiology","reference-count":30,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2022,10,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The complexity of sleep hinders the formulation of sleep guidelines. Recent studies suggest that different unhealthy sleep characteristics jointly increase the risks for cardiovascular disease (CVD). This study aimed to estimate the differences in CVD-free life expectancy between people with different sleep profiles.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We included 308683 middle-aged adults from the UK Biobank among whom 140181 had primary care data linkage. We used an established composite sleep score comprising self-reported chronotype, duration, insomnia complaints, snoring, and daytime sleepiness to derive three sleep categories: poor, intermediate, and healthy. We also identified three clinical sleep disorders captured by primary care and inpatient records within two years before enrollment in the cohort: insomnia, sleep-related breathing disorders, and other sleep disorders. We estimated sex-specific CVD-free life expectancy with three-state Markov models conditioning on survival at age 40 across different sleep profiles and clinical disorders.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We observed a gradual loss in CVD-free life expectancy toward poor sleep such as, compared with healthy sleepers, poor sleepers lost 1\u00b780 [95% CI 0\u00b796-2\u00b775] and 2\u00b731 [1\u00b746-3\u00b729] CVD-free years in females and males, respectively, while intermediate sleepers lost 0\u00b748 [0\u00b741-0\u00b755] and 0\u00b755 [0\u00b749-0\u00b761] years. Among men, those with clinical insomnia or sleep-related breathing disorders lost CVD-free life by 3\u00b784 [0\u00b761-8\u00b759] or 6\u00b773 [5\u00b731-8\u00b748] years, respectively. Among women, sleep-related breathing disorders or other sleep disorders were associated with 7\u00b732 [5\u00b733-10\u00b734] or 1\u00b743 [0\u00b720-3\u00b729] years lost, respectively.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Both self-reported and doctor-diagnosed poor sleep are negatively associated with CVD-free life, especially pronounced in participants with sleep-related breathing disorders.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2022.10.27.22281630","type":"posted-content","created":{"date-parts":[[2022,10,30]],"date-time":"2022-10-30T19:45:10Z","timestamp":1667159110000},"source":"Crossref","is-referenced-by-count":0,"title":["Influence of Poor Sleep on Cardiovascular Disease-Free Life Expectancy: A Multi-Resource-Based Population Cohort Study"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8543-3152","authenticated-orcid":false,"given":"Bo-Huei","family":"Huang","sequence":"first","affiliation":[]},{"given":"Borja","family":"del Pozo Cruz","sequence":"additional","affiliation":[]},{"given":"Armando","family":"Teixeira-Pinto","sequence":"additional","affiliation":[]},{"given":"Peter A.","family":"Cistulli","sequence":"additional","affiliation":[]},{"given":"Emmanuel","family":"Stamatakis","sequence":"additional","affiliation":[]}],"member":"54368","reference":[{"key":"2022110106002109000_2022.10.27.22281630v1.1","unstructured":"World Health Organization. Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age [Internet]. World Health Organization; 2019 [cited 2021 Sep 23]. 33 p. Available from: https:\/\/apps.who.int\/iris\/handle\/10665\/311664"},{"key":"2022110106002109000_2022.10.27.22281630v1.2","doi-asserted-by":"crossref","unstructured":"Baglioni C , Altena E , Bjorvatn B , Blom K , Bothelius K , Devoto A , et al. The European Academy for Cognitive Behavioural Therapy for Insomnia: An initiative of the European Insomnia Network to promote implementation and dissemination of treatment. J Sleep Res [Internet]. 2020 Apr [cited 2021 Sep 23];29(2). Available from: https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jsr.12967","DOI":"10.1111\/jsr.12967"},{"issue":"10","key":"2022110106002109000_2022.10.27.22281630v1.3","first-page":"S57","article-title":"Canadian 24-Hour Movement Guidelines for Adults aged 18\u201364 years and Adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep","volume":"45","year":"2020","journal-title":"Appl Physiol Nutr Metab [Internet]"},{"issue":"1","key":"2022110106002109000_2022.10.27.22281630v1.4","doi-asserted-by":"crossref","first-page":"9","DOI":"10.5665\/sleep.3298","article-title":"Sleep Health: Can We Define It? 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Recommended physical activity and all cause and cause specific mortality in US adults: prospective cohort study. BMJ [Internet]. 2020 Jul 1 [cited 2020 Jul 4];370. Available from: http:\/\/www.bmj.com\/content\/370\/bmj.m2031","DOI":"10.1136\/bmj.m2031"},{"key":"2022110106002109000_2022.10.27.22281630v1.16","unstructured":"Authors ASA, Reviewers RP at ASA, physicians W certified sleep MD, scientists, editors, ASA writers for. Sleep Disorders ICD 10 Codes - Research & Treatments | American Sleep Assoc [Internet]. American Sleep Association. 2021 [cited 2021 Jun 11]. 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